Quelling Candida Is An Internal Balancing Act

A healthy inner ecology proves the best defense against a fast-growing fungus.
Candida albicans, an opportunistic fungus that normally inhabits the mouth, throat, gastrointestinal tract and vagina is a problem on the rise. When C. albicans overgrows in the body, it can cause illnesses such as thrush and candidiasis. Medical mycologists are finding more and more cases of C. albicans overgrowth, along with overgrowth of other pathogenic fungi, in patients. Much of this may be due to greater use of antibiotic drugs, poor diet and nutrient deficiencies, heightened toxic exposure and the consequences of stress. Each of these factors contributes to greater disturbances in the body's inner ecology and lowers immune resistance.

Candida ordinarily exists harmlessly in the body. It was originally considered to be a problem only in infants (in whom it may appear as thrush), people who are debilitated or women (in whom it often manifests as vaginitis). Now, however, a growing number of physicians believe candida overgrowth is involved in many common gastrointestinal and genitourinary problems.

Although there are more than 80 species of candida, C. albicans is one of the most commonly treated in clinical settings and most widely discussed in clinical literature. Technically, C. albicans is a mold and yeast fungus. Since it lacks chlorophyll, C. albicans is unable to produce its own food through sunlight-induced photosynthesis. Hence, it must depend upon a host organism such as the body for nourishment.

Medical advances are helping researchers more fully understand the complexities of inner ecology, including the interrelationship between candida and various body systems. For example, vaginal candidiasis appears to occur concomitant with C. albicans in the large intestine. When this occurs, successful treatment of vaginal overgrowth also requires addressing the health and balance of the large intestine.

It is when candida species, particularly C. albicans, have the opportunity to proliferate beyond their normal numbers that trouble can result. Increased levels of candida often initiate the proliferation of long root-like structures (mycelia/rhizoids) that penetrate mucosal membranes, creating microscopic breaks in the normal mucosal boundary of the gastrointestinal tract. The resulting perforations permit antigens--foreign substances and toxins such as candida and its toxic acetaldehyde by-products, and incompletely digested dietary proteins--to leak into the blood stream, which in turn creates antibody release and inflammation.

Intestinal permeability, called "leaky gut syndrome," is a common but poorly recognized problem linked to ecological disturbances. It is a polysymptomatic syndrome that causes individuals to experience a wide range of problems including allergic responses, mood swings, depression, agitation, joint and connective tissue pain and inflammation, headaches, irritable bowel syndrome, fatigue, and skin problems, to name a few. Long-term "leakiness" may also predispose an individual to autoimmune responses such as inflammatory bowel disease and rheumatoid arthritis.

Leaky gut is linked to factors that predispose an individual to intestinal microflora imbalances and gut wall lining irritation. These factors may include antibiotics; steroids; common over-the-counter, non-steroidal, anti-inflammatory drugs (NSAIDs) like acetaminophen, ibuprofen and aspirin; abdominal X-rays; malnutrition or maldigestion; intestinal infection; stress; or foods that irritate the gut.

Eliminating candida requires addressing the body's ecological balance, its gut integrity, and overall immune strength.
It is possible to identify candida overgrowth and monitor treatment with simple laboratory tests such as candida antibody panel (IgG, IgM, IgA); intestinal permeability testing (for leaky gut); and digestive stool analysis. These tests can help health care practitioners detect candida overgrowth, measure resistance levels, and determine digestive efficiency and the presence of leaky gut. The following diagnostic tests are commonly used to refine the therapeutic program to an even greater degree: food allergy screening (including IgG, which exposes delayed or hidden food responses); gluten sensitivity screening; and immune profile.

Healthy Cure > One nutritional method to address candida overgrowth is called the "4R method"--remove, replace, reinoculate and repair. This program is a comprehensive, supportive therapy developed by biochemist Jeffrey Bland, Ph.D.3 The program goes as follows:

1. Remove any pathogenic organisms including candida.

2. Replace digestive secretions (HCL and pancreatic enzymes) if deficient.

3. Reinoculate the body with proper nutrition (diet and supplementation), intestinal microflora and agents that support immunological function.

