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Candida overgrowth

Candida overgrowth

Introduction

Introduction

Very few females will not have heard of candida overgrowth (a.k.a. candidiasis or dysbiosis) which basically means opportunistic yeast or fungal overgrowth. Overgrowth, like in your garden, means that one species gains ground at the expense of another. So it is, yet again a matter of a balance having gone astray.

It was Dr. Elie Metchnikoff - Director of the Pasteur Institute, Nobel Prize recipient for his work on the link between the immune system and intestinal flora in 1908 - who coined the phrase dysbiosis and I think his terminology reflects the problem best. As you know, there should be a symbiotic balance of health promoting and opportunistic bacteria and fungi throughout the entire digestive tract (on skin epithelium too as it so happens).
Consequently an imbalance can happen throughout the entire digestive tract which, in almost all instances leads to fungal overgrowth. Anyone, especially females, with symptoms such as wind, bloating, disturbed bowel function, rectal itching, non-bacterial cystitis and recurring vaginal thrush (females only obviously) would be suspect to have an abnormal bowel ecology (i.e. have dysbiosis). Let’s talk through core issues:

Causes - Milieu

You cannot grow rhododendrons in Market Harborough’s own soil, so Nancy Lancaster had cartloads of acid soil brought to Kelmarsh Hall and planted a fine hedge of pink and white rhododendrons that still grace this historic house today. A long enough change in gut pH (acidity/alkalinity balance) allows flora to flourish that likes that particular pH. Next, this flora contributes to and thus perpetuates the environment it likes. In whichever way you kill the harmful bacteria or fungi, you also must improve the gut environment via diet, lifestyle and a probiotics support regime.

Causes - Friendly Fire

Prolonged use of oral, broad spectrum antibiotics may kill an offending bacterium, but these also decimate the health-beneficial bacteria in the bowel ecology, thus shifting the symbiotic balance. Coming back to gardening, weeds for some reason always grow faster than plants. A prolonged prescription of say Tetracycline or Erythromycine for acne neatly paves the way for dysbiosis later on. It is a wise mother who gives her child a substantial course of effective probiotics afterwards (or even during) and a wiser one still who pairs up her probiotic regime with Aloeride®. The contraceptive pill and HRT (hormone replacement therapy) alter levels of female sex hormones and this may be one of the main reasons why 60% of dysbiosis (candidiasis) sufferers are women.

Causes - Emotions

From Psycho-Neuro-Immunology we know that depression causes the immune system to function less effectively, and a less effective immune system in turn opens the door to dysbiosis, other infections and more.
 
Also stress and anxiety (in your face or more commonly prolonged in background) depresses your immune system. It triggers the flight or flight mechanism so your adrenal glands increase their corticosteroid output. Now, to put this in perspective, in solid organ transplantation corticosteroids are used for immunosuppression because of their profound effect on the concentration of peripheral white blood cells (lymphocyte, monocyte, basophil counts decrease, while neutrophil counts increase; T-cells lose their ability to proliferate and react to specific antigens). No mistake, stress and anxiety make you immunologically vulnerable.
 
Increased levels of corticosteroids may cause mood changes ranging from euphoria to depression (just irrational, mini bipolar, pseudo PMS), insomnia (sleep deprivation), jitteriness (pseudo ADHD), impaired glucose tolerance (diabetes), retention of salt and fluid (blood pressure) and increased appetite are common (comfort food eating). In Medicine corticosteroids have long become persona non grata in immunosuppressive regimens. So how are you going to normalise your ongoing fight/flight trigger? If you can’t do it on your own, get outside help.

Causes - Diet

Long term intake of excess empty calories (high-energy foods with poor nutritional profiles such as all refined sugars) and excess dietary carbohydrates without proportionate supportive macro- and micronutrients fuel opportunistic growth. And leads to dysbiosis. I talked about this extensively in the chapter ‘putting diesel in a petrol tank’ in my ebook. Thank goodness the long term solutions are simple and do-able: use low glycaemic index foods, the paleolithic diet or the specific carbohydrate diet. Just stay well clear of bombarding your body with sugary drinks and sugary foods. Ultimately your food intake lifestyle is about making choices, drat that can be so difficult!

