CHRONIC FATIGUE IMMUNE DYSFUNCTION SYNDROME (CFIDS)
YEAST SYNDROME or YEAST RELATED ILLNESS
By Elmer M. Cranton, M.D.
Copyright © 2007 Elmer M. Cranton, M.D.
Terminology varies widely between different practitioners and differing theories of cause. The acronym "CFIDS" will be used in this article to refer to a clinical syndrome which can cross the boundaries and involve, more or less, any of the below:
CHRONIC FATIGUE IMMUNE DYSFUNCTION SYNDROME — CFIDS — CHRONIC FATIGUE SYNDROME — CANDIDA ALBICANS SYNDROME — CANDIDIASIS — MYALGIC ENCEPHALITIS — EPSTEIN-BARR SYNDROME — FOOD ALLERGY — MONILIA — ENVIRONMENTAL ILLNESS — SICK BUILDING SYNDROME — ECOLOGICAL ILLNESS — CHEMICAL SENSITIVITY — ALLERGIC TENSION FATIGUE SYNDROME — HYPERACTIVITY SYNDROME — ATTENTION DEFICIT DISORDER — DYSLEXIA — ASTHMA — HYPOGLYCEMIA — POST FLU SYNDROME — MERCURY TOXICITY — HEAVY METAL TOXICITY
INTRODUCTION
A variety of widely diverse symptoms, seemingly unrelated, affecting many different parts of the body, are now believed to be caused, at least in part, by an overloaded immune system and immunologic dysfunction. A stressed-out and malfunctioning immune system is felt to be an important and treatable cause of many the above listed conditions. Chronic fatigue and nervous tension are almost always present.
A
number of case histories are presented in the patients own words on another page.
The treatment plan described here was empirically developed by the author over many years and has brought relief to hundreds of patients who been treatment failures elsewhere. Benefits have sometimes been dramatic and complete, after attempts with many other therapies had failed.
Chronic fatigue is increasing experienced in the industrialized nations throughout the world. Related immune dysfunction is becoming an epidemic. This increase in the latter part of the twentieth century parallels proliferation of stress to immunity from food allergy, environmental, nutritional, pharmaceutical, and lifestyle factors.
It has been observed that over 60% of Americans needlessly suffer from some form of delayed food allergy, food intolerance or environmental sensitivity, causing chronic health problems, as partially outlined in the list below. Food and chemical sensitivity are associated with a large number of chronic conditions, either as a cause or a contributing factor. These include:
Anxiety (acute or chronic)
Arthritis (osteoarthritis especially)
Asthma
Nasal and sinus congestion
Attention Deficit Disorder
Learning and behavior disorders
Bed wetting
Bloating
Bronchitis
Celiac Disease
Non-tropical sprue
Ulcerative colitis
Chronic Fatigue
Constipation
Cystic fibrosis
Depression
Diarrhea
Gastritis
Headaches
Hyperactivity Disorder
Inflammatory Bowel Disease
Insomnia
Irritable Bowel Syndrome
Itchy skin problems
Malabsorption
Migraine
Sleep disturbances
Water retention
Weight control problems
Sexual dysfunction
Infertility
Menstrual disorders
And many more
The diagnosis as listed above may be correct but treatment can often be easier and more successful by also following this protocol. Symptoms of autism and Down's syndrome can also be helped.
Symptoms of CFIDS are commonly misdiagnosed as neurotic or psychosomatic. A variety of diagnostic terms are used to describe this variable constellation of symptoms, or syndrome. A common denominator, collectively referred to as CFIDS, is immunologic dysfunction, often accompanied in women by hormonal imbalance. Premenstrual symptoms and fertility problems can be related.
Great improvement in hundreds of patients has followed the treatment program described below. Because there are no specific laboratory tests to confirm a diagnosis in advance, medical history and response to a trial of therapy remains the only way to make the diagnosis.
This paper and the program of therapy described is unproven and anecdotal by strict scientific criteria. Conclusions herein are based on the author's personal observations and success in treating hundreds patients with symptoms of CFIDS. Many of those patients had failed to respond to multiple prior treatment programs. What is described here is eclectic, based on experience with patients. Much was learned from the patients themselves and not from medical schools or elaborate scientific research.
This treatment regimen often works in practice. It is safe and inexpensive, relative to the cost of the many prior unsuccessful treatments. Not all patients respond. Significant improvement occurs in only about half of patients. Unfortunately, it is not possible to know in advance who will respond and who will not. Of the non-responders, many would not follow instructions or found it impossible to avoid offending substances in their diet or environment.
Nothing in medicine is 100% effective. The scientific basis for the observations, recommendations, and conclusions in this paper is hypothetical. Blinded placebo controlled studies have not been done. Most physicians would consider the conclusions and recommendations in this paper as experimental at best and pure quackery and exploitation at worst. Medical insurance commonly often refuses to reimburse the costs.
