Topic: Clindamycin--do you HAVE to take Florastor (saccharomyces boulardii)?
Hoosiers51
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Member # 15759
posted
I am starting oral Clindamycin (notorious for causing C. diff).
My LLMD told me I don't need any special types of probiotics in addition to the ones I'm already taking---VSL #3 and UltraFlora DF by Metagenics, which are normal probiotics, but expensive and high potency.
They said to just increase those probiotics.
I have heard from people seeing other LLMD's though that you need Florastor (saccharomyces boulardii) to prevent C. diff while on Clindamycin?
I have been on heavy duty Amoxicillin in the past, along with other abx, and never got C. diff.
So do I really need this special probiotic with my Clindamycin, the Florastor?
And if so, I guess I'd have to stop my Nystatin to take Florastor?
Also, they say you can't take Nystatin with Florastor, because Florastor is a "good" yeast, and the Nystatin will just kill it off.
BUT, wouldn't that be the same as taking probiotics even though we're on antibiotics? We still take the probiotics, even though antibiotics kill them, right? We still benefit from replenishing the probiotics.
Can anyone provide insight as to what to do?
Posts: 4590 | From Midwest | Registered: Jun 2008
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posted
Hubby has always taken Jarrow brand of s. boularrrdi or some other health store brand -- as long as it is refrigerated. Has never taken Florastar. Think a lot would depend on dose of clindamycin.
Are you taking the clindamycin for bart or BLO? Hubby took it in the past at low doses (1 or 2 capsules daily) with quinine for babs. The first time he tried it the first dose gave him diarrhea. Took about 3 weeks to clear that up with olive leaf extract.
Used higher doses of probiotics and took the clindamycin for 4 months 3 different times I think. Would love to try it again for bart but don't think LLMD will go for it -- has already refused twice.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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seekhelp
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Bea has your husband ever tried a real dose of Clindamycin as outlined by IDSA? I'm thinking 1,500 mg+ daily. Real dose and IDSA are kind of odd words to place together.
I don't believe the low-dose protocol is common at all.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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CD57
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I don't know about the nystatin thing but you definitely should think about taking the s. boulardi with clindamycin. I think Wild Condor on here is in the know about that.
What is the clindy for? Is there any way you can do it IV instead? It has a lower likelihood of causing c. diff.
Posts: 3528 | From US | Registered: Apr 2007
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posted
Don't take Florastor.. just take saccr. boulardi.
It's available at Vitacost.
Clindamycin is notorious for causing c.diff. Somehow I managed to take it without hazard, but if I were to take it again I would definitely take the s.boulardi.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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Hoosiers51
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Thanks for the replies.
I will be taking it for babesia, along with some herbals, and we may add quinine later.
I will be doing a high dose, three times per day. The total dose per day will be in line with what the IDSA recommends, if what Seekhelp said is correct.
I read something Wild Condor wrote on Lymenet, and she said not to take Florastor (so I'm assuming that means other brands too) at all while on Nystatin.
So I guess the question is, do I stop my Nystatin?
If I had to choose whether to stop Nystatin and not do s. boulardii, vs. doing s. boulardii without Nystatin, I don't know what I would choose.
I'm hoping doing both together would still provide some benefit.
If the s. boulardii on Vitacost.com (Jarrow, Allergy Research, Nutricology) is good enough (sounds like it is), I'll just do that.
But should I stop my Nystatin? Agh...can't decide. I'm leaning towards staying on it. And can't ask LLMD, since they told me not to bother with the new probiotic in the first place. They'd think I was crazy for calling and asking them that question, after telling me not to worry about it.
And I don't have a PICC, so right now trying IV just for this is not worth it to me.
Posts: 4590 | From Midwest | Registered: Jun 2008
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posted
I just spoke to my lyme friendly family Dr (she goes by what my LLMD says for the most part but makes her own recommendations which are almost always right on the money) about Nystatin and the s. boulardii.
She suggested I talk to my LLMD about pulsing the Nystatin instead of taking it daily. I'm going to call LLMD for other issues and will ask about this and post his response.
Posts: 237 | From WV | Registered: Mar 2007
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Hoosiers51
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Thanks!
Posts: 4590 | From Midwest | Registered: Jun 2008
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OH.. my brain wasn't working. I was thinking that if you took a different brand it was OK. Because I was thinking that the problem was with Florastor itself due to the way it works.
Not so. It's the way s.boulardi is structured, right? The Nystatin can kill it?
Seems if you pulsed the Nystatin, you'd have to also pulse the s.boulardi.
If I'm just being brain dead again...ignore me!!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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I see a well known LLMD and the whole family has always been on Nystatin and S. Boulardii. No issues here at with it at all.
IMO Nystatin is really just to ensure against yeast in the gut. S. Boulardii is needed when ever taking abx IMO.
Posts: 476 | From Columbus, Ohio | Registered: Aug 2007
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WildCondor
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posted
S. boulardii IS Florastor folks. You do have to take it when you take Clindamycin and any other antibiotic to prevent c.diff. The reason Florastor (brand) is recommended is because it is the only brand of s. boulardii that is tested for potency and viability, it has also been through research trials and proven to be effective. Other brands are not held to the same standard and will not be the same quality. Most other s. boulardii you have to keep refrigerated. Florastor is stable at room temp. You can not take Nystain or Diflucan with Florastor because the anti-fungal drugs will just kill it off, leaving you unprotected against c.diff. S. boulardii is not a propbiotic really, it is a beneficial fungus. Anti-fungals mess with gut flora too, so be careful taking too many of those. Nystatin is not absorbed and stays in the gut only. Diflucan is systemically absorbed.
