Posted by Jim on October 03, 1998 at 01:37:17:
Candida can cause Headaches
This article submitted by Jim on 8/26/98.
Email Address: Biker110@aol.com
The Chronic Candidiasis Syndrome
Intestinal Candida
and its relation to chronic illness
------------------------------------------------------------------------
The information herein is copyright (c) by The OAM 1996-1997, all rights reserved. This document is intended for physician education and medical research. If you are a patient who suspects you may have candidiasis, please follow the link below to obtain a PHYSICIAN REFERRAL or consult your primary care physician.
Please respect the author: if you are doing research and you find this information helpful, please include a reference - thank you. The information here represents the latest research and is solely available from this document.
This document is still being developed and is updated periodically.
------------------------------------------------------------------------
Index to this Document
•Introduction •Symptoms •Diagnosis •Treatment •Question & Answer •How to get more information and a physician referral list •Candida links •After you are cured.... •An important note to those who have been cured •References •Back to my Homepage
------------------------------------------------------------------------
Introduction
The "Chronic Candida Syndrome" also known as the "Candida Related Complex" (CRC) is the result of intestinal Candida proliferation. It has recently sparked much attention as being a cause or a factor in various health problems. Candida is a fungus of the yeast category. Although pathogenic strains of Candida share simialar characteristics with food yeasts, food yeasts do not carry the same pathogenicity and ability to strongly adhere to and colonize mucous membranes (Saltarelli). Previously, the syndrome was incorrectly dubbed the "Candidiasis Hypersensitivity Syndrome." Candidiasis, an infection with yeast, has been most noted in AIDS or cancer patients under chemotherapy in which the body's ability to defend itself from pathogens is weakened. It has been seen to be extremely pathogenic in these immunocompromised individuals, and primarily originates from the gastrointestinal complement of Candida. Infants, diabetics and individuals with various immunological dysfunctions have also been seen to be more succeptible to candidiasis.
The Chronic Candida syndrome is a series of vague, sometimes seemingly unrelated symptoms. The patient may even be referred to a psychiatrist for their "neurotic condition" and the failure of "modern science" to find a physiological diagnosis. Routine blood tests usually don't reveal anything unusual.
Because of the drastic visual symptoms in patients with systemic Candidiasis, the thought of Candidia as a pathogen that can afflict immunocompetent individuals has been somewhat ignored. Candidiasis, and especially intestinal Candida proliferation, has recently come to light as a pathogen that can strike immunocompetent individuals (those who have "normal" immune systems). It has been subject to much debate, lack of understanding and has brought about new thinking and research. The entire etiology of the disorder is not fully understood as of yet, however thousanads of patients with chronic illnesses have been helped or cured with antifungal and diet therapy (Cater-1, Cater-2,Crook-1,Crook-2,Truss-1,Resseger,Jenzer,Trowbridge, etc.). Despite all the research and findings, most of the medical community is ignorant of Candida as a pathogen that can affect immunocompetent individuals, and medical students are still misinformed about the real consequences of intestinal Candida in both the immunocompetent and immunocompromised.
There are many factors that may contribute to Candida proliferation in the intestines. The primary contributing factor is the use of oral antibiotics (esp. tetracycline). It is common knowledge that antibiotics, especially over a period of time or with repeated uses, will eliminate much of the normal microbiota of the gastrointestinal tract. However, there are consequences of the elimination of these important bacteria that compete with other organisms for mucosal epithelial cellular receptor sites. It is recognized by the medical community as a whole that as a result of the elimination of the normal flora defense mechanism, yeasts are allowed to grow excessively in the gut. They may also extend and proliferate in the skin with antibiotic use (Ross). In obviously immunosuppressed patients, antibiotic use often has extreme or even fatal consequences from Candida proliferation due to elimination of the normal flora.
