Metronidazole & Fluconazole (Combination therapy for BB)

[KeepTrying09]

I know it's more difficult for those living in the West to cut out things like bread and pasta from their diets. Bread is like the staple food in the West. It's a bit easier for me since I live in the East now, where rice, not bread, is the staple food. But luckily rice is widely available to buy in the West too. I don't eat white rice though, I eat brown rice. Brown rice is high in fiber which is good for digestion, and it's also good because fiber feeds the good bacteria in your gut. Plus it's filling, so you don't get hungry as you would on most other things. I would try adding brown rice to your diet. You can eat it with just about anything.

But, if you simply can't live with out bread or pasta, there are solutions. If you do a google search for "yeast free bread" you will find a ton of online stores that sell this product. You might even get lucky and find a shop in your area that offers yeast free bread, that way you don't have to order it from online. Also, if you like to eat pasta noodles, you can substitute with rice noodles, which are made from rice.

Hopefully you have a health food shop in your area where you might be able to find some of these things. If not, you can always purchase them from online.

[halitosisux]

Jimi & keeptrying,
Yes these are both drugs with possibly very dangerous side effects and should only ever be taken with correct medical supervision and nobody should be taking them without striving to do their utmost to have them prescibed by a doctor. I think a good doctor would be able to consider trying this out though, these are not expensive drugs, so they wouldnt need to justify the costs, only the risk of potential side effects, and with medical supervision the risks are minimal.
The case for trying this out is very stong and I cant see why a doctor would be unwilling to try it out. If they wont then try another doctor.

[halitosisux]

Its like putting out a fire, if you dont do it properly and with the right equipment it will re-light. Some people found that metronidazole helped temporarily, and now some have found antifungals did too. Some are lucky and find themselves completely cured because that's all they needed and approached things more positively and more disciplined.

The fact that such improvements are generally noticed with either metronidazole or with antifungals, then its definitely worth trying both because the theory makes so much sense.

[KeepTrying09]

Jimi & keeptrying,
Yes these are both drugs with possibly very dangerous side effects and should only ever be taken with correct medical supervision and nobody should be taking them without striving to do their utmost to have them prescibed by a doctor.

(Sorry I'm gonna write a lot because I have strong feelings about the whole medical community in general)

Tylenol (an over the counter pain reliever) can have serious side effects if taken incorrectly. Cold medicines such as Robitussin, Nyquil, Vicks Formula 44, and Coricidin HBP Cough and Cold tablets can be dangerous if taken incorrectly. Even natural herbs such as tea tree oil, Ephedra, and garlic supplements can have serious side effects if taken incorrectly. I'm not arguing with the fact that both Fluconazole and Metronidazole could have potential serious side effects, but it's important to remember that those serious side effects are very rare and usually only happen to those who are taking the drug incorrectly or who have a medical condition which predisposes them to the serious side effect. Both these drugs have been around for a long while. If they were unsafe for the general population, i'm sure they would have been yanked from the market a long time ago. As a patient, it is your responsibility to research the precautions and potential side effects of anything you take, whether natural or synthetic, and weigh the potential risks with the possible benefits.

I agree with you that everyone should try and find a doctor who is willing to explore all possible causes of bad breath, including a Candida infection or a bacterial imbalance. It's just that it's a lot easier said than done. Some people don't have jobs, or they don't have medical insurance, and are therefore unable to seek medical treatment. Some people live in a country where their health care has been nationalized. Needless to say they have to jump through bureaucratic hoops just to get anything accomplished, and it usually takes months just to see a doctor. And some people live in a country whose health care system mirrors that of Americas'. If they have medical insurance, they have to follow the rules of their insurance company, which usually means they have to pick a primary care physician and stick with that one doctor for a year, or until they are allowed to update their policy again. And they still have to get a referral from their primary care physician before they can see a specialist, which again can take months. I can tell you dealing with an HMO is not pleasant. Just look at the state of the health care debate in America currently.

