Northampton Wellness, Associates, LLC

The Candida Question
(Is There a Fungus Amongus?)

Q. I've been feeling very tired on and off over the last couple of years and it seems to be getting worse and more frequent. I often have dull headaches and a "spacey" dizzy sort of feeling. I'm embarrassed to say I usually have a lot of gas and abdominal bloating. I seem to be reacting to a variety of foods, pollen, and chemical fumes in ways I never did before. Also, I've been getting one vaginal yeast infection after another. This all began shortly after I took a course of antibiotics a few years ago. I'm not sure if it's because of all these problems, but I've been getting more and more depressed lately. My doctor tells me it may be all "in my head". Is he right?

A. All of your symptoms taken together support a picture that is being recognized frequently these days as chronic candidiasis or the “yeast syndrome”. In medical circles this is a controversial diagnosis, since there are no universally accepted laboratory tests for it. Nor have there yet been rigorously controlled experiments to narrowly define it. However, several hundred physicians have found that many patients improve - sometimes dramatically - when treated for it. Contrary to popular belief, it can affect men as well as women.

What is Candida? Candida is a yeast, a very small organism which enjoys living in warm, dark, moist places in association with other living things. It likes to feed on carbohydrates, especially sugars.

We usually think of yeasts as our friends. They cause bread to rise and beer to ferment. Most often they live in balance with other micro-organisms in our intestines. However, when this balance is upset for any reason, Candida can overgrow and take over, causing a variety of problems.

Lactobacilli are bacteria that compete with yeasts for an ecological niche in our large intestines. These bacteria help digestion take place. They are essential for the absorption of certain vitamins and other nutrients. After a course of antibiotics, particularly if it is prolonged, these "helper" bacteria can die off. Yeasts, however, are unaffected by antibiotics and can multiply and spread throughout the intestinal tract, without competition.

Other factors which may lead to Candida overgrowth are pregnancy, surgery, birth control pills, steroid medications or any severe or prolonged stress or other chronic illness. It is common for a more severe form of candidiasis to develop in people who have advanced cancer or immune disorders, or who are on immuno-suppressant drugs. Here the Candida organisms can spread to the lungs, nervous system or other parts of the body. In the less severe form of candidiasis that occurs in otherwise healthy people, the yeast is generally confined to the mucous membranes of the intestinal tract and vagina, and is often accompanied by related skin infections.

Thus, in patients with candidiasis, we usually see symptoms of impaired digestive ability: diarrhea and/or constipation, gas and bloating. This is often traditionally diagnosed as "irritable bowel syndrome". We might also see yeast vaginitis and fungal skin infections, such as athlete's foot or ringworm in these people.

But although candidiasis may stay in the intestines, its effects do not stop there. There are well-documented cases where it was found that patients had a high alcohol level in their blood even though they did not drink any alcohol. Those patients appeared "drunk" on a regular basis, with disastrous consequences, until they were put on an anti-yeast medication. At that point, the "phantom" alcohol levels went back to zero. It's theorized that there may be other byproducts of this process which can affect the brain and other organs in various ways.

Candidiasis seems to particularly affect the immune system. This is comprised of cells and proteins called antibodies which have the job of searching out and destroying foreign "invaders". The immune cells tend to become very sensitive to Candida, and also to Candida's close relatives, such as bread yeast and molds in the environment, because these closely related fungi tend to have similar protein markers on their outer shells. The immune system may also become hyper-reactive to other compounds, such as chemicals, to which it previously had not reacted. With impaired digestion taking place, larger than usual protein fragments may enter the blood stream, making food allergies a very common problem.

Food, mold and chemical sensitivities may cause a wide variety of symptoms. Some of the more common ones are: depression, headaches, fatigue, skin rashes, asthma, ear infections, sinusitis and joint pain, to name a few.

Persons with candidiasis may often feel spacey, dizzy, or inappropriately drowsy. Premenstrual symptoms, such as headaches and irritability, are likely to worsen. Hypoglycemic fatigue may become a real problem.

