QUESTION: Hi Doc – I’m an averagely healthy, active 37-year-old female but I think I have systemic Candida, having suffered from the same symptoms for 15 to 20 years now.
I’ve been to a homeopath and was treated for allergies, heavy metal poisoning, and detoxed and did not win. I also did a course of AllergoStop, but nothing improved. I’m now on regular cortisone nasal spray but the phlegm and post-nasal drip continue.
I believe it’s in my gut so I saw a gastroenterologist recently, but he believes Candida does not exist in the gut and thinks I have standard IBS (irritable bowel syndrome). He added fibre to my diet and reckons that if I “pass” twice a day I’ll be fixed. The bloods he did are fine and he doesn’t think there is an accurate test for Candida.
My gynaecologist says I’m fine and that my pap test is normal but I detect an odour. My dentist and oral hygienist are also happy, but my breath smells like a dead rat.
There is so much information online and various and treatment programmes, but it’s incredibly confusing and overwhelming and I’m fast losing hope and my finances are low. I cannot afford to continue spending money (no medical aid) and paying consultation fees to find out I’m barking up the wrong tree.
The major obvious symptoms are bad body odour, halitosis, discharge, allergies, post-nasal drip, gas and feeling tired.
I’m aware that each could have its own individual issue and that emotions, nutrition and lifestyle create and contribute (to my condition). I cannot help leaning towards Candida (as a diagnosis) and just wish there was some sort of evidence in a test to prove exactly what it is! And then a clear-cut proven programme to cure the core issue once and for all.
Is there any chance that you are able to just tell me your thoughts and what your success rate has been in diagnosis and treatment?
ANSWER: Thank you for sharing such a descriptive and interesting story. You have alluded to a cluster of symptoms that are having quite a dramatic impact on your lifestyle and stealing your joy. The first step is to take action and seek help – which you have done. I agree that there are endless sources and information on the topics you have searched and this is part of growing cyberchondria.
My greatest critique of online diagnosis is the quality of the research behind certain sites and the lack of clinical guidance and governance of attributing the right emphasis to the complaint during a thorough history taking. Nothing can replace the clinical experience of physically examining a patient and using insight to arrive at a possible diagnosis. Being well-informed, educated and prepared before seeing a doctor is very good practice as we need to keep them accountable and current.
Your concerns are primarily around the yeast or fungus infection, Candida. It is a well-described infection that can manifest in various ways and like all fungus it flourishes in moist and warm conditions.
What is Candida?
It’s a type of yeast called Candida albicans. Normally it is found in small amounts in the human body but overgrowth can occur in association with certain conditions like diabetes and secondary to medications such as steroids for asthma and especially after taking antibiotics. So many of us forget to take probiotics when taking prescription antibiotics. Antibiotics can change the normal pH or acid level , resulting in the overgrowth of fungus.
Others who are prone to infection are infants, elderly people, patients having chemotherapy and people with HIV – conditions that weaken the immune system.
Women complain regularly of extreme itching in the vaginal area, accompanied by soreness and redness. Scratching further cracks the skin and makes secondary bacterial infection and abscesses possible.
Men can get a yeast infection too but this is more common in uncircumcised cases.
The most important thing to remember is that both partners should be treated, otherwise we won’t win and manage the infection.
The nitty gritty of Candida:
The overgrowth of the fungus leads to various clinical manifestations throughout the body, so we need to make the environment unfavourable for fungus. Effective hygiene and maintaining a good Ph balance on our skin membranes is important. Diet has a direct bearing on acid levels. Keep hydrated as this assists with issues like bad breath and concentrated urine. Replacing any lost “good” bacteria that lives in the gut is important.
The growth of fungus is in direct proportion to one’s sugar intake.
There has been a huge surge in research directed at gut flora and enzymes, their role in obesity and the metabolic syndrome. There is also work being done on the genetic links to this flora composition.
If you suffer from recurrent fungal infection you should see a good physician due to the strong association with certain systemic illnesses, as well as the common side-effects of certain medications.
Treatment
In superficial skin infections, a topical application is suitable. For oral thrush, lozenges and potent mouthwashes can be used. When the manifestations are diffuse and many areas are involved, system oral medication is used. Sporonax, Flucanozole, Terbinifine and Lamispor are just a few we know.
Women can use a once-off intravaginal tablet, while for oral thrush, Nyastatin drops and antifungal lozenges will do the trick.
To our reader, I recommend a very clearly defined plan with a dedicated physician who explains the process of what we are looking for and treating before blindly shooting in the dark with all sorts of multiple therapies.
You are spot-on in your assessment that the approach should be based on lifestyle modification. Sometimes it is the simple things that help most – things like stress reduction, a decent sleep schedule, reduced intake of sugar and white flour products.
Scrutinising your environment for triggers can also prove useful. - Cape Argus
Common areas for fungal infection
* Skin – nappy rash.
* Genitals – vulvovaginal yeast infection.
* Throat – oropharyngeal thrush.
* Mouth – oral thrush.
* Blood – invasive Candida.
* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.
He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.
If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen. Catch him in Cape Town on 567 CapeTalk, most Fridays at 1.30pm.
The advice in this column does not replace a consultation and clinical evaluation with a doctor.