posted
The best way to avoid getting C. Difficile is to take Saccharomyces Boulardi probiotics.
You are right, antifungals do kill the Saccharomyces Boulardi.
I have to take antifungals for systemic candidiasis. I also have a history of C. Difficile.
What I have been advised to do is to take the saccharomyces boulardi as far away from the antifungals as possible -- I wait at least 2 hours and preferably 3-4 hours after taking an antifungal and then take the saccharomyces b. And I take the saccharomyces b. 2 x a day.
Also, it was recommended to me that, when possible, I could pulse the antifungals -- dosing them every other day or 2 days on and 2 days off, or 5 days on and a few days off -- whatever pulsing schedule worked. By taking breaks in the antifungals, the saccharomyces boulardi is given a better chance to temporarily colonize the intestinal tract.
It can be a big juggling act sometimes.
Hope this helps.
Posts: 503 | From Maryland | Registered: Oct 2007
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posted
I've had the same problem. I thought taking them as far apart as I could would alleviate the problem. Hopefully? Sometimes when I wake up in the night, I take my 2nd dose of probiotics.
Can't believe my LD never said anything about this, especially that I keep testing positive for c-diff.
Posts: 847 | From upstateNY | Registered: Dec 2007
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quote:Originally posted by keltyl: Can't believe my LD never said anything about this, especially that I keep testing positive for c-diff. [/QB]
Some doctors are just not up on gut issues, including c.diff and yeast.
Sad, but true. Not your fault!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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WildCondor
Unregistered
posted
Let us clarify the problem.
Florastor (sacc. bouardii) is used to prevent c.difficile. Florastor is not a normal probiotic, it is a beneficial yeast that works by crowding out the c.diff spores in the colon.
You cannot take Florastor when you are taking antifungals like Diflucan and Nystatin. Even if you space them out the antifungal drugs will just kill off the beneficial yeasts so save your $$.
So, the answer to your question is to follow a yeast free, sugar free diet and take good quality, and scientifically tested probiotics like VSL #3. You can also try the antifungals for a week or 2 and then stop them and start the Florastor if you have a yeast infection.
You can also use pulse therapy to treat your Lyme disease where you take breaks off all antibiotics.
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posted
And I'm going to clarify WC's clarification. lol From my own personal experience and from what my treating doctors have suggested.
Folks with severe candidiasis AND c. difficile are in a real difficult spot because of the antifungals killing the saccharomyces boulardi, as I mentioned.
The suggestions I mentioned in my post above (including suggestions of pulsing therapies) have worked for me and I think they are worth trying for just about everyone else who is in the same predicament.
My experiences with C. Difficile have been awful. It's a very dangerous illness and has a great many symptoms that are more than incapacitating. This is not an infection that anyone can afford to fool around with -- it's that serious.
Telling a patient that they are wasting their money in trying to take both much needed antifungals for serious yeast issues while taking much needed saccharomyces boulardi for serious infection like C. Difficile, isn't exactly constructive, in my opinion.
I'm a VSL #3 fan as well. It's the best probiotic I've ever found. I'd be lost without it.
I'd be dead without the saccharomyces boulardi.
And without the antifungals -- well, as bad as things have gotten in the past, I'd probably be dead from severe candidiasis.
With spacing apart and pulsing as I suggested above, the two infections can be addressed concomittantly and successfully.
By the way, it is common for patients with C. Difficile histories to develop lactose intolerance. The Florastor brand of saccharomyces boullardi has a fair amount of Lactose in it.
If one has C. Difficile-induced lactose intolerance (or lactose intolerance from any other condition), then one will have to use a different brand of Saccharomyces Boullardi.
Fuzzy
Posts: 503 | From Maryland | Registered: Oct 2007
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littlebit27
Frequent Contributor (1K+ posts)
Member # 24477
posted
Ok-I'll admit I read most of the responses but not all. I was on nystatin but then I got a mild yeast infection-the woman kind. I was on penicillin for a tooth infection and I'm pretty sure that's what did me in.
