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Probiotics and Antibiotics

October 12th, 2006 · 40 Comments

probioticsI am a supplement taking fool. Really, I am. I believe in the importance of getting all of the things your body needs to function properly, whether you get it from a perfect diet (mine is NOT), or not. Probiotics are something that I include in my diet every day as well, partially because they are good for my digestive system, and partially because it is theorized that with good bacteria in your body, bad bacteria will not be able to take hold as easily.

pro·bi·ot·ics (prb-tks)
n.
Live bacteria ingested to supplement normal gastrointestinal flora, especially after depletion of flora caused by infection or ingestion of antibiotics.

The American Heritage® Stedman’s Medical Dictionary, 2nd Edition Copyright © 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

Some say that you can use probiotics at the same time you are taking antibiotics, but others say that the use of probiotics during antibiotic therapy will negate the efficacy of the antibiotics. Unfortunately, all I have found on the internet says that it is ok to do. For example:

During antibiotic therapy, a good dose is between 6 and 25 billion total viable probiotic cells per day. They should be taken as far away from the antibiotics as possible (for instance, if the antibiotics are to be taken every eight hours, the probiotic supplements should be taken four hours after the antibiotics). Probiotic therapy should be continued a week to a month beyond the antibiotic treatment period to replenish any beneficial bacteria lost during antibiotic use. Probiotic use should not interfere with the effectiveness of antibiotics. Source

My doctor (who I will admit is not a “supplement friendly” doctor) said not to take probiotics during antibiotic use, and I have heard several other MRSA patients say the same thing, so the question remains - is it safe to take probiotics during antibiotic therapy? What do you know about this?

More info on probiotics: USProbiotics | Probiotics

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40 responses so far ↓

  • laura // Dec 23, 2006 at 10:56 pm

    i tried to find the feeds to this question above about probiotics and antibiotic use but did not find any comments left by others…how do i find the responses to this post above? thanks

  • Christina // Dec 23, 2006 at 11:28 pm

    Yours is the first response, Laura. Anything in particular you are looking for, maybe I can help?

  • laura // Dec 26, 2006 at 10:59 am

    hi christina, thanks…i am interested in the responses this generates and in particular
    what is the dosage and timing to take antibiotics and probiotics propholactically to stop the antibiotic damage (tooth infection, unable to stick to a detox so need antibiotics to take care of the infection hopefully, but want to use probiotics to curb te damage from the antibiotics)
    thanks alot
    laura b

  • Christina // Dec 26, 2006 at 11:21 am

    Laura- are you seeing a doctor? A tooth infection is potentially very dangerous and is definitely a case where you need antibiotics. You can talk to your doctor about probiotic usage as well.

  • docwrite // Feb 11, 2007 at 9:46 pm

    Numerous studies have shown the benefit of probiotics in preveting and treating illnesses like diarrhea and infections. However, the effects of probiotics are unlikely to be permanent but more likely to end just a few days after stopping the probiotics.

  • Christina // Feb 12, 2007 at 12:49 am

    Hi docwrite - that’s why I take them on a regular basis - and I do think they have been beneficial - at least I know they aren’t hurting anything!

  • Shishot // Sep 19, 2007 at 10:46 am

    Did you find out a more clear cut answer to your question? Aside from the anti-diarrhoea benefit of probiotics during antibiotics, is it better to take or not take probiotics while taking antibiotics (i.e. from the perspective of getting rid of the infection that necessitated taking antibiotics)? I currently have a sinus infection and two ENT doctors have said that it would be good to take probiotics (specifically I asked about drinking kefir). However, they didn’t have a reason as to why it would not inhibit the antibiotics efficacy in eliminating the infection (logically, and maybe naively, it would seem probiotics would counter the antibiotics efficacy). And I’ve had the same sinus infection for 5 weeks. The first course of antibiotics started 5 weeks ago didn’t get rid of it, and I finished the 2nd course (14 days instead of the normal 10, and at the highest strength) yesterday but still have the sinus infection. And I have been drinking 8oz of kefir twice a day (morning and night). I was skeptical of taking probiotics during antibiotic treatment 5 weeks ago, but am even more skeptical now. Any help would be appreciated.