It is not surprising for a patient to become discouraged when confronted with many of these symptoms, especially if medical therapy aimed at alleviating the symptoms has not proven helpful. By treating the underlying candidiasis, however,a remarkable recovery can often be achieved.

Candidiasis should be suspected when some combination of the cardinal symptoms develops. Various blood and urine tests have been tried, but with mixed success. Special stool tests can be helpful. But a therapeutic trial remains the only sure way to confirm the diagnosis.

This is not as bad as it sounds. The appropriate therapy is very safe, and a positive diagnosis is confirmed if one feels a definite improvement within one to two weeks on even a partial program. After a brief trial, if you do not feel better, another explanation for your symptoms should be sought.

There are four basic modes of Candida therapy. Any of these modes might be useful by themselves, but more rapid and complete resolution seems to take place when they are used together.

1. DIET. Our thinking about the anti-Candida diet has evolved considerably over the last few years. It used to be thought that total carbohydrates needed to be restricted, but this is only necessary in very rare cases. It is important, however, to avoid all refined carbohydrates, such as sugar and white flour. At the beginning, it is useful to also avoid yeasts, molds, and fermented foods. This cuts out yeasted breads, alcohol, aged cheese, pickles and vinegar. Early on, people may also react to bottled juices (because they tend to ferment) and leftovers (because they become moldy with age). Some people do not have a cross-allergy to the various yeasts and molds, and can do well on a more liberal diet. Most can start to liberalize fairly soon, especially if they are using other modes of therapy along with the diet. A few people must adhere to a stricter diet for some time.

Such dietary modifications may seem overwhelming at first, but there really are a larger number of foods that can be eaten. With proper menu planning, and especially with the help of a good nutritionist, it's not so hard.

2. MEDICATIONS. Nystatin is a drug which is deadly to Candida, but very safe to humans. This is partly because it is not absorbed from the intestines. One can get slight reactions from killing off too many yeasts at once, so it does need to be introduced gradually. But if your symptoms improve with Nystatin, you have really confirmed the diagnosis of candidiasis.

In tougher cases, we may need to use stronger medications, such as Diflucan, Sporanox, Nizoral, or Lamisil. Although problems from these medicines are rare, be sure to have your liver function tests monitored if you are on prolonged therapy.

3. NUTRITIONAL THERAPY. There are a variety of supplements which are helpful to the body in fighting off candidiasis and strengthening the immune system. Certainly, the most important is Acidophilus in high-potency, heat-stable form, utilizing several species. This consists of the "good bacteria" which need to be replaced in the large intestine. It can also be helpful to take caprylic acid, undecenoic acid, tropical citrus extract to inhibit the growth of yeast. The proper and safe dosages of these and other helpful supplements will vary from case to case.

4. IMMUNOTHERAPY. As we mentioned earlier, candidiasis is frequently accompanied by allergic sensitivities to foods, mold, chemicals and other inhalants, such as pollens and dust. These can often be diagnosed through blood and skin tests. Neutralization therapy is effective in relieving symptoms and giving support to your immune system. Some physicians do this through shots, but many find that treatment drops taken under the tongue are just as effective. This is called "sublingual" therapy, and is also used for various medicines, such as nitroglycerine, when direct entry into the bloodstream, via the small veins under the tongue, is desired.

The same methods can be used to neutralize the effects of the immune system's over-reaction to Candida itself. This is often referred to as the "Candida vaccine". It is very effective in combination with other modes of therapy, especially for preventing future recurrence.

Bear in mind that there may be other causes for your symptoms, and appropriate medical tests will rule these out. But it has been estimated that there are millions of people suffering from this problem and many are undiagnosed and untreated. The majority of physicians and medical authorities do not yet accept it, although a growing number of doctors and several eminent researchers do.

It is hard to fund research without the help of drug companies these days, and the treatment of candidiasis emphasizes nutrition, self-care and a non-patentable medicine. Appropriate therapy is effective for so many people, however, that it is not surprising that more and more of us are seeking and finding a solution to what can be an otherwise disheartening complex of symptoms.