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Candidiasis

Category: Illness or disabilities

Type

Involuntary

Introduction and description

 

Candidiasis is a fungal infection due to any type of CandidaCandidemia or Candedemia are subsets of this and describe the presence of yeasts in the blood, they are potentially extremely serious conditions as we shall see.  

Candida is a genus of yeasts and is currently the most common cause of fungal infections worldwide. Many species are harmless, however, when mucosal barriers are disrupted or the immune system is compromised they can invade and cause disease.

 Candida albicans is currently the most commonly isolated species, and can cause infections (candidiasis or thrush) in humans and other animals.  However...

Candida auris, first described in 2009, has since emerged as an important, multidrug-resistant, nosocomial agent of candidemia, with large outbreaks reported worldwide and high mortality rates associated with therapeutic failure. PMID:  27547827

Symptoms

very mild case under arms

Candida infection is most commonly thought to be an unfortunate infection of the genitals or the mouth and throat.  But the fungus can actually spread via the blood stream and lymph system throughout the whole body, resulting in some extremely serious illnesses, depending on the parts of the body affected.

Mouth and throat

Signs and symptoms include white patches on the tongue or other areas of the mouth and throat. Other symptoms may include soreness and problems swallowing. When it affects the mouth or the vagina, it is commonly called thrush.

Reproductive system disease

Vaginal yeast infection, also known as candidal vulvovaginitis and vaginal thrush, is excessive growth of yeast in the vagina that results in vaginal itching, which may be severe. Other symptoms include burning with urination, white and thick vaginal discharge that typically does not smell bad, pain with sex, and redness around the vagina.  Vaginal yeast infections are generally due to excessive growth of Candida spp. in general, not just one.  For example in one study "The most common species was Candida albicans (85%), followed by Candida glabrata, and other Candida species including Candida dubliniensis [Orv. Hetil., 2015, 156(1), 28–31].

Candida can also attack the Penis -  resulting in much the same symptoms.

 

 

Eye disease

The fungus can cause quite severe eye problems, if it reaches the eye via the blood vessels, including macular degeneration, cataracts and blindness:

Fungal infections of the eye are an important cause of significant visual loss and blindness .....Corneal infection is the most frequent presentation, but the orbit, eyelids, lacrimal apparatus, conjunctiva, sclera and internal structures of the eye can also be affected. Candida spp., Fusarium spp. and Aspergillus spp. are the most frequently isolated organisms in fungal keratitis and in endophthalmitis.  PMID: 26771986

and

Fungi being slow growing organisms are an important cause of delayed post-cataract surgery endophthalmitis. PMID:  26124631

Skin problems

Candida appears to be one of the causes of psoriasis.  Candida albicans and other Candida species are often found in much higher amounts than in the saliva and faeces of healthy people, for example:

 The quantity of Candida in saliva and faeces of the psoriatics proved to be significantly higher than in the controls. Candida was detected in 78% of the saliva samples of the psoriatics but in only 50% of the controls, and in the faeces samples in 72% of the psoriatics, but in only 46% of the controls. Qualitative analysis revealed a predominance of Candida albicans (saliva, 77%; faeces, 64%) and Candida rugosa (saliva, 28%; faeces, 28%).   PMID: 11413927

Autism

Arabitol or arabinitol is a sugar alcohol and can be used to test for fungal infections such as Candida albicans or other yeast/fungus species.  The following paper shows there is a clear link, the disruption of gut flora has enabled the fungi to grow; and the fungi has thus spread through the body and caused brain damage.