  • Dezi'smom // Oct 5, 2007 at 12:59 pm

    My one year old has been battling multiple ear infections. The pediatrician told us that he would prescribe a super antibiotic to really get at the infection this time. I have been giving my son probiotics for a while now and have continued to do so during this most recent medication regime. He had chronic diahrrea from previous treatments, and the probiotics were the only thing that helped. I have been worried though that I am may be decreasing the efficacy of this most recent antibiotic. If this one fails, then he will need surgery to get tubes in his ears. I am inclined to stop all probiotics and just resume the regime once the antibiotics are done, but he has been sick for so long, and I hate to see him go through more diahrrea! Help! Any advice? (Basically, I have the same question as “Shishot.”)
    Thank you

  • Barry // Oct 10, 2007 at 4:37 pm

    I am so sorry to hear about your son, Dezi’smom. My kids had a number of ear infections and we began talking about tubes, but then, as I remember (it has been about 8 years), we found a chiropractor who helped and the kids did not have to take anymore antibiotics. Perhaps, they grew out of it, but I don’t think that was all. Have you considered food allergies, such as wheat and milk? Perhaps Kefer would be a good alternative to milk and it is full of probiotics, better than yogurt I am told. I drink it and do much better with it than with yogurt - and regular milk kills me. Another idea would be to see if D’Adamo’s eat right for your type books offer a direction you could go. I find that I gravitated to the diet that he recommends for my blood type before I ever picked up the book. If your son is AB blood type, I would suggest using olive leaf extract - it is wonderful for my kids and I. Another opportunity is to find a doctor who treats disbiosis - poor gut flora - I think this is the doctor (such as a licensed chiropractor or naturopath) who helped the kids and I so much. He tested us using an advanced kinesiology testing scheme and gave us herbs and supplements that killed the “bad” bacteria and allowed the good to flourish. He said that without the herbs, the probiotics would never flourish. This helped a great deal - herbs such as coptis chinensis, isatis, supplements such as Thorne’s 9-undecanoic acid, similar to capryolic acid. Does your doctor, MD, suggest/prescribe guaifenisen (plain Robitussin/tussin) for congestion? This helps me a lot on the few occasions that I am congested and it has little to no side effects. Whereas sudafed actually gave me and the kids/led to ear infections. Finally, if you live near Seattle, I can suggest a 6th generation Chinese physician who makes a difference (I live in St. Louis, but my ex-wife was helped tremendously by this physician). Another opportunity would be to find a true homeopathic physician - you can find those who are members of national/international organization as opposed to just some guys with 100 hours of training - same with those people with 100 or 200 hours of accupuncture training who claim to do accupuncture.

    Good luck.

  • Cris // Oct 24, 2007 at 2:00 pm

    I have just started taking antibiotics for a sinus infection, and my doctor said that probiotics are good to help me with stomach discomfort and diarrhea from the antibiotics. I had worried about mucus with dairy products and he told me not to worry about that. In the past, I used to just wait until the antibiotic was finished, and then go for a heavy intake or probiotics to replenish lost flora immediately after the antibiotic is finished.

    It seems sensible to me that maybe because the anitbiotic might just kill off any probiotic you injest and therefore possibly detract from its attack on the infection, that maybe a good course of action is to only take the probiotic if you are having bad stomach problems to alleviate that, but otherwise if its just a few cramps here and there, just wait until your done and then make sure you ramp up probiotic intake to make up for what you lost. I hate taking antibiotics, but I guess I might as well let them do their work, let go of my intestinal flora for a week, and then replenish them when the infection is gone.

  • Barry // Oct 24, 2007 at 5:29 pm

    I did some lit research using peer reviewed journals. In this case, the subject was C. diff infection/overgrowth treated with oral vancomycin. Very often, C. diff overgrowth is due to a compromised immune system (i.e. antibiotics plus chemotherapy/radiation/cancer). We all have C. diff, but it is kept in check by our flora and immune system. A meta-analysis of treatments for C. diff and a paper from the U. of Washington medschool showed a treatment using a specific probiotic, Saccharomyces boulardii, reduces recurrence of the infection/overgrowth. The point of this long message is: the protocol calls for beginning the probiotic on day 7 of a 10 day oral vanc protocol. And continuing for 30 days. They don’t say to start the probiotic on day 1 and they don’t say to start on day 11 or 10. I don’t know why they picked day 7; I did not read the paper in great detail (only to know the probiotic and the day 7 thing). Maybe, people should begin probiotics at the end of a round of antibiotics, not at the beginning and not after completion. Maybe. The paper also went on to say that for general antibiotic caused diahrrea, not C. diff caused, that a particular strain of Lactobacillus was helpful and that mixed probiotics were helpful.