The most frequent and incapacitating symptom in patients with CFIDS is fatigue, without an evident cause. Depression or other mental dysfunction is commonly present, but may be an effect of the underlying illness rather than the primary diagnosis. Physical examination and laboratory tests are seldom diagnostic.
Adverse reactions to many otherwise desirable and nutritious foods (so-called food allergy) are common. Sensitivity to chemical fumes, perfumes, solvents, and other substances is also very common. Respiratory allergy, nasal and sinus congestion, and hay fever may or may not be present. Digestive tract symptoms, urinary symptoms, and musculoskeletal pain are common.
By reducing stress on the immune system, and by keeping that stress to a minimum for several months, many patients who have suffered with symptoms for many years have found relief. Significant reduction of immune system stress and relief of related symptoms can be accomplished by following the treatment program described below. A hypothetical mechanism of action is offered, but the treatment protocol is based on observations of what works in practice, not on theory.
There is no easy way to do this. Because of the non-specific nature of symptoms, a thorough initial evaluation with laboratory testing are important to rule out other unsuspected causes. But there are no reliable tests that can be done in advance, to diagnose specific sensitivities.
On many occasions, patients who may have found partial relief based on blood tests, skin tests, adrenal tests, etc., have subsequently discovered up to 40% false positives and/or 40% false negative results from testing alone. They usually find that there is much more to their problems by following the full protocol described below
―a program that is as useful for diagnosis as it is for treatment.
YEAST AND FUNGUS
Yeast and other microscopic fungal organisms compose a normal part of the body's internal ecology. They are normally well tolerated by a healthy immunity. If they increase in number, however, they cause additional stress to the immune system. Is is widely recognized that mold, including yeast and fungi, are among the most allergic of environmental exposures.
It is a medical fact that every healthy person will react allergically to
Candida albicans, a common yeast, also called Monilia. A clinical test for normal immunity requires injecting a small amount of Candida (Monilia) yeast extract under the skin and observing for a raised, red allergic reaction over several days. If that reaction does not occur, the patient is diagnosed as "anergic," indicating that the immune system is not functioning. In other words, a healthy human body is expected to react allergically to
Candida yeast unless immunity is paralyzed or non-functional. This universal reactivity to
Candida albicans is evidence that the presence of yeast in the body creates stress to the immune system. If
Candida increases, immune stress increases.
For purposes of simplification, all species of yeast and fungus, which grow in the human body, are collectively lumped together in this paper as "yeast."
Many pharmacological, dietary, environmental and life-style factors encourage growth of yeast in body's of people in industrialized countries. When yeast overgrowth becomes obvious, it is easily diagnosed as an infection and treated appropriately with anti-fungal medicines. More commonly, however, yeast colonization increases, especially in the large intestine, but is not adequate to diagnose an infection. It is an ecological imbalance in the body that adds to total load on the immune system.
Treatmentwith a combination of prescription medicines to eliminate yeast from the body, combined with other dietary and lifestyle strategies to remove other stresses from the immune system, can successfully treat CFIDS in many cases. This program has helped hundreds of Dr. Cranton's patients who had previously been unresponsive to treatment elsewhere.
Yeast overgrowth is partly iatrogenic (caused by the medical profession) and can be caused by antibiotics and cortisone medications. A diet high in sugar also promotes overgrowth of yeast. A highly refined and chemicalized diet now common in industrialized nations not only promotes growth of yeast, but is also deficient in many of the essential vitamins and minerals needed by the immune system. Chemical colorings, flavorings, preservatives, stabilizers, emulsifiers, etc., add more to stress on the immune system.
The most effective and long-lasting treatment for CFIDS has proven to be a four-pronged approach: (1) a combination three anti-fungal medicines, taken together; (2)
a diet that avoids many commonly eaten foods to which the immune system is often sensitized; (3) avoidance of environmental pollutants, fumes, fragrances, food additives, etc. and, (4) supplemental vitamins, minerals and trace elements to support immunity. That program reduces stress on the immune system in many ways while providing nutritional support. It has been found most effective to continue treatment for several months to allow normal immunity to recover and allow normally present bacteria to repopulate the digestive tract after yeast have been eliminated.
Most of what the author writes about this condition stems directly from experience treating patients. The existence of and treatment for CFIDS is still considered controversial in medical centers.
OCCULT FUNGAL PATHOGENS
Yeast and fungal infections of the skin, mouth, nails, vagina, and digestive tract have long been recognized and are easy to diagnose, but a relationship has only recently been discovered between yeast colonization, often sub-clinical and otherwise unapparent, with a wide variety of disabling symptoms.(1-8)
Yeast and molds belong to a broad family of plant life called fungus. Mildew, bread mold, and mushrooms are also types fungus. All yeast are fungi (plural of fungus) but all fungi are not yeast. The terms "yeast," "fungus" and "mold" are often used interchangeably. They all share allergic potential and immunological properties.
The most widely present single-cell fungal organism (yeast) is
Candida albicans (formerly called Monilia), which exists quite normally in low concentrations on the skin and inside the digestive, respiratory and reproductive organs. Because
Candida is a normal constituent of human micro-ecology, the mere presence of
Candida is not sufficient to make a diagnosis of "infection." It is always present.
