A personal experience with a mysterious, tough-to-treat condition.
When I experienced my first major health issue at age 43, I found myself stumbling in the dark — I had candida, a disorder I’d never even heard of. Although my nurse practitioner diagnosed it and tried to treat it, I actually became worse over time. When I looked up my illness on a well-known holistic physician’s website, I read that he did not think such a disorder truly existed. Not being one to have health issues, and feeling as bad as I did, I knew my problems weren’t psychosomatic. My search for answers continued.
I can’t even remember how I finally put the pieces together, because I was incoherent at the time — one of the common symptoms of the disorder is foggy-headedness. In addition, my symptoms included muscle weakness, fatigue and some vaginal irritation. My skin appeared gray, and the whites of my eyes disappeared under a red glaze. If I didn’t eat every two hours I became extremely weak and unable to think.
The first clue came from my yearly physical exam with my nurse practitioner, when she discovered I had a vaginal yeast infection. At the time, I had no noticeable symptoms. Though I took the prescribed drug (Diflucan, an antifungal), in the next several months I began to experience muscle weakness and foggy-headedness. Then one day I went for a bike ride and had a flat tire. Oddly, I found myself unable to either manipulate the tire or determine how to get home.
After the bike incident, I went to the health-food store to get help — the clerk told me about candida and how to treat it with herbs and diet. Because my symptoms had intensified, she surmised that the vaginal infection had spread to my intestines (or vice versa). This “diagnosis” of an overgrowth of Candida albicans, a yeast strain, in my intestines was later confirmed by a naturopath. It is difficult to know for sure where it originally started, but it might have been brought on by antibiotics I took for a tooth abscess early in the year and then become exacerbated by stress, lack of sleep, and a bit too much sugar, flour and wine.
The Diflucan my nurse practitioner prescribed knocked the candida out temporarily, but the yeast always came back in a few days. I took the medication several times over the course of about six months whenever my symptoms were strong, but I always ended up frustrated when the candida returned. Starting with the information from the store clerk, I began to learn how to undertake a cleanse. I cut out sugar and alcohol and took herbs the clerk recommended to kill off some of the yeast in my body, but I had no idea how long to continue my “treatment” or what foods to eat.
A friend suggested I see an Ayurvedic practitioner, who recommended taking soil-based microorganisms and probiotics, drinking kefir and eating a lot of vegetables. I improved but was not cured in three months, as she said I would be. I talked to a nutritionist and an acupuncturist and followed their advice. On a very restrictive diet free of sugar, alcohol, yeast, wheat and gluten, focused on lots of organic vegetables, I felt my digestion improve further. Doing yoga, getting massages and Reiki, and going to bed early every night helped my immune system keep the yeast under control.
But after nine months, I was still physically weak and susceptible to flare-ups with the slightest detraction from my diet. I consulted a naturopath who tested my blood, saw nothing terribly amiss and suggested I eat some meat and take some trace minerals and the amino acid glutamine to restore my intestines and muscle strength. He said to alternate taking garlic, caprylic acid (a long-chain fatty acid) and oregano oil to keep the yeast count down, and to continue the probiotics to restore floral balance. With these changes, I finally regained my full muscle strength and digestive health.
Candida refers to various yeasts that normally inhabit the body, including the intestinal tract. Under certain circumstances, candida proliferates, causing infection, particularly in warm, moist areas. Often called a yeast infection, a candida overgrowth can show up in the mouth (called thrush), the vagina or in folds in the skin where moisture is trapped (often in babies).
“The reason the yeast overgrows is that the tissue is weakened by a previous or another concurrent illness, a nutritional deficiency, or a medication or toxic compound in the body,” says John Hibbs, a naturopathic physician at the Bastyr Center in Seattle. Prolonged stress and lack of sleep also can create conditions favorable to yeast overgrowth, he adds.
No official studies have determined the prevalence of candida overgrowth, and indeed, it can be difficult to diagnose. Some physicians don’t recognize it, probably because candida exists in the body anyway, says Terry Willard, a clinical herbalist and president of the Canadian Association of Herbal Practitioners. Willard says he never saw candida overgrowth among his patients in the early ’80s but began to see it in the latter part of the decade. By the early ’90s, he saw it in his Calgary clinic in about 60 percent of females and 30 percent of males.