  • Cris // Oct 24, 2007 at 5:34 pm

    that sounds sensible, sounds like it is ideal to begin taking the probiotic as you are toward the end of your antibiotic round to ease back into a normal state of affairs! I’m going to try that this week! of course, i already took some probiotics on the first day of my antibiotic treatment, i’ll hold off though until i get toward the end and see what happens.

  • Lynn // Oct 26, 2007 at 7:52 am

    For many of you with chronic ear infections or sinus infections, please look at casein (milk-protein) allergies and gluten (grain)allergies. We are nine months gluten and casein free now. My son had lost hearing in one ear due to congestion and chronic infections. Five pediatricians, an otologist and an allergist never resolved it. This change in diet cleared the ear infection, his chronic diarrhea, my mother’s chronic sinus infections. I was also able to take my other son off of allergy shots and steroids (for three years) for allergies and allergy induced asthma, simply by taking all wheat and dairy out of our diets. It is hard to at first, but so worth it. There is tons of information and help on the net. By the way, the allergist tested both boys and said they had no food allergies.

  • Gerrad // Oct 26, 2007 at 9:18 pm

    I also have wondered about using probiotic during antibiotic treatment…. It doesn’t seem like it would be wise unless diarrhea and other stomach problems are severe…. I have also theorized that using probiotics during anti-biotic treatment would reduce the efficacy of the antibiotics…. This is just my personal logic and I haven’t found any specific studies backing it up, but I will personally try to refrain from using Kefir and other probiotic, just until the end or near the end of antibiotic treatment…

  • Cris // Oct 27, 2007 at 2:16 am

    So I’m now four days into my 7-day antibiotic treatment. I have been trying to avoid probiotics, but the stomach pains were driving me crazy, so I have had a few of those little probiotic drinks, but have tried to only do that at least a couple of hours after and before I take my antibiotic so that the probiotic and antibiotic are not in my stomach at the same time. The probiotic seems to bring some relief that then goes away each time I take the antibiotic again (three times a day). It’s really hard for me to tell if its reducing the efficacy, but the antibiotic seems to be working and my sinus infection is slowly getting better, but I’m trying to function like normal through this and all this is making me quite tired!

  • Gerrad // Oct 27, 2007 at 9:01 am

    Chris: If your stomach is really bad I would try and drink some Kefir in between doses of antibiotics or just call your doctor and ask him if you could try another antibiotic…. Everyone is different and some antibiotics that may not cause problems for many; may in fact cause you problems and likewise there is most likely some antibiotic that won’t cause too much GI disturbances for you…. I’ve been on three different antibiotics since my surgery in August and whenever I have bad tummy trouble, cramping, pain, diarhhea, or even just indigestion, I’ll drink 8oz. of Kefir and that usually calms it down to the point that I can continue my stupid antibiotic therapy….

  • Cris // Oct 28, 2007 at 4:17 pm

    Thanks Gerrad, I’m taking Augmentin 3x day for seven days and I guess its not so bad that I would switch, but bad nonetheless. I’ve come up with a little game plan to get through the last few days. I try to wake up a little early in the morning and drink a bunch of kefir or other probiotic drinks. I take my daily vitamins, C and a multi, at the same time I drink the probiotics because I understand that the lack of good intestinal flora hinders the absorbtion of vitamins and minerals. Then I eat breakfast and wait until after I am comfortable that my food and vitamins have been digested before I take the first antibiotic of the day. I did this today and it seemed to help, and I also had more energy. I agree, antibiotics drive me crazy! Stupid sinus infections… ;)

  • KissyFace // Nov 2, 2007 at 10:34 am

    I had a very bad tooth infection that needed an emergency root canal and a prescription of some serious, heavy duty antibiotics. My dentist told me to get some probiotics because this prescription was going to reek havoc on my body.
    I am now going through my second infection and have decided to take the probiotic after my prescription is finished.
    I’m not sure if it’s related or if I’m just prone to infection, but that is my plan of attack this go round.
    I think a lot of it has to do with your body and the type on antibiotic you receive. Its all a matter of choice. There are going to be studies that back up both sides because there are too many variables, its about learning how your body reacts to certain treatments.

