Herbal and NutritionalApproaches to Candidaby Jo Dunbar MSc Dip Herbal Medicine MNIMH

Candida albicans is normally aninoffensive yeast-organism which lives in^mall populations within the intestine.However, under certain conditions, it iscapable of mutating into its aggressivelungal form which invades the body•systems, causing a great deal of damage.

One of the essentials to bear in mindwhen treating Candida overgrowth is that\uu are treating an environmental imbal-;nicL' and not simply a fungal infection. Themouldy bathroom provides a good metaphorlor this concept. In a dark dank mouldybathroom, you can use all the anti-fungalsprays you Uke and the mould will die - forI time, but it always comes back! However,if you change the environment by allowingfresh air and sunshine to perfuse the room.the mould finds itself in an environmentwhich is no longer conducive to growth.Thus it is absolutely pointless simply treat-ing Candida with anti-fungal agents,because if the environment remainsconducive to Candida thriving, the popula-tion will continue to explode. More so, thoseyeast organisms which survive will becomeresistant to the anti-fungal medications.

It is absolutely imperative to establishwhy the Candida was given the opportu-nity to overgrow in the first place, and ifat ail possible, treat that imbalance aswell as killing the yeast.

Common environmental imbalanceswhich allow Candida to overgrow include:• High blood sugar levels such as in

cases of diabetes or a high sugar diet;• Changes in hormone levels as a result

of the Pill, HRT, pregnancy, pre-menstuation, puberty, menopause,

and environmental hormones as foundin non-organic dairy products:

• Changes in normal gut flora or gutdysbiosis often as a result of systemicantibiotics, or intestinal infections;

• A compromised immune system,possibly as a result of long termillness such as AIDS, Chronic FatigueSyndrome, immunosuppressive ther-apy or even long term stress.

What Happens When CandidaOuerqrows?

The Candida population found in ahealthy intestinal tract is small: it is held incheck by the intestinal flora and fauna, aswell as a healthy immune system. If thisnatural control system is disrupted, or someother homeostatic imbalance occurs withinthe body. Candida is provided with anopportunity for a population explosion. Theenvironment has become conducive towardsallowing a Candida, overgrowth: anyonewho ha.s made bread or wine will have anidea how quickly yeast can grow!

The GutWithin the gut. the yeast cells start to

change from their benign yeast-form intothe more invasive fungal-form. Thefungal-form hegins to extend its livingspace by secreting toxins, which inflameand damage the gastric mucosa. This hasa twofold effect. First, the digestiveenzyme secretion is impaired resulting inthe partial digestion of food and, secondly,the gastric mucosa is easier to penetrate.

The fungal-form of Candida developsaggressive root-like structures calledrhizoids which are able to penetrate thewall of the gut and access the bodysystems via the blood stream. As therhizoids pierce the gut wall, they create aporous leaky gut allowing the partiallydigested food particles to enter the bloodstream and set up food sensitivities. Thefungus also ferments the sugars in ourcolon, and produces large volumes of gasleading to the common symptoms ofexcess gas, bloating and abdominaldiscomfort.

The Immune SystemThe porous leaky gut allows undigested

food particles, enteric toxins and foreignpathogenic organisms to enter the bloodstream as immune-challenging antigens.The antibodies of the white blood cellscombine with the antigens to create 'anti-gen-antibody-immune-complexes' whichmay be deposited at various sites in thebody. These immune complexes may bedeposited in the lungs leading to symptomssuch as asthma, in the joints and musclesresulting in inflamed tender joints ormuscles, or even the brain leading to whatis referred to as 'brain allergies'.

The large undigested food particleswhich enter the blood stream via theleaky gut activate the white blood cells torelease antibodies against these mole-cules, thereby setting up food sensitivitiesand the plethora of symptoms associatedwith food intolerance.

30 POSITIVE HEALTH NOVEMBER 2004

Some of the antigens may so closely resemble the body's owncellular tissues that the immune system can become confusedand begin to attack 'self tissue' leading to auto-immune disease.

