My treatment plan for imbalanced microbiota / candida

[paradoxx]

Hey guys, I create this thread to share my current treatment approach and progress. Candida is a highly controversial topic but I decided to trust my new doctor who diagnosed a weak liver, an imbalanced microbiota and Candida overgrowth. He proposed the following treatment plan:

Phase 1: Strenghtening the liver
- Silymarin for 8 days

Phase 2: Candida diet + antimycotic drugs
- Amphotericin B (Infusion) for 7,5 days, then Nystatin for 16,5 days
- Toxaprevent Medi Plus for 20-25 days for liver support
- After 7 days: Fish oil + B-Complex + Minerals (until they run out, should last a while)
- Strict Candida diet during this phase

Phase 3: Reestablishing microbiota balance
- Probiotics for 90 days
- Probably continued Candida diet during this phase, strictness based on what happens in phase 2

I will post updates on how this goes. I already completed phase 1 and started today with phase 2. For information about my POIS read http://poiscenter.com/forums/index.php?topic=426.msg21121#msg21121

[Muon]

Thanks for sharing. I'm really interested in how phase 2 will play out. Some doctors will prescribe a combined trial of antibiotics and antimycotics in case there is a suspicion for an additional bacterial overgrowth. There are no diagnostic tests for candida overgrowth so it's all guess work and trial and error. How did your doctor diagnose the weak liver, imbalanced microbiotica and candida overgrowth? Looking forward to your updates. 

[paradoxx]

Hi Muon, the doctor used applied kinesiology for the diagnosis, another very controversial topic. I also asked about more scientific tests but he said there are only ones that are likely to be misleading or inaccurate.

[paradoxx]

Update:
Today, monday 13.11, is day 8 of phase 2 (day 7 of amphotericin). Since day 2 I noticed a bit more flu like symptoms (runny nose, headaches, coldness, maybe a little fever) than ususal in this period (currently on day 17 since last O). On friday morning I started to get intense coldness/shivers coming from my kidneys as well as tension and light pains in this area (I think its the same as what I get as one of the first symptoms after O but more intense). It got worse until sunday where I got a little scared because I was freezing cold in the morning and shivers continued throughout the day. Also I had light burning sensations when peeing and noticed many small white flakes/pieces in my urine, never seen that before. I was afraid my kidney and liver were working too hard and, tough unlikely, might be infected or something. So I made an appointment with the doctor where I just was. Luckily, when I woke this morning, the urine was clear again and the coldness as well as most of the kidney tension was gone. What remains now is what I would describe as light soreness in the area. The doctor asked me for a urine sample and I will call later today about the results.

On another topic, I asked him whether abstinence over longer periods of time could be a problem. He said no, so I'll continue my current strategy of having the least ejaculations as possible. He also told me its best not to worry too much about POIS for now and recommended to start addressing psychological/emotional problems besides the gut therapy (He mentioned that POIS might be related to the autonomic nervous system, which is why we're addressing POIS indirectly for now). I will have another appointment with another doctor in the same office to discuss whether this would make sense and if yes what kind of psychologist would be the right fit for me.

So for now, I think I'm in good hands. Altough I'm still skeptical about the kinesiology part, the doctors competence and medical background seem impressive. He studied medicine, had several specialised educations (e.g. urology and chiropractic) and also training in traditional chinese and naturopathic medicine.

[Quantum]

Hi paradoxx,

It is very encouraging to hear about a doctor who really invests himself in POIS treatment. 

Keep us updated !

[paradoxx]

I called and he said my urine results are normal. Also my blood test results were ready and everything is in normal range except vitamin D which is very low, so he prescribed a supplement. Will add details about the type of supplement and dosage once I receive the prescription. I'll also try to use a full spectrum light.

Update: Added Vitamin D3 20000 IU, will take it twice a week for the next 2 months.