  • kim // Nov 4, 2007 at 10:37 am

    ’scuze me, folks, but how does the probiotic hinder the effectiveness of the antibiotic if the probiotic is a different bacteria (”good”) and the antibiotic kills everything anyways? i recently had surgery and an infection to boot. i was on flagyl for the infection, had surgery, finished the flagyl, and kept the keflex “in case”. the entire time i’d been taking probiotics, religiously, and even BEFORE all this for some time due to IBS symtoms mostly exhibiting as diarrhea (chronic). i had no idea the probiotics could “hinder” and thought it would just ride along side and be the “GOOD” whilst the antibiotics killed the “BAD”. however, when i finished all the antibiotic (flagyl) i seemed to possibly have developed an infection and have started the keflex originally prescribed for post surgery. i’m so confused but happy to find this discussion - perhaps ya’all can enlighten me. if i was already diarrhea problematic would it be wise to stop probiotics??? how do the probiotics kill the effectiveness of the antiobiotic??? thanks.
    have a great day!

  • Becky // Nov 16, 2007 at 11:32 am

    Note: I’m not an expert by any stretch just an educated layperson but this is my opinion.

    It depends what you mean by hinder. In any single course of antibiotics it’s more that the antibiotics kill off the probiotic as soon as you take them than the other way round. After all an antibiotic kills off any bacteria in your system that isn’t resistant to it.

    I can see that they might be concerned with it increasing the chances of resistance developing at a later date but some got bacteria survive most antibiotic ourses due to natural mutation so that’s pretty much moot.

  • Randy // Dec 10, 2007 at 8:31 am

    Dr. S.K. Dash Ph.D. who has decades of research in the area of pro-biotics says to take your pro-biotics between the times you take your anti-biotics. He is a leader in his field and has written books on this subject. His website is www.usalabs.com.

  • Cris // Dec 10, 2007 at 9:03 am

    I think Dr. Dash is right. If I take antibiotics again, I will do that. My last antibiotic treatment was followed by yeast related mouth infection and I got sick again pretty quickly. I took the probiotics after the antibiotic dosage, but not a lot and only for a few days.

    Based on my experience, I would recommend being more rigorous about taking them during and after the antibiotics. Also consider cutting out sugars and wheat products for a week or so to make sure that any intestinal yeasts don’t have anything to feed off of. After years of antibiotic therapy and the most recent one that may have created other problems for me, I am doing one of those anti-candida diets with lots of probiotics for a few weeks to be super safe and hopefully strengthen my immune system. Not sure of the science behind it, but it is making a big difference in the way I feel and seems to be helping with my sinus issues as well.

    It seems when the antibiotics kill off all the probiotics and we don’t replenish them properly, that creates a sort of vicious circle that weakens your immune system and makes it more likely you will have to take antibiotics again.

  • Randy // Dec 10, 2007 at 10:46 am

    Chris you might want to take a look at Dr. Dash’s book “The Consumer’s Guide to Probiotics.” I know they sell it on his site but you might be able to get it for a couple of bucks at www.abebooks.com. God bless you and hope you will enjoy great health over the holidays.

  • Pauline // Dec 12, 2007 at 2:57 am

    Olive leaf is the best thing I have used for candida. I have had allergies all my life and just lately a sinus problem that just kept recuring and nothing would help;olive leaf fixed it and it has not returned and my milk allergy while still there is greatly improved. Olive leaf kills all the viruses,bacteria and fungi it has been tested on. I think that if you have allergy problems then you probably have an overgrowth of candida and the olive leaf gets rid of it. It doesn’t destroy ‘good’ bacteria either.

