www.cfidsinsights.com
Updated: 2/23/01

May 18, 1999

A Case Analysis:  Candida Albicans and Chronic Fatigue Syndrome

By Mark Leavitt, Email 

As far as being useful, it may or may not show accurate results since candida lives in all of us including many strains besides C.Albicans. Blood testing does not evaluate every possible strain of candida. For example, besides C.albicans, there is C.tropicalis, C.krusei and many other strains. One test called the candisphere, is supposed to be very accurate and looks for large, abnormal candida cells causing harm to the body. Based on some quick information I found on the web, the candisphere test looks for specific proteins antigens (IgG). It still has to follow the same basic protocols as explained above, so, it falls pretty much in the same area.


5. CASE PARAMETERS

My wife first encountered the onset of the flu in 1987. Today, the recurring bouts of fatigue, muscle and joint pain still persist. A diagnosis of Chronic Fatigue Syndrome was finally determined in 1990. In general, her disability with CFIDS is 40%-50% bedfast. In March of 1998, a serious decline occurred in her health which caused a 90% disability. She lost about 25 pounds. Over time, she lost her complete appetite for food and bowel movement.

The decline which occurred in 1998 was due to Candida Albicans. The diagnosis was made by Dr. Majid Ali who is a specialist in CFIDS, Candida and various other long-term disorders. Ironically, this was our first appointment with a new doctor in over 3-4 years due to frustration with no results from previous doctors.

In this section of case parameters, I would like to share the information below in regards to symptoms and diagnosis for Candida and CFIDS. The treatment protocol for Candida is in Part 6 and for CFIDS in Part 7.  Prognosis and current results can be found in Part8. In addition, I discussed the possiblity of Candida Albicans being the long term cause in this case in Part 9.

Patient Profile
Age:	43
Sex:	Female
Location:	NorthEast, USA
Married:	Happily married, 18 years, no children.
Work:	Medical secretary, currently not working due to CFIDS disability.
Conditions:	Hypothyroidism, 1981.
History:	Initial onset of flu in 1987, CFIDS followed thereafter severe yeast overgrowth in May 1998.
Other:	Common usage of antibiotics and birth control throughout life. Car accident in 1970. Back problems, but recovered years later. Avid tennis player before CFIDS. Energy level pretty normal.

Candida Profile
Severity:	Severe (moderate, serious, severe)
Initial onset:	March 1998
Disability:	90% Bedfast
Symptoms:	severe fatigue, weight loss (25 lb.), constipation, chronic headaches, loss hair, cognitive, fever, vomiting, heavy vaginal discharge, thrush and sleeplessness.
Tests:	Live blood analysis by HRM ( High-Resolution Microscopy), toxic metals, urine/steroid, basic chem, allergy.
Diagnosis:	Severe yeast overgrowth, entered into bloodstream. HRM: +4 (+1 best to +4 worse)
Elimination:	8+ months, May 1998 through Dec 1999. Condition after treatment was very good. HRM: +1.5
Relapse's:	March 1999, condition from moderate to serious, HRM: +3. The cause due to going off anti fungal and raising sugar levels in diet staring in Jan '99.

CFIDS Profile
Severity:	Serious (moderate, serious, severe)
Disability:	40%-50% Bedfast, 60%+ during allergy seasons.
Symptoms:	Primary symptoms are chronic fatigue and muscle/joint pain. Secondary symptoms are chronic headaches,  unfreshing sleep and cognitive difficulties.
Diagnosis #1	1990, CMV/EBV, CFIDS
Diagnosis #2:	1998, CFIDS, FM, Allergy, Candida Albican's Overgrowth
Initial onset:	1987, Flu
Other:	Airborne allergy and vaginal yeast infections
Tests:	Full Chem Blood/Urine Profiles, Toxic Metals, Lyme, Lupus, MS, Mono, Parasitic, Stool, Hormonal, Diet.

6. CANDIDA TREATMENT PROGRAM:

The basic approach we took on the candida problem incorporated painstaking work and a long road entailing about two years of work to get where she is presently as of July 2000. The core treatment program consists of using prescription antifungals and naturopathic remedies, high dosage probiotics, bowel detox and changes in your diet. The goal of the program is to create harmony or a balance of good and bad yeast in the bowel flora. Presently, it appears to be under control or at tolerable levels based on the last High-Resolution Microscopy and improvement of candida related symptoms.

