Paging Dr. House

November 5, 2011 11:06 PM

What could I be doing that keeps getting me infected with fungal infections and infections in general?

This is a longshot, but I gotta ask someone who isn't my doctor, and yes, I know, this is the internet, none of you are doctors/my doctor/valid medical advice. Please don't harass me for this. I am out of town, can't access my normal health care provider, my blood test results aren't back, and I am sick and stressed.

I have been to Urgent Care and my doctor's office more times this year than I care to admit. I've had minor sinus infections, UTIs, fungal infections, YIs, and even a bout of shingles that thankfully got taken care of within a few days of treatment. Now I'm breaking out in these weird pimples on my face and my inner thighs, and I just discovered a new case of ringworm inside that little dip under my nose (fourth area). I have tested negative for STDs, I'm not pregnant, and I just had my doctor do a full blood panel on absolutely everything we could think of except cholesterol.

I am doing all that I can not to think of myself as unwell but why am I getting infections all the time? I am ashamed of going to Urgent Care over and over every few months. It's not like I'm faking it; the only thing that my doctors can't explain is why I keep getting infected with these things.

What am I doing wrong? I wash my clothes and bedding and towels like I'm supposed to, I take showers regularly, I use sulfate- and detergent-free soaps and laundry solutions. What do I do if my blood tests don't yield anything conclusive? Could a nutrient deficiency cause this?

Factors I am trying to correlate: I take BC (Zovia), this is the first year I've ever had sex, I have not been able to exercise super regularly but I do enough where I sweat pretty good once or twice a week, I am not often thirsty and am frequently dehydrated, and sometimes I have bizarrely strong fatigue. My thyroid is being tested, and diabetes has been eliminated as a possible cause.

posted by These Birds of a Feather to health & fitness (18 answers total)

I'm not a doctor, but I'll share with you what has kept colds and viruses at bay for me for the majority of the past 5 years of my life - eating low carb, nutrient-dense homemade food. Nixing the sugar and pasta and sweets, and eating meat (free range beef, mostly), fatty fish, fruits, veggies, dairy, and nuts, basically. I know it sounds boring and unscientific, but I truly believe that a clean diet along with fish oil supplements have helped me to dodge infections, clear my skin, lose weight, and stop getting those energy crashes and afternoon fatigue from carb heavy meals. Sleep is also crucial to keeping your immune system strong, so perhaps look into your sleep patterns and the quality of your shuteye. I urge you to scale back on carbs for a month - go gluten-free if possible - to see if any of your conditions clear up.
posted by sunnychef88 at 11:38 PM on November 5, 2011 [2 favorites]

are you on any asthma or allergy meds? i found that after starting flovent and flonase that i got a bunch of infections and pimple problems.
posted by nadawi at 11:49 PM on November 5, 2011 [1 favorite]

Is your house damp or moldy? Get an inspection to see if the fungal stuff is environmental. But I would also follow sunnychef's advice with one really important addendum - give up all fermented and yeasted foods and ALL SUGAR EVEN FRUIT. Just for a while, see if it helps. IANAD but this approach helped me with some of the things you describe.
posted by yogalemon at 11:57 PM on November 5, 2011

How long and how well do you sleep? Do you wake a lot during the night or find that you don't feel rested even after a decent night's sleep? I notice you talk about "bizarrely strong fatigue." Fatigue or lack of sleep can affect immune response.

I've had a couple of odd infections in the last few years that my doctors and I never quite figured out. I don't have any immune-related conditions nor any other health issues that would predispose me to infections. The only thing we could come up with is that they happened at times when my sleep schedule was greatly disturbed for a period of time (international travel, etc.)
posted by jdwhite at 12:03 AM on November 6, 2011

I'd start on 1,000 to 2,000 mg of Vitamin D a day right away. Read up on the latest medical findings about Vitamin D - not those funded by vitamin manufacturers, but straight medical studies instead. They've found that most people are deficient in Vitamin D, mostly because we don't work outdoors in the sunlight like people used to; instead we're indoors most of the time and losing out on the health aspects of sunlight. Vitamin D deficiency impacts the immune system and makes a person much more susceptible to infection and illness. If you're uneasy about taking a vitamin in such high dosage, have your doctor test you for deficiency and go from there. I'm 64 and have Parkinson's, severe COPD and osteoporosis. My doctor came up with the idea of testing for Vit D deficiency and mine was extremely low. I was put on 1,000 mg a day and after a year I was still low, but my level had come up a little bit. The doctor then put me on 2,000 mg a day and after that year my level was nearly normal - but I'm still supposed to keep taking it. I can only tell you that I haven't been hospitalized in the last 2-1/2 years, and that's unusual for me.

I hope you give it a try and I certainly hope you get a handle on this very soon and get back on your feet.
posted by aryma at 12:34 AM on November 6, 2011

Are you doing classes at a gym where mats are shared? When I used to do yoga, I got a bunch of skin infections and similar (including scabies, yuck!) from using the studio's mats. They sanitise between users, but obviously not well enough. Alternatively, if you are swimming, and using communal showers, maybe you are picking things up there?
posted by lollusc at 12:36 AM on November 6, 2011

It's a tough question, but just thought I'd throw out there the possibility that some of this may be interrelated. It depends on the timing and how many of each of the infections you mention that you've had, but infections can tend to beget other infections.

