Last updated March 4, 2022 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. This often occurs when introducing antifungal or probiotic foods and supplements into your regimen. (1)

The sheer number 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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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. (2, 3)

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, add a liver-supportive supplement like milk thistle, or increase 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 likely overwhelmed.

Candida 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 of the commercial antifungal Nystatin found that “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.” (4)

7 Ways To Cope 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 cleanse 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.

1. Look After Your Liver

Taking a liver support supplement during your Candida treatment is a must. Look for a high-quality product that includes molybdenum and milk thistle, as these are the best-known natural medicines to boost your liver’s functioning capacity. They will also help to flush out Candida-related toxins.

Milk Thistle extract is a powerful liver medicine that can enhance liver function more than any other herb. It increases production of glutathione, which is the body’s most important antioxidant. Glutathione helps to ward off damage from free radicals that are generated by our environment. (5)

Molybdenum is especially useful during the Die-Off periods, as it helps your body to produce enzymes that convert the neurotoxin acetaldehyde into acetic acids. This can then be flushed out of the body, or else converted into helpful digestive enzymes.

Milk thistle has been used in traditional medicine to treat liver or biliary disorders for centuries, thanks to this superior antioxidant activity. As a major bonus, the silibinin content of milk thistle has been reported to have its own antifungal effect, due to its ‘fungal apoptosis’ (killing of yeast cells) against Candida albicans. This makes it an excellent choice for your Candida treatment! (6)

2. Moderate Your Antifungal Treatment

Cutting back on the amount of natural antifungals in your treatment regime can reduce your symptoms. Although you may think that you’re doing the right thing by attacking your Candida, you’ll also be suffering the effects of many toxins.

Antifungal supplements work by breaking down the walls and biofilms of the Candida yeast cells, which then release all sorts of toxins into your bloodstream. The physical symptoms of all that junk can be nasty! That’s why it can really help to dial back your dosage for a short time. When your body has recovered somewhat, you can build up your dosage again.

3. Moderate Your Probiotics

Taking probiotics is a must. A daily dose of healthy bacteria will help to rebalance your gut and crowd out the pathogenic yeast that have led to your Candida overgrowth.

Finding a good probiotic for Candida can also help with digestion, reducing uncomfortable symptoms such as bloating and diarrhea. They work to break down the food that you’re eating so that you obtain the nutrients you need from your diet.

Most importantly, probiotics will help to boost your immune system. Because up to 80 percent of your immune system resides in the cells lining your gut, the right balance of healthy bacteria in your gut is crucial.

However, although probiotics are unlikely to produce the uncomfortable symptoms associated with Candida Die-Off, they can temporarily disrupt your digestive system. While establishing themselves in the gut, probiotics can cause a little discomfort such as bloating. These symptoms are temporary, but it may help to reduce your dosage if you suspect you are experiencing Candida Die-off symptoms.

4. Keep Hydrated

Increasing your daily water intake will help to keep those toxins being moved out of your body. All those Candida by-products that are being released as the yeast cells die will be floating around in your bloodstream and lymph. The more water you drink, the faster your kidneys are able to process those toxins and send them out through your urine or sweat.

Aim to drink at least 2-3 liters of pure, filtered water a day. Try carrying a drink bottle around with you at all times to help you remember to keep sipping. A good way to make water more ‘palatable’ is to add a dash of apple cider vinegar and a pinch of Himalayan salt. These are both naturally alkalizing to the body, which may help with the symptoms too.

5. Allow Yourself To Rest As Much As Possible

When you’re stressed, your HPA axis (hypothalamus-pituitary-adrenal glands) is working overtime to keep you alert and functioning. However, the longer your stress goes on for, the harder your HPA axis has to work. This is because your body starts to adapt to the level of ‘stress hormones’ in your system, which means you need more and more of them to have the same benefits. (7)

Eventually, your HPA axis becomes dysfunctional. The result is a weakened immune system and reduced ability to fight off opportunistic pathogens. A Candida infection will be even more difficult to overcome because your body won’t have the energy to defeat those yeasts. What’s worse is that the Die-Off reaction you’re going through can actually increase the physiological and emotional stress that you are facing. The result can be a long, uncomfortable journey that may not even be successful.

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That’s why it’s so important to chill out!

Taking the time to relax and have some time to yourself can be a big help to your immune system. If you can’t get any ‘me time’, cut down on social plans and give yourself a break from intense exercise programs until you start to feel better.

You need to let your body switch from ‘fight or flight’ mode back into ‘rest and digest’ mode in order for the necessary repairs and restoration to take place within your many bodily systems. This can only happen if you allow yourself to step out of your normal stressful routine.

A great way to relax is with yoga or meditation, or even just low-impact exercise such as walking or swimming. Do something you enjoy, such as reading a book or watching Netflix!

6. Try Other Detox Methods

There’s a whole world of detoxification methods out there! Skin brushing, sauna therapy, contrast showers and lymphatic massage can all help your Candida treatment. These methods work by boosting your circulation and lymphatic system, which in turn helps to move toxins through your body to your detoxification organs – the liver and kidneys. The more efficient your circulation, the faster you’ll get rid of those dying Candida cells.

