Let me tell you about a patient who came to my office recently.
She was just 35 but suffered from a laundry list of health problems.
She had chronic fatigue, recurrent yeast infections, itchy ears, dandruff, irritable bowel syndrome, muscle twitching, acne rosacea, malabsorption, headaches, and more.
Were these problems related?
You see, they're all related to an overgrowth of yeast. This patient had such a fungus problem that she was practically a walking mushroom!
The cause was clear.
She had taken many, many courses of antibiotic over the years.
That's because she had been diagnosed with a condition called mitral valve prolapse and "needed" antibiotics every time she went to the dentist -- a problem I believe is overdiagnosed and overtreated.
She also had many urinary tract infections and many more courses of antibiotics to treat those.
So what's the problem?
There is normally a balance between the healthy bugs in the gut (lactobacillus, Bifidobacter, E. coli) and other potentially dangerous bugs, including yeasts, bacteria, and occasionally parasites.
These bad actors are often present in small numbers.
But when the good guys are killed by antibiotics or not fed with adequate fiber, or the bad guys are fueled with too much sugar, or the gut is damaged by too much stress, then the bad guys take over.
The result? Chronic illnesses and symptoms like allergies, chronic inflammation, joint and brain problems as well as digestive symptoms.
In my patient's case, all the antibiotics she'd taken had killed off all the healthy bacteria in her gut -- and the yeast (which antibiotics don't kill) took over like weeds.
This led to her symptoms, including yeast infections, dandruff, rosacea, itchy ears, and abdominal bloating, because the yeast ferment sugars in the diet.
Yeast overgrowth is so common -- yet many people don't know they have it.
Conventional doctors have largely ignored this problem.
That's because, in medical school, we're taught that you either have a disease or you don't. It's black and white.
But our bodies weren't designed with an "on" or "off" switch for disease. People suffer in shades of gray.
So medical students learn that some people do have clear yeast overgrowth problems.
AIDS patients, for example, have severe yeast and fungal infections and need long-term anti-fungal treatment.
People with diabetes tend to grow yeasts because yeast likes sugar.
Babies get thrush and need antifungal treatment. Women get vaginal Candida yeast infections.
All of these are well-accepted and treatable problems.
But what about more subtle problems related to yeast?
Unfortunately, they are often ignored and not linked back to the patient's complaints.
On the flip side, many alternative practitioners overdiagnose yeast problems.
But the simple fact is, there are many people out there who do have yeast problems. And most don't know it.
I admit, there is not enough research on this topic. But with the collective intelligence of many doctors working in this field for decades with thousands of patients we have learned a lot.
This week, I'm going to draw on this evidence to explain how yeast problems occur and how to treat them.
Yeast overgrowth can be triggered by a number of things. These include a high-sugar, high-fat, low-fiber diet, impaired immunity, use of drugs like antibiotics, birth control pills, estrogen, and steroids like prednisone, and psychological stress.
Could you have yeast overgrowth?
Although its symptoms are similar to those of many other conditions, you could have a yeast problem if you have these signs.
Chronic fatigue Loss of energy General malaise Decreased libido
Thrush Bloating and gas Intestinal cramps Rectal itching Altered bowel function
Menstrual irregularities like pain, bleeding, etc. Premenstrual syndrome Thyroid dysfunction
Nervous system complaints:
Depression Irritability Inability to concentrate
Immune system complaints:
Allergies Chemical sensitivities Low immune function
Chronic yeast infections Chronic antibiotic use for infections or acne Oral birth control pill usage Oral steroid hormone usage
Sensitivity to foods, chemicals, or other allergens Eczema Psoriasis Irritable bowel syndrome Craving for foods rich in carbohydrates or yeast Toenail fungus
[Adapted from the Textbook of Natural Medicine, Pizzorno and Murray, Churchill Livingstone 1999]
So how can you be sure you have a problem with yeast?
Unfortunately, most testing for yeast is not definitive.
There are tests that can be helpful if they come out positive but don't rule yeast out if they're negative. These include blood antibody levels for yeasts, stool tests, and organic acid urine tests for yeast metabolites.
