Candida and the Toxic Effects of Candidiasis

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Candida are a genus of yeasts that are symbiotic to the human organisms and integral in the natural fermentation of foods in our intestines. The various types of Candida may turn into a fungus, and assume a hyphal form to disseminate, as well as form protective biofilms to evade the immune system and anti-fungal drugs. Scientific study in the last decade has discovered that the human Biome of balanced symbiotic bacteria and other microorganisms is our best defense against Candida infective state, and that most cases may be linked to an immunodeficiency induced by corticosteroids or immune suppressing drugs.

The word candida comes from the latin root meaning clear and white, and Candida albicans represents even a whiter meaning, since albus refers to the whiteness of chalk. Mucocutaneous candidiasis is usually evident as a white fungal coating on the tongue (thrush), skin or nails. Circular lesions are also noted on the mucosa of the mouth or vagina. Most chronic candidiasis, though, has no visible signs, and symptoms are varied and unclear. There is a high association in more severe cases of candidiasis with autoimmune disorders, especially polyglandular autoimmune disorder and vitiligo, endocrine pathologies, especially adrenal pathologies and hypoparathyroidism, as well as hypothyroidism, and chronic fatigue syndromes. Candida is a family of yeasts that are normally beneficial and symbiotic in the human gastrointestinal system, but with an unhealthy imbalance of microbial biota, and a dysfunctional and unhealthy stomach and small intestine, these yeasts may overgrow, transform into a hyphal, or fungal form, form biofilm, and disseminate in the blood and lymph, contributing eventually to many health problems with disseminated Candidiasis.

The tendency to control symptoms of a dysfunctional gastrointestinal system and unhealthy intestinal membrane with drugs, rather than to restore function and health, especially immune health, has left many people open to chronic health problems related to disseminated candidiasis. Most cases of disseminated Candidiasis are attributed to iatrogenic and nocosomial causes (the result of normal health care protocols and hospital stays). Instead of fearing and attacking the Candida, understanding how to restore a healthy symbiotic and beneficial relationship with this intestinal microbe, and improve gut health, while countering the ill effects of the disseminated fungal form of Candida, will get you back to a normal healthy state. Since Candida species are a healthy part of the human Biome, simply eradicating them should not be the goal. Complementary and Integrative Medicine will help you understand and achieve these real goals of biotic balance and control of overgrowth and dissemination of Candida species. To stick with a concept of treatment that was outmoded decades ago is not the answer, and prevention of a Candida pathology should be emphasized, utilizing Complementary Medicine and a holistic protocol.

The key to understanding candidiasis and the associated pathologies is to note that the problem lies with the immune response to disseminated candida, the imbalance of natural symbiotic flora and fauna that allows overgrowth and fungal expression, and the ill health of the small intestinal lining with localized immune dysfunction (Celiac disease). The key problem is not the candida itself, as it is normally a benign symbiotic microorganism in our bodies, beneficial to our health. The focus on therapy needs to address not just the overgrowth of candida, but these other factors. Effective therapeutic measures also need to address the variety of health problems and dysfunctions associated with the candidiasis, or there will be little chance of overall success. Attempts to oversimplify therapy have been the most prevalent cause of the failures to cure these problems.

There are many types of candida in our bodies, but Candida albicans is the most prevalent. Candida yeasts are endosymbionts, or organisms that live within our bodies and our cells and form a useful symbiotic relationship. They are usually considered commensals, or organisms that mutually benefit us by both consuming nutrients and providing nutrients in the process, but with overgrowth may develop an unhealthy commensalism where we are harmed as the yeasts are benefited. In immunocompromised patients, we frequently see the signs of candida overgrowth, even the overgrowth in the mouth called thrush, where a white candida overgrowth is visible. The health of the immune system is thus important in the balance of candida colonization in our bodies. The taking of antibiotics often leaves patients with a gut flora and fauna imbalance and a consequent candidal urinary tract or vaginal infection (yeast infection). Therefore, healthy probiotic intestinal flora and fauna balance is also important when dealing with candidiasis. Recent research, though, has revealed a much more complicated set of causes, as well as implications, of candida overgrowth. This research has finally objectively tied the suspected systemic symptoms that have been attributed to candidiasis to the homeostatic imbalances that result in systemic candida overgrowth. The age of dismissing the subject of candida overgrowth as a significant factor in a variety of chronic disease mechanisms is thus over.

When faced with the possibility that a candida overgrowth has caused or contributed to serious chronic disease, the patient needs to understand that the problem is more complex than a simple, acute candidiasis. Acute candidiasis may be the beginning of a long pathway of health problems, and we should be aware of how these acute candida overgrowths occur, but when chronic candidiasis finally produces symptoms linked to chronic disease, the situation is no longer simple, and must be dealt with in a more complex manner. While candida is a symbiotic and beneficial inhabitant of our intestines, this yeast/fungus may be carried sytemically throughout our body when our immune defenses are insufficient, and when the flora and fauna balance in our small intestine is not balanced and controlling the expression of the candida. When candida overgrowth affects us systemically, various stresses on our immune system and metabolism can contribute to a number of autoimmune and neurological diseases, as well as hypothyroidism and hypoparathyroidism. The key aspects of a pathological candidiasis are conversion of the Candida fungi to a hyphal form and the formation of biofilms, of colonies of Candida that protect the inner growth from the immune cells. Stopping these processes, as well as the pathological consequences of disseminated low-grade Candida infection and toxicity, require a more holistic protocol, and much research now reveals how specific herbal chemicals and nutrient medicines can achieve this set of goals.

Chronic candidal infections of the mucous membranes and skin are associated with a wide variety of endocrine disorders, including diabetes, psoriasis, andrenal pathologies and polyglandular autoimmune disease. When the systemic candidal infections become severe, especially in immunodeficient patients, the disease may become fatal. Serious Candidemia has a mortality rate of 30-40 percent and presents an enormous challenge and cost to our health care system. Over a decade ago studies showed that the average hospital stay for a patient with a serious Candidemia was almost double that of a comparable patient without a fungemia, and there has been little progress in treating these systemic infections. While most patients are not faced with a serious systemic Candidemia, it is prudent to adopt a persistent and aggressive treatment protocol to resolve milder cases of disseminated candidal fungicemia, and both the ability to control candidal growth and the restoration of homeostatic mechanisms related to candida must be addressed.

Biofilms present a key factor explaining the persistence of Candida pathology, and the link between Antibiotic-resistance and Candidiasis

A biofilm is created by any microorganism as a means of self preservation, and most biofilms are beneficial to our environment and to the human organism, often protecting our Biome. Groups of microorganisms often survive and function by clumping together and adhering to a membrane, and seem to intelligently work together to create a living biofilm, both producing a collective matrix surrounding the group that functions to aid the survival and function of the individual organisms, and also appears to actually sacrifice the outer microorganisms when necessary to protect the inner microorganisms in the biofilm. This is both dramatically intelligent, and perplexing to our scientists. We generally have noted biofilms in our oceans and lakes in the environment, but in recent years we have realized that organisms such as yeast and fungi, as well as bacteria, organize into biofilms on our human membranes, and that this explains much of the success in keeping antibiotic, antibacterial, and anti-fungal chemicals from destroying them. Of course, with increased use of these chemicals, increased development of biofilms seem to have occurred. Overuse of antibiotics especially have triggered enhanced biofilm development, making the control of microbial overgrowths and pathological conditions harder to treat. The array of adaptive methods that these biofilms have created to avoid antimicrobial treatments is both astounding, and still not well understood.

Microbial species linked to biofilm formation include not only Candida species, but Bacteroides, Bifidobacterium, and Fusobacterium, an anaerobic genus that is shown to play a key role in biofilm formation and requires association with aerobic species in certain environments, promoting Helicobacter pylori biofilms in the gastric mucosa. Some biofilm is healthful, though, and becomes pathological when disrupted and pathogenic microbial species colonize. To successfully treat these pathogenic biofilms without harming the symbotic biota and their biofilms we need to focus on breaking down biofilm formation first with short courses of benign formulas of enzymes and chelators, while utilizing researched herbal medicines to help the body inhibit the pathogens. In vitro research at the University of Calgary has supported an array of enzymes used together, such as Serratia peptidase, Glucoamylase, Chitosanase, Cellulase, Pectinase, Beta-glucanase, and DDP-4 complex, which have been utilized to clear fibrins, resolve Celiac disease and Irritable Bowel Syndrome, and improve gastrointestinal function. We see that for such difficult problems as pathological biofilms we need a broader treatment protocol, not just a certain herb or enzyme. Persistent breakdown of biofilm followed by persistent repeated short courses of antimicrobial herbal formulas, and restoration of gastrointestinal membrane health and the Biome will eventually resolve these difficult cases of resistant Candida and other fungal and bacterial infections, as well as decrease the invasion of such pathogens into the blood and lymph.

In recent years much study has centered on the potential for an array of herbal and nutrient chemicals to be used intelligently to decrease these biofilm protections, especially in the case of pathological Candida species and their conversion in the biofilms from a fungal to a hyphal form, thus moving into the blood and lymph circulation. Some of this research is presented below in Additional Information, showing how a variety of herbal chemicals in Traditional Chinese Herbalism (CIM/TCM) provides an array of mechanisms to reduce pathological Candida overgrowth and spread by overcoming fungal biofilms, as well as inhibiting growth of bacterial species that encourage these biofilms. In addition, the use of herbal antimicrobial therapy will help to decrease the overuse of antibiotics, which is shown to increase the growth and development of protective microbial biofilms. Fungal biofilms are proving difficult to overcome when trying to stop a pathogenic overgrowth of a problematic fungus, though, and often the resulting chronic immune responses add to a disease mechanism. It has become obvious that often one needs a therapeutic approach that is more complex to finally get rid of problematic fungal biofilms, especially with species of Candida.

The 12 known Candida species that replicate in the human body usually grow as hyphae outside of the body and blastospores (reproducing buds) within it. Studies have shown that fungal biofilms on surfaces of medical equipment involve both the hyphal and yeast forms, and the various Candida albicans species grow easily as both yeast and hyphae within the body, explaining why this fungal species is so pathogenic. Candida ablicans can change back and forth from a yeast bud to a hyphal form to evade immune defenses, and this allow for this species to also more easily form biofilms, as well as penetrate into the blood circulation and distribute through the body. Increasingly anti-fungal medications are found to be ineffective because of these defenses, and the Candida colony easily rebounds even after dietary and anti-fungal measures appear to diminish it. The formation of complex biofilms is thought responsible, and these biofilm colonies are thought to be capable of chronic immune stimulation that creates a number of chronic diseases, especially autoimmune disorders and celiac disease. Besides specific herbal chemicals studied to reduce Candida biofilm, a number of specialized enzymes, chelating enzymes and probiotics have been researched and developed, and formulas of these nutrient medicines appear to work well, especially when combined with the researched herbal chemicals.