A healthy person will tolerate normally present
Candida. However, yeast and other fungi release many bioactive and allergenic substances into the body, which increase to exceed tolerance as yeast increase. These substances can be toxic, allergic, and hormonal in nature.
Substances released by yeast include:
1) Allergens, which react classically, causing symptoms of itching, hives, skin rashes, nasal congestion, cough, bronchitis, irritable bowel, and asthma. More than 70 distinct allergic molecules have been found to be produced by Candida albicans.(4)
2) Fungal poisons (mycotoxins) include aflatoxin, ergot poisoning and mushroom poisoning. The list ofknown mycotoxins is very long and not widely recognized.(9) Dr. Iwata, in Japan, has icataloged many toxins produced by
Candida albicans, which poison the nervous and immune systems.(10) Acetaldehyde (similar to formaldehyde) is also secreted by
Candida albicans and is one potential cause of yeast-related symptoms.(11) Immune system abnormalities have long been associated with
Candida.(12) Other incurable diseases of unknown cause, presumed immunologic, such as psoriasis and multiple sclerosis, have been reported to improve, sometimes dramatically, following anti-fungal therapy.(13-14)
3) Hormonally active molecules are also produced by
Candida. Symptoms related to the female reproductive system, including PMS, cystic breast disease, infertility, and reduced sex drive, have been reported to improve following treatment with anti-fungal medications. Those observations are evidence for interference with normal hormonal function by yeast and fungus overgrowth.
There are many different strains of
Candida albicans. Different strains produce widely different toxins, allergens and hormone-like substances. Patients also vary widely in their sensitivity and response to those substances. This results in a wide diversity of ill-defined yeast-related symptoms in CFIDS. The seemingly neurotic nature of many such complaints has delayed more widespread recognition of this clinical syndrome. Response to therapy of CFIDS following anti-fungal medications does provide evidence for a direct causal relationship between yeast and symptoms.
Many physicians are unaware of lasting adverse effects caused by routinely prescribed medications such as antibiotics. Antibiotic therapy for minor colds and runny noses is a common practice. People routinely receive multiple courses of broad-spectrum antibiotics throughout life or are injected with long-acting corticosteroid medicine for joint or muscle pain.
Once established, sub-clinical colonization with yeast in the body may persist unrecognized for many years. Antibiotics, such as tetracycline, can greatly increase yeast in the colon after only a few days.
Yeast is well recognized to cause vaginitis in women, diaper rash and thrush in infants. Yeast and fungus are also common causes of other skin infections including athlete's foot, jock itch, ringworm, paronychia, intertrigo, anal itching, seborrhea (dandruff), tinea versicolor and onychomycosis (causing fingernail and toenail deformities). Those conditions are rarely considered serious, although many women troubled by persistent or recurrent vaginitis would state otherwise.
It is not widely recognized that those conditions often occur in patients with previously weakened immune system, resulting in lowered resistance to yeast infection. The most common and overlooked site for yeast proliferation is the large intestine. Constipation is commonly caused by yeast. Yeast in the colon release large amounts of allergens, toxins and other hormonally active substances into the circulation, without raising a suspicion of where the problems are coming from.
IF THIS IS SO COMMON, WHY IS IT NOT MORE WIDELY RECOGNIZED?
It is common in the history of medicine that recognition of a safe and effective therapy may not occur until an accepted scientific rationale is found to fully explain observed benefits.(15) Highly effective therapies have been rejected in the past, sometimes for decades, merely because they were innovative and did not fit with currently accepted theories.(16)
Clinical experience and observation of benefit should be the "gold standard" on which patient care is based. Patients should not be deprived of a safe and effective treatment only because the scientific basis has not been fully researched and proven.(16,17) If thorough medical evaluation shows no other plausible cause for symptoms of CFIDS, a trial of anti-fungal therapy with dietary and environmental avoidance of potentially offending substances will cause no harm.
There are no definitive tests to diagnose CFIDS in advance of treatment. Response to therapy, as described in this paper, is the only practical way to confirm a treatable condition, which would otherwise remain untreated.
HISTORY
In the late 1970's Dr. C. Orian Truss, an allergist in Birmingham, Alabama, first published and lectured on the wide variety of CFIDS symptoms associated with
Candida albicans.(4-6,11) Dr. Truss successfully treated many hundreds of chronically fatigued, allergic and depressed, seemingly neurotic patients. His patients experienced great improvement following prolonged treatment with oral nystatin, an anti-yeast medicine. Dr. Truss' patients suffered with a wide variety of symptoms which had often not responded to many other treatments.
Patients of Dr. Truss' who improved with his therapy reported the following types of medical histories:
1. Having been treated, sometime many years previously, for acne with prolonged courses of tetracycline or other antibiotics.
