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Diflucan protocol for lyme disease

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My doctor mentioned trying diflucan some months ago; it has apparently worked well for some who have ABx resistant borreliosis/lyme and those who have neuroborreliosis.

A New Approach to Chronic Lyme Disease

05-05-2005 By Jill Neimark

In May of this year I sat down at the beautiful Essex House on Central Park South, with a German physician specializing in internal medicine, Fritz Schardt. Dr. Schardt, who is associated with the University of Wurzburg in Germany, published an interesting pilot study in the European Journal of Medical Research in July of 2004 on the use of an antifungal drug, fluconazole, in treating chronic, advanced lyme disease. This pilot study examined 11 patients with chronic lyme. Dr. Schardt has slowly refined the protocol since then, and believes it holds great promise in treating this difficult condition—which is often misdiagnosed as chronic fatigue or fibromyalgia. Here follows our interview:

JN: What made you think of using diflucan, an antifungal, to treat lyme disease?

FS: I was actually my first patient. I got lyme disease in 1989, and was given two weeks of doxycycline. Our country follows the protocols set by yours, so that’s what is generally recommended. I now know that was very inadequate and I do not think doxycycline should be used in early lyme disease at all. It is only bacteriostatic, meaning it inhibits the bacteria but does not kill them.
JN: I know, the same thing happened to me. At the doses they recommend, it also does not penetrate the central nervous system. I had a fever, stiff neck and bullseye rash. The stiff neck means it was already in my nervous system. Therefore I probably needed six to eight weeks of doxycycline at double the dose I was given. Higher doses will penetrate the CNS.

FS: Right. I recommend penicillin in early lyme disease.

JN: Amoxicillin is given here. Is that what you recommend?

FS: No, that’s broad spectrum, so you end up killing many bacteria, including necessary ones in your gut. I recommend smaller spectrum penicillins. The syphilis spirochete has not become resistant to penicillin, and there’s good evidence that borrelia, the lyme spirochete, has not either. In Germany, we have cefalosporine, roxithromycin, cotrim-TMPO, and clarithromycin. These are all good choices. They should still be taken for 20-30 days.

JN: Okay, well, you took doxycycline so you ended up with chronic lyme disease. What happened then?

FS: I was sick for 18 months. I was given intravenous rocephin several times. I would feel better, but then once I stopped taking the antibiotics, I relapsed. I was often bedridden and I thought I was ready for the wheelchair. Then, I developed a fungal infection, possibly because of all the antibiotics. So I was put on diflucan. This was around 1990. It was a new drug that was being used mainly for opportunistic fungal infections in AIDS patients.

JN: And what happened?

FS: I got better. But I only stayed on it for two weeks at first, and then I got worse again. So I went back on it for 30 days, and I got well.

JN: What was the dose?

FS: I took 100 milligrams twice a day.

JN: Are you completely well?

FS: I am very active and energetic and I feel quite well. I have since competed in athletic events and won them. However, I do have an occasional heart arrhythmia that I believe may be due to permanent damage from the spirochete.

JN: Tell me your reasoning as to why diflucan might work in chronic lyme.

FS: There are several reasons. First of all, it inhibits an enzyme called cytochrome P450. This is an enzyme that your liver, for instance, uses to detoxify chemicals and drugs. Borrelia has a very primitive p450 defense, so if you inhibit it, it is easily weakened. Therefore I believe that diflucan inhibits the growth and replication of borrelia. It does not necessarily kill it. In addition, it penetrates well into the cells and into the nervous system and brain, where borrelia may hide.

JN: What is your current protocol?

FS: I recommend 200 milligrams a day, for 50 days. There are now 200 milligram pills available, so once a day is fine. Then I recommend 20-30 days of any of the penicillins I mentioned. You may have to go through several cycles of this protocol. You must also be very aware of other drugs that act on the p450 enzyme system, specifically a subset that inhibits CYP3A4. You should not be taking any of these drugs at the same time as you take diflucan.

JN: What are some of these drugs?

FS: There are many, and it’s best to check with your doctor. Some common ones are erythromycin, amitryptylin, midazolam, Lovastatin, and others.

JN: I hate antibiotics. Do you have to take the penicillin?

FS: I understand, many lyme patients come to hate antibiotics because they have to take so many of them for so many years and are still ill. In fact, I also was made ill by the antibiotics.

