The Encyclopedia of Natural Medicine, 3rd Ed.

Candidiasis, Chronic

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• Positive demonstration of yeast overgrowth on stool culture

• Higher than normal levels of candida antibodies or antigens in the blood

In the past 30 years, overgrowth in the gastrointestinal (GI) tract of the usually benign yeast Candida albicans has become increasingly recognized as a complex medical syndrome known as chronic candidiasis or yeast syndrome.1,2Specifically, the overgrowth of candida is believed to cause a wide variety of symptoms in virtually every system of the body, with the GI, genitourinary, endocrine, nervous, and immune systems being most susceptible.3

Although chronic candidiasis has been clinically defined for a long time, it was not until Orion Truss published The Missing Diagnosis and William Crook published The Yeast Connection that the public and many physicians became aware of the magnitude of the problem.1,2

Normally, C. albicans lives harmoniously in the inner warm creases and crevices of the digestive tract (and in the vaginal tract in women). However, when this yeast overgrows, when immune system mechanisms are depleted, or when the normal lining of the intestinal tract is damaged, the body can absorb yeast cells, particles of yeast cells, and various toxins.3 As a result, there may be significant disruption of body processes, resulting in the development of yeast syndrome.

Patients who have chronic candidiasis generally say they “feel sick all over.” Fatigue, allergies, immune system malfunction, depression, chemical sensitivities, and digestive disturbances are just some of the symptoms patients with yeast syndrome may experience.3

The typical patient with yeast is female, as women are eight times more likely to experience yeast syndrome compared with men owing to the effects of estrogen, birth control pills, and the higher number of prescriptions for antibiotics (see box).4

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TYPICAL CHRONIC CANDIDIASIS PATIENT PROFILE

Sex: Female

Age: 15–50 years

General symptoms:

• Chronic fatigue

• Loss of energy

• General malaise

• Decreased libido

Gastrointestinal symptoms:

• Thrush

• Bloating, gas

• Intestinal cramps

• Rectal itching

• Altered bowel function

Genitourinary system complaints

• Vaginal yeast infection

• Frequent bladder infections

Endocrine system complaints:

• Primarily menstrual complaints

Nervous system complaints:

• Depression

• Irritability

• Inability to concentrate

Immune system complaints:

• Allergies

• Chemical sensitivities

• Low immune function

Past history:

• Chronic vaginal yeast infections

• Chronic antibiotic use for infections or acne

• Oral birth control usage

• Oral steroid hormone usage

Associated conditions:

• Premenstrual syndrome

• Sensitivity to foods, chemicals, and other allergens

• Endocrine disturbances

• Eczema

• Psoriasis

• Irritable bowel syndrome

Other:

• Craving for foods rich in carbohydrates or yeast

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Causes

Chronic candidiasis is a classic example of a multifactorial condition, as shown in the list below. Therefore, the most effective treatment involves addressing and correcting the factors that predispose to C. albicans overgrowth. It involves much more than killing the yeast with antifungal agents, whether synthetic or natural.

Predisposing Factors in Candida albicans Overgrowth

Decreased digestive secretions

Dietary factors

Impaired immunity

Nutrient deficiency

Drugs

Prolonged antibiotic use

Impaired liver function

Underlying disease states

Altered bowel flora

Prolonged antibiotic use is believed to be the most important factor in the development of chronic candidiasis in most cases. By suppressing normal intestinal bacteria that prevent yeast overgrowth and suppression of the immune system, antibiotics strongly promote the overgrowth of candida.

There is little argument that, when used appropriately, antibiotics save lives. However, there is also little argument that antibiotics are seriously overused, both clinically and in animals raised for food. Although the appropriate use of antibiotics makes good medical sense, what does not make sense is reliance on them for such conditions as acne, recurrent bladder infections, chronic ear infections, chronic sinusitis, chronic bronchitis, and nonbacterial sore throats. Relying on antibiotics in the treatment of these conditions does not make sense, as either the antibiotics rarely provide benefit or these conditions are effectively treated with natural measures. Equally problematic is the heavy use of antibiotics in animals raised for food. According to the FDA, 80% of antibiotics in the United States are used in animals. This contributes to antibiotic resistance as well as human exposure to antibiotics.