2. Multiple courses of antibiotics for urinary tract infections, sore throats, ear infections, bronchitis or sinus trouble;
3. Use of oral contraceptives;
4. Treatment with cortisone-type medicines or injections.
Dr. Truss was the first to describe this syndrome of "yeast-related illness," characterized by the following symptoms, with varying severity and in different combinations (I now classify these symptoms more broadly as CFIDS):
1. Nervous symptoms, including fatigue, headache, dizzy spells, anxiety, "nervous tension," panic attacks, depression, schizophrenia, insomnia, irritability, impaired memory and "spaced out" feelings. Complaints of nervousness, depression and unexplained fatigue were the most commonly present symptoms.
2. Reproductive tract symptoms, including premenstrual syndrome (PMS), infertility, cystic mastitis (painful breast lumps), pelvic pain, painful intercourse, recurrent vaginitis, prostatitis, reduced sex drive and impotence. Patients had often received repeated courses of antibiotics for infections of the bladder or prostate.
3. Digestive tract symptoms, including unexplained and chronic abdominal pain, canker sores in the mouth, esophagitis, indigestion, heartburn, constipation (often alternating with diarrhea), anal itching, gas, bloating, spastic colon, and intolerances to common foods. Multiple surgical procedures had sometimes been performed, without benefit until anti-yeast therapy was prescribed. A persistent coating on the tongue was a common finding.
4. Other chronic and resistant symptoms, including unexplained muscle and joint pain; arthritis; headaches; visual disturbance; difficulty thinking, remembering and concentrating; recurrent sore throats; swollen or painful glands (lymph nodes); low grade fevers of unknown origin; sensitivity to heat or cold; hair loss; numbness or tingling in the face or extremities; persistent nasal congestion; cough; and respiratory allergies. Many patients were abnormally sensitive to a variety of environmental exposures, including tobacco smoke, perfumes, sprays, formaldehyde, petrochemical products, exhaust fumes and other odors. They became "spacey" or felt ill breathing the chemical odors in shopping malls, fabric stores or shoe stores. They reacted adversely to many common and nutritious foods, especially the grains, sugar, and milk products.
Much to their distress upon seeking medical advice, such victims of CFIDS are often told, "Your physical examination and laboratory studies are all normal. Your symptoms are '
"psychological." In other words, "you're imagining your illness." Physicians and family alike would consider such patients to be "hypochondriacs." Victims of CFIDS would go from doctor to doctor, year after year, with no benefit.
William G. Crook, M.D., a pediatric allergist from Jackson, Tennessee, subsequently published confirmatory reports to support Dr. Truss' original observations.(2,3,7,8,15)
Patients included all age groups and both sexes. Children with learning disabilities, dyslexia, hyperactivity, attention deficit disorder, food allergies, drug abuse and a variety of delinquent and emotional disorders, had often received repeated courses of antibiotics for recurrent ear infections, bronchitis and other conditions
―including prolonged courses of tetracycline for acne.
Even patients who had been committed to mental hospitals have been helped by anti-fungal therapy. Other puzzling immunologic diseases, including multiple sclerosis, rheumatoid arthritis and lupus erythematosus, have responded better when attention was given to reduction of yeast and immune stress. A wide spectrum of allergic disorders, from classical hay fever to chronic, delayed-onset type of food allergy and petrochemical sensitivity, have improved following anti-yeast therapy.
The use of allergy injections has been eliminated in many cases. Injection therapy has never been of much help in food allergy. Avoidance and anti-yeast therapy are the most effective long-term programs. Tolerance to previously offending foods and exposures often improved after several months of anti-fungal therapy.
DIAGNOSIS
Unfortunately, there exists no reliable laboratory test to prove or disprove the presence of CFIDS. Yeast and fungus are normally present in everyone. Because of the ubiquitous nature of yeast, cultures and microscopic smears are not of much use.
A thorough examination prior to therapy is important to insure that an otherwise treatable condition is not being overlooked. Response to a course of therapy will then confirm or refute the diagnosis of CFIDS. Many laboratory tests are available to assess antibodies and immunity. In practice, however, those laboratory tests do not predict which patients will respond to this therapy. Because testing is expensive (and often too new for routine reimbursement by medical insurance) a trial of therapy may be the most reliable and also the most cost-effective way to diagnose and manage CFIDS.
The most reliable predictor of response is the typical past medical history and symptoms. Several
case histories will demonstrate this. In addition to factors described above, a diet high in sugars, including natural sugars such as fruits, fruit juice and honey, etc., is common. Yeast grow more rapidly in the presence of sugars and simple carbohydrates. Symptoms often worsen following sugar intake. So-called "hypoglycemia" frequently has an element of CFIDS and will improve following anti-yeast treatment.
Adverse and allergic reactions to prescription and non-prescription medications, chemical fumes, solvents, perfumes, shopping-mall odors, and even nutritional supplements are a common complaint. Presence of those symptoms increases the likelihood of benefit from this therapy.
Response to treatment remains the most reliable way to confirm or disprove a suspected diagnosis of CFIDS. Diagnosis can only be suspected from the medical history, after other types of illness have been excluded by a thorough medical evaluation and by lack of response to other therapies.
