Before I begin the discussion, although a little out of place, I want to write about the "Spittle Test" (Don't let the capitals fool you into respectability—it's a little gross.) As you'll come to read from the below longer essay, it's not easy to acquire lab tests that will lead to a Candida "diagnosis". The following test, however, is pretty easy, and pretty conclusive:
The Spittle Test:
First thing upon arising in the morning, (even before clearing your mouth), spit into a glass of water. If your spit remains floating, in a nice, cohesive "blob", you're probably pretty much Candida-free. However, if after a moment, your spit begins to develop long strand-like tendrils that dissolve down into the water, or if your spit spreads out over the surface of the water, you probably have a Candida condition. --Although this "spit test" test can be done—with success—at any different time of the day, morning will be the most indicative.
The In-depth Candida discussion...
This essay, as you can see is quite long. Much of the information for it came from a website by Doc Darren, a molecular geneticist. I have tried to condense what was some pretty technical information there, and to strike a balance between what would be clear, yet more in-depth informative. I felt it important to include both a quick checklist as well as a more detailed discussion for those that wanted to know information on the subject. I've also incorporated here information from my readings in other sources.
Systemic candidasis is a co-infection that is fairly common in anyone whose taken repeated antibiotics over their lifetime; this by it's very nature, includes lyme patients. It is furthermore commonly under-recognized even by those docs who are considered "lyme literate". (To speak of its common nature, one health food store owner recently reported that two thirds of her customers come in to her store to treat this condition.)
The symptoms that accompany Candida--or yeast--infection are shockingly similar to those that accompany lyme: fatigue, feeling of being "drained", pain or swelling in joints, memory problems, depression, and allergies, to name a few. I personally believe that a significant amount of the symptoms that we deal with as lyme patients are not entirely from the lyme, but in part from the Candida -- whose infection also works to diminish immune function.
Its Entry Point
There are two main ways in which Candida gains a foothold: antibiotic use and sugar consumption. Our intestines are normally lined with bacteria that is beneficial for our health. Two major functions of this "good" and normal bacteria are (1) to absorb nutrients into our bloodstream from the foods we eat, and (2) to re-absorb water and electrolytes (minerals etc.) back into our system before we pass waste. The proliferation of this "good" bacteria is normally in large enough amount to not allow any place for Candida yeast to "colonize" in the intestines -- which competes for the same living space on the intestinal mucosal epithelium.
The use of antibiotics (esp. tetracyclines) however, has well known side effects to work to eliminate this "good" bacteria. This is why some doctors will so strongly urge DAILY yogurt and acidophilus supplementation, to replenish what is being destroyed by the antibiotics. Antibiotics destroy bacteria, but they are powerless against yeasts, allowing those residing in the gut to grow unregulated. In addition, the use of steroids (cortisones), birth control pills, antacid and anti-ulcer medications (Tagament, Zantac, Pepcid, Axid) etc., are also very important contributing factors when taken along with antibiotics, since Candida proliferates rapidly in the presence of these substances. If the antibiotic effect is strong enough, or long enough, it can eliminate the "good" bacteria along a portion or all of the intestinal wall. Because one of it's functions is to absorb water, diarrhea is a sign of the destruction of this bacterial layer.
Now, both of these substances are aggressive in its competition for space along the intestinal wall, and when "good" bacteria is eliminated, the Candida yeast is allowed to take up residence. The problem is, that whichever organism predominates in a section, this is the one that will work to keep out the other type. For instance; normally, good bacteria keep out the Candida, but the reverse is also true: when good bacteria are eliminated, and Candida gets a foothold, it is just as aggressive about keeping out the good bacteria. Candida then becomes the "norm" although it's proliferation in our bodies is anything but normal.