Catidida attacks the immune system in a double whammy bynot only imposing heavily on the humoral arm of the immunesystem, but also by releasing up to 100 thus far isolated toxins,some of which specifically act to suppress the cellular arm of theimmune system.

The Nervous SystemAlthough it is commonly known that Candida, sufferers can

experience mood swings, depression, brain fogginess, poor concen-tration, even autism, the mechanism by which Candida affectsthe nervous system is still unclear. Several theories exist; onesuch theoiy centres on the possibility of the leaked proteins fromthe gut being termed as exorphin. Like endorphins, they canaffect the neurological reactions, but are derived from outside thebody. Exorphins may be able to slot into receptors within thebrain, thereby influencing the mood of the sufferer by switchingthe neurological reactions on and off. Another theory, againrelated to the leaked protein molecules ofthe leaky gut, suggeststhat these undigested protein antigens form complexes with theantibodies and are deposited in the brain as "brain allergies'.

The Hormonal SystemCandida has within its structure a steroid-binding protein,

which allows it to bind with progesterone and other hormones inthe endocrine system. Once Candida has bound to the hormone, itis capable of participating or interfering with the hormonal signals.Hormonal conditions associated with Candida include severepremenstrual syndrome, possibly endometriosis, thyroid condi-tions and a condition first described by the endocrinologist PhyllisSaider as 'APICH Syndrome' (Auto-immune PolyendocrinopathyImmune-dysregulation Candidosis Hypersensitivity).

Some Symptoms associated with Catidida overgrowth:• Abdominal bloating and gas;• Leaky gut and food intolerances;• Thrush ofthe mouth, vagina, penis or anus;• Sugar cravings;• Athletes foot or fungal nail infections;• Dandruff;• Sinusitis or nasal catarrh;• Pain behind the breastbone;" Constant tiredness and lethargy;• Brain fogginess and poor concentration;• Frontal headaches;" Intolerance of perfumes and other smells;• Pain in the muscles or joints;• Symptoms worse in damp weather.

Protocol for Treatment:1. Anti-Candida Diet

Diet is one of the most fundamental aspects of treatingCandida. Catidida being a yeast feeds voraciously on sugars, sothe diet must completely avoid ALL sugary foods. Refined carbo-hydrates break down into sugars, of course, so these should beavoided for the first few months of treatment. There is an argu-ment regarding fruit and fructose. Some opinions are thatCandida, relies on an oxygen deprived environment, and that asfructose produces oxygen, it is possibly a safe sugar to use.Fructooligosaccharide (FOS) is a fruit sugar and is often used asa prebiotic in the treatment of Catidida. However, several of mypatients who have chosen to eat fruits too early in theprogramme have had a recurrence of their symptoms, so to err onthe side of caution. I would suggest focusing the diet on protein,vegetables and salads, with a few unrefined carbohydrates suchas rye bread, oats porridge or brown rice.

It is far beyond the scope of this article to outline a CandidaDiet, but there are some very good books on the market, and Ialways recommend to my patients that they invest in one ofthese for menu inspiration (See Further Reading).

Some people believe that one can treat Candida with dietalone; however, it has been shown that if Candida is deprived ofsugars, it will begin to feed on proteins, so it is important tofollow the entire programme as outhne below.

2. Anti-fungal MedicationsThere are many very effective natural anti-fungal agents avail-

able, and I always rotate them to deprive the yeast of the opportu-nity to develop resistance. Candida has the ahility to adhere rathertenaciously to the gut hning, so it can help to discourage this adhe-sion by using cranberry extract, which has been found to be aseffective in the gut as it is with the bacteria of the bladder wall.

GarMc, of course, is an absolutely superb anti-fungal herb andbest taken in its raw state on an empty or nearly empty stomach, oras a suppository! Some other herbs which exhibit excellent anti-fungal actions include Tabebuie impeteginosa, Commiphora inolmol,Oregano vulgare, Tliyinus vulgaris and Aloe vera barbadensis orferox - amongst others. Aloe has the double action of acting as ananti-fungal agent, as well as a potent healer of the leaky gut wall.

