Last week, I wrote about the care and feeding of a healthy vaginal microbiome, the “normal” bacterial melange living peaceably “down there”.
There are, however, troublemakers, decided annoyances, sometimes stubborn hangers-on, never severe enough to be, say, a line item on your death certificate or the final sentence on your obituary reading, “Contributions may be made in her name to the American Candida Association.” Still, life would be easier without vaginal infections. The troublemakers: Candida, Bacterial Vaginosis, Trichomonas, Chlamydia, Gonorrhea.
CANDIDA (a/k/a “Yeast Infections”): These single-cell organisms have always been in our bodies since the dawn of time. For theater buffs, the musical, “Yeast Nation”, in which actors played singing candida buds opened in both London and New York. The show did poorly.
Candida resides in our intestines, vaginas, and surfaces of the skin. Candida overgrowth is kept in check by our good microbiome bacteria, but sometimes, and usually, inadvertently, we do something to upset the delicate balance and allow candida to take the forefront. The commonest culprit is antibiotics we gobble like M&M’s, which kill off the good bacteria and allow candida to flourish. The main symptom of a vaginal yeast infection is easy to recognize: vaginal itching (often quite intense), irritation, and a thick white discharge described as ‘cottage-cheese’. Some women get these during pregnancy, others when on birth control pills and corticosteroids. Diabetics are especially prone to yeast infections as yeast have an undeniable sweet tooth.
The fastest way to get relief from an acute vaginal infection is to race out and buy a package of Monistat 7 vaginal cream. Use it nightly for a week. This stuff kills vaginal yeast on contact, and you can almost hear candida screaming in death agony. Since much candida is harbored in your intestines, you can ask your practitioner to prescribe 7-10 days of oral fluconazole or itraconazole tablets, and also continue your probiotic. Monistat, fluconazole, and itraconazole are all ‘azoles,’ a chemical that causes yeast cell death immediately.
One important historical fact about candida: In 1986, a general practitioner from Tennessee, Dr. William Crook, published a mega-bestseller, “The Yeast Connection”, which attributed a vast variety of body wide symptoms to chronic intestinal candida. His findings were immediately trashed by conventional doctors. The Wikipedia entry is written by Quackwatch editor, Stephen Barrett, and it is especially vicious and mainly inaccurate.
After working with chronic candida patients for almost four decades (yikes!), the syndrome certainly does exist. Heavy candida overgrowth in the lining of the intestine damages the intestinal wall (“leaky gut”), and the toxins from the candida enter the bloodstream producing a variety of symptoms (brain “fog”, headache, chronic fatigue, joint pain, mood swings, fibromyalgia-type muscle pain, oral thrush, coated tongue). In addition, the candida in the intestine itself causes irritable bowel symptoms (bloating, diarrhea, constipation).
However, and to me this is a “big however”, I have seen far too many patients over the years told by a variety of practitioners, “You definitely have candida”, and then sold a vast array of unnecessary products and told to follow sometimes brutally austere diets. If they return to their practitioner a few weeks later not feeling better, the practitioner blames them for not following the diet carefully enough and adding more supplements “to cover your self-inflicted damages”.
This produces another condition, which I have termed, “The Candida Anxiety Syndrome”.
Just like you wouldn’t undergo cancer chemotherapy thinking you might have cancer, you really don’t want to start treatment for candida overgrowth syndrome without firming up the diagnosis. The most commonly ordered tests are:
If you actually have candida overgrowth, the line item ‘candida’ will be 4+ or “heavy”.
The most frequently ordered herbal treatments for chronic candida are:
If you need help with your vaginal yeast infection or chronic candida, schedule with any of our practitioners.
Be well.
David Edelberg, MD