What could be causing my Autistic son to have orange stools?

[JenzDeals]

My son is 4 1/2 years old and Autistic.  Since my son was about a year old, he consistantly has soft orange stools, usually with little or no smell.  We have changed his diet off and on for the past 2 years to see if anything would change, i.e., we removed all dairy and casein, then wheat and gluten, then both, then reintroduced both seperatley, yet he still has orange stools. We are fairly certain that he has some digestive/absorption/gut permeability problems, and are starting enzyme therapy to address some of those problems.  He has also had problems with yeast, which we are treating now with probiotics.  We have been giving him vitamin supplaments but he had orange stools before we gave him the vitamins, although it seems like the vitamins make the stools more orange. We just recently gave him an Organic Acid test and are awaiting the results.  Could the orange stools be due to some unknown culprit, like a parasite?  Are there any diseases or conditions that have orange stools as a typical sign or symptom?

[Kevin Pho, MD]

Medications such as Rifampin (an antibiotic) and beta-carotene (a form of vitamin A) can cause orange stools as a side effect.  

I am unaware of a parasite causing orange stools.

If the stool is more pale-orange, lack of bile salt (which gives stool a brownish color), antacids containing aluminum hydroxide, barium from recent barium enema test, and hepatitis can be causes of this.  I would consider checking some baseline liver tests to evaluate for this.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[PAJ]

Jenz , I’m sorry to hear of your sons problem , as you probably know autism is always accompanied with a vastly altered gut flora. That could  point to your sons problem . Without tests it’s impossible to say for sure what is causing the orange stools, but it is associated with liver problems ,that would fall inline with pathogenic organisms  in the gut producing toxins that the liver processes. Many people with a candida infection report Orange stools!. No smell could be inappropriate gut flora. I see you have taken the Organic Acid test that will identify yeast toxins [metabolites] yeast infections & autism go hand in hand. Many autistic children have improved dramatically when the yeast infection is treated some to the point of being considered  cured.. Read my posts below & the sites here, get back to me with any conclusions.
BTW   mercury poisoning  seems to have been ruled out,the problem is metabolising mercury.  The latest thinking is something overwhelms the immune system allowing yeast to grow to the point that it becomes pathogenic this altered gut condition allows other pathogenic organisms to proliferate Chief suspect is vaccines many gulf war syndrome combatants developed GWS even though they were never deployed . they were given the vaccine shots. Hope this helps cant think of anything more at the moment . if you need specific info I’ll dig it out .
Question, do you associate your sons autism with the triple MMM vaccine?


Autism and the Human Gut Microflora
http://www.fst.rdg.ac.uk/research/fmsu/Autism.htm
Toxic metal clue to autism
      http://www.eurekalert.org/pub_releases/2003-06/ns-tmc061803.php

[PAJ]

Jenz,  I missed a few points, , If the Organic Acid test finds yeast metabolites in the urine  because of the way the body works it indicates a systemic infection . Treating the infection with probiotics  unfortunately   does not work .Crowding out the bad with good bugs is a wonderful thought but it just doesn’t happen. The effect of probiotics is transient, whilst taking them you will find them in the stool stop taking them you don’t find them in stool . What makes a microbe a fixture in the gut is unknown, our resident flora is recognised as self, To change inappropriate gut flora back to a healthy stock if you like is a lengthy business & it takes prescription drugs. Fungal infections evade & depress the immune system , other co-infections are common. I note you use the term “we are treating” ,is that you as parents ? Is your doctor supportive , is he interested in trying to cure your son?
I have the references to the above information if you need them

[JenzDeals]

PAJ,

"We" refers to me, my husband and our son's Dr.  We have been taking our son to see a Dr. who follows the DAN! protocol in treating Autism.  My son has a regular Pediatrician, who has not been any help with any of my son's symptoms, on the contrary, he usually offers to prescribe antibiotics for everything and nothing more.  The DAN! Dr. has run some basic tests.  Our son does have an overgrowth of yeast;  he does not have elevated levels of toxic substances, namely Mercury; and he has a mild to moderate intolerance to Wheat (Gluten).  