COEXISTING VIRAL INFECTION
Persistent and chronic viral syndromes have been well-documented in patients with CFIDS. Those include Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Coxsackie-B, and other viruses. Laboratory tests are available for many viruses, and both alpha interferon and interleukin-2 (IL-2) tend to be elevated in the presence of viral replication. It is postulated that some symptoms of CFIDS may be caused by increased alpha interferon and IL-2.(18-21)
If immunity is impaired, increased susceptibility to viral infection is expected. Many viruses normally lie dormant throughout life. They only become active if the body's defenses are weakened. For the most part, the only good defense against viral infections is a healthy immune system. The treatment program described below can benefit CFIDS by removing immune stress, allowing immunity to become stronger. Although chronic viral syndromes and CFIDS may co-exist, not all patients with CFIDS have viral problems.
The presence or absence of a diagnosable viral syndrome does not seem to alter potential benefit from this therapy. Viral testing is also expensive and is therefore not routinely performed prior to therapy.
Both viruses and fungal organisms create stress to the immune system. It is therefore quite probable that one can predispose to the other. Any treatment which strengthens natural immunity can improve either condition. In that way anti-fungal therapy may hasten recovery from a chronic viral syndrome.
TREATMENT
1. DIET
During the first three months or more of treatment a so-called "
Cave Man Diet" or rare food diet is recommended. Bear in mind, however, that after two months of elimination combined with triple anti-yeast medicines, many foods that would have previously caused symptoms will be better tolerated.
Simple carbohydrates are restricted. Even natural sugars, fruits and fruit juices are reduced, since they promote the growth of yeast. Many nutritious foods that are more stressful to the immune system are eliminated. Equally nutritious but rarely eaten foods are substituted. Foods eliminated for several months include milk products (all dairy and everything containing dairy products) and all grains (including wheat, corn, rye, rice, barley, etc.) and most other frequently eaten foods. Of the so-called "junk foods," chocolate, cola, candy, pastries and other sweets are eliminated. Food intolerances can be quite individual but these eliminated foods have been the most common food allergens in clinical practice. Regardless of the reason, this program works in practice.
The following foods should be minimized:
1. Refined and simple sugars, including table sugar, honey, syrup, molasses, fruit juices and dried fruit. Small servings of unsweetened fresh fruit may be consumed in limited amounts--up to three moderate servings per day.
2. Breads and bakery products, which contain wheat, rye, corn and yeast, are eliminated. Rice, oats and barley are somewhat better tolerated, but most patients respond better if they avoid all grains for several months. Potatoes are better tolerated as a substitute for grains. Sweet potatoes and yams are highly nutritious and are the best grain substitutes that are least likely to cause problems.
3. Other foods stressful to the immune system that might will slow recovery include mushrooms, chocolate, cola (even diet cola drinks), chemical flavorings, colorings and sweeteners, and alcoholic beverages. An occasional patient must temporarily restrict all carbohydrates to as little as 25 to 50 grams per day before improvement begins. As improvement progresses, intake of unrefined, complex carbohydrate may be increased to a more desirable level.
The most frequently eaten foods are those which are most likely to cause or aggravate symptoms. The immune system becomes sensitized by prolonged and repeated exposures. Symptoms may be triggered by either protein and carbohydrate foods. Fats are less likely to be bothersome. Sensitivity should be suspected to favorite foods, especially if they are craved and eaten frequently. Sensitivities to foods can best be diagnosed by testing for provoked symptoms after strict dietary elimination until symptoms improve.
In order to consistently relieve and then provoke food-related symptoms, elimination should be preceded by a few weeks of daily consumption. Sensitivity tends to fade with avoidance.
Sensitivity most often occurs to a number of different foods simultaneously, making diagnosis difficult. All of the reactive foods and environmental exposures must be avoided for long enough for symptoms to fade before provocative testing can be done.
Impaired immunity predisposes to food and chemical sensitivity. So-called food allergy might be best considered a symptom of CFIDS and not the primary problem. All potentially reactive foods should be avoided during the initial period of treatment with anti-fungal medicines to remove as much stress as possible from a disordered immune system. Continued intake of just one reactive food can mask reactions to another food when it is added back. Only after most if not all symptoms have improved is it possible to do provocative testing for food allergy. The so-called "
Rare Food Diet," also known as the "Cave Man Diet," has clinically been most successful in relieving symptoms.
Various blood and skin tests are promoted for food allergies, but false-positive and false-negative results are common. Blood testing can be accurate for the rapid onset type of allergy accompanied by hives that can occur with shell fish or grass pollen. Most food allergies come on slowly, they often require repeated exposures and tend to fade with elimination from the diet. Blood testing for that type of allergy has proven to be very unreliable, with a high percentage of both false positive and false negative results. The only reliable test for sensitivity to a specific food or chemical is consistent improvement following elimination and reoccurrence of symptoms following a challenge. Onset of symptoms after exposure to a food allergen may not occur until hours or even days later, and often requires multiple exposures.