  • Barry // Dec 12, 2007 at 11:18 am

    With all the talk of antibiotic treatments and reinfections, even with probiotic treatment, it could be that there is an overgrowth and imbalance of intestinal flora that needs to be rebalanced and probiotics alone may not do it. The Olive Leaf extract suggestion would help and there are other supplements and herbs that rebalance and/or kill problem flora: Thorne makes a product called SF722 (if I remember correctly) - this is 10-undecenoic acid or something similar to a long chain fatty acid that kills certain offending organisms. Coptis chinensis - I took it as a tincture. And there are others, some of which are made by Thorne Research. I get this information from treatments that I received from a competent chiropractor who had take advanced applied kinesiology classes and specialized in gut health. It is really helpful to find someone trained and competent, even if they are not perfect though understand their scope of practice. If you have to experiment on your own with herbs, start with low doses to and gradually build up. And start with one at a time so that you can recognize your responses to these new introductions into your system. Plus, you don’t want a nasty detox reaction, even if it is transitory. I once was given a tea tree “pill” and thought I was losing my mind for a few hours because I am very sensitive to tea tree oil, not to mention that it should only be given orally with care - that was a mistake by a practitioner that I don’t want to repeat. Good luck everybody.

  • Cris // Dec 13, 2007 at 3:34 am

    One question I still don’t think we’ve answered, I’ll put it in terms of a hypothetical:

    If I am taking antibiotics, and in between doses I take strong doses (kefir, acidophilus, whatever) of probiotics, will that reduce the efficacy of the antibiotic?

    anyone have, or maybe you have seen, a definitive answer to that question?

  • carlie // Dec 22, 2007 at 9:26 am

    I have a really bad UTI.Have been taking antibiotics and probiotics.Is this why I’m still in pain?

  • Terri // Dec 22, 2007 at 10:10 am

    I have a bad sinus infection. I started Anti-biotics 5 days ago and I am only getting worse. I will try probiotics and sinus rinse to help. I won’t take them together though…

  • Cris // Dec 23, 2007 at 12:03 am

    My sinus infection is back, and its worse than before, now I am taking a strong dose of 4000 mgs of Augmentin per day. The sinus rinses have stopped working too. The probiotic in between seems to help, but I am having massive sugar cravings.

    Does anyone know if there are certain foods to avoid or a special antibiotic support diet to help the probiotics and antibiotics do their job?

  • Randy // Dec 23, 2007 at 7:07 am

    Chris stop eating any white and anything with a parent (poultry, fish, beef, pigs….animals) No sugar, white flour, white rice, white bread etc. No can goods. Eat fruit, vegetables, grains. At least two quarts of good water a day. Get your protein from soy, beans, nuts etc. Take a good multivitamin. No dairy, a good probiotic daily. Plenty of citrus fruit, oranges, grapefruit, lemon, lime. You should start seeing a marked improvement in a week.

  • LORI // Jan 9, 2008 at 2:04 pm

    Has anyone thought about using colloidal silver? I was told that would help with fungal infections which if a sinus infection is not clearing up, it may be caused by fungus and not bactieria. I was told to use it in a sinus rinse.

  • Cris // Jan 10, 2008 at 6:15 am

    I have just finished a 20-day treatment of Augmentin for sinus infection, the probiotics in between doses helped me get through it without too much stomach illness, now I am doing heavy probiotic intact with olive leaf extract and lots of vitamins to try to reset my system. Scary enough, I am still congested, my doctor says the infection should be gone, I just need to let the sinuses calm down.

    The only thing I am doing now is a light spray of colloidal silver, no heavy sniffing it up, to try to calm the sinuses. I’ll let you know if it works.

  • Jim Locke // Mar 10, 2008 at 2:36 pm

    Would like to see answered on when to use Probiotics along with antibiotics.

  • MommaP // Mar 21, 2008 at 9:55 am

    Here is my question. Previously on an antibiotic, I got a yeast infection, apparently in women this happens a lot. I am worried about getting another yeast infection. Will probiotics help? I currently have a sinus infection, bronchitis and ear infection. Quite frankly the yeast infection was worse. Either way, I will not sleep due to the pain or from not being able to breathe. Previous comments were about intestinal upset. Any suggestions.

  • Matthew // Mar 22, 2008 at 2:01 pm

    I was just diagnosed with empetigo and started an antibiotic regimen. Almost instantly my acid reflux was through the roof. I started taking probiotics and the empatigo which was looking better got worse. This is day 4 and I’m going to try to stop the probiotics till the antibiotics have gone their course. I’m going to try prilosec for the acid reflux, and get some throat coat tea, it has slippery elm. It seems to me that probiotics definitely interfere with the effectiveness of antibiotics. Best not to mix the two.