If having to fight with the health care system wasn't difficult enough, then you have to pray that you get a doctor who is actually willing to help you. I've come across story after story of bad breath suffers who said something like "I told my doctor I had bad breath and he said he didn't smell anything", "I asked my doctor about bad breath and they told me I was imagining things", or "I asked my doctor about bad breath and he just referred me to a dentist". The fact is that the medical community treats halitosis as a "cosmetic" illness. It's not life threatening, so it can be put on the back burner. In their minds they don't even think it has serious effects on people's lives. Ask any bad breath suffer and they will tell you how serious the effect on their life is.

Anyway, there are a few people who do actually find a good doctor. My doctor was good. She was very kind and helpful. And she was serious about finding the cause of my bad breath. How long did it take to find her? About 10 years. I hope the majority of people don't have to search for that long....but judging by these comments from other forum members, we have a long way to go to change the minds of the medical community...

Don't hesitate to share as much information as you can, people here are very serious and thorough about beating BB. Last time i went to the doc, i asked her to prescribe me an antifungal and she refused, ****ing bitch - she didn't believe in candida.

All the doctors that I've talked to didn't even know what Candida is! Or at least the extent and other things that Candida causes. So not only was I told that nothing's wrong with me, but I'm left feeling once again lost and hopeless. My determination and knowledge of research only seemed to irritate the doctors even more.

Unfortunately, changing my doctor wouldn't be such an easy thing to do. In the UK we are allocated a GP depending on the area we live in, so I wouldn't be able to get a new doctor unless I moved into another catchment area, that's just the way the NHS works

I would prefer to be examined to find out if I actually have candida, but, as that's unlikely to happen, I'm willing to take the risk of unprescribed medication. As you said, when you have bb, you become fairly desperate and are more willing to take health risks.

I too am surprised at the efficiency of Eastern doctors compared to Western ones. Please do not take this as an insult, but rather a compliment. I suppose as Americans we have an inbred arrogance when it comes to thinking we have the most advanced systems. Obviously not the case.

I have often thought over the years that this may be my problem. I had an endoscopy done a while back, but at the time I did not think to ask my doctor about yeast - I ask him long after the fact and he said he did not see yeast, but he looked like he was just saying that to get rid of me.

I'm hoping to find someone here that can help me diagnose my horrible problem, doctors don't seem to believe me. I'm a 30 year old man and have been suffering since I was 15, that's half my life, and I'm not willing to have this anymore.

Doctors don't seem to believe me, since they cant smell it when I see them, I cant ask them to sit next to me for 30-40 minutes to see for them selves. Some of them wanted to send me to psychiatrist, one removed my tonsils (that didn't help) one sent me to get upper endoscopy (everything was fine). They all seem to give up on me in the end, witch is bad because it takes me many months to sum up the courage to see them.

I went to the doctors, a very kind doctor he was, I said I had white coating and he said it was normal, I mentioned the bad taste and he said probably acid reflux and gave me omeprazole and then I mentioned my bad breath, he said he couldn't smell anything at all, and I believe him; he was very close to me, and he wasn't showing a reaction at all, my mother or father doesn't show a reaction at all either.

I went back to my doctors two weeks later, and I broke down, I literally burst into tears, and I told him everything, and this was the turning point with this 'good' doctor, he showed no interest, he wanted me out ASAP, said to try and do well at my school, see how things goes, and if I want to talk to him again make an appointment, he basically me told to get the ***k out.

bloorain

stop visiting doctors, that is my suggestion, everone of us goes thru the same procedures and nothing helps. The doctors think they are so smart and put you thru all painful procedures with no results.

If you want to go on, then go on, but my suggestion is to ignore them. Soon they will say that your bb is just in your head, probably put you on some psychiatroc meds and laugh at you.

They are jerks, that is my opinion.

Bb is still such a big tabum that if you dare to say it docs say you are crazy.