[paradoxx]

Update:
Today was day 15 of phase 2 (day 7 of nystatin, day 24 post-o). The second week of the diet and antimycotics is over and I feel mostly ok. Had brain fog at least for some hours most of the last 7 days, like staring at things but not seeing anything. Flu-like symptoms and coldness persisted but are less intense. Some mild and short headaches. There is also a constant restlessness, always thinking about whats next, have to keep going. Many times in a day I forget to breath properly because I'm so caught up in my thoughts. I have this restlessness on most days unrelated to the current treatment but never really wrote it down. Last monday I started adding magnesium, calcium, minerals, b-complex and fish oil. There was a misunderstanding in my interpretation of the treatment plan, I initially thought these would be added in phase 3. Also lowered the dosage of toxaprevent so it lasts longer. I edited the initial post to reflect that. Another thing I noticed are frequent and very emotional dreams relating mostly to traumatic experiences.

[paradoxx]

Update:
Day 23 of phase 2 (day 15 of nystatin, day 4 post-O). Treatment is carried out as planned. Unfortunately I had a NE few days ago and after 28 days without O and feeling relatively good (still flu-like symptoms and coldness but low intensity) these last days POIS symptoms were as usual.

I visited the doctors again yesterday and we did a test of the autonomous nervous system (ANS) using heart rate variability (HRV). I was hooked up to a chest strap and first was instructed to breathe normal for ~8 minutes. The result said my HRV (RMSSD metric) was ok. Then during another ~8 minutes I followed a specific breathing rythm (8 breaths per minute) to stimulate the vagus nerve (an app showed me when to inhale and exhale). Results were unusual. The "normal" result (for most people) according to the person who supervised the test would have been that my RMSSD goes up indicating increased parasympathetic influence (relaxation) while sympathetic influence (fight or flight) goes down. For me the opposite happened, RMSSD went down while sympathetic influence and heart rate went up, i felt very stressed where most people would relax more. This seems to confirm a dysregulation of the ANS like suspected by the doctors, but I have 2 more appointments next week where we'll discuss these results. Also, we will test for possible food intolerances and discuss the progress of my current treatment.

[Muon]

Dysautonomia related symptoms/findings are not uncommon in POIS patients. Some food for thought:

https://www.ncbi.nlm.nih.gov/pubmed/14798651

https://www.researchgate.net/publication/282516337_Autonomic_Nervous_System_And_Allergic_Diseases_Integrative_Literature_Review

[Vandemolen]

My doctor gave me miconazole (Monistat) against the white tongue. Maybe it’s Candida. The POIS and antibiotics is the may cause for my white tongue. My esophagus and mouth is very dry.

[Vandemolen]

‘This is what cured my UT/prostatitis fungal infection.
Itraconazole 200mg plus Terbinafine 250 mg (one a day for 3 months)

I took the combination after researching its synergistic effect against resistant yeast strains and looking for better tissue penetration with Itraconazole. I discussed it with a yeast expert before to follow the treatment.
Thanks god, it cleared my UT.
Jorge.’
https://www.thecandidadiet.com/forums/topic/candida-in-prostate-58/

[paradoxx]

Thanks Muon and Vandemolen for the links.

Update:
I completed phase 2, no more antimycotics. Currently day 8 of phase 3 (probiotics) and day 15 post-o. Went to the doctors again twice since the last update. First of all, the doctor focussing on the diet/intestinal approach told me candida was sufficiently treated (no more candida clinging to the walls of the intestines) and that I should continue as planned with the probiotics. He mentioned that he was hoping for clearer results aka that I would feel a significant improvement of my symptoms which I didn't but to continue nonetheless. Since I started the probiotics my emotions are all over the place, which they often are but higher fluctuation than normal. Also there was congestion on most of these days. For a few days now I can also slowly start to eat things I couldnt in the 30 days before.   

