Complementary therapies

The Yeast Connection

We all have the yeast candida albicans inside us, but the question dividing health practitioners is:
C an it spread out of control and cause sym ptom s of disease? N o, say m ost doctors at least not in
M .E . Y es, says m edical herbalist Jo D unbar, author of How to Cope Successfully with Candida,
w ho shares her perspective on tack ling this controversial gut organism .
T h ere lies b etw een M .E . a nd ca nd id a a
d efi nite b u t s om etim es confu s ing
a s s ocia tion. M a ny of th e s y m p tom s of
ca nd id a ov erg row th a re a la rm ing ly
s im ila r to M .E ., a nd m a y inclu d e long term d eb ilita ting fa tig u e, h ea d a ch es ,
food intolera nces or a n irreg u la r b ow el
h a b it, joint a nd m u s cle p a in, a nd b ra in
fog .
O th er com m on s y m p tom s w h ich a re
m u ch m ore s p ecifi c to ca nd id a inclu d e
h orm ona l s y m p tom s s u ch a s s ev ere
P M S , m ood s w ing s (es p ecia lly
d ep res s ion), p a in b eh ind th e b rea s t
b one, intolera nce to s trong od ou rs ,
d a nd ru ff, a th letes foot, v is u a l
d is tu rb a nces , ora l or g enita l th ru s h , a n
itch y a nu s a nd a feeling of b loa ting or
fl a tu lence.

Candida overgrowth
m ay resu lt from an
im m u ne b reak down,
esp ec ially if the su fferer
relies on su gar as an
energy sou rc e
W h ile I d ont b eliev e th a t ev ery one
w ith M .E . h a s a ca nd id a p rob lem , I d o
th ink its a n is s u e for a s ig nifi ca nt
p rop ortion p a rticu la rly p eop le w h o
a ls o h a v e food intolera nces , b loa ting ,
th ru s h , or a n itch y a nu s . W h erea s th e
ca u s e of M .E . s till es ca p es u s , th e
ca u s es of ca nd id a p rob lem s a re m u ch
clea rer, w h ich h a p p ily m a k es it ea s ier to
trea t.
I b eliev e th a t in M .E . p a tients ,
ca nd id a ov erg row th m a y res u lt from a n
im m u ne b rea k d ow n, es p ecia lly if th e
s u fferer relies on s u g a r a s a n energ y
s ou rce (w h ich feed s th e y ea s t) a nd /or
coffee, w h ich s tim u la tes th e relea s e of
b lood s u g a rs .
14

InterAction 53 Au g u s t 2 0 0 5

H ow ev er, a lth ou g h ca nd id a a lone

d oes nt ca u s e M .E ., it m im ics th e
s y m p tom s s o clos ely th a t d is ting u is h ing
b etw een th e tw o ca n s om etim es b e
d iffi cu lti.

W hat c au ses c and id a?

It often s u rp ris es p eop le to fi nd ou t
th a t ca nd id a liv es in ou r g u t na tu ra lly,
a long s id e oth er m icros cop ic b ow el
fl ora , w ith ou t ca u s ing u s a ny h a rm . It
m a y ev en h a v e th e b enefi cia l effect of
h elp ing to rem ov e ex ces s h ea v y m eta l
tox ins from ou r b od ies .
H ow ev er, th ere a re certa in cond itions
w h ich a llow th e y ea s t org a nis m s to
ex p lod e v ery q u ick ly from a norm a lly
s m a ll p op u la tion g rou p into a n
enorm ou s d om ineering fu ng a l
ov erg row th . If y ou h a v e ev er s een fru it
ferm ent into w ine or b rea d ris e, y ou
g et th e p ictu re of h ow q u ick ly y ea s t
ca n g row , g iv en th e rig h t env ironm ent.
O nce th is h a p p ens , th e y ea s t ca n
a ctu a lly ch a ng e s h a p e from a s m a ll
non-inv a s iv e org a nis m into its
a g g res s iv e a nd inv a s iv e fu ng a l form
w h ich d ev elop s root-lik e s tru ctu res
ca lled m y celia ii, m ore of w h ich la ter.
In my ex perienc e, the fi v e major
c au ses of c and id a ov erg row th
inc lu d e:
1 d ep letion of th e g u ts friend ly
b a cteria , s om etim es ca u s ed b y long term a ntib iotic trea tm ent or g a s tric
infection
2 com p rom is ed im m u ne fu nction, a s in
th e ca s e of M .E ., ch em oth era p y or
H IV
3 ex ces s fem a le h orm ones , e.g . a s a
res u lt of m u ltip le p reg na ncies , H R T ,
th e P ill, d u ring a p re-m ens tru a tion
p h a s e or th e m enop a u s e
4 h ig h b lood s u g a r lev els ca u s ed b y a
h ig h s u g a r d iet, s tres s or d ia b etes
5 d ru g th era p y m a inly a ntib iotics ,
s teroid s , h orm one th era p ies or
im m u no-s u p p res s iv e d ru g s

