Have you recently been diagnosed or suspect you have yeast overgrowth?
Also known as Candida overgrowth, this excess of yeast in the gut often leads to leaky gut and other digestive issues. Your doctor may have you on a specific Candida diet or prescribe specific antibiotics to fight the infection.
If that’s the case, I want to warn you about Herxheimer reactions, a response to the treatment of Candida infections that can be confusing and frustrating for those who experience it.
What is a Herxheimer Reaction?
If you’ve ever experienced flu-like symptoms, such as nausea, swollen glands, headaches, chills, fever, or other odd symptoms, after recently switching to a healthier diet or taking medication for your Candida infection, you might have experienced yeast die-off. Candida die off symptoms are also known as the Herheimer reaction.
Herxheimer reactions are usually brought on by an increase in endotoxins, a toxic substance living inside bacteria and fungi (such as yeast).1 Usually, these toxins are stored within the bacteria, but if the bacteria begin to disintegrate (or die-off), the toxins are released into the body.2 If enough “bad” bacteria or yeast die in a short amount of time, the toxin overload can cause the sudden onset of the symptoms listed above.
Often, patients are confused and frustrated by these symptoms because it doesn’t feel like the medication or diet changes are working. In fact, it can feel like you’re actually getting sicker!
It can be unsettling if you don’t know what’s going on, so let’s take a look at the causes and symptoms of Herxheimer reactions, as well as ways to avoid them completely.
Symptoms of Herxheimer Reactions or Yeast Die-off
In this article, I am addressing specific patients who may experience a worsening of their condition after starting a program for yeast control.
Common symptoms of yeast die-off include: 3,4
- Fatigue
- Brain fog
- Gastrointestinal distress (such as nausea, gas, bloating, diarrhea, or constipation)
- Low-grade fever
- Headache
- Sore throat
- Body itch
- Muscle and joint soreness or stiffness
- Flu-like symptoms
Less common symptoms include:5
- Lethargy
- Intense sweet cravings
- Rashes
- Irritability
If you’ve recently been diagnosed with a yeast infection and your doctor has prescribed a yeast control diet or medication, you may experience some or all of the symptoms above. In most cases, this is normal, although unpleasant.
However, also keep in mind that yeast die-off reactions are not necessarily a sign that the yeast treatment is succeeding. In some cases, these symptoms may be the body’s way of telling you that its elimination pathways, such as the liver, kidneys, and bowels, are overburdened by the toxins it’s trying to remove. If you are constipated or have been experiencing these symptoms for longer than seven days, your doctor will need to work with you to help your body eliminate those toxins.
It’s worth noting that these symptoms, if associated with yeast die-off, should last less than one week. If they last longer, be sure to ask your doctor to do further testing to see what’s going on.
So What Causes Yeast Overgrowth in the First Place?
Yeast overgrowth can happen in response to improper diet, poor immunity, difficult digestion, and overuse of antibiotics.
- Poorly-digested food can lead to putrefaction (rotting) in the gut and encourages the growth of organisms, such as yeast.
- Excessive antibiotic use often destroys the normal balance of gut flora and opens the door for bad bacteria and fungi to move in.
- Hormonal therapies and steroids can make this condition worse. This includes hormonal birth control.
- If the immune system has been weakened or there are not enough probiotics to combat the yeast, the fungi will begin to grow unchecked and lead to a condition called leaky gut.
However, the number one reason most people suffer from yeast overgrowth is the overconsumption of simple sugars and refined carbohydrates. If you’ve been eating a diet high in sugars, carbs, or alcohol, it’s highly likely that your gut microbiome might be unbalanced, putting you at risk for yeast overgrowth.
Eight Ways to Prevent Yeast Overgrowth and Avoid Herxheimer Reactions
Maybe you haven’t had a Herzheimer reaction, but you’d like to prevent yeast overgrowth in the future. Here are some strategies to help rebalance your gut flora and keep your digestive tract healthy:
- Reduce antifungal and antibiotic use. If you’re on antifungal or antibiotic medications, ask your doctor about ways to slowly reduce your dosage.
- Increase the good bacteria in your gut. To avoid dealing with yeast die-off later, it’s best to start addressing your diet now and make any changes needed to rebalance your microbiome. I recommend taking a good probiotic, such as Probiotic Essentials, to help reintroduce good bacteria into your digestive system.
- Add enzymes at mealtime. Adding enzymes may improve the digestion of foods that limit the rotting of food in the gut. Be sure to use pancreatic enzymes, not fungal or plant-based enzymes.
- Stay hydrated. I recommend you drink 4-6 fluid ounces of warm water every 45 minutes throughout the day. Mineral water may help too!
- Get your sleep. Your body needs rest, especially if it’s working to remove an excess of toxins. Aim for 8-10 hours each night.
- Supplement wisely. Supplements I recommend to neutralize fungal toxins include Biotin Plus, Activated Charcoal, Molybdenum Glycinate, and Pantethine.
- Up your antioxidants. Vitamin C, vitamin A, or N-acetyl cysteine, which supports liver detoxification, are all powerful antioxidants that will help minimize the oxidative reactions created by toxins.
- Keep your bowels moving. Consult with your doctor if you have any trouble with bowel elimination—if you are not eliminating properly, your body will reabsorb any die-off toxins being released. Here are a few tips if you’re feeling constipated:
- Use Magnesium CitraMate™ daily or until you begin having normal, soft bowel movements one or more times a day.
- Drink an 8-ounce glass of warm water immediately upon waking.
- Drink 1-2 tablespoons of extra virgin olive oil several times daily on an empty stomach.
- Mix 2 tablespoons of ground flax or chia seeds into water and stir. Let the mixture sit for 10 minutes, then stir and drink on an empty stomach.
