Nutritional Therapy Oxford Dip ION, mBANT
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Candida – The Great Debate

Candida – The Great Debate

Mutter symptoms of poor digestion and foggy thinking and it may be suggested that you have a candida infection.

Candida albicans is a single-celled yeast that is naturally found in the gastrointestinal tract of 60% of the population.  For most people candida albicans is kept in check by the protective bacteria that also reside in the intestine.  But if a person has a compromised cell-mediated immunity or an imbalance in their intestinal microflora then Candida albicans overgrowth can occur which can develops into candidiasis.

In these circumstances, Candida albicans changes into an invasive budding form of yeast capable of damaging an already compromised gut lining.  Candida albicans releases a proteinase, which destroys intestinal defences of secretory IgA whilst damaging the delicate mucosal microvilli.  The toxic chemicals which are produced by Candida albicans as it grows interfere with cellular metabolism and further damage the intestinal lining.  All in all, candida compromised the integrity of the intestinal lining causing poor digestion, malabsorption and gut permeability.

Sufferers often experience digestive discomfort alongside symptoms associated with gut permeability.  The lack of gut integrity leads to food particles, bacteria, yeast components and various toxins being able to enter the bloodstream.  This translocation triggers a series of immune responses often resulting in food allergies, inflammation and, in severe cases, autoimmune disease.  In some cases, the candida can spread from the gut to different sites in the body such as joints and organs and this is known as systemic candidiasis.

Triggers for Candidiasis

1.    Antibiotics
Many lives have been saved from infectious diseases by antibiotics and for this we must be very grateful.  However, the consequence of taking antibiotics is a disruption of the careful balance of gut flora.  Scientists in America found that patients with antibiotic associated diarrhoea had significantly more Candida albicans in their stool compared to healthy patients.  Antibiotics are regularly overused in the West particularly against viruses for which they have no effect.  This overused, together with our Western culture of poor diet, environmental toxins and stressful lifestyle is a probable factor for candidiasis.

2.    Other Medications
Vaccinations, hormone therapy, immunosuppressive drugs, steroids and chemotherapy also tip the balance of gut ecology and impact on intestinal immune defences.  Regular reliance on these drugs can lead to a gut that is more susceptible to candidiasis.

3.    Western diet and lifestyle
Nutritional Therapists are well aware that high-sugar Western diets are favourable for Candida albicans overgrowth.  As the Candida albicans overgrowth increases, sugar cravings worsen, leading to an ever-increasing overgrowth.  Other dietary factors include a lack of dietary fibre which compromises digestion and gut ecology.  Alcohol also takes a swipe at probiotic bacteria levels so today’s binge-drinking culture leaves the individual susceptible to an overgrowth.
4.    Stress

Stress also causes a reduction in gastric hydrochloric acid (HCl), pancreatic enzymes and bile production which impacts on digestion.  Stress reduces levels of secretory IgA and causes probiotics to decline, which impacts on protection from Candidiasis.

Getting tested

Comprehensive Parasitology – this is used to detect parasites as well as beneficial intestinal microflora, imbalanced flora, and bacterial or fungal pathogens.  This is a great test because it gives a sensitivity panel which indicates some useful antifungal supplements.  According to testing laboratory Genova, “Occasionally Candida albicans can be missed because it is so embedded in the wall of the GI tract that no cells are shed”.

Candida albicans Antibody Profile – these blood and saliva tests screen for IgA and IgG antibodies.  The presence of IgA antibodies indicates early stages of candidiasis and IgG indicates the presence of a longer-term infection.  However, you need to be aware that antibodies can be present even if candidiasis has been treated.

Live blood analysis – some Nutritional Therapists use live blood analysis to assess for Candidiasis.  However there is no scientific evidence to substantiate this as yet.

Questionnaire – many other Nutritional Therapists, including myself, believe the best way to discover if you have Candidiasis is by using Dr William Crook’s anti-Candida questionnaire.  Click here to see questionnaire

Tackling candidiasis

This is a very controversial subject and many leading Nutritional Therapists tackle candidiasis very differently.  Some opt for a more traditional approach which involves a very strict exclusion diet with strong antifungal supplements.  Others choose a gentler, more ‘functional’ approach that focuses more on supporting digestion, immunity, liver function and gut ecology whilst following a more relaxed diet.

Martin Hum from the Institute for Optimum Nutrition comments, “Beneficial gut flora are essential for good health, but the delicate balance of micro-organisms in the gut is easily upset by a poor diet or antibiotics.  Nutritional therapy can be a very effective way of restoring the natural balance”.