Some studies have shown that sauna therapy not only boosts detoxification but may also increase metabolic function, blood circulation, immune function and many other systemic processes. (8)

Sauna therapy and lymphatic massage is also highly beneficial for boosting the immune system and keeping your tissues nourished. Be sure to drink plenty of extra water while using these treatments, as your output of toxins will be much higher.

7. Take Vitamin C

A twice-daily dose of Vitamin C is an excellent way to support both your adrenal gland function and your immune system.

Research has shown that many cells within the immune system need a regular supply of it in order to function properly. This is especially the case for phagocytes and t-cells, which play a major role in fighting off opportunistic yeasts such as Candida. (9)

Low levels of vitamin C can result in a reduced resistance against certain pathogens, while a regular dose of a quality Vitamin C supplement can enhances several aspects of the immune system. Several studies have found that vitamin C works best as a preventative, but can also reduce the duration of the illnesses such as the common cold.  Daily supplementation with vitamin C is most effective in those who are under physical strain, such as during a Candida Die-Off reaction.

Vitamin C is a powerful antioxidant as well as a nutrient. It can help to neutralize the harmful free radicals that your body may be exposed to during your Candida Die-Off, which will go a long way in helping your system recover. You’ll also be protecting your organs and tissues from cellular damage.

Because vitamin C is water-soluble, your body cannot store what it doesn’t immediately need and will flush out any excess. This  means it can be more effective to take vitamin C in small, regular doses rather than single large ones. Try taking 500mg of Vitamin C twice daily to start with, and see if you can build up over a few weeks.

How To Avoid Candida Die-Off

A well-designed Candida treatment plan aims to make your treatment as fast and easy as possible. However, there are some treatments that advertise cures within such a short period (like 12 hours in one example!) that they are simply not credible.

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.

Going too fast can expose you to a severe Candida Die-Off reaction. This is an unpleasant condition that will make your Candida treatment much more difficult. You can avoid it by following a proper recovery plan and taking it slow.

The symptoms of Candida Die-Off are pretty similar to regular Candida symptoms – in fact they are caused by exactly the same group of toxins. The major difference is that Candida Die-Off is much more intense. This is because instead of being released slowly, as a result of Candida’s metabolic processes, all those byproducts are released at once in a flood of toxicity. Some people who experience Candida Die-Off report nausea, migraines and other very unpleasant symptoms. However, the good news is that if you follow the right diet and treatment plan, you do not need to worry about experiencing Candida Die-Off at all.

Make sure that you don’t make too many large changes at once. That’s why, in our Ultimate Candida Diet treatment plan, Dr Wood and I recommend taking breaks between introducing any new dietary changes, probiotics, or antifungals. This is the safest, easiest method to beat your Candida. Allowing enough time between each phase of the plan allows your liver to adjust and prevents too many Candida toxins from being released at the same time. In our plan we lay out a specific timeline that should keep you from experiencing any Die-Off symptoms at all.

Supplements for Candida Die-Off

A healthy liver is the best defense against Candida Die-off. Your liver is the organ that processes and removes the metabolites released by Candida albicans.

To keep your liver in optimum health, take a good liver-supportive supplement before and during your treatment. Supplements like milk thistle extract and molybdenum are great for eliminating Candida toxins like acetaldehyde, ethanol, and uric acid. They will also reduce the risk of you experiencing Die-Off symptoms when you introduce a new food or move on to the next phase of the treatment plan.

Liver One by Balance ONE is the supplement that I recommend for Candida Die-Off. I helped to formulate it, and it has a range of liver-supportive ingredients.

The first ingredient is milk thistle extract. We used a standardized European milk thistle extract that contains at least 58% silymarin, as well as the 6 most important silymarin isomers – Silybin A and B, silychristin, silydianin, isosilybin A and B.

Other ingredients in Liver One include Molybdenum, Artichoke Leaf, Turmeric Root, Dandelion Root, Beet Root, Ginger Root, Choline, and Selenium.

If you’re suffering from Candida Die-off and looking to get relief from your symptoms, this supplement contains all the scientifically-backed, liver-supportive ingredients that you need.

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  1. Cathy Oliver says:

    I would like to purchase your information in a book. Is that available?

  2. Reese Daniel says:

    Candida Die Off sounds exactly like “Keto Flu” which I have been experiencing for 4 weeks now since starting this Keto diet.

  3. Michelle says:

    What a great page! I am 99% sure I have been dealing with this for about 5 years, and it has slowly turned me into a hypochondriac….thinking there must be something wrong with me having so many odd symptoms that don’t seem to point towards anything else. Until I read up about Candida due to my new recent symptoms, excema on my feet and very slow weight gain without habit change. In the past I have suffered from almost everything on the list except for vaginal issues. I’ve even had what I truly believe was thrush, but the doctor said no, gave me some steroids and sent me in my way. If anyone has attempted to clear this up and has other tips preventing the die off please let me know! I already have the supplements ordered, and plan to start next week. Have already started on probiotics and Milk Thistle. My main concern is, I am still working (not under quarantine) so I MUST keep working…..and I can’t have people thinking I am “sick”. Any tips would be great. And again, thank you for such a thorough informative page!!!!

    1. Lisa Richards says:

      Hi Michelle,
      Thanks for your kind words!
      To completely avoid die-off symptoms, the most important thing is to start slow. Make gradual changes to your diet, and start with low doses of each of the supplements. Your digestive system and liver will be able to cope with these gradual changes much better than if you jump into the different treatments all at once 🙂
      Best, Lisa

    2. Jeanette says:

      Hi Michelle I have suffered going on 4yrs of hell and none of the doctors would help me an I even had one tell me I was crazy an I needed to see a psychiatrist . I have been horribly sick and bizarre symptoms no one could explain and many doctors later . I decided to start research of my own and came up with Systemic yeast ,I then demanded a referral to an infectious disease doctor and sure enough that was what I had !! I am currently taking fluconazol every day and that is really bad for me it can damage my liver but I have felt better , but I have decided to look into a more natural approach . I went to see an herbilist and he put me on Caprylic acid 2-4 a day ,adaptamax 2 day ,capylimune 2-4 a day , stress J 1 – 2 a day and probiotic eleven 2-3 a day . I have yet to get them as I am waiting to get paid . However I have researched what he wants me to take and I have high hopes !! Hope this helps you to know that you are NOT crazy what you are going thru is real ! Sorry you have to go thru this also Mine started in my mouth as well . Oh yea and mouthwash can cause thrush thought you may want that tid bit . I have never used mouthwash however many do. Good luck with you journey please let me know if you have found anything that has helped you !!

      1. Amy says:

        Hello. I was wondering what test was used to verify it was yeast? All the doctors I have contacted here say there is no test for Candida. Thank you Amy

        1. Katie says:

          Hi Amy! I’m not sure what the OP’s test was, but I found out I had Candida with an OAT that I went over with an M.D health coach. If you can find someone who can read an Organic Acids Test, that can help you get an accurate diagnosis.

      2. Gail S says:

        If you get or have thrush in your mouth, buy myrrh liquid in a bottle. It tastes terrible, but it really works. I overcame thrush on my tongue that way once — thrush is contageous; don’t kiss anyone — and I actually put it on my dog’s gums. She hated it, but she had such bad gum disease — I rescued her and she was badly neglected — that I didn’t know what else to do. It worked for my dog as well. I don’t know how well myrrh toothpaste would work, however. Probably not that well.

    3. Tracy says:

      Michelle I agree. I was dealing with the same thing and no diagnosis. Only an elevated platelet level that 3 doctors blew off. It I had an endoscopy done and I had a yeast infection in my esophagus. I got it from my asthma steroid inhaler. I have been sick for 2 years for sure. Maybe longer and it was just so mild I didn’t realize. I am on antibiotics and I’ve been so so plant based vegan for a few years but I have seriously stepped it up and am seriously changing my diet to kill off the candida. It’s kills for sure. Scary

    4. Donna says:

      I used diflucan about 2 weeks and it completely got rid of my candida. I don’t know if they still make it. I’ve been taking colloidal silver because it kills most all bacteria, fungus, and I had a recurrence of Candida rash on my chest I believe because it was clearing out from my system. I took 12 mg of ivermectin for three days and it was almost gone. Topically I used the colloidal silver and it Was very good about clearing the rash. One thing I did several times a day was get under the shower as hot as I could stand it because that can kill the fungus and then finished with cold water/ice packs. This is a great reliever for vaginal yeast infectionsEspecially if you do it three times or more a day. Do it at night when it first starts and you will be about 70% better the next morning and several times the second day and it will be gone by the third morning. By the way cortisol will absolutely stop the itching Best wishes

  4. Emily says:

    Die off can be so dangerous. I just returned from a stay in the ER after I passed out in the bathroom and fell on my back. This was during the detox part of the program. I had to eat carbs when I got home from the hospital because it could have happened again, I was that messed up,m. So bummed I had to compromise, but I know I’m lucky just to be alive after that fall! (Which happened on my 40th birthday, btw.) Am now stuck on the couch in serious pain from my fall. So be careful and take it slow! (Btw, neither the doctor or paramedic had ever heard of candida die off and dismissed it.)

  5. Mark says:

    I’d like to add to the discussion. My body is VERY sensitive to things it desperately needs but never got. When I first tried MSM, I started at 1/2 the recommended dose. I developed EPIC nausea that I treated with Zofran. I had to start with 1/8 the recommended dose and gradually work up.

    I noticed someone mentironed Myrrh. Frankinse AKA boswellia is also pretty powerful. However even at 1/8 recommended dose my joints ached like mad and I felt like I had the flu.

    Vitamin c is a good start and can pitch hit until the big guns arrive. I take 4 NAC caps with my candida busting cocktail. The liver eventually turns it into glutathione. When I do that, no herx.

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