Candida

What is Candida?

Yeast, including the organism Candida albicans, live in healthy bodies, on skin and mucus membranes, including the digestive tract.  In small amounts, their presence is normal and causes no harm.  However, when the immune system deteriorates, the hormonal balance is altered, or when the normal intestinal balance is affected, yeast can grow in number, a condition called “yeast overgrowth”, “Candidiasis”, or “Intestinal Dysbiosis”.  Candida is called an “opportunistic” pathogen because it only causes disease when it has the opportunity due to these imbalances.

What causes the normal body balance to be altered?

Anything that causes changes in the intestinal flora (bacterial and other organisms who reside there or lowers immune resistance can increase susceptibility to yeast overgrowth.  These include

• Use of antibiotics, which kill good intestinal bacteria as well as those bacteria which they are intended to kill. (Some researchers feel that the meat of animals that have been fed antibiotics also contribute to this problem.)  These good bacteria normally prevent Candida from growing.
• Birth control pills
• Pregnancy
• High doses of steroid medications such as cortisone and prednisone or immunosuppressive drugs
• Diabetes mellitus
• Malnutrition
• Severe stress and anxiety
• Excessive intake of yeasted foods
• Excessive eating of sugary foods and refined carbohydrates
• Toxic exposure to xenobiotic agents, such as pesticides, heavy metals, mercury, etc.
• Immunosuppressive viruses, such as HIV

What happens in the body then?

Overgrowth of yeast can occur on any mucus membrane in the digestive tract, in the mouth, skin, or in the vaginal area.  The organism can then release immunotoxins, which can suppress the immune system and allow further yeast growth.  Neurotoxic proteins from yeast can contribute to fatigue, irritability, headache, mood swings, and other neurological symptoms. Ordinarily, Candida exists in the yeast form that looks like a bud or ball.   The growth form of yeast is called the mycelial form, which resembles the roots of a plant.  These mycelia can damage the normal barrier in the intestinal lining, causing increased intestinal permeability or “leaky gut syndrome”.  Larger particles, such as undigested proteins from food, can then be absorbed from the intestine into the blood stream, setting the stage for food, mold, and other allergies, and chemical sensitivity as the immune surveillance recognizes these foreign invaders and launches an immune response.  Yeast and bacterial cell membrane fragments upregulate the immune system, increasing the tendency to allergies and auto-immune diseases.

How will I feel when this happens?

There are many general symptoms of a yeast infection.  You may have many of them or just a few.  They include: headache, depression, low energy, recurrent bladder or vaginal infections, prostatitis, rectal itch, chronic diarrhea or constipation, irritable bowel syndrome, menstrual irregularities, menstrual cramping, fungal skin or nail infections, heart burn, abdominal pain, bloating and gas, anxiety, confusion, disorientation, insomnia, impotence, lack of coordination, muscle weakness, joint swelling, chest pains, blurred vision, sore throats, persistent cough, rash and blisters in the mouth, sugar, bread, or alcohol cravings, chronic sinusitis, environmental and food allergies or worsening of symptoms in an atmosphere of smoke, perfume, mold, or on damp days.

Diagnosis

Based on your symptoms and history, further testing may be requested by your doctor.  Some tests, which I have found particularly useful in diagnosing and treating Candida, include the Comprehensive Digestive Stool Analysis or CDSA, the Intestinal Permeability test, and blood testing for elevated antibody/antigen levels to Candida.  The CDSA is the most useful test because it assesses digestive function, which is frequently impaired in patients with Candida. This test cultures not only for Candida and other yeast but assesses the state of all intestinal flora, favorable and potentially problematic.   It can also check for intestinal parasites.  The antibody testing can be useful in certain situations but has the drawback that it tests only for Candida and not other yeast and bacteria causing dysbiosis. Oral, vaginal, and rectal cultures can also be performed but are useful in a limited number of situations.  The Intestinal Permeability study is helpful in identifying damage to the intestinal tract, particularly important in those who have food allergies.  This test also assesses malabsorption.

Treatment

The treatment for candidiasis is focused on restoring the normal balance in the system. In order to be successful, several important aspects must be addressed:

1. Reducing the total amount of yeast in your system by:

• Taking antifungal medication or herbs, as prescribed.
• Avoiding foods that “feed” the yeast: sugar and refined carbohydrates.
• Eating foods which suppress yeast: garlic, onion, broccoli, etc., and plain yogurt.
• For Herxheimer (“die-off”) reactions:  Zymex 2 (from Standard Process): 2-4 caps every 2-4 hours with lots of water. If this is not completely successful, add Vitamin C 1000-2000 mg every 2-4 hours and/or Trisalts (or Alka-Seltzer Gold or Baking Soda) 1 tsp in 8 oz of water (or 4 caps) with each dose.

