What is Chronic
Candidiasis?
An overgrowth in
the gastrointestinal tract of the usually benign yeast (or
fungus)
Candida albicans has been suggested as the origin of a
complex medical syndrome called chronic candidiasis, or Yeast
Syndrome.1 2 Purported symptoms of chronic
candidiasis are fatigue, allergies, immune system malfunction,
depression, chemical sensitivities, and digestive disturbances.3
4 Conventional medical authorities do acknowledge the
existence of a chronic Candida infection that affects the whole
body and is sometimes called “chronic disseminated
candidiasis.”5 However, this universally accepted
disease is both uncommon, and decidedly more narrow in scope, than
the so-called Yeast Syndrome—a condition believed by some to be
quite common, particularly in people with a history of long-term
antibiotic use. The term “chronic candidiasis” as used in this
article refers to the as yet unproven Yeast Syndrome.
Checklist
for Chronic Candidiasis
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Nutritional
Supplements |
Herbs |
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Betaine
HCl
Caprylic acid
Enzymes
Lactobacillus acidophilus
Ionic Copper
Ionic Zinc
Ionic Sulfur
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Barberry
Echinacea purpurea
Garlic
Goldenseal
Goldthread
Oregano oil
Oregon grape
Peppermint oil
Rosemary oil
Tea tree oil
Thyme oil |
What
are the symptoms of chronic candidiasis? Symptoms
attributed to chronic candidiasis include abdominal pain,
constipation, diarrhea, gas, bloating, belching, indigestion,
heartburn, recurrent vaginal yeast infections, nasal congestion,
sinus problems, bad breath skin rashes, allergies, chemical
sensitivities, rectal itching, muscle aches, cold hands and feet,
fatigue, depression, irritability, difficulty concentrating,
headaches, and dizziness.
Conventional
treatment options: Chronic candidiasis is not a
conventionally recognized medical condition, so no conventional
treatment is standard. Conventional treatment of chronic
disseminated candidiasis usually consists of oral antifungal
medications (e.g., nystatin [Mycostatin®], ketoconazole [Nizoral®],
fluconazole [Diflucan®], and itraconazole [Sporanox®]).
Dietary
changes that may be helpful: Based on their clinical
experience and on very preliminary research, several doctors have
suggested that certain dietary factors may promote the overgrowth
of Candida albicans. The most important of these factors
are high intakes of sugar, milk, and other dairy products; foods
with a high content of yeast or mold (e.g., alcoholic beverages,
cheeses, dried fruits, and peanuts); and foods to which individual
patients are allergic. However, few clinical trials have
investigated whether these dietary factors affect people with
conditions for which Candida is the causative agent.
One study compared
levels of various sugars in urine of healthy women with levels
found in women with chronic vaginal Candida infections.6
Urine sugar levels correlated with dietary intakes of sugar,
dairy, and artificial sweeteners. Among women who reduced their
intake of sugar, 90% reported no vaginal yeast infections during
the following year. These researchers reported a “dramatic
reduction” in the incidence and severity of vaginitis caused by
Candida as a result of reducing intake of dairy, sugar, and
artificial sweeteners.
Many apparently
healthy people have some Candida in their gastrointestinal tract.
In one trial, high-sugar diets given to healthy people had mixed
effects on the concentration of Candida found in their stool,
though some subjects did show an increase in Candida after eating
more sugar.7 These preliminary reports suggest, but do
not prove, that diet might affect the ability of Candida to infect
the body.
Yogurt that
contains Lactobacillus acidophilus has been reported to
have a therapeutic effect in women with vaginal infections caused
by Candida.
Nutritional
supplements that may be helpful: Lactobacillus
acidophilus products are often used by people with
candidiasis in an attempt to re-establish proper intestinal flora.
Acidophilus produces natural factors that prevent the overgrowth
of the yeast.8 9 Although there are no human
trials, supplementation of acidophilus to immune-deficient mice
infected with C. albicans produced positive effects on
immune function and reduced the number of Candida colonies.10
The typical amount of acidophilus taken as a supplement is 1–10
billion live bacteria daily. Amounts exceeding this may induce
mild gastrointestinal disturbances, while smaller amounts may not
be able to sufficiently colonize the gastrointestinal tract.
