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Mark Hyman, MD

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Is Hidden Fungus Making You Ill?

Posted: 07/24/10 08:00 AM ET

A hidden fungus may be making you ill. A 35-year-old recently walked into my office suffering from a whole list of health problems (which is why I often call myself a "whole-listic doctor"). She had chronic fatigue, recurrent yeast vaginal infections, itchy ears, dandruff, patchy itchy skin rashes, irritable bowel syndrome, muscle twitching, acne rosacea, malabsorption, headaches and more.

These symptoms can have multiple causes, but in her case all of these problems were related. They were symptoms of an overgrowth of yeast in and on her body. This patient had such a fungus problem that she was practically a walking mushroom!

The cause was clear. She had taken many, many courses of antibiotic over the years. She had been diagnosed with a mostly benign condition called mitral valve prolapse--a problem I believe is over diagnosed and over treated--and "needed" antibiotics every time she went to the dentist. In addition, she had many urinary tract infections for which she took many more courses of antibiotics.

Frequent use of antibiotics disrupts the normal balance between healthy bugs in the gut (lactobacillus, bifidobacter, e. coli) and other potentially dangerous bugs, including yeasts, bacteria and occasionally parasites. These bad bugs are usually present in small numbers in the digestive system. But when the good bugs are killed by antibiotics (i) or not fed with adequate fiber, or the bad guys are fueled with too much sugar, or the gut's delicate ecosystem (ii) is damaged by too much stress, then yeasts and other noxious agents take over.

This can result in many chronic illnesses and symptoms including allergies, chronic inflammation, joint problems, mood and brain disorders, digestive symptoms and more.

In today's post I will explain why yeast overgrowth is such a common problem, why conventional medicine tends to overlook it, and provide you with a comprehensive plan to reduce and remove yeast and rebalance your gut's delicate ecosystem, which sits at the center of your health.

Yeast: A Common But Often Unrecognized Problem

Yeast overgrowth is quite common, but many people don't know they have it and conventional doctors tend to ignore it. In medical school, we are taught that you either have a disease or you don't. It's black and white. However, our bodies weren't designed with an "on" or "off" switch for disease. All diseases occur in shades of gray along a continuum of imbalance along spectrum of disease.

Medical students learn about fungal and yeast problems, but only in a limited way. They know that AIDS patients have severe yeast and fungal infections and need long-term anti-fungal treatment. People with diabetes tend to grow yeast because yeast likes sugar. Babies get thrush and need antifungal treatment. Women get vaginal Candida yeast infections. All of these are well-accepted and treatable problems. Unfortunately more subtle problems related to yeast are usually ignored and not linked to patient's complaints. If a subject is not taught in medical school, it is assumed not to be real. Medical history proves this is a dangerous assumption.

On the other hand, many alternative practitioners over diagnose yeast problems. However, there are many people who do have yeast problems, and most of them don't know it.

There is not enough research on this topic. But the collective intelligence of many doctors working in this field for decades with thousands of patients has helped us learn how to appropriately diagnose and treat this often misdiagnosed problem.

We know that yeast overgrowth can be triggered by a number of things. These include a high-sugar, high-fat, low-fiber diet, impaired immunity, use of drugs like antibiotics, birth control pills, estrogen, and steroids like prednisone, and psychological stress.

Although symptoms of yeast overgrowth are similar to those of many other conditions, you may have a yeast problem if you have these problems (iii)

General Symptoms

• Chronic fatigue
• Loss of energy
• General malaise
• Decreased libido

Gastrointestinal Symptoms

• Thrush
• Bloating and gas
• Intestinal cramps
• Rectal itching
• Altered bowel function such as diarrhea (iv) or constipation

Genitourinary Symptoms

• Yeast infections
• Frequent bladder infections
• Interstitial cystitis (irritable bladder)

Hormonal Complaints

• Menstrual irregularities like pain, bleeding, etc.
• Premenstrual syndrome
• Thyroid dysfunction

Nervous System Complaints

• Depression
• Irritability
• Inability to concentrate

Immune System Complaints

• Allergies
• Chemical sensitivities
• Low immune function

Past History

• Chronic yeast infections
• Chronic antibiotic use for infections or acne
• Oral birth control pill usage
• Oral steroid hormone usage

Associated Conditions

• Sensitivity to foods, chemicals, or other allergens
• Eczema
• Psoriasis
• Irritable bowel syndrome
• Craving for foods rich in carbohydrates or yeast
• Toenail fungus

Many tests we use for diagnosis of yeast problems are not definitive or foolproof. It is often a diagnosis that must be made from a patient's story, symptoms, and physical findings on examination. Blood antibody levels for yeasts, stool tests, and organic acid urine tests (v) for yeast metabolites can be helpful if they come out positive but don't rule yeast out if they're negative.