JN: They really disrupt your digestion.

FS: Right, that was my problem.

JN: So, this protocol is your best one-two punch against borrelia, but you don’t have to take the antibiotics if you truly hate them.

FS: Right. In addition, diflucan has a slow half-life so it can slowly build up in your bloodstream. Sometimes patients call me after a few weeks and say they are feeling very ill on the protocol. Perhaps it’s a herxheimer, or perhaps it’s that the levels of diflucan are higher than they can tolerate. So I say, take a 3 or 4 day pause, and then go back on the protocol. This is perfectly acceptable.

JN: What happens if you have a weak p450 system? Have any of your patients have raised liver enzymes from the diflucan?

FS: I have been lucky, not one of my patients have had raised enzymes. It is generally well tolerated. If it is a problem, however, you can lower the dose of diflucan. This would be overseen by your doctor. I recommend 100 milligrams in pediatric cases.

JN: How many patients have you treated now?

FS: At least eighty.

JN: What is the most difficult case you’ve had?

FS: I have one 75-year-old patient who has had lyme for 18 years. He was very ill. He has had to do this cycle of diflucan and penicillin 3 times. He is much, much better. In fact, he’s so happy with his improvement he called the drug manufacturer to tell them they need to run a publicity campaign to promote diflucan for chronic lyme disease.
JN: Some patients on some internet groups are adapting your protocol, probably in concert with their doctors, and I’d like to know what you think of this. They are suggesting staying on diflucan for 9 months, and some of them are adding in low-dose minocycline. Are you aware of this?

FS: No, I am not aware of this.

JN: What do you think of the idea?

FS: I believe in the narrow-spectrum penicillins for borrelia, not the cyclines.

JN: What about 9 months?

FS: That remains to be seen. Perhaps, like tuberculosis, some patients will need to be on diflucan at least six months or more. Borrelia is a very sophisticated organism, and one of the few bacterium with two cell membranes. There is much we still have to learn about it.



New Member
Thanks so much for the great info. I am going to ask my doc about this. I know he said he would do diflucan if I wanted. Very interesting!!


New Member
Thanks for this interesting article, Tansy. I'll take it to my Dr. when I go next week. He's been wanting me to take Amoxicilin & Samento, but I only do the Samento because I don't like antibiotics; however, I've been feeling so much worse that I was going to start the antibiotic. I'll ask him about the Diflucan. Thanks again.


New Member

Thanks for the informative article. I remember my mother
taking diflucan for a yeast infection and we were wondering
why she felt so wonderful for a few months after taking the
med. I wonder now if she has lyme instead of fibro. We
will be checking this out.



I am always amazed, though, when docs talk about ABX killing good bacteria. Don't they know about probiotics? Guess not.

For anyone who does not want to take ABX, I think transfer factors are a good alternative. Actually, I believe they are better because instead of killing the pathogens, they train the immune system to recognize and kill them. The TF C sold here targets Lyme Disease. There is even one for mycoplasmas. I wish I had known about it before I took the Doxycycline for 2 1/2 years for the mycoplasma infection. Still, the Doxy worked well and it never caused a stomach problem for me because of the probiotics.

Thanks for another excellent article, Tansy.

Love, Mikie


New Member

Do you know how long one would need to take transfer C
for lyme? I wonder if insurance will ever consider paying
for it.



New Member
If you guys would set up your email to receive Immune Support email news from this web site you would receive news like this hot off the press. No offense Tansy as I think you are a sweetheart just trying to get people to realize that this web site has more to offer then just postings from members.

love and light



New Member
Hi Tansy and all

Just to let you know that I have been on Dr Schardt's protocol for 3 weeks now and it is really doing something great. I still cannot get up to 150 mg daily because I start to feel really unwell once I take it 2 days running but this doesn't matter because it is a very long acting drug with a half life of 30 hours. Therefore it is ok to take it every other day until your body gets used to it.

This past week I have had some of the best days since I first got sick with CFS which is really neuroborrellios. It was pretty rough at first and I got some horrendous migraines. I have had to be really strict about my diet and go low carb with absolutely no sugar or chocolate. This is the only way I could stop the dreadful migraines occuring whilst on the Diflucan.