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CANDIDIASIS QUESTIONNAIRE

History

Score

1. Have you taken broad-spectrum or other antibiotics for acne for one month or longer?

25

2. Have you ever taken broad-spectrum antibiotics for respiratory, urinary, or other infections for two months or longer, or in short courses four or more times in a one-year period?

20

3. Have you ever taken any broad-spectrum antibiotic, even a single course?

6

4. Have you ever been bothered by persistent prostatitis, vaginitis, or other problems affecting your reproductive organs?

25

5. Have you been pregnant . . .

 

One time?

3

Two or more times?

5

6. Have you taken birth control pills . . .

 

For six months to two years?

8

For more than two years?

15

7. Have you taken prednisone or other cortisone-type drugs . . .

 

For two weeks or less?

6

For more than two weeks?

15

8. Does exposure to perfumes, insecticides, fabric shop odors, and other chemicals provoke . . .

 

Mild symptoms?

5

Moderate to severe symptoms?

20

9. Are your symptoms worse on damp, muggy days or in moldy places?

20

10. If you have ever had athlete’s foot, ringworm, jock itch, or other chronic infections of the skin or nails, have the infections been . . .

 

Mild to moderate?

10

Severe or persistent?

20

11. Do you crave sugar?

10

12. Do you crave breads?

10

13. Do you crave alcoholic beverages?

10

14. Does tobacco smoke really bother you?

10

Total score for this section

_________

Major Symptoms

 

For each of your symptoms, enter the appropriate figure in the Score column.

If a symptom is occasional or mild

score 3 points

If a symptom is frequent and/or moderately severe

score 6 points

If a symptom is severe and/or disabling

score 9 points

1. Fatigue or lethargy

____

2. Feeling of being “drained”

____

3. Poor memory

____

4. Feeling “spacey” or “unreal”

____

5. Depression

____

6. Numbness, burning, or tingling

____

7. Muscle aches

____

8. Muscle weakness or paralysis

____

9. Pain and/or swelling in joints

____

10. Abdominal pain

____

11. Constipation

____

12. Diarrhea

____

13. Bloating

____

14. Persistent vaginal itch

____

15. Persistent vaginal burning

____

16. Prostatitis

____

17. Impotence

____

18. Loss of sexual desire

____

19. Endometriosis

____

20. Cramps and/or other menstrual irregularities

____

21. Premenstrual tension

____

22. Spots in front of eyes

____

23. Erratic vision

____

Total score for this section

_________

Other Symptoms

 

For each of your symptoms, enter the appropriate figure in the Score column.

If a symptom is occasional or mild

score 1 point

If a symptom is frequent and/or moderately severe

score 2 points

If a symptom is severe and/or disabling

score 3 points

1. Drowsiness

____

2. Irritability

____

3. Lack of coordination

____

4. Inability to concentrate

____

5. Frequent mood swings

____

6. Headache

____

7. Dizziness/loss of balance

____

8. Pressure above ears, feeling of head swelling and tingling

____

9. Itching

____

10. Other rashes

____

11. Heartburn

____

12. Indigestion

____

13. Belching and intestinal gas

____

14. Mucus in stools

____

15. Hemorrhoids

____

16. Dry mouth

____

17. Rash or blisters in mouth

____

18. Bad breath

____

19. Joint swelling or arthritis

____

20. Nasal congestion or discharge

____

21. Postnasal drip

____

22. Nasal itching

____

23. Sore or dry throat

____

24. Cough

____

25. Pain or tightness in chest

____

26. Wheezing or shortness of breath

____

27. Urinary urgency or frequency

____

28. Burning on urination

____

29. Failing vision

____

30. Burning or tearing of eyes

____

31. Recurrent infections or fluid in ears

____

32. Ear pain or deafness

____

Total score for this section

_________

Total score for all three sections

_________

Interpretation

   

If your score is:

   

