Last year, in my blog post about antibiotics, I wrote that I thought I should do a dedicated post about antifungals at some point. I’ve decided to do that this month! 

I am not going to talk about gut health in any detail, because I have already done that at length in previous blog posts.  If you haven’t seen those and are unsure why I place so much importance on gut health in interstitial cystitis and other inflammatory conditions, you can check out:

Tiny Tips for Dietary Approaches to Chronic Health Issues

Are Interstitial Cystitis and Leaky Gut Connected?

Food Intolerance Testing for Chronic Health Issues

How to Look After Yourself During and After Antibiotics

I’m going to assume that you already know about the role of the gut in maintaining our general health and get straight onto the subject at hand. 

Antifungals are used to treat all sorts of fungal and yeast conditions, including:

• Candidiasis, also known as candida, which can be present on the skin, in the mucosal membranes (for example, in vaginal thrush and oral thrush) and in the intestinal tract.
• Ringworm
• Athlete’s foot
• Fungal toenail infections
• Fungal pneumonia
• Aspergillosis
• Fungal cystitis

Interestingly, there is research to suggest that during interstitial cystitis flares, higher levels of fungi rather than bacteria are present in patient urine.  Candida was one of the species particularly found and I have often advised people with interstitial cystitis to research and address leaky gut and candida as part of their healing journey. 

It is important to say at the outset that antifungals are unlikely to be effective unless you are willing to also make some dietary changes, if only for a few months.  I have used the analogy of shoes rubbing blisters on feet before – you might use plasters and soothing creams, but you would not dream of concluding that these did not help if you continued to wear the same offending shoes every day.  You would stop wearing the shoes for a while and then restrict them to appropriate activities – nobody climbs Everest in stilettos and for good reason!  If you begin taking antifungals, but continue to exist on a diet of refined carbohydrates, sugars and alcohol, any improvements you see will be significantly hampered.  To give them the best possible chance of doing the most possible good, you really do need to step away from the chocolate muffins, pasta, and chips for a while. 

It is also important to say that when you begin a regime of antifungals, or change from one antifungal to another, you should expect to experience some die off symptoms.  In my opinion, unless you start things off with incredibly cautious doses and build up very slowly, a complete lack of die off symptoms is indicative of an ineffective antifungal.  Die off symptoms occur when pathogenic cells die and release glycoconjugates that trigger inflammatory responses as the immune system moves to ‘clean up’ the dead cells.  All of the dead cells and debris that is created in the clean-up has to leave the body somehow.  The best way for this to happen is via the bowels, hence why starting antifungals so often causes bloating, wind, or mucus in the stools. However, in cases of intestinal permeability (which most people with intestinal fungal overgrowths like candida have), some of the toxins can also enter the bloodstream and trigger other kinds of die off reactions.  These might include headaches, rashes, feeling feverish, general aches and pains, and perhaps a worsening of your own particular inflammatory condition. 

Personally I quite like to experience die off symptoms, because I feel like I am achieving some sort of progress.  For me, they normally entail bloating and passing mucus, perhaps tummy ache, waking up earlier than usual (and not in the well-rested, satisfying way), and possibly a worsening of anxiety.  They generally come on about two days into a new antifungal and would normally last not more than a few days now, although I do recall being that way for two or three weeks during my first antifungal experience.  I don’t get any kind of general aches or fevers.  If you don’t like the idea of any kind of die off, you can start very low and slow and you can also take steps to support your body’s detoxification pathways (which I won’t discuss here).  I tend to just go for it and then I can make progress more quickly! 

I have personally never found die off reactions to be that bad, in spite of my very poor gut health when I first attempted an antifungal regime.  I only warn you about them so that you will be aware of them and won’t assume that a minor die off reaction is a bad thing.  It could actually be a promising sign that you are on the right track!  Obviously, consult with a qualified healthcare practitioner and stop taking whatever it is you’re taking if the reaction is too dramatic or does not go away!  I don’t want you going the other way and stoically ignoring an anaphylactic shock or something just because I told you to expect some die off!  

