In the past 20 years overgrowth in the gastrointestinal (GI) tract of the usually benign yeast Candida albicans has become increasingly recognized as a complex medical syndrome known as chronic candidiasis, or the yeast syndrome. C. albicans is a small fungus that normally lives harmoniously in the digestive tract of all people (and vaginal tract in women). However, when it overgrows, the immune system is weakened and the lining of the intestinal tract is damaged, as a result the body can absorb yeast cells, particles of yeast, and many other toxins. In turn many bodily processes can become disrupted, resulting in the development of the “yeast syndrome”.
Symptoms such as fatigue, allergies, gas and bloating, chronic vaginal yeast infections, muscle weakness, menstrual irregularities, depression, mood swings, and chemical sensitivities, to name a few, are often erroneously attributed to ‘part of aging or part of life’. Many people will say things like “I just don’t feel right” or “my head feels foggy”.
A careful evaluation by a physician knowledgeable about yeast-related illness is the best method for diagnosing chronic candidiasis. The physician will use a comprehensive questionnaire, which is one of the most useful screening methods for determining the likelihood of a yeast-related illness, along with a detailed medical history and sound medical judgement to make a diagnosis. The physician must first rule out any other possible causes of the symptoms present as they can be due to a number of other health conditions. Once he/she has determined that the symptoms are in fact related to a yeast problem then he/she can use tools to confirm the diagnosis and determine a possible cause for the overgrowth. These tools include laboratory techniques such as stool cultures for C. albicans, measurement of antibody levels to C. albicans or C. albicans antigens in blood, as well as a comprehensive digestive stool analysis.
Chronic candidiasis is a classic example of a “multifactorial” condition. There are numerous predisposing factors to its overgrowth, such as altered bowel flora, certain dietary factors, decreased digestive secretions, impaired immunity, nutrient deficiencies, impaired liver function, underlying disease states, and most importantly, drugs such as birth control pills, steroid hormones, and particularly antibiotics.
The candida organism does not normally proliferate within the body, because it is kept in balance by the friendly bacteria, known as acidophilus, which also inhabits the digestive tract. Acidophilus uses the candida organism as food, maintaining a healthy balance within the intestinal tract. Therefore, anything that destroys the acidophilus can lead to candida overgrowth. Once this overgrowth has begun to take over the chemistry of the digestive tract, it can invade other parts of the body.
Prolonged use of antibiotics may be the most important factor in the development of chronic candidiasis. Antibiotics are unable to distinguish between the good and bad bacteria in the digestive tract, therefore killing them both! Once this ‘natural enemy’ of the candida organism is destroyed, then the candida yeast will be allowed to multiply out of control.
There is little argument that, when used appropriately, antibiotics save lives. Unfortunately they are often overused, and relied on for conditions such as acne, chronic bladder infections, chronic ear infections, chronic sinusitis, and nonbacterial sore throats. These conditions are effectively treated with natural measures, therefore antibiotics for these conditions does not make good medical sense. Unfortunately, prescriptions for antibiotics are not the only source of concern as they have been added to animal nutrition since the 1950s.
A poor diet will contribute to the overgrowth of C. albicans, however, it will not cause the problem alone. It is best to avoid a high intake of sugar as sugar is a chief nutrient of C. albicans. In addition, milk and other dairy products should be kept to a minimum as dairy’s high lactose content promotes the overgrowth of candida and may contain trace levels of antibiotics. Foods containing a high content of yeast or mold, such as alcohol, cheeses, dried fruits and peanuts should be avoided as well. Food allergies are another common finding in patients with the ‘yeast syndrome.’ Determining these allergies through laboratory testing or an elimination diet may prove beneficial.
Gastric hydrochloric acid, pancreatic enzymes, and bile all inhibit overgrowth of C. albicans and prevent its penetration into the small intestine. Decreased secretion of any of these can lead to overgrowth. Therefore, supplementation with hydrochloric acid, pancreatic enzymes, and substances that promote bile flow is a critical part of treatment. In addition, avoiding drugs such as Tagamet (cimetidine) and Zantac (ranitidine) which affect proper hydrochloric acid secretion must not be overlooked. A comprehensive stool analysis can help determine which factor is most important.
Recurrent infections, including chronic candidiasis, are characterized by a depressed immune system. A depressed immune system leads to infection, and infection leads to damage to the immune system, further weakening resistance. Unfortunately, this repetitive cycle makes it difficult to overcome infection without aggressive treatment. In the case of chronic candidiasis, the depressed immune function is related to decreased thymus function. There are expensive laboratory tests to document this depressed immune function, however, the history of repeated viral infections, like the common cold, outbreaks of cold sores or genital herpes, and prostatic or vaginal infections are a good indicator of a depressed immune system. Restoring proper immune function is key in the treatment of chronic candidiasis. This can be achieved through a combination of lifestyle modifications, stress management, exercise, diet, nutritional supplementation, and glandular therapy, to name but a few.
People with chronic candidiasis usually exhibit multiple chemical sensitivities and allergies. This is a good indicator that detoxification reactions are stressed and that their liver function must be supported. In order to aid the body’s detoxification through the liver, the diet should focus on fruits and veggies, whole grains, legumes, nuts, and seeds, and the avoidance of alcohol. Lipotropic factors such as choline, betaine, and methionine are critical, as well as a special extract of milk thistle (Silybum marianum).
Proper detoxification also involves adequate elimination. If one is not able to promote proper elimination with a high-fiber diet, additional support through a natural fiber formula composed of psyllium seed, kelp, agar, pectin, and plant gums are available.
As discussed above, healthy bacteria, such as acidophilus play a major role in the health of the gastrointestinal tract. Probiotic supplements can and should be used to promote overall good health and as postantibiotic therapy. The ingestion of 5 to 10 billion viable L. acidophilus or B. bifidum cells daily is an adequate dose for most people. Requirements increase depending on the circumstance at the time and especially with postantibiotic therapy.
Caprylic acid, berberine-containing plants, garlic, enteric-coated volatile oil preparations, and propolis are natural agents with proven activity against C. albicans. Detoxification and elimination must be adequate before starting any of these antiyeast agents in order to avoid the Herxheimer (“die-off”) reaction. The Herxeimer reaction refers to a worsening of symptoms as a result of the rapid dying off of the yeast. Antiyeast agents should be started in low-doses and gradually increased over one month to achieve a full therapeutic dose.
Treatment should be aimed at addressing the underlying cause of C. albicans versus treating symptoms alone. Simply trying to kill the C. albicans with a drug or natural anti-C.albicans agent will result in reoccurence and only short-term effects as this approach fails to address the factors that predispose one to chronic candidiasis. A step-by-step approach which includes identifying and addressing predisposing factors, implementing a C. albicans control diet, providing nutritional support, supporting immune function, promoting detoxification and elimination, and the use of a proper probiotic and antiyeast agent will yield he most effective results in most cases.
Dr. Sabrina Giustra, ND, is a naturopathic doctor and owner of the North Bay Naturopathic Clinic. www.northbaynaturopath.com
References are available upon request.