2.  Strengthening the immune system by:

• Taking vitamins (A, C, Zinc, Selenium, and others) as prescribed.
• Supporting and balancing the endocrine system, if indicated.
• Thyroid function is especially important to normal immune function, as those who are hypothyroid are more susceptible to infections and therefore getting antibiotic therapy.
• Avoiding immunosuppressive medications, high doses of steroids, and oral contraceptives (birth control pills).
• Eating a high quality whole foods diet.
• Increasing exercise to improve circulation, digestion and general conditioning.
• Stress reduction: biofeedback and relaxation techniques, counseling.
• Decrease heavy metal exposure, such as mercury, which has been shown to suppress immune function, increase allergy and chemical sensitivity, and promote the growth of yeast, especially in the more damaging mycelial form.  Mercury is present in all silver dental fillings.  Get tested for mercury and consider removal of these fillings by a dentist experienced in the removal of this toxic substance, particularly if you have had Candidiasis for a long time or it has been difficult to treat.

3.  Restoring normal digestion, restoring the normal balance of organisms in the digestive tract by:

• Taking Lactobacillus acidophilus, Bifidobacterium bifidum, and other helpful bacteria.  These are available in oral supplements (powdered (dosage: 1/4 to 1/2 tsp. a day or two to four capsules a day).  Since these are living organisms, they are susceptible to being killed by heat, strong sunlight, etc. so keeping refrigerated best preserves them.  We recommend only probiotics that are enteric coated and stabilized. Some of these do not require refrigeration.   These are good options for traveling.
• Eating high fiber foods to encourage food elimination.  Constipation works against restoring normal digestive flora as aerobic bacteria such as Lactobacillus does not survive in an anaerobic environment created by delayed intestinal emptying and prolonged intestinal transit time.
• To measure transit time: take 10 activated charcoal caps and measuring how long it takes for the stools to become black from the charcoal and then to return to a normal brown color.  Alternatively, those who do not digest corn or beets can use those foods to measure transit time and watch for undigested particles.  A transit time of greater than 24 to 36 hours can prevent restoration of normal aerobic bacteria and favors the growth of anaerobic bacteria and Candida.
• Avoid medicines (such as antacids, Zantac, Tagamet, Pepcid, Axid) that lower stomach acid.  Adequate hydrochloric acid is necessary for normal digestive function and to kill yeast in food. Many people who suffer from Candidiasis and food allergies produce inadequate stomach acid, a condition called hypochlorhydria. This also frequently happens with age.
• Avoid antibiotics that kill off helpful bacteria and destroy the normal intestinal balance.  If you do need to take antibiotics, be sure to take acidophilus for at least a month after finishing the course of antibiotics.  If you have had a severe yeast problem, you may need to take anti-fungal supplements or medications while on antibiotics to prevent recurrence.

4.  Decreasing exposure to allergens and other substances that may depress immune function or encourage the growth of yeast by:

• Avoid foods that contain yeast or are fermented, including vitamins.  Check that the vitamins you are taking are yeast-free and are manufactured by a reputable company who specializes in producing vitamins from natural sources.  Brewer’s yeast is a common source for B-vitamins and chromium-GTF.
• Get allergy tested and avoid foods that you are allergic to, as these exposures can increase intestinal permeability, as well as causing allergic symptoms.
• Eliminating smoking, passive inhalation of smoke, and other air and water pollutants as much as possible.  Good quality air and water purifiers are available which help reduce these exposures.
• Cleaning molds and mildews from bathrooms, basements, crawl spaces, etc. and by removing dead leaf litter from outside your house and from houseplants.

5. Immunotherapy:  Desensitization of allergic reactions to Candida and other molds, foods, and inhalants.

• Allergy testing and treatment can be very helpful in the treatment of Candida and the allergies that can stem from it.  Allergy testing can identify which substances are provoking symptomatic reactions and allow you to focus on removing them from your diet or environment.  In addition, immunotherapy based on that testing can desensitizes or neutralize allergic reactions to Candida, molds, yeast, foods, smoke, perfume, and other substances. This strengthens your immune system by removing the stresses produced by the reactions.  Immunotherapy can greatly improve symptoms and even allow for re-introduction of foods into your diet after 3 to 6 months, as your body’s reaction to those substances is reduced.  Many times, persistent Candida symptoms even after treatment are due to allergic reactions to Candida, rather than an overgrowth of the organism itself.

SPECIFIC GUIDELINES FOR YEAST FREE DIET

 What is a yeast free diet?

A yeast free diet eliminates food that encourages yeast to grow, such as sugar and refined carbohydrates, and foods that are likely to be cross-allergic, such as yeasted, fermented, or moldy foods.

