Candida – that is, infection with Candida
albicans, the thrush germ – is
now big business. Probably no condition in the natural health
arena is attracting more interest at present. Many magazines and
newspapers feature articles on it, yet doctors’ journals
virtually ignore it. It recently gained notoriety in the
when a pop star’s wife was said to suffer from it and the public
watched her getting sicker and sicker until it was obvious that
the treatment was more deadly than the disease.
What are the real facts? So much ignorance and
misinformation abounds that you may be wondering if there is
anything really known about the topic. I will attempt to
summarize just what we do know about Candida and also put
an end to some of the nonsense and falsehoods, spread
principally by unqualified medical practitioners. Many of these
enthusiastic amateurs have set themselves up as ‘Candida
experts’ and are making belligerent claims they cannot justify
and treating individuals with techniques that are sometimes
worthless or – at worst – downright dangerous.
Some of the
confusion about Candida comes from the fact that a number of
widely circulated ‘anti-candida
diets' do have beneficial effects, at least at first. What isn’t
understood is that the mechanism at work is often that
of eliminating a food allergy and
not eradication the Candida at all. I saw one diet in
which asked patients to exclude dairy produce as part of an
anti-Candida regime; a naturopath here in
says ‘no grains’. There is absolutely no rationale for these
omissions in the fight against Candida but these methods ensure
that a great many people who are dairy
or wheat allergic will ‘miraculously’ get better. This creates
the false impression that the patients had indeed had Candida.
Another incorrect datum that has gained much currency is
that once you have got Candida you are stuck with it. One hears
of people who are supposed to have had it for years. Again, the
amateur meddlers’ fundamental lack of knowledge is to blame.
Because they are not able to prescribe proper anti-fungal drugs
– and indeed, to protect their own shaky position as ‘experts’
some even say that it is undesirable to take an anti-fungals
– they are not able to effect proper eradication. This means
that many sufferers are denied the full treatment that they
need, treatment that would enable them to overcome their
number of factors are known to predispose infection with
Candida. Anything that compromises the immune system is likely
to have this effect (AIDS patients often die of severe systemic
Candida; they are simply unable to fight it off). ME cases seem
to get it very consistently. Any long-term debilitating
illness may be accompanied by what we call ‘opportunistic
infections’ (those that get under way while the patient’s
resistance is low).
Steroids (including the birth control pill, which is often
overlooked as a steroidal) sometimes lead to
Candidiasis. However, there is
little doubt that the single most widespread cause of
Candidiasis is the administration of
Incidental to their main, beneficial effect, these antibiotics
kill off resident bacteria in the gut. This ‘gut
flora’ is needed for optimum health and proper gut
performance. When the bacteria are killed off other pathogens
are free to move in, and Candida is one of the most common of
these. Countless patients have become chronically ill after
frequent or prolonged use of antibiotics and can pinpoint the
onset of their troubles to such a course of treatment.
Finally, some Candida patients have none of the above
predisposing causes yet they seem to have the condition. Perhaps
our modern, manufactured ‘junk’ diets are partly to blame.
able to ferment and release alcohols from sugars in food (see
intestinal fermentation). To many people these alcohols
are quite allergenic. There have been several celebrated cases
in which individuals who were guilty of driving under the
influence of alcohol were able to show they had not been
drinking but that they did have significant infections with
Candida and so escaped the laws. Remember Candida is
a yeast, related to moulds, and these
organisms themselves are also often quite toxic and may be
highly allergenic in their own right.
But the real problem is that Candida also appears able to
generate food and chemical sensitivities. Increase in food
intolerance has been blamed on damage to the gut wall. Like many
yeasts and fungi, Candida has a vegetative from, which grows out
small threads or hyphae into the
surrounding cells. It has been hypothesized that these
hyphae may provide channels through
which the products of digestion escape prematurely into the
bloodstream. This means that food substances have not been
broken down fully and are thus still
biochemically ‘wheat’, ‘pork’ etc.