4. Repair the intestinal wall and heal the leaky gut by replacing or augmenting with nutrients that support gastrointestinal mucosal healing. These nutrients include zinc, antioxidants, L-glutamine and substances such as insulin that stimulate short-chain fatty acid production in the colon.

These therapeutic steps can shift the internal ecology from an unhealthy internal state (dysbiosis) to a healthy, efficiently functioning one (symbiotic/eubiotic). Such a program not only eliminates candida overgrowth but deals with its causes and helps repair some of the damage.

One key factor in candida management is maintaining a healthy and sugar-free diet. Researchers agree that candida feeds on sugars. Sugary foods, especially packaged and processed foods, should be avoided.

Yeasted foods also should be avoided for at least the first one to two weeks of therapy. Although food yeast is different from candida, some people may have allergies or sensitivities to yeasts in general. If a patient tests negative to yeast allergy, however, yeast foods may be added back slowly by following a rotation diet. Patients who test positive must avoid these foods indefinitely or until the health care provider determines they may be rotated back into the diet.

The candida control program that some doctors recommend includes the following foods and beverages. Note: Some people may be allergic to some of these foods:

* low-carbohydrate vegetables (fresh, frozen, cooked or raw) that provide significant amounts of fiber;

* fish, meats, poultry and eggs;

* unprocessed nuts, seeds and oils;

* cautious use of high carbohydrates found in foods such as whole grains, including breads, muffins and biscuits (all of which must be yeast-free and made with baking powder or baking soda as the leavening agent); and

* purified water.

Food sensitivities, hidden food allergies and/or gluten problems may be compounding problems that need to be addressed with additional dietary modifications and food rotations. When health improves after following this regimen, the diet is often expanded according to individual response and clinical assessment.

Natural Remedies Although diet is the most important aspect of the program, a number of popular natural products enhance yeast elimination and correct dysbiosis and leaky gut. Most nutritionists and physicians effectively use a wide range of products to help their patients. Some of the most typically recommended are:

* Garlic (Allium sativum) is one of the easiest herbs to use in supplement form, as well as within a medicinal food program. Studies show that it can inhibit candida by damaging the structure and integrity of the yeast cell wall. Research shows that garlic posseses strong anti-microbial properties--allicin, one of garlic's key ingredients, is believed to provide many of its anti-microbial benefits.

* Barberry (Berberis vulgaris) is a valuable anti-microbial herb that also has anti-diarrheal activity. One of its key alkaloids is berberine, responsible for many of its therapeutic benefits. Note: Should not be used by pregnant or lactating women.

* Pau d'arco or lapacho (Tabebuia) is a South American herb known for its antiinfective qualities. Its primary active components, lapachol and xyloidine, have demonstrated anti-candida effects.

* Fatty acids have anti-microbial/antifungal benefits. Two commonly occurring fatty acids are available for therapeutic purposes:

a. Caprylic acid is a medium-chain fatty acid commonly used to fight microorganism overgrowth. The body naturally produces small amounts of this fatty acid, and it is also found in certain animal and plant fats including butter, coconut and palm oils. Therapeutic doses, however, must be delivered through supplementation.

b. Undecylenic acid is a monounsaturated fat that is also found naturally in the human body and is produced commercially by the vacuum distillation of castor bean oil. Studies show that undecylenic acid is as much as six times more effective than caprylic acid.

* Oregano (Oreganum vulgare L.) is a pungent herb of the mint family. Commonly used as a strong aromatic seasoning, oregano contains a variety of substances that supply anti-fungal and anti-mycotic effects. In a study assessing the inhibition of C. albicans, carvacrol, a major phenolic constituent of the oil, was able to inhibit candida to a greater extent than caprylatic acid.

