Controversial Diagnosis #3: Candida Overgrowth Syndrome

Health Tips / Controversial Diagnosis #3: Candida Overgrowth Syndrome

Patients come to WholeHealth Chicago regularly with this common refrain: “You’re the fourth (or seventh or tenth) doctor I’ve seen. I feel terrible but am always told that my tests are normal and there’s nothing wrong with me. Recently I read about Candida overgrowth and the symptoms seem to fit me exactly. But the doctors I’ve seen all tell me there’s no such illness.”

These truly miserable people are suffering from exhaustion, abdominal bloating, fuzzy thinking, muscle weakness, joint pains, congested sinuses, loss of interest in sex, sugar cravings, and recurring vaginal infections. And when they tell me that as teenagers they took a year’s worth of antibiotics for acne, I know their self-diagnosis is absolutely correct. They are poster children for candida overgrowth syndrome.

Our bodies host a multitude of microorganisms, and a proper balance among them is one of the keys to good health. Candida (full name Candida albicans) is a microorganism that lives in our gastrointestinal tract. The candida population is held in check by the multiple billions of bacteria that share space with it. However, when this bacteria population plummets, usually after a broad-spectrum antibiotic is taken for an extended period, overgrowth of candida can occur and usually manifests in women as a vaginal yeast infection.

Vaginal infections are well recognized by conventional doctors. Problems arise when candida grows out of control and excessively populates one or more locations in the body. Let’s review:

Vaginal candidiasis. The most common form of candida overgrowth is vaginal candidiasis (a yeast infection), which often occurs after taking an extended course of antibiotics. Remember, antibiotics kill the helpful bacterial strains that typically keep candida within bounds. Candida, however, is unaffected by antibiotics and in the absence of its natural bacterial counterbalance proceeds to reproduce wildly. Intense vaginal itching and other discomforts, along with a white discharge, are characteristic signs of a vaginal yeast infection.

Oral candidiasis (oral thrush). Candida overgrowth in the mouth, also called oral thrush, can occur in people using steroid inhalers for asthma (steroids encourage candida proliferation) and in breast-fed infants whose mothers are taking antibiotics. Oral thrush also develops in people whose immune systems are severely depleted–for example, people undergoing cancer chemotherapy, those taking immunosuppressive therapy after an organ transplant, and people with HIV/AIDS.

Candida overgrowth syndrome. Vaginal candidiasis, oral thrush, and candida overgrowths on the skin such as diaper rash are common medical conditions. When they occur, all physicians agree they should be treated. A third type of candida proliferation within the intestines, however, is the controversial disorder, accepted by some physicians and rejected by others as a fad diagnosis. It is known variably as candida overgrowth syndrome, chronic candidiasis, or simply “a yeast problem.”

The start of the Candida wars
In the early 1970s, two physicians working separately, William Crook, MD, and C.O. Truss, MD, proposed a syndrome they’d observed primarily in women who had taken antibiotics for weeks or months, usually for acne. The main symptoms were digestive (gas, bloating, diarrhea) with recurring vaginal yeast infections. In time, Dr. Crook added numerous other symptoms to his list, including fatigue, brain fog, sinus congestion, skin rashes, and the development of food sensitivities.

Because he was unable to get his research into mainstream medical journals, Dr. Crook self-published The Yeast Connection. Knowing he’d receive little acceptance from his medical colleagues, he included a questionnaire to help readers with self-diagnosis and self-treatment, using diet changes and nutritional supplements.

However, because the information went to the general public before being broadly accepted by physicians, Dr. Crook’s readers (mainly women) who diagnosed themselves with “yeast overgrowth” encountered a wall of unexpected hostility, irritation, and disbelief from their physicians. They’d arrive, The Yeast Connection in hand, questionnaire carefully completed, and face a look of withering contempt from their doctors.

“Yeast,” by the way, is a misnomer—your bread doesn’t rise because it has candida. For more on that, click here.

It didn’t help the situation that articles denying the existence of candida overgrowth actually were published in medical journals in response to this rising public interest. And it really did not help the situation that Dr. Crook, aware of the resistance, marketed his book mainly to alternative practitioners (chiropractors, naturopaths, nutritionists). This tack resulted in two unfortunate consequences.

First, the separation between the “yes-candida-exists” and the “no-it-doesn’t” camps grew wider because candida was adding fuel to the longstanding hostility between conventional and alternative practitioners. Second, and of equal concern, candida overgrowth became vastly overdiagnosed by alternative practitioners because they “owned it.”

“Your arm hurts? Must be candida!” “Tired? It’s your candida!” Or even “My intuition tells me your body is filled with candida” (very Stephen King, eh?). At the same time, candida was vastly underdiagnosed by conventional doctors who should have known better. (“I know you’ve been taking antibiotics for a year and have daily vaginal infections, but there’s no such thing as yeast overgrowth.”)

Now, almost 40 years later, the bickering continues. Patients, mainly women, continue to hear “I think you have candida” from alternative practitioners of every stripe, including well-meaning health food store clerks, and then face a barely repressed sneer from their physicians who declare “There’s no such thing.”

Risk factors for candida overgrowth and the tests that confirm it
If you’ve taken a prolonged course of a broad-spectrum antibiotic (which triggers an ecological catastrophe against the helpful bacteria in your intestines) and you’ve developed protracted digestive symptoms and especially if you now have recurring vaginal yeast infections, then indeed you may have candida overgrowth syndrome.

Other risk factors include (though definitely not necessarily) taking birth control pills or oral corticosteroid drugs such as prednisone or being diabetic (having high blood sugar). Contrary to popular belief, a high-sugar diet doesn’t predispose you to candida. If this were the case, the entirety of western civilization, devouring as it does 120 pounds of sugar per person annually, would be suffering from it.

With candida thoroughly and deliberately ignored by conventional physicians, symptoms reported by their patients are not taken seriously and many doctors are reluctant to order the relatively simple tests that can prove or disprove the diagnosis (many are even hostile to the suggestion).

The three diagnostic tests are:
–A stool sample sent to a microbiology lab for microscopic examination and culture of candida.
–A blood test for the presence of antibodies to candida.
–If needed, a microscopic examination and culture of vaginal discharge.

Once a candida diagnosis is confirmed, treatment is fairly straightforward. Prescription anti-candida medications (fluconazole, nystatin) are safe and effective. For those averse to prescription meds, several natural remedies (grapefruit seed extract, caprylic acid, garlic) are effective as well. You’ll also need to eat fermented foods or take a good probiotic to replenish the helpful bacteria in your intestines.

Eating a healthful diet is always beneficial, but the extremely restrictive eating plan originally proposed by Dr Crook is really not necessary. Even he backed off its almost painful austerity in his later years. Although virtually all patients report feeling vastly better on an anti-candida diet, this doesn’t mean they necessarily have candida, but rather that anyone would feel better after eliminating junk and processed foods, simple carbs, and sugar.

Our associates Drs. Alaina Gemelas and Caley Scott have been especially interested in candida overgrowth syndrome and, working with clinical nutritionist Marla Feingold, have developed an extremely effective program that will establish once and for all whether or not you have candida and help those who do get rid of it.

Be well,
David Edelberg, MD