If this were so we would certainly expect trouble form
allergies, so the supposition fits with the observed facts. But
please remember, it is only another theory. It sounds good but
may be totally wrong. Clinical ecologists call it the
leaky gut syndrome’.
I believe personally that Candida doesn’t really cause
allergies but that Candida and allergies share a common origin:
a poor or ‘flat’ immune system.
I use the
concept of Candida in talking to patients since most people have
heard of it and believe that is what they have got. However, I
prefer the label I used in my Allergy Handbook (Thorsons,
1988), the so-called ‘mouldy
patient’. It is a term that stays in the mind, broadens out the
debate and gives better insight into what we are dealing with.
Whatever the nature of this illness, its manifestation is of a
disease caused by encountering and being sensitized by
biological products from yeasts, fungi and moulds.
Patients are made worse by anything that can be fermented,
such as starch and sugars; they react to foodstuffs containing
yeast or mould (bread, wine, mushrooms; etc.); they are often
ill in mouldy or musty surroundings
(old buildings, woodlands or animal byres); some are even
sensitive to damp weather, when moulds are
sporing freely; often there are accompanying infections
of the fungus type including athlete’s foot or other skin
infections such as Tinea and
Epidermophyton; finally, the
patient may have been diagnosed as having
candida, either in the mouth, gut or vagina.
plagued by the lack of a suitable diagnostic test to show
whether or not a patient has Candida. Some practitioners use
applied kinesiology techniques but this is hardly
acceptable to the medical community. Until the time comes that
we have a proper test we must rely heavily on taking a careful
patient history, seeking to elicit symptoms typical of those
Fatigue is an almost constant accompaniment of
Candidiasis and mould problems;
depression and disturbance of mood are also particularly
prominent, However, lists of symptoms
are not reliable guides to candida
infection or any other mould problem. Most such lists give
symptoms that are typical of food allergy, ME and many other
states. These simply reflect a body under stress and not some
However, there are four symptoms that I have found very helpful
in pin-pointing Candida: a craving for sweet foods, a poor
tolerance of alcohol, chemical sensitivity and bloating. This is
the ‘awesome four-some’! All four means a certainty, any three
will do. Craving for sugary foods is often outstanding among
One thing is certain, there is
virtually no correlation between Candida in a stool sample and
the existence of the ‘yeast syndrome’. Indeed, Candida
albicans is rarely identified in
specimens, despite it known very wide occurrence.
are trying to establish a valid gut fermentation test. The idea
is to take a resting blood alcohol level and then repeat the
test some hours after a sugar feed. If alcohol appears in the
blood this would suggest that fermentation going on. But it
doesn’t tell us what is doing the fermenting.
A likely improvement is to look for a wider range of
fermentation products. At the moment Biolab
are testing for short-chain fatty acids such as acetate,
succinate and butyrate, and for other alcohols such as
butanol and 2,3-butylene
glycol. The advantage of this newer test is that it doesn’t need
‘before’ and ‘after’ samples, so it is easier to do.
At the end of the day, we rely mainly on what is called a
therapeutic trial. That is, we give the patient the appropriate
treatment and, if it works, we infer he or she must have had the
anti-mould programme must include
efficacious restoration of bowel flora. That means removing the
offenders and replacing them with ‘friendly’ bacteria. Several
steps are necessary: killing off the moulds, avoiding sugars,
minimizing further contact with mould and yeast, especially in
the diet and, lastly, recolonization
with suitable flora.
The most important step is medication with suitable anti-fungals.
These must be prescribed by a competent physician.
Nystatin is the most popular. Even
among allergics it is well
tolerated, The usual doses are in the
range of 1,000,000 units = quarter of a teaspoon).
