Not Well? Could it be Candida?

By Ron Hunninghake, M.D.

To understand how candida could contribute to “unwellness,” a review of the gastrointestinal system is needed.

There are two ways to understand the gastrointestinal system. The GI system can be viewed as a long hollow tube called the gut. The gut begins with the mouth, for chewing, continues with the esophagus, for swallowing, goes into the stomach, for digestion, empties into the small intestine, for assimilation, and ends in the colon, for elimination. The gut, viewed this way, is simply an organ of digestion.

Candida overgrowth is extremely pervasive in our culture.

Another view of the gut is equally important, though not as readily appreciated. The gut is the home of over 300 trillion micro-organisms, representing 300 plus species. Living in symbiotic harmony, this “friendly flora” performs many functions essential to health and well-being. The production of natural antibiotics, the synthesis of B vitamins, and the toning and strengthening of our native immunity are but three of numerous important functions of this hidden part of our GI system.

One of the micro-organisms that makes its home in the gut is Candida albicans. This fungal organism, when its growth is properly controlled by the white blood cells that constantly patrol the gut lining, is benign and non-pathogenic. By analogy, Candida is like crabgrass. When the lawn (Le. gut flora) is green and healthy, there is no place for the pesky crabgrass to grow. But if the lawn is dug up, or improperly sprayed, the crabgrass will seize the opportunity to invade into the “unhealthy” part of the lawn. This may make your lawn more prone to other undesirable weeds.

Like crabgrass, Candida is an opportunistic organism. When the underlying health of the gut is challenged, the self-regulatory mechanisms that normally maintain ecologic balance are weakened. Candida proliferates beyond its normal role in the gut flora. Large numbers of Candida growing in the gut result in the excessive release of metabolic by-products called canditoxins.

Many doctors working with patients who have Candida overgrowth believe that the many associated symptoms, involving almost every organ system in the body, are due to reactions to canditoxin (not the direct effect of a localized infection of Candida, as the conventional viewpoint correctly points out is unlikely).

What factors cause candida to proliferate out of control? There are basically four:
1. High cortisol levels (due to stress, prescription steroids, prolonged illness, and malnutrition),
2. High estrogen levels (female, pregnancy, birth control pills, estrogen replacement therapy, and obesity),
3. High sugar levels (refined sugar, excessive juices, and diabetes),
4. Antibiotics (recurrent treatment of chronic infections, including acne, sinusitis, and urinary tract infections).

These four underlying, predisposing factors are extremely common in Western civilization. When they occur in concert together, the gut flora’s inherent balance becomes disrupted, and the stage is set for the otherwise benign Candida organism to begin proliferation.

Candida is a dimorphic organism; this means it can exist in two forms. The yeast form is proliferative, but not invasive. The mycelioid form is quite invasive, and is characterized by the growth of “roots” that actually infiltrate the intestinal wall, causing inflammation and the resultant leakage of undigested, large peptides across the gut lining. This results in multiple adverse food reactions, another common finding in the Candida picture. The mycelioid form of Candida is normally controlled by the nutrient biotin, a B vitamin that is synthesized by a healthy gut flora. When the four predisposing yeast overgrowth factors are present, the flora health diminishes, and the production of biotin is cut short. Non-invasive Candida proliferates. The lack of biotin leaves the gate wide open for the mycelioid form to “dig deep.” As many a chronic Candida patient will tell you … this condition, once established, is tough to heal.

The manifestations of chronic Candida overgrowth are global. The almost universal symptom is fatigue. Canditoxin can affect every organ system in the body. Cumulatively, the end result is fatigue. Each individual affected has their own “weakest links.” This means that this condition will show up differently in different individuals, depending upon which organ systems are the most vulnerable to attack. For example, an individual with a weak central nervous system might manifest Candida overgrowth as poor memory, drowsiness, and depression. Weak joints would show up as arthritis-like pain. Irritable bowel symptoms (gas, bloating, diarrhea alternating with constipation) could be Candida related. A long list of organ-specific symptoms have been linked to this fundamental gut imbalance. Therefore, symptoms alone cannot be diagnostic. The entire clinical picture, a thorough evaluation, and specific laboratory testing are necessary to make a correct diagnosis. Working with a health practitioner who understands Candida overgrowth is immensely helpful.

Treatment of this ecologic disruption of the delicate symbiotic balance of the gut flora needs to be holistic to be effective. Treatment with antifungal medications alone may tone down symptoms, but will not cut at the root of this “lifestyle illness.” Control of refined sugars and excessive juices in the diet is a good starting point. (Some practitioners prefer the more stringent elimination of all sugars, fruits, and yeast containing foods for a period of time.) Botanicals such as grapefruit seed extractor low risk pharmaceuticals such as nystatin of lamisil can be used to actually kill Candida in the gut and systemically (if it has colonized in remote cavities such as the gall bladder or the sinuses.) Nutrient testing to correct deficiencies will boost overall immunity. Biotin, as a supplement, will discourage transformation to the invasive mycelioid form of Candida. And finally, a whole host of “probiotics” to restore ecologic balance of the gut flora are available, the most important of which is high quality Lactobacillus acidophilus.

Candida overgrowth is extremely pervasive in our culture. It can masquerade as almost any chronic illness. Indeed, it probably accompanies most chronic illnesses. (Chronic parasitic illnesses such as Giardiasis is commonly associated with Candida overgrowth.) The diagnosis of Candida overgrowth is seldom made in conventional medicine, except in the case of vaginal Candida or oral Candida (thrush). This is unfortunate, but a reality to be dealt with nevertheless. Those patients who believe they are afflicted with Candida as an overgrowth syndrome need a comprehensive, compassionate approach to this very complex illness. Candida overgrowth can be controlled, but not by so called “magic bullets.” As with most chronic illnesses, it is not the agent of illness that needs the focus, but the host in which it has found a place to proliferate.