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Medical Director: Dr. A. Econs MRCS LRCP |
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Site by Webskills UK |
Fungal Problems - Candida |
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INTESTINAL FERMENTATION (FUNGAL DYSBIOSIS -“CANDIDA”) & CANDIDA SENSITIVITY
Summary In
modern Medicine, yeasts, are often seen as harmless micro-organisms,
capable of causing only trivial problems such as oral or vaginal thrush,
fungal nails and some irritating skin rashes (ringworm, etc.). Fungal
infections are known, well documented complications of various common
medicines including steroids, antibiotics and female hormones. These
respond well to brief courses of anti-fungal ointments, pessaries or
tablets. Since the early fifties, doctors made the observation
that some patients’ otherwise unexplained symptoms would clear, when
they stopped dietary yeast and sugar with the parallel use of antifungal
medications. In medical textbooks these symptoms fit the description
of intestinal candidiasis), yet laboratory tests often fail to
confirm such infection. Today there are specific tests to confirm if fungi (candida
or others) are active and potentially harmful. Antifungals are usually
effective to eradicate these mycelia, if combined with a diet devoid
of foods known to act as “yeast promoters”. An additional issue involving Candida and other fungi
such as Trichophytum (and some others causing dandruff, athlete’s foot
and fungal nails) is a type of delayed immune reactivity, actually
mimicking immediate allergy, manifesting itself with urticaria (“hives”)
and/or angio-oedema. The diagnosis of this phenomenon is possible with
blood tests (measuring levels of some antibodies) and intra-cutaneous
tests. The treatment is very similar and as effective to that of the
Fungal Dysbiosis. Dysbiosis and human health Clinical research has shown that fungal fermentation:
cause an array of symptoms or conditions (see below)
intolerance) causing additional symptoms known as “leaky gut” or “intestinal hyperpermeability”
How Dysbiosis is diagnosed Dysbiosis (intestinal fermentation) is not easy to diagnose. Ironically it is easier to identify in HIV or cancer patients who have received treatment with chemotherapy or steroids (in this group, intestinal candidiasis is a common post mortem finding). Intestinal yeast is as common amongst healthy people as in those who are ill with it. Standard cultures of the colon/rectum often fail to confirm the presence of candida and when vaginal swabs confirm its presence, the patient is sometimes unaware of any symptoms. The Gut Fermentation Test is a blood test, used to assess patients’ tendency to convert a small load of sugar to ethanol (alcohol) and this conversion is specific to abnormal fungal activity. For this reason, sometime ago it was described as “auto-brewery” syndrome. Occasionally we have encountered individuals who feel “drunk” after a meal with high intake of carbohydrate and especially sugar. However, it is unusual for this phenomenon to account entirely for a positive breathalyser test! Immune reactivity to Candida and other fungi can also be confirmed with blood tests, measuring the levels of Candida antibodies and the local reaction in intra-cutaneous tests, both available in our clinics. One’s medical history is likely to give important clues pointing to this diagnosis: previous/recent use of antibiotics; courses of various types of female hormones (chemically being female steroids); regular use of steroids including inhaled; daily use of sugar or sweeteners; craving for sugar; poor memory/concentration; recurrent thrush; frequency or “cystitis” with negative urine cultures; vague irritating rashes/eczema; pre-menstrual syndrome; irritable bowel (digestive problems or pain, wind/bloating/IBS, constipation or diarrhoea) and others. Due to the absence of reliable laboratory tests, fungal fermentation is not a generally accepted diagnosis in conventional Medicine; it often presents in a variety of other problems including digestive, gynaecological, skin problems and unexplained fatigue; due to an extensive use of female hormones, it affects women more than men; it is more common in people using/abusing sugar; it is a common and undiagnosed problem; it usually responds to an adjustment of one’s eating habits combined with antifungal treatment. Symptoms/problems associated with fungal dysbiosis: Cardiovascular Palpitations, hypertension. Digestive Indigestion, heartburn, gatritis, oesophagitis, flatulence, irritable bowel syndrome, constipation, diarrhoea, anal irritation. Ear/Nose/Throat Catarrh, giddiness/dizziness, sore throats, ear discharge. Eyes Visual problems (more common in diabetics). Gynaecological Vaginal thrush, pelvic inflammation, polycystic ovaries, abnormal cervical smears, endometriosis, infertility, heavy/irregular periods, premenstrual syndrome. Metabolic Craving for sweets, weight problems. Muscle/joints Joint aches/pains, muscle tenderness/wasting, gout, chronic/ recurrent back pains, cramps. Neurological Migraine, headaches, black-outs. Psychological Poor memory and concentration, fatigue, irritability, anxiety, depression, PMT. Skin Skin rashes/eczema/acne, psoriasis, fungal nails. Urinary Tract Non-bacterial cystitis, frequency, urgency.