Food allergies tend to change as diet is changed. They are often not "fixed" allergies. The foods, which are eaten most, are most likely to cause symptoms. Sensitivity to those foods slowly fades after elimination. Allergic foods may again be tolerated after several months of avoidance while previously "safe" foods may begin to cause symptoms, as their frequency of consumption is increased.
Rotation of dietary foods, avoiding repeated consumption of botanically related foods more often than every fourth day, is sometimes helpful for severely allergic patients. After a course of anti-fungal therapy, especially the triple therapy as recommended here, reactive foods are often better tolerated.
Small traces of bakers' yeast or other types of yeast which occur in food may be tolerated, while the foods themselves, such as dairy or grain products, may cause symptoms. It is a common misconception that the yeast in bread and not the wheat is causing the problem.
Patients usually discover that they feel better and have fewer allergic symptoms if they limit consumption of milk products, wheat and corn throughout life. If eaten infrequently, they may not cause problems.
2. MEDICATION
Yeast and fungi can develop resistance to anti-fungal medicines, and a significant percentage of yeast and fungi in the body at any given time will be resistant to any one anti-fungal medicine. In clinical practice, it has been found more effective to combine more than one anti-fungal medicine simultaneously. Two or three of the following medicines are given together for one to two months. These medicines require a physician's prescription:
A. Nystatin: Brand names include Nilstat
®, and Mycostatin
® (available in powder, tablet, suspension, suppository and capsule forms). Generic forms of nystatin are also available but some sources can be bitter tasting and impure. Only the pure powder, available from compounding pharmacists, is free of chemical colorings, additives, and allergens. Beware of receiving nystatin a foot powder instead of the pure pharmacologic grade for internal use.
When the powder is taken directly into the mouth it is more effective and eliminates yeast in the mouth which can seed the intestine. The usual dose of nystatin powder is 1/4 teaspoon four times daily (which is equivalent to 4 tablets containing 500,000 units each four times per day). This is twice the dose customarily prescribed by most physicians. Nystatin is not absorbed from the digestive tract in any significant amount and is an extremely safe medication, even at higher doses. This dosage is what works best in practice.
Nothing should be taken by mouth for 20 to 30 minutes after taking the nystatin powder. This allows a coating to remain in the mouth and upper digestive tract for long enough to eliminate yeast in those locations. Prolonged administration is usually necessary
―several months (occasionally a year or more) before full benefit is achieved.
The "
rare-food diet" is maintained throughout the time of anti-fungal therapy and for several weeks thereafter. Gradual improvement is usually observed during the second and third month of therapy
―although sometimes sooner. This program requires patience. After improvement plateaus out, and symptoms are much improved, medicines are discontinued. The greatest improvement may not occur until after the anti-fungal medicines are stopped.
If symptoms return, anti-fungal medicines may again be prescribed for a month at at a time and the more allergenic foods again eliminated until improvement can persist without medication. Lasting benefit has been seen much more frequently after two or three anti-fungal medicines are given together. When improvement is maintained for at least a month without medication, a more normal diet may gradually be resumed, doing provocative testing for each added food for sensitivity as described above. Eliminated foods are added back one at a time to test for continued sensitivity.
If antibiotic therapy should become necessary for treatment of a serious bacterial infection, which would not otherwise resolve spontaneously, it is advisable to subsequently resume the anti-yeast program for a month or more, but only after antibiotics are discontinued. Administration of anti-fungal medication simultaneously with antibiotics could theoretically promote the growth of resistant fungal organisms against which no therapy would be effective.
Broad-spectrum antibiotics such as ampicillin, tetracyclines, and the cephalosporins are more likely to cause yeast overgrowth. Treatment with topical antibiotics on the skin or the use of less potent antibiotics, such as penicillin-VK, sulfisoxazole, and nitrofurantoin, are not as likely to reactivate yeast overgrowth.
Nystatin powder should be stored in a refrigerator if kept for a prolonged period, although a few weeks at room temperature will not cause a problem. Nystatin slowly takes on a bitter taste at room temperature. Nystatin should not be exposed to high temperatures or left in a parked automobile on a hot, sunny day. Taste and bitterness normally vary somewhat from batch to batch. Nystatin is one of the least toxic of prescription drugs. It is safer to use than most non-prescription products. Nystatin merely coats the interior of the mouth, throat, esophagus, stomach and intestine, preventing yeast from multiplying.
Mild side effects may occasionally occur during anti-yeast therapy, including nausea and skin rashes. Most such symptoms are the result of yeast die-off and not from the nystatin itself. Some patients may experience a temporary increase in the symptoms, such as fatigue and depression during the first few weeks of treatment with anti-fungal medicines. This phenomenon has been attributed to a yeast "die-off" effect or Herxheimer's-like reaction and long-term benefits are not reduced. If the medicine is stopped too soon, yeast can easily recolonize.
