Dr. Jacob Teitelbaum's Column
...expert advice on CFS, Fibromyalgia and other Health Topics.
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Monday, March 5th, 2012:
What's New in S.H.I.N.E. — Part X: Infections (Clearing Up Candida)
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by Jacob Teitelbaum MD
This article continues our discussion of "What's New in the S.H.I.N.E. protocol" by moving on to "Infection" — the "I" in "S.H.I.N.E."
People with CFS or fibromyalgia usually have many different and even unusual infections. But in most cases the infections aren't always the primary cause of the CFS/FMS. Instead, they may be the result of the immune dysfunction that makes those with CFS/FMS more susceptible to infections.
Infections in CFS/FMS fall into four main categories:
- Yeast or fungal infections (Candida)
- Viral infections
- Bacterial, or antibiotic-sensitive infections
Today, I'll discuss the first of these — and often the most important infection. Candida, an overgrowth of yeast/fungi (I use the two terms interchangeably), occurs largely in the gut and can make toxins; spark inflammation; trigger chronic sinusitis and spastic colon; further weaken the immune system; and generally cause ill health.
When people have CFS/FMS, I recommend they simply assume they have Candida and then be treated for it. This often not only dramatically helps the CFS and fibromyalgia, but often also makes the sinusitis and spastic colon go away!
New and more effective ways to help you overcome a Candida infection now exist. Take the quiz below to learn the probability that yeast overgrowth could be significant to your CFS/FMS. Also, see my discussion on new treatments for Candida.
Do You Have Candida? It's Easy to Find Out!
There's no lab test that I find reliable for Candida. In the past, I used to help my patients figure out whether or not they had the condition by having them answer a questionnaire developed by the late and great Dr. William Crook, who discovered and helped lay the foundation for our understanding of Candida. Over time, I've adapted his questionnaire into a new and shorter version that simplifies the process. As I noted above though, if you have CFS/FMS, chronic sinusitis, or unexplained spastic colon, it is reasonable to simply assume you have Candida, and get it treated.
The following is my revised questionnaire.
Answer yes or no to each of the questions below. Your total score shows you the probability that yeast overgrowth is a significant factor in your case. To calculate your total score, simply add the point values shown in parenthesis for each of the questions you answer "yes" to.
_____ (50) Have you been treated for acne with tetracycline, erythromycin, or any other antibiotic for one month or longer?
_____ (50) Have you taken antibiotics for any type of infection for more than two consecutive months, or shorter courses over 3 times in a twelve-month period?
_____ (50) Do you have CFS or fibromyalgia?
_____ (50) Do you have sinusitis and/or spastic colon?
_____ (5) Have you ever taken an antibiotic (even for a single course)?
_____ (25) Have you ever had prostatitis or vaginitis?
_____ (5) Have you ever been pregnant?
_____ (15) Have you taken birth control pills?
_____ (15) Have you taken corticosteroids such as Prednisone, Cortef or Medrol?
_____ (20) Have you ever had a fungal infection — such as jock itch, athlete's foot, or a nail or skin infection — that was difficult to treat?
_____ (20) Do you crave sugar or breads?
_____ (10) Do you frequently get painful sores in your mouth (not on your lips)?
If your total was 70 or higher, consider antifungal treatment.
Step 1: A Probiotic That Saves You Money
The healthy bacteria in a probiotic supplement can help fight Candida. My favorite probiotic is Pearls Elite (by Enzymatic Therapy). Each Pearl contains 5 billion healthy probiotic yeast-fighting bacteria, using a mix of Lactobacillus plantarum, Bifidobacterium lactis, Lactobacillus acidophilus and Bifidobacterium longum. Unlike most other probiotics, it's formulated to resist being destroyed by stomach acid, so the friendly bacteria actually reach your intestines. (This brand even saves you a little bit of money, because with the concentration in this product you only need to take a single pearl a day, as opposed to other products where you'd need to take several for the same effect.)
