Candida Die-off: Your Healing Friend and Foe
by Tarilee Cornish, Certified Nutritional Practitioner
Candida Related Complex (CRC) is a condition involving an overgrowth of yeast. "Die-off" is a term used to describe the experience caused by the death of a large number of pathogenic organisms (like yeast.) In clinical settings, the phenomenon may be referred to as a Herxheimer reaction.
The death of the pathogens is usually caused by remedies or drugs that are antagonistic to the organism, i.e. anti-fungal nutraceuticals or herbal remedies.
Living yeast, when at unhealthy levels, can cause a myriad of constant symptoms by releasing toxic metabolic by-products into the body. Unfortunately, when anti-fungal treatment is begun, they release even larger amounts of these toxins, (or mycotoxins, if from fungus.)
In the case of CRC, once yeast populations in the intestines and/or systemic yeast levels have grown to the point that it causes symptoms, it is crucial to a full recovery that the yeast population is reduced to normal or even, for susceptible individuals, to below normal levels through the use of an anti-Candida diet and supplementary anti-fungal agents. Unfortunately, the catch is that the phenomenon of Die Off is almost always a part of any successful yeast reduction program.
Causing discomfort on their way out
Die Off symptoms can be felt for as long as it takes the body to clear out the toxins released by dead and dying yeast cells, (which create further waste that then needs to be flushed out.) As the toxins circulate in the bloodstream they can strain the eliminative capacities of the liver, kidneys, colon and lymph as they make their way out of the body, producing uncomfortable symptoms. Depending on the individuals level of overall health, symptoms may last a few hours up to a few days.
Feeling worse before you feel better
Generally speaking, most people experience die-off as an exaggeration of their existing Candida-related symptoms or as a worsening of chronic health conditions.
Providing there is no other illness or intolerance at play, feeling some symptoms worsen a bit after beginning the WholeApproach Candida program can be seen as positive as it helps to confirm both the presence of Candida and the effectiveness of the anti-fungal you are using.
There is an additional force at work that can confound your analysis of the problem somewhat. This is something recently coined the "ketogenic flu".
Here is a post about this.
Unique to each Person
Die-off is experienced differently by each person. Most people experience die-off at some point in their recovery. There really is, however, no sure way to predict what point or to what degree one is likely to feel it.
Some start the program and feel better almost immediately, noticing positive effects such as increased energy, better mental focus, better elimination, etc. For these folks, the die-off experience may be minimal or may occur a few weeks into the program.Others start their yeast reduction program and experience diet off symptoms right away.
The die-off reaction can be felt for some people after simply changing their diet to a more pure, healthy diet that does not feed the yeast. It is unclear whether the symptoms experienced with diet alone are die off from the yeast dying due to starvation or if this is a general detoxification phenomenon. However, it is periodically reported and so is a reality for some, either way.
Die Off Symptoms
Common symptoms of Die Off include flu-like symptoms (stuffiness, headache, general aches and pains), skin rashes, vaginal irritation/discharge, numbness, mental confusion, fatigue, brain fog, constipation, and/or diarrhea. Mental and emotional symptoms such as irritability, anxiety or depression are also quite common.
Die Off Duration
Die off generally lasts from one day to a week but can last longer for highly sensitive individuals or if anti-fungal treatment is rushed through aggressive dosing. It is likely that Die Off will come and go throughout the program and is especially likely to occur during the first weeks of a new Phase of the Whole Approach program. As your body becomes stronger, your susceptibility to Candida toxins is reduced and thus your die-off symptoms will also subside.
Absorbing the Toxins
The products in the Whole Approach product protocol are combined partially for their ability to absorb the mycotoxins which cause the symptoms of Die Off. Both the Psyllium seed and husk blend and the Bentonite Liquid clay are effective at absorbing these toxins and thus reducing the severity of symptoms that may be felt in other anti-fungal protocols.
Generally speaking, the severity of symptoms depends upon an individual's overall health; strength of their immune system; degree of Candida infestation; environmental and emotional stress and how gently the treatment is approached and how complete and effective the self-care
Candida most commonly colonizes the sides of the colon. It typically thrives behind and inside any build-up of fecal waste. Where there is a large amount of fecal build-up or intestinal mucous, die-off may be delayed or prolonged. It can take some time for the WholeApproach Program to scrub away at the wastes so that the anti-fungals are able to exert their full effect on the colonized yeast or fungi.
It's important to keep this in mind as at any time through the program if Die Off symptoms emerge it is advisable to ease off on anti-fungal intake temporarily while symptoms subside.
Of course, you'll want to try to prevent die-off symptoms from manifesting throughout the rest of your program. The fact is that more die-off symptoms don't necessarily indicate that you are killing more yeast, just that your eliminative organs are becoming overwhelmed. This is how die-off can become your foe instead of your friend, since overwhelming your body is not conducive to healing. A slow, gradual yeast elimination process is much healthier.
The best strategy is to begin taking the anti-fungal of each consecutive Phase at a very low dose and increase it gradually, according to your response. If you have moderate to severe die-off symptoms you can cut back to reduce the number of dead yeast cells and toxic waste material your body has to cope with. Keep in mind that the effect of the anti-fungal can be accumulative so try to increase your dose slowly, say every 3-5 days. In some cases you may even want to stay at each dose for a week or more.
Not too much, not too little
The art of feeling the best you can through a Candida purge involves learning to manipulate the die-off process through body and mood awareness. Eventually you'll get used to how it feels to be detoxifying healthfully and you can strive to maintain this feeling without suffering through symptoms. You want to use enough product to be sure you are effectively reducing the yeast but not so much that you feel ill.