A good program not only consists of just treating the candida but looking at the patient individually as a whole. This includes environmental, nutritional, microbiological and stress-related factors. Support for airborne and food allergies, toxic metals, hormonal, nutrition and stress control and other medical factors is a complete program. This brings me to the point of self-treatment. I do not recommend self-treatment in cases of chronic yeast conditions unless your case is extremely mild. If your daily lifestyle is effected by this condition and you continue self treatment, in my opinion it's self-sabotage. You loose complete objectivity during self treatment. One person does not possibly have the medical training, clinical resources and case experiences to make the proper decisions in there treatment program.


Prescription Antifungals:

1. Diflucan 150mg
2. Sporanex 100mg
3. Nystatin  500,000 IU

Based on severity levels, a prescription program may consist of picking from a various antifungal prescriptions, then rotating every 1-2 weeks. For example, Diflucan one week, Nystatin, Sporanex and then repeat. Based on our experience, prescription antifungal medications on a rotation basis as the first wave of attack worked very well. I personally believe just taking herbs or homeopathics in cases of high severity of candida just doesn't cut it. We tried various combinations of natural remedies and prescriptions in the early part of the program as well as trying 100% naturopatic remedies and this didn't work.

Some practitioners strongly believe that using prescription antifungal medication is going to mutate yeast in all kinds of new creatures or strains. This is an open question and there's not a lot of research in this area. It may be possible for some strains, but what many people don't realize is that candida has over 200+ strains. Albicans is just one strain. There is not one herb or drug that can reduce every strain in your body anyway. I would proceed with caution on this kind of advice. In any event, the theory of rotation is used to prevent drug resistance and mutation. Other complaints with antifungal drugs is some people have a bad reaction to the drug and give up in a few days or a week. This gets back to what I was explaining earlier, a good program has various options. One way around this is to start on a reduced dosage and work your way up to the normal dosage requirements over time.

Natural Remedies (non-prescriptions):

1. EastPark Olive Leaf Extract (38% Oleuropein)
2. Tanalbit/Viracin
3. Biocidin (requires medical doctor approval)
4. Ionic Silver (better and safer then colloidal silver)
5. American Biologics, Dioxychlor (liquid drops)
6. Herbal parasitic protocols and immune support.
7. Aloe vera (liquid drops)
8. Grape seed extract (Paracan MYC)
9. For oral thrush: hydrogen peroxide, Orithrush-D or prescription nystatin oral suspension (if intolerable).

Natural remedies such as herbs and homeopathics are usually used in a candida program in combination with prescription antifungals on a rotational basis. In our case, the program was modified to reduce drug usage and introduce natural remedies once symptoms have improved. It's very possible, that a mild case of candida may only be introduced to natural remedies, it depends on the individual case. Based on the list above, we found best results with EastPark olive leaf, Ionic Silver and Biocidin.

There's all kinds of antifungal products on the market today. Some of the products make significant claims with no clinical research except antidotes. You can save time and money if you find a good medical practitioner who offers a good treatment program and/or do your homework before shelling out a lot of cash. In addition, some products may do more harm then good based on individual circumstances.

Digestive:

1. Betain hydrochloride with pepsin
2. BioTonic (requires medical doctor approval)
3. Wobenzym N (gastrointestinal)


One of the things with the digestive process is the hyrochloridic acid which breakdowns your food, also destroys foreign invaders. This may include some of your oral protocols as well. Based on the design of the capsule and chemical structure of the product your taking, some protocols are OK to take while you eat and others after your done eating. For example, Natren markets a probiotic with a hard-shell capsule which is designed to get through the digestive process, then breakdown later in the digestive process. A thin probiotic capsule is usually recommended to take after you done eating (hydrochloric acid will be less at that time).

Candida may be related to malabsorption and pancreatic insufficiency. Pancreatic enzymes contribute to the digestion process after food leaves the stomach and enters the small intestine. Biotonic is a mixture of many herbs which is supposed to support this process. Biotonic is recommend to be taken in combination with Biociden. It's suppose to cool the effects of the biociden during the digestion process to avoid stomach upset. Wobenzym N is support for pancreatic insufficiency.


Probiotics:

1. Natren Health Trinity, capsule (30 Billion), powders (2-4 Billion)
2. BioClear (liquid drops, requires medical doctor approval)
3. Custom Probiotics: customized powders ranging from 100-300 billion, capsule (25 billion)

When I first heard of probiotics, especially the friendly bacteria names of Lacto-Acidophilus, Lacto-Bulgaricus and Bifidobacterium, the first thing I didn't want to do is swallow this stuff. It's amazing to me the number of people that take probiotics and don't really understand what probiotics mean.

