Ask the Doctor: Candida Overgrowth

How is Candida overgrowth one of the most notorious conditions for opening the door to widespread inflammation in the body?

By starting a cycle of inflammation affecting the intestinal wall, it allows entry of potentially immune stimulating foodstuffs, bacterial endotoxins, and aggravating substances from Candida itself to escape into the bloodstream and the surrounding lymph tissue, known as Peyer’s patches. This condition of disruption of the tight junctions between the cells of the intestinal microvilli is now known as “leaky gut.”

Once substances leak out inappropriately, they can be recognized by the immune system and stimulate a response against themselves and the tissues to which the blood carries them. If tissues in one’s own body resemble any of these substances the immune army is attacking, those similar tissues may be attacked as well, causing inflammation and autoimmune disease. It is recognized by many in the integrative medical community (and much less so by the conventional medical community) that intestinal Candida overgrowth can cause leaky gut, and is a key step in controlling a variety of chronic inflammatory diseases.

Antibiotic treatment kills normal bacteria living in the gut, but not Candida. It also dramatically reduces the normal bacterial population of the gut and leads to overgrowth of Candida yeast to fill the ecological niche. Studies on mice show that Candida do not colonize the gut unless they are first treated with antibiotics. Our culture, with frequent use of antibiotics and the average person’s diet containing 150 pounds of sugar per year, supports the notion of many people having an excessive culture of Candida yeast in their intestines. There is a vicious cycle whereby yeast growth is favored by inflammation, and inflammation favors more yeast growth, sometimes leading to overgrowth. Candida causes an elevation of a number of lymphocytes, called TH17, in the gut associated with autoimmune disease and inflammatory intestinal illnesses such as Crohn’s disease and ulcerative colitis. TH17 is also associated with psoriasis, another inflammatory disease of the skin.

Other indirect associations of yeast in medical literature are the many benefits reported for addition of probiotics to reduce the incidence of eczema in infants. Literature from Scandinavia shows that probiotics given around the time of birth either to the mother or the infant cut the incidence of eczema in half. Probiotics have been shown to benefit a number of other inflammatory illnesses as well. Another article implicating yeast in inflammatory disease shows that yeast elimination improves patients with hidradenitis suppuritiva, an uncomfortable acne-related cystic inflammatory disease.

Candida is not the only substance that leads to disruption of the intestinal barrier. Gluten is well known to cause this in some people who are sensitive to it. Bread containing both yeast and gluten can lead to both intestinal barrier disruption in some people and subsequent inflammatory disorders of all sorts. Candida’s role in inflammation is further supported by evidence that multistep treatment processes to restore it to normal levels and improve the gut barrier lead to improvement of a variety of digestive and skin disorders.

Candida is a complex organism that changes from a round form to a long (hyphael) form that penetrates into tissues. Its components have immune similarities to chemical structures of other yeasts that live in the skin and the body such as Malassezia, a type of yeast that lives in the skin and hair follicles. An immune attack against Candida can lead to attacks against Malassezia and its byproducts, leading to red and scaly skin or scalp. Also, various yeast-generated foods like bread, wine, and beer are loaded with other forms of yeast which can stimulate additional cross-reactive attacks against candida-related targets or, by their large numbers, turn off the gut immune system from controlling the population of Candida in the gut and elsewhere.

Candida put out a huge number of chemical products, including enzymes to digest their surroundings, mycotoxins to kill competing organisms, and other irritating compounds including alcohol, acetaldehyde, ammonia, and gliotoxins. These toxins can cause irritation, inflammation, and disruption of other normal processes in the body that lead to inflammation and disease.

Genetic analysis shows that 17 to 31 percent of Candida DNA is similar to human DNA, depending on the study. It is not hard to see how they can either make themselves look like us to escape detection or, if recognized, incite an inflammatory reaction against various aspects of our own human tissues. We have a delicate balance with Candida organisms in our body. Too little immunity can lead to dangerous overgrowth and behavior of Candida as an invasive and spreading pathogen that can kill us. Too much immune reaction can lead to attack of our own tissues. We must eat and treat to maintain the fine balance of gut microbial organisms for maximum synergy with our systems. We need to be sure that Candida albicans and its cousins do not stray/fall out of balance and cause us to attack ourselves.

 

By Alan M. Dattner, MD



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