In the community of holistic physicians, candida was “all the rage” when it came on the alternative health scene 20 years ago, Hibbs says. “Fortunes were made in treating everyone for candida. Some doctors still overdiagnose it, because there are a lot of things that can cause GI symptoms that an anti-candida diet will fix.”
Critical thinking and a differential diagnosis are therefore important, Hibbs says. “A person might be allergic to one of the foods that’s removed on a candida diet.” Just because a patient’s symptoms improve with candida treatment doesn’t necessarily prove they had candida, Hibbs says.
Both Willard and Hibbs agree that the conditions of modern life contribute to the problem. “There are so many more drugs and chemicals around that depress immunity and so much more stress and sleep deprivation, more processed foods, more diabetes. It would have to correlate with that,” Hibbs says.
“The problem seems to increase with the size of the city and the amount of fast-food restaurants,” Willard says. “The more processed and packaged foods there are, the more people who have the yeast.” It also seems to have something to do with the social aspects of modern life, Willard notes. He associates the disorder with increasing population and degradation of our ecosystem.
Willard adds that many people have semi-addictive eating habits, particularly to flours and sweets. “I’ve definitely seen a higher level of candida in vegetarians than I do meat eaters,” he says. “And it’s probably mostly because they’re eating more flour and sweets to fill the void from eliminating meat.”
Each practitioner seems to work out his or her own way of diagnosing candida, and there is much variance in dietary and supplement recommendations. Most practitioners look for particular symptoms, as blood and fecal tests can be inconclusive.
“Diagnosis is a can of worms,” Hibbs says, “because broad symptoms, like fatigue and PMS, that in some people are legitimately caused by candida, also could be caused by many other things.” Over time, Hibbs has developed a set of symptoms and predisposing factors, and if he sees a significant number of the symptoms and risk factors coming together in a person, he finds they are likely to improve with candida treatment.
Hibbs’s criteria, developed from his observations and readings, include chronic abnormal GI symptoms (gastritis, gastroeso-phogeal reflux, irritable bowel syndrome, gas and bloating, loose stools) and visible yeast or fungal infections on the body (including vaginitis, oral thrush and tinea). People who’ve had a history of immune-depressing circumstances or medications, such as corticosteroid use, sleep deprivation, intense periods of prolonged stress or significant antibiotic use, may have candida. Nutrient deficiencies (a very low protein or plant-nutrient diet) and family or personal history of high blood sugar or diabetes often are also associated with candida overgrowth. Taking birth control pills has an effect on blood sugar and can make women more susceptible to candida than men.
Willard uses a symptoms questionnaire in his diagnostic process: Is there a sensitivity to perfume and smoke? Is there fatigue; hypoglycemia; a feeling of bloating after a meal; reflux; or a craving for sweets, flour or dairy products? Sometimes he can smell candida on the breath or see it in the eyes or on the tongue, he says. And some people with candida get barometric headaches or eczema related to oil metabolism (candida inhibits how the liver processes oil).
“If the candida overgrowth is advanced, you start getting significant mood changes, a lot of times reactionary,” Willard says. At higher levels, candida can cause microperforations in the bowel, leading to irritable bowel syndrome, which has an effect on the overall immune system. “The person’s immune system becomes compromised, or you could almost say ‘hijacked’ by the yeast,” he says. “Then you can get into a cascade of immune issues and symptoms that don’t directly look like they’re yeast-oriented.”
Another interesting fact, Willard notes, is that “a lot of people who are at the first stage of low thyroid function actually have a yeast problem. If you get rid of the yeast problem, the thyroid problem seems to disappear.”
“A big part of the first step of treatment,” Hibbs says, “is to look at what’s created susceptibility in the individual.” The factors he tries to address with treatment are those that created the vulnerability. For example, blood sugar and carbohydrate consumption are factors that can contribute to yeast growth. If the person has high blood sugar, then simple carbs must be restricted over the long run to prevent adult-onset diabetes and yeast overgrowth. If the patient doesn’t have high blood sugar, they will likely only need to reduce carbohydrate intake for the duration of the candida treatment.