My belief is that my son was typically developing until 1 year old or so.  I think that it was the combination of so many vaccinations in such a short period of time, and too many antibiotics (due to a number of sinus infections), his little immune system couldn't handle it.  Our son's pediatrician was VERY pro-vaccination and VERY pro-antibiotics, like a lot of pediatricians  Our son had all the normal vaccines and some additional ones; chicken pox, pnumeococol/strep, meningitis, etc.  He had more than 30 vaccines  before he was 3 years old!

I will inquire about the prebiotic/synbiotic treatment for the overgrowth of yeast to my son's DAN! Dr. at our next appointment. I will also request that his liver functioning be tested.  

I am very interested in more information about changing "inappropriate gut flora back to healthy stock."  Which prescription drugs work for this?  Anti-funguls?  Would we need additional tests before we begin using this type of medication?  Any additional information you could provide would be so appreciated.  Thanks so much for taking the time to reply.  

Thank you, thank you!

Jennifer

[PAJ]

Jennifer, it’s a privilege to help your son.  If your anything like me information overload is a problem especially at first with all the new information . You need to get the principles of what’s happening . In order to gain the overall picture we need to look at different but related problems . On the question of the DAN protocol read this very important article

http://www.mercola.com/2003/sep/13/inflammatory_bowel_disease.htm

it gives an insight & puts into context diet .Your sons doctors are swatting symptoms! Diet is a common sense step but it,s only the beginning .fungal antibiotics are an essential  part of the treatment protocol. The drugs & dosage must be carefully worked out hopefully you may get the help & support of your doctor.
The drug protocol is based on Dr Crantons ,Triple drug therapy ,with modifications . Information on body weight to drug ratio is available , I’ll need to dig it out .i’ll get back to you.  


It’s interesting that your son developed sinus infections ,the cause is now acknowledged as fungal based .


Mayo Clinic researchers have proposed that most chronic sinus infections may
be caused by an immune system response to fungi.

* Article in Mayo  <http://www.mayo.edu/proceedings/1999/7409a1.pdf>
Clinic Proceedings

* News  <http://www.mayo.edu/comm/mcr/news/news_773.html> release
about this research

Many studies here at the Mayo Clinic have added evidence to our thinking
that chronic rhinosinusitis is caused by an immune reaction to fungi in the
nose. Our original study linking chronic rhinosinusitis to fungi in the
nose, which was published in the Mayo Clinic Proceedings in September 1999,
has been reproduced and confirmed by a sinus center in Europe (ENT
University Hospital in Graz, Austria).

There are currently 16 studies at Mayo Clinic Rochester to further
investigate the role of fungi in inflammatory diseases of the respiratory
tract.
In addition, researchers from the Allergic Diseases Research Laboratory at the Mayo Clinic in Rochester found that certain white blood cells called T-Lymphocytes are reacting to the fungi and were producing the kind of inflammation we see in the sinuses, and that healthy people did not react in that way. This work was presented at the 2001 Annual Meeting of the American Academy of Allergy, Asthma and Immunology and will be published soon.

The evidence was so convincing that the National Institute of Health (NIH)has given Mayo Clinic a $2.5 million grant to further investigate the mechanisms behind this immunologic response to the fungi.

If you have chronic sinusitis—that is, a sinus inflammation that persists
for three months or longer—we recommend that you see your personal
physician or an ear, nose and throat specialist (otorhinolaryngologist) for
the appropriate treatment for this disease. Many times the disease is
associated with asthma or allergies and treatment of those associated
problems tends to help the chronic sinusitis.

Antibiotics don’t help chronic sinusitis in the long run because they target
bacteria, which are not usually the cause of chronic sinusitis.
Anti-histamines, nasal steroid sprays and systemic steroids are the
mainstays of treatment today, depending on the symptoms of the patient.

Over-the-counter medications, including salt-water nasal washes and mist
sprays, are useful in treating the symptoms of chronic sinusitis, but do not
eliminate the inflammation.

