Candida is usually thought to result from a weakness of the immune system following antibiotic therapy. This may be true, but it may not be the whole truth. If it isn't then any treatment based on it is unlikely to be completely successful in all patients. Our data indicates that whilst the majority of sufferers do recover (occasionally relapsing at a later date) a minority fail to recover at all. Effective treatment requires satisfactory explanations of underlying causes.

As long ago as the 1980s American physicians noted that their most difficult-to-treat candida patients had endocrine systems that were not working properly, known as the APICH syndrome. As an unbalanced endocrine system may play a role in all candida overgrowth, it is important to look carefully at the relationship between candida and the endocrine system. We begin with the usual description of the causes of candida.

What is candida?

'Candida' is the popular term for an overgrowth of candida - a condition known to medical doctors as 'intestinal candidiasis' when found in the intestines or 'systemic candidiasis' when found elsewhere in the body. It was first diagnosed by American physicians in the 1970s.

When we are healthy, candida lives (in its yeast form) in our intestines where it competes with bacteria for room. Like bacteria, it is aerobic i.e. it needs oxygen to live. When we die, oxygenated blood stops coursing through our bodies, suffocating the bacteria. But candida (like all yeast) can survive without oxygen by changing into its fungal, anaerobic form. It spreads rapidly into the area vacated by the dead bacteria, putting down roots into the walls of the intestines, and sporing through the gut wall into the rest of the body.

Candida decomposes cell membranes, providing food for other microbes, particularly the maggots which infest corpses. The Egyptians realised this thousands of years ago. When they wanted to mummify a body they extracted the intestines as soon as possible after death, to stop the body rotting from the inside out, embalming the rest of the body with eucalyptus and other anti-fungal oils to kill any remaining candida and other microbes.

Sounds revolting, but a diagnosis of 'candida' means that this process has started, whilst we are still alive. It doesn't mean that you are at death's door. On the contrary candida rarely kills. But its presence in large numbers means that your immune system has an unremitting battle to keep it under control - a battle which takes a terrible toll on your health.

Common symptoms of candida

The damage to the intestinal wall allows toxins to enter the bloodstream. This condition called 'leaky gut syndrome' often leads to food allergies, foggy brain, migraines and depression. Symptoms in the intestines include diarrhoea or constipation, bloatedness, flatulence and itchy anus. Once through to the rest of the body, the candida can live anywhere there are mucous membranes - it particularly likes the vagina, lungs and the sinuses, providing food for bacteria and viruses. It has an ability to disrupt the endocrine system causing symptoms such as weight gain or weight loss, PMS, menstrual irregularities, joint pains, asthma, hayfever, muscle fatigue and chronic tiredness. Testing usually reveals vitamin, mineral and enzyme deficiencies and low blood sugar. Thyroid tests often indicate that the thyroid is functioning normally, but body temperature is inexplicably low.

Some of the most obvious symptoms of candida overgrowth are thrush, cystitis and fungal infections of the nails or skin, such as athlete's foot. Local medication is not permanently successful. This list of symptoms is illustrative not exhaustive.

Causes of candida - the traditional view

A decade ago books on candida were hard to come by - but now most bookshops stock a good choice. We have a lot more information and a vast increase in the choice of supplements, as new anti-fungal properties of herbs are discovered and added to supplements. But we haven't made any progess in understanding why candida has become so prevalent. Authors of recent publications seem to agree that the number one cause is overuse of broad spectrum antibiotics. Candida then overwhelms the immune system by producing toxins which repress T-lymphocytes, the main search-and-destroy cells in the immune system.

This is a far simpler account than that given by earlier writers (often practising physicians) who cited a complex mix of contributory factors. GPs have difficulty accepting this simpler hypothesis. They know that antibiotics cause thrush in susceptible individuals, which they (wrongly) regard as little more than a temporary nuisance, restricted to the genitals and mouth. They don't believe that a microscopic organism (which our bodies have accommodated for thousands of years) can permanently overwhelm a healthy immune system to do such wide-spread damage.

It seems that we are in danger of talking up one possible hypothesis (disregarding others) and unfortunately our chosen one alienates the medical profession and provides poor guidance for the very people who need it most: severe cases with complications, and those who relapse. It is time to take a fresh look at the underlying causes of candida.

Who suffers from candida?