For example, you start off with a UTI, then you treat it with a systemic antibiotic, and that causes you to get a yeast infection because it kills off the good bacteria in your vagina. Now let's say you either are prone to UTIs (this is not uncommon, in fact, it's happened to me) and suddenly you just started having sex this past year. Well, then it would make sense that you start getting UTIs, and with the antibiotics for the UTIs, getting YIs. (does not apply to Macrobid/nitrofurantoin, this antibiotic is not systemic and if other antibiotics have been causing YIs, I recommend asking your doc about Macrobid). This might be telling you something you already know, but most UTIs in young women are caused by sex, and so if you are new to having sex and still not sure how to avoid UTIs, that is almost definitely playing a role in this part of your issue. (are you peeing after sex right away every time? are you drinking cranberry juice? are you avoiding sexual positions that can be more prone to causing UTIs? etc)

Yeast infections are another thing that once you get them, can be really difficult to treat and require multiple treatments. So I can definitely see how if you had a tough to treat YI that kept sort of seeming to go away then recurring, it would get frustrating, especially if it followed on the heels of a UTI or multiple UTIs.

Then when you're going to the urgent care/doctor's office, you're hanging out with sick people, in a waiting room and exam room where sick people have been. They can then give you their colds and coughs and sinus infections. If you have been having a lot of colds and other upper respiratory infections this theory is less plausible.

Finally you could have picked up some resistant bacteria. UTIs that are resistant to some of the common antibiotics and pimples caused by community acquired Methicillin Resistant Staph Aureus (MRSA) are unfortunately not all that rare these days and so getting both of these things within one year would not be that surprising. Once you get MRSA it can be really tough to get rid of because you are 'colonized' by the bacteria and sometimes people just keep getting recurrent abscesses or pimples from it, and have to go through a 'decolonization' regimen to get rid of it.

As for the ringworm, I've got nothing. Might be just bad luck. And if your pattern of infections or timing of infections does not fit with any of what I've said above, then disregard all this conjecture...
posted by treehorn+bunny at 12:37 AM on November 6, 2011 [8 favorites]

I am FAR more prone to infections, including skin infections, when I am not eating well and not taking my vitamins. Eating healthy, keeping an eye on your nutrition, and taking your vitamins will never hurt, and it might help.
posted by Countess Sandwich at 1:46 AM on November 6, 2011 [1 favorite]

Has anyone tested your blood sugar levels?
posted by taff at 1:51 AM on November 6, 2011

Could it be that you have a low-grade chronic infection which is going undiagnosed? I have no specialist knowledge whatsoever, but here is how I understand what doctors have told me: for a few years, I had untreated low-grade gum infection, which rarely bothered me - it only flared up whilst I had not tooth-related outbrakes (the flu, UTI etc.). It urned out that the gum problem made me much more susceptible to infections elsewhere, cause it was leaving me much more vulnerable than I had been before. Conversly, an added infection elsewhere in my body could lead to the gum infection becoming temporarily more acute. But it still went unnoticed for a long time until diagnosed by a dentist, because it just seemed to be part of the general feeling ill when it played up.
posted by miorita at 1:51 AM on November 6, 2011

I had similar problems through my early 20s. UTIs, gum problems, horrible skin, fatigue, and anxiety about all of it. All of the infections had weakened my immune system so much that anything at all could trigger another one, or a cold, or feelings of lethargy, nausea, anxiety, depression, whatever. It was a vicious cycle and everything seemed to compound negative effects.

This may seem trite, but changing my diet was the only thing that helped, and in a big way. Figuring out what my particular body does and doesn't need was key. YMMV, but nowadays I don't eat/drink hops, oats, wheat (that's the biggie there), barley, sugar, soy, cows milk (if I can help it). I go big on yogurt, veggies, meat. I go happy on some rice, cheese and salty, tasty, fatty treats.

It took a while to build back a balance. I haven't had a UTI in many years and probably won't under normal circumstances. I avoid taking antibiotics at all costs. I can feel that my immune system is stronger. I don't get sick when everyone around me does. I don't need my environment to be sterile or even super clean. I smell better, I sleep better and I feel better. I can take mental blows and injuries and taxing days and long nights like I couldn't before. And the anxiety about it all is gone.

There's something about our society that diminishes the importance of food on our health and well being. Yet, you put sugar in your gas tank and it's a no brainer why the car won't run, no matter how much fuel cleaner you chase it with.
posted by iamkimiam at 1:49 AM on November 6, 2011 [3 favorites]

I would carefully document all of your symptoms, and see your regular doctor as soon as possible - you may have something more serious going on that they can test for.
posted by jb at 5:40 AM on November 6, 2011

Drinking more water may help with the sinus infections -- it has for me. And upping my Vitamin D dose has helped me with fatigue -- I've been diagnosed clinically low on that. (And why not cholesterol? I knew someone with a cholesterol deficiency; it's been linked to depression, which could cause fatigue.)