The use of a broad array of herbal and nutrient medicines to achieve an array of effects appears to have the best chance of finally breaking down these biofilm protections so that the immune system and Biome can finally eradicate pathological overgrowth. Enzymes such as cellulase, chitinase, beta-glucanase, and dipeptidyl peptidase 4 (DPP-IV), which is found to be deficient in most patients with celiac disease, are combined with EDTA, a chelating agent to break up the heavy metal accumulations in biofilm, and probiotic yeasts, such as Saccharomyces boulardii, are now found in the same formula. Chinese herbal chemicals, in cinnamon bark (Rou gui), quercetin, in Stephania tetrandra (Han fang ji), in Houttounyia cordata (Yu xing cao), Magnolia officianalis (Hou po chemicals Magnolol and Honokiol), and other clearing herbs are now proven to inhibit or help break down biofilms, and after this type of thorough therapy, a course of anti-fungal herbal formula and then probiotics should be used to finally regain the natural microbial balance that will provide lasting protection. A persistent step-by-step course of therapy and immune enhancement if necessary will insure that all of the factors are addressed.

Understanding how candidiasis may multiply the effects of environmental toxins, and contribute to acetaldehyde toxicity

Acetaldehyde is a common organic carbohydrate alcohol in our bodies that is integral in the creation of Acetyl-Coenzyme A (Acetyl-CoA), a cellular fuel, but excess of acetaldehyde may create significant metabolic problems for our bodies. Acetaldehyde is one of the key nutrients produced by candida, and candidiasis may significantly contribute to disease mechanism related to excess acetaldehydes, which have been shown to create central nervous system dysfunction by altering neurotransmitter balance, cause nutritional dystrophy, cause protein tubulin dysfunction and brain plaques, and cause hardening of red blood cell membranes with poor movement of RBCs through tight capillary beds in the brain. Acetaldehyde is a key molecule in the breakdown of alcohol as well, and excess acetaldehyde is thought to be the explanation for the symptoms of an alcohol hangover, which often resembles the chronic symptoms of candidiasis. This may be the explanation for a large number of chronic fatique syndromes that elude other diagnosis.

Increasingly, acetaldehydes are also found in our environment and the products we buy as well, and concurrent candidiasis and environmental aldehyde toxicity may both contribute to health problems related to chronic candidiasis. Various plastics and solvents contain acetaldehydes, and the commercial production of many chemicals and products create many environmental acetaldehydes that get into our air, water and food supplies. Car exhaust, industrial burning, cigarette smoke, and many other sources make acetaldehyde a recognized environmental toxin that the World Health Organization (WHO) and the United Nations Environment Program has called an environmental hazard since 1994. As this environmental toxin increases in our environment, and as we create excess acetaldehyde from overconsumption of alcohol and breathing of cigarette smoke, the addition of candida overgrowth as a producer of excess acetaldehyde may create an alarming problem of acetaldehyde excess in our bodies. On top of this, many of us may inherit an epigenetic propensity to acquire a deficiency in processing acetaldehyde metabolically, or we may be faced with excess stress on our liver function that creates reduced capacity to breakdown acetaldehydes with the necessary enzymes. Even those of us that do not smoke cigarettes or drink, eat a fairly healthy diet, and have an overall healthy aspect, can be affected by acetaldehyde toxicity from a combination of candidiasis and environmental toxins.

The effects of excess acetaldehyde from overgrowth of candida in the small intestine also is proven to cause increased permeability in the intestinal lining, commonly referred to as 'leaky gut syndrome'. This permeability leads to a variety of toxins and antigens, as well as the fungal form of candida, entering the blood circulation through the intestinal wall. When there is a problem with the health of the intestinal lining, there often occurs an enhanced immune reactivity, and potentially an autoimmune disorder occurs. There is a high association between candidiasis, Celiac disease, gluten and gliadin hypersensitivity and allergy, and a variety of autoimmune disorders. Autoantibodies to various hydoxylases and to a side-chain cleavage enzyme of the P450 liver enzyme (which breaks down a high percentage of medical drugs and many toxins in the liver) have been noted in a majority of cases of autoimmune polyglandular disease and adrenal pathologies associated with candidiasis. When there is an autoimmune reaction to these various enzymes, there are a variety of health problems that occur. Some of the enzymes implicated are useful in the catabolism of acetaldehyde, and so a self-perpetuating condition occurs. These problems are being explored to explain the difficulty in treating candidiasis.

Of course, the immune system and its responses to candidal infection must be restored to insure adequate control of candidal growth in the future as well as the present, and this may be complicated as well. The complex cell-mediated immune reaction to candida in the body may be deficient (immunodeficiency), but there may also be a hyperreactive immune response, such as an autoimmune reaction or a hypersensitivity disorder, that produces its own problematic set of symptoms. In this case, we may see both immunodeficiency and excess immune reaction. With a symbiotic microorganism such as candida, our body's immune system must also respond differently in different tissues of the body. Since the pathogenic candida has assumed its fungal hyphal form to disseminate in the body, allergic reactivity to mold and fungi, which is now common in the population, could increase the antibody hypersensitivity to the fungal form of candida. Once again, the cure for these complex immune dysfunctions involves a gradual restoration of immune homeostasis, with a careful analysis of each individual case, and a step-by-step process to restoration. The Complementary Medicine physician is ideal for this type of individualized immune restoration.

The fact that this disease mechanism may have many components besides candida overgrowth should not stop us from trying to understand the mechanisms and properly address the health concerns. In fact, the research that is uncovering the holistic mechanisms of disease associated with candidiasis should generate interest in understanding these biological mechanisms and deal with the whole array of health threats. One reason why candidiasis has been so difficult to correct, and why the chronic health problems associated with candidiasis have been difficult to treat effectively, is that the patient and physician has not taken the time and effort to properly assess the systemic consequences and systematically address these various pieces of the health puzzle. Because resolution of the broad effects of candida overgrowth cannot be countered by a simple allopathic drug, candidiasis has been routinely dismissed by the standard medical community for decades, despite the sound research and recognition of this problem by health organizations throughout the world. A comprehensive and holistic course of therapy needs to be implemented in a step-by-step fashion to both decrease candida overgrowth and counter the various immune, metabolic, and nervous dysfunctions that the imbalance has generated. This article attempts to provide the patient and physician with helpful information that will help to guide and course of therapy over time, as well as to provide the public with the information they need to prevent the chronic complications associated with candidiasis.

Candida and the pathophysiology of candida related disease

There are many species of the genus Candida which cause what is termed candidiasis, and a number of candida mutations that may be more likely to cause symptoms. Candida is a commensal organism in the majority of humans, and routinely present in the intestinal tract, mouth and vagina. Most acute cases of candidiasis occur with immunodeficiency, loss of normal bacterial balance due to antibiotic therapy, or steroid therapy, or after an invasive surgery or process. Chronic overuse of steroid medications, such as asthma inhalers, may also contribute to acute overgrowths of candida. Normally, our symbiotic bacteria control the growth of candida species, and our immune system stops the fungal form of candida from entering our blood circulation and growing in our lymphatic circulation. There does not appear to be a significant difference in the pathogenic potential of different Candida species, and specific cases appear to be determined by host factors, although the capacity of the candida yeast to form a fungal hypha, or branched form, may be a key to some of its pathogenicity, and the many Candida species appear to have a greater capacity to change back and forth from a yeast to a hyphal form of the fungus to evade immune systems and antifungal drugs.

Candida ablicans is the most prevalent species of candida observed in humans. C. albicans normally is a harmless commensal in the host epithelial tissues, or tissues lining the intestines, mouth and vagina, though. The small intestine houses most of the candida in our bodies (not the large intestine, as is commonly suggested), and dysfunction in the small intestine plays a major role in disseminated Candida. Candida can assume 2 forms in the body, a round yeast cell, or a branching hyphae, or fungus. A healthy microbial balance and immune response will keep most of the candida in the benign yeast form to benefit our ability to ferment and breakdown foods. As the yeast candida works, predominantly on carbohydrate fermentation, it produces alcohol and acetaldehyde. Acetaldehyde is a product of alcohol breakdown, and is toxic at high levels, so excess acetaldehyde and/or slow breakdown of acetaldehyde may cause a variety of health problems. In fact, with overgrowth of candida, the blood alcohol level will actually rise. In the fungal, or hyphal, form, the candida may more easily penetrate the intestinal wall and cause a dysfunction termed 'leaky gut syndrome', where more alcohol and acetaldehyde, as well as the candida themselves, enter the bloodstream, and are carried to tissues throughout the body. This scenario produces the most serious chronic problems associated with candida.

A common treatment protocol with candida has been to deny the yeast sugars in the diet. Of course, if the problem with candida were confined to the small intestine, this would be effective. Unfortunately, for a majority of patients with a chronic disease mechanism related to candida, the candida has entered the bloodstream and is affecting the whole body, and thus, the simple denying of sugars to the yeast will not have a significant effect. This treatment protocol may be effective for one stage of the candidiasis, the restoration of the intestinal flora and fauna balance, but is not a method to achieve the end goal of stopping systemic candidiasis and its harmful effects. When patients adopt a diet to supposedly starve the candida, much of the decreased carbohydrate is consumed by the candida and the body is starved of these nutrients. Commonly, the patient will quickly lose weight and feel ill on the common candida diet. Usually, the candida will survive and resume an overgrowth pattern when the diet is discontinued if the conditions for candida overgrowth are not properly addressed. The formation of candidal biofilms and the latent cycle of the fungal spores from pseudohyphae in yeast are ways that the various Candida species survive when starved of abundant nutrients. Since the healthy balance of the small intestine flora and fauna (Biome) needs to be restored to control candida growth and expression as a hyphal fungi, more efficacious protocol in this first stage of therapy would be to decrease excess pathogenic flora and fauna in the gut, with herbal medicine, and then restore it with an effective probiotic regimen and improved diet. Once the intestinal balance is restored, though, the more significant aspects of therapy need to be applied, and the problems created by excess alcohols and acetaldehydes need to be corrected with more persistent and systemic detoxification. While a dietary protocol may seem to quiet the symptoms of excess Candidal growth, recurrence usually happens, and a broader treatment protocol is more sensible.

Iron is an essential nutrient important to the growth of microorganisms such as candida, and this aspect has been heavily researched in hopes of finding a novel pharmaceutical to depress excess candidal growth, with chelators such as EDTA added to protocols to more successfully treat Candidal biofilm. Iron overload toxicity is a concept that has also been researched in relation to systemic candidiasis. Iron accumulation may occur from a number of dysfunctions in the systems of carrying and utilizing iron, and may be associated with an anemia. Most patients with an anemia are not properly diagnosed, but instead are prescribed an iron supplement that is often difficult for our bodies to utilize. This may contribute to iron overload toxicity. Standard medicine has stubbornly resisted the warnings of health experts and concerned medical doctors concerning iron overload toxicity (refer to a more extensive article on this website concerning Iron Overload Toxicity and Chronic Disease, and iron homeostasis). This refusal to recognize new scientific findings is similar to the years of denial in standard medicine that systemic candidiasis could be a cause of chronic fatigue syndromes and other difficult to diagnose chronic health problems. Patients are finally starting to request that their anemias are fully diagnosed and explained, and appropriate therapy utilized. Patients are also becoming more interested in simple iron chelation therapies to potentially correct underlying iron overload toxicity.