Preliminary
research from the 1940s and 1950s indicated that caprylic acid (a
naturally occurring fatty acid) was an effective antifungal
compound against Candida infections of the intestines.11
12 Doctors sometimes recommend amounts of 500 to 1,000
mg three times a day.
It is unknown if
taking pancreatic enzymes or betaine HCl (hydrochloric acid)
tablets is beneficial for chronic candidiasis. Nonetheless, some
doctors recommend improving digestive secretions with these
agents. 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.13 14 15 Decreased
secretion of any of these important digestive components can lead
to overgrowth of Candida in the gastrointestinal tract. Consult a
physician for more information.
In theory, the use
of any effective anti-yeast therapy could result in what is
referred to as the Herxheimer or “die-off” reaction.16
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.
Are there any
side effects or interactions? Refer to the individual
supplement for information about any side effects or
interactions.
Herbs
that may be helpful: Garlic has demonstrated significant
antifungal activity against C. albicans in both animal
and test tube studies.17 18 19
Greater anti-Candida activity has resulted from exposing Candida
to garlic, than to nystatin—the most common prescription drug
used to fight Candida.20 No clinical studies of garlic
in the treatment of candidiasis have yet been conducted. However,
some doctors suggest an intake equal to approximately one clove (4
grams) of fresh garlic per day; this would equal consumption of a
garlic tablet that provides a total allicin potential of 4,000 to
5,000 mcg.
Volatile oils from
oregano, thyme, peppermint, tea tree, and rosemary have all
demonstrated antifungal action in test tube studies.21
A recent study compared the anti-Candida effect of oregano oil to
that of caprylic acid.22 The results indicated that
oregano oil is over 100 times more potent than caprylic acid,
against Candida. Since the volatile oils are quickly absorbed and
associated with inducing heartburn, they must be taken in coated
capsules, so they do not break down in the stomach but instead are
delivered to the small and large intestine. This process is known
as “enteric coating.” Some doctors recommend using 0.2 to 0.4
ml of enteric-coated peppermint and/or oregano oil supplements
three times per day 20 minutes before meals. However, none of
these volatile oils has been studied for their anti-Candida effect
in humans.
Berberine is an
alkaloid found in various plants, including goldenseal, barberry,
Oregon grape, and goldthread. Berberine exhibits a broad spectrum
of antibiotic activity in test-tube, animal, and human studies.23
24 Berberine has shown effective antidiarrheal activity
in a number of diarrheal diseases,25 26 27
and it may offer the same type of relief for the diarrhea seen in
patients with chronic candidiasis. Doctors familiar with the use
of berberine-containing herbs sometimes recommend taking 2 to 4
grams of the dried root (or bark) or 250 to 500 mg of an herbal
extract three times a day. While isolated berberine has been
studied, none of these herbs has been studied in humans with
chronic candidiasis.
The fresh-pressed
juice of Echinacea purpurea has been shown to be helpful
in preventing recurrence of vaginal yeast infections in a
double-blind trial; it may have similar benefit in Yeast Syndrome.28
The typical recommendation for this effect is 2 to 4 ml of fluid
extract daily.
Are there any
side effects or interactions? Refer to the individual herb
for information about any side effects or interactions.
References:
1.
Truss CO. The role of Candida albicans in human illness. J
Orthomol Psychiatry 1981,10:228–38 [review].
2.
Crook WG. The Yeast Connection, 2nd ed. Jackson, TN:
Professional Books, 1984, 1–2 [review].
3.
Kroker GF. Chronic candidiasis and allergy. In: Brostoff J,
Challacombe SJ (eds). Food Allergy and Intolerance.
Philadelphia, PA: WB Saunders, 1987, 850–72 [review].
4.
Bauman DS, Hagglund HE. Correlation between certain polysystem
chronic complaints and an enzyme immunoassay with antigens of
Candida albicans. J Advancement Med 1991;4:5–19.
5.
Bennett JE. Candidiasis. In: Fauci AS, Braunwald E,
Isselbacher KJ, et al (eds). Harrison’s Principles of
Internal Medicine New York: McGraw-Hill, 1998.
6.
