Anti-fungal agents

[Dr Girish Mahajan]

Any latest review on current antifungal scenario?
Thanks

[e-mail]

[Morganna]

I have suffered from fungal sinusitus for about 3 years, and have seen countless doctors and have done my own research, diflucan seems to be the best drug for yeast/candida, but the newest and most stable anti-fungal is Voraconazole. Its newest form comes in a nasal spray. I am have had it up to here with doctors trying to make money off me by taking dangerous catscans frequently, and now The Mayo clinic wants to patent thier amphotericin B for nasal irrigation, I knew about this years before and there are already several compound pharmacists already making this, another company is trying to sell the nasal spray for 150.oo for a months supply , I did my own research and found a compound pharmacy willing to make this for 50.00 ,all I can say is, do your own research and stand up for yourself when spekaing to doctors who mainly see you as a dollar sign. it saddens me the medical community wants to make money off of the sick.

[Morganna]

Morganna wrote:

I have suffered from fungal sinusitus for about 3 years, and have seen countless doctors and have done my own research, diflucan seems to be the best drug for yeast/candida, but the newest and most stable anti-fungal is Voraconazole. Its newest form comes in a nasal spray. I am have had it up to here with doctors trying to make money off me by taking dangerous catscans frequently, and now The Mayo clinic wants to patent thier amphotericin B for nasal irrigation, I knew about this years before and there are already several compound pharmacists already making this, another company is trying to sell the nasal spray for 150.oo for a months supply , I did my own research and found a compound pharmacy willing to make this for 50.00 ,all I can say is, do your own research and stand up for yourself when spekaing to doctors who mainly see you as a dollar sign. it saddens me the medical community wants to make money off of the sick.

After months of research, and much pain and suffering I finnally got an undertstanding ENT to prescribe for me this new anti fungal Nasal spray - voriconazole nasal spray. This is a compound medicine , but do not let some pharmacists fool you, it is very simple to mix, and can be done cost effectively. After the first evening of using it I cleaned out a lot of black pieces of fungus from my sinus, and am on my third day, I hope others will not have to go through the 3 years of pain and suffering and dealing with doctors who want to make money from your ilness , as I did.
All I can say is, NEVER take one doctors word as gospel and do your own research.
I am planning to set up a website and provide help for others who suffer from chronic sinusitus. good luck

[Morganna]

A- if you have a long standing condition, of which antibiotics, haven't worked for you, most likely it is fungal.
B- As much as some surgeons will toot thier own horn abour how surgery is so great and will cure you , if you do your own research there are a number of patients who have recurrance , even after surgery.
C-Realize this , that whomever your talking to, they will almost always lean toward the profession they are in,..... in other words, if you talk to a surgeon, they will tell you surgery is your answer, if you talk to a pharmaceutical company or manufacturer, they will tell you that drugs are the answer, etc.
This is what I want to share with you.
There are some anti-fungal drugs out there which you might want to try BEFORE you consider surgery,(I am generally against surgery)
The first and oldest drug which every doctor has heard is NYSTATIN, but what most doctors do not know is, that it comes in the pure ORAL POWDER FORM.
2 companies make this:
Paddock and Medisca
Ask your pharmacist,( they may have to order it and you may have to speak and call a few different pharmacists)
you can mix this with sterile or distilled water and irrigate your sinus with it , and or take a bulb syrine, fill it with the mix, and lay down and let in fill up in your sinus for as long as possible then blow and clean.
This method actually works a little better and gives the powder more time to treat the fungus.
This used to work for me but I had to switch to something stronger.
I used to order it from College pharmacy, but they have thier own formula and I do not know how they weaken it but they do, I suggest you get it straight from either Paddock or Medisca through your pharmacy.
The Paddock one has to be kept refridgerated.
Now even though Nystatin is an old drug and is considered safe, I have been told that there is little or no absorption of any drugs when your using it for sinus irrigation or spray.
The Second one I want to talk about and will be much talked about very soon (because The Mayo Clinic is seeking a patent on it)... is :
Amphotericin B for irrigation.
I ordered this and it was rather expensive $160.00 for a 30 days supply from SINUCARE and it did seem to work , but it was costly and needed refridgeration.
After about 2-3 months I stopped because it didn't seem like a cure, but more like I was a slave to this medication.
The third NEWEST AND MORE STABLE ANTI-FUNGAL drug, which can be made into a nasal spray is, as I mentioned earlier.
VORICONAZOLE NASAL SPRAY.
When speaking to College pharmacy this was preferred and thier pharmacist told me at the time it was stronger, more stable and saw better results than the ampho B.
IF you do your own research on the web, you will find that Dr. Ponikau has prescribed this to patients, now this information will most likely be less available given the fact that even though he is a leading doctor and researcher for the MAYO CLINIC and they are ones who pioneered and discovered this fungus connection, they will more than likely be pushing the amphotericin B because like I said earlier, they are seeking a patent and made a deal with a manufacturer (JCB LABS)who supplies this formula.
You can also purchase thier Voriconazole nasal spray, and they insist they have a "special formula"
of which they want to charge you a $ for it.
but I really think it is just a mix with saline water and the powder or injectable form itself.
Do some research yourself, Voriconazole or Vfend has been shown to be more effective than ampho B.
IF all else fails and you and your doctor decide on surgery, also consider this.
The newest method of treating this, is by endoscopically scraping the area of infection, but at the same time, irrigating it with an anti-fungal during surgery for a more complete and more effective results.
Good luck