But the best "test" for diagnosis is a good history for risk factors like antibiotic use and symptoms of chronic yeast problems. So I mostly rely on a patient's story.
Another tricky thing with yeast is that its manifestations vary from person to person and the response to treatments will vary.
Some people may need very aggressive treatments, while others many need only simple changes to make a huge difference.
In fact, treatment is often a matter of trial and error, like tailoring a suit, trying it on, making adjustments, seeing if it fits, and making a few more alterations until you get it just right.
Often, a systematic approach to yeast overgrowth, like the one outlined here, can help overcome this common but underdiagnosed ailment.
Here is what I recommend to address a yeast problem.
1) Deal with predisposing factors. Don't take antibiotics, steroids, or hormones unless absolutely medically necessary.
2) Do a trial of the yeast control eating program (below).
3) Use probiotics.
4) Take antifungal herbs and medications.
5) Identify potential environmental toxic fungi.
6) Reduce Stress
==> The Yeast Control Eating Program
A simple 5-day elimination of yeast and molds in your diet, followed by a challenge or binge of yeasty foods will often relieve and then trigger your symptoms.
This can be a good diagnostic tool to see if a long-term yeast control diet would be helpful for you. Remember, different people with different sensitivities may require varying degrees of dietary restrictions.
Often, the process of healing requires listening to your body and its signals and sensitivities.
Nowhere is this better illustrated than in the management of yeast problems!
Follow these guidelines as the first step to assess your yeast problem:
* Eliminate all yeasty and moldy substances from your eating regimen (see list below)
* Try to be totally strict during this time to get the best results
* Do this when you are at home and can control your food intake
* Plan what you will eat and go shopping so you have the right foods in your house
* Keep a food diary and track what you are eating. You should try to vary your meals and make sure you are not eating a lot of any one food.
* Avoid the test foods for 5 full days
* On the sixth day, eat large amounts of the foods you have been avoiding and monitor your reaction. If you get a recurrence of symptoms, you have identified your problem. If not, then yeast may not be a problem
* Remember that sometimes a dietary change may not reduce the yeast overgrowth enough to resolve your symptoms. Then you may need to proceed to the next steps -- medication or non-prescription treatments.
* If you feel great off the yeasty foods, you might not want to do the challenge. It could make you feel very ill. Continue to follow a yeast control eating program for at least 3 months and continue with the other recommendations here.
Foods allowed on the program:
* Meat * Fish * Chicken * Eggs * Nuts -- fresh. Don't eat peanuts or pistachios. Use cashew or almond butter instead of peanut butter. * Fresh fruit -- washed/peeled; 2 servings per day. Don't eat fruits with moldy skin, such as grapes, berries, and melons. The skin is the site of mold growth in fruits. * Grains -- brown rice, amaranth, buckwheat, and corn. It may be necessary to avoid gluten grains such as wheat, spelt, malt, barley, oats, rye, and millet. * Water -- lots! * Juices -- fresh-squeezed fruit or vegetable. Dilute with water or seltzer. * Snacks -- air-popped corn or Guiltless Gourmet Chips. * Oils -- old pressed olive, sesame, or walnut.
Foods to avoid:
* Sugar and refined carbohydrates * Honey * Syrup * Malt * Fructose * Corn syrup * Fermented, vinegar-containing foods, such as: - Salad dressings - Mustard - Ketchup - Mayo - Soy sauce - Tofu/ tempeh * Yeasty foods and substances, like: - Beer and wine - Bagels - Bread - Foods in the fungus family, e.g. mushrooms - Olives - Juices not freshly made - Coffee and teas - Dried fruits - Most condiments (salad dressings, vinegar, soy sauce, etc.) - Fermented foods (sauerkraut, pickles, miso) - Vitamins. Some of the B vitamins are produced by yeast fermentation -- look for yeast free vitamins
Often, I find that patients need extra help and should take antifungal herbs, medications, and probiotics.
Here are my favorites:
I have written a lot about these beneficial bacteria, which you need to help keep your gut in balance.