The best method for diagnosis is a good history for risk factors like antibiotic use and symptoms of chronic yeast problems. The symptoms of yeast overgrowth vary from person to person and the response to treatments will vary. Some people may need aggressive treatment, while others many need only simple changes to make a significant difference in their health.

I recommend a systematic approach to yeast overgrowth. Taking the following steps can help overcome this common but under diagnosed ailment.

Overcoming Yeast Overgrowth

1. Address predisposing factors. Don't take antibiotics, steroids, or hormones unless absolutely medically necessary.

2. Eat a diet that doesn't feed yeast in the gut (low sugar and refined carbohydrates, and low mold and yeast in food (see below).

3. Use probiotics to repopulate the gut with healthy bacteria

4. Take antifungal herbs and medications when indicated

5. Identify potential environmental toxic fungi and molds in your home or workplace

6. Reduce stress.

The Yeast Control Eating Program

A simple five-day elimination of yeast and molds in your diet, followed by a challenge or binge of yeasty foods will often relieve and then trigger your symptoms. This can be a good diagnostic tool to see if a long-term yeast control diet would be helpful for you. Remember, different people with different sensitivities may require varying degrees of dietary restrictions. Often, the process of healing requires listening to your body and its signals and sensitivities. Nowhere is this better illustrated than in the management of yeast problems. Follow these guidelines as the first step to assess your yeast problem:

• Eliminate all yeast promoting or yeasty and moldy substances from your diet.

• Try to be totally strict during this time to get the best results.

• Keep a food diary and track what you are eating. You should try to vary your meals and make sure you are not eating a lot of any one food.

• Avoid the test foods for five full days.

• On the sixth day, eat large amounts of the foods you have been avoiding and monitor your reaction. If you get a recurrence of symptoms, you have identified your problem. If not, then yeast may not be a problem

• Remember that sometimes a dietary change may not reduce the yeast overgrowth enough to resolve your symptoms. Then you may need to proceed to the next steps -- medication or non-prescription treatments.

• If you feel great off the yeasty foods, you might not want to do the challenge. It could make you feel very ill. Continue to follow a yeast control eating program for at least three months and continue with the other recommendations here.

Additional Steps You Can Take to Reduce or Control Yeast Overgrowth

Often, I find that patients need extra help and should take antifungal herbs, medications, and probiotics.

Probiotics

Take at least 10 to 20 billion live organisms a day of lactobacillus and bifidobacter species. (vi) A special "yeast against yeast" probiotic called saccharomyces boulardii (vii) can be very safe and effective in controlling yeast.

Non-prescription Anti-fungals

Using antifungal therapies such as herbs and other naturally occurring compounds can be very helpful in controlling yeast. The dose for all of the following herbal remedies is generally two pills with meals, three times a day for two to three months. You might need less or more based on your response and symptoms. Sometimes these remedies can be combined for better effect. To find the right combinations and doses for you and identify quality products, consult with a qualified practitioner trained in functional medicine (www.functionalmedicine.org) Some of the best antifungal compounds include the following:

Oregano -- Oil of oregano has many antibacterial and antifungal properties.
Garlic -- Fresh, crushed garlic is a potent antimicrobial and immune booster.
Citrus seed extract -- The phytochemicals in citrus seeds have been found to have potent antimicrobial properties.
Berberine -- This potent yellow plant extract comes from goldenseal and barberry
Tannins -- These are the astringent compounds found in tea and the bark of trees.
Undecylenate -- This chemical compound is a potent antifungal.
Isatis tinctoria -- This Chinese herb can be a useful adjunct to treating intestinal imbalances.
Caprylic acid -- This is another useful compound for treating yeast.

Antifungal Medications

Sometimes, nutrition and supplements just aren't enough to clear up stubborn yeast overgrowth. That's where prescription medications can help. (viii) They're often needed to treat more resistant cases of yeast for either the short or long term -- and in some cases can be miraculous in their results.

Nystatin is the most common antifungal drug and is often used to treat thrush in babies. It is not absorbed by the intestinal tract and has no systemic effects. Unfortunately, many fungal organisms are resistant to nystatin and you may need stronger medications. I say "unfortunately" because these drugs are generally processed by the liver and occasionally can cause reversible elevation of liver function tests. They also may have serious interactions with other medications.

