I took nystatin for only two days and developed an allergic itchy rash over my whole body which lasted for a week. Is this more likely a reaction to the medication or a die-off reaction? Given the reaction, I’m slightly reluctant to try nystatin again.

Chris Kresser:  I don’t blame you. It’s tough to say. I’m not sure it’s always one or the other. It could actually be both in some cases. I think another question that’s important is even if is a die-off reaction, does that mean that it’s safe to continue with that medication? If something causes that big of a die-off reaction and makes you miserable, it may not be the most effective means of dealing with that condition. It may be better to use something like A-FNG, which we talked about that you can dose very finely and start with as little as one drop per day and then build up really slowly. You could combine that with Lauricidin and Yeastonil, which is part of GI Synergy antifungals. Biotin at a higher dose is antifungal. With Lauricidin you can start with just a few pellets. You could start with half a capsule of Yeastonil, just a couple drops of A-FNG per day, and that might be a better way to start. Maybe after you ramp up to full doses of those botanicals and other nutrients, you could consider then starting at a much lower dose of nystatin and by that time you might have knocked back the fungal overgrowth to a level where you wouldn’t have that strong of a reaction to nystatin.