Women

Men

 

>180

>140

Yeast-connected health problems are almost certainly present

120–180

90–140

Yeast-connected health problems are probably present

60–119

40–89

Yeast-connected health problems are possibly present

<60

<40

Yeast-connected health problems are less likely to be present

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Diagnostic Considerations

Although the candida questionnaire can help, the best method for diagnosing chronic candidiasis is clinical evaluation by a physician knowledgeable about yeast-related illness. It is more than likely that the doctor will take a detailed medical history and ask you to fill out a patient questionnaire. He or she may also employ laboratory techniques such as stool cultures for C. albicans and measurement of levels of antibodies to C. albicans or C. albicans antigens in the blood. Although these laboratory examinations are useful diagnostic aids, they should be used to confirm the diagnosis. In other words, the diagnosis is best made by evaluation of a patient’s history and clinical picture.

Comprehensive Stool and Digestive Analysis

Compared with simply culturing a stool sample for the presence of C. albicans, the comprehensive digestive stool analysis (CDSA) is more clinically useful. This battery of integrated diagnostic laboratory tests evaluates digestion, intestinal function, intestinal environment, and absorption by carefully examining the stool. It is a useful tool in determining the digestive disturbance that is likely to be the underlying factor responsible for C. albicans overgrowth. In addition, the CDSA may determine that the symptoms are related not to C. albicans overgrowth but rather to a condition such as small-intestine bacterial overgrowth or leaky gut syndrome.

Antibody and Antigen Levels

Another laboratory method to confirm the presence of C. albicans overgrowth involves measuring the level of antibodies to candida or the level of antigens in the blood.5 However, our feeling is that these tests are rarely necessary, as the results typically only confirm what the patient history, physical examination, and CDSA reveal. Hence the test does not change the course of action. Nonetheless, some patients and physicians may desire confirmation that C. albicans is a significant factor in the patient’s health. In this situation, blood studies can be helpful and can also be used as a way of monitoring therapy.

Therapeutic Considerations

A comprehensive approach is more effective in treating chronic candidiasis than simply trying to kill the C. albicans with a drug such as nystatin, ketoconazole, or fluconazole, or with a natural antifungal agent. These rarely produce significant long-term results because they fail to address the underlying factors that promote C. albicans overgrowth. It’s a bit like trying to weed a garden by simply cutting the weeds, instead of pulling them out by the roots. Nonetheless, in many cases it is useful to try to eradicate C. albicans from the system, preferably with the help of natural antiyeast therapies described below. A follow-up stool culture and C. albicans antigen determination will confirm if the candida has been eliminated. If it has and symptoms are still apparent, it is likely that the symptoms are unrelated to an overgrowth of C. albicans. Symptoms similar to those attributed to chronic candidiasis can be caused by small-intestine bacterial overgrowth, for example. In such a case, pancreatic enzymes and berberine-containing plants such as goldenseal can be helpful.

In addition to using natural agents to eradicate C. albicans, it is important to address predisposing factors, go on a diet that helps control candida, and support various body systems according to your individual needs.

Diet

A number of dietary factors appear to promote the overgrowth of C. albicans. The most important factors are a high intake of sugar; milk and other dairy products; foods containing a high content of yeast or mold; and food allergies.

Sugar

Sugar is the chief nutrient for C. albicans. It is well accepted that restriction of sugar in-take is an absolute necessity in the treatment of chronic candidiasis. Most patients do well by simply avoiding refined sugar and large amounts of honey, maple syrup, and fruit juice.14

Milk and Other Dairy Products

There are several reasons to restrict or eliminate the intake of milk in patients with chronic candidiasis:

• High lactose content promotes the overgrowth of candida.

• Milk is one of the most frequent food allergens.

• Milk may contain trace levels of antibiotics, which can further disrupt the GI bacterial flora and promote candida overgrowth.

Mold- and Yeast-Containing Foods

Many experts generally recommend that individuals with chronic candidiasis avoid foods with a high content of yeast or mold, including alcoholic beverages, cheeses, dried fruits, and peanuts. Even though many patients with chronic candidiasis may be able to tolerate these foods, we think it is still a good idea to avoid them until the situation is under control.