Other anti-fungal agents include Capryllic acid and Grapefruitseed extract. 1 have to say that I never suggest grapefruit seedextract, as I find it very corrosive on the gastric mucosa; however,it is excellent as a topical agent for athletes foot or fungal nail infec-tions, as well as for cleaning the fridge etc of fungal spores.

3. Heal Leaky GutIt is essential that the leaky gut is addressed and healed to

avoid further food sensitivities developing and to give theimmune sy.stem a chance to recover. Butryric Acid, L-Glutamine,N-Acetyl Glucosamine. and MSM are easily available supple-ments which provide the necessary nutrients to rebuild the gutwall. As mentioned above. Aloe vera or ferox is a superb healer ofthe alimentary canal as well as acting as an anti-fungal agent.Herbs such as Calenditla officinalis. Matracarin recatita andBerberis aquifoliuni stimulate the growth and repair of thegastric tissues; I find that these are best taken as an infusion onan empty stomach, so that the watery extracts can gently washover the inflamed gastric intestinal tract - healing and soothing.

4. Repopulate the GutLactobacillus acidophilus and Bifidobacteria are major players

in the body's tactics to keep Candida under control, and their popu-lations are commonly depleted in Candid-a overgrowth, thus supple-mentation is essential. Make sure that the probiotic supplement ofyour choice is of a human strain, guaranteed live, acid stable andcapable of attaching to the gut lining. Initially, it may be useful to

POSITIVE HEALTH NOVEMBER 2004

use hifjh doses such as 30 billion bacteria per day. then reducing tofour billion per day as a maintenance dose for at least three months.

The friendly bacteria feed on a substrate known as a 'prebi-otic", and an excellent prebiotic is FOS (Fructooligosaccharide). IfFOS is not included in the probiotic cap.sule. it is available in agranulated form, and has the advantage of providing somewelcome sweetness to the diet. The down side of FOS is that itcan produee gas; if this oceurs, simply reduee the intake. Otherprebiotic agents such as psyliium seeds, pectin, aloe vera juice orslippery elm are very good alternatives.

angustifolia. or Garlic (Alium sativiim). Garlic. Pau D'Arco andOlive leaf are ideal immune tonics, as they also have anti fungalproperties.

8.

5. Support the Digestive ProcessApart from the food sensitivities which may occur as a result

of the leaky gut. the inflamed and damaged intestinal mucosacan have difficulty secreting the digestive enzymes necessary forthe complete breakdown of food. Poorly digested food means thatnutrients are difficult to absorb, so patients may also find them-selves in a state of malnutrition.

The undigested food particles can form a substrate on wbichthe yeast may feed and ferment, thereby producing gas andsymptoms of heaviness and bloating.

At the beginning of the treatment programme, it can helptremendously to take the full spectrum of digestive enzymes witheach meal. After several weeks, when there is some repair to the gutwall, it is appropriate to introduce some bitter herbs such asBerberis vidgaris, Gentiana lutea or Artemesia absinthium, whichactually stimulate the body to produce and release its own digestiveenzymes. Berheris aquifolium has the double action of stimulatingdigestive enzyme release as well as the healing of the mucosa.

6. General DetoxAs discussed earlier, Candida produces up

to 100 difference toxins, which are releasedinto the blood stream and poison thebody. Not only does the liver have tocontend with these toxins, but it alsoneeds to deal with the toxins leachedinto the system via the porous leakygut. Apart from the everyday toxinswhich the liver needs to eliminatefrom the body, the additional loadplaces this organ under enormousstrain, and it would be prudent toinclude a liver detox within theCandida treatment programme. Thebitter herbs mentioned above are all herbswhich act to increase the flow of bile, thusflushing the liver and depositing the toxins inthe .stools for elimination.