In this post, we will only be discussing natural antifungals that are available to buy over the counter.  If you are able to get concrete diagnosis of a fungal infection (for example, by stool or urine analysis, or because there is visible evidence of one), your doctor might be willing to prescribe you pharmaceutical antifungals as well. 

Grapefruit seed extract

This used to be one of my favourites, because I found it very effective, but not harsh.  I used it in drop form from a brand called Higher Nature, although the formulation has since changed and I now have NutriBiotic liquid concentrate.  I used to take 10-12 drops in a full glass of water, two or three times a day on an empty stomach.  The taste is incredibly bitter and the drops MUST we well diluted and mixed, or else they will burn your throat.  I find that they mix easily and I have no issue with taking them, as long as I have a tiny bit of dark chocolate to take away the taste right after!  I have never tried capsules, although perhaps this is an oversight, as a small trial mentioned here seemed to show better results with capsules than drops.  I cannot find reference to the original trial on the usual clinical study websites, but it is worth mentioning that the doses used of both drops and capsules seem to me very conservative. 

I really rate grapefruit seed extract and for me it strikes a great balance of just enough die off to know that something must be happening, but without feeling like my digestive tract is being aggravated.  It’s a handy thing to have in the medicine cabinet, because it also has antiviral and antibacterial properties, meaning it is great to take at the first sign of a cold or infection.  It does not irritate my bladder, so no need to worry about that, although please check the ingredients on any brand you consider just in case they have included ascorbic acid.  Please be aware that grapefruit is known to interact with other medications, so do not try this one without medical advice if you are taking prescribed medication. 

Oregano oil

I tried this in drop form, but did not like it because it felt a bit harsh for me.  I know loads of people really recommend it, but I couldn’t get the oil to mix well enough and it made my throat feel quite sore.  SC Nutra has just launched a very clean, wild oregano oil capsule, which is a great way to avoid the burn of oregano oil drops.  I have not tried the capsules yet, but they are made from organic oregano oil in a base of organic extra virgin olive oil, encased in a vegan softgel. 

Anecdotally, interstitial cystitis patients report success with oregano oil.  Aside from being an antifungal, oregano oil also has antibacterial and antiviral properties and has been shown to be effective against drug-resistant biofilm-forming uropathogens – in other words, stubborn urinary tract infections.  Beyond antimicrobial properties, oregano oil might also have antioxidant and anti-inflammatory properties, as discussed in this article.  The combination of antifungal, antibacterial and anti-inflammatory effects makes oregano oil a great choice for interstitial cystitis patients, in my opinion.  Oregano oil is also effective against candida, as discussed in this study. 

I no longer take antifungals every day, but now and again I have a quick blast on them, just as a sort of ongoing maintenance for my gut health.  I will definitely be trying SC Nutra Oregano Oil Capsules at some point and I am glad to have some on hand for next time colds and flu are doing the rounds! 

Caprylic acid and related products

First let’s clear up some confusion.  Coconut oil and caprylic acid are not the same.  Nor are coconut oil and medium chain triglycerides.  Rather, coconut oil contains medium chain triglycerides and medium chain triglycerides contain caprylic acid. Although coconut oil does therefore contain caprylic acid and has some antifungal properties, a dedicated caprylic acid supplement will contain far more…well, caprylic acid! 

Coconut oil contains other constituents besides caprylic acid, including capric acid, which also have antifungal effects, so some people do use coconut oil as an antifungal in its own right.  Personally, I think it would be difficult for most people to eat enough of it to pack a real antifungal punch without getting fat, as it coconut oil is rather calorific!  (Calm down, extreme keto people – I’m talking to ‘most’ people, not to you.) 

I really like caprylic acid, because to me it seemed both potent and gentle.  It produced a reassuring amount of die off symptoms, but in no way seemed to aggravate my digestive tract.  If one takes medium chain triglycerides, they have none of the throat burn of grapefruit seed extract or oregano oil.  I took my caprylic acid in the form of Biocare Mycopryl 680 capsules and I was perfectly happy with them.  I would not hesitate to purchase them again. 

