What is the recommended treatment for a 10-year-old female with elevated yeast and fungal markers, impaired oxalate metabolism, and glycolytic cycle support?

From the Guidelines

The recommended treatment for a 10-year-old female with elevated yeast and fungal markers, impaired oxalate metabolism, and glycolytic cycle support should include oral fluconazole, 200–400 mg (3–6 mg/kg) daily, for 14–21 days, along with dietary modifications and supplements to address impaired oxalate metabolism and glycolytic cycle support. The patient's elevated yeast and fungal markers, such as Citramalic, 5-Hydroxymethyl-2-furoic, and Arabinose, indicate the need for antifungal therapy, as suggested by the Infectious Diseases Society of America guidelines 1. For impaired oxalate metabolism, dietary modifications are essential, including reducing high-oxalate foods like spinach, rhubarb, and chocolate, as recommended by the American Urological Association guideline 1. Ensuring adequate calcium intake (about 1000 mg daily) to bind oxalates in the gut is also crucial. Vitamin B6 supplementation (25-50 mg daily) may help improve oxalate metabolism by supporting the conversion of glyoxylate to glycine instead of oxalate. For glycolytic cycle support, B-complex vitamins, particularly thiamine (B1, 25-50 mg daily) and riboflavin (B2, 25-50 mg daily), are important. Magnesium citrate (100-200 mg twice daily) can support both enzymatic functions and help with oxalate issues. Probiotics containing Lactobacillus and Bifidobacterium species (10-20 billion CFU daily) may help restore gut flora balance, which can influence both yeast overgrowth and oxalate metabolism. Some key points to consider in the treatment plan include:

• Monitoring of symptoms and periodic laboratory testing to assess treatment efficacy and make adjustments as needed
• Addressing the underlying metabolic issues while supporting the body's natural detoxification and energy production pathways
• Considering the patient's overall health and medical history when selecting supplements and medications
• Ensuring the patient's diet is well-balanced and provides adequate nutrients to support overall health. The patient's elevated oxalate metabolites, such as Oxalic, Glycolic, and Glyceric, and glycolytic cycle markers, such as Lactic and Pyruvic, also support the need for a comprehensive treatment approach that addresses these metabolic issues. Regular follow-up appointments with a healthcare provider are necessary to monitor the patient's response to treatment and make any necessary adjustments to the treatment plan.

From the FDA Drug Label

Nystatin Oral Suspension, USP, is indicated for the treatment of candidiasis in the oral cavity. Nystatin is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi.

The patient has elevated yeast and fungal markers, including Citramalic, 5-Hydroxymethyl-2-furoic, and Arabinose. Given the presence of these markers, Nystatin (PO) may be considered as a treatment option to address the yeast and fungal overgrowth. However, it is essential to note that Nystatin is specifically indicated for the treatment of candidiasis in the oral cavity, and its effectiveness in addressing systemic yeast and fungal issues is not explicitly stated in the provided drug labels.

• The patient's impaired oxalate metabolism, as indicated by elevated Oxalic, Glycolic, and Glyceric levels, and glycolytic cycle support, as shown by elevated Lactic and Pyruvic levels, should also be considered when developing a treatment plan.
• It is crucial to consult with a healthcare professional to determine the best course of treatment, as the provided information is insufficient to make a definitive recommendation 2 2.

From the Research

Elevated Yeast and Fungal Markers

• The patient's yeast and fungal markers, such as Citramalic, 5-Hydroxymethyl-2-furoic, and Furan-2,5-dicarboxylic, are elevated, indicating potential yeast or fungal overgrowth 3.
• Arabinose is also elevated at 51, which may suggest impaired gut function or dysbiosis 4.
• Treatment for yeast and fungal overgrowth may involve antifungal medications, probiotics, or dietary changes, but more research is needed to determine the best course of treatment for this patient.

Impaired Oxalate Metabolism

• The patient's oxalate metabolites, such as Glycolic, Oxalic, and Glyceric, are elevated, indicating impaired oxalate metabolism 5.
• This may be related to the patient's dietary intake or underlying genetic disorders, such as primary hyperoxaluria 6.
• Treatment for impaired oxalate metabolism may involve dietary changes, such as reducing oxalate intake, or medications to reduce oxalate production.

Glycolytic Cycle Support

• The patient's glycolytic cycle markers, such as Lactic and Pyruvic, are elevated, indicating increased glycolytic activity 6.
• This may be related to the patient's energy metabolism or underlying disorders, such as diabetes or mitochondrial dysfunction 7.
• Treatment for glycolytic cycle support may involve dietary changes, such as increasing glucose intake, or medications to support energy metabolism.

Additional Considerations

• The patient's bacterial markers, such as Hippuric and 4-Hydroxyhippuric, are elevated, indicating potential bacterial overgrowth or dysbiosis 3.
• The patient's mitochondrial markers, such as Succinic and Fumaric, are also elevated, indicating potential mitochondrial dysfunction 6.
• Treatment for these conditions may involve antibiotics, probiotics, or dietary changes, but more research is needed to determine the best course of treatment for this patient.