H ow d oes it aff ec t
the b od y?
O nce th e y ea s t h a s ch a ng ed into its
a g g res s iv e fu ng a l form , it p enetra tes
th e g u t lining b y s ecreting infl a m m a tory
ch em ica ls w h ich w ea k en th e w a ll a nd
a llow th e m y celia to p ierce it, lea d ing
to a lea k y g u t. T h e lea k y g u t is lik e a
h os ep ip e w ith la rg e h oles in it.
N orm a lly th e intes tine b rea k s food
d ow n into tiny p a rticles w h ich a re th en
tra ns p orted th rou g h little g a tew a y s in
th e g u t w a ll into th e b lood s trea m .
H ow ev er th e lea k y g u t a llow s la rg er,
undigested food p a rticles to enter th e
b lood s trea m . If th e im m u ne s y s tem
d oes nt recog nis e th es e u nd ig es ted
food p a rticles a nd a s s u m es th a t th ey
a re a foreig n inv a d er, it im m ed ia tely
s ets a b ou t form ing a ntib od ies to th es e
food s , th u s crea ting s y m p tom s of food
intolera nce. B eca u s e th e im m u ne
s y s tem is s o b u s y fi g h ting th es e food
intolera nces , it b ecom es h y p er-rea ctiv e
a nd d is ru p ted . T h is a lone ca n a ccou nt
for fa tig u e, a llerg ic-ty p e s y m p tom s s u ch
a s s inu s itis or a s th m a , a nd b ra in-fog .
F u rth erm ore, ca nd id a is k now n to
s ecrete tox ins ca lled m y cotox ins , w h ich
ca n s u p p res s th e im m u ne s y s tem
fu rth er, a s w ell a s ca u s ing liv er tox icity,
h ea d a ch es a nd m u s cle p a iniii. O nce
ca nd id a h a s entered th e b lood s trea m ,
a ntib od ies from th e im m u ne s y s tem
com b ine w ith it to form a ntig ena ntib od y com p lex es , w h ich w h en
d ep os ited in th e joints , lu ng s or b ra in
res u lt in joint p a in, a s th m a , d ep res s ion
a nd h orm ona l d is ru p tioniv .
C a nd id a , b eing a y ea s t, th riv es on
d a rk , w a rm , w et a nd s u g a ry
env ironm ents . P eop le w ith a n
ov erg row th often h a v e intens e s u g a r
cra v ing s th e y ea s t d em a nd ing to b e
fed ! In th e w a rm m ois t g u t, it
ferm ents th e s u g a rs to p rod u ce
s y m p tom s s u ch a s fl a tu lence a nd
b loa ting , w h ile th e infl a m m a tory
ch em ica ls relea s ed res u lt in p oor
d ig es tion a nd a b s orp tion, h a v ing th e
k nock -on effect of fu rth er d ep leting th e

E ight steps to a healthier

body
Clearly, gut imbalances leading to
candida overgrowth are a complex
problem which requires a multi-faceted
approach to treatment, ideally under
professional supervision. To treat this
problem effectively you need to address
the following eight areas:
1 G et the correct diagnosis
There are several methods of testing for
candida overgrowth, but the most
accurate is the saliva or blood test.
These measure your immune systems
antibody response to candida, and so
are able to tell you how badly you have
it. The only problem may be if your
immune system is so exhausted that it
cannot raise antibodies to candida,
which will result in a false negative.
A stool analysis can also test for
candida, but is less reliable as
sometimes the candida is so embedded
in the gut wall that it does not come
out in the stool and again, you might
get a false negative. However, the
advantage of a stool analysis is that it is
also able to analyse your levels of
beneficial gut flora (the good
bacteria), whether you also have a
problem with parasites, if you have an
inflamed intestine and how effectively
you are able to digest and absorb your
food.