* Take at least 10 to 20 billion live organisms a day of Lactobacillus and Bifidobacter species. * A special "yeast against yeast" probiotic called Saccharomyces boulardii can be very safe and effective in controlling yeast. I prefer a product called Florastor; take 250 to 500 mg once or twice a day.
==> Non-prescription antifungals
Using antifungal therapies such as herbs and other naturally occurring compounds can be very helpful in controlling yeast.
The dose for all of the following herbal remedies is generally two pills with meals, 3 times a day for 2 to 3 months.
You might need less or more based on your response and symptoms. Sometimes these remedies can be combined for better effect.
To find the right combinations and doses for you and identify quality products, consult with a qualified practitioner.
Some of the best antifungal compounds include the following:
* Oregano -- Oil of oregano has many antibacterial and antifungal properties. It comes in oil form, capsules, and tablets. Sometimes it causes an aftertaste and burping; take it right before meals to prevent these problems.
* Garlic -- Fresh, crushed garlic is a potent antimicrobial and immune booster. It can also be taken in tablets or capsule form -- but make sure they don't just contain garlic oil, but all the phytochemicals found in whole garlic.
* Citrus seed extract -- The phytochemicals in citrus seeds have been found to have potent antimicrobial properties. They come in pill form in doses of about 250 mg per pill.
* Berberine -- This potent yellow plant extract comes from goldenseal and barberry .
* Tannins -- These are the astringent compounds found in tea and the bark of trees.
* Undecylenate -- This chemical compound is a potent antifungal.
* Isatis tinctoria -- This Chinese herb can be a useful adjunct to treating intestinal imbalances. The dose is generally 350 mg per pill.
* Caprylic acid -- This is another useful compound for treating yeast. The dose is generally 500 mg per capsule.
==> Antifungal medications
Sometimes, nutrition and supplements just aren't enough to clear up stubborn yeast overgrowth.
That's where prescription medications can help.
They're often needed to treat more resistant cases of yeast for either the short or long term -- and in some cases can be miraculous in their results.
Your doctor will probably start you on nystatin. It is the most common antifungal drug and is often used to treat thrush in babies. It is not absorbed by the intestinal tract and has no systemic effects.
Unfortunately, many fungal organisms are resistant to nystatin and you may need stronger medications.
I say "unfortunately" because these drugs are generally processed by the liver and occasionally can cause reversible elevation of liver function tests. They also may have serious interactions with other medications.
People with liver or heart diseases cannot take these drugs. If you do take Diflucan, Sporonox or Lamasil, you have to have your liver function checked every 6 weeks.
For all of these reasons, you should only take prescription antifungals under the supervision of an experienced and qualified practitioner.
But there is a bright side.
Despite these warnings, these medications can often be life-saving treatments for many conditions unresponsive to conventional treatments.
Killing off yeast is a good thing.
But in some people, the dead yeast release enough byproducts to cause a "die off" reaction wherein you might feel worse before you feel better.
It goes away after a few days to about a week. You can minimize its effects by following the yeast control eating program for a week or so before you start taking any antifungal preparations.
I also recommend taking 2 to 3 activated charcoal capsules every 4 to 6 hours during the day. Taking a soluble fiber supplement that contains guar gum, psyllium seed, or pectin to bind to yeast toxins before bed can also be helpful in reducing the "die off" reaction.
Ask you physician about these medications for yeast:
* Diflucan -- 100 to 200 mg a day for one month * Sporonox -- 200 mg a day for one month. This is used to treat benign toenail fungus and the treatment often lasts months * Lamasil -- 250 mg a day. This is also used to treat benign toenail fungus and often lasts months * Nystatin -- the dose is generally 500,000 IU twice a day for a month
==> A Special Note on Environmental Toxic Fungi
Before I go, I'd like to tell you about another troublesome type of fungus.
Toxic fungi, including the dreaded "black mold," or Stachybotrys, strains of Aspergillus, Chaetomium, and Penicillium, have found their way into the news and into our homes. (New York Times Magazine, Haunted by Mold, August 12, 2001 and Time Magazine, Beware: Toxic Mold, July 2, 2001).
They can inhabit basements and lurk behind bathroom walls -- but their worst effects are in the body.
