Monday, December 6, 2010

Step 1 -- Supplements and probiotics

Treating a candida overgrowth requires these three steps, done at the same time.  Why all three?  Any one of these steps would help, over time, but would take much much longer.  I've also found that all three steps simultaneously will relieve sugar cravings very quickly (sometimes in a matter of days), which makes it so much easier to make progress and feel better.

The longer you stay on a candida program, the better you'll feel, but three to six months is the minimum.  If you feel better after a couple weeks, then this means you really have a candida overgrowth.  The treatment is the diagnosis, in this case, and therefore you should probably stay on the program for 6 months to a year.  If you have any kind of chronic fatigue, fibromyalgia, chronic pain, or an autoimmune disorder, then 1-2 years of treatment may be required, and probably longer.  But don’t worry, by that time you really won’t miss sugar (it’s mostly a learned taste) and treats can be included here and there.

Many people feel so much better while doing a candida program that they just stay on it, to some degree.  It's a pretty good way to eat!  Also, if you've had any frightening or extensive health problems, and you feel better on a candida program, then you'll be happy to stay on it, believe me.  If you need a specific timeline, ask me.

Kill the yeast
Take an anti-fungal supplement, twice a day -- morning and evening. This helps kill the yeast, which is a fungus, in your gut and elsewhere. See more details on the supplements, below.

Stop feeding the yeast
Stop eating sugar of all kinds, including white table sugar (sucrose), any added fructose, corn syrup, high-fructose corn syrup, honey, molasses, agave, brown rice syrup, dextrose, maltodextrin, sugar added to anything.  Read all labels.  Also no sweeteners except xylitol or stevia.  Absolutely no fruit juice and no dried fruit either. Minimize or eliminate all "white" and starchy foods (rice, pasta, bread, potatoes).

Day 1-30 -- no fruit of any kind (fructose) as well as any other sugar listed above (and any I've left out). If absolutely necessary, you can have 1 serving a day of the low-sugar fruits listed below.
Day 31-60:  can add in some low-sugar fruits -- raspberries, blueberries, blackberries, (no strawberries), kiwi, grapefruit, and granny smith apples, 1-2 serving a day (equivalent to 1/2 cup berries or 1/2 large apple).
Day 61-90:  best to stay with the second month's program, or ask me for your specific situation

Rebuild the good bacteria
Take a probiotic supplement at least once a day, on an empty stomach unless it has an "enteric" coating. Probiotics are simply good (“friendly”) bacteria that will repopulate themselves in your gut and compete with candida for their place. Eventually the good guys will win! It’s part of getting your gut flora and fauna back in balance.

Any of the above steps could be done alone with some benefit, especially if it were cutting out sugar or taking probiotics. It would take much longer, however, to get results

Goal is Optimal Digestion.  These three steps are aimed at getting your digestive system working again, or working better. And eventually getting it working optimally and back in balance. So what’s the big deal about the digestive system? It’s just food, right?  Well, half of your immune system is in your gut, it makes some nutrients like certain B vitamins, some neurotransmitters like seritonin are made in your gut, and so forth.  Really important stuff, that can get messed up with a yeast (or other bad bug) overgrowth. 

Why Bother with Food? Well, let’s take a moment and reflect how important food is. Eating food gives us nutrients and these nutrients power our entire body – brain, heart, blood flow, hormones, all the glands, muscles, bones, all of it! I come across so many people who barely give a thought to what they eat, or when. And even think it’s ridiculous to focus on food, digesting food, or the digestive system as a whole.

And yet, we often forget just how it is that we keep our body’s machinery running. Yes, the body has back-up mechanisms for what to do in case no food comes in, or when barely useful food comes in, or even destructive food (like white sugar). This is how we can keep going for so long even though things are screwed up – like our gut (intestines).

Unfortunately, the body’s back-up systems get taken from somewhere else in the body, such as using muscle glycogen during when no food is coming in, to keep blood sugar levels functional. So in the long run, you’ll be doing something very good for yourself by keeping your digestive system in optimal condition. It ultimately powers and affects all parts of your body.

Anti-fungal supplement (“Candida supplement”)
Take on an empty stomach, one hour before eating – morning and evening (two hours after eating).

