host posted on May 08, 2009 13:11
Candida is a common mold or fungus. It can exist either as a small single celled or yeast form or as a branched multi-celled form. The most common species of Candida is Candida albicans, but many other species of Candida are found in humans including C. tropicalis, C. glabrata, C. parapsilosis, C. krusei, C. guilliermondii, and C. lusitaniae.
When Candida or yeast is mentioned, most women tend to think of Candida causing unpleasant vaginal infections. While Candida often causes nasty vaginal infections, Candida can infect every part of the body except the teeth (C Kibbler M.D., Principles and Practice of Clinical Mycology, England 1996). The largest area of Candida colonization is usually the intestinal tract, although Candida frequently also infects the sexual and urinary organs (of both women and men), the mouth, and the skin. Candida infections sometimes create a whitish cottage-cheese like discharge in the mouth. Many women, and men, have heavy Candida overgrowth in their intestines without having any symptoms in their urinary or genital organs.
Candida is present in the digestive, urinary and sexual organs of most humans. The extent of Candida growth varies greatly in people, all the way from small and nonsymptomatic infections, to life threatening infections, which can invade large areas of the body. Candida can be spread by a wide variety of mechanisms including by the air, water, touching inanimate objects (fomites), food, hospital spread and personal/sexual contact.
Candida infections are likely to be especially bad in patients with compromised immune systems such as HIV/AIDS patients, organ transplant patients and patients with certain cancers like leukemia and lymphoma. Frequent use of antibiotics also kills off beneficial bacteria in the intestinal tract and encourages overgrowth of yeast. Use of steroids, such as prednisone or birth control pills, can also lower the body’s resistance to Candida. A diet rich in sugar and poor in nutrients can also increase the risk of yeast overgrowth. The number of serious Candida infections has grown in recent years, probably due in large part to the increased use of antibiotics.
Acute, fast growth of Candida can destroy organs and cause life threatening health problems. However, Candida usually does not cause life threatening problems in most people with intact immune systems, but can still cause chronic colonization, which can lead to significant health problems. Such Candida related chronic health problems include chronic fatigue, asthma, digestive problems, urinary tract infections, depression, skin rashes/infections and poor concentration and memory.
The most noticeable problems with Candida in women involve vaginal yeast infections. Such vaginal yeast infections can cause a number of problems including a whitish vaginal discharge, itching, burning, soreness and pain during urination and sexual activity. As noted earlier, exposure to antibiotics, a high sugar diet, or steroids, such as prednisone or birth control pills, increases the risk of Candida infections. Candida can also be spread by an infected sexual partner. A heavy growth of Candida in the intestines can increase risk of developing vaginal Candida infections.
Vaginal yeast infections can be treated with either oral or topical antifungal drugs such as fluconazole (Diflucan). The woman’s sexual partner may also have to be treated. Women with Candida infections should eat a low sugar, low yeast diet and take oral probiotics such as Lactobacillus and Bifidobacterium bacteria. Reducing levels of Candida in the gut can significantly reduce vaginal yeast problems. A study of 33 women with vaginal yeast infections has reported that eating yogurt with living Lactobacillus bacteria significantly reduced vaginal yeast infections and significantly reduced the numbers of Candida colonizing the vagina. (This study was published in the Archives of Internal Medicine on March 1, 1992;166:353-7.) A recent study of women treated for vaginal Candida infection with a single dose of 150 milligrams of Diflucan reported that taking two Lactobacillus probiotic capsules daily for 4 weeks was associated with significantly lower incidence of vaginal symptoms and Candida reinfection (Letters of Applied Microbiology, March 2009;48(3):269-274).
Candida growth in the intestines has been shown to produce a number of harmful substances including ethanol (beverage alcohol), acetaldehyde (toxic to many metabolic reactions in the body) and a number of highly allergenic proteins called “Canditoxins.” Candida overgrowth can increase gut permeability and thus allow partially digested allergenic proteins and various toxins to more readily enter the intestine. There have been a number of reports of patients who did not drink any beverage alcohol but who became drunk due to the Candida in their gut fermenting foods into alcohols. These persons have been called “drunken liars” since they insist that they have not drunk any alcohol.