Hibbs also addresses GI symptoms, digestive strength (too little hydrochloric acid can contribute to yeast growth), diabetes, taking birth control pills, a very low-protein or low-phytonutrient diet, and taking immune-suppressing drugs, such as prednisone, for an inflammatory illness. He’ll recommend reducing stress, losing weight to reverse insulin resistance, and exercise for those who need it. “We’re setting the stage for the anti-candida treatment to work for the long run,” he says.
Treatment generally involves a diet stripped of foods that feed yeast (particularly sugars); herbs and supplements to devour the yeast; and probiotics to help build up the healthy bacteria in the body that has become dominated by yeast. While practitioners’ dietary recommendations range from very restricted to more flexible, all recommend eating fresh vegetables and good proteins. Some suggest taking glutamine when the yeast settles down, to repair the intestines.
To starve the yeast, Willard advises a strict diet, eliminating all dairy, flour and sweets for a month or two. After that, he allows flour products but not yeasted ones. He believes the structure of the grain might be the important factor. “It seems the finer the mechanical molecules, the stickier it gets in the system, and that creates a breeding ground in the intestinal tract,” he says. (For example, Willard believes rice is okay but not rice flour.) Dairy seems to feed yeast and help it breed by creating a mucus lining in the digestive tract. He prohibits tropical fruits because they have a high sugar content, and oranges because they have fungi on them. Peanuts and grapes contain yeast, as well. Foods patients can eat include vegetables, meat and grains (not the flours), as well as beans.
To starve the yeast, practitioners advise a strict diet.
Taking supplements speeds up the process, making it a three- to nine-month program, depending on whether the patient cheats and how bad the overgrowth is, Willard says. (A strict cleanse at the beginning of the process can speed things up.) One supplement Willard favors is homeopathic candida. He also prescribes an overall immune antioxidant containing beta-carotene, vitamin C, zinc and B6.
Willard almost always suggests digestive enzymes because one of the causes of candida, he says, is sluggish intestines that don’t properly digest food, allowing it to ferment in the digestive tract. “That gives a perfect breeding ground for the yeast,” Willard says.
In addition, Willard gives patients probiotics and continues the program for three to nine months. If the person gets stuck, he uses caprylic acid or pau d’arco (Tabebuia spp.).
Hibbs simply recommends the following dietary changes, while acknowledging that it is possible he might not be encountering patients with severe cases of candida (who may need a more radical treatment). He has patients avoid any food that’s altered to taste sweet, including dried fruit and fruit juices. He stresses eating antibiotic- and chemical-free food, especially fresh vegetables. The diet should be high in fiber, nutrient-rich and include healthy fats and carbohydrates, as well as good protein. Hibbs’s treatment lasts for a minimum of eight weeks, though some people need a longer treatment or to repeat the treatment later.
Hibbs puts all candida patients on two or three antifungals at a time because there are many candida species, and each has different sensitivities. He usually prescribes nystatin, an antifungal taken as a pill or topical cream. It only can be prescribed by medical doctors in most states, and by naturopathic physicians in particular states. Hibbs rarely prescribes Diflucan because it can be harsh on the liver.
The supplements Hibbs recommends include caprylic acid, berberine, oregano oil or garlic extracts. “Most of the herbal oils are antifungal, antibacterial and antiviral because they’re very important parts of the plants’ immune systems,” Hibbs says. “These are the compounds that the plants use to fight off the same creatures from invading them.”
Finally, Hibbs puts patients on a probiotic with Lactobacillus bifidus and acidophilus. He says he has found the Pharmax HLC series (available online at www.RockwellNutrition.com) to be very effective. “A good probiotic functions as an antifungal in itself simply by successfully competing for space and food. They’ll suppress the colonization by the other undesirables,” he says.
Both Willard and Hibbs note that candida overgrowth can recur. Patients might need to repeat the healing regimens recommended or do periodic cleanses to keep their immune and digestive systems strong.
As I look back on my bout with candida, I’m grateful I had an illness that taught me good habits. I learned to provide my body with optimal nutrition, cleanse it and care for it using yoga, massage and Reiki. I peeled away another layer of my social conditioning (in the area of diet) and gained a more rewarding connection with the fruits of the earth — its wonderful nurturing, healing plants.
For more information and specific dietary and supplement recommendations, visit our website at www.HerbsForHealth.com.
Lynda McCullough is a freelance writer in Loveland, Colorado.
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