Probiotics meaning "pro life", is the good bacteria or the good guys. Probiotics or good yeast seem to be the miracle cure for everything today. This is another area where research is limited but a lot of antidotes. One thing we do know about probiotics, you can't live without them (and you can't live without bad yeast). It's been this way since the beginning of time. We do know, that a harmony must exist between good and bad yeast. This balance is one of the keys to good health. Otherwise, you have an overgrowth where the bad yeast outweighs the good yeast.

Candida not only lives in the bowel, but in our stomach, mouth and various other places throughout the body. During a treatment program the goal is to get things back into balance, so it makes sense to introduce good yeast to the body. However, nobody really knows how much or what the long term effects of high dosage probiotics would be, if any. Many doctors start off with low doses around 1-10 billions strains per day. Based on our research, the human body is made up of trillion(s) of various strains (the numbers are staggering). In our mindset, it makes sense to supplement high doses of probiotics in severe case of candida (with or without our doctors consent). We started at a low dose and gradually increased the dosage over a period of time using a customized probitoic powder of 200-300 billion strains per day. As the symptoms improved we lowered the dose to a daily maintenance level of 50+ billion per day. The magic question in all of this is: does this work? The answer is it's very difficult to clinically prove how probiotics are working during a treatment program that uses many approaches at once. This needs to be medically researched further as well as clinical studies.


Diet:

1. Very strict on high sugar related foods.
2. Simple food rotations if you find you have a lot of food allergies.
3. Essentail oils: olive oil, canola, sesame, flaxseed and more..


The important idea of diet and candida is yeast feeds on sugar. In addition, allergies to foods are present in some people with candida infections. It's very important to rule out food allergies or environmental sensitivity because both of these can mimic symptoms of candida.

I believe my wife relapsed during the middle of the program when she started feeling better and went back to her old diet of high sugar foods. I have no way of proving it clinically or medically. To be perfectly honest, I'm not sure how all of this works: sugar and yeast. Candida is a very complex subject with many open questions. I understand the basic concepts of diet and sugar, but some doctors laugh at the idea that sugar feeds yeast. Sometimes, in all of this, you don't know who to believe. The road less traveled is sometimes the best choice if it works for you. That road may become popular if research dictates this later in the future.

So, what does this mean? You use common sense and avoid high sugar items: soft-drinks, cookies, ice cream and alcohol etc.. I don't subscribe to these cave man diets where you avoid every particle of sugar. It's virtually impossible to avoid sugar in your diet. If you insist on doing something like this, make sure you have the right circumstance and medical guidance. Once you start feeling better, you can treat yourself every once in a while. The additional bonus, is that you will loose some weight which in many cases, people do not object.


Bowel Detox:

1. Colon therapy, organic coffee enema (short-term only)
2. Bowel protocols (psyllium, senna, beet root) in capsules and/or powder if constipation is a problem.
 

Some of the symptoms of candida is constipation and bowel problems. In our research, we came across that if you don't do high colonic enemas or hydrocolon therapy your not going to get rid of the yeast. That yeast colonies live in the bowel and are stuck to the intestinal wall like flies in maple syrup. Well, again, i couldn't find any medical or clinical research that proves this theory. Common sense dictates if something is stuck in your bowel (intestines) your going to have major problems that may result to hospitalization.

However, I do believe if your bowel response is abnormal, your going to feel abnormal not only in the short-term but may have future complications in the long term. This is a medical fact. I also think strict diets, food elimination's and some rotation diets, yeast-free food diets and no-sugar diets can put oneself under so much stress due to these restrictive diets that your bowel system probably will lock up.

Some doctors do use colon therapy in there program to treat candida. The intent is to detoxify and irrigate the bowel. There are many oral bowel ecology protocols on the market such as: psyllium husk, beet root fiber, fennel seed, senna and cascara sagrada. We use them from time to time when needed. Other enemas such as retention or cleansing are more involved which require an enema bag. This area is something to try to see if it helps. Our experience enemas is just a good cleaning out and that's about it.

Intravenous Protocols:

1. Hydrogen Peroxide
2. Nutrient

Both of these are controversial in the mainstream medicine world. Hydrogen peroxide IV has been in use in Europe for a long time. The use of hydrogen peroxide therapy which is oxygen based presents itself to the yeast which destroys it. IV nutrient therapy is to help build up your immune system faster then oral protocols. Our treatment with both of these therapies have been only short term. The results were temporary relief for a few days.

7. CFIDS TREATMENT


Oral vitamins and herbs

Some of these protocols are formualted by Dr. Majid Ali, others are from our prefered source:

Vitamin C, B-Complex, Mineral-complex, Antioxidant, MSM, Calcium, Taurine, Potassium, Magnesium, Glutathine, Amino acids, NADH (Enada, 10mg) and DHEA (25mg)..


