Positive Health Online

Jekyll turned Hyde?

Has our modern day lifestyle reduced our state of general health to the point where a 'communal inhabitant' is able to develop into a disease-causing factor causing a wide range of health problems?

Based on 15 years of clinical practice, journeying through the various diagnostic methods, allopathic and naturopathic treatments, and patient findings, and years of unsatisfactory and short-term results, my research has led me to an effective holistic approach that can revolutionize the treatment of Candida related disorders.

The case of Candida albicans is a perfect example for the controversial approaches of our western 'school' medicine versus the integrative approach of modern Naturopathic Medicine. Candida albicans plays but a marginal role in allopathic medicine. While there is the rare diagnosis of oral soor/thrush (in infants, AIDS patients and immune suppressed patients) or the awareness of Candida in Gynaecology (e.g. vulvitis), Dermatology or in Paediatrics (e.g. diaper rash), there is practically no acknowledgement of such a disease as intestinal candidiasis. One might say that allopathic medicine only recognizes Candida when it causes visible infections on the skin or in the body's orifices.

On the other hand there is a growing focus on Candida in Naturopathic medicine. In over 80% of the almost 4,000 patients that I treated over the last 15 years, intestinal candidiasis was documented. Most of these patients were not aware of having Candida infection, but were seeking help for conditions such as allergies, painful muscles and joints (e.g. fibromyalgia), chronic fatigue, chronic ear-nose and throat infections, chronic sinusitis, gastritis, bloating, inability to lose weight, high cholesterol, hormonal problems, auto-immune diseases, skin problems, chronic diarrhoea or constipation, among others. How can all of these conditions be linked to Candida overgrowth or infection?

Candida mycelli ©2002 Dennis
Kunkel, Microscopy Inc.

Candida visualized using dark
field microscopy

Candida attached to villi on gut wall

Pathogenic Agent or Opportunistic Parasite of our Times?

The fungus Candida albicans is a two-faced creature. Unlike its more benign cousin Candida cerveciae, the yeast used to brew beer and bake bread, Candida albicans is a dimorphic organism, appearing in two different forms. The bud-like form found in small amounts in the mouth, digestive tract, genitals and on the skin of healthy individuals is considered a 'communal' inhabitant, not suspected of causing any health problems. But given the proper environment, Candida albicans has the ability to change from the bud form into a mycelial form with filaments able to infiltrate the intestinal mucosa and feed on the putrefied crustifications on the inflamed intestinal walls and pouches. These mycelial Candida cells flourish, feed and excrete substances that are highly toxic for the immune system. This can lead to a vicious circle of further inflammation, pH change, heightened immune response as well as systemic disturbances.

Dark field microscopy is a great tool to actually see this happening. Native fresh blood is looked at without the use of staining, using light coming through a slit from the side. The plasma between the red and white blood cells shows an enormous activity of little particles known as 'symbionts' moving around actively. As we grow more and more acidic, these particles are reduced in size and motility and other pathological structures become apparent. Prof Enderlein who developed the scientific background of dark field microscopy in the 1930s, called these pathogenic structures the precursors of bacterial and fungal infections.

Which Disorders Could be Caused by an Underlying Candida Infection?

Generally recognized diseases and disturbances that are triggered by the vicious circle of toxic waste, hyperacidity, overgrowth of pathological organisms and their toxic waste products are: CFS (Chronic Fatigue Syndrome), IBS (Irritable Bowel Syndrome), meteorism (gas and bloating), chronic diarrhoea and constipation, food allergies, mould allergies, dermatitis, vaginal yeast infections, persistent irritations of the skin (including: anal itching, 'jock itch' and athlete's foot), prostate problems, urinary dysfunction, cystitis, 'brain fog', depressive mood, among the most common.

How Can You Find Out if You Have a Candida-Related Problem?

To diagnose candidiasis is quite difficult. Serum Candida IgG, IgM, and IgA antibody levels do not represent the extent of the infection, because of the body's limited immune response to Candida due to its position in the gastrointestinal tract. Positive as well as negative responses are difficult to interpret. Negative responses on cultures are inconclusive. Positive stool results are dependent on shedding of Candida from the intestinal walls. Culture negative results can also be the result of the yeast dying before it can be cultured or improper selection of growth medium. It is also suggested by Leo Galland, MD that in advanced cases, the sigmoid colon produces chemicals preventing yeast from growing on normal culture medium. He, therefore, recommends direct microscopic observation using special staining. This has also been my experience. I had to look around to find a laboratory in Germany that was able and willing to look microscopically for the 'shells' of the Candida cells that didn't survive the sampling or transport.

Please be aware that in routine stool exams yeast is not looked for or reported unless specifically requested!

