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CANDIDIASISWhat Is It?

The presence of Candida albicans, a benign sugar-fermenting yeast, in various parts of the body—the skin, the genitals and especially the intestinal tract—is entirely normal. In small amounts, this yeast is an integral part of the intestinal ecology and, when kept in balance with other microorganisms, does no harm. Candidiasis, however, is a complex medical syndrome resulting from an overgrowth of Candida albicans. This yeast (or single-celled fungus) is one of 600 strains of Candida, and is among the minority that can become pathogenic (disease-causing).1

In candidiasis, normally harmless yeasts proliferate and change into a mycelial or hyphal form2 where they take root in tissues and colonize. This upsets the ecological balance in the gastrointestinal tract. When the friendly gut bacteria that normally control Candida die off and Candida gains an upper hand, local problems can result—in the vagina (yeast infection), throat (thrush), nails (fungal infection), bladder (candidal cystitis), etc. When Candida colonizes in the gut, it can cause problems throughout the entire body due to the fact that potent, immune-suppressing toxins are absorbed into the bloodstream. Candida is actually a form of parasite, an organism that feeds off of the human body and can pollute the system with its toxic waste products if it is present in disproportionate quantities.

What Causes It?

There are multiple factors that may trigger the form change and proliferation of Candida that result in candidiasis. This condition develops when the balance between yeast and bacteria is upset as a result of:

• Immune dysfunction• Disruption in ratio of good to bad bacteria in the

gastrointestinal tract• Upset in intestinal pH

Immune dysfunction is caused by a number of factors:

• Ingestion of certain drugs (acid-blocking medication and antibiotics)

• Exposure to toxic metals• Internal toxins from poor digestion• Consumption of refined carbohydrates• Chemotherapy• Stress

All of these factors create an imbalance of gut flora (with the bad bacteria outnumbering the good) called dysbiosis, that can result in reduced immunity.

An alteration of the ratio of good to bad bacteria in the GI tract is a very common cause of candidiasis. In fact, the prolonged—and sometimes inappropriate—use (and overuse) of antibiotics is perhaps the most widespread cause of chronic candidiasis today. These drugs suppress

A 3D rendering of the human body with an endoscopic image of Candida overgrowth

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not only pathogenic or bad bacteria, but also the friendly bacteria whose job it is to prevent yeast overgrowth. The net result is proliferation of Candida. As Candida proliferates, the fungus releases toxins (waste products called mycotoxins) that further weaken the immune system.

A by-product of Candida digestion of protein is beta-alanine. Beta-alanine is absorbed through the intestinal lining and secreted by the kidneys. It competes for reabsorption with the amino acid taurine in the kidneys and this lowers taurine levels. This is a significant problem because taurine enhances the intracellular uptake of magnesium and potassium. In addition, it helps to bind toxins and remove them from the liver. Thus, it has been clinically observed that patients with candidiasis of the intestinal tract may have problems absorbing magnesium and potassium, despite oral supplementation. (Personal communication with Dr. David Quigg, nutritional biochemist at Doctor’s Data Laboratories.)

While the sources of heavy metals are many and varied, one of the most important with regard to candidiasis is the dental use of mercury. The silver amalgam dental filling routinely used by dentists is actually composed of from 50 to 53 percent mercury.3 It will be extremely difficult for the person with amalgam fillings to rid the body of Candida because mercury has an antibiotic effect, killing off the friendly bacteria so they cannot control yeast overgrowth.4

Yeast-connected illness affects people of all ages and, although both sexes are affected, women are eight times

more likely to experience the yeast syndrome.5 Women may develop vaginal yeast infections following a course of antibiotics, during pregnancy, or while using oral contraceptives. Progestin from birth control pills changes the vaginal lining to make it more hospitable to yeasts, and also causes the release of yeast-feeding sugar into the bloodstream.6 Candida may be transmitted sexually, and a mother may pass it on to her newborn.7 Candidiasis in the form of oral thrush and/or diaper rash is common in babies.

Factors that might predispose one to candidiasis include:8,9

• Use of antibiotics• Use of corticosteroid drugs (which suppress the immune

system and permit the overgrowth of yeast)

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Healing HOPETestimonial

“A few years ago I was su!ering from severe fatigue. I was just tired all the time, and no matter what I did, it just kept getting worse. I went to several di!erent doctors and had so many tests done—bloodwork, CAT scans, X-rays—you name it, I had it done. Eventually I was referred to an infectious disease doctor, but after another round of testing, even he said there was nothing wrong with me and he just told me to go home and rest!! It was so frustrating, and that’s when I finally turned to Brenda who told me “Katie, it’s all in your gut” and it was…and she changed my life!