Candida infections in the gut can be measured by a number of ways including measuring levels of Candida in stool samples and measuring levels of antibody to Candida. However, none of these tests is 100% accurate and many clinicians recommend using a therapeutic trial of anti-Candida treatment if a patient has health problems which suggest yeast overgrowth.
Diet is the cornerstone to treating Candida overgrowth in the intestines. The diet should emphasize meats, poultry, fish, eggs and vegetables. Vegetables in the onion family (onion, leeks, garlic, chives) and the cabbage family (cabbage, broccoli, cauliflower, brussels sprouts, bok choi, radish) should be eaten regularly because they have some antifungal properties. Fresh dairy products, whole grain products, seeds, oils and fresh fruits can be eaten in moderation. Avoid sugary foods, sweetened colas and beverages, fried foods, alcohol, dried fruits, fruit juices, mushrooms, yeast containing breads and aged cheeses. Doug Kaufmann’s books, such as the Fungus Link 1 through 3, offer a good dietary program for correcting problems of Candida overgrowth. Books by William Crook, M.D., such as the Yeast Connection, also offer helpful advice in the dietary and medication treatment of Candida problems.
Use of probiotic bacteria, such as Lactobacillus and Bifidobacterium and certain dietary supplements like caprylic acid, are useful in controlling Candida overgrowth. Sometimes systemic oral antifungal drugs, such as ketoconazole (Nizoral) or fluconazole (Diflucan), are helpful in treating chronic yeast overgrowth problems. Nystatin is also often used to treat intestinal Candida infections, however, it can not be used for systemic Candida infections since it is not absorbed into the bloodstream from the gut.
Some preliminary research has reported that reducing levels of Candida in the intestines can improve health in many people with chronic health conditions. As noted earlier, oral probiotics can reduce problems with vaginal yeast infections. Anti-yeast treatment is often helpful for chronic fatigue patients. Carol Jessop M.D. treated 900 of her chronic fatigue patients with the antifungal drug ketoconazole (Nizoral), along with careful diet which eliminates refined sugar, yeast, alcohol and fruit juices. After 3 to 12 months of treatment with ketoconazole and a careful diet, 529 (59%) patients regained their former health, another 232 (26%) patients showed significant health improvement and 136 patients (15%) stayed the same or got worse (American Medical News May 26, 1989). Many of these patients showed resolution of chronic health problems such as vaginal yeast infections, skin rashes, irritable bowel syndrome, depression and problems with concentration and memory.
A Norwegian study reported on the effects of nystatin and a sugar-free diet in 116 adults. These adults were selected as those who had multiple health complaints which suggested Candida related illness. These patients experienced multiple health problems such as chronic fatigue, asthma, depression, poor memory & concentration, spaciness, headache, insomnia, muscle & joint aches, digestive problems, skin rashes, vaginal itching and burning, impotence, sensitivity to foods and low level chemical exposures and other problems. This study found that both the sugar free diet and the nystatin significantly reduced overall health problems in these patients. Average symptom reduction in the patients receiving both the nystatin and the sugar-free diet was 37% as compared to placebo. There were significant improvements noted in most of the adverse health symptoms in the patients receiving both the nystatin and the sugar-free diet (This research was published in Family Practice June 2001;18:258-65.)
Several studies have reported that lowering exposure to indoor molds can reduce risk of asthma. Antifungal drug treatment may also improve asthma symptoms by reducing the level of Candida and other molds living in the body. Dr. David Denning and colleagues treated 58 patients with severe asthma with fungal sensitivity (SAFS) with either 200 milligrams of itraconazole (Sporanox) twice daily or placebo for 32 weeks. The group of patients receiving the itraconazole had significant improvements in lung functions and significant declines in asthma and rhinitis (stuffy nose) symptoms, while the group of patients receiving placebo did not improve. About 60% of the SAFS patients receiving the anti-mold itraconazole treatment were judged to have a major improvement in quality of life. This research is now in press at the American Journal of Respiratory and Critical Care Medicine.
Much more research is needed on the treatment of Candida overgrowth problems.
Luke Curtis, M.D., C.I.H.