Best to take VSL # 3, Theralac, and FLorastor while on CLindamycin. Pulsing probiotics and FLorastor makes no sense whatsoever. You need to keep your gut populated with the s.boulardi so if c.diff tried to take over it fights it off. if you take Nystatin with Florastor then you are wasting alot of money killing off gut flora for no reason. It makes no sense whatsoever to take them together.
(why are you going with CLindamycin in the first place though? ) FOr babesia...that is an outdated and very risky protocol, better ones are available. In my experience, clindamycin does not make sense to be doing given the risk.
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I've taken clindamycin 3 and 1/2 years now for Lyme. I take the Healthy Trinity probiotics. I've not gotten C diff from clinda. I got it from erythromycin once.
Clindamycin takes my fibro pain to zero, and majorly reduces joint swelling and pain. I started with 150mg 4x/day, then dropped down to 2x/day.
We're all different in how we respond to meds!
Posts: 13171 | From San Francisco | Registered: May 2006
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WildCondor
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Robin, you are extremely lucky, and/or have a gut of steel!
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I bow to WildCondor. Forget anything I said here!!
I can't believe I took as much clindy as I did and got away with it.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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seekhelp
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posted
Because most people can't afford to buy Malarone/Mepron WC. I'm guessing that's the reason why we hear that treatment for Babesia sometimes.
quote:Originally posted by WildCondor: (why are you going with CLindamycin in the first place though? ) FOr babesia...that is an outdated and very risky protocol, better ones are available. In my experience, clindamycin does not make sense to be doing given the risk.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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Hoosiers51
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Mepron and Malarone don't work for everyone. That is another reason.
Posts: 4590 | From Midwest | Registered: Jun 2008
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blinkie
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Can someone clarify for me? I have c diff but am having other yeast issues at the moment.
I feel I really need to do a round of diflucan to get it under control but won't that kill the s boulardii and the c diff will flare up?
What should I do? I currently have a yeast rash that I need to get rid of.
Posts: 1104 | From N.California | Registered: Jan 2008
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I've taken Clindamycin for extensive periods of time at high doses (600 mg tid) multiple times without any problems at all. I use to use all those expensive probiotics also, but switched over to Primal Defense as the only proby. I only take it once a day before bed at 2 tabs. It can be increased to tid, but probies really don't do much good when they are taken so close to abx anyways.
The secret is to take one that is tougher than most, and then to give it all night to work without any interference from meds. Primal D has S. Boulardii as well, so you don't have to spend even more money for it. It's a BIG savings for me, and I never worry about getting a bad batch of worthless (dead) lactobacillus probies. Primal D is very cheap at Vitacost or Papanature online
-------------------- You're only a failure when you stop trying. Posts: 945 | From U.S | Registered: Oct 2004
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btmb03
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Wow interesting thread - might ask my LLMD about clindamycin..good luck with it!!
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seekhelp
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Micul, is there anyway 600 mg Clindamycin and 325 mg of Quinine daily for 10 days can kill/put a dent in Babesia?
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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Seek: 325 mg of Quinine a day wouldn't be of much help IMO no matter how much Clinda you took, but 600 mg Quinine 3 x's a day along with 600 mg's of Zith 2 x's a day (1200 mg total Greenstone generic per day) + 100 mg Doxy twice a day for 14 days is VERY effective against Babs.
High doses of Quinine has made me almost deaf while taking it, but my hearing has always come back to normal after a few days of stopping it.
-------------------- You're only a failure when you stop trying. Posts: 945 | From U.S | Registered: Oct 2004
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Some people have had very good luck with clindamycin. But whether it was working on babesia or some other protozoan is hard to say.
Posts: 8430 | From Not available | Registered: Oct 2000
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seekhelp
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Lymetoo, but I always ask myself does effective or a pretty number next to a percentage mean eradication of the bug or long-term remission, not just a few symptoms subside for a week, month, etc.? Yep, Lou makes sense.
I reacted favorably to Clindamycin in the last, but not at a low dose of 600 mg daily.
I have little doubt I'd go deaf on 1,800 mg of Quinine daily. 325 mg caused ear issues.
Posts: 7545 | From The 5th Dimension - The Twilight Zone | Registered: Mar 2008
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I have been using Clindamycin (w/malarone/art/doxy/factive) for over one month. No problem and, I am starting to think, some gains! Kris
Posts: 520 | From Maryland | Registered: Jan 2007
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WildCondor
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quote:Originally posted by Lymetoo:
quote:Originally posted by Hoosiers51: Mepron and Malarone don't work for everyone. That is another reason.
My LLMD's own stats ( for HIS patients ) showed that clindy/Q was 5% more effective than mepron/zith.
Those stats coming from that doctor about Mepron/Zithromax are inaccurate because that doctor uses too low dosing in all of their protocols.
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