One of the "rst things she did was a comprehensive stool analysis (CSA), and with her help I discovered that all my health problems were starting in my gut. Sure enough, I had dysbiosis, Candida overgrowth and a low immune response in my gut. Basically, I was a mess on the inside! So after balancing my system with the help of pharmaceuticals, natural supplements, and cutting things out of my diet like re"ned sugar, dairy, wheat and gluten, I now feel amazing.“–Katie

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• A compromised immune system (evident in people with AIDS, cancer and autoimmune diseases, as well as those taking immunosuppressive drugs and those with a heavy body burden of toxins)

• A damp, moldy environment• A diet high in refined carbohydrates and other yeast-

promoting foods (See the Candida Diet in the Appendix.)• Presence of mercury-containing silver amalgam fillings

in the teeth

• Stress (which suppresses immune function)

• Decreased digestive secretions

• Nutrient deficiency

• Impaired liver function

• Altered bowel flora (bacteria)

Also at increased risk for developing yeast infections are patients who have undergone surgical interventions, catheterizations or dialysis, as well as burn victims and those with diabetes mellitus and hypothyroidism.10

What Are the Signs and Symptoms?

Candidiasis can affect many parts of the body and may be characterized by a wide variety of local and systemic signs and symptoms, including:11,12

• Chronic fatigue• Brain fog• Anxiety• Depression• Food cravings (especially for sweets, fermented foods,

alcoholic and carbonated beverages)• Hyperactivity and learning disabilities in children• Lack of libido• Suppressed immune activity; autoimmune disorders• Headaches• Muscle aches• Arthritis• Bladder and kidney infections• Gas and bloating• Bad breath• Rectal itching• Clogged sinuses/sinusitis• Acne• Burning tongue• White spots on tongue and in mouth• Nail infections• Diaper rash

As mentioned, Candida releases toxic waste products when it proliferates. One mycotoxin produced by Candida is acetaldehyde. Acetaldehyde is toxic to the central nervous system. It also interferes with normal hormone metabolism, affecting the pituitary, thyroid and adrenal glands.13 Additionally, it has been shown that abnormal gut fermentation by yeast or bacteria can produce

Auto-Immune Diseases Resulting From Leaky Gut

• Lupus• Rheumatoid arthrtis• Polymyalgia rheumatica• Multiple sclerosis• Chronic fatigue syndrome• Fibromyalgia• Thyroiditis• Crohn’s disease• Vitilego• Vasculitis• Ulcerative colitis• Urticaria (hives)• Diabetes

An enhanced rendering of the intestinal lining developing into leaky gut

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increased blood-alcohol levels.14 These processes explain how Candida can produce “brain fog” symptoms.

It is important to note that Candida is an underlying factor in many, if not most, diseases and conditions. Candida infection must be ruled out when addressing other health conditions.

The development of allergies and other autoimmune disorders is viewed by many progressive physicians and alternative practitioners as a consequence of mycotoxins entering the bloodstream. Normally, the semi-permeable lining of the intestinal tract will prevent contamination of blood with these and other toxins, microorganisms and undigested food particles. However, when the roots of Candida (known as rhizoids) burrow into the

intestinal lining, they leave microscopic holes through which these contaminants may pass. The body sees undigested food particles as foreign substances and therefore launches an immune reaction that gives rise to autoantibodies that promote allergic responses, or even worse, autoimmune disease.

Candida toxins are carried through this leaky gut via the bloodstream to the liver. From there, they proceed to other organs of the body—the brain, nervous system, joints, skin, etc. If the liver’s detoxification ability is impaired due to inadequate nutrition and toxic overload, these toxins will not be eliminated and can initiate states of chronic disease.

In addition to suppressing the immune system, Candida also disrupts the endocrine (glandular)15 system, which has a regulating effect on the body. Leaky gut and bacterial dysbiosis, (when the bad bacteria outnumber the good) also contribute to the development of non-alcoholic fatty liver disease (NAFLD).16 This condition is becoming more prevalent and can lead to the development of diabetes and even liver failure. These effects make it possible for Candida to cause, or contribute to, virtually any disorder anywhere in the body.

It has been shown that abnormal gut fermentation by yeast or bacteria can produce increased blood-alcohol levels. This is known as auto-brewery syndrome.

Microscopic view of Candida albicans

Candida yeast

Candida shifting from yeast to hyphal form (growing roots)

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Healing HOPETestimonial

How Is It Diagnosed?

