The following article is an account of my journey through Hell as a result of auto-brewery syndrome (ABS), often referred to as simply Candida, 'intestinal yeast overgrowth, or sometimes 'fungal-type dysbiosis'. It is meant as an educational piece as well as a warning of how bad things can get for those already suffering some degree of yeast-related illness or those at risk (immunocompromised individuals, chronic antibiotic of conctraceptive pill use etc) if action is not taken as early as possible to tackle the problem. I also hope doctors and researchers reading this will take note and aside from the enlightened few, stop burying their heads in the sand.
Candida and other opportunistic yeast are often the cause of death in the severely immunocompromised such as AIDS patients. As is often the case with the medical profession however they work in extremes. Either you have AIDS and Candida can kill you or you don't and it can't cause any health problems for you at all (other than mild irritating skin infections or thrush).
As someone who was diagnosed with chronic fatigue syndrome/M.E. aged 12, I can assure you that the immune dysfunction associated with this illness including low natural killer (NK) cell activity, TH1/Th2 imbalance, and RNase L abnormalities, are enough to allow Candida and other yeast to thrive (at least in the gut) given the right environmental factors such as antibiotic use and a high carbohydrate diet. I suspect these factors alone or combined with genetic susceptibility and/or unhealthy gut flora (due to caeserean section birth, formula-feeding etc) may be enough to allow for the proliferation of intestinal Candida and the problems I will describe, even in the absence of ME/CFS or otherwise compromised immunity; meaning people considered healthy may also become ill due to fungal-type dysbiosis.
The following is my story:
My Early Years
My story begins before my birth as my mother had always suffered from bowel problems include symptoms of bloating, indigestion, an abdominal pain...particularly after certain foods, fermented foods for example. This would be diagnosed as irritable bowel syndrome by the conventional medical profession. IBS patients have been found to have disturbed gut flora with an increased risk of small intestinal bacterial overgrowth (SIBO).1 It is also likely that my mum had increased amounts of Candida/yeast and recurrent thrush provides some evidence for this.
Now, before a baby is born their gastrointestinal tracts are sterile, i.e. they contain no microorganisms at all. The innoculation with what will become the individual's gut microflora begins during birth. As the baby makes its way down the birth canal the mother passes on her microflora to the baby. So if the mother has an unhealthy makeup of gut microflora herself the baby inherists this and is off to a bad start. This was the case for me.
The second "hit" was the fact that for various reasons my mum was only able to breast feed me for 2 weeks. Despite what medical professionals or infant formula companies may tell you...breast milk is FAR superior to formula milk. The reason for this is that breast milk contains substances such as oligosaccharides(prebiotics) which act as food for beneficial types of gut bacteria, particularly Bifidobacteria. Research shows that the gut microflora of breast-fed infants is dominated by Bifidobacteria while bottle-fed infants have a less healthy mix containing much more Enterobacteriaceae, Enterococci, Bacteroides, and Clostridia.2,3
Now this was all very bad news for me as believe it or not an estimated 80% of the entire immune system is located in and around the gut and the gut microflora are now known to be instrumental in the development and regulation of immunity. Unhealthy gut microflora in infancy and associated immune system dysfunction are linked to an increased risk of allergic diseases as well as inflammatory bowel disease (IBD), for example.
Signs of gut problems didn't take long to surface with me as I suffered severe colic for the whole first year of my life. Infant colic has recently been linked to overgrowth of Klebsiella bacteria and increased risk of irritable bowel syndrome (IBS) in later life (I was diagnosed with IBS in my teens and a CDSA showed elevated amounts of Klebsiella aged 20).
To further damage any hope of me establishing a healthy gut microflora and robust immunity I was repeatedly given broad spectrum antibiotic drugs throughout my childhood for repeated ear, throat and chest infections. Antibiotics wipe out all types of bacteria in the gut, including beneficial ones such as Bifidobacteria and Lactobacilli, but don't kill yeast such as Candida, potentially allowing them to multiply unrestricted by the beneficial gut microflora that usually keep them in check.