How Long Yeast Die-Off Lasts and What To Do About It
If you have been diagnosed with yeast overgrowth and are dealing with a subsequent Herzheimer reaction, the good news is you won’t have to deal with these nasty symptoms for too long. Most patients undergoing yeast overgrowth treatment experience Herxheimer reactions for no longer than 3-7 days. If your symptoms last longer than a week, ask your doctor to do further testing.
Unfortunately, you’ll probably feel worse before you begin to feel better. Here are a few things you can do to mitigate the symptoms of yeast die-off in the meantime:
- Try eating high fiber foods. Fibrous fruits and vegetables can help bind with toxins in the gut and flush them from your body.6, 7
- Add 1 tablespoon of apple cider vinegar to a glass of water. Drink this first thing in the morning as it encourages bile flow, which leads to increased detoxification.8
- Try an Epsom salt bath. Not only does this encourage detoxification, but it’s a great way to relax and unwind. Your body is going through a lot and needs all the extra love and support it can get! 9
- Get a massage. Similar to the Epsom salt bath, this will help you relax and will also activate the lymph system, another avenue for detoxification.10
Moving Forward: Diet, Lifestyle, and Other Changes You Can Make
If you’ve been diagnosed with yeast overgrowth, or you’re just worried that you might have a fungal overgrowth, there’s good news: prevention is doable and totally up to you!
By implementing a healthy diet, avoiding excess sugar and carbs, keeping up with exercise and sleep, and following some of the steps outlined above, you can take steps to ensure you’ll have a healthy gut. You won’t have to worry about overgrowth in the future, and you’ll never have to experience the symptoms of the Herxheimer Reaction.
Here are some additional articles I recommend that discuss gut health:
- “What is Your Total Toxic Burden? How To Reduce It For Better Health”
- “Small Intestine Bacterial Overgrowth: Signs, Symptoms, and the IBS Connection”
- “4 Detox Methods That Actually Work”
Now I want to hear from you—do you take steps to limit fungal overgrowth in your digestive system? What methods do you use to reduce toxins in your body? Share your thoughts in the comments below!
References:
- https://www.ncbi.nlm.nih.gov/pubmed/11721624
- https://www.ncbi.nlm.nih.gov/pubmed/6752295
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5239707/,
- https://www.ncbi.nlm.nih.gov/pubmed/25786900
- https://www.ncbi.nlm.nih.gov/pubmed/28077740.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105045/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488002/
- https://www.ncbi.nlm.nih.gov/pubmed/25219289
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579607/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2755111/
I was having this last week and through the weekend, finding your blog and this article was timely. Magnesium did the trick for me – it was truely a blessing from God to get this information and I had sent for magnesium the week before all of this started, not because I was preparing – I just read about how great magnesium was for us. Just the first two tabs worked so well, that I doubled the recommended dose to 1,000 mg and I feel better than ever! I was having aches and pains before the Herxing started, but once it started I was in so much pain I could barely move and yet had to host my family from out of town for Christmas. Then I took the magnesium and it made the last day of their visit so much better. The magnesium worked immediately for me. Thanks so much for your help from afar Dr. Jill! God bless you!
Wonderful news, Kim! I hope you are feeling better soon… yes magnesium is simple, safe and profoundly effective!
What is a good pain medication to help manage some of the aches and pains and headaches associated with the die-off? I’m sure that we want to be careful not to cause any major additional strain to the liver during this process. Thanks!
SPM Active is a very powerful anti-inflammatory pain reliever. You may take 2 gel caps up to 3X daily
Hey, great article and very beneficial. Ive recently carried out a couple of liver flushes (lime, garlic, ginger and olive oil) to help with my Psoriasis, which seems to have created an adverse effect than what I was hoping for.
Im now very gassy, itchy, feels like i’m consitpated but actually having diarrhea and more Psoriasis on the skin.
I did suspect a bacteria overgrowth (saliva test) and my naturopath believes this too…
My question is… due to the large amounts of lemon juice and garlic i had for 5 consectutive days – could this trigger a die-off? Ive started taking HCL with pepsin in case its low stomach acid.
Is there a connection between low stomach acid, liver flushing and die-off?
hope to hear back 🙂
Garry
Hi Garry,
Thanks for your comments! Yes, it is possible you triggered a “herx” reaction. I generally do not recommend the liver flush you are describing, especially without knowing what is going on in the gut, liver and gallbladder. With psoriasis you very likely have underlying imbalances in microbes in the gut (http://doccarnahan.blogspot.com/2013/01/healthy-gut-healthy-you.html) I suggest finding a functional medicine doctor to order more extensive testing, like the comprehensive stool analysis to determine the extent of dysbiosis and a determine a treatment plan. Garlic is a potent herbal anti-microbial and may have triggered your symptoms.
Take care
Dr Jill
Great article!
Hi, can you recommend or tell me how to find a good integrative medicine doctor in the western Chicago suburbs? thank you
You could try searching on http://www.functionalmedicine.org for physician in your area.
In the past two months I have started progesterone cream and estrogen suppositories and after about three weeks I started with a yeast infection and diarrhea that is continuing ..into second week or so … I am 53 and in menopause .. I am also started taking thyroid medicine t3 lioyhyronine.. Could yhe hormones be causing this .. I eat clean .. My diet has not changed on these new prescriptions .. I am losing weight with the diarrhea and I and eating more .. Only veggies, clean meat, protein , and only two fruits a day , no grain or bread or gluten , clean protein powder, organic Greek yogurt and all organic veg and fruits basically , lots of water .. Again only thing changed is the prescription .. Any suggestions
Help !
Hi Lisa, if you have underlying fungal dysbiosis, the hormones can make yeast worse
Does bentonite clay help with die off symptoms?