How widespread is disseminated candidiasis in the population?

Systemically, blood infection with candida is very common, and systemic candidiasis may cause or contribute to a host of allergic and autoimmune responses. Up to 40% of blood infections noted in hospital studies include candidal infection, telling us that a high percentage of us may have a milder, or subclinical, disseminated candidal infection. Depending on the so-called Candida diet is not going to help with a low-grade disseminated blood infection with a Candida species.

How these disseminated candidal infections occur have also been widely studied. While most serious cases involve immunocompromised patients, this does not mean that persons without immunodeficiency are exempt from disseminated candidal infection. Many studies have also proven the relationship of disseminated candida with a host of other common health problems. Studies have shown that antibiotic regimens and the resulting candida overgrowth in the intestinal tract lead to increased incidence of airborne allergies, especially to airborne mold spores such as Aspergillus fumigatus. (Infectious Immunology.2004 Sep;72(9):4996-5003). Other research has linked intestinal Candidiasis to Celiac Disease, an autoimmune disorder where IgG and IgA antibody responses are damaging the intestinal lining, or epithelium. Celiac disease is usually accompanied by a hypersensitivity disorder to glutens and gliadins (see separate articles on this website about these problems). Gluten hypersensitivity is especially strong in the industrial world because of the longstanding practive of using high gluten content flours in industrial production. A variety of autoimmune disorders have been associated with gluten intolerance and hypersensitivity, or allergic reactions, and Celiac Disease, and Candidiasis is often a significant comorbid disease with chronic autoimmune syndromes that involve multiple autoimmune manifestations. In addition, there is a strong association uncovered in scientific studies between candidiasis and endocrine disorders, many of which are subclinical (see the eMedicine overview in additional information links below).

Other health problems that have a significant impact on Candidiasis are liver dysfunction, excess alcohol consumption, and high oxidative stress. Poor liver function may be subclinical, or not causing clinically alarming test results, but still causing poor liver enzyme metabolism that decreased our body's ability to handle overloads of alcohol and acetaldehyde. Oxidative stress is another important factor, and either increased need for oxidative tissue clearing, as in acute illness or chronic inflammatory states, or decreased ability to mount oxidative clearing, can significantly inhibit our body's ability to handle candida overgrowth. Taking care of the overall health, consuming antioxidant nutrients, and helping the glutathione metabolism, which is the chief cellular detoxification and oxidant clearing metabolim in our bodies, may be important parts of the holistic approach to therapy.

Diet can have a significant effect on candida colonies. Since candida is a symbiotic microorganism that feeds off of fermentation, two significant dietary factors could lead to excess candida growth. One is the chronic eating of simple carbohydrates in excess, including the drinking of excess fruit juice and sweet sodas, or alcohol. The second is a diet high in red meat, which is slow to breakdown and decay, and often creates a high degree of slow moving decaying matter and prolonged fermentation. Research has proven that the fungal form of candida thrives on decayed matter, while the more benign yeast form prefers fresh digestive material. Decreasing red meat in the diet and eating more fresh vegetables and whole grains will decrease the amount of decaying fermentable material in the small intestine. A diet high in whole grains and fresh vegetables will create less of an environment where the yeasts can overgrow and promote an evironment where normal healthy bacteria may thrive. The key to long term control of candida overgrowth is the promotion of normal health flora and fauna in the intestines.

Over the years, the complexity of the problem of candida overgrowth has led to a number of wrong assumptions that have been clarified with more research. Unfortunately, many products and diets were created based on faulty information, and to promote these products, wrong information continues to be disseminated to the public. One confusing aspect of candida overgrowth is the subject of acidity. It has been widely assumed that candida thrives in an acid environment, but this has been disproven in a number of studies. Researchers in Japan found that Candida species may grow rapidly in almost any acid or alkaline medium. On the other hand, normal symbiotic bacteria in the intestine cannot thrive unless the pH is normal. In an acid state, certain pathological bacteria will thrive over the others. This is the main reason why we need to restore a normal acidity and regulation of acidity in the small intestine. Gastric hypofunction must be corrected, and the normal physiology of gastric acid production and stomach emptying, which includes proper pancreatic enzyme metabolism and bile release, must be restored to normal homeostasis to really create a normal acidity. The taking of drugs to block gastric acid production, the ill health of the liver and gallbladder, and excess stress on the pancreatic and spleen metabolism may all contribute to poor gastrointestinal homeostasis. Acidity in the body, or the blood, may also eventually play a part in a defective homeostasis, but less so than gastric hypofunction, poor liver and gallbladder health, and poor health of the pancreas and spleen. Systemic acidity often results when the body has a poor ability to alkalize, and the chief alkalizer in the body is calcium. Calcium is highly regulated in the body, and problems with calcium metabolism are not significantly related to calcium intake, but to calcium regulation with the endocrine, or hormonal system. To improve systemic acidity, the first place to assess would be the hormonal system and its balance.

Common symptoms associated with candida overgrowth and systemic Candidiasis

  • Fatigue
  • Weakness
  • Muscle and joint aches
  • Headaches
  • Asthenia, or feeling of being 'hung over'
  • Episodic diarrhea, constipation, nausea and bloating
  • Depression, anxiety, irritablity and mood swings
  • Cognitive dysfunction with poor memory and concentration
  • Recurrent vaginal and vulvar infections
  • Menstrual problems and infertility
  • Skin irritations, rashes, and acne
  • Recurrent throat and ear infections, or congestion
  • Hypoglycemia

Testing for candidiasis

In the past, testing for Candidiasis was grossly oversimplified and produced little applicable benefit for diagnosis. For example, in large studies of the patient populations in hospitals, over 65 percent of patients receiving stool analysis of normal fecal florae tested positive for candida. It is possible that the patients that tested negative were patients with a strong lower intestinal immune response that destroyed the candida before it was excreted, and some scientists thus believe that a great majority of humans, perhaps 100 percent, have a normal Candida colonization of the small intestine, and this makes the testing for Candida in stool samples unreliable, although the data could be used in a more thorough assessment. Since Candida is symbiotic with the human organism, there is usually no detectable antibodies to candida, even in patients with systemic candidal infection. The testing must explore a complex set of metabolic variables related to Candidiasis and the physiological effects, as well as markers of related diseases, such as Celiac disease. The laboratory that tests must thus produce an individualized analysis of this complex testing as well as simple test results. Simple deductions from laboratory analysis should be suspect. Normal hospital and clinical lab tests do not accomplish this more nuanced assessment, and so the patient must insist on adequate testing and analysis by specialized laboratories, and an analysis by reliable physicians to arrive at a real diagnosis and treatment plan. The usual plan in standard medicine is to ignore such analysis and just prescribe a one-size-fits-all drug, but this has not been effective, and has led to a great majority of patients with a very frustrating health problem, and in fact has led to a large percentage of patients now afflicted with a drug resistant strain of Candida.

As we see, there are a number of reasons why testing for Candida overgrowth in the intestinal tract is problematic, inaccurate, and has led to a treatment plan that has largely made the problem of Candidiasis worse over time by creating a now ubiquitous trait of evolved resistance to drug therapy. Many patients may choose to first try to clear the overgrowth with a simple persistent holistic course of therapy, utilizing herbal formulas and probiotics, before even spending the money on testing. Standard medical practice will rarely pay for the comprehensive tests needed except when alarming symptoms are presented. A number of quality specialized laboratories have emerged in the last 10 years that utilize the latest research on testing for Candidiasis, and the results of these tests can be brought to a CIM/TCM physician to aid the therapy. Organic acids analysis in urine will provide an initial assessment of cofactors that can be analyzed. The Major labs that provide this analysis include Metametrix Clinical Laboratory, The Great Plains Laboratory, and US BioTek Laboratories, and metabolites related to systemic candida metabolism are analyzed in excretion, such as pyruvate, alpha-ketoglutarate, and beta-hydroxybutyrate. The profile created will help the physicians with guided therapy, and costs about $130. A comprehensive stool analysis is most widely used today by physicians, and provides a host of information on not only the amount of yeast casts (mycology), but also on metabolism and intestinal function. This test is available from Genova Diagnostics and Great Smoky Labs, as well as a few other reputable laboratories. The cost is about $150. Intestinal permeability analysis, liver function tests, and allergy testing are also applicable. IgG and IgA antibody tests are routine to diagnose Celiac Disease. A link below will lead you to more information on this subject.

Testing for disseminated Candidiasis is even more problematic. Candida may eventually penetrate the immune barriers of the intestines and disseminate via the blood and lymph, often causing chronic low-grade infection, and cell toxicity. Although Candida species may present as opportunistic pathogens, they are symbiotic and normal to the intestinal tract and other membranes, such as the mouth and vagina, and most cases of Candidiasis diagnosed in the hospital today do not involve immunosuppressed individuals. In the past it was assumed that patients with disseminated Candidiasis were immunocompromised. The predominant risk factors for disseminated Candidiasis are iatrogenic and nocosomial factors (standard medical care such as antibiotic and steroidal drugs, and hospital-acquired infections).

Individualized treatment protocol with Candidiasis

Since treatment for candida related diseases may present such variance in the patient population, a simple description of the treatment protocol is not possible. There is no one-size-fits-all therapy, except perhaps in standard medicine, where the anti-fungal drug Fluconazole (Diflucan) is prescribed in most cases, generally with poor results, and with a considerable percentage of cases involving fungal resistance to Fluconazole. There is no simple short course of acupuncture and herbs that will miraculously cure difficult cases, although patients that come to this type of therapy in an early stage, or seek prevention of candidal-related health problems, may achieve much benefit from a short course of acupuncture with herbal and nutrient therapy. There are some general overviews of the treatment protocols that may be explained, though.

The first step in restoring homeostatic balance and reducing systemic candidiasis involves restoration of the gastrointestinal function as well as the balance of flora and fauna in the small intestine. Since the symbiotic bacteria in our intestines controls the growth of candida, it is essential that this balance is restored. There is a 60 percent association of candidiasis and Celiac disease, which is a disease of the intestinal lining, and an exaggerated immune response, or autoimmune process. So, not only restoration of healthy intestinal microorganisms, but restoration of the health of the intestinal lining and its localized immune responses must be achieved.