Antibiotics, which are powerless against yeasts, but destroy bacteria, allow yeasts residing in the gut to grow unregulated. The imporatnat ecological factors of the gut are often overlooked due to lack of understanding of gastrointestinal immunity. Antibiotics may also allow various strains of bacteria resistant to the specific antibacterial drug to grow excessively, leading to bacterial overgrowth. In this day and age where many physicians increasingly and liberally prescribe oral antibiotics, often unnecessarily, intestinal Candida proliferation is becoming an ever increasing problem. (Have you ever wondered why so many people recently seem to be suffering from Chronic Fatigue Syndrome and Irritable Bowel Syndrome?) The treatment of teenage acne with such drugs as tetracycline has been implicated as one of the most important factors in the Chronic Candidiasis Syndrome.
The misunderstanding of the importance of Candida as an affliction of immunocompetent individuals may be the result of several difficulties. First, physicians must learn and retain enormous amounts of information. Patients expect their physician to know everyhthing, which is quite impossible given the massive amounts of published biological and medical literature. New and rare disorders can take months ot years to find or may never be diagnosed. Second, the immense use of antibiotics started in the early 80's, and only now is there a large enough population that has used a significant amount of antibiotics to realize possible side effects. Third, the true significance of the normal microbiota of the gastrointestinal tract has only recently been established. Previously, it was associated with old wives tales and sometimes frivolous naturopathic medicine. However with the introduction of antibiotics, diseases like AIDS especially, and the onset of systemic Candidiasis following antibiotic treatment, it can not be ignored. It is now considered an extremely important defense mechanism by leading microbiologists.
The use of steroids (cortisones), birth control pills, antacid and anti-ulcer medications (Tagament, Zantac, Pepcid, Axid) etc., in addition to antibiotics are also very important contributing factors since Candida proliferates rapidly in the presence of these substances (Crook, Saltarelli, Segal, Minoli, etc. - common knowledge). Modern day diets extremely high in sugars are also blamed for the condition and is quite reasonable given knowledge of microbiology. (Sugars are rapidly metabolized by fungi, esp. yeasts, and prevent the growth of bacteria). In fact, eliminating sugars from the diets of various individuals has been demonstrated to be of equal importance with antifungal therapy, although it certainly can not replace it. Candidiasis is a serious condition and must therefore be seriously considered and treated. Fungal infections of the skin epithelium are genereally dificult to eliminate. The intestines, also composed of epithelium, provide a warm, moist, nutrient-rich, environment favorable to Candida growth, especially when provided the above conditions. Unfortunatley, some physicians do not have the time to think that because something can't be seen, doesn't mean it's not there.
Candida has also been suggested to play a part in creating what is called a "leaky gut," an unfavorable increase in intestinal permeability. Undigested macromolecule food particles and toxins are allowed to pass directly into the body creating a host of problems. This creates havoc with the immune system when these particles trigger an immune response sensitizing the individual to normally harmless molecules. When this happens, the individual is suggested to become "environmentally sensitive," responding to various harmless inhalants in the environment the person is exposed to as well as various foods. These reactions do not create typical allergic symptoms. Because of the strain on the immune system to break these undigested molecules down, the body's ability to defend against Candida may be further weakend, creating a cycle. These particles may also pass through the blood/brain barrier, be mistaken for neurotransmitters, and produce other mental symptoms that may create a misdiagnosis of neurotic disorder. Research is currently being done at the National Institute for Health to this end.
Candida has been found to produce 79 distinct toxins. These toxins have been shown to cause massive cangestion of the conjunctivae (eyelid area), ears, and other parts of the body in rats (Iwata). It is these toxins that are also suggested to be responsible for many of the symptoms that Candida sufferers have as well as the "die off reaction." Certainly, there are other complex complicating factors that are unknown to us at this point which will require further research and funding to find.