Hi Dr Jill, thank you for such great information. I have been dealing with candida overgrowth for several years. My diet is gluten-free, soy-free, dairy-free…you get the picture! I finally found a doctor to help me with this. She did a stool analysis and found that the candida is still high. She prescribed diflucan 100mg, twice a day. By the 5th day I was totally incapacitated…everything in my body was in such pain that I could not even sleep. I have stopped the medicine and I’m still trying to recover. I asked my doctor to prescribe nystatin instead, but she says it is not strong enough and wants me to stay on the diflucan and reduce it to once a day. I don’t think I can make it! By the way, she wanted me to take the diflucan for 60 days!!! How have your results been with nystatin? Any advice?
Hi Cricket, That sounds like an intense herxheimer reaction and it likely means that your doc was on the right track. Nystatin is not systemically absorbed so may treat the gut but not if you have yeast in other areas of the body. Best to discuss with your doctor and make decisions together. Read more about yeast here.
best
Dr Jill
if we suspect there is yeast overgrowth,we can take lemon juice early in morning fasting to increase stomach acid.
You may take lemon juice but I am not sure there is any evidence it will raise stomach acid.
Hi Dr. Jill
In the talk you did for Genova on difficult GI cases, you mention that you have a handout for Herxheimer Reactions. Is this something you make available online or only through your office? Thank you! (great talk by the way)
Thank you, Andrew
I give this out to my patients
warmly
Dr Jill
What a great article, very helpful! Thank you. I have been dealing with sibo, ibs, gluten & lactose intolerance mostly because of extreme antibiotic use. I’ve been GF and LF for years now, eat a fodmap free diet for 2 years and still have extended belly plus pain. I did a spit test and it undoubtedly showed yeast. I’ve started a very low carb and high fiber diet and have had migraines straight through since 2 days in. I generally feel like I have a flu without the respitory issues. Taking Epsom baths now and drinking detox tea as well as oxygen therapy. My question is how long will this last? I really feel awful and don’t want to fall off the low-carb wagon!
Thank you, Sara
Sorry I forgot to mention I’m taking 150 billion + a day probiotics and trying to use enzymes at each meal but that’s very difficult as most enzymes make me extremely nauseous. Thank you!
Hi Sara,
Yeast can take 3-6 months to treat
warmly
Dr Jill
Also, you just started a Low carb diet, and doing this can cause an electrolyte imbalance(“Keto-flu”). Up your sodium intake, and magnesium. Trying drinking some broth and see if you feel any better after that. I often find I get headaches whenever my sodium is too low.
hey dr jill,
I had been suffering from some thyroid issues and after intense examination they discovered i have some yeast. Dr put me on fluconazole 200 mg daily for 3 weeks. In about the second day it hit me. I was getting sort of paranoid. It really felt very bad. As if i was having a heart attack. I am also on an intense diet. I had to bee taking warm bathes to cool down and drink linden leaves tea. In the past i was on h. pylori treatment and was being treated for hyperthyroidism. I am struggling and dr wants me to continue. I am trying to cope with die off symptoms which affect me a lot.
Hi Mario,
If you are having an intense detoxification reaction or herxheimer it is likely that you are overwhelming your body’s detoxification ability. In that case I always suggest patients slow down on treatment
warmly
DR Jill
Thanks…
I have stopped for now. My body feels numb. Is this normal… drinking a lot of water… It is and feels very strange My doctor wants me to continue with the pills. All he says is that it is normal.
Hi Dr. Jill
I am on my 3rd day of Organic Olivia’s parasite cleanse. I’ve had horrible herx reaction. Got flu like symptoms, sever headache, chest pain sore throat. It all started just a few hours after taking my first dose and now 3 days later it hasn’t gotten any better. The only reason I started this cleanse was because I had a case of pinworms. Along with my cleanse I am taking garden of life raw probiotics 100 billion. I am not sure how much longer I can endure these side affects my headache is excruciating. I don’t want to quit but I’m not sure if I’m doing more harm than good? Any advice would be greatly appreciated.
Thank you!
Nicole
Hi Nicole
I am not familiar with that program but feeling terrible is never a good idea. A herx reaction means you are overloading detox system and need to slow down or increase support for detoxification. You may also be reacting to an ingredient in the cleanse.
warmly
Dr Jill
In 2006 I lost 40 pounds due to antibiotics, started on colonic hydra therapy and it helped, problem now is closest is 100 miles. 30 days of vancomycin has me in about same situation
Doc,
I’ll try to keep this concise; I recently (late September) became unemployed and left behind a lifestyle that I have discovered was toxic and unsustainable. Towards the end of my time at the job I was eating out two to three times a week, drinking a thermos full of coffee and smoking cigars on occasion, sometimes once or twice a week. After a few weeks of unemployment I started doing some light exercise and unexpectedly became bored with being home all day with all sorts of freedom. I was looking forward to it for a few weeks before transitioning to more schooling and new work.
Fast forward to now, I’ve started having increased anxiety and depression, something I’ve not had much experience with. I don’t have a good reason to be depressed or anxious, but I did some research into my toxic habits and discovered that an imbalanced gut environment could be at the root of my causes. I’ve started taking probiotics, multivitamins and fish oil supplements to try and re-balance the gut. Also, these past few days I took some garlic and oregano oil supplements to try and kill the excess bacteria, and it seems to have worked. I’ve been itching in various spots and have had bouts of minor drainage/ brain fog/mild depression as a result. I’ve been drinking lots of water and have adjusted my diet. No more coffee, cigars are gone and I am working to curtail my stress. I’ve also gotten back into taken herbs like lemon balm, st. john’s wort and ashwagandha.
My point in writing is to ask how long it generally takes to re-establish the gut biome that is necessary for these symptoms to ease. I’ve read various timelines, but am uncertain as to how long it takes.
Also, do you find coffee to be an okay addition to gut flora?
