Candida

Yeast infections, also called Candidiasis or thrush, can be located in the mouth, genital region, digestive tract and may present systemically, in a wide variety of internal organs in immunocompromised people. They are caused by a group of organisms known as Candida, with C. albicans being the most common. Other forms of candida that may cause infection are C. topicalis, C. glabrata, C. parapsilosis and C. krusei.

Candida is a fungus that inhabits areas of the body in all individuals. In the intestines, it co-exists with a wide range of other organisms, including the friendly intestinal bacteria such as Lactobacillus acidophilus. However, due to a variety of factors, Candida overgrows and overwhelms the friendly bacteria, causing an imbalance of intestinal flora. As Candida becomes the predominate organism in the intestinal tract, it secretes a multitude of toxins that can produce many symptoms which go beyond the digestive tract. Newborns, immunocompromised patients, long-term antibiotic, corticosteroid and cytotoxic drug use, lack of digestive secretions, nutrient deficiencies and a high sugar diet can all lead to the development of Candida infection.

Symptoms

Symptoms of Candida infections depend on the site primarily involved. In oral candidiasis, or thrush, the tongue may have white, milk-curd like patches on it, which can be taken off by scraping; the tongue may be red and painful. In genital yeast infections irritation, redness with itching and discharge may be present. Women primarily experience severe symptoms but males are often carriers and can give the infection to partners.

Intestinal candidiasis infections can present in a number of ways, from gastric symptoms such as bloating and gas to skin disorders like eczema, to headaches, fatigue and depression. Usually a person has a history of chronic antibiotic use, oral steroid use or for women the use of birth control pills. Most people with candidiasis have a lowered immune status and may suffer from chronic infections, chemical sensitivities, and generally feel unwell

Diagnosis and Pharmaceutical Interventions

Diagnosis of Candida infections also depends on the site of infection. Oral infections are usually diagnosed by taking a scraping of the white lesions and examining it under a microscope with a potassium hydroxide solution. This test can also be conducted for genital yeast infections. For further diagnosis the specimen can be cultured. A culture will specify which Candida species may be involved.

Intestinal candidiasis can be diagnosed several ways, most commonly by a thorough health history assessment. A stool analysis may be done, which looks for and isolates Candida organisms via a yeast culture.

Conventional medicines

Amphotericin B

– Used to treat systemic fungal infections. Usually injected but is also available as a powder. Side effects may include fever, chills, headache, irregular heartbeat, muscle cramps, nausea, pain at the place of injection, vomiting, diarrhoea, indigestion, dizziness, and loss of appetite. Amphotericin B depletes calcium, magnesium, potassium, and sodium.

Diflucan

– An antifungal. While expensive, it is considered by many doctors as the best overall antifungal medication. It may cause gastrointestinal irritation, headaches and skin rashes. Diflucan should not be used while breast feeding as it is transferred in mother milk, or with oral contraceptives (which contribute to Candida overgrowth). It should also be used with caution if used with medication for diabetes.

Lamisil

– An antifungal agent which can be used orally or topically; it can cause gastrointestinal problems and skin rashes. It is metabolized in the liver and should not be used with any known liver disease, or in women who are breastfeeding. It is not known to deplete any nutrients

Nizoral

– An antifungal agent which can be administered orally or topically; it is not known to deplete any nutrients. However, Nizoral does interfere with the adrenal hormones cortisol and DHEA. This hormonal interference may produce feelings of weakness and fatigue.

Nystatin

– drug used to treat fungal infections of the intestinal tract. It is taken orally, and rare side effects include diarrhea, upset stomach, stomach pain, and skin rash. It is not known to deplete any nutrients

Sporanox

– An oral antifungal. It should not be used in pregnancy or with certain cholesterol lowering medications (especially HMG-CoA reductase inhibitors). It can interact with many medications: certain antibiotic, calcium channel blockers, oral coagulants, antacids and some chemotherapeutic drugs form the treatment of cancer. Side effects include gastrointestinal upset, headaches, dizziness, menstrual disorders and neuropathy.

Lifestyle and Dietary Modifications

An anti-Candida diet is the most effective treatment and will provide long lasting results for many people. The main point to this diet is to avoid sugars in its many forms: all junk food, all refined sugars and natural sugars such as honey, molasses and maple syrup, all fruit and fruit juices, and a reduced intake of carbohydrates, especially leavened breads. It is also important to rotate foods; eating the same food every day can create more cravings for foods that may be a problem.