Nystatin powder is preferred over tablets, capsules and suspensions because the pure powder contains no chemically derived coloring agents, binders, flowing agents, sugar or other potential allergens. The powder begins its work in the mouth and coats the upper digestive tract. Tablets and capsules do not dissolve until they reach the stomach or lower and are therefore less effective. Commercially available nystatin suspensions marketed as prescriptions for the treatment of thrush in the mouth contain very little medication and it suspended in a solution of sugar. The pure powder is thus much more effective.
Nystatin powder is best placed on the tongue dry by inverting a half-teaspoon measuring spoon in the mouth and tapping the spoon against the upper teeth, then allowing the powder to mix with saliva. Rub it into the tongue and swish it around for several minutes in contact with the tissues in the mouth and throat, before swallowing.
Nystatin powder possesses two advantages over tablets and capsules. It is less expensive and it is effective against yeast in the mouth, throat and esophagus where the tablets and capsules have no effect. Patients with symptoms of sore tongue, canker sores, indigestion and heart burn (hiatal hernia or esophagitis) improve more quickly following treatment with nystatin powder
―providing evidence that yeast overgrowth is at least partly responsible for those symptoms.
If saliva is not adequate, a small sip of water or juice may be used to swish the powder into the mouth, making a paste to coat the gums and tissues. Small children may object to the taste unless a small amount of fruit juice or applesauce is used to mask the taste of medicine. The more concentrated the nystatin, the more effective it will be.
Female patients may improve more rapidly with the simultaneous use of small doses of an anti-yeast vaginal cream, one-half applicator or less once daily at bedtime, when symptoms of vaginitis are present. Some yeast are normally present on vaginal tissues and even small numbers may increase symptoms in a highly sensitized patient. Keeping yeast colonization to a minimum throughout the entire body for several months lowers stress on the immune system and allows gradual recovery.
Vaginal creams and suppositories all contain a chemical preservative, which is potentially allergic. The creams themselves may cause allergic symptoms which mimic yeast. If either Sporanox
® or Diflucan
® is used together with nystatin, as described below, vaginal therapy is usually not necessary.
B. Sporanox
® (generic name itraconazole): Is taken by mouth in capsule form and is fully absorbed in the upper digestive tract. Because it is absorbed, Sporanox is not as effective for reducing yeast inside the intestinal cavity and colon where there is no blood circulation. The usual dose is one 100-mg capsules daily with the largest meal of the day. Absorption is better with food in the stomach.
Sporanox
® is indicated in preference to Diflucan (described below) when skin or nails are affected by yeast or fungus. Sporanox is concentrated to a greater extent in skin and nails.
C. Diflucan
® (generic name fluconazole)is very similar to Sporanox
®. Diflucan
® seems to work somewhat better when vaginal yeast is a symptom. Concentrations of Diflucan
® in body fluids are somewhat higher than Sporanox
® but Diflucan
® is not concentrated as much in skin and nails. Otherwise, in practice there does not seem to be much difference between Diflucan
® and Sporanox
®. It probably does not make much difference which one of the two medicines is used.
Either Sporanox
® or Diflucan
® is used as one of the three anti-fungal medicines administered in combination. But Sporanox
® and Diflucan
® are never prescribed together. (Nizoral
® is no longer preferred because of greater potential for liver toxicity.)
D. Amphotericin-B is an anti-fungal drug which, like nystatin, is very safe and not absorbed systemically when taken by mouth. (An injectable form of amphotericin-B is quite toxic, however, and its use is restricted to treatment of life-threatening systemic fungal infections.)
The oral form of amphotericin-B is very safe and non-toxic. Amphotericin-B is a more potent anti-yeast medicine than nystatin. Oral forms of pure amphotericin-B are presently available at only a few specialized compounding pharmacies in the United States. It has been approved by the FDA for use by mouth and was marketed in the United States for many years in combination with tetracycline. That FDA approved product was named Mysteclin-F
®. To treat yeast problems, you do not want the form that is combined with tetracycline.
Amphotericin-B in pure form for oral administration is can also be obtained at pharmacies in many other countries (often without a prescription). It is sold in France, on prescription only, under the brand name Fungizone
®, in 250 mg capsules. In Germany and Switzerland the prescription form is called Ampho-Moronal
®, as 100 mg tablets.
Patients recover more quickly and often remain well without further medication when amphotericin-B is combined with nystatin and Sporanox therapy. The best form of amphotericin-B is a powder inside 250 mg capsules (Fungizone
® is formulated in this manner). The capsules can be opened and emptied into the mouth four times daily, along with the nystatin, and mixed with the nystatin powder in the mouth.
Several US sources of Amphotericin-B and nystatin powder are listed on our webpage entitled "
How to get Amphotericin-B".
E. "Triple therapy", the simultaneous daily administration of nystatin powder, amphotericin-B and either Sporanox
® or Diflucan
®, for one to two two months, has led to lasting improvement in a large percentage of patients who had previously been resistant to therapy. Patients should continue all three medicines for a month or two and then continue with the dietary restrictions for another month or longer, for as long as progressive improvement continues to occur.