Hi Shane,
That is wonderful! I’m awfully proud of the fact that you took the initiative to get healthy and work on the gut! Balancing the gut starts with a very clean diet (generally gluten-free, dairy-free, processed food-free and sugar-free at the very least) As you mentioned, avoiding sweetened beverages and alcohol is also key. Probiotics are a great next step. Dealing with the dysbiosis with herbal regimens should improve the gut in 8 weeks or so. However, if you hit a road-block, be sure to find a functional medicine doctor to test so that you are not missing anything.
Best to you
Dr Jill
Hi dr Jill, I have been stuggle with an yeast infection for months now, I have tried everything, diflucan, flucess, vaginal inserts and nothing seems to work, I then ordered a bottle of yefense my symptoms started to clear up finally but however I find myself feeling tired and experiencing cold sweats and chest pains, overall I feel terrible I don’t know if to discontinue, but it’s the only thing that’s working for me
Hi Chrissy,
You might try backing off on dose for awhile and working with detox tips. IF that doesn’t help, then stop the product
warmly
Dr Jill
Dr, I suffer from all of these symptoms. My psychiatrist wrote me 150mg qd diflocan for 2 weeks, then nystatin for 3 months. I’m concerned about the hormones I take. I have secondary hypogonadotropic hypogonadism. Pituitary gland is “asleep”. I take testosterone cyp and arimidex because my estroidiol is 125. Also I have factor v lieden mutation (heterozygous). High risk for DVT / PE. The steroids are required for life so I hope that is not a problem. Oh, I eat a gallon of ice cream every night. I know this must stop. Thanks
Joshua Tackett
[email protected]
Hi Joshua,
Cut out sugar and ice cream and you will be doing yourself a huge favor!
warmly
Dr Jill
Hi Jill
I been diagnosed with mold toxicity from IGG allergy test and Vcs eye tes t and having Lyme symptoms,anxity,depression and ms symptoms as well..everything was high except black mold. My candida was the worst. It took 5 years to figure this out .I went from jogging everyday ,bike riding and being super working mom. To bed ridden and lost 20 in 3 weeks. I was wearing my 12 year olds clothes. Threw the years I have educated myself more and more and always suspected mold.I moved into 3 different homes all moldy!! Such bad luck.. wow! Everyone thought I was going crazy & even myself . No! I am not crazy i am sick and won’t give up! Nobody believed my theory of mold sickness. I made my family move 3 times i needed to know if was the house. Final move into a newer home now no mold and I felt better when I moved in and could take a full breath and my son no asthma yay! Anyway I work for Integrative medicine and they treat mold and Lyme patients. I learned so much working here and took me a while to realize.this was it even though I th ought i had every illness out there. It was all mold!! Yay!! test confirmed. Last house tested comfirmed! I’m not crazy .. Well maybe a little thanks to the mycotoxins. Anyway I was trying to say that I moved into a new home and felt better but after 2 days and taking probiotics only i am so nauseous, feel dizzy and cramping in pelvic area. I also am taking baths with bentonite clay. I was drinking it, but stopped. For some reason I feel skinnier when I take a bentonite clay bath s. I do Epsom salt as well. I drink lemon water with ACV and coconut oil in my tea and coffee. Work gave me Gpur to take ,but I feel so bad I can’t eat or do anything and because this sickness went on for 5 y ears i put hope into everything and everybody and was let down. Besides knowing its mold finally. A part of me is scared i will feel this way forever .in know work can help me but I feel them getting sick of me..My son is 6 and I have almost been sick the whole time he has been around. I hate it and sometimes I just want to die and give up. My patience is thin now and this is getting old. I’m 37 and feel 87 or dead. This is ridiculous that some mold is this bad in your body. What can I do to get bette r? Will I get better? I know u can’t answer this ,but hope has let me down and for years I’ve diagnosed myself and doctors just have me on anxiety meds. I have no idea what a good feeling feels like anymore i just know pain. I feel cursed! I don’t eat gluten and I eat healthy.digestive enzymes,probiotics and multivitamin. I eat More of a keto diet. I haven’t been able to workout much and constantly feel like fain ting. I have before at the last house it was really scary. I’m still.scared i wi’ll faint again.I was out on beta blockers i don’t take them though. I live in fear of dying! I feel i am fighting for my life everyday i don’t want to be taken away from my kids.they are to young.I’m sick of fighting i want to live life. sorry this is long and hope it makes sense. i have a hard time typing on a tablet. Do u have a link of people who recovered? Or what has worked the best for the worst case.scenario? so over this and I feel I’m just detoxing ow..because symptoms changed i can breath and head pressure gone but im.nauseous and dizzy and aches and pains
I hope you found help by means of a functional doctor!!!!! I am 32 and my story is so so so similar to yours, i found help. Its been two months since treatment for mold and associated lyme. Still quite ill but not nearly as bad. You can so this. You are not crazy, just sick from mold. It doesnt matter what anyone thinks. Everyone and western doctor told me i had anxiety. Please. Its such a long illness but we will overcome. Get help if ypu havent. Save plenty of money.
Hi Dr Jill,
I have a history of Lyme disease and have been dealing with leaky gut and yeast overgrowth issues off and on for many years. Recently I have been on a protocol of diflucan, prescription strength probiotics and L-Glutamine powder with immunoglobulin IgG. I also take digestive/pancreatic enzymes with each meal. I also use bioidentical hormones, Biest cream and testosterone. Do the hormones contribute to the fungal dysbiosis in my body?
Hi Susan
Estrogens can make it more difficult to eradicate fungal infections.
warmly
Dr Jill
Hi Dr Jill,
Thank you for the great article. My naturopath says I’m going through a healing crisis right now. I’m doing plenty of research about it. Most articles and books say they usually last about 2-3 days and in rare cases a few weeks. Have you seen any cases where a person has flu-like symptoms or fever/chills/sweats for over a week during a healing crisis?
