Candida and The Human Microbiome

The Candida hypothesis

Dr. Orion Truss of Birmingham, Alabama first brought the Candida hypothesis forward in 1978. Dr. Truss is a psychiatrist with a special interest in clinical ecology; his seminal papers in the Journal of Orthomolecular Psychiatry [“Tissue Injury Induced by Candida Alb cans,” vol. 7, no 1, 1978, pp 17-37 and “Restoration of Immune Competence to Candida Alb cans,” vol. 9, no 4, 1980, pp 287-301] certainly revealed an extensive and fascinating area of personal investigation. His work was taken up enthusiastically by the late Dr. William Crook, who did more than any single individual to popularize the Candida hypotheses, or what has now become known as ‘the yeast connection,’ taken from the title of his book.

The Yeast Connection, Professional Books, 1983]. Since that time, the whole theory seems to have gripped the public’s imagination and clinical ecologists have been keen to extol the existence of the problem and the enormous benefits to be gained from tackling it vigorously. The fact is there are health gains to be made by following a so[1]called anti-Candida program, taking antifungal drugs and excluding sugar and yeast foods from one’s diet. Yet Truss’s idea is no more than a theory. Please remember that.

Historical background

Truss was in fact far from being the first investigator in this field. My late British colleague Dr. Keith Eaton researched this topic extensively and found Truss’s ideas were anticipated almost seventy years earlier by a physician called Turner, who presented a paper on what he termed ‘intestinal germ carbohydrate fermentation’ [Proceedings of the Royal Society of Medicine Symposium of Intestinal Toxemia, 1911] [Eaton KK, Gut fermentation: a reappraisal of an old clinical condition with diagnostic tests and management: discussion paper, J Roy Soc Med 1991; 84: 669-71].

The ‘problem patient’ attitude was probably what sank the condition in the 1950s. At that time, the psychosomatic theory of disease was enjoying a great revival. The tendency was to dismiss all patients with vague, ill[1]defined symptoms as psychiatric cases. Unlike today, there were no physical findings to disprove the psychiatric label and so it stuck. It’s still with us, to a large degree.

Intestinal fermentation

So the idea of a yeast-like gut pathogen that lives on starches and sugars and causes bowel disturbance is far from new. It seems to enjoy a vogue in medical circles every few decades and then lapses out of sight once again. The reason is probably that, as in the 1980s, some doctors become convinced they know what causes the syndrome, but then can’t seem to find a workable proof that affords a satisfactory explanation. This casts doubt on the basis of the theory. So it is today with ‘Candida.

On-board brewery

Historically, Sarcoma ventral collate is an important organism. In the old days, when surgeons operated in top hats and frock coats, often smoking a cigar while they butchered, once in a while they would literally blow up their patients as the alcoholic gases generated by Sarcoma were released from the patient’s stomach when cut open; the cigar would ignite the fumes and a fireball was the disastrous result! These ‘on-board breweries’ are probably quite common. In the early 80s we began to realize that an individual could present with quite high levels of blood alcohol and yet be a non-drinker. There have been several celebrated cases, including one of my own, in which individuals who were guilty of driving under the influence of alcohol were able to show they had not been drinking but that they did have significant infections with Candida and so escaped the laws.

Breath hydrogen test

In Man, only anaerobic bacteria in the colon are capable of producing hydrogen in our bodies. They do this by fermenting sugars, such as lactose, sucrose, orbital, fructose, lacunose etc. (depending on the purpose of the test). The hydrogen enters the bloodstream and is out[1]gassed via the lungs. This gives rise to the possibility of testing breath for hydrogen content as a means of estimating bacterial activity in the colon. Prior to hydrogen breathe testing, individuals fast for at least twelve hours.

At the start of the test, the individual blows into a balloon, filling the balloon.The concentration of hydrogen is measured in a sample of breath removed from the balloon. The individual then ingests a small amount of the test sugar. Additional breath samples are collected and analyzed for hydrogen every fifteen minutes for three to five hours.

The problem with Candida diets

Candida was really just a hook to hang things on. Do not believe what you read in the media and on the Web, unless the author specifically acknowledges this lack of real understanding. I will attempt to summarize just what we do know about so-called Candida and symbiosis and also put an end to some of the nonsense and falsehoods, spread principally by unqualified medical practitioners. Many of these enthusiastic amateurs have set themselves up as ‘Candida experts’ and are making belligerent claims they cannot justify and treating individuals with techniques that are sometimes worthless or – at worst – downright dangerous.

Another incorrect datum that has gained much currency is that once you have Candida you are stuck with it. One hears of people who are supposed to have had it for years. Again, the amateur meddlers’ fundamental lack of knowledge is to blame. Because they are not able to prescribe proper antifungal drugs – and indeed, to protect their own shaky position as unlicensed ‘experts’ some even say that it is undesirable to take antifungal – they are not able to effect proper eradication. This means that many sufferers are denied the full treatment that they need, treatment that would enable them to overcome their condition.

Testing for Candida and yeasts

There are four symptoms in all that I have found very helpful in pinpointing Candida, yeast overgrowth and other causes of symbiosis:

  1. A craving for sweet foods
  2. A poor tolerance of alcohol
  3. Chemical sensitivity
  4. Abdominal bloating.

This is my ‘awesome four-some’! All four symptoms mean almost a certainty; any three will do for a strong presumptive diagnosis. Craving for sugary foods is often outstanding.

Last word

I continue to use the concept of “Candida” in talking to patients since most people have heard of it and believe that is what they have. However, I prefer the flippant label I used in my Allergy Handbook (Torsions, 1988), the so-called ‘moldy patient.’ It is a term that stays in the mind, broadens out the debate and gives better insight into what we are dealing with.

Whatever the nature of this illness, its manifestation is of a disease caused by encountering and being sensitized by biological products from yeasts, fungi and molds. Patients are made worse by anything that can be fermented, such as starch and sugars; they react to foodstuffs containing yeast or mold (bread, wine, mushrooms etc.); they are often ill in moldy or musty surroundings (old buildings, woodlands or animal byres); some are even sensitive to damp weather, when molds are sporting freely; often there are accompanying infections of the fungus type, including athlete’s foot or other skin infections such as Tine and Eider python.

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