Yeasts thrive on poor quality food, chemicals, foods containing sugar including fructose and other yeasts (like in bread, some cheeses, alcoholic drinks, Marmite, etc.). The objective of the treatment is (i) to deprive it from its main fuel supply, (ii) to reduce the yeast activity in the bowel, (iii) to strengthen the immune system by means of correcting any mineral or vitamin deficiencies. Yeast Free/Low Sugar Diet This contains only foods, which do not promote the growth of yeast. The intention is to reintroduce various grains, natural nuts and some fruits later when most or all of the symptoms have cleared. A number of common foods have been omitted because they foster the presence of yeast (e.g. Marmite or high intake of fructose in fruits); others, due to frequent use, may cause food intolerance (wheat and other grains, caffeine, additives, etc.). The majority of patients find that when starting a strict Yeast Free/Low Sugar Diet for the first week or two, they feel a little worse. This is mainly due to the sudden reduction of the levels of sugar/glucose they may be accustomed to (reactive hypo-glycaemia). Later on, they experience a steady improvement. Others, with a more serious problem, start improving well into a long-term course of antifungal medicine (Nystatin powder, Fluconazole capsules and so on available only on prescription). Sometimes, the regular use of certain foods cause additional symptoms and may have to be avoided long term. Others who find it very difficult to avoid various problem foods, require structured desensitisation. The Enzyme Potentiated method (EPD) contains highly diluted vaccines, which allow you to eat some “difficult” foods without suffering any symptoms. Anti-fungal Treatments A number of substances with anti-fungal properties are currently in use with variable degrees of success. Prices vary like their potency: A. Probiotics eg Lactobacillus Acidophilus & Bifidus Two useful bacteria, normally present in the colon, which keep yeasts in check. They are also found in small amounts in live yoghurt. Acidophilus is usually recommended, as a long term supplement after proper antifungal treatment or as short courses, when antibiotics are necessary. Preferred dose: 4-8 billion micro- organisms per capsule/tablet daily. Availability - in health stores and some chemists. B. Caprilic Acid (Mycopril) This substance has an antifungal effect and is used in cases of mild fermentation problems or long term, to prevent the relapse of symptoms. Medically it is regarded as a food supplement. Availability - health food stores and manufacturers; not on NHS prescription. Used mainly by lay nutritionists, not qualified to prescribe antifungal drugs. C. Nystatin Powder Powerful, “old-fashioned” antifungal medicines with action limited in the bowel. Potentially, serious side-effects, if taken intramuscularly or intravenously. Orally its molecular structure is too large to escape into the blood stream and therefore, it can be safely used for several months. It can cause some nausea and the so-called “die-off” (see below). Availability – only on prescription. D. Fluconazole (Diflucan), Itraconazole (Sporanox) & other antifungals Effective modern antifungals, prescribed mainly for short courses, as they are capable of causing side-effects sometimes involving liver and kidneys . Other factors It is essential to explain that the issue of fermentation is not a “local” problem, confined to the intestine. It is closely related to: the person’s immune system; stress factors and emotions; any deficiencies of vitamins, mineral or other nutrients; the presence of food, inhalant or chemical allergies/intolerance. To illustrate this point, in the case of a mixed problem affecting a patient with chronic fatigue, IBS, asthma and acne, progress will be made in some areas when the food and inhalant allergies have been cleared or when nutritional deficiencies are corrected by appropriate dietary measures and antifungals. Hexheimer’s response (“die-off”, die-back”) This describes the sudden aggravation of one’s symptoms, due to the increased activity of intestinal yeast, resulting from increasing doses of antifungal treatment. This can be manifest with abdominal pains, feeling bloated, headaches, tiredness and a host of other symptoms, which occur during the gradual increase of the dosage of antifungals. It is important to recognise it, reduce or stop the antifungals and start increasing it again, once the symptoms have completely subsided. The temptation to ignore these symptoms should be resisted as this phenomenon passes quickly. Duration of the treatment This varies considerably, the rule of the thumb being that, the more severe the problem, the longer it takes to treat. Most patients require a 2-3 month course of antifungals combined with the yeast-free/low sugar diet but various foods can be reintroduced during the last 2 months, while antifungals are gradually being phased out. Some patients with a severe form of dysbiosis, may take much longer to recover and often need to address thoroughly their other problems (e.g. food, chemical or inhalant sensitivities). After the treatment It is common for the symptoms of fermentation to return a while after the diet is relaxed and one starts making greater daily use of foods, which contain yeast and sugar. In this case, many people find that, taking a mild or a powerful antifungal medicine does not prevent the initial problem from coming back. The ideal long term scenario, therefore, is to do without the regular use of yeast and sugar. Medical References 1. Dr. Eaton K.K. Gut fermentation: A re-appraisal of an old clinical condition with diagnostic tests and management: Discussion paper. J. Roy Soc Med 1992;3:295-301. 2. Dr. Kroker G.F. Chronic candidiasis and allergy, in Brostoff J, Challacombe SJ eds. Food Allergy & Intolerance. London, Bailliere Tindall 1987.850-72. 3. Drs. Eaton K.K,, McLaren Howard J., Hunnisett A., Harris M. Abnormal gut fermentation: Laboratory studies reveal deficiencies of B-vitamins, zinc and magnesium. J. Nutr Biochem 1993;4:635-8. 4. Drs. Hunnisett A, Howard J, Davies S. Gut fermentation (or the “auto-brewery” syndrome): a clinical test with initial observations and discussion. J Nutr Med 1990;1:33-38. 5. Dr. Eaton K.K. Sugars in food intolerance and gut fermentation. J Nutr Med. 1992;3:295-301. Other Books 1. Drs. J. Brostoff & Linda Gamlin. Food Allergy & Intolerance. 2. Drs. G. Lewith, J.Kenyon & Dowson. The Complete Guide to Allergy. 3. Dr. O. Truss. The Yeast Syndrome.
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