Thank you!
Laura
Hi Laura
It can certainly last longer than a few days… I suggest cutting back on your regimen and increasing detox methods, like sauna, hydrotherapy and epsom salt baths.
warmly
Dr Jill
Hi Dr. Jill,
Great article. Thank you for it. I have been suffering with vulval lichen sclerosus for nearly 10 years. I suspect I have major gut dysbiosis, and have been slowly transitioning to Full GAPS, to then start Intro once I have some time off work in the summer. I am off most grains, only have small amounts of honey and fruit daily, nothing processed, eco meats. I live in Spain and my monetary limitations have made me really need to transition more slowly than I’d like. (I also cannot afford any naturopath, and the national health system wants me to continue steroid and hormonal treatment, despite a decade of them failing, and causing a whole host of additional problems.
I read that borax can be helpful for those with LS, and began doing twice weekly soaks with 1 Tbs. of borax (in a small tub). I then got so sick, I thought I had a 2-week long flu, until I realized this could be a Herxheimer reaction. I backed down to 1 tsp in a bath a week, and after the first 2, I was fine at that level, but my 3rd, again, I woke up and all the same symptoms, congested, nauseous, mild headache, chills, swollen glands in my throat, body aches. Do you think that such a small amount of borax in bath water can have such a big impact? I will again back off. I really can’t mother or work feeling constantly like I’m nursing a flu, but at the same time, I am noticing improvements to my vulval skin. I plan to try some of your suggestions! Sorry for the length … I guess I needed to unleash my perpetual state of imbalance. Thanks!
Your post is over 2 years old, but I am a fellow lichen sclerosus sufferer. I have found borax to be very helpful in treating LS. I also have found that I seem to be more prone to yeast infections and sometimes I think I am confusing itchy skin that is LS with itchy yeast symptoms.
I recently began an herbal regimen (along with my continuing borax use) that is really helping but I did have a pretty big herx reaction, too. Hang in there. I know LS is a terrible thing to live with.
I don’t know what it is I’m dealing with but I believe it’s candida. I believe I was misdiagnosed with anxiety/panic and it actually was this. I have been sick for over a year now. I’m 6 months off the doctor rx’d medication for the anxiety. It’s been a total nightmare. During this time, I developed yeast in my mouth and in my urine. I was rx’d Nystatin and then later Diflucan as the former failed to rid it all. It seems to just re-occur. The pain from this is unreal and I’ve been experiencing a lot of off moods-crying hysterically and just feeling so off. I’m wondering if that sounds right for candida or something else..I so need help with this..thank you
Hi Kim,
You may need to support your immune system or look for what might be causing the recurrence…. things like weak immunity and mercury can make candida hard to eradicate.
warmly
Dr Jill
Hello ,My ND tested me (via stool and saliva samples) for suspected parasites but found that i have moderate yeast with low total salivary sIgA level. He started me on oil of oregano tablets, soil based probiotic and caprylic acid. Ive been taking the combination for 3 weeks and feel worse! nausea, acid reflux, lump in throat, stomach pain. Could my symptoms be die-off symptoms? I had all these symptoms prior to starting the treatment , all the symptoms started right after i had a miscarriage. I believe excess hormones from pregnancy cause the imbalance in my guts. Would you agree?
Hi Tyra, this is quite typical… I suggest decreasing dose and going more slowly with treatment until you can tolerate the full dose. You may need to assess immune function and other factors like mercury levels, too
warmly
Dr Jill
Hello Jill
My ND linked me in to your article. I have Hashi’s, under active thyroid, SIBO and Candida. I have debilitating anxiety most days along with nausea. I am GF, dairy and sugar free and following Bi-Phasic Diet. My ND says I am methane dominant but my levels arn’t that bad. She says I also have histamine problems. She is treating my SIBO and has me on numerous supplements. I started on Neem (1 three times daily) about a month ago and added in some Allimed starting on a quarter cap a day and I built up to 3/4 cap where I have been now for nearly 3 weeks. A couple of days after starting the Allimed I think I had some awful die-off which lasted a couple of days. I had a good week last week with little or no anxiety, 5 days in a row is the most I have felt well in over 2yrs. But a week ago I started to go downhill again with the anxiety, nausea, fatigue, weak, brain fog, aching joints. My ND says that die-off can come in waves and she believes it’s happening again. She gave me Toxaprevent, charcoal, high dose VitC for the die-off. She said that Allimed doesn’t suit everyone and I wondered whether I should stay on the 3/4 cap or lower it. What would you advise please?
Do you think I am experiencing die-off again? I feel very frightened as I write because it feels like my head is going to explode and I am in fear and flight mode constantly. Are these normal symptoms?
Amongst many supps I am also taking HCL & Pepsin and Designs for Health Plant Enzymes but I spotted in your article not to have plant enzymes. Why is this please? My ND didn’t seem concerned by them.
My symptoms are not being helped by the fact that my T3 is very low, I don’t seem to be able to convert well and I don’t understand why, nor did my former Endo.