Females! Males do get it - see our last edition for a male member's story, but overwhelmingly it is a female condition. At least 60% of sufferers are women; 20% are men; and 20% are boys and girls. If candida is caused primarily by antibiotics, why is it predominantly a female condition? Do women swallow more antibiotics than men? Maybe they do, but anecdotal evidence suggests not - women avoid oral antibiotics because they know they will get vaginal thrush if they don't.

Considering the number of male teenagers who take antibiotics for acne and the children dosed with antibiotics for infections, shouldn't this ratio of sufferers be more balanced? Perhaps this imbalance can give us a clue about the causes of candida. Some of our male members think that antibiotics caused their candida, but a significant number think otherwise. They cite:

·         handling chemicals e.g. pharmaceutical workers, farmers

·         dental mercury amalgam poisoning

·         use of recreational drugs

·         side-effects of medication, especially corticosteroids

·         stress (usually as a contributory factor).

Causes in women?

Mandy Smith (then Bill Wyman's wife) was the first UK public person reported in the press to be suffering from candida, which was attributed to her continuous use of the contraceptive pill from puberty. In fact, it still seems likely that hormonal pills are the major factor in women developing candida. The factors are:

·         contraceptive pill or HRT including 'natural' progesterone cream

·         other corticosteroids (hydrocortisone, beconase, prednisolone etc.)

·         hormonal changes e.g. puberty, sexual maturity, pregnancy, sterilisation, menopause including peri- and post-menopause

·         broad-spectrum antibiotics

·         dental mercury amalgam poisoning

·         chemical poisoning in the home or office

·         stress (usually as a contributory factor).

Causes in children?

Our evidence is too scanty to offer any definite conclusions, but we note that most of our young members (if not all) have had antibiotics and/or corticosteroids.

What do these factors have in common?

They all disrupt the body's endocrine system, causing hormonal abnormalities, which can be aggravated by antibiotics, and even by candida.

What is the endocrine system?

The endocrine system is the regulatory system of the body. Whilst the immune system is our defence system (an army), the endocrine system is our internal policeforce, preventing local trouble from escalating and keeping everything running smoothly.

How does the endocrine system work?

In simple terms, the endocrine system (part of the hormonal system) has a number of glands e.g. ovaries, testes, adrenals and thyroid all controlled by the pituitary gland (the master gland) and the hypothalamus in the brain. Under direction from the brain, each gland releases a chemical messenger (hormone) into the blood stream, that circulates until it finds its target site - a receptor specially-shaped for it on various organs. The hormone fits into the receptor and turns it on - like a key opening a lock. All of our organs (including the brain) have receptors, and the arrival of the hormone messenger governs the activity of the organ, turning it up or down, on or off.

This is the basic mechanism for how most drugs work in the body, as drugs are made to mimic hormones. Quantities of all circulating hormones are continuously monitored and adjusted by the brain. It is a complex system because some hormones have more than one function, and hormones work with or against each one other.

Let's look at how your hormones affect thrush. The endocrine system governs the acid-alkaline balance in the vagina. Normally it is kept slightly acidic, but if the endocrine system decides to raise the pH level (making it alkaline), the vaginal wall becomes less hospitable to the bacteria that live there. They die, and the vacated space is filled by an organism that likes an alkaline environmentl i.e. thrush. This is why to get rid of thrush permanently, you need to return the vagina to its natural acidic state. Go gently - drastic treatment will certainly banish the thrush, but a sudden vacuum will be quickly filled by an opportunistic strain of bacteria that will bring as many problems as the thrush. You also need to discover why your endocrine system is altering the acid-alkaline balance (e.g. are you taking HRT or other corticosteroids?) and let the body get back to the balance that it wants to maintain for your good health.

Relationship with candida?

Let's return to the factors that members thought might have caused their candida, and look at one way that they might disrupt the endocrine system (undoubtedly there are others too). Corticosteroids, dental mercury amalgam and chemicals such as dry cleaning materials, carpet sprays, plastics, paints and pesticides can all jam oestrogen receptors. Oestrogen is a hormone that is made in the ovaries (in pre-menopausal females), in the adrenals (in men and in post-menopausal women), in fat cells and in the bowels. As oestrogen and its opposite number progesterone are particularly important in a female, we would expect any imbalance to have more effects on the female than male. In addition, both of these hormones have more mundane functions (in both sexes) such as controlling the bladder, bowel functioning, blood sugar regulation. In fact, all of the symptoms of candida mentioned earlier, including weight gain, asthma etc. can result from hormonal imbalance.

