Back in the 1980’s a revolution in the practice of integrative medicine and thinking about health and illness occurred, though no one at the time realized its significance. William Crook, a physician in Alabama, recognized that candida albicans, a yeast organism found in all human digestive tracts, had a major impact on health. He found that patients with overgrowth of candida not only were subject to vaginitis and thrush (commonly recognized as being caused by candida) but fatigue, allergies, digestive problems and a myriad of other problems.
Academic medicine scoffed at the idea that an organism found in the gut of almost all humans and not actually causing infection, has any impact on health. Despite this attitude, those of us practicing what was then called alternative medicine found many of our patients had this problem and responded to a treatment approach including dietary restriction of sugar, simple carbohydrates and aged foods, medication like Nizoral, Diflucan and Nystatin as well as probiotic therapy. I frequently observed enormous improvements in energy, digestive complaints, headaches and allergies when treating candida problems.
Today I continue to use these treatments and more sophisticated botanical therapies to reduce the candida load in the gut and build immune tolerance to this organism. The revolution that Crook foretold was the realization that the inhabitants of the gut, now called the microbiota (including candida, bacteria, viruses and parasites and numbering in the 10 trillion cell range), has enormous effect on health and disease. (See previous blogs on the microbiota and obesity). Academic medicine has now embraced the importance of our gut organisms in staying healthy, yet the candida issue is still not widely accepted.
We are now discovering the mechanism of how candida is so disruptive to the immune system and overall health. One of the keys is the adherence to the digestive tract wall from the hyphae form of candida. In response to this, the immune system produces anti-gliadin antibodies, the same antibody associated with gluten intolerance. These antibodies are associated with fatigue, mood changes, attention issues and even depression. In addition, candida creates a biofilm of protein around the colonies, making the body’s immune response less effective. However, treatment can make a big difference. In a study done in Norway in 1998, 21 of 25 patients placed on an anti-yeast diet and oral Nystatin had resolution of symptoms of digestive issues, fatigue and depression over a 3 month period.
There are some studies showing candida colonization is also associated with inflammatory bowel disease (Crohn’s disease and ulcerative colitis) as well as celiac disease and gluten intolerance. Current treatments include the same medications I have used for decades, Nystatin, fluconizole and itriconizole as well as newer botanical therapies designed to disrupt the biofilm, including Interfase, saccharomyces boulardi and quercitin. We need to keep candida overgrowth and intolerance in mind as a contributing factor for any digestive complaint ranging from bloating, gas, heartburn to colitis as well as systemic problems such as fatigue, depression, attention issues and allergies.