Candida is a ubiquitous human pathogen which is well known, understood and researched by traditional medicine. However alternative practitioners have put forth a new understanding about how it may function in the body and though this theory is not well established or well supported in research yet, some people find that addressing "candida" in the alternative paradigm helps them reach their goals.
With this in mind, and with the experience of a few of our members who have in fact felt they have done better by embracing this alternative approach along with the CAP, we offer here this information to give you a brief overview of what the theory is and how it may possibly be helpful. We have also compiled a list of the anti candida supplements our members have found helpful for relieving their symptoms. This is in no way part of any CAPS protocol endorsed by either Dr Wheldon, Dr Stratton or used at all at Vanderbilt, although any competent physician will address candida in the symptomatic patient experiencing traditional candida (ie a vaginal infection)
The inclusion if this page should not be interpreted as an endorsement of the relatively unproven alternative form of candidiasis, nor should it cause you to think that all people using CAP have this issue because our experience has been that few people do. This is assumed to be because the CPn is an immune system pathogen and as the system is freed of it's pathogenic load, the improved function allows any other secondary or opportunistic infections to be cleared up as well. That having been said, it is also true that antibiotics, especially long term ones, are known to disrupt the balance of bacteria and yeast normal to the gut and therefore yeast issues are, to a certain extent, considered a possibility by any practitioners prescribing these drugs.
Please be aware that this page is not intended to be an exhaustive review of the theories and possibilities, it is just to give you a brief overview of what it is and how it might be an issue for our members and give you enough information to decide if you need to pursue it further.
The wewll established view of traditional medicine:
Candida Albicans is a yeast that lives in all human beings and it is part of what is considered normal flora for the body (normal germs). It thrives in dark moist places on the body such as the intestinal tract, the mouth, the vagina and the moist crevices of the skin. Ordinarily, there is also other normal flora in these places that keeps the yeast in check and stops it from overgrowth.
When something upsets this natural balance, then pathogenic numbers of candida can be allowed to grow. Taking antibiotics is one of the primary things that allows this over growth to occur because the "other normal flora" that keeps candida in check are reduced by the antibiotic. People then may experience monilial vaginosis (vaginal yeast infection), thrush,skin infections or dysbiosis (intestinal imbalance in the yeast population resulting in diarrhea or constipation). According to traditional medicine, these are temporary problems that are easily fixed with probiotics and/or antifungals and a little time, as the body and immune system straightens this issue out without too much difficulty in the normal person.
In the immunocompromised person, such as an AIDS patient whose immune system is severely impacted, the yeast can overgrow and actually become systemic (in the blood, body wide). This is a grave emergency requiring ICU care and IV antifungal drugs. This systemic version of yeast in the immunocompromised patient is very obvious, severe and potentially fatal.
The traditional view is very black and white on this. Either candida is a minor non issue that your body can handle with minor assistance or it is very, very grave and life threatening due to some kind of profound immune dysfunction. An example of the traditional view on candida can be found HERE.
The alternative view:
Alternative practitioners agree with all that is stated above as it is well documented. But they also believe that there can be a subacute version of candida dysbiosis that the body does not correct on it's own.
This is the theory: the person takes an antibiotic and intestinal dysbiosis in the traditional sense occurs. The body for some reason does not get back into balance and the yeast remains the dominant organism in the intestines. It changes forms into a mycelic type (it puts out tendrils) that penetrate the intestinal walls causing the barrier to be compromised so that foods and other things the person eats are allowed to "leak out" as undigested proteins into the person's blood stream (ordinarily food is broken down thoroughly into generic components like simple carbohydrate). This "leaky gut" creates havoc system wide as the person will react to these foreign proteins as if they were bacteria, causing the immune system to react and creating antibodies and inflammation. This results in a multitude of symptoms in the patient in nearly every organ and system in the body. Some authors suggest there is even molecular mimicry involved, meaning that these foreign proteins that do not belong in the blood may cause the immune system to create immune cells that cross react (attack the foreign protein of the food that leaked out as well as accidentally attacking some of your own tissues). In this paradigm, this is theoretically seen as the cause of "autoimmunity".