It is generally agreed that a diagnosis of candidiasis is best made on the basis of a thorough patient history. A good questionnaire can be helpful toward this end. (See the Candida diet in the Appendix.) The section includes two versions of the self-scoring yeast questionnaire—adult and child—both developed by the late William G. Crook, MD, a pioneer in yeast-related illness. Doctors may wish to confirm their diagnosis of candidiasis through use of specialized laboratory tests such as stool cultures for Candida (comprehensive stool analysis (CSA) or 16s rRNA analysis), and measurement of antibody levels to Candida or Candida antigens in the blood.17 (See the Appendix for more information.)

The CSA can also be useful in detecting parasites that tend to coexist with Candida. Since a certain amount of yeast is normally present in the GI tract, its detection in the laboratory tests does not necessarily mean that it has overgrown and is causing disease. For this reason, these tests alone may not offer a definitive diagnosis. That’s why

a thorough history should also be taken.

What Is the Standard Medical Treatment?

Traditional medicine employs fungicides (which kill fungus) to treat severe yeast infections. Fungistatic drugs

that inhibit the growth of fungi, preventing it from getting worse, may also be employed. While these may effectively suppress fungal growth, it may resume once medication is discontinued unless the primary problem is handled and dybiosis, or bacterial imbalance, corrected.

While many doctors of complementary and integrative medicine will rely upon herbal and nutritional remedies solely, some may opt to do a short course of drug (anti-fungal) therapy first in an effort to shorten treatment time. Some antifungals, like Sporanox and Nizarol are all absorbed in the upper GI tract and taken into circulation, so therapeutic doses do not reach the colon. However, antifungals like Diflucan are now available in oral suspension and remain in the GI tract. Nystatin can be used in conjunction with the systemic drugs for a short period of time to help ensure the elimination of Candida,18 It is important to understand that handling Candida is more than just taking a pill. It is a holistic approach consisting of diet, supplementation, lifestyle modification and mental and emotional support.

Fill out the yeast questionnaire in the Appendix for an easy way to determine whether you have an underlying Candida overgrowth.

“A few months ago, I was diagnosed with an overgrowth of Candida lambica, as detected by stool analysis. I began the Candida Cleanse. Now, three months later, my stool analysis shows that I have no Candida!”– Scott

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Candida infections run a spectrum from minor oral thrush and vulvovaginal candidiasis to overwhelming Candida sepsis (usually in severely ill ICU patients or immunocompromised HIV patients). Hospital-based allopathic medicine does a great job with anti-fungals on the seriously ill. However, when patients have low-grade recurrent Candida infections, they are treated with appropriate anti-fungal agents, but then o! ered nothing else to prevent recurrences. This is another example of symptom-based medicine not focusing on the original nature of the problem.

In patients with relatively intact immunity, the only manifestation of Candida may be abdominal bloating, poor digestion and elimination problems—usually constipation. Many doctors have not accepted these symptoms as a Candida problem. However the urine, stool, and blood antibody testing, followed by appropriate diet, and antifungals yield good results. There are major considerations with regard to normal physiologic processes (such as normal HCl production and immune competence) and dietary and nutritional supplementation that help in prevention. Many research findings support the concept that inadequate stomach acid is at least a double-edged sword: higher pH promotes Candida growth and also blocks the absorption of iron, folate, vitamin B6 and zinc. It is well known that both zinc and vitamin A are critical for normal cellular immunity. So it is easy to see that immune deficiency will further exacerbate the problem of chronic Candida overgrowth. It is also likely that the Candida may be consuming the deficient nutrients, oxidizing the essential fatty acids and leaving toxins in their place. Eradication of the problem does require dietary changes and anti-fungals (pharmaceutical, nutraceutical or both), depending on the clinical situation.

Dr. Smith’s Comments

Candida mycotoxins produced from Candida overgrowth can lead to mood disorders such as depression and anxiety. These toxins disable the brain’s pituitary gland shutting down the production of healthy levels of antidepressant hormones, and disrupting normal transmission between brain cells. (See the Depression, Anxiety and Addiction sections for more information.)

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The following anti-Candida guidelines will help to bring the body back into balance:

Rule Out:

• Food sensitivity, especially to gluten or dairy (See the Allergies section and Gluten Sensitivity section for more information.)

• Mercury toxicity• Oral infection• Hormone imbalance (See the Menopause or

Premenstrual Syndrome section.)

Recommended Testing

• Comprehensive stool analysis (CSA) (See the Appendix.)

Diet

• Follow the Candida diet in the Appendix of this book for at least 30 to 90 days. This is critical to the success of any anti-Candida program. (For many people, 30 days may not be enough and for some, it may need to be followed for up to a year.)

• Switch to the Fiber 35 Eating Plan, which keeps simple carbohydrates and sugar to a minimum, after the Candida program.