  • M Do // Apr 3, 2008 at 5:46 pm

    Correct me if I am wrong but I thought ANTIbiotics killed both good and bad bacteria and that PRObiotics replaces the good bacteria. I may have to take some ANTIbiotics starting next week because of a possible ulcer and I am currently taking PRObiotics. I have no idea what I should do after reading so many different ideas.

  • Jim Locke // Apr 3, 2008 at 6:10 pm

    M Do:

    You’re correct.
    My personal research has led me to believe that if using Antibiotics, using Probiotics in-between the doses of antibiotics daily is generally best.
    I site mentioned here earlier led me to some comments from a Dr. who research this a great deal apparently.

    I asked a homeophatic Nurse practitioner is she felt there was a problem if Probiotics were used at the same time as antibiotics, and she said no firmly.

    I did not specifically mention I had “popped” them literally at the same time.

    You are likely to find multiple opinions on this. For what it’s worth, my N.P. (the nurse I mentioned) said it was fine to use them at the same time.

    I also feel using antibiotics for a couple weeks -without- repopulating the gut with any flora significantly lowers the immunity temporarily.

    One reason I asked the N.P. this question was because I had a sore throat come back.
    I got another Strep test done. Negative. So she gave me a homeopathic medication. turned out it seems I needed a different one, since this different ones worked.
    Found this out on my own as I’m pretty knowledgeable on homeopathy for not being a Doctor.

    My point is: it appears the antibiotic worked just fine, even with use of probiotics in the same handful.

  • teresa // Apr 21, 2008 at 1:21 pm

    For over a year I have had a lesion on my scalp that is infected and fills up quickly after being drained. A dermatologist recently prescribe the anitbiotic, minocycline, for three months at 100 mg. to take twice a day. I have also been taking proxene, a probiotic, for the past month or so. It dawned on me that they may be cancelling out the affect of each other. Plus, I have been experiencing severe headaches lately. I went to this site to learn the feasibility of taking probiotics and antibiotics at the same time. I have yet to find the answer. I am as confused as I was before. Several comments were to take probiotics between antibiotic doses, this is what I will try in hopes of alleviating my headaches. If anyone has an definitive information regarding the subject, please post it. Thanks for listening to me whine.

    terriperry

  • Jim Locke // Apr 21, 2008 at 3:02 pm

    teresa:

    Are you eating unprocessed foods most of the time and drinking enough water? (around half your body weight measured in pounds, in ounces - i.e. if you are 150 lbs, youd drink about 75 ounces daily).
    If you are, your body may simply be getting rid of junk.

    When using a probiotic after being sick, the body rebalances. In doing this, it can push junk out of the body, including through the skin.

    Of course, don’t take this as formal advice, but it’s possible.

    Have you looked for a chiropractor who knows Kinesiology, or an herbalist?

    Just thoughts, again.

    I have had good luck applying a high-quality Lavender oil around the body and head if I have a headache.
    The Lavender is a great balancing herb that helps the body adapt to things.
    I have had great luck with Young Living’s Lavender oil. The aroma is stronger and richer than Aura Cacia’s and similar to Simpler’s (two brands).

  • PJ // May 7, 2008 at 6:24 pm

    I am now on my 3rd round of antibiotics for a sinus infection. My cough was so horrible my doc did a CT of the sinus region and an x-ray of chest. He finally saw my sinus infection in there, he had been saying was cleared up. NOPE!

    So now I am on an additional 21 days of Levaquin. I started with a z pak and moved on to 10 days of levaquin and am still on it.

    I feel somewhat better but still have this horrible cough. A holistic med friend said take probiotics & not to wait. The girl in Whole Foods said not to take them together as the antibiotic will kill the probiotics. She suggested several hours after the antibiotic dose…
    I think the rule of thumb is this: The antibiotic can interfere with the probiotic good effects and the probiotics will be wasted.

    I don’t think the probiotic could make an antibiotic not work, not the strong antibiotics yall are talking about.
    It would be a very weak antibiotic to be adversely affected by a probiotic. Just my opinion.

    I have decided to take some proB each day because I have been on the antibiotics for so long now (several months) and I am concerned with yeast and candida, thrush, etc.

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