| | | | Also known as: Candida albicans, Candidiasis, Yeast Syndrome, 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.
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 [Mycostatinr], ketoconazole [Nizoralr], fluconazole [Diflucanr],
and itraconazole [Sporanoxr]).
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
EEchinacin Therapiewoche 1986;36:3352-8.
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