[Morganna]

Update on my Voraconazole Nasal Spray Therapy:
the first 2 days upon using the spray and irrigating my sinus, I cleaned out a lot of black stuff and what looks like bits of fungus/,molds. its been over a week and it seems to be taling care of the fungus because I do not clean out black stuff anymore, just the ocasional small bits of grey-ish and what appears to be dead fungus.
One more thing to consider about those of us who suffer from long term sinus infections is, the fact that secondary bacterial infections are common when there is a primary fungal infection. Another thing I have discovered is my adeniods may be infected.
I may need antibiotics, but it might make the fungal infection worse.
If you do have a secondary bacterial infection with a primary fungal infection, try to NEVER TAKE ANTIBIOTICS without some form of antifungal afterwards because the antibiotics make the fungus grow more.
I will go back to my doctor to discuss adenionds and possible round of antibiotics. will keep you posted.
Good luck and god bless

[Morganna]

Okay update week three. I suspected having intestinal candida overgrowth ever since my sinus symptoms started, I feel it contributes a lot to the reaction to the mold in my sinus. I especially noticed a yeasty odor from my pores especially the day after drinking a bottle of wine. The next day I started not only treating my sinus but swallowing the nystatin by mouth 4 times a day and also avoiding a lot of foods, after just the second day I feel I am improving. For some poeple the allergic reaction to molds in the sinus might be stemming from a yeast overgrowth in the stomach and intestines and what is called leaky gut. I have a feeling most ent's will not see the connection.
eating raw foods containing natural enzymes is important.
I am also going to get myself an ozone generator. active oxygen has long been shown to safely kill mold, virus'es and bacteria.
Good luck to you.

[Morganna 8-23-2006]

Feeling a lot better today, and fasting seems to be very important for removing all undigested food. from your body giving less for the fungus to feed on.
There is a lot of differing information on the net, and many sites that are there to lure you with information, but really just want to sell you something.
I want to share with you a wonderful site I found about Candida, Yeast overgrowth can actually be contributing if not the cause of the sinus symptoms.
yeast is hard to kill, but the best solution and one which is working for me so far is, the combination of the diet, and 2 or more different types of anti-fungals.
http://www.drcranton.com/CFIDS.htm
check out Dr cranton's site, and his advice and information including diet, and specific drug therapy.
He doesn't mention Ozone, but anyone who has a fungal infection of any kind should try to get themselves one to clean the air they breathe, kill mold spores in thier home, and purify thier water.
It makes sense and has been long used and proven that Ozone safely kills germs mold, fugus, and virus's.
I know that that the therabreath company actually sells a personal ozone generator for about 20, you can also find them on Ebay, which is where I intend to get mine.
Best of luck to You
and God bless

[e-mail]

[Bill]

Morganna 8-23-2006 wrote:

Feeling a lot better today, and fasting seems to be very important for removing all undigested food. from your body giving less for the fungus to feed on.
There is a lot of differing information on the net, and many sites that are there to lure you with information, but really just want to sell you something.
I want to share with you a wonderful site I found about Candida, Yeast overgrowth can actually be contributing if not the cause of the sinus symptoms.
yeast is hard to kill, but the best solution and one which is working for me so far is, the combination of the diet, and 2 or more different types of anti-fungals.
http://www.drcranton.com/CFIDS.htm
check out Dr cranton's site, and his advice and information including diet, and specific drug therapy.
He doesn't mention Ozone, but anyone who has a fungal infection of any kind should try to get themselves one to clean the air they breathe, kill mold spores in thier home, and purify thier water.
It makes sense and has been long used and proven that Ozone safely kills germs mold, fugus, and virus's.
I know that that the therabreath company actually sells a personal ozone generator for about 20, you can also find them on Ebay, which is where I intend to get mine.
Best of luck to You
and God bless
[e-mail]

What are your symptoms?