INJECTION THERAPY
Skin testing with allergens and injection therapy with extracts containing reactive pollens, molds and dust is sometimes helpful, but allergies often resolve following this anti-yeast program without the need for injections. Injections have not been found to be of benefit in food allergy. The use of triple anti-yeast therapy, and the complete program described in this paper, have eliminated the use of skin testing and injection therapy. The same is true of other types of neutralization therapy or sublingual therapy. If this treatment plan restores more normal immunity, the allergies are no longer such a problem and other types of therapy become irrelevant.
Stresses to the immune system are additive. Once a threshold for tolerance is exceeded, adverse reactions tend to occur to many different substances. When the immune system becomes stronger, the threshold for tolerance increases and so-called allergies are less likely.
Think of the immune system as a tired pack horse, which has been forced to carry an excessive load for many miles. When it finally collapses it is greatly weakened. It will not be able to tolerate a normal load until all of the load is removed and the horse is nursed back to health. The same principle applies to the immune system. By eliminating yeast, fungus, potentially allergic foods, chemical exposures, perfumes, insecticide residues, etc., from the body, the load is greatly reduced. After a period of rest, often requiring several months, immunity recovers to the point that a more normal diet and life-style can once more be enjoyed.
OTHER TREATMENT MEASURES
Non-specific supportive measures include:
A. A healthy, active life-style, a nutritious diet with avoidance of refined and processed foods, avoidance of tobacco and avoidance of excessive alcohol are important. A good attitude also speeds recovery.
B. Nutritional supplementation with a balance of high-potency, hypoallergenic, yeast-free multiple vitamins, minerals, trace-elements, and anti-oxidants will insure optimal intakes of essential micronutrients and support immunity. Many nutrients essential for immunity (B-complex, selenium, zinc, vitamin C, vitamin E, and many others) are marginal to deficient in the diets of many Americans. DHEA 25-50 mg/day has been shown to help boost immunity.
C. Avoidance of exposure to petrochemicals, fumes, perfumes, hair-sprays, insecticides, exhausts, and other potentially reactive substances, which stress immunity, will speed recovery. Careful avoidance of insecticide fumes and residues, which are quite toxic, and avoidance of musty, moldy areas in the environment, both at home and at work, will assist recovery.
DISCUSSION
CFIDS does not have a single cause such as
Candida albicans or Epstein-Barr virus. Disordered immunity is the underlying common denominator, with many contributing factors, all adding together until a threshold of tolerance is exceeded. All people normally have
Candida albicans in their bodies. A positive skin test for allergy to
Candida is a medical test for a competent immune system. Every healthy person is sensitized.
Everyone also harbors a variety of inactive viruses. Healthy immunity keeps them inactive. Only when immunity is impaired do Epstein-Barr and other viruses leave dormancy and multiply. Yeast and viruses are also kept in their proper place without symptoms if immunity is adequate.
For those reasons cultures for yeast, blood tests for yeast antibodies, skin tests and viral studies have thus far not been very useful in the diagnosis or treatment of CFIDS. If symptoms are typical, a trial of therapy is the easiest and most cost-effective way to determine if benefit will result. The form of treatment described in this paper has helped hundreds of patients who previously did not benefit from other types of treatment.
The most common pitfall of this therapy is loss of patience, lack of persistence and stopping therapy before full improvement is realized. Initial benefits often take two to three months to begin. The so-called yeast "kill-off" effect and "withdrawal" from favorite and addictive foods may initially make symptoms worse. Patients become discouraged.
Patients who have been sick for a long time and who have failed to find benefit elsewhere are the ones who will be motivated to follow this program for the months required to achieve lasting benefit." - Dr. Cranton
January is Radon Awareness Month - a good time to learn more about this carcinogenic natural radioactive element. Radon is an odorless, colorless gas produced by the breakdown of uranium that seeps out of the earth. The Environmental Protection Agency estimates that about 21,000 lung cancer deaths are caused by radon each year. In the home, radon sometimes enters basements through concrete cracks and becomes concentrated in the air that we breathe. It can also be present in natural materials that are brought into the home - including granite countertops. Some granite and other natural stones contain trace amounts of uranium; if it emits radon, it typically does so at very low levels. But in some instances, tests have found that granite countertops give off potentially dangerous levels of radiation: The New York Times reported in July 2008 that the increased popularity of granite countertops over the past decade has resulted in an expansion of the kinds of granite available and that reports of "hot" countertops seem to come from "the more exotic and striated varieties from Brazil and Namibia."
Fluoride Does Not Make Your Teeth More Resistant to Decay
An Even Bigger Issue: Water Fluoridation
Studies Link Water Fluoridation to Reduced IQ in Children
Fluoride has Been Repeatedly Linked to Brain Damage
Other Fluoride-Induced Health Problems
Parents Beware: Never Use Fluoridated Tap Water when Making Infant Formula
What's the REAL Cause of Tooth Decay?
How You Can Help End Water Fluoridation in Canada and the United States