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Candida Albicans
Treatment
Nutritional Program for Yeast
Syndrome
Elson Haas, M.D. (Excerpted from Staying Healthy
with Nutrition Celestial Arts)
The "yeast" problem with
Candida albicans is one of the new medical concerns of the
1980s that will continue into the next century. It has been
described by many prominent physicians, including C. Orian Truss in
The Missing Diagnosis, William Crook in The Yeast
Connection, and Keith Sehnert in The Candidiasis
Syndrome. It is a very common problem, one of the most frequent
I see, and is to me a medical adventure, because I learn a great
deal while working with people with this problem. Often the therapy
for yeast, or candidiasis as it is commonly known, will positively
and dramatically change lives. The somewhat complex, multilevel
treatment program has been effective in a high percentage of the
people I have treated, and I have worked with hundreds with this
problem to date.
Factors Common
to Patients with Yeast Syndrome
- Frequent or long-term use of
antibiotics, such as tetracycline for acne
- Frequent use of broad-spectrum
antibiotics for recurrent infections, such as in the ears,
bladder, vagina, or throat
- Birth control pill use in
women
- Premenstrual symptoms
- Recurrent vaginal yeast infections
in women or prostate problems in men
- Regular use of cortisone-type
drugs
- Cravings for sweets, breads, or
alcohol
- Sensitivity to molds, dampness, and
smells
- Mental symptoms such as depression,
mood swings, or confusion
- Chronic fatigue, indigestion, or
food reactions
- Recurrent skin fungus infections,
such as ringworm, athlete’s foot, "jock itch," or nail
problems
The yeast syndrome is a
controversial topic. Most traditional doctors do not want to hear
about this condition and call it a "fad" disease, but those who will
explore the possibility and look for it in their patients will be
hard-pressed not to accept this problem as "real." One of the
reasons, I believe, for medicine not really accepting the "yeast
syndrome" is because the problem arises predominantly as a side
effect from the use of commonly prescribed drugs—antibiotics, birth
control pills, and corticosteroids.
The problem originates
when a common yeast, Candida albicans, begins to overgrow
in the intestinal or genito-urinary tract. It may be contracted
initially through sexual contact. When other normal body microflora
are killed off by antibiotics, the yeasts will then proliferate and
coexist with the useful germs. Mild mucocutaneous infections (of the
skin, vagina, throat, or bladder, for example) may develop in the
yeast phase of this dimorphic organism. This common yeast is usually
noninvasive (that is, it remains localized) except in the severely
debilitated patient. However, with long-term infestation or with the
weakened immune state that can result from a reduction of normal
colon bacteria, the yeast can shift into its fungal form, wherein it
develops rhizoids, or roots, that can be implanted in the intestinal
wall or other mucosal linings. This allows absorption into the body
of by-products (toxins) of fermentation and other antigenic material
generated by the fungus. The body will then make antibodies to the
Candida albicans organisms. This can lead to an
immunological or hypersensitivity reaction that is manifested as the
polysystemic disease for which this syndrome is now known.
The yeast problem thus
occurs at two levels—the localized infections, of which skin rashes
and vaginitis are the most common (intestinal overgrowth is also
common), and the secondary and more serious systemic reactions. This
problem can then produce such symptoms as recurrent skin fungus
infections, examples being ringworm, athlete’s foot, "jock itch," or
nail problems; headaches; fatigue; cystitis or prostatitis; mental
symptoms such as mood swings, poor memory or concentration,
depression, or confusion; premenstrual symptoms; recurrent herpes
infection; joint pains; cravings for sweets, bread, or alcohol;
indigestion or food reactions; and sensitivity to molds, dampness,
environmental pollution, cigarettes, and various smells.
This yeast syndrome is
much more common in women than in men and seems to affect the
hormonal balance, initially causing mild premenstrual symptoms of
irritability, depression, fatigue, and swelling, and leading to
actually abnormal and/or painful menstrual periods. I would estimate
that a significant number of women with PMS have a problem with
Candida albicans, and probably more than half the women
with candidiasis have some uncomfortable premenstrual
symptoms.
Diagnosing polysystemic
candidiasis may involve several tests. Most doctors who work with
this problem use a questionnaire such as the one provided by Dr.
