What's the story on intestinal Candida imbalances?

Great Debates
1

Recently, a friend of mine was diagnosed by a naturopath as having high level of Candida in his body. Sort of a non-genital yeast infection, perhaps centered in the intestines, but also other parts of the body including the brain. The naturopath claimed that a whole range of symptoms (from fatigue to memory and vision problems) could be explained by this imbalance.

To his and my skeptical ears, this sounds like a bit of poppycock. Some googling confirms that Candida is widely diagnosed by naturopaths, but I can’t find much in the way of conventional medical research on this phenomenon (nor am I in a position to evaluate it even if I found it).

So, what's the story?  

1) In what parts of the body can an otherwise healthy person have an imbalance of Candida?

2) Can this imbalance be responsible for such a wide range of symptoms? (One website attributed "brain fog" to candida).

3) Is this something that is relatively new, and hence untested either way, or is there clear evidence that this is a sham/reality?
2

Candida (i.e. C. albicans) is an entirely normal part of the body’s microbial flora. It’s found in the mouth and genitourinary tract, for example. Under some conditions including but not limited to immunosuppression, it can cause symptoms (thrush, genital yeast infections etc.).

In recent years an industry has grown up around the proposition that this generally harmless yeast causes an enormous range of diseases, “syndromes” and vague symptoms of all kinds. Tons of books, products and services have been marketed with the aim of convincing people that they have some dread infestation that needs curing.

It’s basically a crock, severely lacking in scientific evidence and manipulated to the benefit of scam artists.

More here.

3

What **Jackmannii ** said.

Really, your friend needs a date with the clue stick if he allows himself to be diagnosed by a naturopath.

Steer him toward Quackwatch, as suggested above.

4

Yes, the Naturopath could well be a quack. BUT, even Consumers Report has come down on the side of increasing the amount of Probiotics (Acidolpholous & kin) in your diet.

Many legit mainstream MD are now suggesting their female patients eat some live culture yogurt after a regime of antibiotics. The link between antibiotic use and a follow-up yeast infecting is pretty well solid.

Canker sores or “thrush” in the mouth can also be caused by “yeast” infections, and Probiotics can help. Same with consipation, diarrhea and gas, at least as far as probiotics being good for your system.

The problem with the dudes in th e’alt health field"is they take a natural “cure” that in general is good for you and does help with a modestly wide range of symptoms, and then make that wide range so wide as to affect nigh everything. I suppose that being constipated every day could give you a sort of “brain fog”, but it’s highly doubtful that yeast imbalance is a direct cause of so many wide ranging symptoms.

That being said, adding some “live culture” yoghurt to your diet is an excellent idea- if you don’t like it, there are pills available.

Here’s a rather “pro” Probiotics site:
http://www.wholehealthmd.com/refshelf/substances_view/0,1525,748,00.html

Note that they limit possible health benefits to: (snipping done)
"Ease irritable bowel syndrome. Acidophilus may bring relief to many people who suffer from irritable bowel syndrome (IBS), a constellation of gastrointestinal symptoms that include abdominal bloating, cramping, and diarrhea. A recent study in the American Journal of Gastroenterology found that acidophilus showed a significant benefit in 50% of patients with the primary symptoms of IBS.

Control diarrhea. If your diarrhea is due to antibiotic use, acidophilus will help to correct the bacterial imbalances caused by the drug.

Reduce flatulence. As it restores a healthy balance of bacteria in the digestive tract, acidophilus can keep gas-producers in the large intestine from multiplying.

Combat vaginal yeast and other infections associated with Candida. A yeast that normally lives in harmony in your body, Candida albicans can begin to overgrow following antibiotic therapy. Chronic candidiasis such as this can produce digestive disturbances, fatigue, and allergies, among other symptoms. Because they promote a healthy intestinal environment, acidophilus and other probiotics can help to halt Candida overgrowth. Using antibiotics only when truly necessary will also help you avoid the problem of Candida infection.
For treating and preventing vaginal yeast infections caused by Candida, acidophilus may be particularly effective*. A 2000 study in the International Journal of Gynecology and Obstetrics attributed the increase in recurring vaginal candidiasis worldwide to growing antibiotic resistance as well as to a lack of sufficient Lactobacilli in many women. According to the study’s authors, Lactobacilli constitute “the vagina’s primary defense mechanism against Candida.”*
Relieve urinary tract infections.
Battle bad breath. "

