I had thrush a few weeks ago, came out of the blue as had been feeling well otherwise. I haven't had thrush in over 10 years. I tried the normal over-the-counter treatment but it didn't work, so I spoke to GP and they gave me 3 day course of fluconazole. The thrush came back 2 weeks later, I again tried over-the-counter treatment but didn't work. Tried to make appointment with GP but could only have a call with them. They gave me 7 day course of fluconazole and continued to use creams. I finished the course last Weds, and have been feeling very unwell the last few days, and now the thrush is back again! I'm also having thrush in my mouth and have a sore throat each time.
The only thing that's different for me is that I started taking Erfa NDT about 2 weeks before this started. I can't see there's a link with this, have done some research and can't find any info. I saw my Endo during the second episode and asked him whether Erfa could be the problem but he didn't think so.
But I wondered if anyone has experience of recurrent thrush and what the cause was, and what treatment worked? Many thanks for your help.
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ShonaGreen
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i believe various fungal infections can be linked with thyroid issues. that s as much as i can offer I'm afraid. apart from the fact that any little thing i getthese days sees to resist treatment.
Hi Wetsuiter , thanks for your message. I've done some more research and there is some link between thyroid issues and thrush, but it seems there's not been enough research to provide any useful insight into the situation. I know what you mean about any little thing becoming a big thing so quickly, as doesn't take much to upset the balance when dealing with thyroid issues too!
I believe thrush/candida/fungal infections can all be triggered by hormonal imbalances. I think it's entirely possible that whilst the Erfa itself isn't the direct cause, this change of thyroid hormones is upsetting your other hormone levels. What thyroid medication were you on before?
OTC thrush treatment is usually 150mcg fluconazole. What dose did your GP prescribe for the longer courses? If they gave you too low a dose, it may not be doing the job.
Hi RedApple , I started on 50mg Levothyroxine in April this year when private blood tests showed low levels of TSH, T4 and T3.
I initially felt a lot better but slumped a few months later and thyroid levels didn’t increased much. Increased to 75mg Levo in August. Met private Endo in Sept that offered for me to try Erfa 30mg along with 25mg Levothyroxine. Had first bout of thrush 2 weeks after starting Erfa. Took single dose of 150mg Fluconazole initially, but this didn’t work so GP gave me 3 day course of 50mg Fluconazole which seemed to clear it up, but thrush started again about 10 days later. GP then gave me 7 day course of 50mg Fluconazole again which I finished last Weds
I saw the Endo again last week, he increased me to 45mg Erfa and no Levothyroxine. But by the end of the week I started to feel very unwell, weak, lethargic, palpitations. I contacted the Endo to ask about adding 25mg Levo again which he agreed with. I finished course of Fluconazole last Weds but unfortunately thrush started again yesterday.
I’m not sure if it would make any difference to get thyroid levels checked as changing medication quite a bit recently. I don’t want to keep going back to the GP as they’re just giving me Fluconazole which I know isn’t good to take all the time. Feel like I’ve been going around in circles for months now, not sure what’s causing what, I wish we could have a full MOT sometimes!
ShonaGreen, "I don’t want to keep going back to the GP as they’re just giving me Fluconazole which I know isn’t good to take all the time."
Well you can't keep suffering the thrush, so you may have to go back to your GP. Whatever it is that's triggered it, it needs to be addressed. You're right, fluconazole isn't something you can be taking indefinitely, but from what I've read, I don't think the 50mcg daily for two weeks is the right approach in your case. The NICE Clinical Knowledge Summary says this about treating recurrent thrush:
Treat the presenting episode.
Initially, prescribe an induction course of three doses of oral fluconazole 150 mg (to be taken 3 days apart) or an intravaginal antifungal for 10–14 days (according to response).
Once the induction course is completed:
Give a prescription for 'treatment as required' (for example oral fluconazole 150 mg once a week or intravaginal clotrimazole 500 mg once weekly) to be used if symptoms recur, or
Prescribe a maintenance regimen of 6 months' treatment with an oral or intravaginal antifungal (off-label use). Options include intravaginal clotrimazole 500 mg once a week, oral fluconazole 150 mg once a week, or oral itraconazole 50–100 mg daily.
Have a good read of the info yourself, and consider taking a copy for your GP too.
Some people find a low carb, and most especially low sugar diet helpful for keeping the thrush at bay too, so that's something to consider. You might find that certain foods you're consuming are exacerbating the problem.
Unfortunately I can't offer much in the way of help with regard to the thyroid hormone medication, other than to suggest dropping the Erfa, as it doesn't sound as if it's working for you regardless of whether it triggered the thrush. Perhaps a T4/T3 combo would be the next thing to try, rather than NDT. For some of us, it takes trial and error with many different medications and doses to find what works best for us.
Hi RedApple , thanks so much for taking the time to post that very useful info. I contacted the GP yesterday and they've put me on a 7 day course of Fluconazole 50mg again and taken a swab for testing. I asked if it could be the NDT/Erfa causing the thrush, her first question was what's NDT, haven't heard of that or Erfa? Then said as such a low dose then unlikely to be the cause of it.
She also said I wasn't diabetic as an Hba1c test from March was 32 (range is >41). In the past some of my urine/blood tests have had some results where the GP has questioned diabetes. I have a blood glucose monitor as sometimes I feel so unwell I know that my blood sugar is low. I tested last week when I started to feel unwell and had some low readings of around 4.0ish, dropping to 3.4. I don't usually have any high readings, but that same day it went up to 8.6. But as my Hba1c is low then GP adamant that not diabetes.
When I took Fluconazole last week I felt OK, but this time I'm feeling quite unwell with chills, weak legs and low energy. The thrush symptoms are getting worse too. But hopefully the drugs will kick in soon and start to feel better!
Shona, I'm so sorry you're having such a tough time with this. A very small consolation is to know that you are by no means the only one. Thrush/Candida/Fungal Overgrowth is very common with hypothyroidism, due to the combination of hormonal imbalances and comprised digestive system that occurs when thyroid hormones are out of kilter for an extended period of time. If you were also on any antibiotics at all during this time, that will also have been a contributing factor.
Unfortunately, the vast majority of GPs have no knowledge or understanding whatsoever of these connections, and no idea how to properly help their patients deal with this debilitating problem.
The fact that you have both recurring vaginal and oral thrush strongly suggests that this is candida overgrowth, for which there is no easy fix. This is a ‘whole body’ problem that needs to be addressed from the inside, with prescription and herbal antifungal medications plus a strict dietary regime, over a long period of time. And apart from giving you fluconazole on prescription, your GP probably won’t be much help at all.
I am by no means an expert in this, nor am I medically qualified, but can tell you from personal experience that you will need to work very hard to get this back under control.
And I cannot stress strongly enough, that it’s essential to get the thyroid hormone medication sorted, because the longer you’re on the wrong type and/or dose of thyroid medication, the harder it will be to get the candida under control.
Some sources of information that I found really helpful are:
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