I am now able to wear my contact lens which I hadn't been able to do for over 7 years since getting sick, my right eye has just cleared up and is now perfectly normal. My left eye always was ok.

I have had some days which I can only describe as brilliant but often a quite bad day will follow when I feel quite disappointed but then the next day can be great again. Therefore I would describe the protocol so far as being very up and down but definitely more ups than downs.

Yeasts have always been an issue for me and the discharge I have had for so many years is now very very light and I think will soon disappear.

For me this protocol appears to be of far more benefit than long term high dose abx.



New Member
Although this protocol does not work for everyone there has been enough positive feedback on it now to make it worth serious consideration particularly for those with predominantly neuro borreliosis/lyme and those who have GI tract issues including candida.

Do keep us updated on your progress, it already looks very impressive and should encourage others to think about this protocol as well.

Love, Tansy


New Member
Canlyme have published the pub med article on Schardt’s intial trial on their web site -

“Eur J Med Res. 2004 Jul 30;9(7):334-6. _Related Articles,_
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt= pubmed_pubmed&from_ uid=15337633)
Clinical effects of fluconazole in patients with neuroborreliosis.
Schardt FW.

Betriebsarztliche Untersuchungsstelle, Bayerische Julius-Maximilians-Universitat, Wurzburg, Germany.

Eleven patients with neuro-borreliosis had been treated with 200 mg fluconazole daily for 25 days after an unsuccessful therapy with antibiotics.

At the end of treatment eight patients had no borreliosis symptoms and remained free of relapse in a follow-up examination one year later.

In the remaining four patients, symptoms were considerably improved. At the end of therapy immune reactivity (IgM+) disappeared in three patients.

Since borrelia spp. are almost exclusively localised intracellular, they may depend on certain metabolites of their eucaryotic host cell.

Inhibition of P450 and other cytochromes by fluconazole may incapacitate Borrelia upon longterm exposure.”

nb Unless mycoplasma also use these enzymes I doubt the diflucan would work. Although I have read up on mycoplasma, it is very difficult to get tested for them in the UK, and even then very few doctors accept they cause ill health, so I have not researched them as much as I have some of the other pathogens involved in these DDs. It may well be that some of the successes using diflucan are because it is also treating a systemic candida infection, some doctors say if we have borreliosis/lyme then we will also have yeast and fungal infections.

What is impressive in terms of treating neuroborreliosis/lyme is this treatment worked in ABx resistant cases.

Love, Tansy


New Member
My doctor is considering the diflucan protocol for me, but we both had some reservations. I had been looking into the liver's detox pathways for some clues, then on another message board secondary porphyria when herxing on anti biotics was mentioned. I knew I had had hyperthyroid like symptoms but they went beyond even that. My metabolism just went totally awry and it ended up getting very scarey.

So even though I am finally tolerating a slightly higher dose of samento than I have managed for many months I am going to see if the blasi protocol helps with this before challenging my body that way again. Activated charcoal and some of the b vits are supposed to help when this happens during herxing, I take the latter and used to react to the former but am more tolerant of some herbs/supps now so will be trying that next time.

love, Tansy


New Member
Very interesting post Tansy! With all of your neurological symptoms I have high hopes that this would be very successful for you,and not cause damage. Thank you so much! Daneen


New Member
Kconrad63, the eye problem I have had on and off for about 7 years only affected my right eye. It would swell up and would keep weeping especially when out in the fresh air. It was one of the first symptoms I had when I first developed full blown CFS (which in my case is probably neuroborreliosis).

This meant it was impossible to wear contact lens. This year I tried again with contact lens because my eye seemed to be so much better after 6 months of antibiotics. However the day after my eye would play up again and there would be a discharge so I gave up wearing contacts in my right eye.

However since being on the Diflucan for over 3 weeks now my right has completely cleared up and I regularly wear soft contacts for around 12 hours in that eye without any problems apart from some itchiness which is caused by hay fever (I get this in both eyes this time of the year).

I really haven't a clue whether this problem could be due to yeasts or not but I would tend to think it was more likely problems with borrelia and that there has been a big die-off of it in my eye or surrounding area.

I continue to do very well most days and now regularly go for a very brisk 30 minute walk at least once a day and still feel well after! Sometimes I don't feel too great in the mornings but usually will really pick up as the day goes on.