Dept of Otorhinolaryngology
Mayo Clinic
Rochester, Minnesota
This latest report supports the link with CFS [ME] and fungal infection
http://news.bbc.co.uk/1/hi/health/3141773.stm


This extract gives an overall view of  Chronic Fatigue and infection I relate to the time scale of treatment quoted in the article ,Your son may well have co-infections.

Identification and Treatment of Chronic Infections in Fibromyalgia Syndrome
ImmuneSupport.com

By Prof. Garth L. Nicolson

The Institute for Molecular Medicine

15162 Triton Lane, Huntington Beach, CA 92649-1401

There are a variety of different theories about possible causes and
progression of chronic illnesses like FMS. We have been interested in the
potential role that chronic infections may play in FMS. Although the causes
of chronic illnesses are for the most part unknown, the complex signs and
symptoms that evolve in many FMS, CFS, GWI and RA patients may be due, in
part, to systemic chronic infections (bacteria, viruses, fungi). Such
infections can follow acute or chronic chemical, environmental or other
insults (trauma, acute viral illness, etc.) that have the potential to
suppress the immune system and cause metabolic imbalances [1, 2].

For the full text

http://www.immunesupport.com/library/showarticle.cfm/ID/3695/

[JenzDeals]

PAJ,
Thanks again for the quick reply.  Wow! I feel like a whole new door has opened for me to begin searching for more clues on ways to help my son.  I am always reading books about Autism treatments, medical/biological and other.  I also spend hours a week looking on the internet as well.  I only recently realized/acknowledged that much of my son's negative behaviors had more to do with the way he was feeling and not just because he was frustrated about his inability to communicate. I have heard of anti-fungals before, but the idea that his chronic sinus infections were possibly fungal caused makes so much sense.  I have visited all of the links that you gave me, printed it all and I will read it all tonight.  I will let you know what our son's Dr. says about the Organic Acid test results, our appt. is for this comming Tuesday.  If you can think of anything else, please let me know.  Thanks again for all your help!

With sincere gratitude,

Jennifer

[PAJ]

Jennifer,
A few more interesting facts on yeast ,from my under construction web site,  you will need to search “pubmed” to get the medline site, type in the numbers quoted to access articles.
What you can ask your doctor for on Tuesday, is a stool test to determine your son’s gut flora . If Yeast is found species & MIC levels can be determined” Minimum inhibition concentration , amount of drug needed to kill or stop growth,”
The drawback with the test is that its not that reliable, for the results to have statistical value four tests must be taken. Don’t know if you found this , it contains ,the basis of whats required to treat yeast .
http://drcranton.com/CFIDS.htm#CFIDS%20Paper

Obviously any proposed  drug regime must be tailored to your son,  I would advocate using non systemic drugs first Nystatin ,amph B to hit at the seat of infection , start with relatively small doses  bearing in mind  die off , Building to high dose ,with the inclusion of systemic prescription drugs . See how you go with your doctor , depending on how he receives the information will determine your next move. Where in the world are you & what is your sons name?