The level of D-arabinitol (DA) and the ratio of D-/L-arabinitol (DA/LA) in the urine of children with autism were investigated. ....The level of DA is significantly higher (P < 0.05) in the urine of autistic children PMID: 22079796

 

 Bladder and urinary tract disease

 

Fungus growths in the bladder or urinary tract as well as cystitis can be caused by fungal urinary tract infection.  For example:

 A 53-year-old male patient presented with complications caused by Candida tropicalis .... The predisposing factors were diabetes mellitus and usage of broad-spectrum antibiotics. The fungus ball, measuring 3.5 × 2.0 cm on the left wall of the urinary bladder, shrank significantly to 1.6 × 0.8 cm after 5 days of intermittent irrigation with saline before surgery. PMID:  26425243

note the problems caused by sugar and antibiotics.

Arthritis and other skeletal problems

Candida can migrate to the joints and cause arthritis and other joint related problems.  For example:

We report a case of arthritis due to Candida (Torulopsis) glabrata in two different joints at different times in the same patient. The first episode of arthritis was situated in the right ankle and lasted more than 1 year before the patient agreed to the proposed treatment. ..... Several weeks later the patient developed Candida glabrata arthritis of the left knee while still taking [the treatment]. .... Because there were no previous invasive point manipulations or trauma, the infections were considered to be haematogenously disseminated. Chronic corticosteroid and repeated antibiotic therapy for infectious exacerbations of chronic obstructive pulmonary disease .. are the presumed risk factors in this otherwise immunocompetent patient.  PMID: 10524556

Miscarriages and still births

The presence of the yeast in the womb having migrated from the vagina can cause stillbirths and miscarriages, this is an interesting paper on the ways this can occur:

Candida glabrata is a yeast which is considered to be a commensal of the vagina with limited pathogenicity in the immunocompetent host. We report 2 cases of severe chorioamnionitis occurring in pregnancies achieved by in vitro fertilization techniques which resulted in preterm delivery and pregnancy loss. Candida glabrata as the causative agent was probably introduced into the uterus by the cannula at the time of embryo transfer.  PMID: 9075555

 Inherited diseases

Pregnancy creates a climate favorable to the growth of Candida albicans, and this yeast often is difficult to eradicate in pregnant women.  This means the embryo and growing baby are exposed to the fungus/yeast.  As we have seen above genetic damage usually results in miscarriages or a stillborn baby, however, it may cause genetic damage, which nevertheless produces a viable baby. Thus many cases of so-called inherited disease may actually be caused simply by infection with this fungus/yeast.

Infertility

Leading on from this the Candida fungi in general are also a cause of infertility:

Statistical analysis … revealed a significant association with infertility. …. Multiple infections such as Candida, Chlamydia and human papilloma virus were observed in 4.2%, 15.3% and 8.3% of infected women, respectively. Results suggest that .. infection is associated with infertility and its absence leads to pregnancy.  PMID:  19833694

Heart failure and other circulatory problems

Fungal infection has been implicated in heart disease.  For example

BMC Infect Dis. 2014 Oct 30;  Isolated pulmonary valve infective endocarditis in a middle aged man caused by Candida albicans: a case report.  Devathi S, Curry B, Doshi S.   ......On further workup he was found to have infective endocarditis with a large vegetation across the pulmonary valve. No other valves were involved. He was treated with intravenous antifungal therapy for eight weeks. Valvular surgery was not performed. Follow up echocardiography after completion of therapy did not show any vegetations and the patient clinically improved.  PMID: 25358458

IBS

Many patients with irritable bowel syndrome (IBS) are disillusioned by the lack of efficacy of treatments and suffer from numerous symptoms not covered by the Rome criteria for IBS, as the current empirical treatment regimens fail to address these persistent debilitating 'IBS associated symptoms'. These symptoms are similar to other symptom complexes like chronic fatigue and ...many seek help from alternative medicine. .... there is increasing evidence for yeasts being able to cause IBS-symptoms in sensitized patients via Candida products, antigens and cross-antigens.  PMID: 15647635

 Muscle problems

When overproduced, Candida breaks down the wall of the intestines and penetrates the bloodstream, releasing toxic by-products into your body and causing a host of unpleasant symptoms such as brain fog, fatigue, digestive issues, and ....muscle problems and pain. 