People with liver or heart diseases often cannot take these drugs. If you do take Diflucan, Sporonox or Lamasil, you have to have your liver function checked every six weeks. For all of these reasons, you should only take prescription antifungals under the supervision of an experienced and qualified practitioner. These medications can often be life-saving treatments for many conditions unresponsive to conventional treatments.

Killing off yeast is a good thing. However you should be aware that in some people the dead yeast release enough byproducts to cause a "die off" reaction that may make you feel worse before you feel better. This reaction goes away may take up to a week to completely resolve. You can minimize its effects by following the yeast control eating program for a week or so before you start taking any antifungal preparations.

I also recommend taking two to three activated charcoal capsules every four to six hours during the day. Taking a soluble fiber supplement that contains guar gum, alginates, psyllium seed, or pectin to bind to yeast toxins before bed can also be helpful in reducing the "die off" reaction.

Now you know that fungi, yeasts, and mold can make you sick -- but there's good news, too. You can treat the problem. I hope you'll use the tools I've given you in this blog to start getting well and feeling healthy now.

Now I'd like to hear from you...

Do you suffer from the symptoms described here? Have you been diagnosed with yeast overgrowth?

How do certain foods seem to affect your symptoms?

Are you seeing a doctor for yeast problems?

What's been your experience in dealing with and treating yeast?

Please let me know your thoughts by leaving a comment below.

To your good health,

Mark Hyman, M.D.

References

(i) Kourbeti, I.S., Alegakis, D.E., Maraki, S., and G. Samonis. (2010). Impact of prolonged treatment with high-dose ciprofloxacin on human gut flora: A case report. J Med Case Reports. 4: 111.

(ii) Hawrelak, J.A. and S.P. Myers. (2004). The causes of intestinal dysbiosis: A review. Altern Med Rev. 9(2): 180-97. Review.

(iii) Pizzorno and Murray. 1999. Textbook of Natural Medicine. Churchill Livingstone.

(iv) Krause, R., Schwab, E., Bachhiesl, D., et al.(2001). Role of Candida in antibiotic-associated diarrhea. J Infect Dis. 184(8): 1065-9.

(v) Tana, C., Umesaki, Y., Imaoka, A., et al. (2010). Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome. Neurogastroenterol Motil. 22(5): 512-9.

(vi) Hatakka, K., Ahola, A.J., Yli-Knuuttila, H., et al. (2007). Probiotics reduce the prevalence of oral candida in the elderly--a randomized controlled trial. J Dent Res. 86(2): 125-30.

(vii) Pothoulakis, C. (2009). Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii. Aliment Pharmacol Ther. 30(8): 826-33. Epub 2008 Jul 23. Review.

(viii) Rimek, D., Redetzke, K., and R. Kappe. (2006). Impact of antifungal prophylaxis on the gastrointestinal yeast colonisation in patients with haematological malignancies. Mycoses. 49 Suppl (2):18-23.

Mark Hyman, M.D. is a practicing physician, founder of The UltraWellness Center, a four-time New York Times bestselling author, and an international leader in the field of Functional Medicine. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on YouTube, become a fan on Facebook, and subscribe to his newsletter.

 
 
 

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A hidden fungus may be making you ill. A 35-year-old recently walked into my office suffering from a whole list of health problems (which is why I often call myself a "whole-listic doctor"). She had c...
A hidden fungus may be making you ill. A 35-year-old recently walked into my office suffering from a whole list of health problems (which is why I often call myself a "whole-listic doctor"). She had c...
 
 
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04:42 PM on 08/13/2010
Maybe this website doesn't allow e-mail addresses to be displayed. I guess if there are any questions, I can answer them here.
04:41 PM on 08/13/2010
The e-mail address got mangled in the last comment:

If anyone reading these comments has any further questions, email me at renegade322@gmail.com.
04:37 PM on 08/13/2010
With a low-carbohydrate diet and aggressive use of Nystatin oral tablets, the signs and symptoms started to recede. In the first six months of treatment, I was also able to lose 15-20% of my body weight since I wasn’t using new carbohydrates as fuel but was instead burning fat that had accumulated in the years when I had a carb-centered diet. Over several years, the condition has started to reappear from time to time—it is difficult to maintain discipline over a diet that largely excludes carbohydrates—but for the most part I have regained full health.

