TREATMENT OF CANDIDIASIS - a proposal by Subhuti Dharmananda

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TREATMENT OF CANDIDIASIS a proposal by Subhuti Dharmananda

JoAnn Guest

Dec 26, 2006 16:10 PST

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TREATMENT OF CANDIDIASIS a proposal by Subhuti Dharmananda

http://www.herbldoc.com/GI.htm

 

Candida overgrowth occurs when the immune system is debilitated, and

perhaps also when the immune functions affecting certain tissues

(e.g. mucous membrane surfaces) are blocked by abnormal blood

circulation or by fluid accumulation.

 

While the ultimate solution to the problem of candida overgrowth is

to recover full immune functions, an immediate treatment is to

directly inhibit candida. This latter function is often accomplished

with antifungal drugs, but it appears that the yeast quickly become

resistant to most drug therapies.

 

In China, candida is treated with herbal combinations. The syndrome

is related to a dampness disorder, caused either by cold affecting

the stomach and spleen (as occurs, for example, with chronic use of

either antibiotic drugs or cold bitter herbs with antiseptic

properties), or by damp-heat accumulation (which may arise, for

example, from dietary components or from transformation of cold

dampness to heat as the fluid remains stagnant over time).

 

Phellodendron is often a key herb in the treatment of candida

because it has antiseptic properties (including ability to inhibit

candida), it dries dampness (astringent), and it clears deficiency

heat. In the case of cold syndrome, it is combined with cinnamon

bark, which is very warming, also has astringent effects (because of

tannins in the bark) and is antiseptic (because of the essential

oils).

For example, Willow Blossom Powder (Liu Hua San) is comprised of

phellodendron (15 g), cinnamon bark (3 g), indigo (qingdai, 9 g),

and borneal (0.5 g) the ingredients ground to fine powder and taken

orally.

For oral thrush, some powder can also be applied topically, and for

intestinal candidiasis, the formula can be used in the form of an

enema. [note when using the powder as an internal medicine, as

opposed to applying it topically, one can substitute 9 grams

cardamon for the borneol (the latter is the main active component of

cardamon).]

 

For systemic effects, the formula can be modified to treat spleen

dampness by adding red and white atractylodes, cardamon, hoelen,

coix, and dolichos.

For kidney and spleen yang deficiency, add aconite, ginseng, dry

ginger, and evodia. In a study of the effects of the formula in 13

cases, all were cured, and the average treatment time was just five

days.

 

An active component of phellodendron is berberine, and this may

inhibit candida. Coptis also contains this component and is often

combined with phellodendron or used in place of it to treat

candidiasis. For example, a modern version of Pinellia Combination,

made with pinellia (10 g), scute (10 g), coptis (8 g), dry ginger (8

g), codonopsis (8 g), and licorice (4 g), was given to more than 20

patients with thrush and a cure was obtained within five days.

 

Other astringent herbs are also found to be effective. For example,

four cases of candida that arose after prolonged administration of

antibiotics and corticosteroids were given a decoction of 18 grams

mume per day, plus tablets of acacia gum (axianyao) 1 gram each

time, three times, for a total of 3 grams. This treatment led to

negative stool culture for candida after a few days. Mume is

extremely sour, so that the decoction would be hard for most people

to take therefore, it could be used in the form of a granule (dried

decoction), about 3-6 grams of the extract per day.

 

The main active component in acacia is catechin (a common tannin

found in tree wood and leaves) and quercetin (one of the most common

flavonoids). Catechin is similar to an ingredient of mume called

epicatechol. Astringents, such as tannins, are often used topically

to treat infections and by enema to treat diarrhea and intestinal

inflammation.

 

In a recent review of herbs that inhibit candida in laboratory

testing (Modern Study and Application of Materia Medica), the

following herbs are mentioned: phellodendron, scute, sophora

subprostrata, melia fruit, and pseudostelaria (tu jing pi this is

the golden larch bark). In an earlier source (Pharmacology and

Applications of Chinese Materia Medica), the following herbs are

mentioned:

 

phellodendron, plantago leaf, pulsatilla, capillaris, cnidium fruit,

houttuynia,- and anemarrhena (these herbs are included in a formula

called Phellostatin produced by Health Concerns). It was also

mentioned in this reference that seven cases of oral candidiasis

that did not respond to nystatin, trichomycin, or amphotericin were

effectively treated with Bupleurum and Rehmannia Combination this

formula includes phellodendron, coptis, and scute. There are many

other herbs and formulas reported to inhibit yeast and fungi, either

by topical application (e.g. polygonatum extract), or oral ingestion

(e.g. rehmannia).

 

Houttuynia is rich in quercetin and related flavonoids. It is

possible that this is an active component against candida. Tannins,

such as catechin, are condensed flavonoids. The role of flavonoids

in tannins in plants is believed to be, in part, as a protector

against fungi and other organisms. Oral thrush was successfully

treated in children in China by topical application of a powder that

included rhubarb (a rich source of catechin) and phellodendron.