Crook in his book, The Yeast Connection. The scores
indicate the likelihood of a yeast problem, and while not exact,
this is a pretty accurate tool. Many doctors suggest a trial
treatment program merely on the basis of an interview, exam, and
questionnaire score, as the response to therapy is often a good
indication of the presence of the problem. However, I like to have
more objective monitors, so I perform two main tests, both
reasonably inexpensive. One is a culture of a stool specimen to
quantify the amount of Candida albicans (or other yeast)
organisms present. This can then be repeated to measure the
effectiveness of the program. Also, a sensitivity test that finds
what substances will actually kill the yeast (in the lab, at least)
can be done after the organism is isolated. The other test measures
the blood levels of three antibodies (IgA, IgM, IgG) to the
Candida albicansorganism, performed by Immunodiagnostic Lab
in San Leandro, California. If these antibodies are elevated, this
suggests that some systemic reaction is occurring in the body (the
stool reveals only an intestinal overgrowth), which may be
correlated with more widespread symptoms. This test also gives us
the opportunity to monitor the body’s status over time to measure
treatment response. Reducing yeast organisms in the body and
replacing friendly bacteria will usually reduce elevated antibody
levels.
Other tests may be
helpful in determining coexisting medical problems. A study of the
stool for ova and parasites may show these to be more commonly
present in yeast carriers than in the average population, as often
the same predisposing factors, poor digestion and low stomach acid,
are present. Treatment may also be needed to eliminate these
parasites. Creating proper colon ecology is a crucial factor in
health, disease resistance, and many important body functions. When
normal colon bacteria are present in sufficient quantities (which
they may not be when other invaders are taking their place), they
will actually produce many vitamins using the nutrient fuel provided
them. Vitamin K and most of the B complex vitamins—niacin, B12,
pantothenic acid, B6, biotin, and folic acid—are among these.
Intestinal bacteria also aid final digestion of food, such as
proteins and milk. With low colon bacteria counts, poor digestion,
and an unhealthy intestinal lining, more food allergies may develop.
A blood test measuring specific antibodies to many commonly
allergenic foods may be indicated in some people with candidiasis,
especially when there is a real problem with food intolerance.
Frequently found reactions, indicated by greatly elevated IgG
antibody levels, include reactions to both baker’s and brewer’s
yeasts, wheat, milk, cheeses, mushrooms, and eggs. Many others are
possible, but those are the ones I have found to be most common and
most strong.
Three-Faceted Approach to Treatment of the Yeast
Syndrome
Do not feed the yeasts
foods upon which they thrive.
-
Reduce yeast growth
through natural treatments.
-
Reestablish normal
intestinal ecology.
The overall approach to
treating the yeast problem is threefold. The first
facet is to refrain from feeding those "yeastie beasties"
what they like to eat so they can thrive and divide. They live on
mostly simple sugars and yeast and fermented foods. These include
fruits, fruit juices, and dried fruits, sugary foods, refined flour
products, alcoholic beverages, cheese, vinegar, breads, and other
yeasted fermented food products, such as soy sauce. All these foods
are avoided on the yeast diet.
What to eat? There are
many recommended foods—fish, poultry, meat, lots of vegetables, some
whole grains, nuts, seeds, and occasional eggs. (The antiyeast diet
is more difficult for vegetarians, but definitely possible.) Some
yogurt, especially acidophilus culture, is all right if milk is
tolerated. Oils are obtained from some butter and more cold-pressed
vegetable oils, such as olive, flaxseed, sesame, and sunflower.
Legumes are often limited because they add to intestinal gas.
Basic meals include
proteins and vegetables or, occasionally, starch and vegetables. For
the first few weeks, the carbohydrates, including pastas and
especially breads, are limited, with only some whole grain cereals
being used. This lowers fiber intake, but usually other aspects of
the treatment help colon function. The Ideal Diet discussed in Part
Three, with certain modifications, will make a good Candida diet.
The rotation is a good way to reduce food reactions. Initially, the
diet includes no fruit, or only one piece a day, and none of the
sweeter fruits, such as grapes, bananas, and melons. The starches
are limited to one portion a day, and the meals are oriented toward
proteins and vegetables.
This is a special
therapeutic diet, and not
necessarily a lifelong one, though many people like the way they
feel on it. Intestinal symptoms decrease, energy improves, and itchy
or irritated skin may start to heal with a decrease in sugar and
yeasty foods. Also, some weight can be shed easily on this diet.
This may be a problem for the already trim person, and lighter
people need to emphasize regular eating to prevent weight
loss.
After a few weeks, we can
test ourselves with fruit, bread, other grain products, or cheese—of
course, one food at a time, and only one daily—to see how we handle
them. If they seem to cause no problems, we can then bring these
foods into our diet on a rotating basis. Eventually, adding more
whole grains and fiber will provide what I believe is a healthier
diet. Different degrees of strictness with the diet may be
necessary, depending on the severity of the problem. A more
stringent diet might exclude all fruits; whole grains, particularly
the glutinous ones—wheat, barley, and oats; herb teas and spices,
which may contain molds; and many nuts, which can also carry
molds.