Biological Terrain Assessment (BTA)

Why Do We Get Candida?

The widely acknowledged predisposing factors enabling a Candida infection are:
• Severe immunodeficiency: i.e. HIV, Cancer therapy, immune suppression in transplant therapy;
• Prior antibiotic treatments or chronic antibiotic therapy: i.e. acne treatment;
• Steroid treatment: i.e. rheumatoid arthritis, allergy treatment;
• Hormone treatments: contraceptives, HRT in post-menopausal women;
• Hypothyroid.

In Naturopathic Medicine, there are additional predisposing factors such as:
• Altered pH: hyperacidity in body fluids and tissue due to lifestyle factors and improper digestion;
• Chronic intestinal dysbiosis: pH change and undigested food cause a shift in the intestinal flora from an immune promoting 'healthy' flora to an excessive growth of putrid gas and toxic waste producing bacteria colonies;
• Environmental toxins: heavy metals, with mercury playing a central role;
• Low enzyme levels;
• Zinc deficiency;
• Dietary factors: excessive simple carbohydrate intake, alcohol, low bulk diet, devitalized 'fast' foods;
• Sedentary lifestyle and stress.

I found the Biological Terrain Assessment (BTA) – Analysis to be a very helpful diagnostic tool in both assessing the individual predisposition for Candida as well as monitoring the progress in treatment. This method is based on the research of Prof Vincent, a French hydrologist, who found that the quality of a liquid could be measured by its pH, reduction-oxidation potential and resistance. He applied these findings to testing the health of humans by measuring the body fluids, saliva, urine and blood. These three parameters are charted on a diagram whereby their relationship to each other and their position on the diagram can be interpreted. The diagram is divided into four quadrants, the upper right field ('Zone 3') being known as the 'fungus quadrant'.

So as you can see, Candida itself is not the culprit, but rather the environment that fulfils its needs and allows it to flourish. Among my patients, I found that those with high Candida levels in their stool also tested hyperacidic (causing an elevated blood pH) and had high redox values in their BTA-Analysis, placing them in the 'fungus quadrant'. This is the reason why any therapy that is solely aimed at eliminating Candida as the 'culprit' can never have long lasting effects. Believe me, I tried!

How to Get Rid of It?

After initially treating the diagnosed candidiasis with assorted anti-fungals like nystatin, systemic anti-fungal medications (diflucan), grapefruit seed extract, colloidal silver, volatile oils, etc., etc. – and seeing 99% relapses – I was forced to develop a more holistic approach. It was obvious that Candida, like their big brothers the edible fungi in our forests, need certain conditions in order to thrive. They need unused, 'dead' material to feed upon and metabolize (that is their role in nature) and a certain pH and microclimate to flourish.

Candida albicans' favourite fuel is sugars in all forms and carbohydrates. Interestingly enough, the highest concentration of intestinal Candida is found in the 'lower' parts of the small intestine. At this point, the sugars and carbohydrates of our meals should have long been utilized and re-absorbed with the help of the necessary friendly bacteria like lactobacillus and bifidus. So, one way of reducing Candida would be to make sure that there are no more carbohydrates available at this point in the GI tract. Herein lies the importance of following a diet low in simple sugars and also why a multitude of microbial preparations (containing lactobacillus and bifidus) are used in Candida treatment.

The bad news is that even with a combination of an anti-fungal medication, carbohydrate reduced diet and probiotic bacteria, the results in 'fighting' Candida were still poor. It seemed that the probiotic bifidus and lacto bacteria couldn't thrive in the altered intestinal climate. They couldn't find a foothold and ended up in the toilet bowl.

The Key is the Elimination of Toxins

Since the underlying hyperacidity of the body hadn't been addressed or balanced by my first treatment approaches, it continued to cause a multitude of symptoms and a perfect climate for new Candida overgrowth. (Since Candida is found absolutely anywhere you can't run from it.)

It is well-known in Naturopathic Medicine that most toxins, i.e. metabolic waste, excretion of pathogenic bacteria, fungi and parasites, environmental toxins like heavy metals, formaldehyde, PCP and so forth produce acidic deposits in the tissues. That is why the elimination of toxins needs to be addressed in order to balance acidity. After a long search, there were two factors that finally resulted in a high rate of long-lasting success in Candida treatment. One was the introduction of colon hydrotherapy, but more importantly the introduction of 'Regulat' (an enzyme preparation) into the treatment plan.

While these enzymes break down toxic deposits, the colon irrigation helps to flush them out of the body and mechanically loosen putrefied deposits. This prevents re-absorption of toxins into the blood stream and a further burden on the liver to detoxify. This concept proved far more effective in fighting hyperacidity than the administration of sodium bicarbonate and other alkaline salts, which will only cosmetically correct the pH, therefore, resulting in but a short-term effect.