Food Allergies

Food allergies are another common finding in patients with yeast syndrome.3 ELISA tests, which can identify both IgE- and IgG-mediated food allergies, are often helpful.

Hypochlorhydria

An important step in treating chronic candidiasis in many cases is improving digestive secretions. Gastric hydrochloric acid, pancreatic enzymes, and bile all inhibit the overgrowth of C. albicans and prevent its penetration into the absorptive surfaces of the small intestine. Decreased secretion of any of these important digestive components can lead to overgrowth of yeast in the GI tract. For example, people on acid-blocking drugs, including over-the-counter varieties, can develop yeast overgrowth in the stomach.6 And pancreatic enzymes are largely responsible for keeping the small intestine free from parasites (including bacteria, yeast, protozoa, and intestinal worms).7,8 Therefore, restoration of normal digestive secretions through the use of supplemental hydrochloric acid, digestive enzymes, and substances that promote bile flow is critical in the treatment of chronic candidiasis. The comprehensive digestive stool analysis can provide valuable information to help identify which factor is most important. See the chapter “Digestion and Elimination” for more information.

Enhancing Immunity

Recurrent or chronic infections, including chronic candidiasis, are signs of a depressed immune system. What makes it difficult for people to overcome chronic candidiasis is a repetitive cycle—a compromised immune system leads to infection, and infection leads to damage to the immune system, further weakening resistance.

The importance of a healthy immune system in protecting against C. albicans overgrowth is well known by any physician who has seen a patient suffering from AIDS or taking drugs that suppress the immune system. In either case, severe yeast overgrowth is a hallmark feature. The occurrence of candida overgrowth in these conditions provides considerable evidence that improving the functioning of the immune system is absolutely essential in the patient with chronic candidiasis.

In addition, patients with chronic candidiasis often suffer from other chronic infections, presumably due to a depressed immune system. Typically, this depression of immune function is related to decreased thymus function and is manifested primarily as depressed cell-mediated immunity. Although expensive laboratory tests can document this depression, it is better to rely on the history of repeated viral infections (including the common cold), outbreaks of cold sores or genital herpes, and prostatic (in men) or vaginal (in women) infections.

Causes of Depressed Immune Function in Candidiasis

As we’ve noted, the person with chronic candidiasis is typically stuck in a vicious circle. A triggering event such as antibiotic use or nutrient deficiency can lead to immune suppression, allowing C. albicansto overgrow and become more firmly entrenched in the lining of the GI tract. Once the organism attaches itself to the intestinal cells, it competes with the cell and ultimately the entire body for nutrition, potentially robbing the body of vital nutrients. In addition, this kind of yeast secretes a large number of mycotoxins and antigens.9,10 Candida is referred to as a polyantigenic organism because more than 79 distinct antigens have been identified. Because of this tremendous number of antigens, an overgrowth of C. albicans greatly taxes the immune system.

Triggers to Impaired Immunity in Candidiasis

Antibiotic use

Corticosteroid use

Other drugs that suppress the immune system

Nutrient deficiency

Food allergies

High-sugar diet

Stress

Restoring Proper Immune Function

Restoring proper immune function is one of the key goals in the treatment of chronic candidiasis. No single magic bullet exists to immediately bring the immune system back to an optimal state. Instead, we recommend a comprehensive approach involving lifestyle, stress management, exercise, diet, nutritional supplementation, and the use of plant-based medicines. For more information, see the chapter “Immune System Support.”

Perhaps the most effective intervention in reestablishing a healthy immune system is measures designed to improve thymus gland function.11,12 Promoting optimal thymus activity primarily involves prevention of thymus gland atrophy (shrinkage) by ensuring adequate dietary intake of antioxidant nutrients such as carotenes, vitamin C, vitamin E, zinc, and selenium.

