The "yeast" problem with Candida albicans is one of the new medical concerns of the 1980s that will continue into the next century. It has been described by many prominent physicians, including C. Orian Truss in The Missing Diagnosis, William Crook in The Yeast Connection, and Keith Sehnert in The Candidiasis Syndrome. It is a very common problem, one of the most frequent I see, and is to me a medical adventure, because I learn a great deal while working with people with this problem. Often the therapy for yeast, or candidiasis as it is commonly known, will positively and dramatically change lives. The somewhat complex, multilevel treatment program has been effective in a high percentage of the people I have treated, and I have worked with hundreds with this problem to date.

• Frequent or long-term use of antibiotics, such as tetracycline for acne
• Frequent use of broad-spectrum antibiotics for recurrent infections, such as in the ears, bladder, vagina, or throat
• Birth control pill use in women
• Premenstrual symptoms
• Recurrent vaginal yeast infections in women or prostate problems in men
• Regular use of cortisone-type drugs
• Cravings for sweets, breads, or alcohol
• Sensitivity to molds, dampness, and smells
• Mental symptoms such as depression, mood swings, or confusion
• Chronic fatigue, indigestion, or food reactions
• Recurrent skin fungus infections, such as ringworm, athlete’s foot, "jock itch," or nail problems

The yeast syndrome is a controversial topic. Most traditional doctors do not want to hear about this condition and call it a "fad" disease, but those who will explore the possibility and look for it in their patients will be hard-pressed not to accept this problem as "real." One of the reasons, I believe, for medicine not really accepting the "yeast syndrome" is because the problem arises predominantly as a side effect from the use of commonly prescribed drugs—antibiotics, birth control pills, and corticosteroids.

The problem originates when a common yeast, Candida albicans, begins to overgrow in the intestinal or genito-urinary tract. It may be contracted initially through sexual contact. When other normal body microflora are killed off by antibiotics, the yeasts will then proliferate and coexist with the useful germs. Mild mucocutaneous infections (of the skin, vagina, throat, or bladder, for example) may develop in the yeast phase of this dimorphic organism. This common yeast is usually noninvasive (that is, it remains localized) except in the severely debilitated patient. However, with long-term infestation or with the weakened immune state that can result from a reduction of normal colon bacteria, the yeast can shift into its fungal form, wherein it develops rhizoids, or roots, that can be implanted in the intestinal wall or other mucosal linings. This allows absorption into the body of by-products (toxins) of fermentation and other antigenic material generated by the fungus. The body will then make antibodies to the Candida albicans organisms. This can lead to an immunological or hypersensitivity reaction that is manifested as the polysystemic disease for which this syndrome is now known.

The yeast problem thus occurs at two levels—the localized infections, of which skin rashes and vaginitis are the most common (intestinal overgrowth is also common), and the secondary and more serious systemic reactions. This problem can then produce such symptoms as recurrent skin fungus infections, examples being ringworm, athlete’s foot, "jock itch," or nail problems; headaches; fatigue; cystitis or prostatitis; mental symptoms such as mood swings, poor memory or concentration, depression, or confusion; premenstrual symptoms; recurrent herpes infection; joint pains; cravings for sweets, bread, or alcohol; indigestion or food reactions; and sensitivity to molds, dampness, environmental pollution, cigarettes, and various smells.

This yeast syndrome is much more common in women than in men and seems to affect the hormonal balance, initially causing mild premenstrual symptoms of irritability, depression, fatigue, and swelling, and leading to actually abnormal and/or painful menstrual periods. I would estimate that a significant number of women with PMS have a problem with Candida albicans, and probably more than half the women with candidiasis have some uncomfortable premenstrual symptoms.

Diagnosing polysystemic candidiasis may involve several tests. Most doctors who work with this problem use a questionnaire such as the one provided by Dr. Crook in his book, The Yeast Connection. The scores indicate the likelihood of a yeast problem, and while not exact, this is a pretty accurate tool. Many doctors suggest a trial treatment program merely on the basis of an interview, exam, and questionnaire score, as the response to therapy is often a good indication of the presence of the problem. However, I like to have more objective monitors, so I perform two main tests, both reasonably inexpensive. One is a culture of a stool specimen to quantify the amount of Candida albicans (or other yeast) organisms present. This can then be repeated to measure the effectiveness of the program. Also, a sensitivity test that finds what substances will actually kill the yeast (in the lab, at least) can be done after the organism is isolated. The other test measures the blood levels of three antibodies (IgA, IgM, IgG) to the Candida albicansorganism, performed by Immunodiagnostic Lab in San Leandro, California. If these antibodies are elevated, this suggests that some systemic reaction is occurring in the body (the stool reveals only an intestinal overgrowth), which may be correlated with more widespread symptoms. This test also gives us the opportunity to monitor the body’s status over time to measure treatment response. Reducing yeast organisms in the body and replacing friendly bacteria will usually reduce elevated antibody levels.