Causes - Pathogens

You can have fungal type dysbiosis or bacterial type dysbiosis, the former is generally referred to as "candida" which points a finger at Candida albicans but frankly any yeast can ferment as can some bacteria. Did you know that there are some 19 species of Candida alone, want to know what 'candida' is precisely?
Candida albicans itself is a ubiquitous commensal yeast of the mouth and gastrointestinal tract which can overgrow into opportunistic infections in various sites, such as the mouth (oral thrush), genital area (genital thrush), intertriginous areas (intertrigo), nails (paronychia) and small intestine. Systemic candidiasis can occur in immuno suppressed patients. Now zoom out for a moment!
Within the genus Candida, fermentation, nitrate assimilation and inositol assimilation may occur. Nitrate assimilation is of particular interest because serum levels of nitrate in patients with active Ulcerative Colitis (UC) and active Crohn’s Disease (CD) differ statistically (are raised) significantly from normal controls. Also a significant positive correlation was found between serum nitrate levels in UC and red blood cell sedimentation rate (ESR), leucocyte and thrombocyte count. These are key pointers for inflammation. So, the by-products and metabolic end-results of Candida are aspect of them causing trouble; in casu more candida - more nitrate - more irritation/inflammation. On a positive note, inositol compounds may inhibit adenocarcinoma development associated in chronic ulcerative colitis. [data from Scandinavian Journal of Gastroenterology, Volume 30, Issue 8 August 1995 , pages 784 – 788]
Next, the genus Candida has the ability to change itself which is called high-frequency switching of colony morphology. Candida tropicalis for instance has even more than one strain-specific switching repertoire. This means that one strain, removed from the blood by say Flucytosine (antifungal) or Amphotericin B (a polyene antifungal antibiotic), can reappear several days later at another site of infection. You can start to see why dysbiosis can be so difficult to eradicate. Here are details of 3 out of 19 species of Candida:

Candida albicans occurs naturally as a commensal of mucous membranes and in the digestive tract of humans and animals. It accounts for up to 70% of Candida species isolated from sites of infection and has been reported as a causative agent of all types of candidiasis.
 
Candida parapsilosis is an opportunistic human pathogen which may cause both superficial cutaneous infections, especially of the nail and systemic disease, especially endocarditis. Other clinical manifestations include endophthalmitis and fungeamia.
 
Candida tropicalis is a major cause of septiceamia and disseminated candidiasis, especially in patients with lymphoma, leukemia and diabetes. It is the second most frequently encountered medical pathogen, next to Candida albicans, and is also found as part of the normal human mucocutaneous flora. Sucrose negative variants of C. tropicalis have also been increasingly found in cases of disseminated candidiasis.

Testing

Quite beside that perhaps 60% of the gut flora remains to be characterised, it is impossible to take specimens from all parts of the gut and do precise counts of micro-organisms. The best test to confirm dysbiosis is via the chemical result of fermentation: alcohol. Provoking fermentation - if this happens - results in alcohols in the blood (ethanol, methanol, butanol, propanol and short chain fatty acids) which can be measured by gas-liquid chromatography. Via their particular end-products of metabolism, a Comprehensive Digestive Stool Analysis (CDSA) can provide further information about which organisms are present in the gut (bacterial and yeast cultures in stool samples). At a doctor’s special request a CDSA can include parasitology (testing for parasites).
Not everyone uses laboratory tests to determine - after medical interview and clinical observation - a state of dysbiosis. Many practitioners arrive at conclusions via symptom questionnaires, Applied Kinesiology, Electro-Dermal Screening, Radionics, or Live blood microscopy. Symptom improvement following sensible remedying is not necessarily a validation of diagnostics used. The most surefooted test still is the above Gut Fermentation Profile with optional CDSA/parasites.

Consequences - nutrients

Opportunistic yeast overgrowth needs feeding, they feed on all saccharides that did not convert into mono-saccharides uptaken into the blood stream. It is a 'guess who came to dinner' scenario for, next to (functional adaptation!) feeding on remaining di-, tri- and polysaccharides, they also feed on essential macro- and micronutrients. So, a portion of what you put into your digestive system is siphoned off to feed dysbiosis, thus doesn’t feed you.
 
Yeast overgrowth’s second reason for malabsorption (of the quantity and quality of nutrients you choose to ingest) depends on quite how much dysbiosis irritates your gut wall. In UC, CD and severe IBS the gut’s epithelial membrane gets irritated, thus its protective mucous layer changes and thus absorption of nutrients dwindles.
 
