Many books on yeast overgrowth advise readers to avoid all yeast in the diet. This advice is based on the theory that an allergic reaction to yeast is the cause of the problem. However, the yeast that is found in most foods (except beer and cheese) is not closely related to Candida, which is the predominant yeast that seems to be involved in overgrowth.
In my experience, trying to avoid all yeast in foods results in a nutritionally inadequate diet and does not substantially help most people. Although a few people do appear to have true allergies to the yeast in their food, they account for fewer than 10% of my patients with suspected yeast overgrowth. These people may benefit from the more strict diet recommended in Dr. Crook's book. Interestingly, once adrenal insufficiency and yeast overgrowth are treated, most people find that their allergies and sensitivities to yeast and other food products seem to improve or disappear.
Nutritional deficiencies such as low zinc or low selenium may also decrease resistance to yeast overgrowth.10 A good multivitamin supplement, such as the Energy Revitalization System, should take care of these deficiencies. This is simply another example of how all the factors involved in CFS/FMS are closely interrelated.
What If the Yeast Comes Back?
It is normal for yeast symptoms to resolve after treatment. After six weeks on Diflucan, most people feel a lot better. If not, you may have Diflucan-resistant Candida, and a trial of Nizoral may be helpful. However, symptoms may sometimes also recur soon after you stop taking either antifungal. If this happens, I would continue taking Diflucan or Nizoral for another six weeks or for as long as is needed to keep the symptoms at bay. More frequently, people feel better after treatment and stay feeling fairly well. Although many people never need to be re-treated for yeast, others need to repeat a course of antifungals after six to twenty-four months, especially after eating too much sugar or taking antibiotics.
The best marker that I have found for recurrent yeast overgrowth is a return of bowel symptoms, with gas, bloating, and/or diarrhea or constipation, vaginal yeast, mouth sores, and/or recurring nasal congestion or sinusitis. If these symptoms persist for more than two weeks, especially if there is also even a mild worsening of the CFIDS/FMS symptoms, it is very reasonable to repeat treatment with six weeks of Anti-Yeast, Probiotic Pearls, and Diflucan. If a second round of treatment resolves the symptoms, you may opt to repeat this regimen as often as is needed, usually every six to twenty-four months. By using the Anti-Yeast and Probiotic Pearls, however, you may be able to avoid the need for repeated use of antifungals and the possible risk of becoming resistant to them.
Some people find that they need to stay on the antifungals for extended periods of time-years, in some cases—or the symptoms recur. As an alternative, instead of taking the antifungals every day, many people find they can get long term suppression of the yeast by taking 200 mg of Diflucan twice a day, one day each week (for example, each Sunday).