Last updated February 1, 2019 by Lisa Richards, CNC   Reviewed by Dr Eric Wood, ND.

Candida Die-Off: Symptoms And Treatment

Woman experiencing Die-Off

A Candida elimination diet will likely involve some big changes in your lifestyle, but it can be made much more difficult by something called Candida Die-Off. This is particularly important because die-off symptoms are one of the biggest reasons why people prematurely abandon their Candida diet.

Being prepared will help you to avoid this ‘bump’ in your treatment and complete your recovery successfully.

What is Candida Die-Off? When large numbers of yeast and fungal cells are rapidly killed, a die-off (or Herxheimer reaction) occurs and metabolic by-products are released into the body.

The amount of Candida cells being killed makes this very different from the regular cell elimination that forms part of the Candida albicans lifecycle. When these cells die, they release all the noxious substances that they contain, including (according to some sources) at least 79 different toxins. This long list of toxic substances includes ethanol, uric acid, and acetaldehyde.

Acetaldehyde, as a known neurotoxin, has a whole host of detrimental effects on your health and wellbeing. It can impair your brain function and even kill brain cells. Your endocrine, immune and respiratory systems can all be affected, and it also damages the membranes of your red blood cells, reducing their ability to carry oxygen round the body.

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You can see how excess acetaldehyde can quickly contribute to non-specific symptoms like brain fog and fatigue. These noxious by-products also cause allergic reactions and inflammation that lead to an array of undesirable symptoms.

Candida Die-Off symptoms will vary from person to person, as each will have different degrees and types of infestation.

A Die-off reaction is more than just the liver becoming overwhelmed. It is when the whole detoxification system (lymphatics/emunctories, liver, kidneys, bowels, etc.) are inflamed from these toxic byproducts and unable to clear them fast enough.

If you are having severe Die-Off symptoms, there are a couple of important things that you can do. Firstly, slow down your treatment and reduce your dosage of probiotics and antifungals. Secondly, consider adding a liver-supportive supplement like milk thistle, or increasing your dosage of the one that you are already taking. The liver is one of your main pathways for eliminating toxins, and the Die-Off symptoms mean that it is being overwhelmed.

Die-Off Symptoms

The symptoms of Candida Die-Off are sometimes compared to those of a common cold or seasonal allergies, but can be quite different from person by person. The toxic byproducts of Candida tend to cause inflammation, which can lead to a stuffy nose, blocked sinuses, and other allergy-like symptoms.

Metabolites like the neurotoxin acetaldehyde can also cause symptoms like brain fog, headaches, fatigue, and nausea. Remember that these toxins are stressing your liver too, so having a sore abdomen (especially in the liver region) is also possible.

In our Ultimate Candida Diet program, we have a whole chapter devoted to recognizing and treating the signs of Candida Die-Off. In the meantime, here are a few of the symptoms you might experience during a Die-Off reaction (otherwise known as a Herxheimer reaction).

  • Nausea
  • Headache, fatigue, dizziness
  • Swollen glands
  • Bloating, gas, constipation or diarrhea
  • Increased joint or muscle pain
  • Elevated heart rate
  • Chills, cold feeling in your extremities
  • Body itchiness, hives or rashes
  • Sweating
  • Fever
  • Skin breakouts
  • Recurring vaginal, prostate and sinus infections

The Die-Off, or Herxheimer reaction, has been well documented in research on antifungal therapies. One study (see here) of the commercial antifungal Nystatin found the following:

“One phenomenon deserving emphasis is seen occasionally when therapy is initiated. It suggests the Herxheimer reaction … The reaction is usually limited to a flu-like syndrome of mild generalized aching and low-grade fever, but may also encompass an exacerbation of the patient’s allergic manifestations.”

Coping With Candida Die-Off

You might think that a severe Die-Off reaction means that you are fighting your Candida effectively, but this is not the case. In fact, it’s far better to take your treatment slow and avoid these symptoms entirely.

The stress that Die-Off causes to your internal organs and immune system can slow down your Candida treatment. These symptoms normally clear up within a week or so, but could last a little longer. There are a few things you can do to diminish this reaction, expel the toxins more quickly, and get back on track with your treatment. Our program contains a more comprehensive list of Die-Off treatments, but here is a brief list.

  • Take a liver-supportive supplement like molybdenum, NAC, or milk thistle to help your liver process and expel the Candida toxins.
    Molybdenum in particular is very useful for those suffering from Die-Off. It is needed for your body to produce enzymes that convert the neurotoxin acetaldehyde into acetic acid, which is then expelled by your body or even converted into helpful digestive enzymes. You can find an updated list of detox supplement recommendations here
  • Cut back or temporarily discontinue your antifungal supplements.
    Most antifungals work by breaking down the walls of the Candida yeast cells, which then release the many toxins that the Candida colonies have been producing. Reducing your antifungal dosage will cut down the amount of toxins being released into your bloodstream. When you feel better, you can start to increase it again.
  • Reduce your dosage of probiotics.
    A course of good probiotics will repopulate your gut, crowd out the Candida, restore your stomach acidity, and boost your immune system. Probiotics are less likely than antifungals to cause Die-Off, but if you start to experience increased symptoms you can temporarily reduce your dosage.
  • Increase water intake to flush out the toxins faster.
    If you want to feel better, all those byproducts that are released by the Candida yeast need to leave your body. You can give them a push by drinking more water.
  • Slow down and rest as much as possible.
    Stress can weaken your adrenals and reduce your body’s ability to fight pathogens like a fungal infection. And a Die-Off reaction will only increase the physiological and emotional stress that you are facing. Relaxing and taking some personal time will help your immune system to do what it was designed to do.
  • Try some alternative detox methods like skin brushing, saunas, or contrast showers.
    Most of these treatments are designed to increase your circulatory and lymphatic systems. They help you to expel the toxins that the dying Candida cells have released.
  • Take 1000 mg of Vitamin C twice daily.
    This multi-purpose vitamin boosts your adrenals and helps restore your immune system to health.

How To Avoid Candida Die-Off

It’s tempting to believe that Die-Off symptoms are a sign from your body that your treatment is working. This is not usually the case. By rushing the Candida diet, and not giving your body time to adapt to each stage, you are putting your body under much more stress than is healthy for a successful recovery. Die-Off symptoms usually lead to a slower recovery, not a faster one.

The best advice I can give you, therefore, is to avoid Candida Die-Off in the first place. The best way to do this is to follow a well designed Candida plan that uses a staggered approach to introducing dietary changes, probiotics, and any other elements of the treatment. The treatment plan that I put together with Dr Eric Wood (you can find it here) uses a carefully designed timetable and clear instructions to avoid the possibility of a Die-Off reaction. It also details the best liver-supportive supplements and toxin binders that you might want to consider to prevent a Die-Off reaction from happening.

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