I have asked my ND if there are any other tests she can do, although I have had many over the last 2 yrs trying to find out what is wrong. I also have a very long history of anxiety and I am 55 now; in fact anxiety is troubled me for most of my life. I did have a 23andme test done last year which picked up various things but I know that test isn’t accurate. My ND recommended a mycotoxin and dried urine neurotransmitter test would be useful. I did have an Organic Acid Test done a few months ago and she recommended that we could do it again (but no the genetic side of it). I so need more help right now. She is my third ND, so much better than the last two but it doesn’t hurt to ask someone else’s opinion. Hope to hear from you, thank you, Jennie
Hi Jennie
Many plant based enzymes are made with aspergillus which can be a problem for mold/yeast sensitive patients
warmly
Dr Jill
Hi Jill, me again. Spoke with my FD about my plant enzymes and she has recommended Designs for Health Digestzymes but then in the next sentence she said to take just one with each meal because they are quite potent which has worried me now in trying them, not that my SIBO levels are that high apparently. I was going to have a look around to see what is available but I have no idea what I am looking for as regard ingredients. She has recommended Designs for Health digestzymes. Do you think they are a good one for me pleaseCan you help please? Thank you
Hi Jennie,
Yes, that sounds like a good idea…some patients also need betaine HCl
warmly
Dr Jill
ingredients:- Betaine HCL 200 mg
GastroENZ™ Proprietary Blend 180 mg
Ox Bile Extract, Protease (DPPIV), Amylase, Pepsin, Protease SP, Glucoamylase, Lactase, Acid Protease, Invertase, Lipase
Because of a throat infection, I went on a detox and took colloidal silver. Maybe too much. I developed anxiety and think it may be a herx. What can I do?
Hello! Im wondering how much is tOo much w symptoms from die off. I have some achiness and trouble sleeping, but nothing else really. I read alot about slowing down when you have candida symptoms but i dont feel like the symptoms im having are too much. I am takihg omegas, vitamins w aloe vera for obsorption, and milk thistle for liver help.
Hi Lori,
That is quite possible. If you feel poorly you may need to slow down or stop your treatment plan
warmly
Dr Jill
Hi Dr. Jill
This is a very helpful posting.
A quick question…What dosage of molybdenum do you recommend to help mitigate candida die off symptoms?
Thank you
500mcg to 1mg twice daily
Thank you for this very helpful information. I started treatment for Candida overgrowth a few weeks ago. I started to have die-off symptoms (headache, abdominal bloating/cramping and flu-like symptoms. Symptoms would resolve if I decreased dosages of herbals and increased hydration/rest. However, each time I increase the herbal amounts the symptoms get worse.
Would a dietary supplement of Beef Liver (Vital Proteins capsules) also help with liver congestion?
Hi Christine,
You might need to go slowly and support the detox routes with NAC, R Lipoic acid and milk thistle in addition to epsom salt baths
warmly
Dr Jill
If doxycycline is taken for ivf treatment pre implantation and it creates symptoms of dizziness and feeling sick can this be related to heavy metals (amalgams) and liver being sluggish? Also citrate lowers ceruloplasm which is also liver implication of not having elimination pathways being helpful in removing toxins that the doxycycline might be trying to force out. Should there have been heavy metal testing or candida Dino testing prior to starting In vitro preimplantation phase. Thanks.
Molybdenum is also a problem with copper issues. Not sure it does not create problems.
What are you thoughts on coffee enemas for detox ? Bentonite clay?
Thank you for all your wonderful information.
Some patients find these incredibly helpful. I love clay and charcoal for binders.
Hi Dr. Jill,
I believe I am experiencing die-off reaction in the form of a rash that is mostly located in my armpits. I’ve been taking probiotics, following the anti-candida diet, and taking the supplement, saccharomyces boulardii. The rash went from being 4 small spots to over 26 large spots. Do you recommend doing a liver cleanse and if so, what cleanse do you recommend?
I was taking candidase for balancing yeast levels, I have read many good reviews about this product but as for myself, I started having an odor while taking these supplements. I stopped the pills and I’m noticing the odor just a couple of times a day. I take an epsom salt soak every day. It’s been a couple of weeks. Do you have any suggestions please. Thank you
I suggest stopping and adding probiotics like lactobacillus now
Thank you for the quick response!
A lot of people with candida issues will have mercury toxicity, so prescribing alpha lipoic acid is one of the worst things you can possibly do. NAC also can cause big problems for thiol sensitive mercury toxic people. Look up the work of Andy Cutler.
Hi MO,
Patient intervention must be personalized so there is no one size fits all. I am very aware of Culter’s protocol but treatment must be individualized based on the patients specific issues. Not all have mercury toxicity either
warmly
Dr Jill
I was treated for fungus/candida using biofeedback/energy medicine to kill off. I had what I thought was a herxheimer reaction, with some nausea, lower abdominal discomfort, bloating, gas, gurgling noises in abdomen, stools are now pencil thin to half size normal and very soft and in pieces. This has been ongoing on for 7 weeks although the nausea is gone, I feel fine physically now, except my stools are still abnormal and the gurgling and some gas is still present. The natural path I was seeing hasn’t dealt with herxheimer that has lasted longer than 4 days and she said it is blockage in my liver and gall bladder that has remained. She said to continue to drink lemon water and stay hydrated. I am scheduled to get a colonoscopy and upper scope as she did not think it is a herxheimer reaction lingering. If the scope is normal then she is going to work on unblocking my passageways. After reading about herxheimer, I am still concerned this is a lingering herxheimer reaction, and I was not sure if there is anything I can do this far out, and what damage may have occured. I don’t want to do anything to interfere with the scope procedure either or possible stool samples they may take. Any advice would be most helpful. I am very concerned about my health and don’t know what to do or who to see to help me.
Hi AW, I suggest getting further testing to determine the cause – stool, organic acids, imaging and blood work
Hello, Last 6 months I had digestive problems such as bloating, constipation, intestinal weird movements, hair loss, acne and weight loss (almost 22lbs) 14 days ago I started taking 40 million probiotic twice a day, my constipation and bloating has been better and I also gained 3lbs, but my piss turned green, I have brain fog and my acne has increased. Is that part of the die-off and how long it should lasts?
It might be… best to do further stool testing if you continue to have symptoms
I’ve heard that alka seltzer has had problems with bleeding of the brain after taking it.
Please site reference, Ingrid
Hi there dr Jill,
I found this article very useful and just understanding what is going on.