 

A compound that can be isolated from many plants, caprylic acid, has

been prescribed by naturopathic practitioners for treatment of

candida.

 

This acid is found in capillaris. It has been reported that caprylic

acid can produce side- effects, such as lower energy, which can be

countered by consuming coenzyme Q10.

 

A combination of phellodendron, capillaris, scute, and mume, could

be utilized as an antiseptic for yeasts in the form of extract

granules. If these are taken with Quercenol (high in quercetin) and

Cartaequin (which contains coenzyme Q10, and crataegus, which has

effects similar to mume), the effects may be prompt.

 

These herbs and supplements are all suitable for patients with weak

constitution as long as the underlying or constitutional condition

is being treated at the same time (e.g. by warming the spleen

otherwise, modify the base formula accordingly with herbs such as

cinnamon bark, codonopsis, dry ginger, licorice, atractylodes,

etc.).

 

In cases of candida affecting the throat, the addition of gardenia

may prove helpful as an adjunctive herb. Gardenia is highly

recommended by Kanpo doctors for irritable conditions of the

esophagus, throat, and mouth. It is given for esophageal

constriction, esophageal cancer, pharyngitis, laryngitis, and

salivary calculus. However, gardenia can cause diarrhea if used in

large quantities.

 

Applicability

 

Rather than the physician diagnosing " candida " as a cause of the

patients symptoms, many patients will arrive convinced that internal

candida is responsible for a wide variety of physical and

psychologic symptoms that have long been undiagnosed or ignored by

conventional physicians.

 

The " candida situation " is a complicated one. The alternative

health care community often commits the same error as the patient,

convinced that candida is responsible for a variety of unrelated

symptoms and furthering the patient's anxieties about 'infestation.'

The nutritional supplement industry produces a vast variety of

products to 'cleanse' the body of every last yeast bud and 'balance'

the remaining microflora. During a recent visit to a health food

store, there were far more products devoted to candida than, say, to

cholesterol control.

 

On the other hand, the mainstream medical community is largely

unconvinced of the existence of the syndrome at all and mainly

express nervousness about excessive use of antifungal agents. Like

most dichotomies, the " truth " is not really known, and probably lies

somewhere in between. A good place to begin is with the book that

started it all. Dr. William Crook, a family physician, wrote " The

Yeast Connection " after having observed a similarity of symptoms in

women with recurrent vaginal yeast infections and a variety of

subjective complaints. He posited that due to a variety of factors

such as diet, stress, use of antibiotics, hormonal imbalances, an

intestinal overgrowth of candida could occur.

 

The symptoms that followed could be classified into several groups:

 

1.Vulvovaginal candidasis from repeated re-seeding

 

2. Gastrointestinal symptoms such as bloating, gas, and frequent

indigestion

 

3. Systemic complaints from absorption of the breakdown products of

candida through a damaged intestinal mucosa 4. An immune complex

syndrome as the absorbed products create antibodies which circulate

and produce areas of local inflammation

 

5. Food allergies as the incompletely digested food products are

absorbed through a damaged and hyperpermeable intestinal lining

('leaky gut syndrome') 6. Food cravings as part of the food

allergies

 

It is very important to understand that what all the books on the

subject describe is an immune complex condition and not the

candidemia associated with a profoundly compromised immune system

like AIDS or during chemotherapy. Much of the alternative literature

on the candida syndrome will use words like 'invasion' and comment

how 'distant organs, beyond the gastrointestinal system'

are 'invaded.'

 

Having joint pains due to an immune complex reaction is, of course,

a whole lot different from having candida proliferating in the

bursar sac but most of the patients, already anxious, do not

understand the nature of an immune complex disease and genuinely

picture their bodies looking something like a ripe piece of blue

cheese.

 

To my mind, the main failures of the book are: 1. Attributing the

vast number of fairly common symptoms all to a single cause. 2.

Inducing an unnecessary anxiety in readers, most of whom, upon

taking the test at the end of the book, will arrive at a self

diagnosis of candida.

 

3. Conveying to both patients and alternative practitioners that the

only reliable way to arrive at a diagnosis is through this

subjective questionnaire that tests, though helpful (see list below)

are unreliable.

 

4. Treatment with prolonged use of antifungal agents and a diet so

rigid that patients are convinced a single cookie will produce

massive immediate overgrowth and exacerbation of symptoms.

 

The 'natural' treatments (like caprylic acid, berberine or gentian)

are probably a whole lot safer than antifungal agents but

necessitate complex dosing schedules for inordinate lengths of time

and seem of 'medium' efficacy.

 

It doesn't take long to put (1) through (5) together and get the

following scenario: a young woman with vague complaints reads the

book, takes the questionnaire, and 'knows' she has candida. She

begins the extremely rigid diet and goes to the health food store

where the clerk prescribes a variety of herbs and cleansers. Feeling

no better, she goes to a mainstream physician who pronounces her

fears unnecessary and the book 'hogwash.' She searches for another

physician and perhaps finds one who knows something about the

syndrome. He orders some tests (let us say stool and vaginal

cultures and serum antibodies) which come back negative. But the

literature has told her the tests are unreliable and the diagnosis

is based on the questionnaire. Finally she locates a physician who

treats candida based on subjective complaints, receives a

prescription for nystatin, diflucan, or sporonox and she feels

better.