Chronic fatigue syndrome (CFS) is the common name for a group of significantly debilitating medical symptoms characterized by persistent fatigue and muscle weakness - and it may be Candida related.

The chronic candidiasis syndrome, … [is] caused by the overgrowth of Candida albicans in the gastrointestinal tract … Patients with this disorder have many of the same symptoms as those with the chronic fatigue syndrome, except for the recurrent flu-like symptoms of the latter disorder. The positive response of a large number of patients with the chronic fatigue syndrome (CFS) to an oral antifungal agent and a diet for intestinal candidiasis has been described by another clinician. There is evidence that Candida albicans infection of the mucous membranes depresses T cell and natural killer (NK) cell function. Similar abnormalities of immune function are found in the CFS. The function of cytotoxic T cells, T helper cells, and NK cells is important in preventing reactivation of infections from Epstein-Barr virus, cytomegalovirus, and other herpesviruses. Reactivation of one or more of these viruses could lead to the expression of the flu-like symptoms in the CFS. …. It is proposed that chronic intestinal candidiasis may be an agent which leads to immune depression in many CFS patients and therefore that it could be a causal factor in CFS.  PMID:  7476598

 Brain damage, Alzheimers, Dementia, Schizophrenia, Manic depression etc

In order to understand the following you need to know that Macrophage are a type of white blood cell that engulfs and digests cellular debris, foreign substances, microbes, cancer cells, and anything else that does not have the types of proteins specific of healthy body cells on its surface in a process called phagocytosis. These large phagocytes are found in essentially all tissues, where they patrol for potential pathogens by amoeboid movement.

Candida glabrata is one of the most common causes of candidemia, a life-threatening, systemic fungal infection, and is surpassed in frequency only by Candida albicans. Major factors contributing to the success of this opportunistic pathogen include its ability to readily acquire resistance to antifungals and to colonize and adapt to many different niches in the human body.

 Here we addressed the flexibility and adaptability of C. glabrata during interaction with macrophages with a serial passage approach. Continuous co-incubation of C. glabrata with a murine macrophage cell line for over six months resulted in a striking alteration in fungal morphology: The growth form changed from typical spherical yeasts to pseudohyphae-like structures - a phenotype which was stable over several generations without any selective pressure. ….

This altered growth form permitted faster escape from macrophages and increased damage of macrophages. In addition, the evolved strain (Evo) showed transiently increased virulence in a systemic mouse infection model, which correlated with increased organ-specific fungal burden and inflammatory response (TNFα and IL-6) in the brain.   …. These results indicate that microevolutionary processes in host-simulative conditions can elicit adaptations of C. glabrata to distinct host niches and even lead to hypervirulent strains. PMID:  25356907

thus in the end, Candida can cause practically any disease.

 Causes

 

The cause of candidiasis is obviously the Candida yeast, but what can cause them to enter the body and then take over and cause disease?

Antibiotics

Few people appear to realise how catastrophic our indiscriminate use of antibiotics has been to our health.  Our intestinal flora includes species of Candida.  Species from the genus Bacteroides alone constitute about 30% of all bacteria in the gut, however, the currently known genera of fungi of the gut flora include Candida, Saccharomyces, Aspergillus, and Penicillium.

Antibiotics can cause yeast infections, including gastrointestinal Candida overgrowth, and penetration of the GI mucosa. Prolonged antibiotic use increases the risk for both men and women.  Once the GI mucosa has been penetrated the Candida can enter the blood stream and from there as we can see it can cause practically any illness from Alzheimers to Schizophrenia.

In other words, by using antibiotics one upsets the balance of the intestinal flora by removing [killing] beneficial bacteria, and allowing blooms of fungal growth.  If the gastrointestinal tract is then damaged the fungus and yeast can also get into the blood stream causing yet more damage.  And as we have seen in the paper above, it can then become virulent, causing a whole host of apparently unrelated diseases.