Effect of blocked oestrogen receptors?

The exact effect is unknown. Depending on which receptors are blocked and what activity the receptor was governing, the net result could be excess or insufficient oestrogen. Excess oestrogen is a cancer risk e.g. for breast cancer. Progesterone dominance (low oestrogen) can cause headaches, migraines, depression, blood sugar irregularities leading to asthma and adrenal gland exhaustion leading to allergies particularly environmental allergies. Low body temperature (but normal thyroid tests) are another sign of adrenal dysfunction. So we find that all of our symptoms listed earlier are signs of an endocrine disorder. Interesting!

Why do antibiotics bring on candida?

Antibiotics can be the final straw that breaks the camel's back. We have already seen how the presence of antibiotics can cause the vagina to become more alkaline predisposing thrush. Short term antibiotics can have another effect as oestrogen is passed into the intestines in bile fluids for conversion to a more active form by bacterial action. (In other words, gut bacteria allow you to make maximum use of your available oestrogen). Broad-spectrum antibiotics kills the bacteria stopping this process. The level of oestrogen plummets below that necesary. Repeated doses of antibiotics can disrupt the endocrine system similar to corticosteroids.

Effect of candida on the endocrine system

Once candida has overgrown, it can bind to hormones changing their ;key' shape so they are unable to fit 'lock' in their receptor. This effectively inactivates the circulating hormone, making all endocrine problems ten times worse.

What is the APICH syndrome?

Autoimmune Polyendocrinopathy Immune-dysregulation Candidosis Hypersensitivity syndrome. This syndrome was identified in the USA in the 1980s as an endocrine disorder afflicting all really difficult-to-treat candida patients. It is far more prevalent in females. (We covered the details in our Factsheet 005, but note that symptoms include ovarian, thyroid and adrenal insufficiency).

Summary of the argument

We are suggesting that candida is a side-effect of an endocrine disorder (hormonal imbalance). It is a continuum with thrush at one end and the APICH syndrome at the other - most severe - end. The primary mechanism may be the blocking of oestrogen receptors, although there will be others too. This hypothesis provides an explanation for the male-female imbalance. Blocked oestrogen receptors can lead to a relative dominance of progesterone, a hormone candida loves. Once candida has taken hold, it can further disrupt the endocrine system by inactivating circulating hormones. The immune system attacks the candida and the candida retaliates weakening it, but the disruption is primarily in the endocrine system.

Steps to recovery

If we accept the premise that candida may be an endocrine disorder, then the key to getting rid of candida for good is to stop this imbalance. In further editions of the Candida Digest, we will investigate how to do this in detail. Here, we outline an approach.

Step One: As candida aggravates any endocrine disorder, reduce candida overgrowth. Classic candida therapy has four aspects to it:

1.    Diet, restricting banned foodstuffs including allergens.

2.    Repopulation of the digestive tract with the correct good bacteria (that you will find in CYS & Threelac)

3.    Dietary supplements as needed to boost the immune system and help with digestion.

All practitioners have their own regime which they advocate. I provide general guidelines to all members, and individual support on request.

Step Two: Consider how you have disrupted your endocrine system. You are unlikely to get well if the disruption is ongoing e.g. by taking the contraceptive pill or HRT. You may want to take expert advice on alternatives. We particularly recommend this if you are menopausal.

Step Three: If you can't work out what may have caused your candida (or are undecided how to proceed) you may benefit from expert help. We can help you find a practitioner, many of whom are using electronic machines to take the guesswork out of identifying causes.

Step Four: See a good practitioner, they will order tests if they are necessary, or your GP may be willing to do so.  Please don't assume that you are low in oestrogen just because you are a female in your forties - remember that high oestrogen is a cancer risk, so you need to be sure!

Step Five: If you discover that dental mercury amalgam is poisoning your system, be sure to follow the correct procedure to remove ALL mercury from your body.  The body will not give up mercury if it is deficient in any mineral, so address that in advance of treatment. After the fillings have been changed, the mercury has to be removed from the blood and then from receptor sites.