I have assisted several people who seemed to be experiencing the same condition. If anyone reading these comments has any further questions, email me at renegade322@gmail.com.
04:35 PM on 08/13/2010
As tests returned negative and specialists were unable to provide a diagnosis, my GP increasingly pushed the idea of mental health counseling and antidepressants. I pushed back since I didn’t believe the condition was imaginary or psychosomatic and since I don’t believe in the widespread use of antidepressants. I also wasn’t happy “masking” the condition or treating individual symptoms when I believed a central condition was causing all these symptoms.

While continuing to visit doctors and have testing performed, I started my own research. Since there were so many seemingly unrelated signs and symptoms, it was difficult to identify a condition where some or all would be present together. As I started to eliminate certain possibilities (Lyme disease, Hepatitis, MS, Celiac disease, Chronic Fatigue Syndrome) based on the presence of signs and symptoms that wouldn’t be present, I narrowed in on Fibromyalgia and something called Candidiasis (other names include Yeast Infection, Systemic Fungal Infection). In comparing the two conditions, I eliminated Fibromyalgia since it’s specific about muscles that are affected (18 possible trigger points, and 11 must be present for the condition to be present).

When I discussed Candidiasis with my doctor, based on an almost perfect match between my own signs/symptoms and those found in this condition, he distanced himself from it and suggested that I consult a doctor of alternative medicine. I found a doctor (MD) who straddles mainstream and alternative medicine, and he suggested that systemic fungal overgrowth was likely the culprit.
04:31 PM on 08/13/2010
I'm glad to see this issue getting some attention. Although I prefer to be cynical, sarcastic and politically incorrect, this is one topic I take seriously. Since I did most of my research using the Internet, perhaps my story can help others using the same research methods.

Over a period of months to years, I developed the following signs and symptoms: Headaches, pressure in head, dizziness, nausea, lightheadedness, loss of balance, memory loss, brain fog, vertigo, chronic fatigue, pain and stiffness in joints, weakness and heaviness in muscles, numbness in limbs, numbness/tingling in extremities, skin irritation/blistering, visual disturbances, redness and irritation in the eyes, ringing in ears, small patches of hair loss, jock itch, chest pain, sore throat, stiff neck, nail fungus, sinusitis, GI disturbances (a Mulligan’s stew), multi-day episodes of hallucination/memory loss/sensory distortion, and some others.

As the condition got progressively worse, I was visiting a general practitioner on a regular basis. I was also getting referrals to visit specialists such as a neurologist, dermatologist, endocrinologist, and radiologist. I received a variety of prescriptions to treat specific signs/symptoms. Blood testing, X-rays, MRI’s etc. all came back negative, and neither GP nor specialists could provide answers.
08:57 PM on 08/07/2010
Dr. Hyman, if you could respond to me it would mean a lot.

I have suffered through a WHOLE list of problems, since I was a kid I have had: Chronic ear infections, ADD/ADHD, IBS... as I have gotten older: chronic muscle pain, constipation/diarrhea/hemorrhoids, anxiety/panic/depression, chronic fatigue, sinus congestion/post nasal drip, insomnia, acne, high blood pressure, etc,

I thought my problems were “normal”, I thought my problems were “in my head”, I thought, “that's just how life is”.

A couple years ago I saw you on PBS. WHAT YOU SAID MADE SENSE. I read your book. I changed my diet. I ordered at least 37 supplements. I started to feel better. But, I was still having issues.

Over the last couple months I started getting more sick. Vomiting a lot.

I read about Candida Albicans, I started thinking, “Maybe that's it?!”

I was getting more sick. You recommended immuno labs. I found a MD who works with them. I found out I had 18 delayed food allergies. Yeast being the highest. We're in the process of waiting lab results from a stool analysis.

I want to know if you think it would benefit me by seeing you directly. Or, if you think I'm on the right path?

I want to end with:

THANK YOU for fighting for people like me. THANK YOU for asking the right questions. For having the courage to go against the establishment and for empowering me to change.
07:56 AM on 08/03/2010
Very informative. I have lived with candida for 12 years. I am also allergic to it and have had several homes with indoor mold. Husband just had quadruple bypass and wondering if the candida in me could have spread to him and be one reason for the 100 percent blockage in 3 arteries or valves. I forget what you call them. Thanks for the info. I have been on the diet on and off for years and recently lost about 10 lbs and am only 104 lbs. Did the Diflican for 8 months years ago but lost the insurance and most doctors don't treat candida. I had my tongue tested and it was candida albicans. Linda
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kolbpilot
09:10 PM on 07/27/2010
You know, I would be worried a lot more to what everyday household chemicals I was around versus alleged mold growing some where.
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11:17 AM on 07/28/2010
That's exactly what I think!!
08:11 AM on 08/03/2010
Many of us get the chemical sensitivities after mold exposure. Teachers are a large group getting ill because so many schools have indoor mold. But when you have fungal disease, chemical problem and the yeast it is very difficult. I am working on the mold issue and chemical issue. Actually a new research paper has just be released by researchers and doctors that I am also member of this group. And legislation has been introduced in the House, the Senate, and also a Cosmetic Bill. Hope something good comes of it.http://achemmic.com/positionstatement.htm This is the Research Paper and Press Release. Linda
Linda
10:14 PM on 08/07/2010
I've been noticing a pattern. Your posts in this thread seem to discredit a lot of people and their experiences and opinions.