The versataliy of Candida has been overlooked. It has been considered that only those who are immunosuppressed are susceptible to Candida infections. However, it is known that women who are not immunosuppressed, develop vaginal yeast infections. The only method in which these are diagnosed are by visual signs. Unfortunately, there is no method besides surgical procedures to easily explore the small intestines. Indeed, there have been case reports of gastric candidiasis viewed by upper endoscopy in immunocompetent individuals (Nelson, Minoli). In addition, there has been further research demonstrating that Candida is responsible for and involved in many forms of psoriasis and other dermatosis (Skinner, Crook, James, Oranje, Buslau). There have also been numerous cases of non-immunosuppressed patients who have developed forms of candidiasis (Magnavita, Hussain, Widder, Crook, Kane, Schlossberg, Schwartz, Minoli, etc.). Again, the only reason these patients were diagnosed, was because of visual signs on the exposed mucous membranes or severe symptoms that required surgical procedures. Yeasts are dimorphic organisms. Under malnourished conditions, Candida can convert from its normal budding form to its mycelial form in which the cells are elongated and attached at the ends, allowing it to grow into different areas. Resistance to phagocytosis in its mycelial form is considered to be an important part in the pathogenicity of Candida.
Many physicians try to compare the immunology of the gastrointestinal tract to that of other organs and systems in the body including the circulatory system. They simply recall being told in medical school that candidiasis affects the severely immunosuppressed only and fail to think beyond. As any competent physician should know, the immunology of the gastrointestinal tract functions separately as local immunity, the weakest of all immunological activity. Immunoglobulin G has practically no significance in gastrointestinal immunity and the activity of Immunoglobulin A (to help prevent binding to mucosal cells) is under question. "The lumen of the gastrointestinal tract is actually outside the body" and needs to be judged accordingly(Shorter, etc.). The primary defense mechanisms of the intestines are acidity and motility. Although obviously not entirely true today, but still with validity, E. Metchnikoff, in his book, The Nature of Man published in 1908 (Putnam) felt that toxins absorbed in the gastrointestinal tract were the cause of most of the problems aquired by humans. Because of the local immunity and the physiology of the gastrointestinal tract, it is source of a vast number of human afflictions.
The average physician, when questioned about candidiasis, might look in a patient's mouth for signs of massive proliferation and/or just outright tell the patient they don't have it because there are no extreme visual signs. The doctor may also refer to a patient's complete blood count (on routine blood testing) telling the patient that they are not immunosuppressed, therefore they don't have it. This serves as an example of how textbook minded many doctors are. These symptoms are only demonstrative of the massive infections seen in AIDS and cancer patients where the immune system is suppressed and not localized intestinal Candida proliferation. In addition, the gastrointestinal immune response functions separately from the systemic immune response. The Chronic Candida Syndrome, despite much speculation, does not require a defective or depressed immune response to affect an individual. Rather, it is primarily a consequence of other favorable conditions.
------------------------------------------------------------------------
The controversy over the existence of this disorder is due to several factors. The major argument against the elimination of normal flora causing yeast proliferation is the theory that eventually your intestinal compliment of normal flora will return after stopping antibiotics and yeast proliferation will "just go away." No conclusive studies have been performed demonstrating this. It has been shown that whatever organisms that has presently colonized an area of the GI tract will remain dominant in that area. The return of normal flora to areas of the GI tract does not necessarily mean that this has stopped the growth of other pathogens nor does it mean that Candida proliferation hasn't damaged the GI tract. When stool cultures report growth of normal flora, it does not mean that their is growth along your entire intestinal tract. It is also suggested that a healthy immune system will be able to overcome the proliferation. However, since it is shown that immunocompetent individuals can develop candidiasis, this is certainly not the case, especially since Candida is so versatile and given favorable conditions in the intestines. Candida even has a unique property in that it can produce "fungal balls" in its acute stage.