Thirdly, above impaired uptake of nutrients is aggravated by long term and strict or even dogmatic application of anti-candida diets. Dysbiosis flourishes in people who are compromised, which rarely goes hand in hand with them having a high nutritional bank balance. Feeding people up without triggering the dysbiosis is the way forward.

Consequences - health

Consequences - health

Mostly symptoms start with digestive discomforts, a demise of general wellbeing which may include unexplained fatigue in the absence of medical red flags. There are directly related symptoms such as you read under Pathogens, and knock-on symptoms such as hormone imbalance or (multiple) chemical sensitivity (foods, dust, moulds, fungi, yeast, inhalants, chemicals). A woman consulting a family doctor for fatigue and premenstrual stress may get her hormone panels checked, may be investigated for fibroids or PCO, but rarely will she be checked or treated for dysbiosis. Dr. Metchnikoff's dysbiosis falls outside the regular medical envelope.

Remedy: diet include

Remedy: diet include

A hypoallergenic approach (e.g. dairy or wheat free) may help you generally but this does not do anything specific for dysbiosis. What you must do is recolonising your gut with health beneficial bacteria which you achieve by eating natural, live culture containing (double fermented) yoghurt or Kefir , by taking good probiotics such as Probion Daily® (one difficulty with probiotics is that their survival, both in the product and after ingestion, is difficult to guarantee), and by supporting the whole process with Aloeride® aloe vera as research has shown this to help improve bowel ecology. Increasing levels of macro- and micronutrients can be achieved with superfoods such as chlorella, spirulina or with dehydrated (sugar removed) raw vegetable, fruit, grapes and berries powder

Remedy: diet eliminate

Avoid all refined sugars and moderate natural sugar intake in proportion to your dysbiosis (like fresh, frozen, canned, dried fruit and fruit juices), all products with yeast in it including baked foods, all fermented products (vinegar, alcohol), mushrooms. I have seen many people who followed a prolonged and strict candida diet, and not only failed to get on top of their dysbiosis but in the process became deficient in macro- and micronutrients. Double trouble!

Remedy: immune modulation

Dysbiosis (especially invasive or systemic candidiasis) finds an easier foothold in immune compromised people than in those with a robust immune defence. A logical intervention therefore is to boost your immune system with natural remedies. Not however with Reishi, Shiitake or Maitake mushrooms as mushrooms are forbidden in the candida diet. Boost it with broad spectrum wholefood nutrition (supplement), plus Aloeride® aloe vera (2-3 cps/day), plus a favourite immune modulator that fights body foreign cells and fights them hard. Of course I am aware of other 'natural immune system' products; but take note of Status Quo's Francis Rossi who - when asked why they always played the same chords - said "why kill the goose that lays the golden egg".

Remedy: killing 1

Never let a dogma of remedies needing to be natural stand in the way of the most effective way to kill opportunistic yeast. What works fast and always is high dosage anti-fungal medications (Nystatin or Amphotericin) over a period of 3 - 4 months. Alternative one can be prescribed systemic anti-fungal medications such as Diflucan, Sporanox or Lamisil in conjunction with Nystatin.

Remedy: killing 2

Natural remedies aplenty: grapefruit seed extract (one product contained antifungal preservative - makes one wonder whether the grapefruit seed or the preservative should take credit for any action), caprillic acid, oregano oil, cinnamon, coconut oil, Pau d'arco, garlic, golden seal, tea tree oil, olive leaf extract, treelac/oxygen elements.

Remedy: warning

As a result of killing off pathogens, a liberation of endotoxins-like substances or of antigens (a substance which causes an immune reaction) from the killed or dying microorganisms is likely to occur. This may cause a transient, Jarish-Herxheimer reaction whereby symptoms become worse before settling down. Such a reaction must remain tolerable (put responsible controls in place) and remember that, although not necessarily pleasant, the Herxheimer reaction is actually a sign that healing is taking place.

Conclusion

Dysbiosis, opportunistic yeast overgrowth, candidiasis - whatever label you put on it - often is a very stubborn problem. As you now know, this is partially because of its switching capacity and partially because many people forget to address their general milieu (environment) or relapse into a 'sweet' diet. Minor dysbiosis may well be manageable with natural remedies plus above support. Mostly opportunistic yeast overgrowth is stubborn and keeps coming back, hence my advice of anti-fungal medication plus the quartet of Aloeride®, Carnivora®, Probion Daily® and dietary modification. The bottom line is that dysbiosis is a problem that can be overcome permanently.