Nutritional deprivation

C. albicans  survives on sugars – it ferments glucose and maltose to acid and gas, and sucrose to acid.  Sucrose is converted by the liver into Fructose.  A description of how fructose and sucrose are processed by the digestive system is provided in Fructose and sucrose digestion.  Both effectively feed yeasts.

In other words a very sugar rich diet may result in fungal blooms.  Thus one way of helping yourself get rid of the infection is to cut down on sugars in general - sucrose, maltose and glucose.

In much the same way, a diet high in carbohydrates also has the same effect.  This is why people with diabetes often get fungal infections as well, their glucose is out of balance leading to the chance for the fungus to have a wonderful feast.  Cutting out the carbs and the sugars may thus help.  Mineral imbalance and particularly zinc deficiency may also play a part as without adequate supplies of zinc, the immune system cannot operate well.

 Other pharmaceuticals

The fungus spreads if the immune system is compromised, thus the use of any pharmaceuticals that depress the immune system - such as antiobiotics [described above], immunosuppressants and antihistamines will result in further spread of the fungus in the body.

The eHealthme site collects the Adverse Drug reports submitted by doctors to the FDA and SEDA in the USA.  It then summarises them for ease of use.  We originally provided a direct link to each of the categories of candidiasis on the site:

  • Candidiasis
  • Candidal infection
  • Candidia esophagitis
  • Candidiasis oral

and the pharmaceuticals that can cause each one, but the eHealthme website developers frequently reorganise the site and thus break the links.  Thus in order to find out which pharmaceuticals are implicated in candidiasis

  • Follow the LINK to the eHealthme website
  • Using the ‘All conditions’ index find the appropriate entry
  • Now scroll down until you get to the section marked ‘Drugs that could cause

The list shows you all the drugs implicated in CAUSING Candidiasis as well as the number of people who have made a complaint to their doctor and had their case reported by him.  Note that it is up to the doctor whether he reports or not.

As of October 2016, about 1,100 pharmaceuticals were in this list.

Stress and extreme negative emotion

High levels of negative emotions do not directly cause Candidiasis, but all forms of stress affect the immune system.  Stress compromises our immune responses and as a consequence the pathogens that may be in our bodies can proliferate and start to attack us.

Sick buildings

In effect buildings whether houses or offices, factories or function rooms that are badly ventilated, poorly cleaned and which are able to harbour fungi as a consequence.  To this we must also add all those communal buildings which are by their nature damp and warm - such as swimming pools and gyms.  There is a particular risk of picking up fungal infections from both these places, the shower rooms, for example, are a paradise for fungus.

Surgery and physical trauma

- to quote

Subcutaneous mycoses involve the dermis, subcutaneous tissues, muscle and fascia. These infections are chronic and can be initiated by piercing trauma to the skin which allows the fungi to enter.

Sexual contact

Men can pass it to women and vice versa.

Not drying between your toes!

C. albicans thrives in warm damp places, so not drying youself properly after having had a bath or shower provides the fungus with a place to thrive.  Similarly, wearing socks and shoes, or clothes that hinder ventilation and do not let perspiration wick away, for example, makes things worse.  Use natural fibres.  Big cotton knickers!

Diagnosis

Diagnosis of the presence of Candida in the blood has been via a blood culture method, but it has been found wanting in many cases due to its low sensitivity and the fact it is time-consuming to perform. Recently, however, more advanced diagnostic methods with a higher sensitivity and a shorter turnaround time than the conventional blood culture method have been developed for the early detection of Candida in blood samples or in blood culture broth.

Most of these newer methods were developed using various molecular techniques, such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, peptide nucleic acid fluorescence in situ hybridization, and a number of DNA-based techniques including in-house and commercial polymerase chain reactions. PMID:  27003437

 

 Treatments

The standard pharmaceutical treatment for candida infections is an anti-fungal.  But what is interesting is that we are starting to see strains of ant-fungal resistant fungi, just as we have antibiotic resistant bacteria.  