Diagnosis of Chronic Fatigue Syndrome & Teen Years
In 1991 on my 12th birthday I was diagnosed with chronic fatigue syndrome (ME/CFS). It is now well established that this is an illness that involves a compromised immune system and allows for latent viruses to be reactivated, and an increased risk for opportunistic infections. Since, as mentioned earlier, 80% of the immune system is located in the gut, it only stands to reason that impaired immunity would lead to disruption of gut microflora and increased risk for overgrowth of intestinal yeasts and bacteria, as well as infection with enteroviruses (viruses affecting the intestines).
I had suffered from gut symptoms such as indigestion and bloating all through my childhood but soon after my diagnosis with ME/CFS I also began to experience severe rectal itching. I would suggest this was due to irritation of the rectal mucous membranes by toxins produced by Candida/yeast.
I am a very stubborn individual and spent my teen years resolutely ignoring the fact I was seriously Ill. I ate junk food and drank alcohol as most British teenagers do. As a result I noticed my gut symptoms of rectal itching, bloating, indigestion, flatulence, foul-smelling stools etc were getting worse. I was also rapidly becoming intolerant of alcohol. It took less and less to get drunk and less and less to cause a hangover. The hangovers were also becoming much much worse. In addition I had a burning sensation in my skin with its focus at my scalp and around my eyes. As I will explain later I believe this to be due to the poisoning of my nervous system by ethanol and acetaldehyde produced my Candida/yeast.
By my late teens I was generally in a very bad way and had gone from one of the highest acheivers in my high school to someone who couldn't concentrate at all in classes and just couldn't seem to grasp new concepts or retain new information. My grades went rapidly downhill along with my mood. I was by this time suffering from severe depression (which I attribute to the effects of Candida).
A Life Ruined by Candida
By 19 I had dropped out of university after a semester and a half after only just being given a place to begin with. Soon after is when my health and life well and truly hit rock bottom....the signs were that my liver gave way under the strain of dealing with Candida toxins day to day and I began to appear jaundiced, had pale stools, pain in the area of the duodenum on passing stools, and general inflammation type pain in the area of my liver under the right ribcage. I had an ultrasound around this time looking at my intestines but the ultrasound operator told me it looked like my liver was enlarged/inflammed. Unfortunately since my doctor had only asked for a scan of my intestines this detail was not recorded anywhere.
With the ultrasound, a Helicobacter pylori breath test, and a duodenal endoscopy all showing no abnormalities my doctor basically told me it was IBS and stress and that was that.
I spent the next few years at home. My daily schedule would be wake up at 1pm, lay in bed all afternoon watching TV or reading until 6pm (getting up only to go to the toilet or get food), then finally get dressed and sit at the computer researching my illness, playing games, or chatting to people in chat rooms (my only social life).
By this time it was clear I was in big, BIG trouble. After any meal I would experience loud gurgling noises from my lower abdomen (ileum area) as soon as I ate and then again, about 2 hours later. This would be accompanied by severe bloating and gas. Additionally, my bowel movements smelled terrible, like they had been fermented, as indeed, in my opinion, they had.
Initially if I ate foods of high carbohydrate content such as grains the symptoms above would be more severe and the next day I would have a hangover. Now let me make this clear. This is not an adjective I am using to describe a general feeling of being ill.....when I say "hangover" I mean a hangover caused by alcohol. The symptoms were exactly the same as those I experienced increasingly after drinking alcoholic beverages. I would wake up with a dehydrated, with a dry foul tasting mouth, the type of headache where moving your head is excruciatingly painful, general muscles aches, nausea, abdominal pain, aversion to light, and symptoms associated with being intoxicated e.g. dizziness, unsteadyness on my feet. Later these symptoms would also occur after any food containing carbohydrate, even low carbohydrate leafy vegetables.
If I thought things could not get any worse I was sadly mistaken. Under the advice of an envionmental medicine doctor I undertook a course of Enzyme Potentiated Desensitisation (EPD) (known in the US as Low Dose Antigens (LDA)). The idea being to lower my allergic load. Unfortunately being a type of vaccine this treatment modulates the immune system and the result in me seems to have been allowing the yeast in my intestines to proliferate even further. After just a few treatments I was now feeling extremely intoxicated immediately after meals, worsening at the 2 hours+ mark. I felt a little drunk but this rapidly progressed to a hangover. The worst part was the severity of next day hangovers had increased exponentially. I was now suffering the symptoms described previously but more severely and I could add cold sweats, tremor, and severe depression, anxiety, and restlessness.
