Why Nystatin May Fail In Psoriasis
Even though Nystatin is one of the best antifungal drugs and repeatedly used successfuly in psoriasis it has its limitations.
Being a non-absorbable drug does not necessarily mean that it will travel through all the digestive tract and reach the lower part of the small intestine and colon which is often a problem in psoriasis.
The researchers in study from 1979 concluded that Nystatin may not reach colon in sufficient amounts even when taken at dosages of 12 000 000 IU per day. This amount is the equivalent of 24 tablets (the most common tablet is 500 000 IU of Nystatin).
Nystatin was administered in ten healthy adult volunteers in increasing doses of 3 X 10(6) I U, 6 X 10(6) I U, 9 X 10(6) I U and 12 X 10(6) I U per day, each dose being given for a five-day period. Faecal samples were collected daily for the determination of their concentration of biologically active nystatin. Nystatin concentrations were determined biologically; the sensitivity of this method was less than or equal to 20 mcg/g of faeces. During the four treatment periods with increasing doses, 38%, 31%, 26% and 20% respectively of the faecal samples contained biologically undetectable amounts of nystatin. This means that nystatin is either inactivated or unevenly distributed through the intestinal contents, or both. The practical consequences of this may be that in a significant portion of the colon there is no inhibitory nystatin concentration against Candida albicans, despite treatment with as much as 12 X 10(6) I U of nystatin per day.
The results proved that even after taking the equivalent of 200 tablets of Nystatin during the 20-day treatment there will be still 20% of feces without any biologically detectable amount of Nystatin.
The reason why there were no detectable amounts of Nystatin in some fecal samples was caused probably by the fact that Nystatin is unevenly distributed throughout the digestive tract and possibly also partially metabolized (like by some intestinal microorganisms).
The biologically active amount of Nystatin is about 78 IU per gram of feces.
The data gathered during the use of Nystatin in infants proved that Nystatin is distributed in the gastrointestinal tract heterogeneously (unevenly) and the excretion “occurs discontinuously”.
Nystatin is also a weaker drug compared to Fluconazole (brand name DIFLUCAN) so successful treatment of psoriasis may take longer.
The results of treatment of oral candidiasis in infants proved Fluconazole to be more effective than Nystatin.
Thirty-four infants were randomized to either nystatin oral suspension four times a day for 10 days or fluconazole suspension 3 mg/kg in a single daily dose for 7 days. Clinical cures for nystatin were 6 of 19 (32%), and those for fluconazole were 15 of 15 (100%), P < 0.0001. In this small pilot study fluconazole was shown to be superior to nystatin suspension for the treatment of oral thrush in otherwise healthy infants.
However, much lower toxicity (due to very low absorption rate) of Nystatin compared to Fluconazole makes it a great choice for yeast infections.
If I used Nystatin as an antifungal treatment I would take 6 tablets (3 000 000 IU of Nystatin) per day at most. It is generally the highest recommended dosage but 3 tablets daily work well.
Nystatin tablets are sold over-the-counter in Germany and can be shipped within the European Union.
It is about 30 USD for 1 month supply (100 tablets). Nystatin should start working for psoriasis and actually everything else caused by yeast overgrowth after about 2-4 weeks. The 3 months is the period after the most people should see if it works for them or not.
Actually, many people improve or cure their health problems (anxiety, psoriasis, fatigue, weight gain, …) on this antifungal. The sad part of the story is that the doctors in