Many substances (herbs, plants, etc.) work very effectively as an anti-candida force when taken orally, in otherwords, they kill yeast. Some of them are:
  • garlic
  • pau d’arco (a tree bark)
  • grapefruit seed extract (an anti-fungal, anti-biotic, and anti-viral)
  • goldenseal
  • oregano oil
  • peppermint oil
  • caprylic acid (from coconut oil)
If this is your first time starting a candida program, I have a few favorite supplements that work pretty well. There’s some individual variation, however, so if what you choose first doesn’t seem to be working, then be ready to switch to something else. Here are a few that I recommend:
  • Candistroy, by Nature’s Secret, comes with two bottles (an anti-fungal and probiotic), about $17 online, $24 retail. (start with 1-2 tablets 2x/day if you get a die-off reaction, see below)
  • Yeast Fighters, by Twin Labs, a combination anti-fungal, about $10 online (a less effective supplement)
  • Candida Cleanse, by Enzymatic The,rapy about $17 online
  • Parastroy, by Nature's Secret, about $20 online, comes with two bottles (a parasite killer and a fiber/cleanse) --works quite well but rotate it because it's more of a parasite killer rather than just candida
These supplements contain a combination of many of the anti-fungal ingredients (listed below), and work pretty well. If you have more severe health issues, you’ll need to keep taking a candida supplement, and it’s best to start rotating them after about 60 days. Yeast can become resistant to the same compound, just like bacteria can become resistant to anti-biotics. Here are a few you can switch to: 
  • Pau d'arco
  • Grapefruit seed extract (this is an anti-fungal, anti-viral, and anti-bacterial)
  • Caprylic acid (an acid in coconut oil, available in capsules)
  • Goldenseal (the Coptis variety is best)
  • Berberine
  • Black walnut
  • Undeclynic acid (sometimes comes under different brand names)
  • Oregano oil (I prefer gel caps)
  • Garlic/allicin (capsules are best, not just raw garlic)
Die-off Reaction.  If this is your first time on a candida supplement, please be aware of a possible die-off reaction that can cause some temporary symptoms, such as diarrhea, gas, bloating (or more of these, if you already have these symptoms). If you get some kind of reaction soon after taking your supplement, this is a good sign! It means it’s working – it’s killing the yeast.
When the yeast die, their cell walls emit a chemical that can be irritating to the gut. If many of them are dying at once, then the effect can cause or worsen your symptoms.  So, don’t’ worry. It often only lasts a day or two, but if it goes on too long or gets uncomfortable, then back off on your anti-fungal supplement (but not the probiotic) and that should take care of it.

If you do get a die-off reaction, please take important note of it, because this means that you, indeed, have a candida overgrowth -- and probably a substantial one. There’s no question about it. This is how the treatment becomes the diagnosis. So hopefully your commitment to recovering the balance in your gut will be renewed with this information.

Take an “enteric coated” capsule, once a day, preferably on an empty stomach. All others on an empty stomach.

Probiotics are the good bacteria needed in the gut. They normally compete with candida for a place in the gut, unless they get killed off with antibiotics which allows the candida to grow unchecked. These good bacteria have many essential functions in the body, such as making B vitamins. To say they are your “friends” is an understatement. Your entire body will never function properly if your good bacteria are out of whack, or missing.

There is also a beneficial yeast that will help compete with the overgrown Candida albicans yeast.  It's called Sachromyces boulardii (or S. boulardii).  You can buy this as a separate supplement in addition to your probiotic (if it's not included in the probiotic) or get a probiotic that contains this beneficial yeast. 

One of the very best probiotics available contains this yeast -- Primal Defense Ultra by Garden of Life.  I highly recommend this probiotic.  Each capsule is about 8 billion so if that's too high of a starting dose, then try something like Probiotic Defense by Now.  It's a powder (or capsule) and 1/4 teaspoon or 1 capsule is only 1 billion bacteria.  Your system may be initially so sensitive you might need to start at this low level and work up.  And how would you know this?  If the probiotic causes too much discomfort, or diarrhea, or any other symptom, then simply start lower. 

If your probiotic supplement has an “enteric” coating on it, this is good. This coating will hopefully keep the good bacteria from getting killed by stomach acid and digestive juices in the gut before they make it to their new home. This is the point of stomach acid and digestive juices, I might add, is to kill off invading organisms. So everything has its purpose.

Other things to know about probiotics. There are many different types of bacteria, even amongst the good ones that we need in our guts. Names such as acidophilus, bifudus, staphlococcus, and such may ring a bell. Ask me, if you want to know what the names of all these good bacteria area, or read up on them.

But to keep things simple for now, it's good to take a medley of these bacteria (different “strains”) to cover all the bases --- you just don’t know which ones you in particular are lacking.  This means that taking only acidophilus is NOT enough, under any circumstances, but eating a good plain yogurt with 5-8 different strains would be a good addition to a candida program, in my opinion.  Read the label on the yogurt.