 

With no way to clinically monitor her subjective response,

recurrences of symptoms trigger the 'candida anxiety' and another go-

round of antifungal agents. I describe all this only to prepare you

for the patient who will burst into tears when you explain there is

simply no evidence of candida in her body. These are not necessarily

tears of relief.

 

She has been carrying the myth of candida infestation, aided and

abetted by books, health food store clerks and well-meaning but

inexperienced alternative practitioners, hoping that this single

diagnosis would 'explain everything.' The other frequent scenario is

the patient who calls, 'knowing' her diagnosis (same sources) and

visits solely for you to write the anti-fungal prescription.

 

Therefore, along with the impressive array of vague symptoms, the

patient often is depressed and anxious (from being chronically

symptomatic, and her situation undiagnosed and untreated).

 

The situation is not helped by the conventional medical community

which, after many years of hearing about the candida syndrome still

seems to think that the patients believe they have candidemia and

try to reassure these neurotic individuals they'd be in intensiw

care units if this were the case.

 

To make matters worse, the alternative medical community has made

candida a virtual growth industry (pun intended). A medical

diagnosis, made by non-medical individuals, based on highly

subjective and common complaints, will invariably lead to

overdiagnosis.

 

The logical fallacy of:

 

The patient has fatigue Candida causes fatigue The patient has

candida

 

or

 

The patient has fatigue and a vaginal yeast infection Candida causes

fatigue The patient definitely has candida

sums up the diagnostic processes of individuals without medical

training entering into an area beyond their skills.

 

In summary: 1. The diagnosis of candida is often made on highly

subjective complaints which could be the basis of hundreds of other

conditions.

 

Because of a barrage of educational materials from supplement

companies reaching the alternative practitioner (the diagnosis is

especially popular among chiropractors and a group called " Certified

Clinical Nutritionists " ) which focus on candida, there is a tendency

to fixate on this diagnosis, adding fuel to the fire of the

patient's fears.

 

Just as the cardiologist might perceive all of a patient's symptoms

as referable to an ailing heart, the alternative community too often

attnbutes candida to everything.

 

2.In an attempt to sell their products, both nutritional supplement

manufacturers and several clinical laboratories offer " diagnostic

aids " which predominantly yield a diagnosis of candida, treatable

(of course) with the company's products. One patient described it

well to me, referring to a nutritionist who gave her the " standard

candida script. " This was a well-rehearsed monologue, a dozen

supplements, and a diet program so complicated she thought she might

as well live with the candida (which, as is frequently the case, she

did not seem to have at all).

 

The standards for making an actual diagnosis among alternative

practitioners vary widely and are inconsistent. Since the Medical

Practice Act forbids unlicensed practitioners from making any kind

of diagnosis in the first place, I once wondered why they so fixated

on this until I appreciated the treatment lay in the only areas open

to them: diet and nutritional/herbal supplements. I remarked earlier

the diet is rigid and the dosing schedule of the natural supplements

very complex.

 

I have heard from the patients themselves how when tests

demonstrate continued candida infestation, the practitioner

basically places the blame on the noncompliant patient. If I sound a

bit testy about all this, it's because of the frequent encounters

I've had with despondent young women, feeling crummy and hundreds of

dollars poorer because a candida diagnosis was 'ascertained' by such

questionable methods as reflexology, applied kinesiology, iridology,

or a single stool culture demonstrating presence of yeast.

 

History The patient usually presents with most of the following:

 

.. Fatigue, depression, malaise, gastrointestinal symptoms of

bloating, food intolerances, constipation, diarrhea · Headaches,

difficulty with concentration · Arthralgias, myalgias · If female,

recurrent monilial vaginitis and PMS, especially with oral

contraceptives There is frequently a history of: protracted

antibiotic use, prednisone use, high sugar/ junk food diet

 

Diagnostics · Two separate stool samples for candida should both

show overgrowth . Vaginal culture - IgG, IgM, and IgA antibodies by

ELISA. IgM elevation appears early if all three are elevated, this

pattern is most diagnostic if IgG is elevated, but not IgM, this

suggests a previous infection. · Food allergy testing may show an

unexpectedly large number of positive results reflecting intestinal

hyperpermeability

 

I have personally found the various candida questionnaires to vague

to be helpful and remind me of the way a magician forces a card on a

member of his audience which he then 'mysteriously' draws out of a

hat. Chiropractors or Certified Clinical Nutritionists reading this

may feel I miss a lot of candida but as an internist, one needs some

basis of a diagnosis beyond a subjective one before starting

treatment. Having a document to show a patient when she gets well is

also very helpful.

 

http://www.herbldoc.com/GI.htm

 

JoAnn Guest

mrsjo-

www.geocities.com/mrsjoguest/Diets