[Morganna]

I wanted to share some links with you, that I found very informative.
http://www.mold-survivor.com/fungal_sinusitis...

I just had a Visit with an ENT this past weekend (DR KIM of staten island ny)and it was disapointing,a lot of doctors just want to go "by the book" of what they learned so far, unfortunately for them and those of us who suffer is, that the fungal infection in the sinus is a relatively new discovery and old methods simply do not work,plus the frustration of having a sinus culture come back negative, and if your doctor does not have exstensive experience of fungal sinus, chances are he or she will not know that sinus cultures are highly unreliable,even catscans may not be able to detect the fungus,( Ihad 2) I have had 2 doctors try to get me to take steriods,and I think it just made my symptoms worse.
My symptoms?
recurrent symptoms
runny nose, post nasal drip, especially (after a meal or gargle)
fatique
edema, swelling behind ankles , knees
white smelly pasty covering my mouth and tongue.
Constant pleghm
bad breath and bad odor from sinus
intermittent moldy or yeasty body odor, and this is from a person who could sweat buckets and never wore deodorent with no complaints all her life.

[Ray]

I have AFS and am currentey on ampthro B by nebulizer and have not seen much in way of relief, but I am gaining some of my smell sence back ( very little) I forgot how good the pot of coffee smells in the AM. After reading about the new drug Voraconazol I am going to ask My Dr about it. I have a question, do any of you that have AFS get small blackish particals in your flem that you cough up ? if so is this the mold ? also do you suffer from fatigue ?

[Morganna]

Ray:
Yes I do,and yes I think it is mold, I have shown doctors samples of this, and not one of them took it from me to test. They tried to get it themselves by nasal swab , but it isn't reliable.
Here is an interesting note about fungal sinusitis:
" An article published in the Mayo Clinic Proceedings in September, 1999 by the Mayo Clinic suggests that fungal sinusitis may be much more common than previously thought. The disease is now know as EFRS (eosinophilic fungal rhinosinusitis) or EMRS (eosinophilic mucinous rhinosinusitis).
"Fungal growth was found in washings from the sinuses in 96% of patients with chronic sinusitis. Normal controls had almost as much growth, the difference being that those patients with chronic sinusitis had eosinophiles ( a type of white blood cell involved in allergic and other reactions) which had become activated. As a result of the activation, the eosinophiles released a product called MBP (Major Basic Protein) into the mucus which attacks and kills the fungus but is very irritating to the lining of the sinuses. We believe that MBP injures the lining of the sinuses and allows the bacteria to proliferate. "
from what I have researched it seems that fungal sinusitus is a life long commitment to treat, and surgery has a high rate of recurrance starting at about after one year post op.
I am considering surgery but am still looking for a doctor who is willing to closely follow my progess.
at this point, some sort of irrigation or antifungals for an indefinate amount of time seems likely.
Ray: I have never done the nebulizer treatment, but because sinus's are so deep and a good concentration of the antifungal is needed, this may be the reason why it isn't working as well for you.
I use 2 methods of irrigating my sinus.
one is I use a nasal dropper or bulb with the antifungal ( nystatin oral powder is one) or amphotericin B is another and I lay down and let it fill my sinus cavity, I stay there like that as long as I can then blow out.
The other and most effective for me is irrigating by using a waterpik device , I put the antifungal powder in resevior with water and then I aim the PIk towards the back of my throat up into my sinus, I lean over the sink and blow out from each of my sinus as hard as I can.
This is a method I use and have thought up myself and it works best for me.
JCB Labs is the company that makes Voriconazole nasal spray,
Contact person Brian Williamson
JCB Laboratories
This guy Brian is very nice and is very knowledgable he told me that the newest and most promising surgical method would involve not only scraping of the area but irrigating it during the surgery (make sense because fungus is very INSIDIOUS)
another note
The use of MORE THAN ONE TYPE OF ANTIFUNGAL Works best, because fungus becomes resistant to the drugs.
luckily antifungal used by way of sinus has little or no absorbtion and is relatively safe.
I would also consider irrigating my sinus with OZONATED WATER, and CHANGE YOUR DIET.

