Many other natural antifungals can be helpful, but when used individually in a high enough dose to kill the yeast they also irritate the stomach. Because of this I like to combine multiple anti-fungal herbs. My favorite combination is Anti-Yeast by Ultraceuticals, which contains 240 mg of coconut oil powder (50% caprylic acid), 200 mg of oregano powder extract, 120 mg of uva ursi extract, 240 mg of garlic powder (deodorized), 160 mg of grapefruit seed extract, 80 mg of berberine sulfate, 200 mg of olive leaf extract, 50 mg of alpha lipoic acid, 50 mg of milk thistle extract, and 50 mg of N-Acetyl L-Cysteine.
Prescription Treatments for Yeast Overgrowth
It is critical to add a prescription anti-fungal as well, because the natural products only kill yeast in the gut and are not as strong. I recommend that almost all of my CFS/FMS patients use Diflucan (Fluconazole) 200 mg/day for 6-12 weeks. If stool cultures (which are negative in most people who need yeast treatment) show the yeast to be resistant to Diflucan, then your doctor may choose to substitute Nizoral at 200 mg/day for 6 weeks. Nizoral can lower adrenal hormone levels, so if your cortisol is low your doctor should consider adding adrenal support when prescribing Nizoral. I don't use Sporanox because it costs over $600, and if your yeast is resistant to Diflucan, it will usually also be resistant to Sporanox but sensitive to Nizoral. The anti-fungal medication Lamisal is simply NOT effective for Candida.
Nystatin, an antifungal medication, has been helpful in the treatment of yeast overgrowth in the past. Unfortunately, more and more fungi seem to be developing resistance to nystatin. In addition, nystatin is poorly absorbed, which means that it has little impact on the yeast outside of the bowel. Because of this, I am now using the Anti-Yeast herbal mix instead.
Any effective antifungal can initially make the symptoms of yeast infection worse. In addition, Diflucan can cause liver inflammation, although this is uncommon (Tylenol is more likely to cause liver problems), and I have not seen it be a significant problem in the more than 3,000 patients I've treated. If you have preexisting active liver disease, you should be cautious about using Diflucan—or not use it at all. The "Anti-Yeast" herbal above also contains lipoic acid, milk thistle extract, and N-Acetyl L-Cysteine, natural supplements that helps to protect and heal the liver.
If symptoms of yeast overgrowth are caused by an allergic or sensitivity reaction to the yeast body parts, symptoms may flare up when mass quantities of the yeast are suddenly killed off. This is called a die-off (Herxheimer) reaction and can occur with the treatment of any chronic infection. To decrease the risk of this reaction, start your treatment with the acidophilus and a sugar-free diet for a few weeks, followed by the Anti-Yeast herbals for one month before beginning the Diflucan. If symptoms flare up, take just 25-100 mg of Diflucan each morning for the first three to fourteen days. If symptoms recur after you stop the Diflucan, I recommend continuing the medication for an additional six weeks at 200 mg a day. If you cannot get the Diflucan from your physician, the rest of the program will still help, but will not kill off the yeast in the sinuses as the Diflucan will.