Mold treatment confusion

nystatin and fluconazole are both antifungal - so it may be that they favour a few weeks of one followed by a few months of the other
fluconazole has some risks of liver damage the longer it is used - so that may be why they prefer to do only a short course of it
nystatin on the other hand is not absorbed systemically and is regarded as very safe

this is one possible explanation - ie a risk benefit type approach

did you ask them to explain their approach ?

To my knowledge the “zoles” are more systemic and the nystatin is more application specific - so orally would be GI only.

Could have something to do with Garzie’s thoughts on the liver angle.

Colonization in the mold space is also controversial - I’d be curious the logic behind docs decision

So anti fungals for yeast vs mold are two different angles from my perspective.

Yeast in stool implies to me a colonization in the gut (which is often something like candida). This is more a disruption in the microbiome vs a colonization from ongoing external exposure.

Anti fungals for mold are often used in cases where it’s thought the patient is still being effected by mold after a detox approach (mold illness/cirs) but appears to have no ongoing exposures. In which cases “zoles” are used for their systemic reach vs nystatin would just be hitting the gut. This is controversial because there’s often little to no definitive testing to warrant this approach outside of a clinical “ educated guess”. Now you can swab the nasal passages to reasonably rule out nasal colonization (and where nystatin could be used as a nasal spray). With all that said.. some people do find help from this approach but we really have no clue what’s going on inside the body.. so it’s assumed there was some sorta colonization that responded to a strong systemic anti fungal.