Anyway I asked for diflucan to clear the yeast infection and now LLMD has me taking diflucan twice a week instead of the nystatin. So far (KNOCK ON WOOD)it's been ok. So I take the florastor on Mon-Wed-Thurs-Sat-Sun and the diflucan on Tues and Fri. So far so good.
It would be great if you could take them in the same day, but even if you space out the Florastor from the antifungals, it will still be killed off regardless of what time of day you take it. With the cost of Florastor it is indeed a wasteful to try to combine them. I took the 2 together before I knew better myself. When I found out my GI said it is like planting some very expensive seeds in your garden then just ruining the whole crop.
If someone has severe yeast issues then they should probably not be on any antibiotics in the first place.
The pulse therapy option makes a ton of sense for many reasons.
The real serious problem is how to treat Lyme once you have c.diff. Usually you have to stop all antibiotics for a very long time if not for life. C. diff has a very high relapse rate and is growing into extremely toxic strains. It is SO important to be on Florastor to help prevent it but it does not guarantee that you will not get it.
Saccharomyces is a fungus and if you take anti-fungal drugs they will kill it off regardless of timing. This is what I have been told, repeatedly from my team of GI's who helped me with c.diff in both the USA, Canada and Australia. That said, it would be nice to see the sensitivity testing with antifungals on Florastor.
According to Biocodex, the manufacturer of Florastor, you need the lactose and fructose in the Florastor to make the yeast work and proliferate in and on the colon wall. It has been extensively clinically tested and is even now on many hospital formularies for c.diff patients in the hospital.
Also, you do have to be careful with Florastor if you have a central line as it can cause a fungemia, a fungal infection in the blood via the catheter.
if anyone needs help with c.diff I suggest www.cdiffsupport.com it is a great bunch of people on there.
a little tidbit
Research has shown that saccharomyces boulardii is an effective, all natural product that will help return gastro intestinal flora to their healthy normal state. Florastor is a natural product that is almost pure saccharomyces boulardii. There are no known side effects expect for people who are allergic to yeast. There is only one drug interaction. Florastor cannot be taken with systemic anti-fungals, such as Mycostatin (nystatin), Diflucan (fluconazole), Nizoral (ketoconazole) or Sporonox (irtraconazole) all of these products in their oral form, neutralize Florastor. Florastor does not permanently colonize the digestive tract so your body does not get used to it. This is a great benefit and safety feature.
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posted
WildConnor - You seem well versed in this topic, but just curious how the antifungals killing off the s. boulardii is any different from antibiotics killing off the probiotics? Wouldn't we want them to do a little bit of work while they are in our system before they get slammed again with the meds? Isn't that the same point of the probiotics?
Posts: 57 | From VA | Registered: Feb 2010
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bcb1200
Frequent Contributor (1K+ posts)
Member # 25745
posted
YOu know..I was wondering this same thing.
ABX kill probiotics...yet we all take them spaced out 2-4 hours from Abx.
How is this different than Nystatin and Florastor. As far as I know, Nystatin isn't a "systemic" drug. If you take a pill, it's in your GI track only, wheras Diflucan is systemic.
-------------------- Bite date ? 2/10 symptoms began 5/10 dx'd, after 3 months numerous test and doctors
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Currently at around 95% +/- most days. Posts: 3134 | From Massachusetts | Registered: May 2010
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bcb1200
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posted
And now another question....Florastore is an anti-yeast medication by itself.
So...am I better taking Florastore instead of Nystatin? Then I will have the C. Diff covered.
-------------------- Bite date ? 2/10 symptoms began 5/10 dx'd, after 3 months numerous test and doctors
IgM Igenex +/CDC + + 23/25, 30, 31, 34, 41, 83/93
Currently on:
Currently at around 95% +/- most days. Posts: 3134 | From Massachusetts | Registered: May 2010
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Some of the symptoms of lactose intolerance are bloating, abdominal cramping, diarrhea. I already knew that I had a dairy/lactose sensitivity so I was on the lookout for reactions when I tried the Florastor. It's a really good brand of saccharomyces b. Sadly, I had to switch brands though because of my lactose/dairy issues.