Intramusclar Injections

1. Nutrient protocols by injection


Intravenous Therapy

1. Nutrient and fatigue protocols
2. Chelation (only if toxic metals are present)


Allergy

1. Immunotherapay injections (if needed)


Muscle Pain:

1. Ultram (Rx)
2. Darvon-Compund-65 (Rx)
3. Wobenzym N (non-prescription; enzymes)


Sleep:

Rotation of prescription drugs including some herbal to avoid tolerance levels.

1. Klonopin (Rx)
2. Ambien (Rx)
3. Xanax (Rx)
4. Herbal protocols: valerian, passion flower, St. John's wort


Other:

1. Peptide and protein drinks (soybean, rice, whey)
2. Liver and gall-bladder flushes (detoxification)
3. Water therapy (increase water intake) and sea salt.

8. PROGNOSIS AND CURRENT RESULTS:

Prognosis:
Based on our medical doctor's clinical experience, he believes recovery is based on many variables, obviously individual results will vary. He believes she can pull out of this Candida problem and hopefully see energy levels improve. However, the process is painfully slow based on many years with CFS/FM. The prognosis on the muscle/joint pain is not as good due to length of time with this illness which has been over ten years.

Current Results:  Candida

7-29-00:

Based on the current treatment program discussed, we started seeing improvements in early December of 1999. The process has been slow, but at this point we feel that she is on her way to recovery. I'm hoping for continued improvement and that things will be kept in check by continuing a maintenace level of probiotics, natural antifungal remedies and a low sugar diet.


Current Results:  CFS/FM

7-29-00:

Energy levels are better in the morning, but lose ground by midday. Muscle pain still exists with little improvement. Headaches are better but still exist on a regular basis, some days are better then others. Allergies are very better due to the shots which we started two years ago. This has been a break through for her because allergy season would set her back four to six weeks.


9. DISCUSSION:

Is it possibile that Candida Albicans could be the long term cause of this case? Is it also possible that chronic fatigue in many cases could in fact be candida related complex (CRC)? It's often called the missing diagnosis because many doctors fully don't understand the devastation that candida can cause in a long term progressive cycle.

What's interesting is that candida has been around a long time, in fact, probably since the beginning of time or at least centuries¹. So, why over the last twenty years is candida suddenly appearing as a medical problem. The answer is suboptimal diets and overuse of antibiotics. Traditional foods have been notably replace by severely altered foods from a multitude of "modern" treatment methods in growing, processing and packaging.² Widespread use of antibiotics used in animal feed which end up in our meats may expose us to long-term, low levels of antibiotics.³ Diary products may also contain low levels of antibiotics. Negative foods such as honey, catsup, ice cream, sauces, candies, cakes and cookies contain high amounts of sugar which yeast feed on. Sugar is basically in everything today including soft drinks. The diets in past generations consisted of natural foods. Have the results of these new food technologies finally caught up to us? Secondly, widespread use of various medications, such as antibiotics kill all bacteria including the good bacteria. Thirdly, birth control can have the ability to stimulate candida growth. Fourth, our life-styles demand uncommon stresses on our immune system today: work, divorce, pollution, alcohol, tobacco and indoor/outdoor allergies.

Candida has been referred to as The Great White Ghost. Candidus in Latin means white, pure or sincere. The white ghost is the shape and it grows in white-colored colonies.⁴ This sounds great if your the host of a balance flora which contains friendly bacteria with your candida kept in check. This co-existence of friendly bacteria consumes candida for food. On the other hand, if the environment or conditions exists for candida to prevail, it will, through overgrowth in the bowel. At this point, the white ghost has three things in mind: to consume, multiply and stay alive. Over time, it will lower the body's ability to absorb essential nutrients from food. In many cases, this can take years or decades. The real intelligence of candida is when it branches from a single cell yeast into a branching fungal form. These branches or roots can attach beneath the surfaces of your mucous membranes. This creates a serious breach to the circulatory system: the blood. This allows undigested proteins, foreign and toxic substances to pollute the body. The result are serious symptoms such as chronic fatigue, muscle and joint pain, chest pain, headaches, sinus, constipation, food/airborne allergies, depression, poor memory and many other symptoms.

