Tuesday, March 17, 2009 Ellen Galo asks

Q: Risk of fungal infections with TNF blockers... am I at risk?

Hi - I am concerned about the risk of fungal infections. I knew someone who had fungus in his lungs and was very ill in other ways (has since passed away). All they could do for him was periodically 'scrape' his lungs to head off disaster.

My husband, who gets NO tartar on his teeth, gets fungus really easily, in fact he has bad toenail fungus, his feet can be red with fungus (he does use topical stuff), and he had 'jock itch' for a long time, until after 2 infections myself, my doctor asked about my husband - and he got something for it. I don't think he was even that aware of it! It must be genetic because his mother's feet were terrible too. I never saw them bare until 2 weeks before she passed away.

My husband does not want to take internal medicine for it because of the risk of liver damage. By the way, his hands are very crusty and dry, and he thinks it is just dry skin but another person told me, this can also be fungus, it happened to her mother. My skin is very dry, my dr. said I have atopic dermatitis. I'm not sure...

I never had any ongoing fungus infection but now, within the last 2 years, my toenails and feet are beginning to be infected. (I usually wear socks to bed just to be warm, but not always.)

So - am I at risk for invasive or chronic fungus? I've started to use cream on my infected foot (as does my husband) and Vick's on the toenails (works for some people). I don't want any more internal drugs either, due to liver enzymes going up and down.

What to do? Anyone else with experience about this?

Thanks -

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Answers (4)

Lene Andersen, Health Guide

3/17/09 8:36pm

The risk of serious fungal infections with TNF blockers is a fairly new development and I simply don't know enough about it to advise you (aside from mentioning that it seems to primarily happen in the southern areas of the US). However, given your husband's fungal infections, I think it's important that you make an appointment to see you rheumatologist as soon as possible to discuss this and what implications it has for your treatment and if you can get in for a while, asked to speak to him/her on the telephone. Does your husband have any specific reason to worry about liver damage? You may want to encourage him to see a doctor to discuss this concern, not just for his own sake, but also to keep you safe, given that you are immunosuppressed.

DAWN

3/17/09 10:53am

ELLEN

YOU MAY WANT TO RESEARCH THE CANDIDA DIET. THERE IS A WEBSITE, AND TV PROGRAM CALLED "KNOW THE CAUSE" WITH DOUG KOUFFMAN. HE TALKS ALOT ABOUT ANTI FUNGAL AND HOW TO HELP WITH IT WITH OUT MEDS. THE WEBSITE IS WWW.KNOWTHECAUSE.COM HOPE THIS HELPS SOME.

DAWN

Ellen Galo

3/18/09 11:29am

Thanks, Lene, I'll be seeing him in a few weeks (isn't that always the case? sigh...) I have been bugging my husband but when we talked this morning, he said he hadn't realized why it could be a problem... maybe because I didn't explain!

As for liver damage - he is a daily beer drinker (must feed the yeast! Isn't it ironic that the yeast left in beer is full of B vitamins and is actually good for you, but the American brewers remove it?). He doesn't have any signs of liver damage, eats very well, exercises regularly, but I understand why he wouldn't want to take internal medicine for it. However, I think we both need to do what we can, otherwise. Funny, until I saw his mother's feet (and she was NOT a drinker, except for the occasional glass of wine, and wouldn't let his dad drink either!), I thought maybe the beer was encouraging the fungus. But I think somehow he's genetically particularly prone to it. There may be some other way to discourage it, other than systemic medicine - I will have to check that out. Maybe a vinegar bath every week! (You know, it's funny but a little vinegar tastes sweet to me, not really sour. I kind of like it! I could try a vinegar bath for my feet - only half joking...vinegar is a good household cleaner. My daughter and many others are making 'green' household cleaners/laundry detergent to avoid poisoning the environment further. Vinegar, baking soda, etc.)

stramber

10/15/09 9:09pm

Yes anyone on immune supressant drugs is at risk - currently all the RA drugs Methotrexate, Arava and the biologics Enbrel, Remicade etc are 'immuno suppressants'.

Even without the drugs someone with RA is automatically somewhat immuno suppressed as the disease gives a lower than normal immune system.