These problems may be addressed by utilizing short courses of herbal formulas that provide a broad spectrum effect to decrease excesses of fungal, yeast and bacterial colonization, followed by effective probiotics and herbs and nutrients to restore the health of the small intestine, such as pycnogenol (pine bark extract standardized) and bovine colostrum. The effects from short courses of milder formulas of clearing herbs will not destroy the normal flora and fauna like antibiotics, but will reduce these microorganisms so that a probiotic course can be utilized effectively to bring back healthy biotic balance. Repeated short courses of herbal formulas followed by professional probiotic regimens should be utilized. Signs and symptoms of gastrointestinal function may be monitored to gauge effect. If there is a gastric dysfunction this must also be addressed as well, and herbal formulas may be utilized as needed to treat constipation. Most gastric dysfunction involves hypofunction, and there are now excellent formulas of gastric acids, herbs and enzymes that address individualized needs. Once the balance of flora and fauna are achieved, the next step would be to improve the immune responses and health of the intestinal lining.

Much research in recent years has revealed the array of problems seen in patients with Celiac disease. Specific nutrient deficiencies have been noted in most patients, and a lack of expression of specific enzymes have also been uncovered. Patented nutritional medicines have thus been created for professional use, and are quite effective to resolve Celiac disease. In addition, enhancement of the complement immune system and gut immune responses, with herbal formulas and bovine colustrum, are often very helpful. Scientific studies have confirmed that the amino acid L-glutamine is beneficial to reduce the excess permeability of the small intestine wall that may be caused by excess acetaldehydes (see the study cited below). Various protease enzymes, digestive enzymes, N-acetyl-cysteine, and even phosphatidylcholine (active metabolite of lecithin) have been well studied and proven to accomplish the goals of restoring to health the intestinal lining, or epithelium. Bovine colustrum is an excellent product with many benefits to finish the healthy restoration of intestinal function and boost the innate immune system.

Once normal balance of intestinal flora and fauna, and restoration of the intestinal lining and immune response is achieved, the systemic effects of candida need to be addressed. The most pressing concern is the excess of acetaldehyde from systemic excess of candida. Recently, much research has uncovered the array of mechanisms that help our bodies to control this metabolic excess, and products such as AL Neutralizer by Vitamin Research, an acetaldehyde clearing formula, are available as formulaic nutritional medicine to help alleviate this problem. The metabolic concerns may be different for each individual, though, and a thoughtful tailored program of acupuncture, nutritional medicine and herbal therapy is often needed to achieve the best results. Besides this metabolic problem, the individual may experience a variety of health problems, and each of these should be addressed in a thorough holistic protocol. Often, when one aspect of this chronic disease is not addressed properly, there is a persistence with the candidiasis. Studies of disseminated candidiasis affecting mucosa and skin have also demonstrated that in chronic cases a defective T-cell response then drives the recurrent inflammation, with overexpressed IL-6 and IL-10, and inhibited production of IL-12, probably due to defects in dendritic cells in the local areas. Such study points to the fact that simple elimination of candida overgrowth may not be enough to stop the recurrent symptoms. A more persistent and holistic approach with immunomodulation may be necessary even after the candida population is controlled, intestinal mucosa restored to health, disseminated candida eliminated, and fungal toxicity reduced. This explains the very difficult nature of these chronic symptoms associated with disseminated candidiasis, as well as the initiation of the autoimmune disorder.

Of course, the physicians overseeing this treatment protocol needs to have some experience and intelligence in these complex disorders. More and more Complementary Medicine physicians are utilizing research and gaining the necessary knowledge to address more complex health problems, and the choice of a physician that is knowledgeable and research oriented is important. Since research reveals an array of useful herbs and nutrient medicines to accomplish the goals of this complex treatment protocol, it is best to allow the physician to guide the therapy over time. In addition, some patients may need herbs to enhance immune responses, as well as herbs that may decrease specific cytokine responses seen in the autoimmune processes. Ultimately, the health of the adrenals, kidneys and liver may need to be addressed, as well as neurological and hormonal restoration.

Popularity, but lack of evidence of any real benefit from so-called Candida diets

Since testing for Candida overgrowth and disseminated Candidiasis is problematic and discouraged, as well as expensive for most patients if paying out of pocket, the popular prescription of so-called Candida Cleanse Diets is common. Unfortunately, there is no real evidence or human clinical trials that support these treatments, and little evidence of actual clinical success as well. While avoiding sugars and simple carbohydrates, wheat, dairy and foods with yeast, as well as most processed foods, will result in a type of "cleansing" and generally help many people feel better metabolically, and perhaps decrease whatever symptoms they are having, this regimen is proven to be ineffective in actually stopping the growth of Candida species. Since many individuals eat diets rich in these foods and have no signs of Candida overgrowth or disseminated Candidiasis, while almost everyone who goes through a harsh course of antibiotics or steroid drugs, negatively affecting the Biome or the immune system, has some degree of fungal overgrowth, it is obvious that we should pay attention to the health of the Biome and the immune function, not the diet, although it wouldn't hurt to incorporate some healthy dietary regimen while restoring the homeostasis of the Biome and the immune system.

Foods with candidicide activities include a number of food herbs, such as spearmint, thyme, oregano, basil, lemongrass, black pepper, rosemary, sage, cilantro, and bay leaf, as well as black currant fruit and tomato, and foods with fungicide activity include ginger root, fennel, carrot, soy, oranges, grapefruit and cinnamon. In addition, fermented foods and yoghurt will help the body establish a better Biome, as well as prebiotic foods such as garlic and shallots. While typical so-called candida diets now advertise a vast array of healthy foods to reduce Candida growth, these diets generally are based more on speculation and theory, or just repeat someone's opinion, with little scientific validity. In general, eating a fresh whole plant-based diet is very important to regain a healthy gut Biome, as well as reducing parasitic overgrowth with herbal formulas and using quality probiotic formulas. There is some evidence that Candida species grow somewhat faster in conditions of higher acidity, more protein breaking down to form ammonia, and in the presence of a relative higher free intercellular potassium, as well as conditions with excess simple carbohydrates or sugars. Candida and yeast fungi in general are very adaptive, though, and thrive in almost any condition. Using a higher dose magnesium oxide supplement has shown to benefit the relative excess intercellular potassium levels that are the main growth regulating factor, and decreasing simple carbohydrates that both supply simple sugars and increase acidity may be the primary dietary approaches, as well as insuring that protein digestion is healthy and avoiding a diet high in excess meat proteins. Of course, complex proteins such as glutens and gliadins may be a problem and contribute to conditions that favor Candida growth as well, but all of these dietary conditions are secondary to maintaining a balance Biome and gut immune health.

Probiotics and the benefits of bacteria, and other microorganisms

Bacteria are perhaps the most maligned and misunderstood living organism on the planet. Anti-bacterial has become one of the most popular terms in our language, and overuse of bacteriocide chemicals, antibiotics, and disinfectants have become one of the leading threats to public health, according to the Center for Disease Control. At the same time, probiotics, or introduction of healthy microorganisms into the digestive tract with supplements, has also become increasingly well known and popular, and now organic farming, or the growing of food without the use of chemicals that are synthesized to kill symbiotic insects and microorganisms, as well as synthetic nutrient fertilizers that destroy the natural balance of microorganisms, is also becoming popular once again in the population. Just as the overuse of chemicals has created a crisis in our food production in the United States, with food crops now resistant to common pesticides and herbicides, and unhealthy feedlot raising of cows creating crises of antibiotic resistant pathogenic bacteria affecting the human population, a crisis is being created in our bodies as well because of our resistance to understanding and working with bacteria and other microorganisms in our bodies. For millions of years, humans have worked together with beneficial bacteria to create a healthy body and environment, and in only the last one hundred years we have ruined this healthy relationship as we discovered ways to kill bacteria.

While bacteria do create infectious diseases that are sometimes devastating, and the creation of antibiotics has changed the way we live and allowed for control of devastating diseases, we need to continue to evolve our understanding of bacteria and our ways of utilizing science to create a better, safer and healthier world. As with many aspects of our lives, the commercial issues often grow to dominate and control issues of public health. As we gain increased understanding of our environment, we are unable to use this understanding to change in a logical manner, purely because a lucrative industry has been created that perpetuates old technology and fights change if it decreases profit. Change often occurs only when we are faced with dire consequences, as we see now with the subject of climate changes accelerated by our dependence on fossil fuels, excess meat production, and overpopulation. In the last one hundred years, humanity has created changes in the way we live that are amazing, yet we have also created a way of life that has abandoned our respect for the natural interdependence with the rest of life on the planet. This co-dependence is a matter of survival, though, and the science of the way of nature must be once again emphasized if we are to re-establish our place in this world and insure our health and healthy future, both outside and inside our bodies.

While the discovery and creation of antibiotics and antibacterial chemicals has improved treatment overall, the statements that imply that there was no antibiotic treatment and disinfectant before these pharmaceuticals were created is patently false. There is a long history of effective antibacterial and antibiotic therapy with herbal medicine. The advent of antibiotics made it much easier to use stronger medications and have a standard supply of these medications on hand. Before these drugs, there were proven herbal antibiotic antibacterial medicines, though, and modern research not only proves that they work, but also that many of them are useful to insure that the antibiotic drug works more effectively when used with shorter courses and smaller doses of antibiotic drugs. In addition, many studies around the world now prove that herbal chemicals are effective against drug-resistant strains of antibiotics. The greater use of herbal antibacterials and antivirals, along with the maintenance of a healthy bacterial flora in the body, and an efficient and healthy immune system, is the choice of most patients that educate themselves to this important health aspect.

Without bacteria, neither our bodies or our world would survive. The book entitled Microcosmos, Four Billion Years of Microbial Evolution, written by Lynn Margulis and Dorion Sagan, explains how bacteria created our living environment, maintain the tight level of oxygen tension in the air we breath (despite rising carbon dioxide levels), are integral to our evolution, and in fact, make up a majority of the cells in our bodies. In fact, there are about ten times the number of bacterial cells in the intestines as animal cells in the entire body. The bacterial colony continues to operate symbiotically and with a type of intelligent decision making that still eludes our understanding. Perhaps this lack of understanding is what perpetuates our fear of bacteria. To frame your understanding of the importance of bacteria, and the intelligent bacterial colony across our entire planet, let me refer you to an article in the New York Times Science section of May 24, 2010, cited with an e-link below in additional information. The article, From Trees and Grass, Bacteria That Cause Snow and Rain, reveals how scientists have only now discovered that a common bacteria, pseudomonas syringae, which grow on our food crops, trees and grasses, are carried in aerosol form into the sky and form the nucleus of raindrops and snowflakes, exerting a living control of the falling of snow and rain by expressing proteins that trigger freezing at higher temperatures than usual, prompting the formation of ice crystals in the atmosphere that then fall to the earth and melt into rain drops. These specific bacteria have been found to compose the nucleus of snow crystals in over 70% of high altitude rain drops and snow flakes in some studies. The healthy balance of bacteria on the plants that we grow for food, the grasses in our yards, and the trees in our backyards and parks, are responsible for the balanced control of rain and snow precipitation in our world. We need to stop using so many harsh chemicals to kill these wonderful bacteria.