Other tests may be helpful in determining coexisting medical problems. A study of the stool for ova and parasites may show these to be more commonly present in yeast carriers than in the average population, as often the same predisposing factors, poor digestion and low stomach acid, are present. Treatment may also be needed to eliminate these parasites. Creating proper colon ecology is a crucial factor in health, disease resistance, and many important body functions. When normal colon bacteria are present in sufficient quantities (which they may not be when other invaders are taking their place), they will actually produce many vitamins using the nutrient fuel provided them. Vitamin K and most of the B complex vitamins—niacin, B12, pantothenic acid, B6, biotin, and folic acid—are among these. Intestinal bacteria also aid final digestion of food, such as proteins and milk. With low colon bacteria counts, poor digestion, and an unhealthy intestinal lining, more food allergies may develop. A blood test measuring specific antibodies to many commonly allergenic foods may be indicated in some people with candidiasis, especially when there is a real problem with food intolerance. Frequently found reactions, indicated by greatly elevated IgG antibody levels, include reactions to both baker’s and brewer’s yeasts, wheat, milk, cheeses, mushrooms, and eggs. Many others are possible, but those are the ones I have found to be most common and most strong.

1. Do not feed the yeasts foods upon which they thrive.
2. Reduce yeast growth through natural and pharmaceutical agents.
3. Reestablish normal intestinal ecology.

The overall approach to treating the yeast problem is threefold. The first facet is to refrain from feeding those "yeastie beasties" what they like to eat so they can thrive and divide. They live on mostly simple sugars and yeast and fermented foods. These include fruits, fruit juices, and dried fruits, sugary foods, refined flour products, alcoholic beverages, cheese, vinegar, breads, and other yeasted fermented food products, such as soy sauce. All these foods are avoided on the yeast diet.

What to eat? There are many recommended foods—fish, poultry, meat, lots of vegetables, some whole grains, nuts, seeds, and occasional eggs. (The antiyeast diet is more difficult for vegetarians, but definitely possible.) Some yogurt, especially acidophilus culture, is all right if milk is tolerated. Oils are obtained from some butter and more cold-pressed vegetable oils, such as olive, flaxseed, sesame, and sunflower. Legumes are often limited because they add to intestinal gas.

Basic meals include proteins and vegetables or, occasionally, starch and vegetables. For the first few weeks, the carbohydrates, including pastas and especially breads, are limited, with only some whole grain cereals being used. This lowers fiber intake, but usually other aspects of the treatment help colon function. The Ideal Diet discussed in Part Three, with certain modifications, will make a good Candida diet. The rotation is a good way to reduce food reactions. Initially, the diet includes no fruit, or only one piece a day, and none of the sweeter fruits, such as grapes, bananas, and melons. The starches are limited to one portion a day, and the meals are oriented toward proteins and vegetables.

This is a special therapeutic diet, and not necessarily a lifelong one, though many people like the way they feel on it. Intestinal symptoms decrease, energy improves, and itchy or irritated skin may start to heal with a decrease in sugar and yeasty foods. Also, some weight can be shed easily on this diet. This may be a problem for the already trim person, and lighter people need to emphasize regular eating to prevent weight loss.

After a few weeks, we can test ourselves with fruit, bread, other grain products, or cheese—of course, one food at a time, and only one daily—to see how we handle them. If they seem to cause no problems, we can then bring these foods into our diet on a rotating basis. Eventually, adding more whole grains and fiber will provide what I believe is a healthier diet. Different degrees of strictness with the diet may be necessary, depending on the severity of the problem. A more stringent diet might exclude all fruits; whole grains, particularly the glutinous ones—wheat, barley, and oats; herb teas and spices, which may contain molds; and many nuts, which can also carry molds.