One of our patients, a 14-year-old girl with juvenile rheumatoid arthritis, was found to have Stachybotrys growing in her bedroom walls and had high levels of antibodies to this toxic black fungus in her blood.
The house was condemned -- and when she moved out she even had a "spontaneous remission" of her arthritis!
If you have chronic health problems and live in a damp or moldy climate, consider toxic fungus as a source.
There is help.
Environmental engineers, specialists in mold removal, and physicians who specialize in environmental and occupational medicine can be helpful in sorting out these hidden hazards.
So now you know that fungi, yeasts, and mold can you sick -- but there's good news, too. I hope you'll use the tools I've given you in this blog to start getting well and feeling healthy now.
Now I'd like to hear from you...
Do you suffer from the symptoms described here? Have you been diagnosed with yeast overgrowth?
How do certain foods seem to affect your symptoms?
Are you seeing a doctor for yeast problems?
What's been your experience in dealing with and treating yeast?
Please let me know your thoughts by clicking on the Add A Comment button below and posting your thoughts.
I have a cronic yeast overgrowth. My immune system has been compromised and by bacteria are totally unbalanced. I am 22 years old and have suffered with this for many years. I believe the cause is a comibination of many things but taking ACUNTANE really seemed to have set it off. I am on probiotics, antifungals, i just started taking psyllium fiber...among other things. My food allergies are through the roof so my diet is EXTREMELY limited. This has been hard on my body because my digestion goes not seem to work well at all. I am always extremely bloated. I also constanly itch as if I had a yeast infection. some things I have found helpful are---- Dr. Whiting's OXYFLUSH KIT---- one of the only things that has ever brought me any relief or energy. and also for help dieting go to---WHOLE FOODS APPROACH---. Just praying God will show the doctor how to heal me eventually :(. Good news is God can heal anything. (this is what keeps me going)
I am getting granules out of my eyes, noe ears and skin. I am very sick and weak. I used a mold test kit from Lowe's and put these samples in the petri dish with the solution and sent it to Pro Labs. These were the results.
I've have recently been diagnosed with candida albicans. I have also enrolled in a Fibromyalgia and CFS program, not covered by insurance, since March of 2010. The candida diet is strict and the die off difficult. My treatment also involves Nystatin and supplements. I'm also given a weekly IV of nutrients administered by a nurse. My concern are two fold. First I have Hepatitis C and second that the yeast can mutate if kept on the same regiment without rotation. I believe most of my symptoms, many severe, are not from Fibromyalgia, but from the overgrowth of Candida.
Would really like to find a program that would take care of the Candidia without facing a recurrence. Too many different approaches on the Internet and with the doctors themselves to know what is best for me. They all contradict each other. This makes it even harder for the patient, like me, to take the proper treatment.
3 weeks ago I was diagnosed with candida albicans which I belive has been the cause of my health problems. I am on a gentle detox as prescribed, however, I am keen to get cracking with getting well. I have made a tea out of cinnamon cloves, nutmeg, licorice, neem leaf and barberry. This is as a result of hours of research. It tastes disgusting but has regulated already my bowel movements, reduced symptoms of IBS and I feel less "foggy". I appreciate this will take time and I am combining it with a no yeast, no sugar high protein diet.
The tea is a cheaper, more accessible alternative, to the plethora of herbs and nutrients out there, there is no magic overnight cure and I know it will take time, dedication and wisdom to overcome this.
I have been on a yeast free yeast kill diet also taking a liver detox program.
I have had an Igg Igm test by alcat and showed high on all the candida yeast etc.
I have terrrible acne, malabsorption, bloating, pms anxiety, gluten intolerance, leaky gut syndrome. I am taking probiotics. I have a history of steroids for infections, and antibiotics for sinus and ear infections. I am 18 and am tired of going from doctor to doctor. Can you lead me to some doctor, alternative, western, holistic. I need someone that can get me through this that specializes in yeast
Very interesting article. Could you tell me whether consumption of dairy products would contribute to a yeast problem? I love milk, and I've tried soy milk, but the taste doesn't compare to cow's milk. Are there any milk products that would be considered better than others. Thanks!