Iv had several issues in my gut since 2018. I had a bladder infection in 2018 for which many antibiotics were given and changed following that i had a cracked tongue and the docs believed it was due to gastro symptoms. After suffering for month’s with reflux and acidity and heartburn i started doing some reading to understand things.
Im a vegan. I eat right. About 3 weeks ago i started s bolloulardi which is when i was proved + for sibo.I started with 1 tablet and then was told by the naturopath to increase it two 4. 2 in morning 2 at night. This made me feel lethargic tired and achy. Im now back at the blader infection. I was prescribed two antibiotics. I had terrible diarrohoea. M wondering if u can advice me on how i can introduce s boullardi safely without aggravating my body. Do u think its due to the high of s.b. ?
Hi Kavita
Some patients are sensitive to s. boulardii so I suggest trying a different probiotic like Klaire Labs Detox Support
warmly
Dr. Jill
Hi Kavita, depends how long you did one tablet of S.B for? S.B is one of the better probiotics for candida, however it’s best to introduce one capsule/tablet for at least a week or two weeks and let your body get used to it. Then increase by one more capsule (again for two weeks) rather than upping straight to four. Just listen to your body. The body can only take so much in one go. When you feel you can tolerate and start to increase, increase by one capsule for another week or two and see how you feel. If you feel worse always drop back down and let the body recoup. Probiotics (particularly S.B) can also create a die-off effect due to the probiotic good bacteria eradicating and taking over the bad bacteria. However, S.B alone most likely will not clear everything so presumably you are using other anti-fungals etc. It’s always best to start slow and build gradually so the body can cope with the changes/detox. Hopefully you have had some luck. Best
It is so impressive you take the time to respond to patients looking to you for advice. I have struggled for years now with fatigue and anxiety. I struggled to understand anxiety before I felt it myself. I had never experienced it- suddenly finding myself fighting consuming anxiety without an apparent reason was difficult. I looked at old pictures of myself and longed for her not understanding what was going on and why I lost interest in things that used to bring me happiness. The fatigue was and still is so profound it has changed who I am, how I mother and what I do. In additional to fatigue and anxiety I have been severely itchy, have had horrible constipation lasting weeks, and I could not clear my face. The acne that would not go away was something I had never had before – the welts would last months. It occurred to me that my breaks out were the one physical manifestation I could show a doctor. My dermatologist had been prescribing antibiotics for months at a time thinking the breakouts were staph. (side note I had months of antibiotics years prior due an apparent infection that turned out to be an ovary cyst) I asked her (after I researched candida) if could be yeast. She said yes and had me on diflucan for a few weeks and and then itraconazole for two months. My face cleared up for the first time in years and I felt better. I found a physician who listened to me and thought my symptoms could be an overgrowth but she said diflucan was too hard on the liver and prescribed nystatin. I started two a day and the third day I felt awful like a had the flu, my lower back hurting so bad I could not sleep. I told my husband I literally hurt from my toes to the top of my head. I found your site and followed your advice of pulling back and stopped for a few then started slowly. Today, I am able to function and not feeling the awful flu like symptoms, but still fatigued and feeling the phantom anxiety I want so desperately to see fade. Do you see anxiety in patients with no history of anxiety or personality disorders suffer when dealing with an overgrowth and do they fade with treatment as the other symptoms? Are there supplements that can help with the mental side effects of this insidious fungus. What are your absolute must do supplements to help aid in all candida overgrowth healing. I feel like I take so many but not sure if I am doing the right thing. Thank you!
yes, fungal dysbiosis can definitely contribute to anxiety. Treating it will improve symptoms slowly
Hello Dr. Jill,
I started on a probiotic last month (Epigenetics Super 12 Probiotic) and about 10 days after I started I suddenly got extremely emotional with sadness, mood swings, and anxiety. I also suddenly had a lot of stomach issues including cramps, diarrhea, black spots in my stool (??), nausea, and loss of appetite. On top of all this, I had insomnia, fever like chills and shaking, and a dry mouth and even period spotting (again, ??). I stopped taking the probiotics and these side effects lasted for about two weeks and finally eased up. I decided to try the probiotics again and all the same symptoms came back 7 days after I had started them again. Are all these side effects just from the probiotics? Is it wise to stop taking them or are these good die-off effects that I should push through?
This does not sound normal. I recommend stopping the probiotic immediately
Hi Alexa & Dr. Jill,
If you don’t mind me asking- how did this work out for you Alexa? I have started taking caprylic acid capsules and shortly after have experienced normal symptoms of candida die off like fever, sore muscles, brain fog, etc. Those symptoms only lasted a few days and now, about 10 days since starting the supplement, I am experiencing very similar symptoms- bloating, cramps, nausea. I have had black and white specs in my stool since starting the supplement. A few months ago, when I was drinking Apple Cider Vinegar every morning, I experienced milder symptoms and spotting that didn’t stop for 2 weeks until I stopped drinking. Overall, my symptoms are very similar and I’m wondering if I should stop supplementing with caprylic acid 600mg 2x day, or keep going as I have had strong suspicions for candida for ~2 years now (reoccurring YI, gluten intolerance, seborrheic dermatitis, fungal acne, etc).
Thank you so much!