Also, bacteria need to be alive, or "live", so check your probiotic supplement label to make sure they started with live cultures.  Some probiotics are shipped in ice to keep the bacteria alive and well.  If they're dead, they're not going to be growing and reproducing themselves down in your gut, even if they make it through the digestive acids.

So what is a bacteria "culture"?  In case you're curious, the term "culture" is used to describe a community of bacteria growing together.  If they are alive, they're growing fast, that's one of the things they do best! Different "strains" of bacteria simply refer to their different identities and functions.

How many billion bacteria need to be in a probiotic?  Any billion or two "live" bacteria would work well.  Remember, many of them won't survive the journey (from manufacturing plant to your gut) but hey, you only need some of them to make it alive and start replicating to do their good work.

GR-8 by NOW is a good, economical probiotic (without the beneficial yeast) and has 8 billion live bacteria, from 8 different bacteria strains.  You know for sure it's working if you get a bit of gas a few hours and longer after taking it.  Don't worry, this just means they're working.  If it's too much for you, take half, or find a probiotic with a few less billion.  After awhile, you'll stop getting gas from them.

I DO NOT recommend launching into a candida program taking 30 billion bacteria in a probiotic.  That's way too many to start with.  This will cause you some misery, so please read your labels.  It would be better to take less billion, more frequently.  Even one billion is fine to start with, and work up from there.

Taking antibiotics again. If you ever absolutely need to take antibiotics again, and you might, then it is essential to be taking probiotics.  I've found it effective to also eat plain yogurt while taking the antibiotics.  This is only if you can eat dairy and the sugar in the yogurt doesn't seem to be interfering with your recovery. 

The probiotics should be taken at a totally different time of day than your antibiotics, because obviously the medication is going to kill off a lot of what ever is in your probiotic capsule, depending on the type of antibiotic you take. However, bacteria are a hardy lot in general and some will make it through.  Here's what I've found can work well:
  • Eat plain yogurt for every meal while taking antibiotics, at least 1/4 cup or so
  • Take a probiotic at a different time than the antibiotic, but still take the probiotic
  • After the course of antibiotic is finished, take extra probiotics for a couple weeks  or so, to again replenish what has been killed off. 
  • If you get a vaginal yeast infection after the antibiotics, then you need to redouble your efforts at the candida program!  This is a red flag.
Yogurt as a source for probiotics. Yogurt should only be a supplemental source of probiotics for the long-term in a candida program.  But it's definitely good to have around.  It should NOT have added sugar. Why keep feeding the yeast what they love and need to survive (sugar) if you’re trying to eradicate them.

Plain yogurt already has sugar in it (about 12 grams) from the milk it’s made from. There is disagreement on whether yogurt (because of the milk sugar) should be eaten on a candida program, but the main argument for eating yogurt at all is that the probiotics are so essential.  For many people, the milk sugar doesn’t seem to pose a problem. It’s different for everyone, though, so you’ll have to see how it goes. My favorite commercial yogurt is “Mountain High” plain yogurt, but there are several good ones out there, especially organic brands.

Rotate your probiotic strains.  If you’re on a candida program for longer than 3-6 months, think about rotating your probiotic strains as well. Try some different brands and different strains.  Read the label of your yogurt container also. You’ll find a huge difference in yogurts for what strains are used to make the yogurt. The bacteria are what ferment the yogurt. And if you “cook” the yogurt long enough (as in, make it yourself at home) you can cook out all the sugar entirely as it feeds the fermenting bacteria. Ask me, if you want to know how to do this, or google "SCD yogurt" for directions.

Probiotics in Juice Drinks.  A recent trend in the food industry is to add probtioics to juice drinks.    However, they often don't list what strains or even how many "billion" of the bacteria were added to one bottle, not to mention whether the bacteria even survived after being added to the drink-making process (e.,g, were they "live" cultures).  The probiotic dosage is reallly too low to do much good on a candida program.  And if they add sugar to the drink, again, what's the point?  At least they're catching on, so I give a lot of credit for that, but until I see otherwise, it looks more like a marketing tool at this point.
Common Questions

What about taking an Rx anti-fungal?
Two anti-fungals are available by prescription: Diflucans (pill) and Nystatin (in various forms). If this is your first time on this program, the candida supplements work quite well so I wouldn’t even worry about taking these medications. They pose too many additional side effects and other concerns.

If you have a severe health condition that you already know about, for example an autoimmune disease such as multiple sclerosis or rheumatoid arthritis, then I’d recommend getting started with several doses of Diflucans (150 mg) every other day for several days. This will help jumpstart your program. To take it longer, unless it’s medically proven that you need it, is known to be hard on your liver. So, be cautious with these.