Anti-Yeast Diet
Plan
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Emphasize |
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Avoid |
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Vegetables—all |
Beans |
Sugar—all forms |
Baked
goods |
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Meats* |
Nuts & Seeds |
Alcoholic
beverages |
Vinegars |
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Poultry* |
Butter |
Fruit juices |
Pickled
vegetables |
|
Eggs |
Cold-pressed oils |
Dried fruits |
Cheese |
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Fish* |
Lemon |
Refined flours |
Mushrooms |
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Whole grains |
Fruit, fresh** |
Breads |
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*Vegetarians
will need to use more whole grains, beans, and nuts and seeds but
this higher carbohydrate diet does not really curb yeast as well.
Furthermore, vegetarians seem to be more prone to yeast overgrowth
because their diet is more alkaline and sweet, which supports the
yeast. **Limited to two pieces daily.
The second
facet of the treatment is to diminish the amount of yeast
present. This is what Western medicine is so good at accomplishing.
Nystatin powder is the most commonly used pharmaceutical for initial
treatment of intestinal yeast. Nystatin itself is made from a
culture of certain bacteria and it will actually kill yeast. It is
not readily absorbed through the intestinal mucosa, so basically it
just handles the gastrointestinal yeast. Since it is most often
given as pure powder dissolved in water, it will also kill some of
the yeast in the oral cavity when it is gargled. A solution can be
used to wash the sinuses as well by dissolving nystatin in saline
solution and using a dropper or inhaling the solution. For men with
candidiasis and recurrent prostatitis or genital or skin symptoms of
yeast, or for women with recurrent cystitis or other systemic
symptoms, I may prescribe a stronger antifungal agent called
ketoconizole, brand name Nizoral. This is effective for most yeast
problems, but it can be damaging to the liver, so its use must be
watched closely. For people who do not respond well to Nystatin,
Capryllic Acid plus grapefruit seed extract are exceptionally
effective and are safe for the liver.
During yeast treatment,
symptoms may arise secondary to killing the yeast. This occurs most
with Nystatin, at times with the natural therapies, and only
occasionally with the systemic medicines. The symptoms might include
headache, fatigue, a mild flulike syndrome, or an exacerbation of
already existing symptoms. It may be helpful during "die-off"
periods to clear the colon every two or three days with a water
enema or have a colonic irrigation every week or two for several
treatments. Adding some Nystatin to the water to introduce it
directly into the colon may help clear some more yeast.
Natural remedies that
help to reduce yeast by killing it or by interfering with its growth
include caprylic acid, fresh garlic and garlic extract, and the
herb, pau d’arco, or taheebo. Caprylic acid is a natural fatty acid
extracted from coconut oil. It interferes with the growing and
duplicating process of the Candida albicans does not
actually kill yeast, but it is effective in reducing intestinal
yeast levels. It must be used for a fairly long period. I often
prescribe the caprylates to follow a two to three month course of
Nystatin and use a caprylic acid product such as Caprystatin or
Capricin for a few months also. The length of treatment for yeast
depends on the degree of the problem, the response to the treatment,
and the results of tests.
Garlic has been shown to
kill some yeast in sensitivity tests in the lab. It can be added to
the treatment regimen and often helps. Two capsules several times
daily is the usual dosage, though good garlic may have a
blood-pressure-lowering effect at that amount, which may
detrimentally affect some people. Goldenseal root also has some
antifungal properties. Pau d’arco, a Brazilian tree bark, has become
a very popular herb in the treatment of yeast, allergies, and other
immune problems. It can be taken in capsules, or tea made from the
bark can be drunk several times daily. It seems to tonify or
strengthen the gastrointestinal tract and may help reduce
yeast.
The third
facet of the yeast treatment involves restoring the colon
to its natural state, mainly by reimplanting lactobacillus
bacteriae. Acidophilus primary products used. There are a couple of
other bacteria that are also helpful in the gut and used in some
formulae. Lactobacillus bifidus, a cousin to provide some
colon support in the adult. Streptococcus faecium, a
friendly form of strep bacteria, also adds a helpful function by
replacing the once-present yeast.