Why Do We Need Enzymes in Candida Treatment?

Humans are made up of 70 billion cells. Our body performs 200 million chemical processes daily. Every single process is controlled and regulated by an enzyme produced by the body specifically for that process. All of these enzymes are ideally made available by a diet rich in organic foods, broken down by the right bacteria and in a 'perfect' digestive tract. (This is seldom the case.)

The basis for good health is the regulated interaction of all the processes performed by enzymes in the body. It follows that disease is the disruption of this harmonious interaction. According to my experience, 80% of all people suffer from low enzyme levels.

What are the Reasons for Low Enzyme Levels in our Food?

Depleted soil, early harvests, synthetic fertilizers and pesticides, long storage periods and additional processing through radiation, heating, sterilization and conservation in today's food industry are responsible for a huge loss of essential enzymes and other bio-active substances. Fast food meals, for example, have a nutritional value dangerously close to zero and serve virtually no other purpose than to make people fat and satisfy the cravings. (It's quite remarkable that in order to satisfy the first three inches of our GI tract, namely the tongue with its taste buds, the following 12 feet of intestine has to suffer for it!)

On the other hand there is an increased requirement for enzymes due to lack of exercise, stress and excess weight. The lack of bio-available enzymes is the most important cause for the accumulation of acid forming waste and toxic deposits.

Here is my Recommended Treatment Approach

The combination of colonic irrigation, mild anti-fungal substances like grape fruit seed extract, Regulat and a low carbohydrate diet, according to my experience, will not only eliminate Candida in over 90% of cases but also de-acidify the body in record time (average three months). Using this treatment concept, most of my patients were symptom-free and full of energy after two or three months and I can highly recommend this approach.

Sample Cases:

Fibromyalgia

A 54 year-old male patient with severe pain in the right shoulder. The pain had been increasing episodically for weeks. The patient was unable to actively lift the right arm and could no longer work. The muscles and soft tissue of the shoulder were extremely sensitive to pressure.

Diagnosis:
An X-ray showed no calcification, cartilage damage or other pathological soft-tissue changes in the shoulder joint. Serum cholesterol and triglyceride levels were high. Uric acid was in the upper norm range. Stool test highly positive to Candida albicans. The patient worked as a lorry driver and was overweight (BMI 42). High alcohol and sugar intake. Extreme hyperacidity in BTA-Test but surprisingly good redox values. Chronic diarrhoea.
Treatment:
It was difficult to motivate the patient to a radical nutritional change. He was willing to reduce his sweets intake and he switched from beer to a mixture of white wine with water. He was not willing to do hydro colon therapy or enemas. In 'Prognos' he tested well for psyllium and bentonite, which he was willing to try. He took Regulat 10ml twice daily and was told to spray the entire shoulder area with undiluted Regulat every morning and evening.
Result:
The pain had already improved by the third day and the patient went back to work. After six weeks, the patient felt only a slight dragging pain upon extreme movement and had lost eight kilos. He discontinued the psyllium and bentonite after three weeks and had still some Candida in his now well-formed stool. Cholesterol and triglycerides were lower and his BTA showed less acidity. He said that he hadn't felt that good for the last 20 years.

Neurodermatitis

Patient report:
A 51 years-old female patient suffering from a severe case of neurodermatitis over the last 12 years. As a child she had allergic reactions to certain fruits and nuts. During puberty she developed hay fever and later asthma. She had noticed that the neurodermatitis appeared just after her asthma was 'successfully' treated. Over the last two years she had tried every available therapy without lasting results. She noticed that stress and coffee consumption made the symptoms worse. She complained mainly of itching attacks that seemed almost unbearable and disturbed her sleep. Her mother had suffered from asthma and both sisters from neurodermatitis.
Diagnostic results:
The bends of both elbows and knees and several patches on the neck and torso were affected. The skin appeared red and swollen with some areas severely scratched open and incrusted. BTA- Analysis showed the typical hyperacidity and high redox readings. Urine and saliva showed high levels of heavy metals, especially mercury. Stool analysis showed a severe dysbiosis and Candida overgrowth. A test for leaky gut syndrome was positive. There was bloating and chronic constipation.
Treatment:
Low carbohydrate diet especially avoiding all sugar, no coffee, minimum water intake increased to two litres a day, a 'Prognos' test showed caprylic acid (a fatty acid with anti-fungal properties) to be the best anti-fungal. Two colonic irrigations weekly followed by an enema with 10ml Regulat (for four weeks). The skin was treated with a silicate powder. The cortisone cream was only allowed once a day (evening). The patient took 10ml of Regulat every morning and evening.
Result:
After two weeks the itching had almost disappeared and the skin surface was intact. The skin was paler and less swollen. The patient was no longer dependent upon cortisone cream.