Hi Halitosisux,

Thanks for the useful website.

i havent yet been tested for h.pylori. I have been to several doctors countless GP and they were quite rude to me. I remember one telling me she cant smell an odour because she had a cold. One said she is not going to request any unnecessary test for me if nothing is wrong with me. Another one ignored me and ran me away told me to go to dentist. So, you see I have not had much luck with GPs like many of you already know.
Even when I requested the test they ignored me and said nothing is wrong with me.

Hi Drastic,

Thanks for your reply, i know how exactly how you feel regarding certain doctors and the negativity that their attitudes can sometimes instil in us in these situations. We have to fight that by remembering that one way or another there is an answer for each of us and we must continue persuing until we find it. While anyone on here still has avenues to explore, there is always hope.

I like your comment above Halitosisux. People do have to fight. People do have to remember that there is an answer for them. People do have to have hope. And people do have to explore all avenues. I'm simply providing another avenue for them to explore.

[halitosisux]

Hi keeptrying,
Yes, I completely agree with what you say. In certain circumstances there really is no alternative other than to take such risks.

But as we've said already, everyone must first do their utmost to try to get these drugs prescribed to them under supervision. I appreciate your point on the dangers of most common medicines, but nevertheless, antifungals can cause serious liver complications for quite a high percentage of people who take them (compared to side effect incidents in general) and for this reason this is usually always monitored with blood tests thoughout the course of treatment.

A doctor may also decide that if the antifungal risk is worth taking at all for this approach to try and deal with BB, to try more modern drugs that might stand an improved chance of success.

[KeepTrying09]

I appreciate your point on the dangers of most common medicines, but nevertheless, antifungals can cause serious liver complications for quite a high percentage of people who take them (compared to side effect incidents in general)

I would have to disagree when you say Fluconazole can cause liver complications for a high percentage of people who take it. While it is true that liver dysfunction is a potential side effect of Fluconazole, the term "a high percentage of people" is exaggerated. If you look at the actual research, Hepatotoxicity (or severe liver dysfunction) is rare (<0.1% of patients), and usually only reported in those patients with severe underlying diseases such as AIDS or malignancy, or those patients taking multiple concomitant medications. Most of the adverse events (side effects) that are associated with Fluconazole are superficial, such as headache, nausea, vomiting, diarrhea, etc....

Fluconazole
In Patients Receiving a Single Dose for Vaginal Candidiasis:

During comparative clinical studies conducted in the United States, 448 patients with vaginal candidiasis were treated with Fluconazole, 150 mg single dose. The overall incidence of side effects possibly related to Fluconazole was 26%. In 422 patients receiving active comparative agents, the incidence was 16%. The most common treatment-related adverse events reported in the patients who received 150 mg single dose Fluconazole for vaginitis were headache (13%), nausea (7%), and abdominal pain (6%). Other side effects reported with an incidence equal to or greater than 1% included diarrhea (3%), dyspepsia (1%), dizziness (1%), and taste perversion (1%). Most of the reported side effects were mild to moderate in severity. Rarely, angioedema and anaphylactic reaction have been reported in marketing experience.

In Patients Receiving Multiple Doses for Other Infections:

Sixteen percent of over 4000 patients treated with Fluconazole in clinical trials of 7 days or more experienced adverse events. Treatment was discontinued in 1.5% of patients due to adverse clinical events and in 1.3% of patients due to laboratory test abnormalities.

Clinical adverse events were reported more frequently in HIV infected patients (21%) than in non-HIV infected patients (13%); however, the patterns in HIV infected and non-HIV infected patients were similar. The proportions of patients discontinuing therapy due to clinical adverse events were similar in the two groups (1.5%).

The following treatment-related clinical adverse events occurred at an incidence of 1% or greater in 4048 patients receiving Fluconazole for 7 or more days in clinical trials: nausea 3.7%, headache 1.9%, skin rash 1.8%, vomiting 1.7%, abdominal pain 1.7%, and diarrhea 1.5%.