Another reason I recommend this particular brand is the unique way it preserves the effectiveness of its probiotic bacteria. Testing shows that the hydrochloric acid found in your stomach will normally kill 99.9% of the probiotics you take (and I'm betting the 1 in a 1,000 that survive isn't in great shape either!). But the coating in Pearls Elite doesn't dissolve in stomach acid. Instead it acts like a tank on a battlefield, safely carrying its healthy troops past your stomach and into your small intestine, where the intestine's alkaline tissue dissolves the pearls and safely releases its 5 billion healthy Candida-fighting troops. To put this in perspective, the effect of taking just one of these specially-coated tiny pearls would be like taking a normally-coated probiotic that contained 5 trillion bacteria — that's 30 gallons of yogurt with live culture!
Step 2: Anti-Yeast: A Natural Replacement for Nyastatin
Nystatin is an anti-fungal medication typically used to treat Candida. Brand names include Bio-Statin and Mycostatin. But just as certain strains of bacteria are becoming resistant to antibiotics, Candida is starting to become more resistant to Nyastatin.
Used individually, many natural antifungals such as oregano or olive leaf are helpful. Unfortunately, dosages that are enough to kill the yeast can also irritate the stomach. In my practice, I found that a combination of anti-fungal herbs — each at a lower dose — works best to prevent the indigestion. One such "combo" brand that I found to be particularly effective is Anti-Yeast (by Nutri Elements). Their combination includes:
- coconut oil powder (50% caprylic acid), 240 mg
- oregano powder extract, 200 mg
- uva ursi extract, 120 mg
- garlic powder (deodorized), 240 mg
- grapefruit seed extract, 160 mg
- berberine sulfate, 80 mg
- olive leaf extract, 200 mg
- lipoic acid, 50 mg
- milk thistle extract, 50 mg
- N-Acetyl-L-Cysteine, 50 mg
Take two capsules twice a day for three to five months.
Step 3: Diflucan
Take the medication Diflucan (fluconazole) 200 mg a day for 6 weeks. You'll likely need a holistic doctor to write this prescription for you. Be sure to get the generic ($42 for a 6 week course vs $600).
Treating Fungus Treats Asthma Too!
It's not just for CFS/FMS, sinusitis and spastic colon anymore. Treating Candida treats asthma too!
A team of English researchers found that treatment with the antifungal Sporanox (200 mg, 2x day for 32 weeks) can help those with chronic severe asthma.
I suspect the treatment worked because it cleared up Candida infections triggered by the antibiotics and steroids prescribed to most people with chronic severe asthma. If you have chronic severe asthma, talk to your doctor about beginning your treatment with the antifungal "Diflucan" at 200 mg a day. It's much cheaper than Sporanox, and you're less likely to develop drug resistance. After you've optimally improved, lower the dose to a once-a-week intake of 200 mg twice a day (e.g., only on Saturdays).
For more information on the study and its results, see Antifungal Treatment May Help Asthma Patients.
Stay Away From Sugar
This tip isn't new, but it's crucial. Why? Because yeast eat sugar, 24/7. If you feed them, they live and multiply. If you don't, they die off more easily. If you can't do without sweetening your foods, use stevia. Stevia is a natural and healthier sugar substitute. An excellent one is Stevia Liquid Concentrate (by Body Ecology). I like this brand so much that I usually carry a small bottle around with me in my pocket. It's a great-tasting liquid, and with none of the bitter aftertaste common to most of the other brands. And this way I can indulge my sweet tooth — healthfully!
Another delicious, healthy, sugar-free sweet treat is sugar-free chocolate. Russell Stover makes a good one that you can find in most grocery stores. Want the best-tasting sugar-free chocolates I've ever had? You can get them at a website called Abdallah Candies. The site has mostly chocolate with sugar, so stay with the ones shown on Abdallah's sugar-free chocolate page. Have a sugar-free chocolate that you think is better that you'd like me to try? Feel free to send some to me for a taste test;-) But until someone shows me better, in my book Abdallah's is the hands down champ!
Used with permission from Dr Jacob Teitelbaum's free newsletters-available at www.Vitality101.com
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