If you step back from all of this for a moment, you may be asking the question, why does nature let this happen? If you think about it for a while, you realize the goals of candida are the same of ours. Again, candida wants to consume, multiply and stay alive. This is the basic premise of existence. Nature also makes a choice to let the badly damaged perish and young flourish base on energy resource utilization. It favors new beginnings.⁵

The possibility of candida to punch holes in your immune system over a long term basis certainly raises questions in my wife's case. The signs are all there: decades of vaginal yeast infections, antibiotic(s), birth control, high sugar diet and stress. I refer to stress in the sense of normal ups and downs we all go through in life. I also thought genetics had a role in all of this and when I read Dr. Orian Truss comments regarding genetics and yeast, it confirmed my suspicions: "The ease with which many individuals acquire yeast infections suggests such a genetic weakness in their immune response to this organism. When the immune response is inadequate to meet the challenge of an invading germ, the agent escapes destruction and is able to multiply and persist in tissues".⁶

We all know that AID patients with lowered immunity can develop serious yeast infections. Thus, the same could hold true for CFIDS. Which brings me back to my original question: is chronic fatigue syndrome the cause and candida a serious symptom in this case or has Candida Albicans finally shown it's face after all these years?


References:

1. Carlsen, Gary, The Candida Yeast Answer, 1999; p 1.
2. WeinBerge, Stanlye, Candida Albicans: The Quiet Epidemic, Second Edition, Healing Within Products, 1995; p 3.
3. Edelson, Stephen, The Candida Albicans Mystery , The Edelson Center web site, 1999; p 2.
4. Ali, Majidi, RDA: Rats, Drugs and Assumptions, First Edition, Life Span Press, 1995; pp 438-439.
5. Ali, Majidi, RDA: Rats, Drugs and Assumptions, First Edition, Life Span Press, 1995; pp 440.
6. Truss, Orian, The Missing Diagnosis, Fourth Edition, Missing Diagnosis Inc., 1985; p 25.

10. ADDITIONAL READING AND WEB SITES:

Books:

 1. The Yeast Connection and the Woman: William Crook, M.D. (excellent)
 2. The Yeast Connection: William Crook, M.D. (very detailed)
 3. Chronic Fatigue Syndrome and the Yeast Connection: William Crook, M.D (easy reading)
 4. Complete Candida Yeast Guidebook, Jeanne Martin & Zoltan Rona, M.D. (excellent, must have)
 5. America Exhausted: Dr. Edward Conley, ( Candida, Stress, Allergies, and CFIDS).
 6. The Whole Way to Allergy Relief & Prevention: Jacqueline Krohn, M.D. (discusses candida too)
 7. RDA: Rats, Drug and Assumptions, Majid Ali, M.D. (candida and many other things are covered)
 8. The Canary and Chronic Fatigue Syndrome, Majid Ali, M.D. (discusses causes and treatments)
 9. Candida Albicans : Could Yeast Be Your Problem? by Leon Chaitow, N.D. (good explanations)
10. The Missing Diagnosis: by C. Orian Truss, M.D. (major researcher, gets to the point)
11. The Quiet Epidemic: Stanley WeinBerger, C.M.T. (interesting views, yeast program/products)
12. Parasities: An Epidemic in Disguise, Stanley WeinBerget, C.M.T. (parastic program/products)
13. Probiotics: Natures Internal Healers, Natasha Trenev (excellent layman's book on body ecology)



Web Sites:

 1. Visit the Canadia Wellness Center at www.bellnet.com/candida.htm . Order free booklet on yeast.
 2. Visit the works of a Majid Ali, M.D.at www.fatigue.net . See the medicine article library.
 3. Visit my site www.cfidsinsights.com for our personal thoughts on CFIDS, medial clinics and books.
 4. Visit the Candidiasis Syndrome site at www.cfs-recovery.org/docdarren2.html
 5. Visit the Biamonte Center at www.health-truth.com/Articles/Candida.htm by Michael Biamonte, N.D.
 6. Visit the Whole Approach at www.wholeapproach.com for candida information and a great forum.
 7. Visit the Natren Company at www.natren.com for information on probiotics and info on yeast.
 8. Visit the Candida Forum at www.healthyawareness.com for exchange of new ideas.




11. AUTHOR'S NOTE:

The information on this document, electronic email or text cannot be guarantee for accuracy and is not intended to replace the advice and treatment of a physician. Any use of the information set forth herein is entirely at the reader's discretion The author of this document, electronic email or text will not be responsible or liable for actions taken as a result of the opinions or information expressed within this document, electronic email or text. Each person and situation is unique, and a physician or other qualified health professional should be consulted if there is any question or concern regarding the presence or treatment of any abnormal health condition.

Please consult a physician before embarking on any medical treatment, therapy or program.