In the US, the assessment of this type of candidiasis is largely done by naturopaths (ND's), who are responsible for the wide spread awareness/concern of this possible issue as they have embraced the model in spite of it's lack of scientific support. For many, treatment and diagnosis of candidiasis comprises the bulk of their practice and is their first treatment and diagnosis of choice in many, if not most, illnesses. In their view, it is seen as a widespread and common illness requiring lots of time (years), effort (including a very stringent and difficult diet) and naturopathic assistance (endless prescriptions for supplements and or antifungals like nystatin) to recover. This is an expensive as well as involved treatment. Chronic illnesses like MS are seen as a "candida leaky gut" causing molecular mimicry and the theory says if you treat the candida, the MS goes away as the chronic immune stimulation is relieved. Diseases like CFS are likewise seen as being foreign proteins system wide and exhaustion caused by the constant battle against this pathogen.
In the case of MS, some practitioners have gone even further and stated in no uncertain terms that MS is caused by candida and/or fungus. An example of this may be seen here. Dr Wheldon has addressed this issue from his extensive background as a microbiologist and recognized immediately that the authors made a critical error in their thinking: the word gliotoxin is descriptive, not specific, and like the word "antibiotic" refers to many things. He notes that the "gliotoxin" found in the brain of MS patients is compeletely different chemically and structurally than the gliotoxin created by candida. You may read about this from Dr Wheldon himself HERE One need not worry that perhaps MS can be triggered by candida; there is no evidence of fungus or fungal byproducts in the brains of MS patients. The "gliotoxin" found in MS brains is a protein, the gliotoxin made by candida is not, and utterly different. There are however a number studies finding the DNA fingerprint of CPn in MS brains many of which we reference in our archives.
There is little in the way of hard science (ie peer reviewed studies that are generally accepted) directly supporting the alternative candidiasis model in any of it's versions. Its treatment and diagnosis instead rely heavily on anecdotal evidence and the proposed theory. Yet, it is not unreasonable to imagine that candida might become problematic in the gut as it certainly can become a problem in the mouth or vagina and these well known types of infections do need treatment. So, while it is not implausible that the intestines also might be infected in the same way as these other areas, it is as yet still theoretical. What would be needed is for many people who had a specific set of symptoms to have a biopsy or some other incontrovertible proof of the proposed mycelic intestinal candida infection, allow half to be treated for the candida and the other half to be given a fake medicine, and for those persons who got actual anti candida medicine to recover normal health with relief of those symptoms as well as demonstrating a normal candida free biopsy after the treatment.
Such a double blind study has not been done and thus treatment remains a kind of empirical treatment for a kind of infection we have no proof exists in the mycelic form in the guts of such individuals.
From the traditional medicinal point of view the theory and treatment borders on quackery and the diagnosis 'candidiasis' in the alternative paradigm tends to be viewed with extreme skepticism. The lack of good studies supporting the diagnosis and the commercially driven candida supplement market do not help. A few conventional MD's who were treating candidiasis in the alternative paradigm have had their practices and licenses scrutinized by their local medical boards for endorsing scientifically unproven and unsupported practices and some have even had their licences suspended. While there are some forward thinking MD's for whom such as yet unproven but anecdotally supported paradigms are a reasonable approach, especially for patients struggling with issues not helped by conventional approaches, by and large you will not find support for this paradigm in the conventional medical community.