A formula that contains
all three of these bacteria is produced and marketed by Klaire
Laboratories in Southern California. This high-quality, milk-free
product called Vital-Plex can be taken as a supplement during the
yeast treatment. Another product that has been well researched is
DDS-1, produced by UAS Laboratories. It is available in powder,
capsules, and tablets. Studies at the University of Nebraska and
Michigan State University have shown acidophilus DDS-1 to have many
positive effects, as described by Keith Sehnert, M.D., in "The
Candidiasis Syndrome, Old Problem, New Mystery." This acidophilus in
the colon can produce acidophilin, which has an antibiotic effect on
a number of potentially pathogenic colon bacteria. It also has been
shown to inhibit growth of Candida albicans yeast. This
product, as do most effective acidophilus cultures, helps restore
bacteria that produce many B vitamins, including B2, B3, B6, B12,
folic acid, biotin, and pantothenic acid. DDS-1 has also been shown
to produce enzymes that help in digestion of proteins and milk sugar
(lactose), and through its effect on fat metabolism, it has a mild
cholesterol-lowering potential. Other research has revealed that
DDS-1 and other lactobacilli may have antiviral effects with some
viruses (herpes is one example) and anticancer effects, especially
in the colon. I have seen lactobacillus treatment reduce the
severity and recurrence of cold sores, genital herpes outbreaks, and
canker sores, which may be a result of its correcting chemical or
acid-base imbalance. By replacing putrefying bacteria in the mouth,
throat, and upper intestinal tract, it has been seen to resolve bad
breath as well as many symptoms of gastrointestinal upset, helping
people’s guts "feel more settled."
DDS-1 Lactobacillus
acidophilus is discussed at such length here because it has
been studied more extensively than others. However, there are other
lactobacillus products that likely have similar effects, and these
are being researched as well. Potency of the product is likely
important. Many cultures now contain billions of live bacteria per
dosage, rather than the few million that were once common. This
should make them more effective, since the higher counts will allow
a greater number of bacteria to actually reach the colon. Replacing
the diminishing yeast with these physiologically active bacteria
will help restore the colon’s normal functions. Yeasts in the colon
use up nutrients, rather than making additional ones, and they
ferment foods, often leading to gas, bloating, abdominal discomfort,
and flatulence. Re-implanting the colon with friendly bacteria helps
to reduce many of the intestinal and digestive symptoms of
candidiasis.
There are a number of
other supplements that can help in treating the yeast syndrome.
Supplemental hydrochloric acid with meals followed by digestive
enzymes after eating can often help us to better break down and
utilize our protein, fats, and food in general to make available the
amino acids, essential fatty acids, and mineral micronutrients we
need for healing. And they help to relieve digestive symptoms and
make it easier for us to obtain the energy from the food. Healing
the intestinal wall is an important part of clearing the candidiasis
symptoms and reducing food reactions. Flaxseed or evening primrose
oil and certain herbs can help with this.
For nutrient
supplementation, a general multiple is used as a base, with some
additional antioxidants to help handle certain toxic by-products,
avoid immune suppression, and improve immune function. Organic
germanium may be used to aid in this immune support and to improve
the gut mucosa. Vitamin A, beta-carotene, and vitamin C are useful
in the regulation of the yeast and support of the immune function.
Extra magnesium is also a part of the program. Less zinc is
suggested than in other programs, at least initially, as it possibly
stimulates the Candida growth. Extra B vitamins, including biotin,
provide support by replacing some of those lost because of the
diminished colon bacteria that produce them. Coenzyme Q10 has been
shown to have positive effects in yeast treatment as well.
Some of the nutrient oils
may be used in the treatment of the yeast problem. In addition to
garlic oil and the caprylic acid formulas, essential fatty acids
(EFA), fish oil (EPA), and evening primrose oil (EPO) may be
helpful, along with vitamin E. A product I have used that
incorporates all of these oils is Samolinic, made and
distributed by the Key Company. I might suggest a product such as
this or separate portions of some of these oils if there seem to be
many inflammatory or allergic symptoms.
The type of herbal
treatment suggested for the yeast condition depends mostly on the
other, coexisting problems. If there are premenstrual symptoms,
diuretic herbs or female tonifying herbs may help (see the
Premenstrual Syndrome program later in this chapter). With
intestinal symptoms or upset, soothing digestive herbs may be
helpful. Peppermint or chamomile teas are beneficial; capsules
containing slippery elm bark and comfrey root powder can help heal
the intestinal lining. Goldenseal root powder in short courses (one
or two weeks) strengthens the mucous membranes, but it also
stimulates liver detoxification, which can cause an increase in
symptoms. Pau d’arco is a tonic herb that is often used in yeast
treatment. Thyme oil has also been claimed to reduce yeast growth,
but I have no experience with that.
Evaluating and treating
the yeast syndrome is a real challenge for both doctors and
patients. It takes patience and can often require a very long
therapy as the body uses its very sensitive biofeedback process to
let us know what is working. Often, Nystatin or other antifungal
products must be taken for years, but usually will produce, within a
few months, a marked change in the symptoms and a reduction in colon
yeast colonization and blood antibodies to the yeast. Many people
experience a profound and positive change in their health with
proper diagnosis and treatment of this condition. However, we must
also be careful not to overtreat and turn this medical concern into
nothing more than the latest "fad" of the 1980s, as the medical
profession would like. Yeast awareness is here to stay, and doctors
and patients must be even more careful in their use of antibiotics,
birth control pills, and the immunesuppressive
corticosteroids. |