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The Vicious Circle of Chronic Candidiasis

Promoting Detoxification

People with chronic candidiasis usually exhibit multiple chemical sensitivities and allergies, an indication that the body’s detoxification reactions are stressed. Supporting liver function will help promote detoxification and may be one of the most critical factors in the successful treatment of candidiasis.

Damage to the liver is often an underlying factor in chronic yeast overgrowth, as well as in chronic fatigue (see the chapter “Chronic Fatigue Syndrome”). When the liver is even slightly damaged by chemical toxins, immune function is severely compromised.

The immune-system-suppressing effect of nonviral liver damage has been repeatedly demonstrated in experimental animal studies and human studies. For example, when the liver of a rat is damaged by a chemical toxin, immune function is severely hindered.13 Liver injury is also linked to C. albicans overgrowth, as evident in studies with mice.14

A rational approach to aiding the body’s detoxification involves the following:

• A diet focused on fresh fruits and vegetables, whole grains, legumes, nuts, and seeds

• A healthful lifestyle, including exercising regularly and avoiding alcohol

• A high-potency multiple vitamin and mineral supplement

• Lipotropic formulas and silymarin to protect the liver and enhance liver function

• A three-to-seven-day nutritional cleansing program or fast at the change of each season

Indications of the Need for Detoxification

More than 20 lb overweight

Diabetes

Gallstones

History of heavy alcohol use

Psoriasis

Natural and synthetic steroid hormone use

images Anabolic steroids

images Estrogens

images Oral contraceptives

High exposure to certain chemicals or drugs

images Cleaning solvents

images Pesticides

images Antibiotics

images Diuretics

images Nonsteroidal anti-inflammatory drugs

images Thyroid hormone

History of viral hepatitis

Lipotropic Factors

The nutrients choline, betaine, and methionine are often beneficial in enhancing liver function and detoxification reactions in patients with chronic candidiasis. These compounds, referred to as lipotropic agents, promote the flow of fat and bile to and from the liver. In essence, they produce a “decongesting” effect on the liver and help improve liver function and fat metabolism. Nutrition-oriented physicians have used lipotropic formulas for a wide variety of conditions, including liver disorders such as hepatitis, cirrhosis, and chemical-induced liver disease. The daily dosage should be 1,000 mg choline and 1,000 mg methionine or cysteine (or both).

Lipotropic formulas appear to increase levels of two important liver substances: SAM-e (S-adenosyl-methionine), the major lipotropic compound in the liver; and glutathione, one of the major detoxifying compounds in the liver.15,16 Alternatively, SAM-e can be taken at a dosage of 200 mg three times per day.

Promoting Elimination

In addition to directly supporting liver function, proper detoxification involves proper elimination. A diet that focuses on high-fiber plant foods should be sufficient to promote proper elimination. If additional support is needed, fiber formulas can be prescribed. These formulas may include natural plant fibers derived from psyllium seed, kelp, agar, pectin, and plant gums such as karaya and guar. Alternatively, they may include purified semisynthetic polysaccharides such as methylcellulose and carboxymethyl cellulose. During treatment of candidiasis, take 3 to 5 g soluble fiber at bedtime, to ensure that dead yeast cells are excreted and not absorbed.

Probiotics

Intestinal flora plays a major role in the health of the host, especially in the battle against GI tract infection.17,18 The kind of bacteria found in the intestinal tract is intimately involved in the body’s nutritional status and affects immune system function, cholesterol metabolism, carcinogenesis, and aging. Probiotic supplements can be used both to support overall good health and during treatment for chronic candidiasis.

The dosage of a commercial probiotic supplement containing lactobacillus or bifidobacteria cultures is based on the number of live organisms. A dosage of 5 billion to 10 billion viable cells per day is sufficient for most people. Amounts exceeding these may induce mild GI disturbances, while smaller amounts may not be able to colonize the GI tract.

Natural Antiyeast Agents

A number of natural agents have proven activity against C. albicans. As we have noted, however, rather than relying on these agents as a primary therapy, it is important to address the underlying factors that predispose to chronic candidiasis.