A 2011 study showed that caprylic acid was effective at reducing symptoms of intractable frequent urination, including where mixed infections of candida albicans, helicobacter pylori and cytomegalovirus were present.  (Could it be worth getting checked for helicobacter if you have frequent urination issues that have not responded to other treatments?  Just a thought.)  In a 2019 study, caprylic acid was also found to work in synergy with carvacrol and thymol to be effective against candida.  Incidentally, carvacrol can be found in SC Nutra Oregano Oil Capsules, meaning that the latter might pair well with a caprylic acid supplement.  Caprylic acid is also thought to have antibacterial and anti-inflammatory properties, making it another great option for those with interstitial cystitis. 

Somewhat linked to caprylic acid is monolaurin, which comes from lauric acid, also found in coconut oil.  While doing research for this post, I discovered a supplement called Lauricidin, a pure monolaurin product derived from coconut oil.  I have never used Lauricidin, but it apparently supports a strong immune system and helps to maintain a normal, healthy balance of intestinal flora and yeast.  It has antifungal, antiviral and antibacterial qualities and gains positive reviews for use in candida.  It is also purported to be useful against UTIs that are not caused by E. coli.  As I say, I have not personally tried this product, but now that it has my attention, I will certainly keep it in mind for future use! 

Garlic

Garlic is a powerful antifungal, antibacterial, antiviral, antioxidant, immune booster and prebiotic, making it a great choice for those with gut dysbiosis and interstitial cystitis.  Garlic is effective against candida as shown in this study and this one. 

Unfortunately, most of the medicinal properties of garlic are found in the stinky bit, so if you were thinking of rushing off to buy some odourless garlic pearls, just wait a minute!  One of the main active components of garlic is allicin and it is possible to buy garlic supplements with specified levels of allicin in them.  However, nothing really compares to eating fresh garlic if you want maximum efficacy.  I’ve always had high-strength garlic tablets in the house and I used to take one of these daily when I first started to address candida many years ago.  I would also take them for a few days if I had a cold.  By chance one time, I ate something very garlicky when I also had a cold and I was astonished at how much stronger the effects were.  It unblocked my nose all right – I could hardly sleep for needing to blow it every few minutes! 

The fact that garlic is best fresh means that a little ingenuity will be required to use it as an antifungal.  I personally find that raw garlic burns and gives digestive discomfort if it is not well mixed with adequate quantities of other ingredients.  However, over-cooking it stops it from being effective.  I wish I had a good solution for you, but I don’t really.  Back when I still ate dairy and bread, I would mix it with butter and have it on toast or mashed into a potato.  I do use it in my garlic sprouts, adding it right at the end and cooking it for only a minute or two.  Possibly you’d like to make some sort of salad dressing with it or add it to a curry or chilli immediately before serving.  If you are going to use fresh garlic for its medicinal properties, you’re going to need to eat it and it’s going to make you smell garlicky!  There is no way around that!  Even good quality allicin supplements will make you smell. 

I believe people shove garlic cloves into all sorts of orifices to address all sorts of problems.  Given how garlic burns the mouth if too much is eaten on its own, I do not advocate the chewing of whole, raw cloves, nor the inserting of them into bodily nooks and crannies.  I’ve never tried it and I don’t think you should either! 

Berberine

Berberine is a constituent of various plants, including Berberis vulgaris/ Mahonia aquafolium (barberry/Oregon grape) and Hydrastis canadensis (goldenseal).  It has a plethora of beneficial actions, including antifungal, antiviral, antibacterial, anti-inflammatory, anticancer, and blood sugar balancing.  If you are interested in the latter two properties, I would recommend you to buy a copy of ‘How to Starve Cancer and then Kill It with Ferroptosis’ by Jane McLelland, which goes into these in detail.  You could also read this study. 

Berberine was found to be effective against candida in this 2016 study and herbalists use Berberis vulgaris for candida, helicobacter, and urinary tract infections.  