We have known for some time of the importance of bacteria concerning the formation of rain and snow, and have utilized the proteins formed in bacteria for cloud seeding and snow making. Commercially, ski resorts have been using these proteins to create snow, and a single bacterium in commercial production may produce enough protein molecules to stimulate a thousand snow flakes. Researchers are now convinced that a variety of bacteria, and even fungi, exist that exert a control over the formation of rain and snow. How does this relate to probiotics, you may be wondering? To fully grasp the subject of healthy flora and fauna, or symbiotic microorganisms in our digestive tract, we, as a community, or culture, need to understand the importance of bacteria, and the intelligent way that bacteria works with us, in our bodies, and on our foods, to maintain the complex balancing act that keeps us healthy, and keeps our environment healthy as well, which is all important to the health of the individual. Just as we depend upon healthy bacteria growing on our food crops, grass, and trees to make sure that we get timely rain and snow to survive, we depend upon healthy symbiotic bacteria to keep our bodies healthy as well. Simply ignoring the subject of bacterial balance, operating on the misconceptions that we maintain in our society, and expecting that eating some yoghurt advertised as containing probiotics will guarantee a healthy digestive system, is a gross oversimplification, and an ineffective way to utilize an understanding of nature and the human organism to achieve or restore healthy function. A comprehensive and holistic approach to probiotics involves restoration of the balance between the bacterial colony and animal cell organism in your body, and involves the intelligent choices of natural foods, avoidance of unnecessary chemicals in the food, household and general environment, and avoidance of unnecessary antibiotic, antibacterial, and disinfectant chemicals as well. This doesn't mean that we vilify these products and technologies, but that we use them intelligently when we need them, and not just because some corporation wants to increase sales.

Utilizing probiotic microorganisms to restore your intestinal health may require not only a superior product, but also attention to the whole environment that these symbiotic bacteria need to colonize and maintain your health.

A sensible protocol to better utilize probiotics and restore the healthy balance between bacteria and our animal cells in the digestive tract

For a person with a relatively healthy digestive tract, simply taking some probiotics is probably reasonably effective. For persons with unhealthy intestinal tracts, the challenge of these probiotic bacteria to colonize and restore bacterial balance is great. For this reason, professional probiotic products now incorporate added ingredients to enhance bacterial growth in the colon, such as fructooligosaccharides, lactobacillus growth factor (pantethine), and pantothenic acid. Oligosaccharides are considered prebiotics, or nutrients that stimulate growth or activity of healthy symbiotic intestinal bacteria. Quality products also utilize various strain of bacteria that are thought to be most helpful, such as Lactobacillus acidophilus, Bifidobacterium bifidum, longum and infantis, and Bacillus coagulans, with at least 10 billion colony-forming units per gram. The serving size would generally be about 100 mg, giving one-tenth of ten billion per dose, or 1 billion bacilli. As research progresses, more and more specialized formulas of probiotic organisms are being developed, and more and more misleading advertising is being generated as well. Using a professional source of probiotic formulas and prescrption, and utilizing probiotics as just part of a larger treatment protocol is often needed.

Lactobacilli are gram-positive anaerobic or microaerophilic bacteria that help convert the carbohydrate sugar lactose, and other sugars, to lactic acid. These make up a small portion of the normal symbiotic bacteria in the intestine, but are proven to possess potential anti-inflammatory and anti-cancer activities. Since Lactobacilli acidophilus are commonly used in food production, this is an easy bacilli to supplement with. Bifidobacterium are a type of gram-positive anaerobic bacteria that are the major genera of the gut flora, or the predominant symbiotic bacteria in the colon. These have been studied and proven to potentially lower incidence of allergic reaction and prevent tumor growth. Bifidobacterium are considered essential to ferment carbohydrates. Fructooligosaccharides are plant-derived sugars that naturally enhance the ability of Bifidobacterium to ferment carbs. Bacillus coagulans is a gram-positive anaerobic bacterium that has been proven beneficial in treating IBS (irritable bowel syndrome), improving bloating, and increasing immune responses to viral challenges. As time goes on, there will be more species approved by the FDA and European Union for human consumption. Pantothenic acid, or Vitamin B5, is an essential nutrient in carbohydrate, protein and fat metabolism, improves the lipid profile, and has been found effective in tissue healing. Pantothenic acid is found in small quantities in nearly every type of food, but high amounts are found in whole grains, legumes, eggs, and royal jelly. Supplementation with a sufficient dosage is found useful in stimulating the metabolism.

Besides these standard probiotic bacteria there are now types of probiotic bacteria that are researched to provide additional benefit for patients that have health problems that are potentially related to imbalance of the symbiotic microbial colony in the intestine. Irritable bowel syndrome, colitis, nutritional deficiencies, and even chronic skin rash (atopic dermatitis) have been linked to poor intestinal health and allergic immune hyperactivity related to unhealthy microbial colonies in the gut. One type of probiotic bacilli that has gone through years of clinical trials and proven to be a potent medicine is Lactobacillus rhamnosus GG (ATCC 531013), which is commonly just called Lactobacillus GG (GG referring to the scientists that patented this strain, Gorbach and Goldin). This type of bacterium is a transient colonizer in the intestine, but does exert some potent medicinal benefits, and thus is recommended for patients with various health problems. Lactobacillus GG is now commonly used as a preservative for yoghurts, but a therapeutic dose is much higher than what is found in standard yoghurts. Lactobacillus GG thrives in acidic guts, is stable in the presence of bile, and produces lactic acid (the deficiency of which accounts for indigestion when eating dairy products). This makes Lactobacillus GG ideal for patients with chronic acidity, potential problems with bile breakdown, and patients with poor digestion of dairy products. Lactic acid is one of our main food fermenters as well, and persons with bloating an constipation may benefit from this probiotic. Studies have shown that Lactobacillus GG benefits patients with chronic urinary tract and vaginal infections by increasing biosurfactant excretion that inhibits adhesion of pathogens to the urinary tract and vaginal membranes. Studies have shown benefit in treating various types of diarrhea, reduction in the incidence of respiratory tract infections (chronic bronchitis), and treatment of atopic dermatitis. In 2005, a study showed that Lactobacillus GG was successful in treating antibiotic-resistant enterococcus that perpetuated kidney infections. Lactobacillus GG is thus a useful addition to therapy when utilizing probiotics for patients with these problems. Lactobacillus GG is patented and marketed as Culturelle in the United States.

Probiotic bacteria that are found to have an antagonistic effects against Candida species include Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus paracasei, Lactobacillus plantarum, Lactobacillus rhamnosus, Bifidobacterium infantis, Bifidobacterium longum, and Saccharomyces boulardii, most of which are included in a standard probiotic professional formula. Many studies across the planet have confirmed that common quality probiotic formulas containing these species successfully interfere with the ability of Candida albicans to form biofilms, a hallmark of initiation and progression of candidiasis. Biofilms occur when microorganisms adhere together on a membrane and produce a matrix of extracellular polymeric substance. These biofilms of Candida often occur in response to anti-fungal medication, or when antibiotic use affects planktonic cells, and chemicals secreted by bacterial biofilms have been found to stimulate dispersal and spread of the Candida biofilm cycle. Research has revealed also how various herbal chemicals interfere with biofilms, often in alcohol tinctures, though, as these biofilm colonies develop a hydrophobic quality (see research on specific herbal chemicals below in Additional Information). Research has also revealed that nitric oxide is able to trigger the dispersal of biofilms and could be helpful in a therapeutic protocol, utilizing L-Arginine and P5P. A more comprehensive course of herbal and nutrient medicine, with probiotics, could stop the pathogenic cycle of candida overgrowth and help the body recover a normal and healthy Biome that includes symbiotic Candida in a system that is not pathogenic.

Besides using a quality professional probiotic product, though, persons with a history of intestinal problems may want to first clear and detoxify the intestine, and possibly promote intestinal wall health, before taking the probiotic, to better insure that the probiotic colonizes and positively affects the intestine. If there is an imbalance of flora and fauna, or if there is evidence of an unhealthy bowel lining, such as in IBS, colitis, Crohn's, or celiac disease, or even with diverticulitis, an individualized course of clearing of unhealthy flora and fauna, and improvement in the immune responses and tissue health, could make the probiotic work for you. A number of Chinese herbs and formulas can effectively clear unhealthy bacteria, viruses, and parasitic microorganisms. Using a short course of these herbs before beginning probiotic therapy, as well as intermittently during the probiotic course, could help normalize the flora and fauna to better achieve an ultimate healthy balance. Use of bovine colustrum may also be helpful to establish an improved immune response, as this mother's milk molecule contains bioidentical antibodies to a number of common human pathogens, including E. coli, cryptosporidium, shigella, salmonella and staphylococcus, as well as rotavirus, that is associated with diarrhea. Bovine colustrum was used as the main source of human immunoglobin therapy before the development of antibiotics. Bovine colustrum is safe and effective, and contains a number of nutrient chemicals that are also beneficial to overall health and health of the intestinal lining. Athletes routinely use bovine colustrum to insure optimum performance, and colustrum contains potent antioxidants, as well as chemicals that improve blood quality, such as hemopexin, which binds free heme (as in hemoglobin) in the body.

The normal bacteria in the intestine not only helps to finish the digestion and fermentation of our foods, but also helps us in a number of other ways. These bacteria produce essential nutrients as needed, especially various B vitamins, such as B12 and biotin, and Vitamin K (needed for healthy blood clotting factors). They also produce various hormones, many of which are needed to regulate fat storage and utilization (such as leptin), and chemokines (molecules that guide immune cells to the right target). Bacteria normally make up most of the flora in the colon, and our feces is composed of about 60% bacterial cells in the dry mass. This shows that the bacterial colony must be healthy and reproduce to insure health. It is thought that about 30-40 species of bacteria make up 99% of the normal flora. These normal bacteria work as a colony to prevent the growth of other harmful bacteria, stimulate a healthy immune response, finish food fermentation to produce gases that supply oxygen to the tissues, and supply other essential nutrients that we may need, such as essential fatty acids. Normal gut flora also maintain the right acidic balance in the intestines, and in the rest of the body. Healthy gut bacteria also inhibit overgrowth of yeasts, such as candida albicans, and fungi. When the intestinal flora are depleted, such as with antibiotic use, they cannot compete effectively for intestinal lining epithelial attachment sites, leaving the epithelium open to invasion by unwanted pathogenic microorganisms, and food molecules that are still not broken down, and lead to overreactive immune responses (celiac disease). When the acidity is imbalanced in the intestines, there is a high chance that various microorganisms will flourish that lead to poor health, such as candida. This chronic acidity also stresses the body and its ability to control acidity, putting stress on the complex calcium metabolism, as well as the kidney, as it produces blood plasma CO2 to control acidity in the body.