Why can't I just take the Rx pills, keep eating normally, and not worry about doing the whole program?
This is a good question, and I don’t blame you for asking it. No one, really, wants to change their diet. Especially if it involves doing something that might feel uncomfortable, like stopping sugary and starchy comfort foods. And might require making changes in relationships too, around food. Not to mention our relationship with our own self.

The main problem, however, is that these anti-fungal pills – just like other pills in every other category – simply don’t do the job over the long-term. A candida overgrowth can be localized in your gut, or it can be more systemic – either way it has taken a long time to develop and cause damage to other body systems, of some kind or another.

There is no easy pill of any kind that can fix this situation! It takes a committed (and perhaps even long-term) effort to stop feeding the yeast while eradicating them with anti-fungals and probiotics.

And a final note on “medications”. It was a medication (antibiotic) that has led to your compromised health in the first place. It was hopefully necessary at the time, especially if you had a life-threatening bacterial infection such as pnenumonia or a urinary tract infection. Sometimes antibiotics are needed, and we’re grateful for them. But most medications (drugs) cause some kind of side-effect and are hard on the body. I would even say “all medications” do this. You should consider this, before taking any medication.

The second problem with these anti-fungal Rx meds is that they each target different areas. Diflucans is useful for more of a “systemic” candida overgrowth. This means if you have a leaky gut and the candida have also grown outside of your gut, Diflucans could be helpful. It doesn’t necessarily mean that your blood can be cultured to show this, however, so there’s probably not a way to know. Unless, from my experience, you have a severe health condition as I stated above. Nystatin works better directly in the gut, but many feel it doesn’t work that well.

In any case, taking either of these involves taking a synthetic chemical – best to be avoided if possible since your liver will have to process it and it may already be under strain. If you have a severe candida overgrowth, your liver is most assuredly under strain, as are many of your other body systems such as your adrenals and hormones, not to mention your digestive system.

An interesting phenomenon lately is that some doctors are starting to give out Diflucans for vaginal yeast infections. If this happens to you, the Diflucans may not work. It may work for the vaginal infection, or may not, but it won't clear up a gut overgrowth.  Not with one dose, or even 60 doses.  Doctors also sometimes give out Nystatin creams for vaginal yeast infections. I’ve never tried Nystatin, so can’t speak to it. Either way, if you have a severe enough vaginal infection that requires a doctor visit and either of these two medications, you can be very sure you need to do a candida program! And a final note: most family practice doctors aren’t aware of the difference between the way these two medications work.

Do I need a health practitioner? 
If you're new to doing a candida program, and have some complicated health issues (and some very troubling symptoms), all of this information can be overwhelming.  Afterall, there's a lot to know!  I recommend finding a good health practitioner who can help you get focused with your candida treatment.  A good practitioner can also help interpret what is going on, for example, differentiating between your regular symptoms and a die-off reaction.  Also, you will likely need to work on other body systems, like adrenal support, to totally regain your good health, so hopefully your practitioner will have a big picture of what needs to be done.  Nothing in the body is isolated into itself (it's all connected), and that's especially true of gut problems.  They affect everything.

Most health practitioners have their own area of "focus", however, and it's not always the gut.  This is an important thing to find out.  This practitioner might be a naturopath, a nurse practitioner or physician's assistant, an M.D., an acupuncturist (such as I started with), or a nutritionist/health educator such as myself.  It doesn't matter so much what the credentials are, as long as the practitioner is knowledgeable, caring, and helps you feel good (and feel inspired) about what you're doing to recover your health. 
How do you know if the supplements are working?

How long should I take the anti-fungal?

How long should I take the probiotic?

How long do I need to be on the entire candida program?

What if I travel or have more stress in my life?

More information is coming on this blog to help answer these and more questions on my candida program.  Also, Steps  2 through 5 are coming in the next few weeks, so subscribe to my blog if you're interested and you'll get them automatically.  In the meantime, if you have any questions, please contact me, if I can be of help at 

Note: I realize that this is a lot of information! However, in the years that I’ve been working with candida programs for myself, and helping others with theirs, one thing was often clear. I had a practitioner who knew the gut, a different practitioner who knew about adrenal support, and other practitioners who knew about other things. But rarely was there someone who could give me the big picture. I have since found a few of these people and they were great teachers for me.

So this is what I’m hoping to do in my own way – to give a big picture of all the variables involved, so that you can see what you’re up against.  And then go in whatever direction is right for you. One person can't know everything of course and things keep changing.  But if I can plant a seed of knowledge in you, about your next step, then that is my goal. That will be enough.

Adele Sonora
Nutrition and Health Educator
B.S. Nutrition Science

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