So, how does anyone know they have candidiasis issues that possibly might be helped by the alternative approach? When might one consider it?:
The evidence for this is largely anecdotal, meaning that if alternative practitioners treat using anti yeast supplements people seem to feel better, rather than there being some kind of objective measure of improvement, like a clear lab result. There are some labs that test for this form of candidiasis and some patient directed tests to do(like the home saliva test seen HERE ) but none of these are generally accepted so you cannot go to your regular medical doctor and ask for a candida test other than the traditional type of smear, such as that used to detect monilial vaginosis. If you have not done it yet, find the clickable word 'thrush' earlier in this document and see the pictures of what a candida infection looks like in the mouth. It is much more than a "white tongue", but one can imagine theoretically if such an infection were in the intestines it could be a problem as it is outlined by the alternative theory.
The symptoms of candidiasis in the alternative paradigm may be seen HERE . It includes a very long list of symptoms that presumably may be related to candida overgrowth.
In addition to the above list of symptoms, the people on CAP who feel they are having an issue with candida overgrowth along with treatment have complained of such symptoms as brain fog, a stall or plateau in their treatment progress, intestinal symptoms like bloating, diarrhea or constipation, thrush, skin infection confirmed as yeast, and typical vaginal candida. If you have these symptoms talk to your doctor about possible treatment as some of our members have had candida issues (like candida skin infections or monilial vaginitis) that were easily diagnosed by their regular doctor and well treated using conventional medicine and prescription medication. If your symptoms are vague and your doctor finds nothing unusual, then you might try using some of the anti candida supplements listed in Michele's chart (link below )working from the alternative theory or seek the help of a competent Naturopath.
Of course do note that taking antibiotics long term even in the conventional medical paradigm results in a person being at risk for candida issues, especially dysbiosis. The CAP supplements include daily doses of probiotics to help keep yeast overgrowth at bay. Since the CPn is an immune system infection and the immune system gets repaired by treatment, the model includes the idea that the body will be able to handle yeast effectively as any normal person would without difficulty as treatment progresses. NAC is also anti yeast as it breaks up the gliotoxin made by candida (reference David Wheldon, link above).
If you, however, feel that you might personally be benefitted by treating for yeast issues via supplements along with CAP, then this brief background of the issue and its various aspects will get you started. Please study further for more information as this is intended as an overview, but be aware that this is an area that has many commercially driven claims. Be cautious and note that the claims in this arena are often not supported by the rigerous scientific standards that would be ideal. As an example, if one company claims that their product is the only one that actually gets rid of candida, one wonders how they can make this statement given that there are no standard tests for this issue, no standardized objective diagnostic criteria and no hard evidence for evaluating whether or not candida is gone. Perhaps what they mean is that all the people we talked to thought they were better after using our product. I personally do not mind using such a product to see if it helps me in some way but I resent weak evidence being presented as if it were real "research".
I personally have used Candex and Candida cleanse in addition to Primal defense and saccaromyces boulardii as probiotics and found the addition of the "anti candida" supplements regulated my elimination back to normal where the probiotics alone (several brands) did not do that, so I use them for a specific symptom because they work for that symptom in me.
Briefly, the kinds of treatments for this issue fall into several catagories:
1 Prescription anti-fungals, such as nystatin, which interfere with replication of the yeast which your regular MD will prescribe if you have a traditional yeast infection recognized by the traditional paradigm.
2 Probiotics which are "healthy" normal bacteria that crowd out the candida overgrowth and return the bowel to balance and which are also killed off themselves by the antibiotics taken in CAP, thus constant doses are needed. These are included in the CAP as they are well known to help reduce the incidence of dysbiosis and possibly even clostridium difficile (s boulardii especially)
3 enzymes which break down the walls of the candida thus killing it and which must be taken on an empty stomach (or it'll just break down the food that is there instead)
The next page on this subject is a list of such items compiled by Michele of all the supplements members of this site have discussed for this issue. We are not endorsing any of these products specifically, just providing a list so people can see what we discussed and the comments made by people about those products...
nor are we offering medical advice or diagnosing any health issue. Only your doctor can do that. And finally, a repeat that these kinds of supplements are not part of the CAPs protocols nor are they viewed as necessary for the ordinary person on CAP. Most people will find they have no problems with candida.