Besides using professional quality probiotics in a step-by-step regimen in Complementary Medicine, one can also incorporate prebiotic nutrients into the diet. These are obtained by chewing a little raw steel cut oats in the morning, barley (or consuming dried barley sprouts), and eating jicama, chicory root, or Jerusalem artichoke (all with inulin). Fermented soybeans, such as in tempe, are also a good source. Other foods that may contain prebiotics include raw garlic, leek and banana (minimal amount), as well as cooked onion, and whole wheat flour. The highest content of prebiotics in food are found in raw chicory root, Jerusalem artichokes and dandelion greens. While many people are reluctant to consume these raw foods, the consumption of a clove of raw garlic is reknowned for improving and maintaining the health. Unfortunately, the garlic smell on the breath is undesirable for most people, and the eating of a little raw leek is a good substitute. Eating homemade whole wheat and barley flour pancakes in the morning is also a good habit to obtain prebiotics. If you juice, you might want to incorporate just a little raw jicama, chicory root, dandelion green, leek, or onion into the juice.

How antibiotic overuse hurts our own cells

The authors of the book Microcosmos reveal that mitochondria, the organelles (small organs) found in most animal cells, that generate most of our ATP (adenosine triphosphate), or cellular fuel, via oxygen utilization, were derived from bacteria. The authors also state that mitochondrial ribosomes (DNA and RNA), as well as symbiotic bacteria, tend to be sensitive to exactly the same antibiotics as pathogenic bacteria. Streptomycin is an example of a common antibiotic that harms the cellular mitochondria and normal symbiotic bacteria in the body. For this reason, overuse of antibiotics creates problems with the health. Imbalance of gut flora and fauna, as well as of symbiotic bacteria in the mouth, vagina, and other tissues, can be negatively affected, and create chronic problems with one's health and immunity. Since mitochondrial dysfunction is now found to be at the heart of many diseases, especially chronic neurological diseases, and degenerative disorders, antibiotic use should be used only when necessary, and restoration of the gut flora and fauna, and strengthening of the immune system, should always be considered after using a course of antibiotics.

The Important Role of Bacteria in Maintaining our Environmental Health

Besides the role of bacteria and fungi in controlling the formation of rain and snow, bacteria maintain an intelligent tight control of the percentage of oxygen in the air we breath, as well as the health of the upper atmosphere that protects us from the deadly radiation emitted by our sun. Oxygen, which is very necessary to our life, makes up about one-fifth of our atmosphere. Study of the fossil records of our planet's past has revealed that it is the stabilization of atmospheric oxygen at about 21 percent that keeps us alive as we now exist. If the oxygen concentration would rise much higher than this, or if it had risen much higher than this in the last hundreds of millions of years, there would be, or would have been, a worldwide conflagation, according to the authors of Microcosmos. This is due to the high combustible state of an oxygen-rich air. If the oxygen level would fall below this tight level of concentration, living organisms as we know them would have a difficult time thriving. If oxygen falls a few percentage points aerobic (oxygen-breathing) organisms would start to asphyxiate. If oxygen increased by a few percentage points in the atmosphere, living organisms could spontaneously combust. While we think that we humans are responsible for the future of our environment, and that the large increase in carbon dioxide gases from industry, increases in the production of meat (methane gas), destruction of the plant life (e.g. the rain forests, coral reef algae, and peat bogs), and overpopulation, show that humans are responsible for the balance of gases in the atmosphere, the truth is that we still lack a fundamental understanding of the complex way that a holistic and synergistic bacterial intelligence actually maintains the necessary balance of gases, temperature and every other aspect of our life-giving environment that evolved in so complicated a fashion over so many millions of years.

This doesn't mean that we should ignore our responsibility to act responsibly in the framework of nature to maintain a healthy environment and life on the planet, but it does show us that we better adopt a new attitude if we are to succeed. We need to adopt the virtue of humility and understand that in all of this wonderful creation, we play a less significant role in a the natural order than we might fantasize, and that we need to operate within our designated role, understanding and working with the rest of nature. By reconfiguring our role in an industrial age, we can quickly adapt to the changes necessary to reclaim a technological way of life that is in harmony with the rest of life on the planet. The bacterial colony is already adapting to us. We need to work with bacteria to improve our world. Bacteria, acting intelligently will modify changes in global warming, and in fact will help clean up a lot of our messes. In 2010, the gulf oil spill was enormous, and the one technology that succeeds in cleaning up most of this spilled oil on the ocean floor is bacterial growth that eats the oil. This enormous bacterial effort dwarfs any man-made technology. Unfortunately, the aerobic bacteria that grow at an incredible rate also consume most of the oxygen, killing themselves and all life on the ocean floor. What happens then is that the organic debris from these bacteria create food and fuel for a fairly quick restoration of the denuded ocean floor. While humans talk, bacteria act.

In the evolution of life on this planet, oxygen and sun radiation, or light, were perhaps the two most toxic elements on the planet. Oxygen and light together were even more toxic. As the molten core of our planet created mineral elements with high heat combustion fueled by enormous pressures, metal oxides came to the surface in the form of gases. These gases escaped from the planet, but eventually, an atmosphere was created that trapped the gases. About 2000 million year ago, natural decay quickly accelerated the oxygen trappead in this atmosphere, from about one part in a million, to about one part in five. Microbial life on the planet was destroyed, yet evolved defenses with DNA replication and duplication, gene transfer, and mutation, to create bacteria that could not only survive, but use these toxic elements to thrive. Cyanobacteria evolved that developed a metabolic system that required oxygen and sunlight, and utilized the combustibility of oxygen to break down carbon based molecules and yield carbon dioxide, creating energy in the process. Eventually, this energy creating process was incorporated into the animal cell, probably in a manner that today we would call an infection, and small but efficient oxygen burning organisms, called mitochondria, became part of our cells. Decay of carbon matter via fermentation produces a couple of molecules of ATP, the fuel of our muscles, from each carbohydrate molecule, while the action of the mitochondria can produce as many as 36 molecules of ATP, making us the efficient organism that we are today. Thank you, cyanobacteria. Cyanobacteria also created photosynthesis, producing the abundant vegetable life that not only feeds us, but also produces the oxygen that we breath. While we tend to look at these scientific facts in isolation, and appreciate them in science, we still tend to ignore the complex holistic balance that is still maintained by these bacterial processes, and overlook our own responsibility to continue to work within this bacterial framework to maintain the balance. The gift of higher intelligence means that we must use this intelligence to understand and exert a conscious effort. Organisms without such a higher intelligence, or type of reasoning, behave according to the natural encoded genetic intelligence that they are born with. Our responsibility is to think.

In much the same way as allopathic medicine ignores the big picture and focuses on a particular aspect of disease and injury to correct it, we have ignored the big picture when it comes to our Biotic health. The human and environmental Biome, or world of symbiotic and commensal microorganisms, is complex, and treating it in a too simplified manner will result in ineffective healthcare. Too simplistic strategies with Probiotic therapy will not produce significant results, and already we see studies using failed simplistic strategies with probiotics as a way to discourage integration into standard protocol. Probiotics need to be just a part of a more comprehensive strategy in Integrative and Complementary Medicine (CIM/TCM).

Autoimmune and Hypersensitivity Responses in Candidiasis

A number of hyperreactive antibody responses have been studies in relation to candidiasis. Excess antibody responses, or atuoimmune and hypersensitivity immune responses, occur when the immune system is overstimulated by excess numbers of molecules or pathogens. An antibody response can be seen to almost any threat to our physiological well being, and even most common foods will stimulate some antibody response. The question is how or why do these antibody responses become pathological. IgG class antibodies are frequently seen in pathologies related to candidiasis. In polyglandular autoimmune disease and Addison's disease related to chronic mucocutaneous candidiasis a vast majority, almost all, of the cases involve antibodies of the IgG class to the enzymes 17 and 21-hydroxylase. In many cases of candidiasis, we see a Celiac disease with excess IgG and IgA antibodies in the small intestinal lining. There is an association as well between Celiac disease and type I Diabetes, which is an autoimmune disorder related to IgG subtype 1 as well. Celiac disease and autoimmune thryroiditis also share a common genetic, or epigenetic, predisposition, namely the DQ2 allele. There is an association of Celiac disease, and gluten/gliadin allergy or hypersensitivity, with these diseases because the gliadin protein binds to the same genetic receptor as the thyroid peroxidase enzyme and other enzymes associated with the DQ2 allele.

The types of dysfunctions in the body that could lead to IgG autoimmune responses of hydroxylase enzymes are varied. Stress upon the hormonal Vitamin D3 system could produce excess hydroxylase production and subsequent autoantibody responses, since the formation of the prehormone and the hormone are mediated by hydroxylases in the liver and kidney. Dyfunctions of the hormone D3 metabolism are also related to parathyroid disorders and a host of other diseases, some of which have a strong association with candidiasis-related disorders. The complexity of these relationships may be too difficult to come up with concrete evidence of cause and effect. We do know that the active D3 hormone 1,25(OH)2D is known to effect a potent immunomodulatory effect on activated human lymphocytes, and may be implicated in a number of immune hyperreactive disorders.

Some researchers are starting to believe that Celiac disease may be integral to a wide variety of autoimmune disorders, and that candida pathology may be associated with a high percentage of cases of Celiac disease. The link between Celiac disease and other autoimmune disorders may be the autoantibody response to tissue-specific transglutaminase enzyme (tTG). tTG is a ubiquitous enzyme controlling apoptosis, or normal programmed cell death, and tTG autoantibodies are noted in most cases of Celiac disease. Interference with tTG functions results in tissue cell death, accumulation of lactate dehydrogenase in the blood, and other toxic metabolic events. Since this enzyme is ubiquitous, antibodies to it may be responsible for a wide variety of common autoimmune disorders as well.

One of the most famous examples of a lifetime spent fighting the autoimmune polyglandular syndrome that is highly associated with candidiasis in its origins is the case of President John F. Kennedy. President Kennedy was diagnosed with Addison's disease, which is part of the now well-known complex of Candidiasis, Polyglandular Autoimmune disorder, Hypoparathyroidism, and Addison's disease. He was later also diagnosed with hyopthyroidism. His life was spent fighting the effects of chronic fatique, anemia, systemic pain, gastrointestinal symptoms of episodic diarrhea, cramping and inability to gain weight, all of which are similar to many patients with chronic candidiasis syndromes. His autopsy revealed a severe adrenal degeneration. After his death, it was believed that he suffered from autoimmune polyendocrine syndrome type 2.

The possibility that candida overgrowth may be associated with initiating a wide variety of these autoimmune and hypersensitivity disorders is a good reason to make sure that your gastrointestinal function is maintained in a healthy fashion, your normal balance of flora and fauna is maintained, and your immune responses are optimal. Treating candidiasis with the thorough holistic protocol described in this article may insure that a number of chronic diseases are prevented in your future. As always, the benefits of treating with Traditional Chinese Medicine, the premier Complementary and Integrative medical specialty, provides numerous benefits and preventive measures, improves quality of life, and has no side effects except improved health.

