Katherine Poehlmann PhD offers a comprehensive guide to yeast infections and how they may complicate and exacerbate rheumatic diseases. In this article, she discusses the prevalence and pathogenic types of yeast infections, the multi-systemic symptoms that may occur with infection, dietary and supplemental supports for immune health and to help avert infection, diagnosis and misdiagnosis, and types of treatments to successfully control these infections.
The mention of “yeast infection” usually leads to an assumption that it is a condition afflicting women “down there.” The truth is, Candida plays no favorites in terms of gender, age, or ethnicity. Statistics show that approximately 80 million Americans suffer from yeast-related problems. Of those, about seventy percent are women. According to the CDC, Candida is the fourth most common cause of healthcare-associated bloodstream infections in the United States.
There are over 20 species of Candida yeasts that can cause infection in humans, the two most common being C. albicans and C. glabrata. Although these pathogens are phylogenetically, genetically, and phenotypically very different, their goals are the same: attach to and invade into the host, obtain nutrients and, evade the host immune response.
Candida is a fungal infection that can often be a major co-factor contributing to many of the symptoms of rheumatic illnesses such as Rheumatoid Arthritis (RA), Fibromyalgia (FMS), and thyroid disorders, including:
- fatigue and low energy
- emotional distress (e.g., anxiety, apathy, irritability, depression)
- mental health (confusion, trouble concentrating, “brain fog”)
- headaches (including migraines)
- impaired metabolism (including hypoglycemia)
- weight gain
- digestive problems (bloating, gas, nausea, constipation and diarrhea in alternation/irritable bowel syndrome)
- food allergies related to “leaky gut syndrome”
- depressed immune system
- respiratory dysfunction (COPD, asthma, cough)
- thrush (whiteness in mouth tissues)
- esophageal lesions (heartburn)
- urogenital inflammation (cystitis, vaginal discharges)
- skin rashes (including psoriasis, hives, eczema, acne, diaper rash)
- persistent fungal infections (e.g., jock itch, athletes foot)
- joint inflammation and pain
- numbness and neuropathy in the extremities
Normally harmless, the Candida organism grows in the gut, kept under control by the inhibitory actions of beneficial bacteria and a robust, healthy immune system. One striking symptom of yeast overgrowth (infection) is called “food coma” or postprandial (after eating) intoxication. Proliferation of yeast-generated metabolites can rapidly induce mental confusion, stupor, and sleep lasting several hours after ingesting a meal containing sugar in any form, which the yeast converts to alcohols and other toxins. Aspartame has been found to raise blood glucose levels, just like sugar, so it should not be part of an anti-Candida diet.
Yeast infections can be partly controlled by minimizing estrogen (found in birth control pills and menopause relief drugs), and by severely limiting carbohydrates in the diet. The Atkins and South Beach diets are examples of low-carb, ketogenic approaches to eating. The Kaufman anti-fungal diet is also effective.
Doctors who prescribe antibiotics do not always advise patients to restore beneficial gut bacteria with a combination of probiotics in the form of supplements such as Lactobacillus acidophilus, Lactobacillus bifidus, and Bifidobacteria bifidus, or dietary additions such as yogurt, buttermilk, sauerkraut, and fermented foods, plus prebiotics (e.g., onions, garlic, asparagus, and omega-3 fatty acids in good fats and oils). Probiotics should be consumed several hours apart from antibiotics so that their intended benefits (kill the bad, restore the good bacteria) do not cancel each other.
The Candida microbe can invade cells and live inside them, making it difficult for antifungal drugs to access and fully eliminate a yeast colony. A permanent diet change is essential for candidiasis control. Dietary guidelines to suppress Candida overgrowth include daily intake of prebiotics and probiotics, which work together synergistically to be effective.
In another of its forms, C. albicans extends a microscopic tube that infiltrates the intestine lining and causes it to leak tiny particles of undigested food into the blood. This causes the so-called “leaky gut syndrome” leading to the generation of blood-borne immune complexes (IgG, IgE) specific to certain foods that cause an allergic reaction. These immune complexes increase the inflammation of other resident infections, aggravating RA, FMS, and other so-called autoimmune disorders. Diabetes and its hyperglycemia amplify systemic yeast infection persistence and symptoms, thus diminishing the immune system’s ability to fight other infections.
Musculoskeletal system weakness is common in candidiasis, manifesting as poor coordination, slow reaction time, a tendency to fall, tension headaches, and pain and stiffness in the joints. The medical establishment may overlook or fail to treat systemic Candida as a serious pathogenic problem, leading to misdiagnosis. Arthritis is routinely diagnosed in patients with candidiasis. Dr. Dennis Remington (Ref 1) asserts that when an anti-Candida regimen is adopted, the result is often a remarkable improvement in terms of decreased rheumatic symptoms.
Laboratory testing is the only way to confirm the diagnosis of candidiasis, but there are preliminary symptom tests that one can perform at home. The best lab test, determined to be 90% accurate for candidiasis, is CECA (CandiSphere Enzyme Immuno Assay Test).
Treatments for yeast sensitivity are directed at greatly reducing the size and extent of the colony. They start with intestinal cleanout as for a fiberoptic sigmoidoscope exam, followed by systemic long term antifungal medication (e.g., oral and/or topical nystatin and perhaps griseofulvin). Sometimes a Jarisch-Herxheimer reaction is induced, so ideally a clinician skilled in the treatment of yeast infections should be controlling the treatment.
According to Dr. Orin Truss, sensitivity to mold, dust pollens, and other allergens in one’s home or work environment affects metabolism in those with candidiasis. In addition to diet management and medications, minimizing exposure to these allergens at home and in the office aids greatly in controlling yeast infection symptoms and is an essential part of the treatment.
A wealth of information on yeast and fungal infections is available on the Internet, such as a comprehensive overview from Nutrition Review. More can be found in published papers and books. Another convenient way to learn more about assessment and treatment options is through online support groups such as the one offered on the Whole Approach website.
(1) Remington, Dennis W., M.D. and Higa, Barbara W., R.D. Back to Health: A Comprehensive Medical and Nutritional Yeast Control Program, Vitality House International, Provo, Utah, 1986.