Oral Thrush

[Whitemagnum]

I'm on Mycophenolate Mofetil 2g daily, steroids, warfarin and lots of other meds. Just recently had 3 bouts of oral thrush. Nystatin clears it up but it keeps coming back. Does anyone have a similar experience and what did you do about it? (I can't take the pills for it as they interact with too many of my other meds). Also, did your Lupus Consultant change your immunosuppressants as a result? Thanks!

[BeeManShrop]

Hi WM My wife was taking (12 months ago) methotrexate and then baricitinib which we think wiped out her immune system completely. Result ---3 X infections = candidiasis (thrush) all the way down her oesophagus, plus pleurisy, plus gastritis (could not eat or swallow). She was taken off the immunosuppressants completely to allow the antibiotics to work. We have had a very hard time for the past 12 months trying to get her back to something like normal -- still a long way to go. She is now on hydroxychloroquine which is supposed to be a much gentler medicine -- this seems to be working but very slowly.I am no medic but you need to be aware that the result of too much suppressant of the immune system will make you vulnerable to all sorts of infections. It is a very fine balancing act.

Hope this helps & good luck and be very careful

[Whitemagnum in reply to BeeManShrop]

Thank you very much for your advice. I take the immunosuppressants as well as Hydroxchloroquine and steroids as my lupus cannot be controlled with only one of these alone. It is a fine balancing act as you rightly say. I hope your wife continues to improve. Thank you once again for your help.

[Ingrid1234 in reply to BeeManShrop]

Up your probiotic intake. Yoghurt will do. Increase good gut bacteria.

[Barbs51]

Hi Whitemagnum, I’m on 2g daily of MM also plus steroids and other meds similar to yourself. I suffer from oral thrush a lot but the meds to help it strips away the benefits of the immunosuppressants so I just live with it I’m afraid. I use mouthwash and hydrate a lot but that’s about it. I didn’t discuss it with my Rheumy just my GP hence my outcome. Best wishes 🌺

[BeeManShrop in reply to Barbs51]

Hi WM Just a thought -- my wife was in the habit of taking a bottle of water to bed for a drink when she went walk-abouts in the night. She was using a Sistema screw top bottle -- you know the type, half a turn and you can have a drink. Well, there is no way of properly cleaning the screw top mechanism and when I eventually took it apart it was full of a horrible black gunge which could well have been the start of the thrush. All those bottles have now been incinerated in our family.

Hope this is not the case with yourself. You can't be too careful though. All the best

[Whitemagnum in reply to BeeManShrop]

Thank you very much for that+ also for replying twice in case I didn't get it, very good of you, much appreciated.

[Whitemagnum in reply to Barbs51]

Hi Barbs51,thank you for your very helpful advice. I've now had 5 bouts of oral thrush in quick succession+was taken off the immunosuppressants+put back on them+taken off again etc. I'm just going to follow your example+ put up with it as I think you're right, there's no easy answer.

[BeeManShrop]

Woops -- sorry I replied to Barbs51 by mistake -- I am not sure whether you would be copied in so here goes again. Hi WM Just a thought -- my wife was in the habit of taking a bottle of water to bed for a drink when she went walk-abouts in the night. She was using a Sistema screw top bottle -- you know the type, half a turn and you can have a drink. Well, there is no way of properly cleaning the screw top mechanism and when I eventually took it apart it was full of a horrible black gunge which could well have been the start of the thrush. All those bottles have now been incinerated in our family.

Hope this is not the case with yourself. You can't be too careful though. All the best

[Sammymoat1986]

Hi I take methotrexate and hydrochloroquine too and I’ve had oral thrush twice and myn went to my throat too very painful my tongue was so swollen I was having trouble speaking by the nystatin cleared it up both times I’ve been on methotrexate for 3 years now and it only happened in the first year of taking it is this something she has recently started taking?