U nfortunately, in my experience the

NHS is not interested in looking for
candida overgrowth unless youre on
immuno-supressant medication, so
most people need to pay privately for
tests. [One exception is D r Michael
Jenkins at the Royal L ondon
Homeopathic Hospital Ed].
2 S tarve the candida
One of the best ways to start treating
yeast overgrowth is by going onto the
candida diet for a month before you
follow the rest of the program. In this
way you starve and weaken the yeast,
starting to kill it off gradually, and thus
lessening the die-off effects.
By raising blood sugar levels you are
feeding the yeast, so you need to starve
it by completely avoiding foods with
refined carbohydrates and sugar. In
addition, people with a candida
problem often become intolerant to
foods with yeast in (finding that they
provoke brain fog and tiredness) due to
the antibody reaction mentioned earlier.
So yeast-containing foods need to be
avoided until youre better, while your
intake of protein, extra virgin olive oil,
salads and vegetables, and complex
carbohydrates should be increased. It
can also help to avoid non-organic
foods, as these often contain high
levels of antibiotics, pesticides and
hormones.
Many people understandably feel
that the candida diet is an awful
regime, but investing in a wellillustrated candida cookbook can make
all the difference.

3 T ak e anti-fungal medications
Y our doctor may prescribe anti-fungal
drugs such as nystatin, although some
may not feel this is justified if you dont
have the more obvious symptoms of
ongoing thrush etc. Alternatively, you
can use a wide range of very effective
herbal and nutritional remedies such as
oregano, pau darco, cinnamon, or
caprylic acid. In treating candida, I
usually use two or three natural antifungals at once and frequently
alternate them to maximise
effectiveness.
4 Heal the leak y gut
Herbal teas such as calendula and
chamomile can be drunk to stimulate
the healing of the intestinal lining,
whilst nutritional supplements such as
L -glutamine and MSM provide the
necessary building blocks for the
healing process. The gut lining can take
up to three months to repair. G iven
that food intolerances will slow down
healing, a laboratory food intolerance
test is also advisable.
5 R e-populate the gut with
friendly bacteria
The two major probiotics or friendly
gut bacteria which help keep intestinal
yeast in check are lactobacillus
acidophilus and bifidobacterium. D ont
be tempted to use cheap probiotic
drinks as found on supermarket
shelves. These only contain the minor
gut bacteria and are usually in a very
sugary liquid perfect for encouraging
fungal growth. Other cheap probiotic
supplements have been shown to be
made up of dead or ineffective
bacteria. Y ou get what you pay for!

InterAction 53 August 2005 15

Complementary therapies

body as one is unable to receive

maximum benefit from nutritional
nourishment.

Complementary therapies

Candida continued...

6 B oost the immune system

In candida, as with M.E., we have one
part of the immune system which is
overactive, resulting in inflammatory
conditions such as muscle and joint
pain and food intolerances, and the
other side which is depressed, resulting
in a poor response to the yeast
challenge. Herbs such as echinacea,
astragalus or sutherlandia are superb at
boosting and rebalancing the immune
system.
7 D etox the liver
Herbs such as burdock, dandelion root,
ginger and lemon juice are very good at
encouraging the flow of bile, which
flushes toxins out of the liver to be
released in the stool. Other foods such
as celery, fennel, parsley and watercress
encourage toxins to be eliminated via
the kidneys. Hot Epsom salt baths also
encourage the elimination of toxins via
the skin, while therapeutic massage
helps to shift toxins into the lymphatic
system and the kidneys for elimination.
Drinking lots of water is absolutely
imperative to effective detoxification.
8 A id the digestive process
Digestive enz yme supplements support
the absorption and digestion of foods,
and in doing the work for the digestive
system, give it the rest it needs for
recovery. A sluggish bowel means that
any toxins released are able to seep
back into the system, thus prolonging
the die-off effect as well as contributing
to tiredness and headaches. Taking two
tablespoons of linseeds daily with some
live plain yoghurt (providing you are not
dairy intolerant) will facilitate regular
and easy evacuation of the stools.