Lifestyle

• Clean out your kitchen, getting rid of temptations and replacing with more appropriate food choices.

• Exercise daily, at least walking.• Stop drinking alcohol at least until through the

program and, after that, only in moderation.

Complementary Mind/Body Therapies

• Colon hydrotherapy is excellent for removing waste from the colon and can be helpful.

Candida overgrowth is a condition that I began working with in 1990 when I realized what a massive problem it was. Today the problem is even bigger. After 20 years of saying the same thing again and again to so many people who have issues with Candida, I am amazed at the scope of the problem.

Candida overgrowth is at the base of so many health conditions. To heal from it, a commitment must be made. People who follow a Candida Diet (see the Appendix) and Candida Cleanse for at least three months and sometimes for as long as a year, get well. Once the Candida is controlled, following a Candida Cleanse for 30 days two times a year is the best maintenance for this condition.

Candida overgrowth in the gut degrades the protective mucosal lining of the GI tract. What many people don’t understand is that the mucosal lining of the intestines needs to properly heal in order for the bene"cial bacteria to be able to adhere to its lining. This can take some time, and it is why Candida overgrowth can recur. Rebuilding and balancing the gut is essential for the digestive tract to heal properly.

The emotional component of chronic health conditions like Candidiasis is often overlooked. Many cases of declining health are triggered by an emotional event such as a divorce, job loss, or the death of a loved one. Taking care of emotional issues that may underlie poor health is an important aspect of healing.

I also want to clarify the difference between a yeast infection (Candida overgrowth in the vagina) and Candidal dysbiosis (Candida overgrowth in the intestines). Women who have yeast infections very likely may have Candidal dysbiosis as well. But even if a woman does not experience yeast infections, the Candida may still be #ourishing in the digestive tract! Candida can grow in many di!erent places, some of them obvious, as with yeast infections and oral thrush, and some of them not so obvious, like in the digestive tract, and even the bloodstream in the most severe cases.

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Recommended Nutraceuticals Dosage Benefit Comments

Critical Phase

Total Body Cleanse See Appendix Encourages elimination and detoxi"cation.

Herbal formula should support the seven channels of elimination.

Probiotics200 billion culture

count per dose for the "rst 15 days

Helps crowd out pathogenic yeast and bacterial organisms.

Look for multi-strain with plenty of bi"dobacteria.

Saccharomyces boulardii

10 billion culture count twice a day

Bene"cial yeast shown to help eradicate candida

overgrowth.

Use this in conjunction with other probiotics.

Candida CleanseAs directed on label. Stay on for at least

30 days. Should follow the above cleanse

Helps to eradicate Candida overgrowth.

Look for ingredients such as uva ursi, caprylic acid, undecylenic acid,

barberry, garlic, neem, grapefruit and olive leaf extracts.

Candida Enzyme Formula Take on empty stomach

several times daily

Taken without food can be bene"cial in reducing bacteria and yeast in the

intestinal tract.

Make sure it contains lysozyme, helpful in breaking apart the

Candida cell wall.

Helpful

High Potency Multi-vitamin/mineral

Use as directed Provides needed nutrients that may be de"cient.

Powder or liquid formulation is easier assimilated and absorbed.

Digestive Enzymes with HCl

1-2 capsules with meals

Restores proper level of gastric acidity to

deter bacteria and yeast overgrowth.

Do not use HCl if ulcer or stomach irritation is present.

Switch to enzyme without HCl.

Daily Maintenance

Probiotics*50 billion count

twice a day after critical phase

Helps crowd out pathogenic yeast and bacterial organisms,

produces uninhabitable environment to yeast

Look for a probiotic formula with a high amount of bi"dobacteria, the

main bacteria in the colon.

Fiber 4-5 grams twice daily

Helps absorb toxins from Candida and reduce

symptoms associated with “die-o!” reaction.

Look for a #ax, acacia and oat based "ber blend.

Digestive Enzymes Take with meals Helps digest and absorb nutrients from food.

If low stomach acid is found find a formula that contains

hydrochloric acid.

Omega Oils At least 2 grams daily of omega combination

Helps restore moisture to the intestinal tract.

Best combination is #ax, "sh and borage oils.

Vitamin D3At least 1,000 iu daily Helps heal leaky gut,

decrease in#ammation.An optimal vitamin D blood level of 50 – 70 ng/mL should be achieved.

*For women with a yeast infection, use a women’s probiotic formula, that contains a high amount of lactobacillus.See further explanation of supplements in the Appendix

Daily maintenance recommendations should also be taken during this phase unless otherwise indicated.

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