Majid Ali, M.D.

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Editor, The Journal of Integrative Medicine
Formerly, Associate Professor of Pathology (adj.), College of Physicians
and Surgeons of Columbia University, NY
Formerly, President of Staff and Chief Pathologist, Holy Name Hospital, Teaneck, NJ
Fellow, Royal College of Surgeons of England - Diplomate,
American Board of Anatomic and Clinical Pathology
Diplomate, American Boards of Environmental Medicine
Past President Capital University of Integrative Medicine

Yeast Overgrowth
Life in America puts our immunity in jeopardy in many ways. Stress is the malady of our times.Stress depresses immunity. Chemical avalanches surround us.  Chemicals depress immunity. The incidence of food sensitivity and malabsorption is increasing.  These disorders depress immunity. Drugs, of prescription and non-prescription type, often depress immunity. Some of us with strong genes can cope with these threats.  Many of us cannot.

Yeast are present in all of us. Yeast are part of the human gut flora, a group of minute organisms which have co-evolved with the human species over a very long period of time.  The gut flora lives in symbiosis with the human tissues.  The gut flora synthesize some vitamins and other essential nutrients; human bowel provides them with a favorable environment.  More importantly, the normal gut flora keeps the dangerous disease producing bacteria from flourishing in the bowel.

Yeast are a family of very small single cell organisms.  Under favorable conditions, yeast grow actively and may form thread-like structures. The full scientific name for the yeast which causes common infection in humans is, Candida albicans.  In medical terminology, Candida infections are sometimes termed MONILASIS. In common language, Candida albicans overload is often referred to as "YEAST OVERGROWTH' or infection.  When seen on the tongue or mouth as a white coating, it is known as THRUSH.

YEAST INFECTIONS cause a variety of clinical disorders.  These infections are considered as "opportunistic infections" - meaning that yeast found an opportunity to multiply freely and cause disease due to a breakdown in the normal defense mechanisms of the humans.  In this form, yeast infections of the mouth, esophagus (tube which connects mouth with stomach) and vagina occur with high frequency in subjects with diminished immunity.  Less commonly, infections of other organs such as lungs, liver and brain may occur.  Such infections are seen in patients with cancer given chemotherapy or radiotherapy, patients recovering from extensive surgery, patients given frequent courses of broad spectrum antibiotics, and patients with many forms of congenital and acquired immunodeficiency syndromes.  The diagnosis of such infections is easily established by taking a specimen from the diseased tissues and doing laboratory tests.

Yeast overgrowth as a cause of chronic ill-health, by contrast, has been recognized widely only in recent years.  In some ways, it is a controversial subject.  The reason for this is difficulty of making a firm diagnosis of Candida overgrowth.  Yeast normally lives in all of us.  Thus, merely recognizing its presence in the gut or vagina by itself is not an acceptable evidence.  This also has been the principle reason why chronic debilitating illness caused by yeast overgrowth has gone unrecognized for so long, and continues to be unrecognized in many many patients at present.
   
Yeast overgrowth and infection occur when the host defense mechanisms have been severely compromised - when the immunity of an individual has bee reduced by one or more factors.
   
How soon can an individual's immunity be decreased?  Consider the development of fever blisters around the mouth caused by herpes virus when a patient develops acute tonsillitis.  In some patients fever blisters develop within several hours of an acute migraine headache attack.  The important point which can be made here is that we do not always have to have devastating illness or injury before our immunity is reduced.  Indeed, our immunity is being constantly threatened by the pollutants in the air we breathe, pesticides and industrial toxins in our water, and chemicals in our food.  Wide spread use of broad spectrum antibiotics has caused drastic changes in the human gut flora.  Our "friendly" bacteria in the bowel are being crowded out by more vicious disease-causing  bacteria.  Not the least of these geneal factors causing impaired immunity is the important role of stress in modern life.
   

Following is a list of some important predisposing factors for yeast overgrowth:

1.   Stress
2.   Use of broad spectrum antibiotics
3.   Hormonal imbalances
       - Caused by birth control pills
       - Caused by multple pregnancies
       - Caused by hormone therapy for a variety of symptoms
4.  Steroids which weaken several defense mechanisms of our immune system
5.   Frequent and chronic infections
6.  Extensive surgery
7.  Food allergy and malabsorption
8.  Deficiency of micro-nutrients (vitamins, minerals, amino acids, anti-oxidants)
9.  Faulty nutrition, metabolic roller-coaster
10. Substance abuse

The symptoms of chronic yeast overgrowth are many and diverse.  Yeast overgrowth can cause illness in the following three ways:

1.  By crowding out the normal gut flora and causing changes in the gut enzymes and absorption mechanisms.

2.  By releasing toxins which are absorbed through the gut and cause illness by involving many different
organ systems.

3.  By yeast allergy --- similar to hay fever allergy caused by a special class of antibody termed IgE antibody.

The clinical syndromes are made even more complex by several other factors.  For example, yeast overgrowth occurs with high frequency in patients with food, pollen and chemical sensitivity.  Other types of illnesses for which patients are administered antibiotics, steroids, and other potent drugs often persist in their chronic form and add to the symptoms of Candida overgrowth.
   
An untold number of patients have suffered for long years from debilitating chronic symptoms due to yeast overgrowth.  They have been found to have "normal blood, urine, and x-ray results." and their symptoms have been attributed to hypochondria.

Following is a listing of symptoms seen in patients with chronic Candida overgrowth:

General Symptoms
Fatigue and a sense of being "ill" and "drained" are the dominant symptoms.  These are often accompanied by irritability, difficulty in concentration, slow mentation, in coordination, and vague feelings of being "spaced-out."  Excessive lethargy may lead to a sense of drowsiness.

Musculoskeletal Symptoms
Vague muscle aches, muscular weakness, pain with or without swelling in multiple joints, and tightness in chest wall.       

Gastrointestinal Symptoms
Abdominal cramps, bloating, excessive belching, abdominal distention, constipation with bouts of diarrhea, excessive mucus in stool and rectal itching.

Ear, Nose, and Eye Symptoms
Sore throat or scratchiness in throat, dry mouth, white coating on tongue and in other areas of mouth (thrush), bad breath, nasal itching, congestion and drip, recurrent sore throats, recurrent episodes of cough or bronchitis, recurrent infections or fluid in the ears, itchiness, burning or tears in eyes, and difficulty with hearing.

Genitourinary Symptoms
Frequent episodes of bladder infection, urinary urgency and frequency, burning on urination, frequent episodes of vaginitis, vaginal discharge or itching.

Management of Yeast Overgrowth
The clinical presentations, disabilities and diseases caused by candida overgrowth and infections are generally complex.  These clinical disorders should be managed under the close supervision of a physician experienced in the candida treatment strategies as well as the management of stress and nutritional disorders and food allergies with malabsorption.
   
The principles of the management of yeast overgrowth are based on an understanding of the nature of this disorder.  It is essential to address the risk factors which render an individual vulnerable to Candida overgrowth. These include stress, food allergy & malabsorption, mold allergy, use of broad spectrum antibiotics, steroids, and a diet rich in simple carbohydrates.
   
For established yeast overgrowth, especially in individuals with long-standing clinical problems, it is necessary to first achieve an adequate control of Candida overgrowth and then plan for a long term strategy to prevent recurrence.