I have been searching for a berberine supplement for a while, but until recently had not found one that I thought suitable.  I could take herbal tincture containing berberine, but I already take herbal tincture daily and as it contains alcohol, which does not agree with me, I did not want to add any more into the mix.  I was therefore delighted to find a clean, high-potency berberine capsule available at British Supplements.  I have incorporated this into my daily regime since reading How To Starve Cancer…’ and if I ever feel a cold coming on or want to do a bit of an antifungal protocol again, I plan to take extra! 

Aloe vera

Well, I had to mention this one, didn’t I?!  Obviously you know that aloe vera has been studied in interstitial cystitis – it’s why most of you come to Tiny Pioneer and read these blogs!  However, aloe does also have antibacterial, antiviral, immune boosting, and antifungal properties.  Although its antifungal activity has not been studied extensively, aloe has been shown to be effective against candida as discussed in this study.  

I would describe aloe vera as quite a mild and gentle antifungal.  In my opinion, if one is addressing a serious yeast infection, it will not be enough on its own.  However, because it is mild, it does not yield die off symptoms as noticeable as some of the other antifungals mentioned.  It is also quite soothing to the digestive tract because of its mucilaginous properties.  It might therefore be a good starter antifungal in those who want to start things very cautiously, as well as being a great add-on product as part of a more comprehensive antifungal regime. 

Aloe vera’s antibacterial and antifungal actions are the reason why you might experience a bit of bloating, wind or tummy ache when you first start a high-potency aloe supplement, even when the anthraquinone laxatives have been removed.  You should not experience diarrhoea and any tummy discomfort should wear off within a week or so of starting. 

N-Acetyl Cysteine (NAC)

NAC is very much a hot product right now, because of its possible effects against Covid-19 and other respiratory tract infections.  It acts as a precursor to glutathione, which is an important antioxidant and helps in the body’s detoxification processes.  NAC is also an antifungal and high concentrations have been shown to be effective against candida biofilms. It has also been shown to reduce the recurrence of preterm births in women with bacterial vaginosis and is currently being studied as a treatment option for bacterial vaginosis. 

I use Solgar 600mg NAC and I have found it perfectly bladder friendly.  I don’t really use it for its antifungal effects – I wanted it for its possible role in healing leaky gut and I wanted to have some on hand during the cold and flu season in case of respiratory tract infections. 

Right, I’m getting a bit bored of stalking PubMed and NCBI for clinical research now!  So I think I will leave this list here and maybe do another post with a few more antifungals in the future! 

Before I sign off, I just want to make a couple of extra points on the subject of antifungals.  Firstly, I would tend to avoid any products that talk about ‘proprietary blends’ without actually telling you how much of what ingredient is inside.  To be really effective, most antifungals have to be taken in fairly large doses for a fairly long period of time (think in terms of months rather than days).  The trouble with a proprietary blend that stuffs three or four different antifungals into one product is that you’re getting only small doses of each.  In my opinion, it is much better to buy each ingredient separately and take a decent whack of each. 

There is some discussion around whether it is best to stick to the same antifungal or rotate them.  I subscribe to the school of thought that you should be taking at least two or three different ones to address a chronic yeast or fungal infection.  If you can find enough different ones that you can tolerate to also manage to rotate them about a bit every couple of months, then I do not see that this will do any harm.  Be prepared to experience a new period of die off symptoms (albeit the first is usually the most noticeable) every time you swap things about.  Personally, and without evidence other than my own experiences to support the sentiment, I think it is more important to take good doses of a range of different antifungals than to rotate.  If, however, you are only going to take one at once, then I would definitely rotate every two to six months.  I feel like if you take a few at once, resistance is less likely to develop.  If you take only one at once, then I think rotating will help to wipe out any resistant beasts further down the line! 

I feel bad that I have only included seven different antifungals, so we definitely need a Part 2 on this, but I don’t know whether I’ll do it as next month’s post, or wait a while.  In the meantime, I hope you will have found some useful information here! 

Wishing you the best of health,

Tiny x

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