...all of this just from eating would be considered healthy home-cooked meals. It is safe to say suicide was constantly on my mind and I even visited websites looking for the most painless methods.
Signs of Candida/Yeast Overgrowth and Alcohol and Acetaldehyde Poisoning Confirmed by Testing
Now, I should point out at this point that the following tests are dismissed by conventional medicine but I believe them along with my symptoms to provide convincing evidence that I am the victim of severe intestinal Candida/yeast overgrowth.
They led to Dr. Keith Eaton and Dr. Sarah Myhill here in the UK diagnosing me with fungal-type dysbiosis/intestinal Candida overgrowth.
Gut Fermentation Profile - Developed by Dr. Eaton and colleagues at Biolab (UK) in London, this test involves measuring blood levels of ethanol and various other alcohols an hour or two after drinking a glucose solution. Due to the severe hangover I would have experienced after drinking the solution I simply had my blood taken after eating a low-carbohydrate snack. Needless to say my blood ethanol was above the normal range anyway. Ethanol (drinking alcohol) is primarily produced by yeast. Other alcohols were elevated too and these indicate the presence of abnormally high numbers of various bacteria.
Toxic Effects Screen - Another Biolab (UK) test. This showed increased D-glucaric acid (17.3umol/g creatinine); a generic marker of toxic exposure. It also showed elevated Gamma glutamyl transferase which is a sensitive indicator of hepatobiliary (liver and gallbladder) disease. It is also an indicator of alcohol ingestion with a sensitivity of 52%-94.4,5 Finally, using a technique called affinity chromatography the lab reported that liver enzymes that deal specifically with alcohol and drugs such as paracetamol (isoenzymes 2A and 4) were raised in my case.
Comprehensive Digestive Stool Analysis (CDSA) - Performed by Great Smokies Diagnostic Lab (now Genova Diagnostics) this stool test showed that Lactobacilli and beneficial strains of E.coli which normally keep Candida/yeast under control were almost entirely absent from my sample. The test also detected abnormally high levels of bacterial genae such as Klebsiella, Pseudomonas, and Proteus. Another stool test a few years later also detected significant amounts of Candida of various species.
Now I don't know about you, but given the fact that I had not drunk one sip of an alcoholic beverage for years before these tests were carried out, I would assume anyone would find it particularly strange that my blood should contain significant amounts of alcohol and that my liver showed all the signs of chronic alcohol ingestion.
Of course anyone in the medical profession could just dismiss my account of my symptoms and dismiss the tests results as those of someone who regularly consumed large amounts of alcoholic drinks.....but this is simply not the case. There is no doubt in my mind that the lower parts of my small intestine are covered in Candida/yeast growth which feed on whatever I eat and poison me with ethanol, acetaldehyde and other toxins which are absorbed through the small intestinal wall before passing down the portal vein to the liver.
Consequences of Ethanol and Acetaldehyde Poisoning
The consequences of chronic ethanol and acetaldehyde ingestion are well known as they occur in alcoholism. So assuming I do have a gut full of Candida/yeast acting as my own personal brewery, many of the effects are the same as those suffered by an alcoholic. At this stage it is worth knowing that ethanol is first converted by the body into acetaldehyde before that is itself converted into non-toxic acetic acid.
Here are some of the effects of ethanol:
- Ethanol metabolism interferes with energy metabolism; this results in fatigue and buildup of lactic acid, causing muscle aches.
- Hypoglycaemia or "low blood sugar" also results from the above.
- Nutritional deficiencies - particularly but not limited to vitamins B1 (thiamine), B6 (pyridoxine), vitamin B9 (folic acid), B12 (cobalamin ), zinc, magnesium, potassium, and molydenum.
- Anaemia due to folic acid and B12 deficiencies.
Gastrointestinal ulcers and increased intestinal permeability (leaky gut syndrome). Ethanol is highly toxic to all GI tract cells. Leaky gut syndrome is implicated in many diseases including food allergies/intolerances, systemic allergies, autoimmune disorders, chronic fatigue syndrome etc.
Here are some of the effects of acetaldehyde (significantly more toxic than ethanol):
- Is responsible for most of the symptoms of a hangover. Causes dilation of blood vessels in the brain which result in the characteristic severe headaches.