However, apparently “. Chronic candidiasis such as this can produce digestive disturbances, fatigue, and allergies”

Here’s Harvard weighing in: (snipped)
http://www.health.harvard.edu/fhg/updates/update0905c.shtml
"Self-dosing with bacteria isn’t as outlandish as it might seem. An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. These microorganisms (or microflora) generally don’t make us sick; most are helpful. Gut-dwelling bacteria keep pathogens (harmful microorganisms) in check, aid digestion and nutrient absorption, and contribute to immune function.

The best case for probiotic therapy has been in the treatment of diarrhea. Controlled trials have shown that Lactobacillus GG can shorten the course of infectious diarrhea in infants and children (but not adults). Although studies are limited and data are inconsistent, two large reviews, taken together, suggest that probiotics reduce antibiotic-associated diarrhea by 60%, when compared with a placebo.
Probiotic therapy may also help people with Crohn’s disease and irritable bowel syndrome. Clinical trial results are mixed, but *several small studies suggest that certain probiotics may help maintain remission of ulcerative colitis and prevent relapse of Crohn’s disease and the recurrence of pouchitis (a complication of surgery to treat ulcerative colitis). *

Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. . But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.

Many women eat yogurt or insert it into the vagina to treat recurring yeast infections, a “folk” remedy for which medical science offers limited support. Oral and vaginal administration of Lactobacilli may help in the treatment of bacterial vaginosis, although there isn’t enough evidence yet to recommend it over conventional approaches. (Vaginosis must be treated because it creates a risk for pregnancy-related complications and pelvic inflammatory disease.) Probiotic treatment of urinary tract infections is under study.

Probiotics are generally considered safe — they’re already present in a normal digestive system — although there’s a theoretical risk for people with impaired immune function."

Thus, it’s not entirely a “crock”. I have italized the “studies”.

So, yes, the Naturopath has a point, but as usual, he’s very likely getting way too carried away.

5

Thanks for the replies. I’ll pass along the relevant cites.

The one that needs to be steered toward quackwatch is his baby-boomer Mom, who insisted that he see this faux doc.

I suppose the one nice thing about being diagnosed by a naturopath is that the cures are often benign. My friend was instructed to eat more yogurt, and avoid sugary food and beer. Were it me, I would have balked at the suggestion of eliminating beer from my diet, but I don’t think the prescription is harmful.

6

Claims like this from alt med sources are, I think, part of the problem. This site goes on to recommend monthlong probiotic treatment for “Candida overgrowth” without specifying what it considers to be “overgrowth” or recommending testing to be sure that people even have any problem with Candida. There are no specific references that I can see to support the claims of “digestive disturbances, fatigue, and allergies” supposedly due to Candida.

Some makers of “probiotics” have landed in trouble for making undocumented claims for their products.

Again, the major difficulty with the “Candida imbalance/Candida overgrowth/Candida allergy” hypotheses is the attempt to blame a vast range of problems and illnesses on a very common and generally innocuous organism, without adequate documentation of infection (as opposed to mere presence in the body), using general fears of infection to market an array of products that with few exceptions have not been shown to be helpful. In similar fashion, many quack practitioners have singled out “parasites” or “toxins” as villains in causing a large number of ills.

As for the naturopath Richard referred to, it’d be interesting to see what his basis is for diagnosing “a high level” of Candida and what his justification is for claiming that “sugary food” and beer cause an alarmingly high level of Candida.