That being said, we are not your doctors and this kind of clustering of immune-system-related things is serious and should be taken seriously. I'd do some research to see what the blood tests include (there are enough possible blood tests out there that I highly doubt they include everything -- thyroid is usually an initial screening and then a follow-up, for example). I'd wait for the results.

Once you get the results, I'd keep following up, even if the results of the initial blood tests were all negative. Be the squeaky wheel! Ask for referrals! If you don't follow up, they assume you're feeling better. Don't sit around feeling crummy and assuming they've done all they can do.

I've been there (with something different), so I can relate -- it sucks. Good luck, and I hope you're feeling better soon.
posted by pie ninja at 5:51 AM on November 6, 2011

You need to see a rheumaologist pronto. "Bizarrely strong fatigue" and frequent fungal infections strongly indicate an autoimmune disorder.

Every rheumatologist I've worked with has been highly procedural. Start making notes now about diet, lifestyle, drugs (OTC, prescription and recreational), and especially your symptoms. Write down everything, whether you think it's connected or not. Autoimmune problems can manifest in highly unusual ways.

And DON'T PANIC! If I'm right, there are fantastic treatments out there to get your fatigue and everything else under control. If you have any questions, please memail me; I'm not a doctor but I was you eight years ago.
posted by workerant at 6:35 AM on November 6, 2011

If you're having oral sex (performed on you) for the first time in your life, that might explain the yeast infections. I seem to get them with regularity when my husband goes down on me, which is apparently quite common.

Otherwise, I'm genetically prone to fungal skin infections. Honestly, the way that I keep them at bay are to use either over the counter dandruff treatments as a skin wash (if you want to go natural, tea tree oil body wash, but it doesn't work as well), or, when it gets really bad, prescription-strength dandruff shampoo, at my dermatologist's suggestion. Usually gets rid of the problem in 1-2 showers. You might need bigger guns than sulfate-free shampoos.
posted by PhoBWanKenobi at 6:48 AM on November 6, 2011

Some suggestions + ideas to put out there:

I'll nth the suggestion to go see a rheumatologist and get some serious workup for an autoimmune issue. There's about a zillion million blood tests regarding your immune system that a general provider typically doesn't draw, to really look at the composition of immune system, and if this has been going on for a year, please ask for a referral to a specialist.

--speaking of interrelatedness, unfortunately there may be a couple of different things going on: it's possible that UTIs + yeast infections may be one thing (post-sex hygiene + sex practices, treatment with antibiotics leading to fungal infection leading to treatment with antifungals and then start the cycle again ...) and then something different going on with your sinusitis + skin infections + etc.

I'm wondering about the correlation in timing between your taking birth control + your symptoms, first off. Birth control can cause or spark off immune problems/autoimmune problems. Not common, but it happens. You could consider a trial off of the birth control for a while, depending, obviously, on why you're taking it, just to see (which might take a while to notice a difference).

questions:
when did you start taking the birth control + when did your symptoms start?
Are you having gastrointestinal issues right now (diarrhea? weird poop? etc?)?
Did you get an HIV test as part of your STD screen?
Do you ever wake up feeling or looking sort of puffy in the face?
For diabetes, did you do a just fasting glucose or get an A1C too?
Are you taking any other medications right now?

Have you ever gotten any of your infections cultured so you can see just exactly what it is? A certain percentage of yeast infections, unfortunately, are caused by something other than C. albicans (the most common one), and they can be harder to treat.

This sucks, I'm sorry you're dealing with this.
posted by circle_b at 9:39 AM on November 6, 2011

In addition to trying vitamin D, and going to a rheumatologist, you should consider going to an allergist and getting tested for allergies (and treated if you test positive). Please also make sure they are checking your level of Vitamin B12 as part of the bloodwork they are doing.

In my case, I tested borderline hypothyroid, so borderline that doctors don't ordinarily treat it. I was getting kind of desperate due to how sick I was getting, including cellulitis a number of times, and finally persuaded my doctor to give me a low dose of synthroid, which has really helped. (My doctor later admitted I was right to push for the thyroid meds.)
posted by gudrun at 11:19 PM on November 6, 2011

Nthing dietary changes work wonders. I also had a ton of systemic infections in my twenties and they cleared up when I took as many carbs (esp. processed foods) out of my diet as I could. Exercise might have also helped, I'm not sure because I did both of these things simultaneously.

FWIW, I've gone back to lots of carbs, sugar, and processed foods in the past year (I had a kid and cooking feels overwhelming to me a lot of the time) and I have started to feel ucky again, getting sick more, and always feeling like I'm on the verge of a UTI and a YI. So while I felt at the time that the diet was the thing but maybe it was coincidence or something, now I am pretty dang sure that good nutrition keeps away all kinds of physical problems, especially those things like you're describing which seem really hard to nail down.
posted by rabbitrabbit at 11:01 AM on November 7, 2011