I must be experiencing candida die off as I have broke out all on my neck. It is very itchy and ugly. I have been on a candida diet, starting my fourth week. Also migraine headaches and chills. I ordered a bottle of Borage Oil from NutriONN after reading where you said this would help with acne. I wondered if you recommend I start this now during the die off or wait until the symptoms slow down? I started this diet due to three different bacteria’s that were found vaginally. I did end up taking one antibiotic and decided I did not want to do anymore. So again after reading a article by you I decided to use boric acid suppositories ( the one you recommended) , seemed to really work. So lastly my doctor had me use Uva Ursi which really helped. So waiting on results but feeling better down there. Now to get through the good, bad, and the ugly of this candida diet die off. I am being followed by my doctor, but really need a health coach like yourself;) Thanks for your attention to this post
hi Dr Jill, I have been infected with candida most of my adulthood if not longer. I started kefir (fermented milk) that contains not only probiotics but also beneficial yeasts 5 months ago. In Feb I had a root canal where the upper gum has been causing pain for a few weeks. About same time had narrow angle lazer eye surgery, I have been having low grade headache for last month or so and have had couple cases of eye flashes that brought me back to retina specialist. Nobody seems to know where headaches coming from although retina dr sending me for lab tests. i’m wondering if you might think that kefir die off could have kicked in and is the root cause of headache. In any event I will cut my kefir dosage in half and finish up thru the week so I guess I will have definitive answer in the not too distant future. But just wondering your take on all this.
Hi Norm, that sounds complicated with many variables… you may want to consult with a functional medicine doctor.
Warmly,
Dr. Jill
What do you if you have tried several different methods and your bowels still aren’t moving daily? For me its a few times a week. Laxatives dont work and neither do natural remedies. I have even tried several of the methods you listed above. I’m having a lot of die off symptoms. It can be very paralyzing at times.
Hi, I was getting terrible die off and got instant relief after doing an enema. It is like a magic wand was waived over me and all the awful discomfort just disappeared. Now I can continue to detox knowing I have the power to stop the die off in its tracks. I use a bucket which makes it quite easy, it is a clear bucket purchased online. Power on and don’t give up 😊
Bacillus HU36®, being a spore, offers advantages of better colonization and survival through the digestive track when compared to non-spore probiotic organisms; it also offers claims related to the most bioavailable form of antioxidants and carotenoids.
Hi Dr Jill
I am coming out of severe chronic fatigue. Was so bad a few years ago that walking for 10min could leave me out of commission for 1-2 days.
I’m a lot better now due to: adrenal healing, antifungals, Mycotoxin Detox, liver support, sleeping well, out of chronic stress, optimizing methylation chemistry, etc.
However I am still working on the Candida and I have ongoing die-off symptoms. I take Diflucan 100-150 daily and sometimes can only do this for 2-3 days before the Herxheimer gets too much. This has been going on for months. I know the Diflucan is helping because each time I take it, then lay off it, my health feels a bit better. Molybdenum seems to help sometimes.
So overall it’s good, but concerned about the ongoing Herxheimer and wondering what tests you would be looking at in this case?
Thanks so much
I am not a fan of pushing if the Herx continues and I am so sorry you are having so much trouble. You may need to stop this treatment or work on detoxification to enable better elimination like drainage remedies or other things to enhance kidney, liver and lymphatic pathways first.
Hi Dr Jill –
Thank you for your great website. Can a Herx reaction involve being more emotional? I cut out all sugar (which can do a number itself) and started taking probiotics and Nystatin. This doesn’t feel like a sugar/low carb flu. Thanks!
yes, I believe that the emotions may play into any reaction. Especially when eliminating simple carbohydrates as they can elevate serotonin or be involved in addiction.
Hey! So basically i have reflux, back pain, brain fog as my main symptoms of SIBO. I started the low FODMAP diet and felt amazing on the second day! Then i felt bad again, but different symptoms, like it was a tiny die-off reaction to maybe some starved bacterias. Then i took berberine and felt bad all over again on the second time i took the pills. I feel really anxiety and tired, my vision is weird and i feel like i’m drunk all the time. Could this be a die-off? can a die-off make the reflux worse? Thx!
Also i’m really hungry! I eat, get bloated and feel hungry again…my stools are kinda colored too, i’m scared that this might be something else even though it wouldn’t make sense cause the diet was helping me and i got worse right after i took berberine! but my main concern is the reflux since it can hurt my esphagus:(
yes, it could be related to die off or reaction to berberine.
Hi there, I am worried about a Candida die off reaction that has been going on for 4 weeks now And whether that is even possible or I should be worried something else is going on? I have googled extensively and everywhere seems to say that it should last up to 7 days but I’m on day 30 and I feel awful still. I was diagnosed with suspected Candida (I’ve had the symptoms for 12 years) and started on Thorne sf722. I felt great the first couple of days, I remembered for the first time in years what it was like to feel well it was amazing, then By day 3 a headache started and that built up by day 12 (as I increased my dose) to an unbearable level of fatigue, brain fog, headache, exhaustion – like the worst hangover that does not leave you. I then stopped the tablets a couple of days as I couldn’t cope and started again on a low dose and built up again, but before I could even get back to the recommended dose I just felt too awful to handle any more so I have stopped again. It’s day 32 now and I stopped on day 26 (although I did start a complete no sugar Anti Candida diet on day 26 – the first time 35 years I’ve removed sugar from my diet) and I still feel awful. On the plus side all my symptoms have almost completely resolved (I had chronic histamine issues) and my skin is glowing but I just feel so bad day after day, I’m having to go to bed by 4pm, it’s relentless and I’m panicking now it’s not going having even stopped the tablets 5 days ago. The only thing I can think is it’s die off but nowhere says it can go on this long. My instinct says it is but the lack of any other mention of it lasting so long has me worried something else awful is going on, so I’d be really grateful if you are able to say whether you’ve seen a long die off reaction like this before? I have MTHFR issues which I have read may not help, but I know mthfr is not that uncommon whereas my experience seems to be. Many thanks for your time and any help
Hi Frances
If you have severe candida and treating but having significant die off reactions, I suggest slowing your treatment down and speaking with your treating doctor. Yes, it is possible to have trouble with the treatments and to need extensive treatment often for 4-6 months or longer, especially in cases of underlying immune deficiency
warmly
Dr Jill
It’s hard to say
It’s hard to say
Very good post. I will be going through some of these issues as well..