Prescription anti fungal drugsLamisil (Terbinafine HCl), Diflucan (Fluconazole) , Sporanox (Itraconazole), Nystatin.Lamisil offers hope in that it is not just fungistatic (stops growth of fungi), but also fungicidal (kills fungi). Lamisil may replace Diflucan as the number one choice. About 30% of Lamisil is unabsorbed leaving about 75mg of the tablet to pass through the intestines. Lamisil and Diflucan are extremely safe and effective. A single dose of 150 mg Diflucan can cure a yeast infection in women. However, its activity in the intestines may not be as significant. Various yeasts are resistant to it as well as Sporanox, most notably, Candida krusei. Liver function problems with Lamisil, like Diflucan, are also rare. Nystatin is the weakest antifungal and many yeast are resistant to it. Prescription antifingal drugs are a NECESSARY part in treatment. Natural antifungal products are far too weak to have any significant effect or else they would be used in cases of severe mycosis. Minimum inhibition concentration (MIC) levels from Candida in stool will be helpful to determine susceptibility of the Candida a patient is carrying to the various antifungal drugs. Despite past experiences with the older antifungals such as amphotericine, ketoconazole, etc., liver toxicity with Lamisil and Diflucan is extremely rare and these drugs can be considered safe, which is very exciting to many physicians who understand this problem. Sporanox is as well, although to a slightly lesser extent. If concern is raised over possible side effects, frequent liver function testing, especially in long term usage or in the case of past liver complications, may be helpful.see Medline 10730913 ,& 12100530  for more on Lamisil
Articles  quoting cures with high dose antifungals. Click related articles for more information.
11291577 & 11766111
Inflammation
Inflammation releases molecules that are destructive & downgrade/disable our immune systems & Yeast /fungus can induce that inflammatory response,
See these extracts,12407412, 12408438 This ones interesting quoting fungi as the cause of sick building syndrome 11181112, 10510392, 12490957 and 12134235
This is part of an article by Dr. Bruce Semon it covers the subject of immunity again but  without medical jargon
To understand how the yeast Candida albicans causes skin problems such as eczema and psoriasis, first a brief overview of the body's immune system and its interaction with Candida will be presented.
The best way to look at the immune system is to understand that the immune system has both defensive and offensive weapons. The main defensive weapon is inflammation. Inflammation is like putting up a wall, a hot wall, which makes it difficult for invading foreign microorganisms to get through. Inflammation will occur anytime the immune system contacts a foreign invader. But as you know the inflammation is painful. Along with the inflammation, should come the offensive weapons which kill the foreign invader. The problem is that Candida has many tricks to evade the offensive weapons of the body's immune system.
Candida is a very difficult organism for the body's immune system to clear.
Why?
Candida has a number of tricks to evade the body's immune system. One of these tricks is to change its outside. The immune system recognizes the outside receptors of the invading organism and then sends out signals to start an immune response. Some of the immune responders then look for cells with those receptors. Candida albicans can change the receptors which it is displaying, making it difficult for the body's immune cells to react appropriately. In essence, Candida albicans is a moving target, which changes its form.
The most important thing to know about Candida is that Candida albicans can make factors which suppress the immune response to itself. These factors can be found in the circulation of people with significant Candida infections. When these factors are purified and placed in cultures of immune cells, these immune cells do not develop the responses to Candida which they are supposed to develop. In other words, Candida can make factors, which prevent the body from reacting to and killing the Candida. These factors prevent the total eradication of Candida from the body.
The Candida can suppress the offensive weapons of the body's immune system. But the inflammation will still be generated because when the immune system detects a foreign invader, there will always be inflammation. The problem is that the foreign invader, the Candida, is not going away, because the immune system's offensive weapons are suppressed. The inflammation will remain and inflammation is painful and on the skin is not attractive.
Tests &  Treatment

There are a variety of tests available , the problem is that as candida is present as part of our normal flora it’s difficult to determine when candida has increased to the point of being  pathogenic! [Harm causing] It adds up to being difficult to test for.
Markers!
Inflammation is nearly always present it’s one mechanism fungi use to disrupt & disable the immune system,[see Medline extracts below] although when testing for inflammation it’s not specifically testing for infection it’s useful in the overall picture

Again two other pointers are present in a large percentage of candidaisis cases ,one being a reduced body temperature typically being 1 degree below normal.
Another is "ACIDOSIS” note Dr. Pasteur's dying words: "The germ is nothing, the inner terrain is everything." It has been demonstrated that an acidic, anaerobic (lacking oxygen) body environment encourages the breeding of fungus, mould, bacteria, and viruses. An acidic condition of in particular the blood although other areas are affected, urine saliva etc; this blood alkalosis inhibits the transport of oxygen to tissues and organs, constricts the blood vessels, and lowers overall circulating blood volume.
Search “body PH Balance for more on Acidosis”. More on this  by Dr Paul Cheney