The yeast Candida albicans is a member of the microbiota in the gastrointestinal and urogenital tracts of most healthy persons, but it can also cause symptomatic infections, especially in immunocompromised patients. During the life-long association with its human host, C. albicans generates genetically altered variants that are better adapted to changes in their environment. A prime example of this microevolution is the development of resistance to the commonly used drug fluconazole, which inhibits ergosterol biosynthesis, during antimycotic therapy. …. This, in turn, raises the possibility that sexual recombination between different variants of an originally clonal, drug-susceptible population may contribute to the generation of highly fluconazole-resistant strains with multiple resistance mechanisms. …. many clinical isolates that contain such mutations do not exhibit fitness defects, indicating that they have overcome the costs of drug resistance with further evolution by still unknown mechanisms. PMID:  26920879

Anti-fungals are symptom based medicine, but it might be better given what is transpiring to treat the cause not the effects or even the pathogen.  Maybe prevention is better than cure.

 

Perhaps we should not be creating 'immunocompromised' patients by giving them very unwise pharmaceuticals.  Maybe we should help relieve the symptoms of stress which allow the pathogen to spread.  And maybe we should adjust our diets to cut out the sugars and carbs a bit more.

The observations provide some suggestions from Dr Duke plus other researched papers on ways of trying to eliminate the fungus infection if you have been unlucky enough to catch it.

The following may also help:

DIETARY RESTRICTIONS:

Overly strict diets are often counterproductive. However, sugar must be avoided absolutely, and the following restrictions have proved adequate:

100% avoidance:

All forms of sugar, including glucose, fructose, honey, soft fruits, fruit juices, dried fruit, sweets, cakes, biscuits, jams, marmalade, refined carbohydrates, soft drinks. Alcohol, particularly beer & wine, vegemite (marmite), mushrooms, canned foods. Antibiotics, cortisones, birth control pills.

Partial avoidance:

Fried foods, fats, colourings, hard cheeses, smoked meats, vegetable juices.

 

How it works

Why do people get hallucinations from Candidiasis?  The fllowing may be an indicator

Truss’s findings were varied but of particular interest was his finding that red blood cells lost their elasticity in the presence of Candida. He also noticed a distinct reduction in available potassium & phosphorus in blood infected with Candida. The combined effect of these is to restrict blood supply, particularly oxygen and nutrients, to vital organs with fine capilliaries such as the brain.

 

References and further reading

  • J Microbiol. 2016 Mar;54(3):192-201. doi: 10.1007/s12275-016-5628-4. Epub 2016 Feb 27.  The development of fluconazole resistance in Candida albicans - an example of microevolution of a fungal pathogen.  Morschhäuser J1.  1Institute for Molecular Infection Biology, University of Würzburg, D-97080, Würzburg, Germany. joachim.morschhaeuser@uni-wuerzburg.de
  • PLoS Pathog. 2014 Oct 30;10(10):e1004478. doi: 10.1371/journal.ppat.1004478. eCollection 2014.  One small step for a yeast--microevolution within macrophages renders Candida glabrata hypervirulent due to a single point mutation.  Brunke S1, Seider K2, Fischer D2, Jacobsen ID2, Kasper L2, Jablonowski N2, Wartenberg A2, Bader O3, Enache-Angoulvant A4, Schaller M5, d'Enfert C6, Hube B7.
  • mSphere. 2016 Aug 18;1(4). pii: e00189-16. doi: 10.1128/mSphere.00189-16.  Comparative Pathogenicity of United Kingdom Isolates of the Emerging Pathogen Candida auris and Other Key Pathogenic Candida Species.  Borman AM1, Szekely A1, Johnson EM1.  1UK National Mycology Reference Laboratory (MRL), Public Health England South-West, Bristol, United Kingdom.

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