Hepatobiliary: In combined clinical trials and marketing experience, there have been rare cases of serious hepatic reactions during treatment with Fluconazole. The spectrum of these hepatic reactions has ranged from mild transient elevations in transaminases to clinical hepatitis, cholestasis and fulminant hepatic failure, including fatalities. Instances of fatal hepatic reactions were noted to occur primarily in patients with serious underlying medical conditions (predominantly AIDS or malignancy) and often while taking multiple concomitant medications. Transient hepatic reactions, including hepatitis and jaundice, have occurred among patients with no other identifiable risk factors. In each of these cases, liver function returned to baseline on discontinuation of Fluconazole.

In two comparative trials evaluating the efficacy of Fluconazole for the suppression of relapse of cryptococcal meningitis, a statistically significant increase was observed in median AST (SGOT) levels from a baseline value of 30 IU/L to 41 IU/L in one trial and 34 IU/L to 66 IU/L in the other. The overall rate of serum transaminase elevations of more than 8 times the upper limit of normal was approximately 1% in Fluconazole-treated patients in clinical trials. These elevations occurred in patients with severe underlying disease, predominantly AIDS or malignancies, most of whom were receiving multiple concomitant medications, including many known to be hepatotoxic. The incidence of abnormally elevated serum transaminases was greater in patients taking Fluconazole concomitantly with one or more of the following medications: rifampin, phenytoin, isoniazid, valproic acid, or oral sulfonylurea hypoglycemic agents.

But as we've said already, everyone must first do their utmost to try to get these drugs prescribed to them under supervision . . . and for this reason this is usually always monitored with blood tests thoughout the course of treatment.

I can't speak for anybody else, but I was not monitored with blood test during my two week treatment. In fact, I don't even recall my doctor asking me if I had any problems with my liver. She did give me an HIV test, and that came back negative, but she didn't test my liver in anyway. Has anyone else who has been prescribed anti fungals been monitored with blood tests during their treatment? Please post your experience if you have.

Personally, I think the only people who are monitored with blood tests during treatment with Fluconaozle are those patients who already have a medical condition that impairs their liver, or those who are immunocompromised, such as AIDS or Cancer patients. If you have any medical condition that affects your liver, or you are immunocompromised, then it's a must you consult with your doctor before starting Fluconazole.

A doctor may also decide that if the antifungal risk is worth taking at all for this approach to try and deal with BB, to try more modern drugs that might stand an improved chance of success.

As far as I know, Fluconazole remains one of the first line treatments in the fight against Candida. Are you familiar with any newer therapies that are both affordable for patients and widely available?

I think we've talked about other anti fungals in these two threads:

viewtopic.php?t=2598&postdays=0&postorder=asc&start=0

viewtopic.php?t=2614

I appreciate your views Halitosisux. I think we both agree that finding a doctor is preferable when trying to find the cause of your bad breath. After all, it was a doctor who found my cause. I think our differences become apparent when speaking about patients self medicating with prescription drugs, and the potential side effects that are associated with them.

[halitosisux]

Hey KeepTrying,
I was quite rushed earlier and didnt describe my thoughts very clearly, so I'm glad you've gathered together so much useful info.

My only experience with antifungals (apart from basic research and tinkerings over the years during my own battle with BB) was fairly recently when I had a fungal infection of one of my fingernails (which got crushed and has given me problems ever since). When I researched this I determined it wasnt worth the risk of using internal antifungal medication for something so minor. So I used something that I obtained OTC which is painted on like a varnish. This contained Amorolfine. At this time I realised how many different kinds there were and where they are of most benefit and the pros and cons/risks etc.

A Wikipedia search on antifungals summarises everything clearly.

I cant remember who it was in my family who had once been given internal antifungal medication, but I do remember the risks being discussed and careful blood monitoring taking place. If I find out who it was I'll find out more and mention it on here.

