Q. Hi Cynthia, I have found your website to be a great source for so many health concerns. I am dealing with systemic candida. I have done oral Nystatin for 6 months and now my doctor has switched me to Diflucan for 1-3 months. I read that you said the yeast became resistant to Diflucan when you took it. I am worried it will do the same for me. What is the next step? I am following strict paleo diet, probiotics and other supplements. Any feedback would be great. ~Thanks, Nicole
A. Hi Nicole,
Taking Nystatin for 6 months is typically the minimum amount of time needed. Nystatin should always be in powder form or lozenges, not tablets, so that it can coat the entire alimentary canal. It should also be prescribed in the dosage of 1.5 million units, 3 times a day.
However, many people still see a return of symptoms once they discontinue Nystatin. It depends on how severe the level of overgrowth is, the strain of Candida, how often it is mutating, and other interrelated factors.
People with mild Candida may recover with a course of Nystatin and Diflucan, but for severe overgrowth, the road is usually not that easy.
Diflucan does not kill Candida in the gut, it only gets what is in the bloodstream. So, if the Candida is not gone in the gut,which is its primary place of residence, then Diflucan will provide only temporary relief.
Yes, Candida can and usually does get resistant to Diflucan and all antifungals. It gets resistant to Nystatin less often, but almost always to Diflucan. I have never heard of anyone who didn’t get resistant to Diflucan, usually in a short amount of time. (about a month or less) It also gets resistant to natural antifungals.
The way to prevent resistance is to alternate antifungals. I recommend alternating every week. However, this creates a catch 22 with Nystatin, because Nystatin must be taken long-term, so it is an exception to the rule.
The most important aspects in recovery of yeast overgrowth are the Paleo diet, probiotics, antifungals and supplements, so you certainly have taken the right steps. You should be seeing some significant improvements in your symptoms long ago. If you’re not, then you need to look at other possible contributing issues.
Other factors involved in Candida overgrowth include pH, heavy metal toxicity, other unfriendly organisms, healing the gut, nutritional deficiencies, food sensitivities and environmental toxins.
For example, if parasites are present, they can harbor Candida inside them. If their is mercury in the body, it can impede the ability to reduce Candida overgrowth. Nutritional deficiencies can make the body more vulnerable to yeast and they also mimic the symptoms of overgrowth. Each of these issues must be addressed. You can find discussions on these issues throughout my blog and site, and they are covered in my ebook, Candida Secrets.
For most people with Candida, remaining symptom free requires a lifelong commitment to the Paleolithic diet and ongoing maintenance with probiotics, antifungals etc. Healing is about making a permanent lifestyle change, not a temporary treatment.
All the best.