Doctors Truss and Crook have been specialising in candidiasis for more than two decades.  It’s their opinion that people with severe overgrowth should follow a strict elimination diet for a least three weeks to ‘starve’ the Candida albicans.  They then suggest a challenge test to see which specific foods trigger symptoms.  These trigger foods should then be avoided further.  At this stage, some individuals may be able to tolerate various low-GL fruits as well as fermented foods and others will not.  Accompanying this diet is an anti-candida supplement programme.

The modern functional approach

Nutritional therapy is constantly evolving as knowledge and understanding become more advanced.  The modern functional approach takes your individual symptoms and body systems into account providing a diet and supplement plan that supports your digestion, immune system, liver function and gut ecology appropriately.  This system also takes into account your capacity and motivation to make dietary changes and take supplements.  This approach is potentially much more achievable and allows people to feel more ‘in control’.  For example – since a lack of HCl, pancreatic enzymes and bile salts are associated with candidiasis these are included as appropriate supplements to support digestion.

Interestingly, a study on mice showed that once Candida albicans is entrenched, it not only releases toxins but competes with epithelial cells for nutrients.  According to Fidel, candidiasis is seen in 90% of people with a compromised immune system.  A good balance of gut flora is vital for a strong immune system and to protect against GI infections.  A trial by a group of American scientists showed that eating 8oz of yoghurt a day significantly reduced candidiasis in the gut and vagina.

Choosing probiotic strains that can colonise effectively in the GI tract such as Lactobacillus and Bifidobacterium is essential.  Immune support also includes foods rich in anti-oxidants, particularly biofavonoids, and supplementation with vitamin C and A, zinc and Echinacea are of merit.

A trial by Abe et al in 1987 showed that candidiasis was significantly more prevalent in mice with liver damage compared to those without.  The increased release of toxins from candidiasis can damage the liver and with compromised immune system, can lead to food allergies and multi-chemical sensitivities.  Drinking dandelion coffee has been shown to increase bile production, this ‘decongesting’ the liver as well as increasing phase two detoxification.  Supporting elimination with a high fibre diet and lots of water can help reduce the toxic load.

Antifungals

Different antifungals have different characteristics and different specific uses.  The functional approach adds antifungal supplements after adequate support has been given to the immune system, GI tract and liver.  Once these supplements are started, you can expect to suffer from “die-off” symptoms due to more candidiasis toxins being released.

Caprylic acid is a natural short chain fatty acid found in breast milk and coconuts.  Early studies have shown this compound to be a strong antifungal, combating candidiasis in the GI tract.  Grapefruit seed extract also has anti-fungal properties and can be taken by people who are sensitive to citrus.  This is a gentle antifungal and the liquid form can be taken in very small quantities, meaning it can often be tolerated when other antifungals can not!

Plants containing berberine (goldenseal, barberry, oregon grape and golden thread) have antifungal activity and can be absorbed through the mucosa layer.  Berberine is particularly helpful with diarrhoea induced by candidiasis.  Olive leaf extract is a very powerful antifungal and may trigger severe ‘die off’ if used at the beginning of an anti-fungal supplement programme.  Garlic has strong antifungal properties and has been shown to inhibit Candida albicans.

A trial by John Stiles in 1995 found that oregano oil was one hundred times stronger than caprylic acid at irradiating candidiasis.  It is worth noting that it can also be absorbed through the mucosa layer and therefore is helpful with systemic candidiasis.  A study by some Japanese scientists showed that oregano oil can be used successfully on external fungal growth like athlete’s foot.

Sacchromyces boulardii, a non-pathogenic yeast, has been shown to have an antagonistic effect against Candida albicans.  An in vivo trial on mice showed a reduction of 50 to 100 times but not a complete elimination.

There are so many natural ways of eradicating candidiasis that you are unlikely to have to rely on pharmaceutical medications.  A quote by Murray and Pizzorno says “Using anti-fungal drugs without tackling the underlying cause of candidiasis has been compared to weeding by cutting the weeds rather than pulling them out by the roots”.  It is plain to see that candidiasis is a multi-factorial condition.

Perhaps the more functional approach, which helps restore and maintain a balanced gut ecology, is an approach that’s more achievable, bearable and sustainable.

 

Click here for references

Abe F, Nagata S, Hotchi M (1987) Experimental candidiasis in liver injury.  Mycopathologia., 100(1): 37-42.  [Online – abstract only] Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/2960898).  Accessed on 14th September 2010.