Foods to enjoy as much as you like:

• Fresh vegetables, whole grains, whole grain pasta, popcorn, seafood and fish, poultry, yogurt (plain only – sweetened with low sugar fruit), yeast free crackers, sourdough, Essene, or soda breads, beans, eggs, organic or “natural” beef, pork, or lamb meat (without antibiotics or steroid hormones).
• Bottled or filtered water or seltzer, can be flavored with a small amount of fresh juice, such as lemon, lime, orange, or apple, for taste.

Foods that are helpful and should be eaten:

• Garlic, onions, ginger, cabbage, broccoli, turnips, kale, cauliflower, Brazil nuts, shrimp, scallops, lobster, yogurt, olive oil, high fiber foods.

Foods to eat in moderation:

• Unprocessed nuts and seeds, and nut butters.
• Fresh whole fruits, preferably those with low sugar content.
• Good quality fermented foods (miso, tempeh, tofu) may be reintroduced into the diet, if there is no reaction to them.
• Coffee and tea.
• Fresh cheeses, such as feta, mozzarella, ricotta, cottage cheese.

FOODS TO AVOID:

Sugar:       

Sugar and refined carbohydrates in any form including sucrose, fructose, maltose, lactose, glucose, high fructose corn syrup, galactose, monosaccharides, honey, molasses, maple syrup and maple sugar, date sugar, brown sugar, raw sugar, turbinado sugar, corn syrup, corn sweetener, white flour (also called enriched wheat flour), white rice, and any products made with these substances, fruit juice, fruit sweetener, high sugar fruits, cola or other soda.

Yeasted, moldy, and fermented foods:

YEASTED FOODS:  bread, crackers, pastries

FERMENTED FOODS: alcoholic beverages (including beer and wine), malt products, vinegar, mustard, ketchup, Worcestershire sauce, Accent, MSG, steak sauce, barbecue sauce, and soy sauces.

MOLDY FOODS:  aged cheese, dried and candied fruits, leftovers (can be frozen instead of refrigerating to prevent mold growth), teas and dried herbs, mushrooms, morels, and truffles, fruit juices, peanuts.

OTHER FOODS containing yeast and/or chemicals, such as trans fatty acids: canned, processed, and “fast food”, processed and smoked meats, including ham, bacon, luncheon meats, sausage, or hot dogs.

FRUIT SUGAR  CONTENT:

LOW SUGAR: any melon, cantaloupe, rhubarb, *strawberries, watermelon

MODERATE SUGAR: apricots, *blackberries, *cranberries, *gooseberries, grapefruit, guava, limes, orange, papayas, peaches, plums *raspberries, tangerines, apples, *blueberries, *cherries, kumquats, *loganberries, mangoes, *mulberries, pomegranates.

HIGH SUGAR: *grapes, pears, pineapple, bananas, *figs, *prunes, *dates, *raisins, *currants, *any dried fruits.

• *All of these berries and fruits should be washed well to remove any white coating, which is mold, or avoided entirely.
• All fruits and vegetables can have mold on the outside and should be washed well or peeled and eaten promptly.

If you have questions or problems with following this diet, please call our office or make an appointment to discuss it.  We also have recipes for soda bread, yeast free mayonnaise and salad dressings, etc.  Learn to read labels in order to identify which foods you can or cannot eat.

Can I ever eat these forbidden foods again?

The change in diet, while difficult and time consuming at first, will contribute to your recovery. The length of time that the diet should be followed varies greatly from person to person.  Depending on the extent yeast overgrowth and the severity of allergic reactions, your diet may be broadened again after a few months to include more foods.  However, sugar, refined, and processed foods, and commercially made products are best avoided for continued good health.

Where can I learn more about candidiasis?

Some relevant books include:

#1Crook, William G., M.D., The Yeast Connection: A Medical Breakthrough, (3rd edition, 1986, Jackson, Tennessee, Professional Books.) and other books by this author. (Also has a website by this name.)

#2 Connolly, Pat, The Candida Albicans Yeast Free Cookbook (New Canaan, CT:  Keats Publishing)

#3 Annechild, Annette and Laura Johnson, Yeast Free Living (New York: Putnam Publishing, 1986)

#4 Truss, Orion, M.D. The Missing Diagnosis, (Birmingham, AL  1983)

#5 Trowbridge, Dr. John Parks and Walker, Dr. Morton.  The Yeast Syndrome.

#6 Schepper, Le Duc, M.D.  Candida.

#7 Appleton, Nancy.  Lick The Sugar Habit.

The following organizations can also provide additional information and support:

International Health Foundation, Inc.

P.O. Box 3494

Jackson, TN 38303

(901)427-8100                FAX (901) 423-5402

Candida Research and Information Foundation

P.O. Drawer JF

College Station, TX  77841