The reason I'm mentioning this is that a number of years ago I did a lot of swimming and noticed that the areas between my toes would sometimes break open when I'd try to dry between there. Immediately I assumed I had athlete's foot and bought some canesten cream and tried to treat it. I noticed that my BB seemed to improve markedly while using this, so I really thought I was onto something and spent months applying this several times a day thinking this had to be the cause of my BB. But it turns out there was no fungal infection on my feet, just purely normal skin and dampness/drying out etc.

I think that what I experienced back then was similar to what happened to meowkity's experience with the cream she used on her chest. I think the cream got absorbed and had an effect on the fungal presense inside my mouth and must have reduced the thickness of my tongue coating, and thus have a proportional reduction in my overall bad taste and breath.

Anyway, I do agree with you that, when put into perspective with other minor drugs and side effects, the risks are relatively low, but serious side effects always remain a real possibility.

You are right, that Fluconazole remains one of the first line treatments against Candida.

[KeepTrying09]

Halitosisux, are you cured of bb yet? I think I remember reading somewhere that you had been cured, but I can't remember for sure.

[KeepTrying09]

Just wanted to post some pictures of the Brand name Metronidazole, which is called Flagyl. They have both 200mg and 400mg here in Thailand. They have generic versions of Metronidazole too, which are cheaper, but I can't find any pictures of the generic versions that they offer here. I would take a picture of the generic version myself, but I haven't bought a bottle of the generic Metronidazole yet.

[halitosisux]

Halitosisux, are you cured of bb yet? I think I remember reading somewhere that you had been cured, but I can't remember for sure.

Hi, yes I'm cured but almost by a chance discovery and not before going to the ends of the earth for over 20 years in persuit of my search, most of it without the internet. Thinking back and with hindsight I could have solved it so much sooner had my logic not become so warped and taken certain advice in my early teens, but instead the path I took was so crooked its actually embarrassing to talk about it. When you sit there and think about it after the event, you know if you could go back you'd do it all so differently, but this is what depression does to you. Depression and BB are part of the same illness, they both feed off each other.

So, like you, I want to get hold of this curse by its proverbial BALLS, like it had over mine. And in so doing I'd like to be able to help anyone who needs it.

[KeepTrying09]

I can't imagine what it was like trying to find the cause of bad breath without the internet. We take the internet for granted nowadays, but really it wasn't that long ago that it didn't even exist. It's amazing how technology is changing the world.

We have a lot in common halitosisux. I too went through trying times during my teenage years, as well as my early twenties. I didn't really have a clear path and often lived a superficial life. Hindsight is 20/20 as they say. But I believe all the things i've been through have shaped me into the person I am now. As I have mentioned already, I found my faith that was lost for so many years and have drawn strength from that.

I'm glad that you are offering your assistance to those in need.

I've learned that you shouldn't go through life with a catchers mitt on both hands. You need to be able to throw something back. ~Maya Angelou

[halitosisux]

KeepTrying, i've enjoyed this debate with you, and I look forward to any others we may have.

I can relate to you on living a superficial life. Its just so numbing, you dont realise until you are able to start getting onto some kind of track of normality. I even had to pretend im gay just to explain my weirdness in the world, it was an easy way to cope with the spanner in the works, and I can think of so many other similar coping methods. So its an uphill struggle to try to revert to the person I guess I was always supposed to be.

I dont think there could ever be anything worse that a person has to live with than this. Not because of what it is, but because of the far reaching effects that your numbness cant comprehend at the time.

And because of my optimistic nature I placed myself into situations where I was always preparing to be free, I always had faith inside that I'd get there one day. For that reason I went to college, I worked and earned and even have a shared mortgage, though im crippled with other debts because of the superficial life I tried to build but I'm fighting my way out of this.