The right anti-fungal amount for you, (which for short periods through your program, may even be reduced to none), is the amount that keeps the symptoms just 'at bay', or just 'below the surface.' Some experimentation will be required throughout your program as you continually 'feel out' what amount is just enough without being too much.
When you approach this gently and patiently, you will kill off as much yeast as is possible without suppressing your healing process. You will be rewarded with faster recovery times when you proceed with your Candida purge at a rate that your body can comfortably cope with.
If you experience a Die Off crisis, don't be hard on yourself. It happens to almost everybody. If you find you have pushed your body too hard and you are feeling like you have overwhelmed your bodies ability to eliminate, you'll want to temporarily stop using any anti-fungal and to drink lots of purified water. You may also wish to consider Daily Detox Tea as it can help to flush toxins through your blood, liver, lymph, and kidneys.
Other gentle detoxification supports that may help include Buffered Vitamin C, Activin Grape Seed Extract, spirulina, non-sweet vegetable juices (especially green juices) and eating extra vegetables at your meals, preferably raw, if your digestion does well with it. One of my favourite herbs is turmeric and I drink a tablespoon of it with lemon juice, water and stevia. It supports the liver in detoxification and alkalizes the body to help rebalance. I recommend, as always, that you read up on the herbs mentioned here and be sure you are vigilant about any contraindications you may have to any herbs you are considering using.
When die off symptoms subside, you can begin to gradually increase the anti-fungal dosage again over a few days or weeks to the level that you were at before the crisis. From there, you can continue to proceed to the recommended maximum dosage according to how you feel. If you never reach the full dosage but finish the three-month phase, this is fine and you can just move on to the next phase.
Is it Die Off or not?
This is not always an easy question to answer, especially if you are wondering if your symptoms are a result of the living yeast or the dying yeast, or both. However, it's important not to miss other serious conditions because you incorrectly dismiss them as Die Off.
If your crisis or symptoms are severe, please consider the possibility that it may not be die off related and consult with your physician. Although your physician may not understand or be aware of the healing strategies that you are working with, they will hopefully be willing to insure there are no other medical conditions at play.
The Winding Road of CRC Recovery
The process of treating CRC doesn't necessarily yield linear results. The recovery process involves a complex spiral of steps - killing off yeast, clearing the by-products, strengthening the body, killing off more yeast, clearing the by-products, and so on. You can trust, however, that no matter what is happening, your body never stops working hard to cleanse, repair, and balance itself. But the improvement of our body functions doesn't follow an exact schedule and our organs are not always consistently successful in meeting the challenges that face them.
The organic nature of the healing process and the number of factors that can influence our healing ability can make it difficult to determine the effectiveness of some of our efforts and leave us wondering if we are on the right path. The use of a detailed health diary and diet diary can help tremendously with the identification of responses to our efforts including any patterns that may emerge.
Tracking your Successes
Filling out the WholeApproach Questionnaire on a weekly basis is a great way to track your progress as it will provide retrospective on the improvements or setbacks of the last week. This will help you assess the dietary and/or natural medicine strategies you employed over the week. Did your actions and efforts lead to symptoms improvement, worsening of symptoms, or worsening of die-off symptoms?
Confidence and Clarity
In general, regardless of the tracking strategy you use, the more methodical your observations, the more likely you will be successful in extracting some certainties about the direction in which your health is moving. This is because you'll feel more confident in your choices and more committed to your ongoing efforts. You will also be better informed so that you can slightly adjust your efforts according to how you feel. You may even decide to substantially alter course occassionally.
This being said, be aware that you can experience stress if you try too hard to make sense out of every phenomenon that occurs during treatment. At some points in your program it may be best to just accept your experience of uncertainty and be ok with not understanding all of it. You could take comfort in the fact that even a trained Naturopathic Doctor who has guided thousands of people to health may not always have the precise perspective required to understand everything in their own healing from day to day. The calm mind facilitates lower inflammation, greater detoxification and more effective immune function so sometimes, just relaxing so you that you are more likely to feel happy, is the most powerful self care. And, if you're feeling the need to share but don't have a supportive network, remember you can find support through your peers and our moderators at WholeApproachForum.com
In the case of severe CRC, extreme sensitivity and immune weakness is common. In these cases it is crucial to remain aware of how your body is coping and be alert to conditions that may require immediate medical attention. You and your health diary have valuable information to decipher what's going on in your body. However you may at times need a medical doctor or Naturopathic Doctor to help you review this information and/or to perform some diagnostic tests to help you find your way.
Dealing with yeast die-off can be challenging and complex. To stay on track throughout your healing process, remember the following key points:
Don't rush the process or you will overwhelm your eliminative organs with toxins from dying yeast.
If/when you experience die-off symptoms, manage your diet and anti-fungal product dosages to minimize the symptoms and clear out potential waste build up.
Strategies include discontinuation of the anti-fungal, increasing water and vegetable intake and using Neutral Vitamin C Plus and Daily Detox Tea.
Die-off reactions that are too uncomfortable can cause you to doubt your progress and may be confused with other health issues.
To prevent doubt and confusion, in addition to going slowly, keep a detailed record to help improve your decision-making and ability to discern what is happening in your body,
These strategies in combination with the WholeApproach Candida treatment protocol, will improve your progress towards renewed health and vigor. If you want assistance through your program or with anything you read on this site, please post questions on the Whole Approach forum.