One of the things that is important to understand is that if our "bout" of diarrhea is over (which is generally accomplished by stopping antibiotics for a period and downing quantities of yogurt and acidophilus -- sources of the good bacteria), that it does not necessarily mean that you have replenished good bacteria along the entire length of the intestinal tract. While there may be a sufficient "re-population" to begin to once again re-absorb water, it does not mean that entire system is repopulated. In other words, there can be entire sections of the intestine still covered in Candida, and causing a diminished ability for normal bodily function along these lengths.
The second main reason that Candida can initially gain a foothold is through consumption of sugars. Quite simply, sugar is the favorite food source for Candida yeast. Happily fed, it will multiply. The sugar of the greatest offense is the simple sugars (sugar and sugary foods). However, although it's lesser in effect, complex sugars (also called complex carbohydrates -- breads, cereals, pasta, etc.) also have the ability to be broken down to be its food source.
How the Yeast Works (Against Us)
I've already mentioned how it can predominate in a section of the intestines, keeping out the normal "good" bacteria. This good bacteria is essential for our bodies to absorb the nutrients from the foods (or vitamins) we eat. If part or all of this is gone, we are without that ability to get that nutritional benefit from the foods we are eating. Furthermore, the yeast works to encapsulate the red blood cells, causing a diminished ability to do oxygen exchange across it's membranes.
Under certain conditions of advanced infection, the yeast becomes dimorphic (which is to say, it begins to grow in a second way.) It begins to grow in long strands that can pierce the intestinal walls, causing a condition known as "leaky gut". In this strand-like form, it's resistant to phagocytosis -- the normal elimination process via the immune system. This increased intestinal permeability can allow undigested macromolecule (large) food particles and toxins to pass directly into the body causing a great deal of problems. Because food particles larger than can be digested are now in the bloodstream, the body reacts to them with an allergic reaction. Furthermore, this creates an increased strain on the immune system, and the ability to fight against Candida (as well as other conditions) is even further reduced, beginning a cycle. Moreover, these particles can also cross the blood/brain barrier and be mistaken for neurotransmitters, creating a host of neurological symptoms.
In even more advanced stages, the fungus can grow into "balls" becoming even more resistant to its elimination.
DocDarren reports on his page (reference link long since gone) that there are well known relationships between yeast and such diseases as Chronic Fatigue Syndrome and Psoriasis. During one study a group of 1100 CFS patients were treated with antifungal therapy, and the number of patients who had been on disability at the beginning of the study, dropped from 685 down to 12. In a separate report from the Archives of Dermatology, Volume 120, April 1984, he lists one group of doctors stating that "four cases of long term, bodily psoriasis (10-25 years) were cured with oral nystatin (an antifungal) within several months."
With such significant findings, it begins to beg the question why it's not more readily recognized by the medical profession. There are several contributing reasons for this: One, medical labs routinely do not report it when they find it in their evaluations. The labs so commonly find it in their specimens that they consider it to be a normal bodily flora. To get these results from the labs, the doctors need to specifically request for these results from them --- a fact that even the good lyme docs are not commonly aware of. Another less cheerful, but perhaps somewhat factual reason may be that there is a great deal of money to be made from the treatment of the symptoms of yeast (chronic fatigue, allergies, psychological malfunction etc), and the actual cure could be a disincentive.
There are two quick ways come to mind here: There are several checklist-type tests listed on the internet and elsewhere. Many of them are various versions of the work of Dr. William G. Crook, M.D. While there is some varying opinion among doctors about this area, these quick tests are a good way to start. See this link for a copy of this test.
Dr. Crook has written several books on the subject, most notably, "The Yeast Connection". Information about contacting Dr. Crook, whose office I've experienced to be wonderfully gracious, is listed at the above named website.
A second, quick way to test is the "spit" test, as mentioned above. First thing upon arising in the morning, before you've cleared your mouth, spit into a glass of water. If your spit remain floating in a nice, adhered ball, you're probably without yeast. However, if it spreads out over the surface of the water, or if a portion of it begins to dissolve down into the water in strands that spread out, then you probably have a yeast condition. (This test is also possible to do successfully at other times of the day, but first thing in the morning is most indicative.)