The four approaches we feel most comfortable in recommending as natural agents against C. albicans are:

• Berberine-containing plants

• Garlic

• Enteric-coated volatile oil preparations like oregano

• Propolis

Most but not all patients can achieve benefits from the natural agents described here.

Use of any effective antiyeast therapy alone, without the other supportive measures we recommend, may result in a Herxheimer reaction (die-off). When an antiyeast agent rapidly kills off the candida, the body must deal with large quantities of yeast toxins, cell particles, and antigens, and symptoms may worsen. The Herxheimer reaction can be minimized by the following measures:

• Following the dietary recommendations for a minimum of two weeks before taking an antiyeast agent

• Supporting the liver by following the recommendations made earlier

• Starting any of the previously described antiyeast medications in low doses and gradually increasing the dose over the course of one month to achieve full therapeutic value

Berberine-Containing Plants

Berberine-containing plants include goldenseal (Hydrastis canadensis), barberry (Berberis vulgaris), Oregon grape (Berberis aquifolium), and goldthread (Coptis chinensis). Berberine, an alkaloid, has been extensively studied in both experimental and clinical settings for its antibiotic activity. Berberine exhibits a broad spectrum of antibiotic activity, having shown activity against bacteria, protozoa, and fungi, including C. albicans.1925

Berberine’s antibiotic action against some of these pathogens is actually stronger than that of some commonly used pharmaceutical antibiotics. And because berberine inhibits C. albicans as well as pathogenic bacteria, it can help prevent the overgrowth of yeast that is a common side effect of antibiotic use.

Berberine has shown remarkable antidiarrheal activity in even the most severe cases, including cholera, amebiasis, giardiasis, and other causes of acute GI infection. It may also relieve the diarrhea seen in patients with chronic candidiasis.2632

The dosage of any berberine-containing plant should be based on berberine content. The recommended dosage of berberine is 25 to 50 mg three times per day. (For children, a dosage based on body weight is appropriate: a total of 5 to 10 mg/kg berberine per day.) With goldenseal, for example, standardized extracts are preferred, as there is a wide range of quality in goldenseal preparations. For goldenseal, the dosage would be:

• Dried root or as infusion (tea), 2 to 4 g three times a day

• Tincture (1:5), 6 to 12 ml (1.5 to 3 tsp) three times a day

• Fluid extract (1:1), 2 to 4 ml (0.5 to 1 tsp) three times a day

• Solid (powdered dry) extract (4:1 or 8% to 12% alkaloid content), 250 to 500 mg three times a day

Berberine and berberine-containing plants are generally nontoxic at the recommended dosages; however, berberine-containing plants are not recommended for use during pregnancy, and higher dosages may interfere with B vitamin metabolism.33

Garlic

Garlic has demonstrated significant antifungal activity. In fact, its inhibition of C. albicans in both animal and test tube studies has shown it to be more potent than nystatin, gentian violet, and six other reputed antifungal agents.3436The active component is allicin, which is also responsible for garlic’s pungent odor. Modern clinical use of garlic features the use of commercial enteric-coated preparations designed to offer the benefits of garlic without the odor (the allicin is released in the small and large intestine).

The treatment of chronic candidiasis requires a daily dose of at least 10 mg allicin or a total allicin potential of 4,000 mg. This amount is equal to approximately one clove (4 g) of fresh garlic. Going beyond this dosage, even with these odorless preparations, usually results in a detectable odor of garlic.

Enteric-Coated Volatile Oils

Volatile oils from oregano, thyme, peppermint, and rosemary are all effective antifungal agents. One study with oregano oil showed the minimum inhibitory concentration was less than 0.1 mg/ml.37 These results indicate that the anti–C. albicans activity of oregano oil is more than 100 times as potent as caprylic acid—a popular natural product to fight candida. Because volatile oils are quickly absorbed and may induce heartburn, an enteric coating is recommended to ensure delivery to the small and large intestine. An effective dosage for an enteric-coated volatile oil preparation is 0.2 to 0.4 ml twice per day between meals—the same dosage used in the treatment of irritable bowel syndrome (see the chapter “Irritable Bowel Syndrome”).