The second argument is that "yeast in the intestines is normal and harmless." The statement is that, "yeast can be recovered from the stool of healthy individuals." However no mention has been made of the effects of proliferated yeast in the intestines and what amount is normal. The colon is home to many pathogenic organisms in healthy individuals, including parasites in 5-10% of the population that physicians wouldn't dare say are harmless if proliferated (A.N.Y.A.S.). No conclusive studies have been performed demonstrating that intestinal yeast proliferation is harmless. In fact, studies have shown the exact opposite. As any woman who has had a vaginal yeast infection knows, it can certainly create quite a problem. It is preposterous to state that heavy growth of yeasts in the intestines, another mucous membrane, is meaningless. Anyone who has had diarrhea from antibiotics will certainly know this as well. Unlike in a woman's vagina, yeasts are provided a perfect environement with enough food and sugars to create rapid proliferation.
The contributing factor to the reluctance of the medical community as a whole to accept the syndrome is the lack of a absolute definitive scientific proof of the Candida/human interaction. There has also been an extreme lack of complete widely published case reports of those who have been cured with anti-yeast therapy. The treatment has preceeded some of the research, and its success in many individuals is proof in itself of the Candida/human interation. Furthermore, failure of doctors to request proper growth medium or request the use of a gram stain and direct microscopic observation to identify the presence of yeast in stool specimens has also contributed to a lack of diagnosis. In addition, many labs consider yeast a "normal flora" and do not report it unless it is specifically asked for. Other potentially hazardous bacteria are also part of the normal flora when not in excess, however parts of the medical community still choose to ignore yeast proliferation despite the facts.
There are still many more reasons lingering why perhaps there is such a reluctance to accept the syndrome:
1.Widespread acceptance of the yeast syndrome will make many doctors who have misdiagnosed these patients appear ignorant. 2.Symptoms of candidiasis can be a big money maker and doctors legally have an excuse not to treat you since as of yet, there is no definitive lab test capable of an absolute diagnosis. 3.The enormous repercussions of the liberal use of antibiotics and the ignorance involved will put many doctors at fault.
There are however many physicians who do not agree with the above. Doctors who have tried antifungal and diet therapy with their patients (maybe as a last resort) have seen their patients lives dramatically turn around in a matter of a few months or less and can no longer deny the existence of this problem. They enjoy the self-satisfaction of knowing they have made a difference in someone's life where others have failed. If your doctor is kind, compassionate, genuinely interested in medicine and helping people (the kind we would all like to have), perhaps he or she will be more open minded to the many areas of medicine that have not been fully explored. If you have been struggling with difficult symptoms or diseases of unknown origin listed below, perhaps your doctor will help you in a trial of therapy. Remember, however, it is ALWAYS important to keep an open mind to other possibilities.
------------------------------------------------------------------------
Candidiasis and Allergies
Originally, the Candida syndrome was thought to be a result of an allergy to Candida in the gastrointestinal tract. This was thought to lead to a series of allergy related symptoms and the continued presence of Candida in the intestines. It was significant in that many or all patients who were cured with antifungasl drugs also had environmental allergies. Hence, the term "Candidiasis Hypersensitivity Syndrome" was created.
The significance of allergies in patients suffering with the Chronic Candidiasis Syndrome, along with increasing data, has lead to a different perspective. An allergy to Candida would promote its destruction in the host. Several studies have demonstrated the significance of IgE antibodies in the defense against Candida (Saltarelli). IgE antibodies are those primarily associated with allergies. It has been found that individuals with systemic candidiasis have an average of nearly a 2000% increase in IgE to Candida. In patients with vaginal candidiasis, and average of over a 1000% increase of IgE to Candida was seen.
The results of these studies suggest several things:
1. IgE antibody plays a significant role in defense against Candida.
2. Individuals lacking in IgE to Candida (perhaps due to allergies) may have a lower defensive ability against Candida.
3. Since IgE's in patients with candidiasis were also elevated to other antigens, this would suggest that candidiasis may increase allergic responsiveness.
Finally and most importantly, the disruption in IgE production in patients with allergies may suggest that these patients, as a result of allergies, have a comprimised IgE response to Candida.
------------------------------------------------------------------------
Samples of Published Medical Research
------------------------------------------------------------------------
Candidiasis Syndrome and Chronic Fatigue Syndrome
presented by Dr. Carol Jessop at the Chronic Fatigue Syndrome Conference, April 15, 1989.