Birdsall TC (1997) Gastrointestinal candidiasis: fact or fiction?  Alternative Medicine Review, 2(5) 346-354.  [Online] Google (http://www.adltests.com/assets/files/pdf/Candida_Review_Birdsall.pdf).  Accessed on 13th September 2010.

Crook WG, Dean C, Crook EB (2005) The yeast connection and women’s health, New York, Square One Publishers.

Dostal J, Hamal P, Pavlickova L, Soucek M, Ruml T, Pichova I, Hruskova-Heidingsfeldova O (2003) Simple method for screening Candida species isolates for the presence of secreted proteinases: a tool for prediction of successful inhibitory treatment, Journal of Clinical Microbiology, 41(2):712-6.  [Online] Pubmed (http://jcm.asm.org/cgi/reprint/41/2/712).  Accessed on 17th September 2010.

Ducluzeau R, Bensaada M (1982) Comparative effect of a single or continuous administration of “Saccharomyces Boulardii” on the establishment of various strains of “Candida” in the digestive tract of gnotobiotic mice, Annals of Microbiology, 1338: 491-501 [Online] Google (http://www.sboulardii.com/old/Florastor_files/gd20051131220231.pdf).  Accessed on 14th October 2010.

Farah CS, Elahi S, Drysdale K, Pang G, Gotjamanos T, Seymour GJ, Clancy RL, Ashman RB (2002) Primary role for CD4(+) T lymphocytes in recovery from oropharyngeal candidiasis.  Infection and Immunity, 70(2): 724-31.  [Online] Pubmed (http://iai.asm.org/cgi/reprint/70/2/724).  Accessed on 14th September 2010.

Fidel PL (2002) Immunity to Candida.  Oral Diseases, 8(2): 69-75.  [Online – abstract only] Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/12164664).  Accessed on 14th September 2010.

 Garrow JS (1988) Kinesiology and food allergy, British Medical Journal, 296(6636): 1573-1574.  [Online] Pubmed (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2545956/).  Accessed on 13th September 2010.

Ghannoum MA (1988) Studies on the anticandidal mode of action of allium satvum (Garlic).  Journal of General Microbiology, 134, 2917-2924.  [Online] Google (http://mic.sgmjournals.org/cgi/reprint/134/11/2917.pdf).  Accessed on 13th September 2010.

Heggers JP, Cottingham J, Gusman J, Reagor L, McCoy L, Carino E, Cox R, Zhao JG (2002) The effectiveness of processed grapefruit-seed extract as an antibacterial agent: II.  Mechanism of action and in vitro toxicity, Journal of alternative and complementary medicine, 8(3):  333-40.  [Online – abstract only] Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/12165191).  Accessed on 14th September 2010.

Hilton E, Isenberg HD, Alperstein P, France K, Borenstein MT (1992) Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis, Annals of internal medicine, 116(5):353-7.  [Online] Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/1736766).  Accessed on 15th September 2010.

Huppert M, MacPherson DA, Cazin J (1952) Pathogenesis of candida albicans infection following antibiotic therapy, Journal of bacteriology, 70(4): 440-7.  [Online] Pubmed Central (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC175599/pdf/654165.pdf).  Accessed on 15th September 2010.

Inouye S, Uchida K, Nishiyama Y, Hasumi Y, Yamaguchi H, Abe S (2007) Combined effect of heat, essential oils and salt on fungicidal activity against Trichophyton mentagrophytes in a foot bath, Japanese Journal of Medical Mycology, 48(1):27-36.  [Online] Pubmed (http://www.jsmm.org/common/jjmm48-1_027.pdf).  Accessed on 14th October 2010.

Isolauri E (2001) Probiotics in human disease, The American Journal of Clinical Nutrition, 73(6)1142S-1146S.  [Online] Google Scholar (http://www.ajcn.org/cgi/content/full/73/6/1142S).  Accessed on 15th September 2010.

Khin-Maung U, Myo-Knin, Nyunt-Nyunt-Wai, Aye-Kyaw, Tin-U (1985) Clinical trial of berberine in acute watery diarrhoea, British Medical Journal, 291(6509):1601-5.  [Online] Pubmed Central (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1418442/pdf/bmjcred00477-0011.pdf).  Accessed on 15th September 2010.

Klein & Klein Bt. (2009) Chronic Candidiasis – Pathogenesis, Symptoms, Diagnosis and Treatment.  Proc. Nat. Sci. Matica Srpska Novi Sad, 116, 267-274.  [Online] Google (http://www.doiserbia.nb.rs/img/doi/0352-4906/2009/0352-49060916267K.pdf).  Accessed on 11th September 2010.

