Yeast Issues - An Update on the Signs, Diagnosis & Treatment of Yeast Overgrowth
by Blake Graham, BSc, AACNEM
Blake Graham is a clinical nutritionist specializing in nutritional and environmental treatments for patients with CFS, FM, and other chronic conditions. He is an associate of the Australasian College of Nutritional and Environmental Medicine in Perth, Western Australia (AACNEM) and Committee Member of ME/CFS Australia (WA). This article is reproduced with permission from his Nutritional Healing Newsletter at http://www.nutritional-healing.com.au
A small amount of yeast micro-organisms - single-celled fungi - are normal inhabitants of our intestinal ecosystem. Disturbance of intestinal microbiology and immune function, which are intimately linked, predisposes to excessive levels of intestinal yeast.
Antibiotics, due to their suppression of healthy flora, are the most common cause of yeast overgrowth, although any factor which impairs gastrointestinal and immune integrity can potentially precipitate a yeast issue.
In excessive levels, yeast can cause or exacerbate a large array of health problems. Dr. William Shaw* has documented [that] one mechanism of yeasts' toxicity is related to their metabolic by-products.
What are possible signs and symptoms of yeast overgrowth?
- Genital thrush in the past 6 months
- Vaginal itching or redness, vaginitis or 'jock itch' in the past 3 months - often scratching/itching at genital area
- White or grayish-white coating on your tongue or inner cheeks, or white patches in the mouth
- Nasal congestion or stuffiness, swelling of the nasal membranes or sinusitis
- Previously noticed a decline in your health following antibiotics, or antibiotics exacerbate your current health problem
- Redness and swelling of the skin between the fingernails and the first knuckle; or inflammation of the margin of the eyelids
- Psoriasis, eczema or hives
- Puffiness/bloating/swelling in the hands, face and feet
- Sugar cravings
- Eating sugar makes you feel worse/worsens certain symptoms
- Negative reaction to certain dietary yeasts/molds (e.g., vinegar, mushrooms, fermented foods, brewers/bakers yeast, aged cheeses, vegemite, beer, etc.)
- Very high fondness for yeasty foods (e.g., vinegar, mushrooms, fermented foods, brewers yeast, bakers yeast, aged cheeses, vegemite, etc.)
- Chemical sensitivities (e.g., car exhaust, gasoline, cigarette smoke, perfumes, etc.)
- Multiple food sensitivities
- Lower abdominal bloating (felt below the bellybutton)
- Gas, frequent constipation, loose/unformed stools, diarrhea or foul smelling stools
- Itchy rectal/anal area or red ring immediately around the anus
- Anus burns when pass stool/'acidic' or burning stools
- Yeasty odor to stools or breath
- Attention problems
- Feel 'spaced out' and/or 'brain fogged'
What are the risk factors for yeast overgrowth?
- History of oral antibiotic use in first month of life or several courses of antibiotics in first 24 months of life.
- History of frequent oral antibiotic use (e.g., recurrent childhood ear infections, recurrent urinary tract infections, tonsillitis)
- History of long-term (greater than 2 weeks) oral antibiotic use (e.g., for acne).
- Taken prolonged courses of steroids (e.g., prednisone) orally, by injection or inhalation.
Which medical conditions are commonly associated with yeast?
- Autism Spectrum Disorders (ASD)/ ADD/ADHD
- Chronic Fatigue Syndrome (CFS)/Fibromyalgia
- Dermatological conditions (e.g., eczema, psoriasis, hives)
- Food allergies/chemical sensitivities
- Inflammatory bowel disease (IBD)
- Irritable bowel syndrome (IBS)
- Multiple sclerosis
- Psychiatric illness
- Rett's & Tourette's syndrome
Lab tests are notoriously unreliable in determining who will or will not benefit from anti-fungal therapies. A variety of lab tests exist for yeast, including stool identification, urine metabolites, blood antibodies, and saliva antibodies.
Dr. Sidney M. Baker, MD,** writes that:
- The gold standard for yeast diagnosis is sequential and aggressive 20-day diagnostic (empirical) trials of anti-fungal agents, and appropriate dietary changes, irrespective of test results.
- No one anti-fungal treatment works for every individual due to strain resistance. A number of clinicians have observed an increasing trend for resistance to nystatin [a widely used antifungal drug].
- Different anti-yeast treatments - two or more - should be used. For example, 20 days of Saccharomyces boulardii [a "probiotic"], followed by 20 days of caprylic acid [a type of fatty acid with anti-fungal properties] or diflucan [an "antifungal antibiotic" drug].
- A die-off reaction and/or a symptom improvement indicates the likely involvement of yeast.
- Anti-fungals (medications, herbs, foods, etc.)
- Dietary changes
- Address predisposing factors.
Anti-fungals. The diagnostic trial procedure also gives the patient information about which anti-fungal agent is effective. These agents can then be continued for a period of months. Avoid oral supplements of lipoic acid, DMSA, cysteine/cystine, NAC, and glutathione during this process, as these supplements can increase yeast proliferation.
Dietary advice is as follows. Generally speaking, higher sugar and carbohydrate diets tend to encourage yeast growth:
- Avoid refined sugars (including soft drinks, fruit juices, cordial, honey, jam, lollies, molasses, maple syrup, corn syrup, brown sugar, etc.) and foods rich in refined sugars (many breakfast cereals, many muesli bars, ice cream, chocolate, biscuits, cakes, etc.).
- Minimize fruits.
- Decrease tubers/starchy vegetables (potatoes, sweet potatoes, yams).
- Decrease grains (bread, pasta, rice, cereals, etc.).
A number of factors predispose individuals to yeast infections. Anything which compromises gastrointestinal and/or immunological integrity appears to predispose to yeast infections. Some of these factors include:
- Zinc deficiency
- Parasitic infection
- Elevated mercury levels
- Deficient healthy flora.
Simply giving anti-fungals has little long term benefit if the predisposing factors are not also addressed, as this opportunistic infection will simply return back to previous levels.
Articles on Yeast
"What is the 'Yeast Problem?" by Dr. Sidney M. Baker, MD. [This article also includes an interesting explanation of how “yeasts damage the body’s defenses.”]
"Yeast Overgrowth" by Dr. William Shaw. [Outlines, for example, how tartaric acid produced by yeast may interfere with the Krebs Cycle of energy generation in our cells, and his observation that supplemental malic acid appears to benefit a large percentage of Fibromyalgia patients with elevated “tartaric acid and/or other yeast byproducts” in the urine.]
* Dr. William Shaw’s Kansas-based Great Plains Laboratory specializes in testing services such as those for "urinary metabolites of microorganisms."
** Sidney M. Baker, MD, is "a practicing physician with an interest in nutritional, biochemical and environmental aspects of chronic illness in adults and children." He is associate editor of the journal Integrative Medicine: A Clinician's Journal.