A word about die-off

The bad news is that as the yeast dies,
it releases its toxins into the blood
stream, which can leave you feeling like
you have a bad hangover. This die-off
period can last between three days and
two weeks. However, if your liver and
bowels are working well, youll be able
to get rid of the toxins more quickly,
and with a careful treatment program,
the die-off may even be avoided. This is
one of the reasons why I recommend
seeking professional help if you want to
tackle suspected candida problems.

Where do we go from
here?
If you do suffer from both candida and
M.E., treating the candida can in my
experience help to reduce many M.E.
symptoms. By clearing the toxic load on
the body, relieving the immune system
of the candida and food intolerance
burden through anti-fungal medicines
and diet, and boosting the immune
system with herbs and probiotics, youll
have gone quite some way towards
helping the body to heal.
Realistically, getting candida under
control takes between 3 and 18
months, depending on how severe it is.
While you would need to stick to the
diet for some time, most people can
gradually re-introduce fruit and enjoy
the occasional sweet treat as they start
to feel better. After the candida is back
in check (which can be confirmed
through another test), you can set
about further tackling the M.E. by
continuing to treat the immune,
endocrine and nervous systems, and by
using adaptogenic herbs to build
stamina.

Although there is no quick fix for either

condition, people who arent sure
whether candida is a problem for them
and are low in funds might want to try
out a sugar and yeast-free diet whilst
including live yoghurt and natural antifungals in their diet (e.g. raw garlic) for
a fortnight. If theres no difference in
your symptoms, candida is unlikely to
be a factor in your illness, whilst a flareup would suggest die-off, and an
improvement in health would also be a
good sign.
From a practitioners point of view,
treating both candida and M.E. very
definitely requires the patients input in
terms of sticking to the diet and
making sure that you get the rest
needed to get better because if these
two areas are not adhered to, even the
best treatment programme will be
sabotaged.

A bout the author

Medical herbalist Jo Dunbar chose
to focus her research on M.E./CFS
when she did her MSc. in
Complementary Therapy Studies,
and has since gone on to treat
many people with the condition.
She can be contacted at Botanica
Medica (based in Claygate, Surrey);
tel. 0137 2 47 09 9 0 or visit:
www.botanicamedica.co.uk

Wed like to hear your views on the

role of candida in M.E. Contact the
Ed by writing c/o our B ristol offi ce or
e-mail interaction@ afme.org.uk

16 InterAction 53 August 2005

F urther information

Most doctors are sceptical of what I will call the candida

syndrome, as outlined by Jo Dunbar. Medical thinking is
that classic candida overgrowth is generally recognisable by
its appearance usually white deposits of the yeast on
inflamed mucous membranes (genitals, mouth and the
gullet) or, in the severely ill, yeasts in the bloodstream.
Although genital candida (thrush) can result for no
apparent reason or from the use of soap, most medically
diagnosed candida occurs in specific circumstances
immuno-suppression such as in HIV or after
transplantation, antibiotic use, diabetes, high alcohol
intake, and other conditions that affect immunity.
Medical diagnosis is based on growing the organism,
usually from swabs or uncommonly from the blood. The
use of antibody testing in medicine has declined since false
positive and negative results often occur, and it is difficult
to distinguish between immune responses from candida on
mucous membranes or in the blood. The latter is important
since mucous membrane infections may be harmless or
easily treated but bloodstream infections are lifethreatening and often require intravenous anti-fungal
drugs. Better antibody tests have now been developed but
repeated and multiple tests might be required to make a
sound diagnosisi.
Candida also remains a confusing organism for
example, many healthy people can have candida isolated
from their mouths, genitals and bowels without symptoms
of ill health, and it is not known why only some people
develop classic candida overgrowth syndrome while others
tolerate the yeasts presence perfectly well. Similarly, the
nature of the immune reaction to candida is far from clear
for example, this might be responsible for causing rather
than reducing symptoms, at least with the inflammation or
irritation caused by mucous membrane candida.
Another area of debate is the anti-candida diet. It seems
possible that such a diet could improve health for several
other reasons for example, if food allergy or intolerance is
present although a paper in the L ancet suggested that
candida might be a trigger for gluten allergyii. Refined
sugar in sufficient quantities could be causing symptoms
regardless of candida, by holding water in the bowel
and/or disrupting the delicate system of bacteria by a
process known as osmosis. Simply put, eat enough refined
sugar and anyone will get diarrhoea.
Fortunately, some research is finally being done into the
role of candida in non-classic circumstances, although the
picture is becoming more complicated still. Gut dysbiosis
the disruption of the large bowels natural bugs, including
candida, is now being linked to the fermentation of certain
foods to produce compounds with problematic effects, like
IBS symptomsiii. Other research suggests that candida
antibodies can cross-react with the bodys tissues, which
could be a cause of disease not traditionally related to
candidaiii, iv.