- Attacks and forms complexes with many proteins and nucleic acid (as in DNA and RNA) disrupting their normal functions.
- Blocks secretion of proteins by the liver and causes swelling of hepatocytes (liver cells).
- Binds and inactivates glutathione - the body's main antioxidant - thus increasing oxidative stress and allowing free radicals to damage cells throughout the body. Mitochondria, the energy producing machinery within each cell, are particularly susceptible to free radical damage.
- Impairs the function of lymphocytes (an important type of white blood cell) and red blood cells (those that transport oxygen).
- Increases the release of adrenaline causes heart palpitations, anxiety etc.
In addition both substances result in liver disease when the liver has to deal with them chronically and in sufficient amounts. They cause the buildup of fat in the liver impairing its function. The liver is the most metabolically active organ in the body and so an inefficient liver interferes with the production of bile (and therefore fat digestion), the production and detoxification of steroid hormones, and the detoxifcation of a huge range of substances such as ammonia from protein metabolism and gut bacteria, drugs, and pollutants.
You are obviously aware of the effects of alcohol on the brain so imagine dealing with symptoms such as confusion, forgetfulness, lack of concentration, mood swings etc, constantly, on a day to day basis. As well as the direct effects of alcohol and acetaldehyde on the brain they also have indirect effects. For example pyridoxine is required for the production of many neurotransmitters that regulate mood such as serotonin and noradrenaline, while the activated form of vitamin D is also required for their production. It is the liver's job to activate vitamin D so a poorly functioning liver due to ethanol and acetaldehyde poisoning can result in mood disorders through this mechanism.
I would also hypothesise that my development of multiple chemical sensitivity (MCS) a couple of years after the symptoms of severe intoxication began was a result of ethanol and acetaldehyde poisoning. It has been proposed that MCS is due to an acquired hypersensitivity to a group of chemical that would include ethanol and acetaldehyde subsequent to either acute or chronic poisoning with these or related compounds (e.g. formaldehyde).6
There was no way I could have sustained living with constant severe hangovers for years on end, and I suspect here is where many of you reading are hoping for a happy ending but I'm afraid that's not the case. I would surely have ended my own suffering by now but for a twist of fate - My development of multiple chemical sensitivity (MCS) which meant I had to move out of home. Living alone my stress levels shot up with the result that ever since my intestinal muscles have always been tensed and this has prevented the large amount of fermentation that was going on. Perhaps I am able to absorb my food before it reaches the Candida/yeast now, that is my best guess. In any case, on occassions where I do manage to relax (very very rarely), the noisy gurgling, bloating, gas, intoxication, and hangovers return.
I have been unable to treat the problem as advised by doctors, nutritionists and multitudes of other health professionals - low carbohydrate diet, antifungal medication/supplements, and probiotics (an approach I agree with) because the side-effects are so severe. I mentioned poisoning of my nervous system earlier. Well, taking anything that kills Candida/yeast results in symptoms of tension, stress, anxiety, restlessness, irritability, anger, feelings of aggression, and burning scalp and skin around my eyes. These increase in severity rapidly and I even begin to get subdermal (below the skin) bleeding around my eyes as the burning sensation becomes severe. I can only assume given the other symptoms this is due to highly elevated activity of sympathetic nerves. In any case, to stay on antifungal treatment would mean I would end up throwing myself under a bus after a few months even when plied with tranquilisers such as diazepam (Valium) in high doses at the same time. At least this serves as further confirmation that Candida/yeast is the problem as this reaction only happens when taking substances with antifungal activity; I have tried many, many different ones both prescription and "natural" and the reaction is always the same.
Now at the age of 30 I am left considering drastic options. Small intestinal biopsy to confirm the extent of the yeast overgrowth and procedures such as a faecal/fecal transplant. Yes, this is what it sounds like. A healthy donor provides samples of faeces which are liquidized and sent down tubes into the recipients small intestine. The idea being the healthy stool contains trillions of beneficial bacteria that can displace the pathogen, in this case Candida/yeast, and restore balance and health to the gut and by association, the body as a whole.
One thing is certain, I will not get well while I have my own personal brewery in my gut, so something needs to be done...