* Citrus seed extract is an effective natural anti-microbial against candida. Although it is caustic and requires dilution for safety and effectiveness, it has been shown to significantly inhibit candida and, to a lesser degree, some strains of bacteria.

The human intestine must maintain a critical balance between various groups of bacteria that support and protect intestinal and immune function. Accounting for close to 3.5 pounds (and made up of close to 400 strains) of bacteria in an average adult, this bacterial mass is critical to health and protection against pathogens, including candida overgrowth.
Lactobacillus acidophilus, Bifidobacterium bifidum and Lactobacillus bulgaricus are three of the most common protective strains of bacterial flora. Research now shows that certain strains of L. acidophilus produce hydrogen peroxide, a by-product that may play a role in the maintenance of microbial balance. Bacillus laterosporus is a single-cell life form that naturally occurs in our food chain and is found in small amounts in the intestinal tract. Plants use this organism found in the soil, then pass it along to us in their food parts or through animals who feed on them. Its action may rid the body of candida overgrowth, and may soon be the focus of greater study.

Fructo-Oligosaccharide (FOS) is a microflora enhancer originally used in Japan as a low-calorie sweetener. Although it is a soluble fiber found in relatively high amounts in artichokes, onions, garlic, burdock, shallots, wheat, barley and bananas, it is difficult to achieve significantly high therapeutic amounts solely through the diet. Therefore, commercial FOS products are often helpful.

Intestinal Support A number of agents that are used to maintain and heal intestinal membranes include vitamin A, essential fatty acids for their anti-inflammatory activity, and antioxidants. Two additional supplements that may also contribute to improving intestinal permeability are:

* L-glutamine is an amino acid known for its benefits as an intestinal fuel. It is an important nutrient for maintaining normal gut barrier function, as research shows that L-glutamine increases IgA levels in the gut.13 IgA is the most abundant immunoglobulin in normal function of the intestines.

* N-acetyl-d-glucosamine (NAG) is a precursor required for the manufacture of mucosal glycoproteins that line the intestinal membranes. The glycoprotein layer protects the underlying tissues from exposure to enzymes, acid and bacterial assault while providing an absorptive surface. Although the synthesis of NAG begins with L-glutamine, many individuals with bowel irritation and dysfunction are unable to make proper conversions to produce sufficient amounts of this protective mucosal product. NAG, taken as a supplement, appears to be effectively absorbed and incorporated into this protective mechanism while also acting as a growth promoter of friendly flora and providing blocking action against the adherence of C. albicans.

Although primarily emphasizing gut and yeast-related balance, therapy should also enhance immune strength and provide antioxidant protection during detoxification for long-term immune maintenance. A program including glutathione, N-acetyl-cysteine, milk thistle (Silymarin), B-complex, and a full range of antioxidants can further help the liver in the detoxification process.

It goes without saying that lifestyle modification is important, because it immediately affects immune strength. Addressing our mental, physical and spiritual needs is vital for long-term health.

CONTROLLING CANDIDA
* Stay healthy and avoid antibiotics unless absolutely necessary
* Replace beneficial flora after antibiotic therapy
* Avoid chemicals and toxic exposure
* Eat only pure, fresh sugar-free foods
* Drink purified, not tap, water
* Exercise in moderation regularly
* Get fresh air and sunshine each day
* Practice stress management techniques
* Strengthen the immune system holistically (mentally, physically, spiritually)
* Practice good hygiene
* Use unscented detergent
* Wear cotton underwear
* Avoid fabric softeners on underpants
* Never wear damp socks or wet clothing after perspiring heavily
* Practice safe sex
* Supplement with beneficial flora if taking oral contraceptives or using spermicide nonoxynol-9

Joan Friedrich, Ph.D., C.C.N., is a board-certified clinical nutritionist, educator and consultant to the health care and natural products industries. She serves on the advisory board of Nutrition Science News.

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