The other doctor focused on the dysautonomia. To her it was pretty clear that the dysautonomia and POIS symtoms are closely related and she recommended that I balance my autonomic nervous system: Starting today I add 3x10minutes of breathing at a 6 breaths/minute rate. Also she suggested to join a yoga class (have been in classes before so wont be hard). And the most interesting thing is that I will start getting infusions with acetylcholine. I've read about choline many times in this forum and it seems to help some of you so I'm opening another thread for discussing this part in detail (http://poiscenter.com/forums/index.php?topic=2584.0).

Also, she recommended to approach the psychological angle. We talked about my suspicions of having aspergers syndrome / high functioning autism. She told me my suspicion is not far-fetched and I should get myself checked for that. Unfortunately it will take long to get an appointment with a specialist.

[Quantum]

Hi paradoxx,

Thanks fo your update.

In your current treatment plan, I am 100% in agreement with the addition of yoga, breathing techniques/meditation, and psychotherapy.  They all have been, and still are, part of my POIS management overall method.

[sop]

Hi paradoxx,

Thank you very much for the thread and the updates... My symptoms are extremely similar to yours... I would really appreciate if you can give us an update on your treatment.

Many thanks.

[Vandemolen]

‘This is what cured my UT/prostatitis fungal infection.
Itraconazole 200mg plus Terbinafine 250 mg (one a day for 3 months)

I took the combination after researching its synergistic effect against resistant yeast strains and looking for better tissue penetration with Itraconazole. I discussed it with a yeast expert before to follow the treatment.
Thanks god, it cleared my UT.
Jorge.’
https://www.thecandidadiet.com/forums/topic/candida-in-prostate-58/

In the link above they talk about fungal prostatitis. I am on 200 mg Diflucan (Fluconazole). I have to take it for a month. If it does not help I will ask my doctor to add Terbinafine.

At the website above they say that Ibuprofen helps in combination with Diflucan. But Dutch candida sites say that ibuprofen can be the cause of candida. I do not take NSAID for more than 10 years becayse they are not so healthy. But now maybe I am gonna try it for a few days.

Because after 3 weeks of antibiotics I have lower back pain. The pain came after I finished. I know candida can cause lower back problems. But I also have a bit pain in the testicles and the groin. Maybe it is the prostatitis. So and the I have to start with antibiotics again. But antibiotics cause candida. And candida causes prostatitis. So this is difficult.

[arenaico]

Hi Paradoxx.

How is it going? Did you see any improvement with vagus nerve stimulations?

[Iwillbeatthis]

Paradoxx can you update on your progress please?

Thanks Muon and Vandemolen for the links.

Update:
I completed phase 2, no more antimycotics. Currently day 8 of phase 3 (probiotics) and day 15 post-o. Went to the doctors again twice since the last update. First of all, the doctor focussing on the diet/intestinal approach told me candida was sufficiently treated (no more candida clinging to the walls of the intestines) and that I should continue as planned with the probiotics. He mentioned that he was hoping for clearer results aka that I would feel a significant improvement of my symptoms which I didn't but to continue nonetheless. Since I started the probiotics my emotions are all over the place, which they often are but higher fluctuation than normal. Also there was congestion on most of these days. For a few days now I can also slowly start to eat things I couldnt in the 30 days before.   

The other doctor focused on the dysautonomia. To her it was pretty clear that the dysautonomia and POIS symtoms are closely related and she recommended that I balance my autonomic nervous system: Starting today I add 3x10minutes of breathing at a 6 breaths/minute rate. Also she suggested to join a yoga class (have been in classes before so wont be hard). And the most interesting thing is that I will start getting infusions with acetylcholine. I've read about choline many times in this forum and it seems to help some of you so I'm opening another thread for discussing this part in detail (http://poiscenter.com/forums/index.php?topic=2584.0).

Also, she recommended to approach the psychological angle. We talked about my suspicions of having aspergers syndrome / high functioning autism. She told me my suspicion is not far-fetched and I should get myself checked for that. Unfortunately it will take long to get an appointment with a specialist.