Horowitz BJ, Edelstein S, Lippman L. Sugar chromatography studies
in recurrent Candida vulvovaginitis. J Reprod Med
1984;29:441–3.
7.
Weig M, Werner E, Frosch M, Kasper H. Limited effect of refined
carbohydrate dietary supplementation on colonization of the
gastrointestinal tract of healthy subjects by Candida albicans.
Am J Clin Nutr 1999;69:1170–3.
8.
Collins EB, Hardt P. Inhibition of Candida albicans by
Lactobacillus acidophilus. J Dairy Sci 1980;63:830–2.
9.
Fitzsimmons N, Berry DR. Inhibition of Candida albicans by
Lactobacillus acidophilus: evidence for the involvement of a
peroxidase system. Microbios 1994;80:125–33.
10.
Wagner RD, Pierson C, Warner T, et al. Biotherapeutic effects of
probiotic bacteria on candidiasis in immunodeficient mice. Infect
Immun 1997;65(10):4165–72.
11.
Keeney EL. Sodium caprylate: a new and effective treatment of
moniliasis of the skin and mucous membrane. Bull Johns Hopkins
Hosp 1946;78:333–9.
12.
Neuhauser I, Gustus EL. Successful treatment of intestinal
moniliasis with fatty acid resin complex. Arch Intern Med
1954;93:53–60.
13.
Boero M, Pera A, Andriulli A, et al. Candida overgrowth in gastric
juice of peptic ulcer subjects on short- and long-term treatment
with H2-receptor antagonists. Digestion 1983;28:158–63.
14.
Rubinstein E. Antibacterial activity of the pancreatic fluid. Gastroenterology
1985;88:927–32 [review].
15.
Sarker SA, Gyr R. Non-immunological defense mechanisms of the gut.
Gut 1990;33:1331–7 [review].
16.
Truss CO. The role of Candida albicans in human illness. J
Orthomol Psychiatry 1981,10:228–38 [review].
17.
Moore GS, Atkins RD. The fungicidal and fungistatic effects of an
aqueous garlic extract on medically important yeast-like fungi. Mycologia
1977;69:341–8.
18.
Sandhu DK, Warraich MK, Singh S. Sensitivity of yeasts isolated
from cases of vaginitis to aqueous extracts of garlic. Mykosen
1980;23:691–8.
19.
Prasad G, Sharma VD. Efficacy of garlic (Allium sativum) treatment
against experimental candidiasis in chicks. Br Vet J
1980;136:448–51.
20.
Arora DS, Kaur J. Anti-microbial activity of spices. Int J
Antimicrob Agents 1999;12:257–62.
21.
Hammer KA, Carson CF, Riley TV. In-vitro activity of essential
oils, in particular Melaleuca alternafolia (tea tree) oil and tea
tree oil products, against Candida albicans. J Antimicrobial
Chemother 1998;42:591–5.
22.
Stiles JC. The inhibition of Candida albicans by oregano. J
Applied Nutr 1995;47:96–102.
23.
Hahn FE, Ciak J. Berberine. Antibiotics 1976;3:577–88
[review].
24.
Majahan VM, Sharma A, Rattan A. Antimycotic activity of berberine
sulphate: an alkaloid from an Indian medicinal herb. Sabouraudia
1982;20:79–81.
25.
Bhakat MP. Therapeutic trial of Berberine sulphate in non-specific
gastroenteritis. Indian Med J 1974;68:19–23.
26.
Kamat SA. Clinical trial with berberine hydrochloride for the
control of diarrhoea in acute gastroenteritis. J Assoc
Physicians India 1967;15:525–9.
27.
Desai AB, Shah KM, Shah DM. Berberine in the treatment of
diarrhoea. Indian Pediatr 1971;8:462–5.
28.
Coeugniet EG, Kuhnast R. Recurrent candidiasis: adjuvant
immunotherapy with different formulations of Echinacin®. Therapiewoche
1986;36:3352–8.
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intended to diagnose, treat, cure, or prevent any disease.
Information and statements made are for education purposes and are
not intended to replace the advice of your family doctor. The Wolfe
Clinic does not dispense medical advice, prescribe, or diagnose
illness. We design individual nutritional programs that allow the
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