The Problem with Yeast in Lyme Disease Treatment

Too many yeast in the intestines (yeast overgrowth) is a common problem that occurs in those with chronic Lyme disease. This problem occurs during treatment, or prior to beginning treatment. Antibiotics used to treat Lyme can lead to too many yeast. Immune suppression prior to starting antibiotics can also cause yeast overgrowth.

Yeast overgrowth can result in an ongoing systemic allergic reaction to the yeast that can suppress the immune system. Yeast overgrowth also leads to inflammatory cytokine excess that cause many of the Lyme disease symptoms and pain. Food allergies and sensitivities are the result of yeast overgrowth too. Learn more about cytokines in Control Cytokines: A Guide to Fix Lyme Symptoms & The Immune System.

In this video and written article

• I provide many natural and prescription medicine plans to treat yeast, and
• I also have plans to eliminate treatment resistant yeast.

How to Diagnose Yeast Overgrowth in Lyme Disease

For information about diagnosing too many yeast read A Silent Problem. Do You Have Yeast?

Yeast Treatment in Lyme Disease

The Azoles Plus Nystatin

The most common and effective prescription medicines used to treat yeast are from the azole family of antimicrobials. These include fluconazole (Diflucan), ketoconazole, and itraconazole (Sporanox).

The other common prescription anti-yeast medication is nystatin, but is much weaker than the azoles.

Start with diflucan 200mg 1 pill daily for 30 days combined with nystatin 500,000 IU 2 pills 2 times a day. You can replace the nystatin with an herbal combination mixture 2 pills 2 times a day. (Common herbs found individually or mixed together include: pau d'arco, caprilic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract.) 

Also take a high quality probiotic. I recommend Prescript-Assist Pro by Researched Nutritionals which is shown to promote intestinal health and healthy immune function. Read more about this probiotic, and why I prefer it over acidophilus-based probiotics, in Superior Probiotic for Immune and Intestine Health.

So a treatment using an azole includes:

• a probiotic plus
• fluconazole, ketoconazole, or itraconazole plus
• nystatin or an herbal combination mixture.

Marty Ross MD Discusses Treating Yeast in Lyme disease.

For more information read the whole article found below the video.

Alternatives to The Azoles

If you prefer to not use the azoles or should not take them then use an herbal combination mixture or a compounded prescription medicine called amphoterecin B.

• Take an herbal combination mixture 2 pills 2 times a day. (Common herbs found individually or mixed together include: pau d'arco, caprilic acid, rosemary oil, thyme oil, garlic, and grapefruit seed extract.) Also take the Prescript-Assist Pro soil-based probiotic I mention above. This herbal approach will work, but may take 3 months. For bad yeast infections you may even need to stop your prescription antibiotics while trying this approach.
• Amphotericin B is only manufactured in an IV formulation. But for intestinal yeast infections it must be mixed up by a compounding pharmacist for oral use. In an oral form it is barely absorbed into the blood stream. Thus it has no systemic toxicities. I am pointing this out because in an IV from it is terribly toxic to the organs of the body. But in an oral form it is completely safe. Take Amphoterecin B as a 200mg pill 3 times a day for 2 months. You will need a prescription for this medication sent to a compounding pharmacy. For a really severe yeast infection you may even need to stop your prescription antibiotics too. Also take the Prescript-Assist Pro soil-based probiotic I recommend above.

Yeast Resistance

Unfortunately yeast are becoming resistant to fluconazole. When this happens there are four other options. With each of these options be sure to include the probiotic mentioned above.

• One is to try the amphoterecin B 200 mg 3 times a day for 2 months. Our local compounding pharmacy charges $250/month for this.
• Another is to use itraconazole 100 mg 2 pills 1 time a day for 30 days combined with either the nystatin or an herbal combintation mixture discussed above. Without insurance coverage this costs around $500/month.
• Another option is terbinafine 250 mg (Lamisil). This medicine is approved for the treatment of fungus infections. It is in an entirely different family than the azoles. In a generic form it costs around $50 for a one month treatment. Take terbinafine 250 mg 1 pill daily for 2 full months.
• An experimental option is lufenuron. This is a veterinary medicine that blocks the production of chitin found in the coverings of yeast. Chitin is a hard fibrous substance found in insects and yeast. It is not found in humans. Take 3 gm for 3 days in a row. I find that 4 rounds of treatment are needed. Repeat doses are taken every 11 days after the first dose for 3 more days. Be aware this is an experimental treatment. Human studies have note been done, but it does appear safe in animal studies. See Lufenuron. An Experimental Yeast Treatment for more information about this medicine and where to purchase it.

Often in yeast resistance I will also advise my patients to stop other herbal and prescription antibiotics. Because of costs I usually use terbinafine first, then amphoterecin B, and finally itraconazole. I save lufenuron as a last resort.

In yeast resistance, based on my clinical experience, Amphoterecin B taken for 2 months works 95% of the time, itraconazole taken for 30 days works 80% of the time, terbinafine taken for 2 months works 80% of the time, and lufenuron taken for 2 months works 80% of the time.

Yeast Diet in Lyme Disease

While treating yeast it is important to limit simple sugars and juices. Simple sugars are those items which have a lot of sugar added like coke, candy, cookies, cake, and ice cream. Limit simple sugars to starve yeast. For those with a great deal of resistance I recommend a Paleo diet. Read more about the Paleo diet I recommend in The Best Brain, Inflammation, Pain, Energy, and Detox Diet Ever.

References

1. Bellmann R, Smuszkiewicz P. Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients. Infection. 2017;45(6):737–779.
2. Ching MS, Raymond K, Bury RW, Mashford ML, Morgan DJ. Absorption of orally administered amphotericin B lozenges. Br J Clin Pharmacol. 1983;16:106–108.
3. Kumamoto CA, Inflammation and gastrointestinal candida colonization. Curr Opin Microbiol. 2011 August;14(4):386-391. Doi: 10.1016/j.mib.2011.07.015
4. Olmstead S. et al., Candida, fungal-type dysbiosis, and chronic disease: exploring the nature of the yeast connection. Townsend Letter, June, 2012 townsendletter.com/June2012/candida0612.html.
5. Ross M. Lufenuron: an experimental yeast treatment. Treat Lyme website. https://www.treatlyme.net/guide/lufenuron-an-experimental-yeast-treatment Accessed August 15, 2018.