Nutritional Supplements

Tea Tree Oil

Tea tree (Melaleuca alternifolia) oil is another option, especially in the topical treatment of candida infections such as thrush or vaginal yeast infection. In one open study, 27 patients with AIDS and oral candidiasis that did not respond to fluconazole were randomly assigned to receive either an alcohol-based or an alcohol-free Melaleuca alternifolia oral solution four times per day for two to four weeks. Overall, 60% of patients demonstrated a clinical response to this oral solution (seven patients cured and eight patients clinically improved).38

Propolis

Propolis is the resinous substance collected by bees from the leaf buds and barks of trees, especially poplar and conifer trees. The bees use the propolis, along with beeswax, to construct the hive. Propolis has antimicrobial activities that help the hive block out viruses, bacteria, and other organisms.

The primary use of propolis has been in immune system enhancement and infections. Propolis has shown considerable in vitro antimicrobial activity against C. albicans, as well as an ability to enhance the effectiveness of conventional antifungal drugs.3942 Its cytotoxic activity against C. albicans, along with its immune-enhancing effects, makes propolis a strong candidate for treatment of chronic candidiasis. The typical dosage is 100 to 500 mg three times per day.

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QUICK REVIEW

• Prolonged antibiotic use is believed to be the most important factor in the development of chronic candidiasis.

• A physician knowledgeable about yeast-related illness can help in diagnosing, treating, and monitoring chronic candidiasis.

• A comprehensive approach is more effective in treating chronic candidiasis than simply trying to kill the candida with a drug or natural antiyeast agent.

• Recurrent or chronic infections, including chronic candidiasis, are characterized by a depressed immune system.

• Restoring proper immune function is one of the key goals in the treatment of chronic candidiasis.

• Enteric-coated volatile oil preparations may be effective natural anti-candida compounds.

• Propolis has shown considerable in vitro antimicrobial activity against C. albicans, as well as an ability to enhance the effectiveness of conventional antifungal drugs.

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TREATMENT SUMMARY

The following is a comprehensive step-by-step approach to the successful elimination of chronic candidiasis.

1. Identify and address predisposing factors:

  images Eliminate the use of antibiotics, steroids, immune-suppressing drugs, and birth control pills unless there is an absolute medical necessity.

  images Follow a health care professional’s specific recommendations if the identifiable predisposing factor is diet, impaired immunity, impaired liver function, or an underlying disease state.

2. Follow the C. albicans control diet:

  images Eliminate refined and simple sugars.

  images Eliminate milk and other dairy products.

  images Eliminate foods with a high content of yeast or mold, including alcoholic beverages, cheeses, dried fruits, melons, and peanuts.

  images Eliminate all known or suspected food allergies.

3. Get nutritional support by taking a high-potency multiple vitamin and mineral formula.

4. Support the immune system:

  images Develop a positive mental attitude.

  images Use positive techniques for coping with stress.

  images Avoid alcohol, sugar, smoking, and elevated cholesterol levels, which can impair immune system function.

  images Get plenty of rest, and make sure that sleep is of good quality.

  images To support thymus gland function, take 750 mg crude polypeptide fractions per day.

5. Promote detoxification and elimination:

  images Consume 3 to 5 g water-soluble fiber from sources such as guar gum, psyllium seed, or pectin at night.

  images If necessary, take lipotropic factors and silymarin to enhance liver function.

6. Take probiotics: 5 to 10 billion viable lactobacillus and bifidobacteria cells per day.

7. Use appropriate antiyeast therapy:

  images Ideally, take the recommended nutritional or herbal supplements, or both, to help control yeast overgrowth and promote healthful bacterial flora.

  images If necessary, take prescription antiyeast drugs appropriately.

These steps should take care of chronic candidiasis in most cases. If a patient follows these guidelines and fails to achieve significant improvement or complete resolution, further evaluation is necessary to determine if chronic candidiasis is in fact the issue. Repeat stool cultures and antigen levels are often helpful here. If the organism has not been eradicated, stronger prescription antibiotics can be used, along with the other general recommendations.