More medically rigorous tests are:
- Serum or urine D-arabinitol levels. This is a Candida metabolite (and also a neurotoxin), although it may be difficult to find a lab to do this test.
- Stool exams using direct microscopic examination employing gram stains is the most accurate tool. Once again, labs routinely do NOT report the presence of yeast unless they are specifically asked for it --- and most doctors are not aware of this fact.
- To test for Serum IgG, IgM or IgA is NOT definitive since the body's ability to fight against Candida in the normal immune response is limited because of it's location in the intestines. Testing for IgE, however, may be helpful.
- Give a test of "challenge" or "elimination". In other words, observe if symptoms significantly change by eating increased amounts of sugar, or by eliminating it.
The elimination of yeast requires working in two basic areas: eliminate the yeast and repopulate the normal bacteria. Repopulating the normal bacteria would be assisted by consuming yogurt and acidophilus powder. The acidophilus powder is very important to take in addition to yogurt, because while yogurt's bacteria count is in the millions, that count from the acidophilus is generally in the billions.
Eliminating the yeast has a few more facets to it. One of the first things to do is to work to reduce or eliminate sugar consumption. Not only does Candida rapidly proliferate in the presence of sugar, but research has shown that sugars dramatically increase Candida's ability to adhere to the epithelial mucosa cells. Antifungal treatment depends heavily on this dietary change.
Another area that may be helpful is to perhaps eat smaller meals. Large meals travel further distance down the intestines before they are fully digested and absorbed. It's believed that the yeast generally resides far down that intestinal tract. If our meals are digested before they hit this area of the intestines, the yeast is effectively starved. Digestive enzymes (available in health-food stores) can help this process.
Attempt to avoid antibiotics, cortisones (steroids) --both topical and oral, and antacid or anti-ulcer medications. Candida has been shown to grow rapidly in the presence of these substances.
Some other suggestions are:
- Increase dietary protein and reduce carbohydrates. Proteins tend to starve yeasts, and carbohydrates ultimately break down into sugars. (I can't help but wonder if it's not this precise mechanism that accounts for success with the Atkins-type diets?)
- Taking oral glucosamine works to prevent the binding of Candida to epithelial mucosal cells, and works to restore the mucosal layer. (Many may remember this recommendation as helpful to lyme patients from the Dr. Burrascano "Guidelines".)
- There are several natural antifungals: caprylic acid, garlic, undeclyenic acid, gentian violet, and grapefruit seed extract (which is my personal favorite.)
- Most importantly, DocDarren, the molecular geneticist from whom most of this information has come, believes that there is no ultimate cure of yeast without prescription antifungals. These would include Lasimil, Diflucan, Sporonox and Nystatin. The antifungals work to dissolve the outer cell membranes of the yeast, causing them to disintegrate. He feels that nothing lesser than this strength would accomplish a permanent cure.
Notwithstanding, it's appropriate for me to mention here that I have personally seen success without such prescriptions by working in two areas: eliminating sugars and taking some natural preparations (see this page for a discussion of these products and strategies.) Although in the early stages of my treatment of this area, I had a two month's supply of the strong prescription Sporonox, in my drawer. At that time, I resisted taking it to see if I had the ability to successfully treat this condition without prescription antifungals. Many years later now, I did not need them, I will no longer take them.
What has been separately most interesting to me in this discovery now, is my understanding as to why those successful things that I had stumbled across to lessen my "lyme symptoms" had been successful in doing so. For instance, I had already found symptomatic success in taking digestive enzymes, and in eating smaller meals. Also, I'd found success in eliminating sugars (which many other lyme people have also discovered.) Further, I had discovered that taking Blue-Green Algae (a protein) or another protein drink on an empty stomach in the morning worked to clear my "brain fog". (Remember that proteins work against Candida?) In the light of the Candida infection, many of these things now make perfect sense.
Finally, in this essay, I've done my best to strike the balance here between "condensed" and informative. Long though it is, believe it or not, I've even left out a few things from this discussion.