Foods which facilitate a liver cleanse include ginger,lemon, peppermint, olive oil, artichokes, garlic and raw chicory -I am certain that you can devise some spectacularly deUciousliver cleansing meals and teas from that list!

Epsom salt baths, hot saunas, massage, AquaDetox' anddetoxifying herbal blends can all contribute towards relieving thebody of its toxic load.

7. Tone Immune SystemAn essential part of the helping the immune system to recover

is to accurately identify the foods to which the sufferer has becomeintolerant, and to avoid these foods for at least six months. In themeantime, focus should be given towards food rotation and heal-ing the leaky gut to prevent further intolerances from developing.

The second important area to focus on is to kill the fungus,thereby relieving its impact on the immune system. Once thesetwo actions are in place, it would be prudent to give the systemimmune tonic herbs such as Olive leaf (Olea. europa), Astraguhismembranaceus, PauD'Arco {Tabebuia impetiginosa), Echinacea

Rebalance the HormonesIt is common that Candida starts to become a problem either

during puberty, pre-menstrually. during pregnancy, when awoman starts to take HRT or the Pill. The common denominatorhere is an increased surge of female hormones. It is unclearexactly why this occurs, but it may have something to do with achange of pH within the body as a result of the influence of onehormone or another. Whilst there are herbs which can be used torebalance the hormones, this really cannot be effectivelyachieved whilst flooding the body with the hormones of HRT orthe Pill and is not an option during pregnancy.

However, one of the major functions of the liver is the break-down and elimination of excess hormones. In the case of Candidabeing a result of an hormonal imbalance, herbs and foods whichencourage the liver to flush out and eliminate excess hormones andtoxins can go some way towards rebalancing the hormone levels,

Candida is a complex disorder with a wide range of symp-toms and causes; it is therefore a complex disorder to treat. Thecomplexity of the symptomatic picture means that Candidacan easily imitate other unrelated disorders and the correctdiagnosis is, of course, essential. There are several investigativetests available which can be employed to identify whether some-one is suffering from a systemic Candida overgrowth and towhich foods they may have developed sensitivities. People suffer-

ing from Candida are strongly advised to seek professionalhelp: they may wish to use the Candida website to

r O O Q S find a suitable practitioner in their home area.

which facilitate aliver cleanse include

ginger, lemon,peppermint, olive oil,

artichokes, garlic andchicory - I am certain that

you can devise somespectacularly deliciousliver cleansing meals

and teas fromthat list!

You can find the National Candida Societywebsite on www.ca/idida-society.org.uk or

the National Institute of MedicalHerbalists on www.nimh.org.uk

nbout the RuthorJo Dunbar MSC Dip Herbal

Medicine MNIMH qualified andstarted practising as a member ofThe National Institute of MedicalHerbalists in 1999. whilst at the same

time going on to study an MSc degi-eein Complementary Therapy Sudies at

Westminster University, where shefocused her research on Chronic Fatigue

Syndrome. Jo has written the guide - How toCope Successfully with Candida. fWellhouse

Publishing, 2003.) - and is registered as a practi-tioner on the National Candida Society website, Jo's

guide is available at her herbal apothecary and clinic BotanicaMedica, certain health food stores or Lloyds Chemists. Jo useshighly accurate laboratory tests to diagnose Candida and gutbacteria levels, and then prescribes individualized herbal medicineformulas, as well as advice about diet and nutritional supplementsto complement the treatment program. Jo may be contacted onTel: 01372 470990; info@botanicamedica.co.ukwww. botanicamedica.co. uk

Further InformationNational Candida Society: www.cand/do-society.org.uk

National Institute of Medical Herbalists: www.nimti.org,uk

Further ReadingDunbar J. How to Cope Successfully with Candida The Drug-Free Way. Wellhouse. 2003.

Whi te E. Beat Candida Caokbaok. Thorsons. 1999

Hampton J. Cooking for Candida. Kingston House. 1996.

Brody K. The Candida Diet Book. Sheldon Press. 1996,

POSITIVE HEALTH NOVEMBER 2004