7

Note that the HARVARD site said "Self-dosing with bacteria isn’t as outlandish as it might seem. An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. These microorganisms (or microflora) generally don’t make us sick; most are helpful. *Gut-dwelling bacteria keep pathogens (harmful microorganisms) in check, aid digestion and nutrient absorption, and contribute to immune function. *

*The best case for probiotic therapy has been in the treatment of diarrhea. Controlled trials have shown that Lactobacillus GG can shorten the course of infectious diarrhea in infants and children (but not adults). Although studies are limited and data are inconsistent, two large reviews, taken together, suggest that probiotics reduce antibiotic-associated diarrhea by 60%, when compared with a placebo.
Probiotic therapy may also help people with Crohn’s disease and irritable bowel syndrome. Clinical trial results are mixed, but several small studies suggest that certain probiotics may help maintain remission of ulcerative colitis and prevent relapse of Crohn’s disease and the recurrence of pouchitis (a complication of surgery to treat ulcerative colitis). * "

I don’t consider Harvard.edu to be an “alt med” source. And, certainly they support the Probiotics for “digestive disturbances” (and, it makes perfect sense for your comensal gut bacteria to be useful for “digestive disturbances” in fact, it’d be strange if they didn’t effect your digestion).

And, there’s a fairly wide range of “of problems and illnesses” listed above:
"keep pathogens (harmful microorganisms) in check,
aid digestion and nutrient absorption,
contribute to immune function,
the treatment of diarrhea
help people with Crohn’s disease and irritable bowel
treat recurring yeast infections
and “under study”=urinary tract infections "

I agree that the 'alt health" dudes have extended this fairly lengthly list to: fatigue, allergies, memory and vision problems. Although I can certainly see having serious “digestive disturbances” as leading to fatigue. :stuck_out_tongue:

8

My sister was on this kick for a while. Her quack said don’t eat bread because it is made with yeast. I thought that this was strange because 1) the yeast is killed by heat during baking, and 2) it’s a different kind of yeast, and 3) I don’t see how it gets from your stomach to your vagina in any case.

9

If you have yeast growing in your brain, you’d be dead. Very very quickly.

10

Or suffer a fate worse than death.

11

I was referring specifically to the “complementary and alternative medicine” site to which you linked, and more particularly to the claims about “Candida overgrowth”.

I think you’re reading too much into what Harvard is reporting. They’re saying things like “studies are limited”, “data are inconsistent” and “Clinical trial results are mixed”. That doesn’t sound to me like “they support the Probiotics for ‘digestive disturbances’” or Crohn’s therapy, never mind treating alleged “Candida overgrowth”. And the line “aid digestion and nutrient absorption, and contribute to immune function.” is a reference to native gut flora, not artificially introduced probiotic products.

Even cautious statements about some probiotic agents possibly having a future in medical therapy are capable of being exaggerated or misrepresented. There are probably supplement dealers’ websites out there implying that Harvard endorses their products.

12

Many- if not most- studies using humans have the same caveats.

Certainly eating some live culture yogurt for breakfast is at worst harmless for most dudes, and at best will aid with a rather wide range of problems.

I agree that some of the claims are overblown, but others have some solid data behind them. It’s hardly a “crock”.

13

Therein lies your friend’s first mistake. Go to a quack with health problems, expect snake-oil remedies. Even when they’re kind of onto something real, the utter lack of commitment to genuine research and a peer-reviewed process means that most naturopaths’ understanding of real health problems is warped at best, scarcely better than base superstition. They rely all too often on anedoctal evidence and the spurious claims of heath-food corporations.

14

What are the diagnostic criteria for “Candida overgrowth”?

15

I’m not sure what you’re referring to here, but the great majority of drugs approved as drugs by the FDA are backed by solid research. When some prove problematic or prone to significant side effects in clinical use (again as determined by research or well-documented clinical evidence) they are taken off the market, have formulas or usage revised or are superseded by better drugs. There is no solid research evidence or clinical track record for suggesting that live culture yogurt will “aid with a rather wide rane of problems”.

DrDeth, I think you’re starting to slide into territory only slightly less ridiculous than your previous insistence that herpes is transmitted by inanimate objects. :dubious:

Bottom line: generalized “Candida overgrowth” is an extremely dubious diagnosis to make in a person who is not severely immunosuppressed. If you like yogurt and the product is safe to eat, fine - but don’t expect it’ll cure your fatigue, “brain fog”, joint aches or whatever. Anyone purporting to diagnosis “Candida overgrowth” or “Candida hypersensitivity” without appropriate cultures, biopsy and/or immunologic testing is almost certainly a quack.

“Candida hypersensitivity” is on the FDA’s list of Top Ten medical frauds.