[Ray]

Morganna, Did you try the anti yeast cave man diet ? along with anti fungals? I read the link and have almost all of the symptoms that were stated along with a few more that I think are related. I also have selective IGG deficiency wich is a primary immune disease this is the cause of all my problems I think, or could it be that the fungal thing causes my immune system to go so out of wack that my IGG is low all the time fighting the fungus hence causing more and more things to go wrong, things just keep happining, skin problems are getting worse every year, this year I had a very very rare form of a skin cancer verrucous carcinoma that had to be cut out in two stages taking 1/2 of my big toe with it, the cancer Dr. stated that he thinks that the low IGG helped cause the cancer, it just seems to go round and round.

[Morganna]

Ray:
yes I am on the Caveman diet along with the anti-fungals, although it is hard to get a doctor to prescribe all of that at the same time, I on the diet and doing better.
It tooks me years of research and trying different meds etc, and a LOT OF SUFFERING To realize and agree with you, The fungus in the sinus, because the mucous drips and goes into your system is causing a yeast/and or fungal overload in the stomach leading to the liver and kidneys being overloaded and the immune system being weakened. Because if this you will need to CHANGE YOUR DIET CONSIDERABLY, you need to eat a lot of raw vegetables in order for your stomach to get back the enzymes needed to get rid of the yeast, properly digest your food ,restore the lining of your stomach. I eat a lot of raw veggies with Kosher salt, I am starting to like it.......PLus DO NOT DRINK ANY FORM OF ALcohol !!
Fasting ocasionally is good also.
If I do not stop the mucous from going down my throat, I will get swelling (edema) behind my knees and in general.

Ray, you might want to discuss with your doctor DR. CRANTON's suggestion and protocol on yeast, along with your current antifungal irrigation of the sinus.
I completely agree with Dr. Cranton in my experience and because I have had a few recurrances, it is very important to attack the fungus in all ways possible in hopes to get rid of it COMPLETELY or else it will come back STRONGER!

The Nystatin oral powder is an excellent chioce and putting the dry powder on your tongue and let it slowly dissolve will help kill the yeast/fungus that is dripping from your sinus into your throat and down your stomach into your system.
I am also taking 100mil dose of diflucan a day and will be taking it for about 6 weeks.
I feel for you Ray and indeed yeast and fungus in the long term can cause cancer, I have read about it.
Ray.. you have to be diligent in making sure there is absolutely no mold in your environment, and clean things with bleach ocasionally.
You might want to seriously consider OZONE , read about it, it has been implicated to be able to kill cancer cells etc.
You can start off by drinking ozonated water and irrigating your sinus with it,it can also kill mold, virus's in your home etc.
The have a few kinds on Ebay that are cost effective if you want to try and others are very pricey.
along with the anti-fungal irrigation, I try to clean my sinus as much as possible, This whole twice a day stuff DOESN"T WORK, the best is doing it a few times a day and especially right after you eat.
Another thing is the skin is a huge organ and you can help it detox your system by sweating , a lot of toxins can be released this way, try to get some excercise and sweat if you can, even a suana might be a good idea.
a hot bath in Epsom Salts is a good idea.
I also brush my teeth with baking soda and peroxide, it cleans my teeth and mouth better than any wash or paste. which is important because that mucous from the sinus goes all over.
and Lastly since I read about what the Mayo clinics say that the primary problem is the MUCOUS.
The last few days I took an antihistamine to stop my sinus drip along with the irrigation, and I am finding this is working very well.
since its the immune reaction that causes "the eosinophiles released a product called MBP (Major Basic Protein) into the mucus which attacks and kills the fungus but is very irritating to the lining of the sinuses"

and for some reason I took a CVS brand Claritin-like type pill, even today when I didn't take one , My sinus isn't leaking like crazy , its like it works for 2 days??? maybe it might eventually shut of this "reaction my sinus has to the mold, and in the meanwhile the anti-fungal can do it's job of killing it.
I feel this is helping my irrigation therapy to work better.

Good Luck to you Ray and Be diligent, I will be here to help you if you need it.

[Morganna]

Ray ,Can I ask if your doctor has ever found out what the black stuff was? how was your afs Diagnosed? was it by CT scan etc.?
what does your doctor think or say about Candida or yeats overgrowth?