This was a report of anti-candida therapy on 1100 patients presenting symptoms of Chronic Fatigue Syndrome, Irritabel Bowel Syndrome, headaches, allergic disorders, emotional disturbances (depression, panica attacks, irritability, and anxiety), etc.
After 3 to 12 months of treatment with ketoconazol and a no sugar, no alcohol diet, a major reduction in symptoms was seen in 84% of the patients. "In September of 1987, 685 of the 1100 patients were on disability; in April of 1989, only 12 of the 1100 were on disability."
------------------------------------------------------------------------
Candida Causes Diarrhea in the Normal, Immunocompetent Host
as published in The Lancet, February 14, 1976.
James G. Kane, Jane H. Chretien, and Vincent F. Garagusi of the Infectious Disease Service , Department of Medicine, Georgetown Universtiy Hospital, Washington, D.C. reported on six cases of chronic, persistent, diarrhea, sometimes associated with abdominal cramps, caused by candida. Five of the individuals had no underlying condition and the symptoms lasted as long as three months until treatment was begun. Blood tests were unremarkable and they report that yeast in stools was best identified by direct microscopic observation. "Symptoms disappeeared in 3 to 4 days of oral nystatin therapy."
It is interesting that after 20 years since the publication of this material, most physicians do not request yeast identification in stools, nor do many labs routinely report its presence or quantity unless specifically requested.
A comment from a 1988 report published in Digestion entitled Dead fecal yeasts and chronic diarrhea follows:
"The authors report 20 patients in whom a large number of dead or severely damaged yeast cells, supposedly Candida albicans yeasts, were the possible cause of chronic recurrent diarrhea and abdominal cramps. It is suggested that the presence of large numbers of these microorganisms in stools may be considered among the possible etiologies of diarrhea in the "irritable bowel syndrome." The possible source of these yeast-like cells, the causes of cell damage, and the mechanisms by which these organisms may induce diarrhea should be investigated." (Caselli)
Candida has also been shown to cause severe diarrhea in debilitated elderly patients. Despite this, many physicians remain unaware while their patients suffer with diarrhea. (Gupta, Danna)
------------------------------------------------------------------------
Intestinal Yeast Causes Psoriasis
as published in The Archives of Dermatology, Volume 120, April 1984:
Nancy Crutcher, M.D., E. William Rosenberg, M.D., Patricia W. Belew, PhD, Robert B. Skineer, Jr., M.D., N. Fred Eaglstein,D.O. of the University of Tenessee Center for the Health Sciences, 956 Court Ave. Room 3C13, Memphis, TN, and Sidney M. Baker, M.D. of New Have, Connecticut report on 4 cases of long term, bodily psoriasis (10-25 years) cured with oral nystatin within several months. Nystatin, a weak antifungal drug, primarily targets intestinal yeast.
As published in the Acta Derm Venereol in 1994:
Robert B. Skionner, Jr., E. William Rosenberg, and Patricia W. Noah report results of studies that demonstrate that psoriasis of the palms is frequently associated with Candida. 7 out of 9 patients were cured or substantially improved after treatment with anti-fungal drugs.
There have also been numerous
Next Article
Previous Article
Return to Neurological Disorder Topic Menu
------------------------------------------------------------------------
Here is a list of responses that have been posted regarding this article...
•information on candida (8/28/98) 12:05 PM •hey poster? (8/26/98) 6:42 AM
------------------------------------------------------------------------
If you want to post a completely new article on any topic you like, click here.
If you would like to post a direct response to this article, fill out this form completely...
Response Title:
Name:
Email:
Remember that your Name and Email Address are optional...you don't have to enter them! You can remain completely anonymous if you like by leaving these fields empty.
Response Text:
------------------------------------------------------------------------
Click HERE to return to the main Neurology WebForum Homepage.
------------------------------------------------------------------------
These forums are maintained by the Department of Neurology at Massachusetts General Hospital
John Lester - Webspinner