The only positive thing to come out of it for me is that the only thing I begged for in life was to be able to have the chance to redeem myself from the perspective of those who matter to me. And I've been given that chance, and once I do I dont care after that, NOTHING from life (or death) hereon can ever have justification for what I've personally been through. I'm not interested in whatever "god's" overall plans are, I have no sense of what I am or what ME actually is so none of that means anything to me. I'm just an empty shell my life was so upside down its like im having to live it in reverse and need to fill that shell as time goes by.

[KeepTrying09]

KeepTrying, i've enjoyed this debate with you, and I look forward to any others we may have.

Likewise

I can relate to you on living a superficial life. Its just so numbing, you dont realise until you are able to start getting onto some kind of track of normality.

Yeah, you totally get caught up in that world without realizing it. You look back and ask yourself "Did I really actually accomplish anything that was worthwhile?"

I even had to pretend im gay just to explain my weirdness in the world

LOL, that's a bit surprising. I think gay people are usually a happy bunch, even though they get discriminated against quite often in life. It's kinda like you were going from one hardship to another hardship. Interesting how different people cope with this condition.

So its an uphill struggle to try to revert to the person I guess I was always supposed to be.

Glad you're there now.

I dont think there could ever be anything worse that a person has to live with than this. Not because of what it is, but because of the far reaching effects that your numbness cant comprehend at the time.

I'd have to say I agree. I mean, there are some terrible diseases out there. And people suffer greatly from them. But for a cancer patient, or a Leukemia patient, or a handicap patient, they most often get love, support, and sympathy from those who are around them, such as friends, family, doctors, nurses, etc. But for a person who suffers with bad breath, they often get ridiculed, laughed at, and avoided. People treat them like it's their fault they have bad breath. It's horrible to go through life like that, especially when you can't seem to figure out what the cause is.

And because of my optimistic nature I placed myself into situations where I was always preparing to be free, I always had faith inside that I'd get there one day. For that reason I went to college, I worked and earned and even have a shared mortgage

That's great! I wish everyone could be like that. Actually I don't think it was optimistic nature that got me through most of those years. It was probably because I was numbing the pain with other things in life. Regardless, I was still successful with a good job actually where I had to come in contact with customers on a daily basis. Honestly I don't know how I managed that, but I did. I had my own car and a nice apartment, and was able to travel around America and see many different cities and states. I never let me bad breath stop me from living. But yeah, it was all superficial. I can't say there was much substance to life at that time.

And I've been given that chance, and once I do I dont care after that, NOTHING from life (or death) hereon can ever have justification for what I've personally been through. I'm not interested in whatever "god's" overall plans are, I have no sense of what I am or what ME actually is so none of that means anything to me. I'm just an empty shell my life was so upside down its like im having to live it in reverse and need to fill that shell as time goes by.

I totally understand what you are talking about regarding the empty shell part, and living your life in reverse. I don't think I could have described the way I feel about my life any better than that. The only difference is that I have found my faith again, and I feel blessed that I am able to reach out and offer my help to those who need it.

[halitosisux]

Hi, you put so much thought into what you say, its great reading your posts. I agree with all that you've said.

I think everyone lives with their BB in their own way depending on how thick their skin is. In my case, because I endured so much taunting and painful memories over BB in my childhood, I think I went to greater lengths than most people usually do to avoid being smelled. Like my fear was stronger than usual, more like a phobia. But maybe im just more of a coward, im not sure.

For instance, until I found this site just over a year ago, hearing of people talking of reactions as a method of gauging the severity of their BB was something totally new to me. But only for the simple fact that I'd avoid anyone smelling my BB at ALL COST. I even smoked cigarettes as an emergency masking method, because for as long as i'd be smoking a cigarette I felt that nobody could smell my breath and I could immediately go from having to hold my breath to TOTAL (if only temporary) freedom. It was the same thing with eating food too.

So for this reason my whole life from the age of about 15 was completely ON HOLD for the next 25 years approx. To say it took over my life COMPLETELY is such an understatement. EVERYTHING revolved around it in a game of survival, that's ALL my life was about.

[badtimes]

how can one test for candida? i hear that spit test is false