As far as one or two of the blanket statements that have been offered ("If someone has severe yeast issues then they should probably not be on any antibiotics in the first place") -- I'd like to just say this:
If I had listened to that declaration rather than approaching my team of doctors for a way to deal with all of the infections, subsidiary health issues, and serious health complications I was experiencing from over 10 years of undiagnosed, untreated Lyme and Co-infections, I would be dead today. I don't feel that this is hyperbolic, by the way.
If I had listened to that declaration at a time when I was seriously ill with -- (I'm just listing a VERY small portion of what hit me all at once) -- fungal infection, Lyme, Babesia, Bartonella, Mycoplasma, chronic viral infections, acute life-threatening vasculitis from those infections, acute life-threatening encephalitis from those infections, a Guillain-Barre type presention that was moving quickly with ascending paralysis from those untreated infections, I would be dead today.
So, while I am in NO way minimizing your individual and harrowing journey with Lyme and associated illnesses/complications, Wild Condor, I would hope that you could keep in mind that there are certain Lyme patients which might even be considered outliers within the Lyme community in terms of the severity and myriad infections and disabling conditions they are presenting with. The complexity of health issues within that minority of the "sickest -of-the-sick" can be astounding.
Those patients literally have no choice but to attempt to treat as many of their complex medicals problems as they (with the help of their physicians) can.
From my personal viewpoint, blanket statements such as "they shouldn't be on antibiotics if their fungal issues are so severe"[sic] or "they might never be able to go on antibiotics ever again if they've had C. Difficile problems," [sic] might not be applicable. In fact, those blanket statements could possibly be seriously harmful were the patient to choose to listen to that rather than relying on their physicians for a way to approach so many big problems at the same time.
Having said all that, I do want to reiterate, C. Difficile is not something to fool around with. It can be life threatening too. And there were times when I had to suspend antibiotic treatment to focus solely on C. Difficile.
For patients who have their C. Difficile under control, and are trying to merely keep it at bay (or prevent it from occurring a first time) during Lyme antibiotic treatment, there are options to try!
We're not all the same. Zealously sticking to a modus "it's my way or the highway" usually leads to treatment failures in patients with many complexities.
One can do concomitant or simultaneous therapies successfully!
That's a good question, I think. I suppose it depends upon how bad your yeast issues are. From my own personal experience, I found that Florastor was not enough to control my yeast issues. But I have heard of patients who were able to control their fungal issues with an anti-fungal diet, probiotics, and Florastor (saccharomyces boulardi) alone.
Hopefully some other people can offer their experiences?
bcb1200
Frequent Contributor (1K+ posts)
Member # 25745
posted
It seems like a damned if you do or don't situation.
I've always been "yeasty" with white on my tongue in the back. I had to go on nystatin in college twice. I've gotten yeast infections in my groin area / jock itch / athlete's foot. So I'm nervous about yeast and I think this is the real threat.
But C.Diff sounds miserable and is life threatening and can derail lyme treatment. Thus the challenge.
Do I treat yeast in a preventive way with Nystatin, Oil of Oregano, and GSE along wth probiotics (Theralac and BP8) at the risk of C.Diff, or do I can the antifungals and take Florastore? I guess I could try it and see how it goes. My toungue is a good barometer.
-------------------- Bite date ? 2/10 symptoms began 5/10 dx'd, after 3 months numerous test and doctors
IgM Igenex +/CDC + + 23/25, 30, 31, 34, 41, 83/93
Currently on:
Currently at around 95% +/- most days. Posts: 3134 | From Massachusetts | Registered: May 2010
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WildCondor
Unregistered
posted
It is really hard to manage all these infections at once. It can be a war with the probiotics vs antibiotics, and beneficial yeast vs antifungals. One of the worst is Lyme + co-infections at the same time as relapsing c.diff=very difficult situation. It's tricky stuff! Don't worry about it Fuzzy, this is a difficult challenge for everyone.