Additional Information and Links to Studies:

  1. An overview of the role of the more than 1200 species of bacteria, yeast and other microorganisms that make up our symbiotic gut flora and fauna, and a guide to candidiasis, testing, and treatment, as well as a complete and professional guide to environmental illness, is available at the wonderful website entitled The Environmental Illness Resource Guidex: http://www.ei-resource.org/illness-information/environmental-illnesses/candida-and-gut-dysbiosis/
  2. Medical websites such as this eMedicine overview now provide a detailed look at the complexity of candida overgrowth and its relationship to a variety of disease mechanisms in the body, as well as the array of factors that increase the risk of systemic Candidal infection: http://emedicine.medscape.com/article/213853-overview
  3. An article in the New England Journal of Health outlines current findings of systemic chronic candidiasis, which is termed autoimmune polyendocrinopathy - candidiasis - ectodermal dystrophy (APCED), as patients are followed throughout their life: http://www.nejm.org/doi/full/10.1056/NEJM199006283222601
  4. A comprehensive report on fungal infections such as candidiasis was presented by an expert from the University Medical Center ST. Radboud, in Veerdam, The Netherlands, in 2011. Here, Professor Ben E. dePauw explains that "only a few of the fungi pathogenic for humans are sufficiently virulent to infect a healthy host", and that most are symbiotic and harmless until a period of immune deficiency is induced by medications such as corticosteroids and immune suppressants that have been used much more aggressively in the last decade or so: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103258/
  5. A 2006 study at the University of California Los Angeles (UCLA) Geffen School of Medicine provides an overview of disseminated Candidiasis, which has increased in incidence dramatically over the past several decades, and is highly associated with iatrogenic and nocosomial causes (overuse of antibiotics and steroids, and hospital stays), which is logical. The standard treatment continues to involve mainly just one anti-fungal drug, with limited effects, and increasingly with fungal drug resistance acquired in pathological species. Attempts to develop other synthesized anti-fungal drugs specific for Candida species has resulted in drugs with alarming adverse effects: http://cid.oxfordjournals.org/content/42/2/244.full
  6. A 2010 comprehensive review of disseminated candididiasis manifesting as recurrent or chronic infections of the of the genitourinary tract, commonly called 'yeast infections' is presented by experts at the Albert Einstein College of Medicine, in New York, New York, U.S.A. Here, we see that vulvovaginal candidiasis mainly affects healthy women, while urinary tract candidiasis affects mostly elderly, hospitalized or immunocompromised patients. Vulvovaginal candidiasis is very common, still poorly studied or understood, and recurrent vulvovaginal candidiasis presents as a health problem that has a great negative impact on work and life. A vaginal culture can be used to diagnose this problem properly, but is still rarely performed. Candida, mostly Candida albicans, are found in the vagina of 20-30 percent of healthy women at any time, ususally presenting no symptoms, and in an estimated 70 percent of all women if studied over a period of a year. The key points in the pathology concern what creates symptoms in just a small percentage of these women. There is now a high incidence of resistance to the azole antifungam medications with Candida albicans, and over 10 percent of women will not benefit from standard therapy, while 70 percent will experience a recurrence after successful drug therapy: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2863365/
  7. A 2016 review of recurrent vulvovaginal candidiasis, by experts at the Wayne State University School of Medicine, in Detroit, Michigan, U.S.A. also noted that this is a common health problem that is not well controlled with standard antifungal medications. The focus of study in finding effective treatment and management involves insights into normal vaginal immune defenses and their aberrations: http://www.ncbi.nlm.nih.gov/pubmed/26164695
  8. A 2006 comprehensive report on Candidiasis and immune deficiency, by experts at the University of Cincinnati and New York University, note that "75% of all women of childbearing age develop vaginal candidiasis and 40% will have a second recurrence. Few women (less than 5%) experience frequent recurrences. In 2006, study of Candidiasis was generally limited to immunocompromised patients such as HIV/AIDS, but today we see that this is indeed a growing health problem in the whole population. This prior study revealed that pathogenic strains of Candida are found in about a third of all individuals, and in 60 percent of all patients diagnosed HIV positive, and that between 60-90 percent of patients with advanced HIV/AIDS experience recurrent oral and vaginal Candidiasis, but that a small percent experience deeper disseminated Candidiasis. Such study shows us that healthy patients need to improve immune health and function, and that this is highly related to Candidasis, obviously. Improving immune health health and function is part of the treatment strategy in CIM/TCM and standard medicine has no real treatment to address this part of therapy and prevention: http://hivinsite.ucsf.edu/InSite%3Fpage%3Dkb-00%26doc%3Dkb-05-02-0
  9. Finally, in 2015, the U.S. CDC provided comprehensive guidelines for standard treatment of Vulvovaginal Candidiasis, long ignored and largely discounted as just those 'yeast infections' that women experience in standard medicine. These guidelines provide important information and clarification for women afflicted with this health problem, which the CDC confirms affect at least 75 percent of all women, with perhaps 5 percent experiencing a recurrent Vulvovaginal Candidiasis that is debilitating and damageing to quality of life, and cannot be dismissed by just calling it a VVC. A fifth of all cases studied now involve a Candida species that is not albicans, many infections are drug resistant, and simple diagnostic tests, such as wet stain and cultures, are not routinely performed, and "the optimal treatment of nonalbicans VVC (vulvovaginal Candidiasis) remains unknown." Of course, the CDC cannot include CIM treatment protocols into guidelines without a lot of trouble generated from the industry: http://www.cdc.gov/std/tg2015/candidiasis.htm
  10. A 2011 meta-review of all study of the efficacy of boric acid powder used in vaginal and vulvar douche and external wash, as well as suppositories, at the Alfa Institute of Biomedical Sciences, in Athens, Greece, concluded that this is an effective treatment protocol for Vulvovaginal Candidiasis that involves non-albicans species and/or drug resistant species of Candida. A multicenter study in the U.S. in 2009 found that boric acid, a very inexpensive over-the-counter remedy, inhibits Candida largely by affecting biofilm formation and hyphal transformation, and by restoring the homeostatic environment to help naturally control the overgrowth of Candida. This understanding is still called "poorly understood", largely because allopathic medicine is stubbornly resistant to understanding holistic concepts in medicine: http://jac.oxfordjournals.org/content/63/2/325.full
  11. A 2015 study of common Complementary and Integrative Medicine therapies for recurrent vulvovaginitis candidiasis by experts at the University of Washington School of Medicine, in Seattle, Washington, U.S.A. notes that there is evidence that vaginal probiotics, with capsules or yoghurt, tea tree oil, boric acid, and aged garlic are all mildly effective, although some women may experience burning sensation. Frequent douche is not recommended: http://www.ncbi.nlm.nih.gov/pubmed/12719677
  12. A 2002 study of microbial biofilms, especially critical to the understanding of Candida overgrowth and pathology, by experts at the University of Manchester, in Manchester, UK, shows that biofilms adapt in a number of ways to pharmaceutical therapies and are integral to a growing antimicrobial drug resistance that is threatening: http://www.ncbi.nlm.nih.gov/pubmed/12073654
  13. A 2014 review of scientific study of biofilms that colonies of microorganisms form that may lead to drug-resistance, at the University of Texas at San Antonio, U.S.A. reveals that Candida albicans is the microorganism most associated with biofilm formation, creating a resistance to standard anti-fungal medications: http://www.ncbi.nlm.nih.gov/pubmed/25205098
  14. A 2015 study in China revealed that a common Chinese Herbal Formula, Longdan Xie Gan Tang, effectively downregulates adhesion molecule expression that are a measure of biofilm formation in Candida infection. An alcohol extract worked best: http://www.ncbi.nlm.nih.gov/pubmed/25011269
  15. A 2015 study in China found that the Chinese herbal formula Bai Tou Weng as an alcohol extract was also able to effectively inhibit Candida species fungal cell surface hydrophobicity, filamentation and biofilm formation: http://www.ncbi.nlm.nih.gov/pubmed/26591532
  16. A 2015 study in China also found that the Chinese herbal formula Huang lian Jie Du Tang worked well with the anti-fungal medication fluconazole to eradicate Candida albicans that showed resistance to the drug. Prior study found that this formula could inhibit the formation of Candida hyphae and biofilm colony: http://www.ncbi.nlm.nih.gov/pubmed/26137698
  17. A 2013 study in China revealed that the common antimicrobial herb Houttuynia cordata, or Yu xing cao, from which is derived the active chemical sodium Houtuyfonate, could effectively inhibit both Candida and Staphylococcus biofilm formation. This herb has been shown to effectively inhibit a number of bacterial and fungal species, and to modulate inflammatory cytokines to decrease symptoms of chronic infection: http://www.ncbi.nlm.nih.gov/pubmed/24660614
  18. A 2013 study at the Second Military Medical University, and the Shanghai Jiaotong University School of Medicine, in Shanghai, China, showed that an extract of the Chinese herb Stephania tetrandra, or Han Fang Ji, and the active chemical tetrandrine, could effectively inhibit both Candida biofilm formation and hyphal formation of the fungus: http://www.ncbi.nlm.nih.gov/pubmed/24260276
  19. A 2013 study at Kansas State University, in Manhattan, Kansas, U.S.A. showed that chemicals in the Chinese herb Gymnema sylvestre (Jiao gu lan), called gymnemic acds, effectively inhibited Candida conversion to its pathological hyphal form, promoted the conversion of the hyphal form to a benign yeast form of Candida, and showed inhibition of the growth of the yeast mildew and mold family of Aspergillus, which creates aflotoxins linked to many allergies and diseases: http://www.ncbi.nlm.nih.gov/pubmed/24040201
  20. A 2015 study at the Medical School of Southeast University in Nanjing, China, showed that key chemicals in the Chinese herb Magnolia officianalis, or Hou po, magnolol and honokiol, inhibit Candida biofilm formation and adhesion, as well as conversion to a hyphal form which penetrates the GI membrane and disseminates: http://www.ncbi.nlm.nih.gov/pubmed/25710475
  21. A New York Times Science article on July 13, 2010, explains how our symbiotic bacteria have been overlooked as a tool in medicine, and how important they are to our health: http://www.nytimes.com/2010/07/13/science/13micro.html
  22. A study funded by the NIH reveals how the amino acid L-Glutamine helps reverse the permeability of the small intestine wall, commonly called 'leaky gut syndrome', that may be induced by excess acetaldehyde from candida overgrowth: http://ajpgi.physiology.org/cgi/content/full/287/3/G51
  23. A 2003 study also reveals how excess acetaldehyde from candida overgrowth, as well as excess alcohol consumption, can cause muscle weakness and fatigue, twitch and tetany, directly, by affecting calcium ion channels: http://ajpcell.physiology.org/cgi/content/full/286/5/C1188