http://www.immunesupport.com/library/bulletinarticle.cfm?ID=3953&PROD=PH12
.
For direct testing read this mans experience. Follow the links for more information
http://www.cfs-recovery.org/research.htm
The tests listed are fine if they are conducted within a short time of contracting the infection, over time it’s now known that we produce a lessening response to candida antigen.This is called an Anergy . There is a test called  Hypersensitivity allergy test It a medical fact that a healthy person will react allegically to Candida albicans,. Using a clinical test for normal immunity, the doctor injects a small amount of Candida yeast extract under the skin and observes for a raised, red allergic reaction. If that reaction does not occur, the patient is diagnosed as "anergic," meaning that the immune system is not functioning. In other words, the body will always react allergically to Candida yeast unless immunity has become paralyzed or stressed-out. That fact proves that the presence of yeast in the body creates stress to immunity.
If therefore we take a Hypersensitivity allergy test we would have a better overall picture.  The outcome should help in assessing serology tests.
see also                http://www.emedicine.com/derm/topic569.htm
Polymerase Chain Reaction [PCR] testing that looks for the DNA of the pathogen,[technically demanding] the Polymerase Chain Reaction, widely used as a genetic probe, is highly sensitive to false positive reactions as even a molecule of genetic material that matches can trigger a chain reaction., Cross-reactions with related Fungi are also possible.
I spoke to a technician who carried out PCR testing he didn’t exactly enthuse about the test with plenty of if’s and butts in the conversation. If seems to me that technically demanding relatively [too] new technology equals unreliable results.
Microscopy using a dark field microscope, this is subject to interpretation as such it cannot be held as definitive.
Other tests notably organic acid testing or metabolic profiling As detailed by Great plains laboratorys These tests have a proven record ,as with all the tests getting the doctors to accept the significance of the result is the problem here.
http://www.greatplainslaboratory.com/yeast.html
Inflammation
Inflammation is nearly always present it’s one mechanism fungi use to disrupt & disable the immune system,[see Medline extracts below] although when testing for inflammation it’s not specifically testing for infection it’s useful in the overall picture
Reduced body temperature
Again  other pointers are present in a large percentage of candidaisis cases ,one being a reduced body temperature typically being 1 degree below normal.
Hormonal imbalance  
hormones are chemical messages .Various trials in America have shown, for example, that many of those with CFS put out either too high or too low levels of DHEA and cortisol, which are hormones produced by the adrenal glands. Research has shown that this constant biological stress causes adrenal fatigue. MRI scans of the adrenal glands of CFS patients has shown that there is actually a reduction in adrenal gland size in some cases
Acidosis
"ACIDOSIS” note Louise. Pasteur's dying words: "The germ is nothing, the inner terrain is everything." It has been demonstrated that an acidic, anaerobic (lacking oxygen) body environment encourages the breeding of fungus, mould, bacteria, and viruses. An acidic condition of in particular the blood although other areas are affected, urine saliva etc; this blood alkalosis inhibits the transport of oxygen to tissues and organs, constricts the blood vessels, and lowers overall circulating blood volume.
Search body PH Balance for more on Acidosis. read this article by Dr Paul Cheney

http://www.immunesupport.com/library/bulletinarticle.cfm?ID=3953&PROD=PH12

[PAJ]

Jennifer, How did the visit to the doctor go?

[JenzDeals]

PAJ,

Hello!  My son's name is Jason and we are from Southern California, how about you?  Name, location, and how the heck do you know so much about all of this?  You have a truck load of info!

The appt. went well.  The results of the Organic Acid test revealed that Jason is in worse shape then we thought!  He tested high for yeast growth (not so much a suprise), he is severly deficient in Magnesium, Calcium, B12, Folic Acid, Riboflavin, Arginine, Carnitine, N-Acetyleysteine, Coenzyme Q10, and 5-Hydroxytryptophn.  SO, we will be implementing supplaments for all of these deficiencies, one at a time.  We started with Diflucan to treat the yeast problem and will switch to Nystatin soon.  We are still giving him the probiotics and the Enzymes. And we are still taking  a multiple supplament, Super-Nu-Thera rom Kirkman labs.  We are also considering which diet changes to implement.  We are trying to figure out how to get the good oils in his diet (Flaxeed Oil or Safflower).  I heard that if you cook with these oils, you loose their Antioxidant power, which would defeat the purpose?  Oh, and we figured that we might as well try the magnesium epsom salt baths to help with the magnesium deficiency.  Whew, I think that covers it.

