You should also be taking at least 100M probiotics with multiple strains. The abx are killing ALL the bacteria, antifungals are keeping yeast under control, but you aren't replenishing the good bacteria. And Roxie—I'm with you, I don't know why LLMDs, NDs aren't advising patients properly on this!
Before I even started my lyme/bart/babs treatment I started taking 200mg diflucan and 10,000 units nystatin daily… After about 2 mos. I felt no change so I was switched to Ketoconazole in lieu of the diflucan (yeast can develop resistance) and switched to a powder form of nystatin, which HAS helped (you put the powder in water, and as you swallow it —it coats your mouth, throat, stomach, GI tract, etc…)
Some yeast/fungal issues are local (in the stomach, in the mouth, sinuses) and the tough ones are systemic—in your blood stream, organs. The diflucan is a systemic anti-fungal and very hard on the liver. You should also be taking something to help support the liver. When I started taking the diflucan, I had my liver enzymes checked and they were very very elevated. LLMD had me start taking milk seed thistle and ND had me also take Burdock root tinctures—and enzymes leveled out within a month. The Nystatin is not a systemic anti-fungal so you can take that indefinitely. But I've read that the typical Rx includes other crap you don't need and it's not as effective as the powder, which I buy from a compounding pharmacy for roughly $60, which is a 3-4 month supply. My insurance company tried denying coverage of it (…sigh…don't get me started) so I will continue to resubmit it until they cover it.
I also take a probiotic before going to bed and drink a Garden of Life Raw fit drink that has tons of raw, organic, non-GMO enzymes and probiotics in it.
Anyway, my point was that I have been taking both antifungals every day since March. I want to get off the Ketoconazole (and you shouldn't take the diflucan long-term either) soon. You probably don't want to be on a daily dose for more than a couple of months. But…I have been on herbal lyme/bart/babs treatment and I am gearing up to start abx for lyme in a couple weeks so don't know what LLMD is gong to do about the Ketoconazole. I have significant GI issues so we're hoping to get the ins. co. to cover long-term IV abx and then I won't need the Ketoconazole… crossing fingers—I will fight them on this. I cannot go back to the GI misery I was experiencing. The Nystatin is safe to take long-term.
It's great that you're on the anti-candida diet. It is absolutely essential in controlling the yeast/fungal overgrowth—everything you eat has the potential to feed it, but particularly sugars and carbs so that is non-negotiable, unfortunately. And it is tough so good for you in following it.
I have read about anti-fungal suppositories but don't know much about that.
I also want to add that DETOXING is a must. Yeast/fungal die-off is very hard on the body.
And the only other thing I would add is that eradicating a yeast/fungal overgrowth is a VERY long process (as in it could take many months). I've read over and over that once you have a problem, it never really goes away and you will always have a propensity for overgrowth and that managing it requires a life-long commitment to an anti-candida diet or at least controlling sugar/carb intake. This makes sense but sounds horrible so instead I focus on what I can do right now. Patience is required w/ yeast/fungal problems. I started my treatment 6 months ago and still have significant problems. Initially, I had a lot of vaginal yeast but it is almost entirely gone. I also had chronic sinusitis that I am sure was from the yeast/fungal overgrowth and most of the post nasal drip is now gone. Now—this next part sounds crazy but after doing a lot of research I now know that I am not crazy—but I am still having problems with my eyes and face. I can FEEL fungus growing or spores coming out of my nose, around the corners of my eyes and mouth. I know it sounds crazy but it is true. My vision is blurry, too. And when I have done some "tests" and eaten something sugary—within hours, this is significantly noticeable.
I wish that I could deal with my candida issues with kefirs and such. But a lot of us can't. I have a fermentation kit sitting and waiting for me! So excited to start that. But the significant fungal cases need to avoid those foods until the balance is a little better and then I think they become helpful—and they also work for light cases, as yours probably was.
But I think the most important thing is to always take probiotics with abx. It should be LAW… what are these doctors thinking?
Chronic late-stage lyme—likely infected in 2000; Clinically dx 3/2014 w/ Babesia, tested positive for Bartonella, CDC-positive for Borellia. Multiple viruses and GI/immune treated first; started AL-Complex in May; started A-Bart and A-Bab in July; will start abx for lyme in Oct.