The N ational Candida Society can be contacted at PO

Box 151, Orpington, K ent BR5 1UJ (please send SAE) or
visit: www.candida-society.org

Dr M orris references
i

Q uindos G et al. Is there a role for antibody testing in the diagnosis of

invasive candidiasis? R ev Iberoam Micol. 2004 Mar;21(1):10-4.

ii

Nieuwenhuizen WF et al. Is Candida albicans a trigger in the onset of

coeliac disease? L ancet 2003 Jun 21;36 1(9375):2152-4.

iii Santelmann H et al. Yeast metabolic products, yeast antigens and

yeasts as possible triggers for irritable bowel syndrome.
Eur J G astroenterol H epatol. 2005 Jan;17(1):21-6 .
iv Vojdani A et al. Immunological cross reactivity between Candida
albicans and human tissue. J Clin L ab Immunol. 1996 ;48(1):1-15.

Tests
Biolab in London offers a range of tests (e.g. candida
antibodies test, 45). Test kits can be sent by post but
results must go to a qualified practitioner; visit
www.biolab.co.uk or call 020 76 36 5959.
The author uses Individual Wellbeing Diagnostic
Laboratories for candida antibody and food intolerance
testing visit www.iwld.net for details or tel. 020 8336
7750.
Medichecks lab also offers useful tests see ad on inside
back cover
P ractitioners
To find a nutritional therapist in your area, contact the
British Association for Nutritional Therapy on 0870 6 06
1284 or visit www.bant.org.uk
The National Institute of Medical Herbalists can be reached
on 01392 426 022, or visit www.NIMH.Org.UK
The Royal London Homeopathic Hospital (with GP referral)
is on 0207 391 8891 or visit www.rlhh.org.uk
Supplements
All Biocare products are discounted for AfME members;
see page 48
U seful articles
Related topics covered in previous issues of InterAction
include: parasites and M.E. (issue 39, 2002), candida
debate (issue 44, 2003; also at www.afme.org.uk); gut
problems in M.E. (issue 45, 2003), probiotics (issue 47,
2004; also at www.afme.org.uk) and food intolerance
(issues 41, 2002 and 52, 2005).
Books
More in-depth information can be found in Jo Dunbars
book: H ow T o Cope S uccessfully with Candida, (Wellhouse
Publishing, 6 .99). This is available post-free by calling
Botanica Medica (see about the author on page 16 ).
Eat to Beat F atigue by Jane Harries has many candidafriendly recipes with all proceeds to Action for M.E. see
review on page 23.
Beat Candida through Diet (Vermillion, 8.99) by Gill
Jacobs also features delicious recipes from leading cookery
writer Michelle Berriedale-Johnson.
J o Dunbars references
i

Cater, Chronic Candidiasis as possible aetiological factor in the

Chronic Fatigue Syndrome; Medical H ypotheses, 44 (0): 507-15 (1995)

ii

Gow, NAR et al. The distinct morphogenic states of Candida albicans.

T rends in Microbiology 12, 317-325 (2004)

iii. Yemma J et al. Chemical and physiological effects of Candida albicans

toxin on tissues. Cytobios. 77 (310):147-58 (1994).
iv Gutierrez et al, Circulating Candida antigens and antibodies; useful
markers of candidemia, Journal of Clinical Microbiology, 31 (9) 255052 (1993)

InterAction 53 August 2005 17

Complementary therapies

Dr K elly M orris comments: