Sahil was initially on Ketoconozole for three months and then we decided to go off it. In the meantime we had an Organic acid panel done from the Laboratoire Phillipe Auguste(4) in Paris and he had also tested positive for Clostridia during this period. The Clostridia/ anaerobic bacteria markers in this case was 3,4-diOH Benzoate and 3,4OH Phenyl Propionate, both elevated well beyond normal range. He was put on Flagyl.
I was really scared – the one time recently i had taken Flagyl it had caused me so much discomfort that i thought i was dying and going to hell on earth, maybe that was my die off reaction but i had thought that it was the medicine. Dan assured me that children take to it quite well, better than adults, when i shared this with him.
The day after we started Flagyl i saw the most wonderful stool i had ever seen. solid, shapely, odourless. And yes then the die off started……… again the violence and aggression. It lasted 4-5 days and nothing helped except the thought that this too will pass.
After the die off- many things disappeared from his behavior. Aggression, stubbornness, sound sensitivity, fear of being in crowded places. So I realized all these were Clostridia Dificile related. Unfortunately, unlike Yeast which responds to many natural substances Clostridia basically responds to prescription drugs such as Flagyl and Vancomycin. Other treatments: It gets crowded out by Probiotics and by Yeast and it gets flattened by HBOT at high pressures. (2)
And unfortunately unless treated it can come back very fast- anywhere between a week to a couple of months. It brings along with it bag and baggage the “Clostridia behaviors” Most parents whose kids have both would prefer the Yeast behaviors anyday.
The Yeast behaviors we have seen are like the giggling, silliness, hyperactivity, shrieking, precocious sexual behavior. The Clostridia behaviors we saw were aggression, loud guttural noises,extreme destructiveness, oversensitivity to sound, crowds, new situations leading to out of control behavior.
When both Yeast and Clostridia coexist in the gut, they have a kind of malevolent balance existing whereby treating anyone of these will lead to the other to over grow. A die off happens- and the Yeast will feed off the dead Clostridia, and the Clostridia will in turn feed off the dead Yeast. So a good attack plan always has to take both adversaries into account. The good probiotics crowd out both.
Life in the Gut…
The problems with capsule probiotics is that how ever much you may give only a part of this repopulates the gut and the gut is actually a massive length; the small intestine is about 20 feet long and the large intestine is 7 feet long.
“The first bacteria in the gut is received from the mother during birth. Later, more bacteria comes from the outside environment, especially from the diet.
By the time a person reaches adulthood, he or she would have about 100 trillion, or 100,000,000,000,000 bacteria in the intestimes – which is more than 10 times the number of human cells in the body.”(1)
“The use of antibiotics destroys both friendly and harmful bacteria. It often causes more harm than good by creating an ‘empty’ environment whereby harmful bacteria, as well as yeast, can multiply more quickly and easily.
In recent years, there has been growing interest in the use of probiotics as a natural way to restore the balance of friendly bacteria in the guts. “(1)
Other problems that should be taken into account is that strong natural antifungals like Grapefruit seed extract also kill some of the beneflora- so if doing naturals on a rotation basis, then care should be taken that this is taken into account especially in the timing of the supplements.
HBOT and the Gut
We stopped Flagyl after 2 months and started HBOT @1.75 atm after 9 days. 3 days after starting the HBOT we saw terrible hyperactivity. Initially we thought that this was a reaction to an increase in the P5P supplement(activated B6) which we had also done at that time – but in retrospect there was probably a Clostridia die off also and it lasted about 4-5 days.
In the mistaken illusion that we had beaten the Yeast, we stopped the Ketoconozole two weeks after stopping Flagyl, i.e. less than a week into HBOT. Big Mistake.
The one thing that we can be sure of when it comes to HBOT- it stirs up the Yeast. Dan told me he thought this was because it killed the clostridia and gave Yeast more room to multiply. But we saw Yeast symptoms from the very first round of HBOT that we did, well before any clostridia symptoms ever showed in Sahil. So some other mechanism may also be at work
They are back…
To cut a long story short- by the end of his 20 dives Sahil was showing classic cravings for sweets and carbs(a common indicator for both Yeast and Clostridia) put on rotation of natural antifungals such as Yeast Aid and garlic. With Yeast Aid, Sahil actually had a nearly 8 day die off and when it got over he was put on raw garlic – after 4 days we started him on Nystatin and he had another 4 day die off. I think the die offs continue much longer for weaker antifungals. That’s why the Ketoconozole had a 5 day die off but the Yeast aid-garlic-Nystatin had a 13 day die off. Obviously the Yeast was flaring and this may have been due to the Clostridia die off during HBOT.
A little over two weeks after starting Nystatin we had to restart Flagyl because the Clostridia behaviors had returned in full force. Obviously the problem was in control as long as he was on medication and resurged as soon as he was off the medication, and this was despite upping his his probiotic capsule intake to about 90 billion cfu’s.This was when we decided to alter Sahil’s diet in order to tackle the problem.
We took him off all complex carbs as these feed both the Yeast and the Clostridia. He was essentially put on a diet of protein, vegetables, lentils,fruit and yoghurt and honey. What did we take out? Well rice, bread, almost all cereals, sugar.
He was on the medication and the diet, and still not back to being calm. At this time we started removing supplements that might be increasing his hyperactivity by causing some disagreeable internal reactions. He was being chelated through D-penicillinamine so that was removed. We also observed that he was more hyper after an mb12 shot so that was also removed. There was an increase in problem behaviors each time a supplement was removed and a subsequent adjustment period which varied from between a week to two weeks, finally he seemed to be back in a better place. It was frustrating to see that despite being on a tight diet which did not allow much feeding to these mal organisms and being on requisite medication we continued to see some behaviors. He was banging his chin with his fist and hitting hs ears and humming.
Infection and Augmentin
He managed to put a pin in one of his fingers and infect it so he was promptly put on a round of Augmentin. Antibiotics in this class are renowned annihilators of our carefully cultured probiotic microbes
Fermented Coconut Water
Scared that we would have a resurgence of Yeast/Clostridia because of this and out of desperation i started a natural probiotic drink that i had read about on the internet fermented coconut water/ Coconut Kefir (5)
It was amazing- So much so that i will write in detail about this drink separately. The humming, hitting ears and chin just disappeared.
Success and the Way Forward….
I think our multi pronged attack had finally borne fruit- we knew the way forward – a)mild medication/naturals/ stronger medications which could be pulsed b)low complex carb diet c)High potency Probiotic supplements d) fermented coconut water.
The exception to this is when we do HBOT, because then we need to continuously use Ketoconozole as he is too vulnerable to yeast during this treatment.
He has been off Flagyl for quite some time succesfully using Coconut Kefir and Culturelle brand of probiotics. I also started a separate batch of coconut water fermented with Culturelle and that seems to work as well or even better than the Culturelle. He is on Nystatin and I plan to take him off it and see if his body can truly do it on probiotics alone.
So watch this space!!!!!!!!