Nystatin can act as a chelating
agent (that is, it binds to metals and blocks them) and so
should not be taken with nutritional supplements (it would
remove zinc, magnesium etc.).
tables and fluconazole (Diflucan)
capsules. The latter is expensive but easy to take. A ‘one-shot’
form exists, for those likely to develop reactions to
medication. Except for Nystatin,
lengthy treatments should not be undertaken, as side-effects are
Capricin, a trade
brand of caprylic acid, has been
frequently advocated as an antifungal. Other substances include
garlic and Taheebo tea (Pau
Much is disseminated about the ‘burn off’ reaction patients
sometime get when first starting anti-fungal treatment. This is
similar to the Herxeimer reaction
that syphilis patients used to get when starting a course of
penicillin; it was caused by a flood of circulating dead
spirochetes (syphilis germs). Burn-off (a sudden exacerbation of
symptoms) does exist but is much exaggerated and rarely amounts
to anything serious. Discontinuance allows it to settle and,
nine times out of ten, when the patient resumes the treatment
there is no further trouble.
Medication needs to be supplemented by avoidance of added
sugars in the diet. Extreme denials are not called for. Some
writers foolishly recommend avoidance of fruit and similar
natural foods. This may lead to dangerous inadequacies in
nutrition and is bad advice because it isn’t necessary.
Anyone with ‘Candida’ made ill by eating fruit has a fruit
allergy, almost certainly. Those who feel unwell after eating
sugars may really have a degree of carbohydrate intolerance due
to deficient enzymes (see
inborn errors of metabolism).
Similarly, with avoidance of yeast or
mouldy foods – fanaticism is not necessary and may be
counter-productive. Patients willing to experiment a little will
find suitable tolerances to a number of items in this category.
The full list of ferments is very extensive and your physician
will probably give you more detailed information. The table
below summarizes all the main yeast and fermentation products.
and yeast products
that contain yeast, moulds or ferments as basic ingredients :
Doughs: breads, buns, rolls,
prepared frozen breads, sourdough and any leavened food.
apple, distilled, wine, grape, pear,
etc. This includes all foods containing any vinegar, e.g. salad
dressings, mayonnaise, pickles, sauerkraut, olives, most
condiments, sauces such as barbecue, tomato, chili, green pepper
and many others.
Beverages: beer, lager, stout, wine, champagne, spirits.
Sherries, liqueurs and brandies as well as all substances that
contain alcohol, e.g. extracts,
tinctures. Cough syrups and other medications, including
including fermented dairy products, cottage cheese, natural,
blended and pasteurized cheeses, buttermilk and sour cream.
Products: milk drinks that have been malted; cereals and sweets
that have been malted.
Moulds: such as soy sauce, truffles and mushrooms.
penicillin, ampicillin and many
other ‘-illins’’ ‘-mycin’
drugs and related compounds such as Erythromycin, Streptomycin
tetracyclines and related
derivatives; all the cephalosporin derivatives and all others
derived from moulds and mould cultures.
Vitamins: B, B
complex and multiple vitamins containing B complex. All products
containing B6, B12, irradiated ergo sterol
(Vitamin D). All health products containing brewer’s yeast or
that contain yeast – or mould- derived substances:
Flours that have
been enriched (most)
Milk enriched or
fortified with vitamins
fortified with added vitamins, i.e. thiamine, niacin,
that may contain moulds as allowed contaminants commercially :
canned or frozen. (In preparation the whole fruit is used, some
of which may be mouldy but not
sufficiently so to be considered spoiled. Fresh, home squeezed
should be yeast-free)
Prunes, figs, dates, raisins, apricots, etc. Again, some batches
may be mould-free but others will have commercially acceptable
amounts of mould on the fruit while drying.
makes sense to try and recolonize
the bowel with friendly bacteria. Most well known among these
friendly bacteria is Lactobacillus acidophilus, the
yoghourt-making germ. Many supplements of ‘acidophilus’ are
currently being marketed. Some contain very few live bacteria
and are of poor value if not completely fraudulent.
In fact Bifidobacteria is much
more prevalent in the gut, comprising some 90 per cent of
natural bowel flora. Top brand
probiotics, as these flora supplements are
known, now include primarily Bifidobacteria.
Look for those that provide human-strain acidophilus; logically
these are more likely to establish themselves in the human