Sugar is the primary food for yeast and fungus. If you can cut out sugars for 3 days, their ‘spell’ will be broken and you will have fewer cravings. Avoid white-starch foods, like white bread, cakes, cookies, white pasta, white rice, potatoes without their skins, and all refined flours, as they convert to sugar very easily in the body. Whole-grain four and whole grains may be eaten with caution. Quinoa is a very nice grain that is high in protein. Any breads or muffins should be made with baking powder or baking soda as a leavening agent.

Vegetables also can convert to sugar quite easily.Checking the glycemic index of a vegetable will allow you to see how much sugar it can make. Include as many vegetables in your diet as possible. Beneficial vegetables include: asparagus, beets, broccoli, Brussels sprouts, cabbage, cauliflower, celery, cucumber, eggplant, green peppers, dark leafy greens: spinach, mustard greens, collard, kale, beets greens, romaine lettuce and arugala; garlic, onions, radish, string beans, tomatoes, turnips and okra.

For more information read the glycemic index.

Dairy products are best completely avoided, but some sugar free yoghurt, buttermilk and butter are acceptable. Cheeses that contain mould are to be avoided. If consuming yogurt one should read the label to make sure it contains friendly probiotic bacteria.

Alcoholic beverages must be excluded, as not only are they made with yeast, and contain high amounts of sugars, but the alcohol is converted to more sugar in the body. Other fermented beverages such as cider and root beer should also be avoided.

Avoid foods made with a fungus or a fermentation process such as vinegar and foods that contain it: sauerkraut, green olives, pickled vegetables, and relishes; fermented soy products, and of course mushrooms.

As this diet can be quite stringent, it is important to avoid stressful situations and promote healthy eating habits.

Medication use that contributes to infection should be avoided. Oral steroid medication can be replaced with herbal anti-inflammatories such as Curcuma or omega 3 fatty acids from fish oil. Hormonal agents such as birth control pills may be harder to replace. It is advised to work with a complementary alternative practitioner to find an adequate replacement. Supporting the immune system with nutrition and reducing the toxic load from the Candida will naturally reduce the need for antibiotics.

Nutritional Factors Shown to be Beneficial

In theory, the use of any effective anti-yeast therapy could result in what is referred to as the Herxheimer or die-off reaction. The effective killing of the yeast organism can result in absorption of large quantities of yeast toxins, cell particles, and antigens. The Herxheimer reaction refers to a worsening of symptoms as a result of this die-off. Although this reaction has not been reported following use of any of the nutritional or herbal anti-Candida agents, the likelihood of experiencing this reaction can be minimized by starting any anti-yeast medications or nutritional supplements slowly, in lower amounts, and gradually increasing the amounts over one month to achieve full therapeutic intake.

Probiotic ‘friendly’ bacteria

Acidophilus products are often used by people with candidiasis in an attempt to re-establish proper intestinal flora. Some forms that are commonly available are Lactobacillis acidophilus, L. reuteri, L. casei GG, L. bifidus, Bifidobacterium animalis and Saccharomyces boulardii. These products produce natural factors that prevent the overgrowth of the yeast.
Dose: 1–10 billion live bacteria daily

Dietary enzymes

Pancreatic enzymes or plant based enzymes can improve digestion and assimilation of nutrients. Hydrochloric-acid secretion from the stomach, pancreatic enzymes, and bile all inhibit the overgrowth of Candida and prevent its penetration into the absorptive surfaces of the small intestine. Decreased secretion of any of these important digestive components can lead to overgrowth of Candida in the gastrointestinal tract.
Dose: 1-2 capsules with meals

Undecylenic acid

A naturally occurring medium chain fatty acid that has antifungal activity, undecylenic acid has very low toxicity. It is also used in as an active ingredient in many topical over the counter antifungal preparations.
Dose: 450-750 mg daily in three divided doses.

Antifungal herbal preparations

Several herbs have antifungal activity, most notably oil of Oregano (from Oregano and Thymus species), Oregon grape (Berberis vulgaris), and Pau D Arco (Tabebuia impetiginosa ). These herbs, when taken internally, can act similarly to prescribed antifugal medication, especially when used with an anti-Candida diet.
Dose: 250-500 mg three times a day of Pau’D Arco and Oregon grape, 100 mg of enteric coated Oregano oil capsules.