This is why pulse therapy for Lyme seems to be one of the best options treatment wise. With pulse therapy, you use antibiotics only some of the time and probiotics when you are off the antibiotics while taking Florastor the entire time and giving your GI system a break. You can do the same thing if you need to treat yeast, use the antifungals for 2 weeks or so then then when you stop add back the Florastor with your antibiotics. Those are just examples. Each doctor will tell you something different of course which makes this a confusing topic. Some people need yeast treatment for months at a time each case is different.
Each patient should ask these questions to their individual doctors, not rely on things said on Lymenet (for educational purposes) to help guide them.
When I said if you have a severe yeast infection, antibiotics will only make that worse, and if it is a fungal infection of the blood you are pouring gasoline on the fire by taking antibiotics.
What I think is scary is that many Lyme doctors do not even put their patients on Florastor. Most people do not find out that they should have been taking it until it is too late and they have c.diff. Please be careful folks and make sure you balance these things correctly according to your treatment protocol.
bcb you can use anti-fungal mouthwash for your tongue. They make Nystatin swish and swallow or Rx troches
The sugar free diet is VERY important when you are treating all of these things at once. Remember that and try to balance the rest, giving your body breaks from antibiotics to care for your gut.
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-------------------- ? date of bite/no rash 10/09 symptoms, 4/10 diagnosed, after 6 mos. ER visits, tons of docs/tests CDC+ 23/39/41/45/58/66/93 currently on oral plaquenil, doryx, rifampin, pyrazinamide, nystatin, numerous supplements Posts: 718 | From Pennsylvania | Registered: Jun 2010
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posted
It's best to talk to your doctor. My LLMD had me on s boulardii and nystatin at the same time, but taken hours apart.
-------------------- sixgoofykids.blogspot.com Posts: 13449 | From Ohio | Registered: Feb 2007
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canefan17
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Member # 22149
posted
WildCondor,
You talk about it being a difficult situation to treat Lyme & Co + C Diff at the same time.
How come no mention of going the herbal route?
Posts: 5394 | From Houston, Tx | Registered: Aug 2009
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Haley
Frequent Contributor (1K+ posts)
Member # 22008
posted
Yes, how do people deal with all of these infections. I am dealing with all of these and I also have a central line so I'm triple screwed.
There is not much research on infections in a central line due to Boulardi.
Does anyone know someone that got this infection in a line from probiotics?
I really don't know what to do.
Posts: 2232 | From USA | Registered: Aug 2009
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WildCondor
Unregistered
posted
Canefan, going the herbal route can be a good option, but it can still affect your GI flora and cause c.difficile. It is probably less likely, but the antibiotic herbs can and do cause GI issues like and including c.diff so you might have to start slow and increase doses slowly if you are prone to GI issues or have already had c.diff once. Some patients can get by with pulsed Flagyl (since it treats both Lyme and c.diff ) but that still disturbs GI flora. Another option is IV Vancomycin for cases where the pt. needs IV for Lyme but has relapsing c.diff. IV Vancomycin WILL NOT work on c.diff though, only the oral form works. So you have to know those specifics. Oral Flagyl also works better for c.diff than IV because it goes right tot the gut.
You also have to be careful with PPI's like Nexium for relapsing c.diff patients.
S. boulardi is NOT a probiotic. It is a beneficial yeast, big difference between something like acidophilus which is bacterial and a fungus like s.boulardii.
People have gotten systemic fungal infections while on IV while taking s.boulardii (but this IS rare) so you want to make sure you do not take too much of it. One cap per day plus your regular probiotics should be sufficient. I would not fear it, just be aware of the risk.
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