I am RA now nearly 60 yrs. After 8 yrs on Methotrexate alone got Aspergillus fungus in the lungs. They cut off half my lung as one 'hole' was nearly 6" and they did not know what it was and cutting it out was only way to find out. They then stupidly put me on Arava and all the round hollow opaic holes came back in my lungs.

After my lung cut off I was taken off Metho never to have it (or Arava) again. I cannot try the new biologics as would get the same problem back. They had to have me on Itraconazone anti-fungal drug for 9 months and the holes/fungus went away. I started taking Olive Leaf extract liquid and I believe this helped greatly.

I now have grown my own olive tree and chop up the leaves and add them to my meals.

I suffer from dermatitis/eczma too with 3 rotten looking fingernails that could look like fungused fingernails but are not. Is you problem truly fungus - doctor can take a scraping from under nails and a piece of nail for testing.

For the exczma I put 2 licorice tea bags in a pot and soak take out then ad 20 drops of lavender oil then 1 litre of water and pour over my head after shampooing takes away the itch. For the groin find an excma gel add 20 drops lavender oil to every 2 tablespoons and put on area of itch.

Nothing is working on my fingernails I guess because it is my RA and the dermatitis is taking advantage of my low immune system.

Ellen Galo

10/16/09 9:03am

WOW - thank you! Someone else had recommended licorice to me for reflux...I had a conversation with my rheumy yesterday where metho was mentioned (I had never wanted mtx and he didn't give it to me because my liver enzymes were high, and are now again.... BUt he had a patient whose liver enzymes were high, and who was given MTX, and they have been normal every since - apparently the liver itself was inflamed, and the MTX helped. My GI doctor has said any organ can be affected by RA. But how to know ahead of time? There is no way. I was wondering if we were heading that way. That gives me another reason not to!

My skin itches A LOT! My GP gave me a steroid cream for 'eczematous folliculitis' and it does take care of it. It's only a very slight rash, a couple dots here and there, but I itch even where there is nothing to be seen ...

I have to cut back apparently on tylenol which means only using it at night to sleep. (Last night even cyclbenzaprine didn't put me to sleep - I still had to take Tylenol.) I'm going to have to increase something else - I have heard that cod liver oil will help eczema. I have tried "fish oil" but even in capsules, it makes my stomach roil up. So I am trying (as of today) some Norwegian cod liver oil. No reaction so far - and also Yucca AR, which I've used a little bit before.

Will let y'all know how things go - thanks for your support! I'll keep in mind the olive oil / tree. My husband and I use olive oil a lot, and I will sometimes use it in place of canola even for baking (canola has omega 6 as well as omega 3, and that's MORE inflammatory. Got to work on this!)

stramber

10/17/09 2:26am

I think you have to try all the drugs, they may or may NOT harm you. Just be aware that they might.

Try Metho and others anyway with blood tests for liver. After say 5 months I'd try slowly going off it - then you will know if it makes a difference. If it does go back on it. It not try something else. Take breaks from it some times if using for a long time. Seems the longer you are on immune suppressants and the higher the dose that's when the 'problems' mostly occur.

I can't eat fish oil either. Have you tried krill oil it is a lot different and only 1 cap. a day. Drink the licorice tea 4 - 6 times a day and I often have 1 licorice strap a day too. Try pineapple juice or fruit.

Nalgesic can help some people 7.5 mg. (it is the herb tumeric)

Make sure your vitamin D levels are good as VD will help with all the pain in the bones and the organs. Make sure iron levels are good too.

Olive Leaf extract is the juice of the olive tree leaves you can buy bottles from the healthfood store or propably Walmart.

If it is candida and not exczema/dermatitis I am sure the doctor can put you on a drug for fungus something like Itraconazole for a few months.

I think Lene advised a Candida diet too which would be good.

Cut back on sugar it is the human race's downfall to bad health its in everything and too much.

But above all NO BEER as the malt/yeast/sugar in alcohol (particularly beer) is feeding the fungus !! Cut back on all alcohol if possible to 1 drink a day and the candida will go within 6 weeks.

Q: Risk of fungal infections with TNF blockers... am I at risk?

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