I read somewhere that one issue that is important that we have not yet discussed with Jason's Dr. is Jason's electrolyte functioning (balance).  I read that until we address that issue, all of these supplaments and meds will not do much good. If he does have an inbalance (which I would assumme that he does)his body won't be able to "process" or utilize all of these treatments.  What are your thoughts on that?  We have another appt. in a month or so to reevaluate his progress.  Thanks again for everything!

Jennifer

[PAJ]

Hello Jennifer ,my name is Paul and I live in the middle of England, I know so much because I’ve researched the subject for almost four years, this came about after I purchased a computer to try and find an answer for my years standing baffling symptoms. Within an hour of searching I came across Dr Crantons site, which proved to be my personal Rosetta stone my e-mail address ***@**** give me a post

It.s very good news to see Jasons doctor is supportive ,many are not, Depletion of vitamins and minerals is standard with a yeast infection. The endocrine system is usually affected too ,Does Jason have a low body temperature ?
Hormonal imbalance  
hormones are chemical messages .Various trials in America have shown, for example, that many of those with CFS put out either too high or too low levels of DHEA and cortisol, which are hormones produced by the adrenal glands. Research has shown that this constant biological stress causes adrenal fatigue. MRI scans of the adrenal glands of CFS patients has shown that there is actually a reduction in adrenal gland size in some cases

Poor absorbsion is one of the effects of a altered gut flora , with that in mind your doc may need to monitor blood plasma levels of Fluconazole, [diflucon] it’s a pity he didn’t try and identify the strain of yeast , there are many strains, Candida glabrata  is becoming more prevalent  and is significantly more difficult to kill off that Candida Albicans.

I,ll give you more of my web page on treatment ,consider very carefully the higher doses , it’s very much inline with my experiences .Doctors sometimes treat yeast as a nuisance infection as you see it’s anything but. The deficiencies & direct infection cause a cascade of debilitating symptoms , Treating the root cause “yeast” will dramatically improve Jasons condition but the dose must reflect the extent of the infection read the info see what you think. The adult dose of 600mg equates to 20mg per kilo

here are a few relevant medline extracts
Terbinafine [Lamisil] 12956204 11576412 Voriconazole is the latest azole  drug keep it in mind for the future 12867215

Omega 3 fish oil is a good supplement to take 10903481

. How to treat a yeast infection is one of the most controversial subjects. Although for the vast majority that in the main were infected by overuse of antibiotics, for most there is a cure, for some, a few ,the condition will have progressed to Chronic Mucocutaneous Candidiasis  [CMC] It seems that a genetic  flaw  affecting the immune system renders the condition  incurable. Selective IgA Deficiency  would  explain the condition but it may not be all the story . As I understand most [but not all] with this flaw are infected early in childhood. CMC is treated with A/F to control rather than cure. See http://www.candida.org.uk/  and. http://www.jmfworld.com/html/selective_iga_deficiency.html
“Both humoral and cell mediated immunity have been demonstrated in patients of candidiasis and some healthy individuals. In spite of this the infection occurs in the latter and continues in the former. This raises doubts on the protective role of immune responses to this organism.” Dr Heaney a top immunologist in the UK is on record stating that even when the diagnosis of Chronic Mucocutaneous Candidiasis is not in question , immunological tests sometimes show nothing abnormal. Sufferers demonstrate a  perfectly normal working immune system
The question is how much and for how long do we use anti-fungal meds. Do we need other supplements? There is a strong case for supplementing with vitamins & minerals we now know that that with a chronic [lasting more than three months] infection most are deficient in both minerals, vitamins and probably hormones.
On co-infections this article is gives an insight.
Garth Nicolson, Ph.D., recommends a series of tests important in charting the proper course of treatment for his CFS and FM patients. To determine the presence of mycoplasma infections, a Polymerase Chain Reaction (PCR) test is crucial because of its being "very sensitive and highly specific." Sensitivity is required to detect mycoplasma presence since these microorganisms hide in the tissues and organs and are not as evident in the blood stream.