After four weeks her belly was flat, no more bloating, her stool had almost no smell. The skin was almost completely healed. A BTA-test showed less acidity and better redox values. The colon irrigations were reduced to one treatment every two weeks. Caprylic acid was discontinued. Regulat was continued twice a day 10ml.

After eight weeks and since then no more visible skin reactions. Occasionally, especially under stress situations or coffee, she felt some itching in the bend of the elbows and knows what to do. Regulat was reduced to twice a day 5ml in the morning and before bed (this dose was continued permanently).

Glossary

BTA: Biological Terrain Assessment involves the study of the state of the cells in the human body and the interstitial fluid that nourishes those cells. With the BTA-test, we can open doors to a better understanding of the body at the functional level, often before the symptoms of a disease appear. The testing of blood, urine, saliva pH, redox and resistivity, help us to evaluate certain vital parameters of a patient's cellular function.
pH: This is a measurement of the alkalinity or acidity of the body's fluids. Nutritious foods, proper functioning digestion and absorption and enzyme activity are all dependent upon very specific pH levels.
Regulat: an elixir made from a selection of organically grown nuts, fruits and vegetables using a patented process (cascade fermentation). The product is rich in energetically 'charged', bio-available enzymes and nutrients.
Redox: This measurement provides data regarding the level of electrons in the fluids. Specific levels of electrons are necessary in order for the body to produce energy. All free radical scavengers work by reducing the redox potential and thereby increasing the number of 'free' electrons.
Resistivity: Measures the mineral content in the body fluids. Sufficient levels of minerals are necessary for the body to carry out its many functions. Levels that are too high or too low can contribute to demineralization, stagnation or congestion, all of which interfere with the cells' abilities to function optimally.
Psyllium: a soluble plant fibre that gets broken down in the large intestine, feeding 'healthy' flora, as well as bulking up the stool.
Bentonite: a medicinal clay, usually in liquid form that absorbs toxins in the large intestine and passes them with the stool.
Prognos: a by-product of the Russian space research programme. Used by cosmonauts to monitor their 'energetic balance' and treat weaknesses before they caused health problems, enabling them to spend record times in outer space. The meridian end and beginning points are measured for their resistance to an electrical current.

References

1. Winderlin C (with Sehnert K). Candida-Related Complex, What Your Doctor Might Be Missing. Taylor Publishing Co. ISBN 087833-935-3, 1996.
2. Truss CO. The Missing Diagnosis. The Missing Diagnosis Inc. 1983.
3. Crook WD MD. The Yeast Connection. Random House Inc. 1983.
4. Cater RE II Somatization disorder and the chronic candidiasis syndrome: a possible overlap. Medical Hypothesis. (35): 126-135. 1991.
5. Kennedy MJ et al. Mechanisms of association of Candida Albicans with intestinal mucosa. Med Microbiol. 24: 333-341. 1987.
6. Vargas SL et al. Modulating effect of dietary carbohydrate supplementation on Candida Albicans colonization and invasion in a neutropenic mouse model. Infection and Immunity. 61(2): 619-626. Feb 1993.

Further Information and Bibliography

Chronic candida/CRC related links
The Candida Forum, a high-traffic bulletin board for chronic candida.
Yeast-L, Information on a listserv group for people with CRC.
National Candida Society, a voluntary organization set up by Dr Christine Tomlinson, an ex-sufferer, in the UK in 1997.
Candida articles, from the American College for Advancement in Medicine website. There is scientific support for some features of the CRC hypotheses. Antibiotics are known to promote GI candida overgrowth, and even penetration of the GI mucosa.5 Elimination of sugar from the diet of mice can improve the outcome of a Candida infection.6 The mechanism for symptoms such as fatigue and 'brain fog' in CRC patients is more of a mystery. However, the same symptoms are common to SBBO.

Review Articles

Candida Yeast Protection Programme, March 1999 Newsletter from Vitamin Research Products.
The Effect of Intestinal Microbes on Systemic Immunity, an excerpt from Power Healing (by Leo Galland, MD) which contains a review of research supporting the diagnosis of CRC.
Yeast Syndrome, an overview from the Doctor's Medical Library, a network of websites on natural medicine.
Yeast Syndrome, an online review article on chronic candida/CRC, by Elson Hass.
Intestinal Permeability, an online article on intestinal permeability by Simon Martin.

Position Statements

Candidiasis Hypersensitivity Syndrome, position statement by the American Academy of Allergy, Asthma and Immunology.
Canadian Medical Association Journal. 139: 728-729. 1988 an online article opposing the diagnosis of CRC.