I, for one, am very glad that Dr. Hyman is hear discussing this information. It is often the "quacks" that are vindicated in time, and who in facthelp the most amount of people:

http://amasci.com/weird/vindac.html
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BannedNBoston
Is hemp legal yet?
10:09 AM on 07/27/2010
Here is the brand I have been taking for over a year Its patented nano particle silver each particle has an electric charge to make it work better.
I used to take small particle colloidal silver for 5 years before that.
http://www.supernaturalsilver.com/
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05:42 AM on 07/27/2010
I was hoping the doctor would post a list of the most commonly eaten moldy and yeasty foods.
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08:31 AM on 07/27/2010
This link contains a list of moldy, yeasty culprits. Not sure how complete it is.
http://www.mold-survivor.com/dietcopyright.html

The body ecology diet has been around a while and has helped many. There's a book and a web site available. Here's a link to the site:
http://www.bodyecology.com/
08:39 AM on 07/30/2010
The old survivor list of foods to eat specifies the use to "drink bottled water"............this makes me question the validity of the site
12:26 AM on 07/27/2010
Unless they are termites, exactly how do you feed "good bugs" with fiber?
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eLucida
Liberate Fitzwalkerstan, defeat A.L.E.C.
09:16 AM on 07/27/2010
There you go, trying to introduce that dang "logic".
09:37 AM on 07/27/2010
Inulin- it is a type of soluble fiber that feeds intestinal flora.
Nothing to do with logic, just a simple nutritional fact....
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eLucida
Liberate Fitzwalkerstan, defeat A.L.E.C.
09:44 AM on 07/27/2010
And exactly how do you feed "good bugs" with the fiber inulin?
07:40 PM on 07/26/2010
I had systemic yeast infection from 1981-86 and was constantly sick when they finally diagnosed and treated me with nystatin, vitamins and acidolphilus and diet. I permanently changed diet but got acid reflux from medication I was on for another problem(arthritis) and was put on pariet (acid reducer). In 2009 I start getting varied infections again and was told that the acid reflux medication had reduced the acid in my stomach to the point that my food was not digesting but fermenting and turning to sugar and feeding the yeast in the bowel. This cause of Candidias is not mentioned in the above article and I wonder if Dr. Hyman has thought about this connection. I have cut out all sugar and diary and many "white" foods and taken the herbal yeast killers and am back on probiotics. I have not had an infection in the last four months.
08:39 PM on 07/26/2010
I'm not denying any of your own personal experiences at all, but I think it is interesting that many people, in these comments and elsewhere, keep saying that acidic conditions are PROMOTING yeast overgrowth. Whereas, as you point out, lack of acidity may actually allow yeast to get out of control.
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08:58 PM on 07/26/2010
But there isn't really scientific evidence for either, is there?
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murmur55
06:21 PM on 07/26/2010
My hidden fungal infection is contributing to my hidden brain fog and I can't find my way out!
06:11 PM on 07/26/2010
I was prescribed Triphala powder for yeast infections by an Ayurvedic doctor. If nothing has worked for you, try it; it has had quite an incredible effect.
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Guitarsandmore
devoted father, community activist, musician, reti
05:31 PM on 07/26/2010
Cardiologists DO recommend that you take antibiotics when you get your teeth cleaned or worked on after you have had heart surgery. Bacteria is released into your bloodstream and ends up in your heart after a trip to the dentist.
06:17 PM on 07/26/2010
Actually, these days cardiologists and dentists generally DON'T believe in prophylactic antibiotics- they recommended them until a few years ago, but have since decided that they are not needed.

http://www.medicalnewstoday.com/articles/97376.php
06:44 PM on 07/26/2010
Just to clarify, cardiologists NEVER recommended that the average person take antibiotics prior to a dental visit- this was just for people with heart defects- it was thought that the rougher surfaces of the tissue around the defect would make any circulating bacteria more likely to adhere...