Dr. Nicolson also suggests PCR tests to detect Chlamydia, Lyme disease, HHV-6, and cytomegalovirus as these infections are also commonly found in CFS and FM patients. Tests to spot various coagulation problems are also encouraged. To receive accurate results for most of this lab work, patients should be off all antibiotics and immune-enhancing products for at least four weeks prior to testing. (For more information on testing see "Important Tests for Chronic Fatigue Syndrome and Fibromyalgia Patients", www.immunesupport.com/library/showarticle.cfm?ID=3683.)

On prescription meds ,if we take a look at Dr Cranton triple drug treatment protocol  we see that he uses hefty doses of drugs with 16 million units [memory] of Nystan a heavy dose of Amph B [both taken orally]  & the maximum recommended dose of Flucanazole [Diflucan] at 200mg daily. The systemic therapy lasts for three months. It’s interesting that he adds a cautionary note stating treatment with Nystan may take up to one year .With this he claims he achieves a 35% cure rate [again memory]
Although that sounds like heavy dose’s, there is a strong case  to say the systemic drug fluconazole is sub optimal. Causing secondary resistance  
Dr Cranton must prescribe within the rules as it were. He must stay within the box.
My experience tells me that most with a yeast infection are seriously ill and extensively infected by the time symptoms develop. That was certainly the case with myself,
On treatment and dosage  
With hindsight if I were asked what strategy I would adopt to cure [or perhaps a better term would be to control] my infection if I had the chance again  I would adopt practically the same protocol That is I would take six to eight weeks of initially high loading dose Anti-fungals using the synergistic affect of using Lamisil [Terbinafine] and Sporanox [Itraconazole] together ,Adjusting the dose to become relatively symptom free.  At the onset of my treatment I took up to 1000mg of terbinafine 250mg every six hours [for approx one week ], smaller doses just didn’t have enough effect I felt some vague effect enough to know the drug was working , but nothing very dramatic. The infection was overwhelming. After about three weeks of high dose medication I was able to taper the dose off to more acceptable levels . I have no hesitation in saying if I had the chance again up to this point I would use the same protocol. Particularly with the systemic drugs , and I would use the dose’s quoted in Dr Crantons paper for the non systemics Nystan and Amph B..
One other point during treatment antibiotics
Obviously do not automatically rely on the reputation of the drugs used of being safe. Take regular liver function tests.  
Once the infection is under control there are choices to be made , one school of thought is to carry on treating with high dose antifungals. There’s plenty of evidence to support this strategy Articles  quoting cures with high dose antifungals. Click related articles for more information.
11291577 & 11766111

But when we consider the fact that candida is intracellular [ can invade the living cell ] in the same way as other micro-oganisms such as viruses Mycobacteria  e. g. Tuberculosis and Leprosy and some protozoa eg malaria parasites   [T lymphocytes  which respond to and kill cells which are infected with intracellular pathogens  are not that effective  intra- cellular infections are renowned as difficult to cure  ].
The importance of CD4+ T cells and macrophages in protective immunity and killing of intra-cellular organisms such as M.tb. and Candida should be evident, but in some cases the "wrong type" of T cell response may be of little benefit to the host, or even harmful. ……………..Full article:
http://www.tulane.edu/~dmsander/WWW/MBChB/6c.html

Doctors generally regard this situation as puzzling, I know this from experience , I saw a Dr Miller yet another  specialist in infectious disease, he couldn’t accept that I had taken anti-fungals long term and yet was still infected ,[ I saw him at his private practice ,to my mind he knew so little about fungal infections  at one point I considered that I may be in front of an impostor Dr Miller  treated people with life threatening conditions including AIDS and cancer , A fungal infection developing as a result of underlying serious conditions such as these would be an overgrowth, and probably detected within days of contracting the infection.