  24. A 2002 study on laboratory animals showed how excess acetaldehyde, which is seen as a byproduct of excess candida, may alter the effects of alcohol in a body when the person is a heavy drinker, causing excessive motor impairment and intoxication: http://www.ncbi.nlm.nih.gov/pubmed/12086125
  25. A 2005 study of the relationship between gastric function and candida overgrowth showedt that both steroid drugs and NSAIDS could promote overgrowth of candida, that candida overgrowth reduced gastric acid secretion and delayed mucosal healing in the small intestine, and overexpression of the immune cytokines TNF-alpha and IL-1beta resulted from candida overgrowth. It was found that probiotics were useful in the treatment of these problems: http://www.ncbi.nlm.nih.gov/pubmed/15932169
  26. A 2005 study of Pycnogenol, a standardized pine bark extract, at the University Autonomous of Barcelona, Spain, found that the extract was broadly antimicrobial at low dosage against 23 different bacterial and fungal species, and was proven to clear Candidiasis: http://www.ncbi.nlm.nih.gov/pubmed/16161029
  27. A 2013 study of 58 traditional Chinese herbs used to treat microbial infections and inflammation, by the University of Western Sydney, in Australia, showed that 30 of these 58 studies exhibited significant antimicrobial effects against fungal and bacterial overgrowth. The degree of effect was correlated with the amount of flavonoids in the herbal extracts, and alcohol extracts were used. 23 of the 58 herbs showed significant antibacterial effects, and 8 showed both anti-fungal and anti-bacterial effects, including Polygonum cuspidatum (Hu zhang, the source of Resveratrol), Uncaria rhyncophylla (Gout teng), Eucommia ulmoids (Du zhong), and Poria cocos (Fu ling): http://www.ncbi.nlm.nih.gov/pubmed/23827142
  28. A multicenter study of the Chinese herbal chemical Berberine, now enhanced and standardized in supplements, at the University of Lausanne, Switzerland, and Jawaharial Nehru University, in New Delhi, India, found that Berberine inhibited excess Candida growth via a number of physiological mechanisms, including inhibiting fungal mitochondrial potential, reactive oxygen species (ROS), and upregulation of cellular detox pathways, such as the glutathione metabolism. These experts suggested that Berberine could be used as part of an herbal antifungal protocol that is increasingly necessary with the spread of fungal resistance to standard drugs: http://www.ncbi.nlm.nih.gov/pubmed/25105295
  29. A 2014 study of one of the standard Traditional Chinese Herbal formulas to treat Candidiasis, Longdan Xie Gan Tang, showed that an alcohol extract of this simple formula was more effective: http://www.ncbi.nlm.nih.gov/pubmed/25011269
  30. A 2014 study with fluorescence microscopy and PCR study showed that an alcohol extract of the classic Chinese herbal formula Huang lian Jie du Tang showed that this formula could inhibit the formation of the pathological hyphal form of the Candida albicans species: http://www.ncbi.nlm.nih.gov/pubmed/25898587
  31. A 2013 study at the Second Military Medical University of Shanghai, China, and the Shanghai Jioatong University School of Medicine, found that the Chinese herbal chemical tetrandine, found in the herb Stephania tetrandra (Han Fang Ji), effectively inhibited the pathological conversion of Candida fungi to the hyphal form that is disseminated in the blood and lymph in Candidiasis. Perhaps an alcohol extract of this herb could help in the treatment protocol with Candidiasis: http://www.ncbi.nlm.nih.gov/pubmed/24260276
  32. A 2013 study at the University of Western Sydney, in Australia, found that of 58 medicinal herbs selected that may inhibit Candida overgrowth and disseminated Candidiasis, that alcohol extracts of 30 or these plants showed significant anti-fungal or antimicrobial activities, with 8 species showing both significant antibacterial and anti-fungal activities. These 8 Chinese medicinal herbs included Eucommia ulmoides (Du zhong), Polygonum cuspidatum (Hu zhang, from which Resveratrol is extracted), Poria cocos (Fu ling), and Uncaria rhyncophylla (Gou teng, or Cat's Claw): http://www.ncbi.nlm.nih.gov/pubmed/23827142
  33. A 2015 study at Kyungpook National University in South Korea found that isoquercetin, a key antixodant and antiinflammatory chemical in a number of Chinese herbs, along with quercetin, exerted a significant activity to disturb the membranes of cells and exert a fungicidal effect against Candida and other species. Quercetin and isoquercetin are found in the Chinese herbs sangye, bianxu, chaihu, yuxingcao, luobuma, sangjisheng, weimao/guijianyu, fanshiliu, diercao/hypericum japonicum, and manshanhong/rhododendron dahuricum. This effect may inhibit Candida biofilm formation as well: http://www.ncbi.nlm.nih.gov/pubmed/25445674
  34. A 2014 study at Kyungpook National University in South Korea found that the herbal chemical curcumin exerted significant membrane effects on Candida and other fungi, inducing destruction of the fungal membrane through leakage: http://www.ncbi.nlm.nih.gov/pubmed/25380239
  35. A 2013 study at Kyungpook National University in South Korea found that the chemical hibicuslide C, in the Chinese herb Abutilon theophrasti (Dong kui zi), exerted significant antifungal effects, working to induce membrane polarization and other effects to destroy the fungal plasma membrane function: http://www.ncbi.nlm.nih.gov/pubmed/23816874
  36. A 2013 study at National Yang-Ming University, in Taipei, Taiwan, found that linalool, a naturally occurring terpene alcohol found in foods, with high concentrations is thyme essential oil, as well as essential oils of tangerine, mandarin, lemon and lime, inhibited adhesion of Candida in the gut, and could be added to a therapeutic protocol. Such companies as DoTerra offer such food-grade essential oils that are safe and non-irritating to consume orally, unlike most essential oils, which may irritate the stomach: http://www.ncbi.nlm.nih.gov/pubmed/23210679
  37. A 2016 study at the State University of Paraiba School of Medicine, and the departments of pharmcology and dentistry, found that 2 herbal extracts, from Syzygium cumini and Sideroxylon obftusifolium, could effectively inhibit Candida and biofilm formation: http://www.ncbi.nlm.nih.gov/pubmed/26987037
  38. A 2011 study at an institute of dental sciences in Bangalore, India, proved that a higher dose supplement with magnesium oxide reduced candida growth significantly, combined with a carrier to affect the mouth tissues directly - magnesium may affect the main growth regulator of candida, free intercellular potassium levels relative to magnesium ions, and a magnesium potassium supplement may be helpful: http://www.ncbi.nlm.nih.gov/pubmed/22124069
  39. A New York Times Science article explains how science has just now discovered, in 2010, the integral role of bacteria on our food crops, grasses and trees on the control of rain and snow formation and precipitation. The importance of bacterial balance to both the human organism as well as the environment has been overlooked with disastrous consequences: http://www.nytimes.com/2010/05/25/science/25snow.html?ref=science
  40. A 2010 study at the University of California at Davis found that rising carbon dioxide levels in the atmosphere has resulted in dramatic decreases nutrient content of basic food plants, resulting in much lower usage of nitrates, and dramatic decreases in levels of protein, amino acids, and other key nutrients needed for health maintenance: http://www.news.ucdavis.edu/search/news_detail.lasso?id=9479
  41. A 2010 article in Smithsonian magazine reveals how a Princeton scientist, Bonnie Bassler, has become the leading expert in the world on bacteria in our bodies, and is unlocking the way that bacteria communicate intelligence: http://www.smithsonianmag.com/specialsections/40th-anniversary/Listening-to-Bacteria.html
  42. An overview of the role of the more than 1200 species of bacteria, yeast and other microorganisms that make up our symbiotic gut flora and fauna, and a guide to candidiasis, testing, and treatment, as well as a complete and professional guide to environmental illness, is available at the wonderful website entitled The Environmental Illness Resource Guidex: http://www.ei-resource.org/illness-information/environmental-illnesses/candida-and-gut-dysbiosis/
  43. A 2015 study of disseminated candida albicans affecting the mucosa and skin of laboratory animals, by experts at the State Universities of Londrina and Maringa, in Brazil, showed that an imbalance of T-helper cell cytokines drove the recurrent inflammation, with TNF-alpha, Interferon-gamma, and pro-inflammatory interleukins 6,12, and 17 expressed during the initial infectious incubation on the animal paws, leading to a rapid elimination of the Candida albicans in the skin, and TGF-beta and interleukins 3, 4, and 10, anti-inflamatory cytokines, expressed after day 4 post-infection to prevent future inflammatory exacerbation. Such study demonstrates that normal immune responses naturally keep pathological growth of Candida species from continuing to affect the skin, while dysfunctional immune responses may be responsible for chronic conditions, with continued or recurrent overexpressions of pro-inflammatory cytokines and deficient anti-inflammatory responses driving the chronic skin conditions associated with disseminated Candida. Therefore, simple Candida elimination may not be enough to stop a chronic skin condition, and a more holistic approach may be needed: http://www.ncbi.nlm.nih.gov/pubmed/26032158
  44. A 2003 study at the University of Newcastle, UK, found that disseminated Candida albicans resulted in deregulated T-cell production of immune cytokines in chronic mucocutaneous candidiasis, with dramatically increased levels of IL-6 and IL-10, which would impair the production of anti-inflammatory IL-12, potentially due to a defect in the function of dendritic cells or macrophages in areas of the mucosa or skin that are affected: http://www.ncbi.nlm.nih.gov/pubmed/14500490
  45. A 2015 study at the University of Amsterdam, The Netherlands, showed that an herbal formula IMOD exerted significant immunomodulatory effects that decreased the production of IL-6 and IL10 expression from dendritic cells, and did not affect lipopolysaccharid (LPS) induced production of the IL-12 anti-inflammatory cytokine. This research showed a beneficial modulation of the Th-1 and Th-2. IMOD is a formula of 7 herbs for immunomodulation developed jointly by Iranian and Russian scientists, and has proven effective in preliminary trials for HIV/AIDs as well. Herbs in IMOD include Urtica doica (nettle), Tanacetum vulgare (tansy), Rosa canina and selenium: http://www.ncbi.nlm.nih.gov/pubmed/25870561
  46. A 2015 study at 16 South Korean University medical school hospitals of deep skin fungal infections from 2006-2010 found 51 cases treated, a third of them Candidal, and half of them in immunocompromised patients. Papula, plaques, nodules, patches of macula, and ulcerative lesions were all common presentations. One fifth of the patients had a disseminated fungal infection. While these persistent skin infections are somewhat rare, this study does much to tell us what to look for in diagnosis: http://www.ncbi.nlm.nih.gov/pubmed/26105506
  47. A 2015 report on the efficacy of topical antifungal medications by the Medical Microbiology Laboratory of Molbis, Germany - newer delivery systems include nanoparticles and vesicular carriers:http://www.ncbi.nlm.nih.gov/pubmed/25918080
  48. As the serious study of herbal medicines to treat skin diseases finally emerges, the relatively sparse body of clinical studies is presented by Dr. Philip D. Shenefelt M.D. at the University of South Florida, a professor of Dermatology: http://www.ncbi.nlm.nih.gov/books/NBK92761/