Krause R, Krejs GJ, Wenisch C, Reisinger EC (2003) Elevated fecal Candida counts in patients with antibiotic-associated diarrhea: role of soluble fecal substances, Clinical and Diagnostic Laboratory Immunology, 10(1): 167-8.  [Online] Pubmed (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC145287/pdf/0162.pdf).  Accessed on 17th September 2010.

Markin D, Duek L, Berdicevsky I (2003) In vitro antimicrobial activity of olive leaves. Mycoses, 46(3-4): 132-6.  [Online – abstract only] Pubmed (http://www.ncbi.nlm.nih.gov/pubmed).  Accessed on 14th October 2010.

Murray MT, Pizzorno JE (2006) Chronic Candidiasis.  Textbook of Natural Medicine (3rd Edition) Missouri, Churchill Livingstone Elsevier.

Quindos G, Dolores Moragues M, Ponton J (2004) Is there a role for antibody testing in the diagnosis of invasive candidiasis?  Revista Iberoamerican de Micologia, 21, 10-14.  Genova Diagnostics UK.

Roxas M, Jurenka J (2007) Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations.  Alternative medicine review: a journal of clinical therapeutic, 12(1): 25-48.  [Online] Pubmed (http://www.thorne.com/altmedrev/.fulltext/12/1/25.pdf).  Accessed 14th October 2010.

Salmi HA, Sarna S (1982) Effect of silymarin on chemical, functional, and morphological alterations of the liver.  A double-blind controlled study.  Scandinavian journal of gastroenterology, 17(4): 517-21.  [Online – abstract only] Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/6753109).  Accessed on 14th September 2010.

Sarker SA, Gyr K (1992) Non-immunological defence mechanisms of the gut.  Gut, 33(7): 987-93.  [Online] Pubmed (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379419/pdf/gut00574-0143.pdf).  Accessed on 14th September 2010.

Stiles JC, Sparks W, Ronzio RA (1995) The inhibition of candida albicans by oregano.  Journal of applied Nutrition, 47(4): 1-8.  [Online] Google Scholar (http://bioticsresearchse.com/Links/ImmuneLit/Lit022OilofOregano.pdf).  Accessed on 15th September 2010.

Sudjana AN, D’Orazio C, Ryan V, Rasool N, Ng J, Islam N, Riley TV, Hammer KA (2009) Antimicrobial activity of commercial Olea europaea (olive) leaf extract.  International journal of antimicrobial agents, 33(5): 461-3.  [Online – abstract only] Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/19135874).  Accessed on 14th October 2010.

Sullivan A, Nord CE (2002) The place of probiotics in human intestinal infections.  Antimicrobial Agents, 20: 313-319.  [Online] Google Scholar (http://www.americadesign.com.br/merck/pdf/place_probiotics_human_intest_infections.pdf).  Accessed on 15th September 2010.

Truss O (1982) The Missing Diagnosis, Alabama, The Missing Diagnosis.

USA.  Department of Health and Human Services (2001) CLIA Regulation of Unestablished Laboratory Tests.  Chicago: (http://oig.hhs.gov/oei/reports/oei-05-00-00250.pdf)

Vazquez JA, Zawawi AA (2002) Efficacy of alcohol-based and alcohol-free melaleuca oral solution for the treatment of fluconazole-refractory oropharyngeal candidiasis in patients with AIDS.  HIV ClinicalTrials, 3(5): 379-85.  [Online] Pubmed (http://thomasland.metapress.com/content/99dy8q52306av0aj/fulltext.pdf).  Accessed 18th September 2010.

Wagner RD, Pierson C, Warner T, Dohnalek M, Farmer J, Roberts L, Hilty M, Balish E (1997) Biotherapeutic effects of probiotic bacteria on candidiasis in immunodeficient mice.  Infection and Immunity, 65(10):  4165-4172.  [Online] Pubmed Central (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC175599/pdf/654165.pdf).  Accessed on 15th September 2010.

White E (1999) Beat Candida Cookbook, London, Harper Collins Publishers Limited

Zeisel SH, Da Costa KA, Franklin PD, Alexander EA, Lamont JT, Sheard NF, Beiser A (1991) Choline, an essential nutrient for humans.  The FASEB journal : official publication of the Federation of American Societies for Esperimental Biology, 5(7): 2093-8.  [Online] Pubmed (http://www.fasebj.org/cgi/reprint/5/7/2093.pdf).  Accessed on 14th September 2010.

 

 

 

 

 

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