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Tuesday, June 10, 2008

What is the role of yeast infections?

Antibiotics displace normal flora, this gives yeast an opening. Yeasts are generally considered opportunistic organisms, they don't become active unless given the proper invitation. Natural systems have evolved over millions of years. There is a normal balance of microorganisms which reside in the tissues of our body. In ecological terms they live in a niche. Colonies of normal colon or vaginal flora create a barrier against expanding populations of yeast,usually Candida species. The Candida are chronically present in small numbers, but unable to flourish due to other microbes which protect their territory as well as host immunological barriers. People who have suppressed immune systems are susceptible as are patients on long term antibiotics. Yeast infections can be problematic in the pharynx, esophagus, colon and vagina. Many doctors recommend low sugar, low carbohydrate diets which deprive yeast of their favorite foods. There is convincing evidence that this strategy work. Although, I recommend low sugar diets to all my patients for other health benefits. Probiotics is the best stategy here as well. Patients may need anti-yeast medications. Since the antibiotics are long term, these drugs may also need to be taken long term. The most often used medicine is Diflucan, which can be given in various doses, usually 100mg or 200mg per day. There have been concerns about the long term safety of this drug and its potential for liver damage. I have found it safe for the vast majority of patients. Liver tests should be monitored. There are reports on the Internet that this drug has anti-Lyme effects itself. This does not make sense to me and to date there is no evidence supporting this theory.

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