[Ray]

Morganna, the DX was done after my second sinus surgury when they did the biopsy's. The CT scans were quite scary looking with one side being completley blocked,
As far as the Dr. saying what the black stuff was I have asked several times if this was some of the mold and he say's that it probley is and leaves it at that, My theroy is that it is and has caused several other things to go wrong like my stomach issues and bouts with diverticulitus and my gall bladder stopping working, no stones just stopped doing it's job. I have never asked about candida or yeast overgrowth, please fill me in on this as I am going to see him on thursday so I can ask about it. Thanks, Ray

[Morganna]

Yeast is a naturally occurring substance occurring in the body, the stomach, intestines in balance with good bacteria in a healthy person.
When the balance is lost through many factors.... one being antibiotic use, stress, hormones ( MSG in food is known to throw hormones out of wack , They also hide this in food lables.) Just to be safe really stay away from processed and frozen foods.
Yeast when allowed to proliferate in the stomach will cause more acid production, a inability to digest food, put a stress on the immune system and cause LEAKY gut, and a VARIETY OF OTHER SYMPTOMS.
Yeast can wear away the lining of your stomach leaking toxins into your system further taxing your immune system.
The above link on Dr Crantons site has some really valuable information on it.
A lot of doctors do not understand the role of Fungus/yeast on the body.
Powdered Nystatin along with Oral powdered Amphotericin B is not absorbed through the stomach and is safe.
Personally I use the Oral Nystatin to irrigate my sinus and I let the powder dissolve in my mouth and it helps a great deal, I am hoping though that I do not have to do this for the rest of my life, and in the meantime I am learning thatmany doctors once they get thier degree do not aquaint themselves to new discoveries in medicine.
So far Ray in my 3 years experience of constant research and trails , the combination of the irrigation by way of water pik stationed inside the mouth and coming out of the nose is best.
Get yourself a water pik and a gentle sinus cleaner tip,*NOT the Grossan* position it deep in your throat where the sinus connects and while the water is coming out also blow. I use other methods of irrigation and for some reason, maybe its the directional flow, this one works best.
You must prevent that drip from your sinus to go into your system.
These are the 2 issues that I battle with daily, the fungal colonization in my sinus and the fact that this drip wreaks havoc in my whole body.
If I ever stop irrigatiing my nose, I notice a very quick difference in my body resulting in edema- that is when the body goes into slight shock and retains water because of the toxic overload.
I know from what my own body tells me that whatever is dripping from my sinus is toxic.
Ray ask your doctor if you can add Oral Nystatin powder to your treatment.
Paddock and medisca makes it, it is a very old and known to be safe medicine when taken orally and use to irrigate, I think when dealing with fungus, you need to attack it in all directions, triple therapy with medicines, diet, environment and natural supplements. CaNDEX IS ONE I have heard good reviews.
ONE LAST AND VERY IMPORTANT THING, There is a oral irrigator which is sort of hard to get but possible,Its called Ozone dental jet. It generates ozone to clean teeth, I am in the process of trying to get this , because ozone is a well known way to kill fungus, I am thinking using this device via sinus would be a really good and drug free way to kill the fungus.
Good luck

[Ray]

Morganna, Wow thanks for the info you sure seem to have done your research I will ask my Dr about nysatin. Oh by the way (congrats on your Yankees I see your from NY ) I am looking forward to the Tigers and Yankees playoff series I see coming, as I am from the burbs of the D
thanks again
Ray

[marie]

Dr Girish Mahajan wrote:

Any latest review on current antifungal scenario?
Thanks
[e-mail]

i am just beginning to take fluconazole 30 mg twice a day, in a nasal lavage... for allergic fungal eosinophilic rhinosinusitis..... i felt better the next day.. i am on it one week... thanks for all your comments and info.

[Morganna]

Marie;
I am glad it is helping you, I must tell you something important that I learned, Do not stop the medication or irrigation just because you THINK you are better, because if the fungus isn't Completely killed it will come back and become more resistant to medication !
I suggest even though you feel better, stay away from alcohol especially wine,and beer, clean out all possible sources of mold and fungus from your environment and diet for as long as possible ,and continue to irrigate your sinus with simple saline water as you feel needed or at least ocasionally.
good luck to you.

[Susan in Virginia]

I have just come across this site. I had sinus surgery this summer. I am still not feeling better and my doctor told me on Monday that he feels I have a sinus fungal infection. I am very interested in the Cave Man Diet and irrigate my sinuses daily. Can you let me know a good site to remove the mold from my environment? I live in a pretty old house and I suspect there is mold present. Thanks for all the great information on this site. I have looked at Dr. Crantons site. Please advise what to ask my doctor for an effective nasal rinse. Thank you.