Candida: Yeasts and fungi

Candida: yeasts and fungi

Candida and other yeasts and fungi are part of the kingdom Fungi. The two main fungal phyla are Basidiomycota (which includes mushrooms) and Ascomycota (which includes moulds and yeasts). The word Ascomycota is derived from the Greek ‘askos’, meaning ‘leather wineskin’. Myco comes from the Greek word mykes, meaning ‘yeast’ or ‘fungus’.

Balance in the gut flora

There should be a dynamic balance between the mucous membranes, healthy gut bacteria and yeasts. The use of antibiotics damages the gut flora and can result in an overgrowth of Candida species. When this happens, the number of yeast cells can become thousands of times higher than normal. Complaints in the intestine, vagina and mouth therefore often occur after a course of antibiotics. If fewer bacteria form part of the gut flora and the diversity of those bacteria also decreases, the number of fungi and yeasts increases.

A strong increase in Candida often indicates reduced resistance. In intestinal disorders, infection with parasites or ulcerative colitis, the gut flora is less diverse and Candida cells are greatly increased in number. When the gut flora has decreased, the number of acid-producing bacteria also decreases. As a result, the intestines become less acidic, allowing yeasts to grow even better. High numbers of yeast in the intestine can cause symptoms such as flatulence, a bloated abdomen, nausea and fatigue.

Symptoms

An increase in Candida cells in the intestine often causes chronic complaints. Symptoms of an overgrowth of yeasts in the intestine include:

• Mushy, slightly acidic stools
• A bloated abdomen
• Flatulence
• Fatigue
• Sometimes headaches
• Itching
• There may also be an overgrowth on the skin, around the anus or in the vagina

Insulin, hyperinsulinaemia

The number of yeasts often increases in people who are overweight, because in many cases they have excessively high insulin levels. Starch-rich foods increase the glucose level in the blood, which raises insulin levels. High insulin levels increase the sucrose level in the intestine. Sucrase is a sugar-splitting enzyme. Overconsumption of starch and sugar and an increase in insulin are associated with this process. There is a clear relationship between high insulin levels, an increase in the sugar content of the intestine and abnormalities of the gut flora. This explains why people who are overweight and people with type 2 diabetes often suffer from Candida infections in the intestine, mouth or vagina.

Fatigue caused by Candida

Candida can cause fatigue. Through the immune system, Candida stimulates an increase in pro-inflammatory cytokines such as TNF-alpha and interleukins. These substances contribute to general malaise, pain and joint complaints. These signalling substances are not specific to Candida; inflammatory cytokines such as TNF-alpha are also elevated in infections with intestinal parasites or bacteria, autoimmune diseases and coeliac disease.

Causes of Candida overgrowth

There are various causes that can lead to an overgrowth of yeasts in the intestine. The main causes are:

• The use of an antibiotic, which damages the gut flora.
• A disturbed balance of the gut flora. When the number of beneficial gut bacteria decreases and the overall diversity of gut bacteria is low, the number of fungi and yeasts increases. The number of yeast cells can become thousands of times higher than normal. This is why complaints in the intestine, mouth or vagina often occur after a course of antibiotics.
• Reduced resistance.
• In intestinal disorders such as ulcerative colitis, the gut flora is less diverse and the number of Candida cells is greatly increased.
• An infection with intestinal parasites. Infection with the parasite Dientamoeba fragilis is often accompanied by an increase in the number of fungi in the intestine.
• A lack of vegetable fibre. A lack of vegetable fibre reduces the number of fatty-acid-producing bacteria and makes the intestinal contents less acidic. This stimulates the growth of yeasts in the intestines.

Risk factors for Candida

Several factors can promote Candida overgrowth. The main risk factors are:

• Medication use
• Use of antibiotics. Antibiotics cause a marked decrease in the gut flora
• Use of the contraceptive pill
• Eating foods high in starch and sugars
• Excessive alcohol consumption
• Overweight
• Diabetes, excessively high insulin levels and blood-sugar problems
• Intestinal disorders such as Crohn’s disease and ulcerative colitis
• Undergoing chemotherapy or using corticosteroids.

Tests to detect Candida

The number of yeasts is determined by means of a stool culture. Normally, 1–3 × 10³ yeasts are present in the intestines. It is therefore considered normal to find 1,000–3,000 Candida cells in 1 gram of stool. Lower numbers are not considered abnormal either. The test is combined with a gut-flora test. The starch content is also assessed and the amount of calprotectin is measured, which can help determine whether there is inflammation in the intestines. If the gastrointestinal complaints are chronic, testing for intestinal parasites is recommended. In a parasitic infection, Candida can occur in large numbers.

Taking a swab from the mouth, vagina and rectum

• An increase in these yeasts in the intestine in women often occurs together with an overgrowth of yeast in the vagina. Candida can also occur on the skin, in the mouth, oesophagus or on the tongue.
• In newborn babies, mild yeast overgrowth in the form of thrush can occur, usually during the first four weeks of life. Temporary overgrowth may occur after birth because the immune system still has to develop; this does not necessarily require medical treatment.

A swab can be taken with a cotton swab for Candida analysis:

• Vaginal swab. Women may suffer from chronic vaginal complaints. Use of the contraceptive pill increases the number of Candida cells.
• A swab from the mouth or tongue in cases of yeast overgrowth.
• A swab in cases of rectal itching or discharge from the urethra in men.

Other yeasts

From time to time, Rhodotorula rubra is found in stool in the laboratory. R. rubra is related to Candida and is a yeast that is commonly found on fruit. Tests of dozens of different fruit salads and pasteurised fruit juices from supermarkets showed that Candida species and R. rubra were present in 97% of the salads and 22% of the fruit juices. If large quantities of these fruit yeasts are present in the intestine, the advice is to avoid sweet fruit. Eat only fresh fruit, on which these yeasts do not occur. Infection can also be acquired in hospital. This fruit yeast was found on the hands of 30% of medical students working in a hospital, compared with only 9% of non-medical students.
An important point is that many children with an allergic predisposition have a yeast allergy. They may react allergically to Candida species as well as baker’s yeast and fruit yeasts. Because R. rubra also has positive properties and produces beta-carotene, it is often added to yoghurt. People with an allergic predisposition should of course avoid yoghurt and other products containing Rhodotorula rubra.

Fungi

Scientists have shown that around 100,000 fungal species occur in nature. The kingdom Fungi may comprise 1.5 million species or even more. The vast majority live in harmony with plants, animals and humans. Fungi are abundant in soil, on leaves and in food. The community of fungi is called the mycobiome.
In 2015, Gouba wrote in the article ‘Digestive tract mycobiota: a source of infection’: ‘The human mycobiome includes 390 fungal species on the skin; 335 species are present in the oral cavity and gastrointestinal tract. Of these, 221 species are found only in the digestive tract, while 88 species are found only in the oral cavity.’ Fungi that live in the intestine are difficult to culture and identify, and some of these fungi have only recently been identified by means of DNA analyses.

Fungal allergy

The human body can react allergically to fungi. An allergic reaction can arise from inhaling fungi. Such an allergic reaction was described as long as 300 years ago. In 1726, Sir Floyer was the first to report an asthma attack in a person who inhaled yeasts in a wine cellar. A century later, Blackley described how bronchitis and tightness in the chest can arise from inhaling Penicillium spores. In 1924, Van Leeuwen established that inhaled fungal spores can cause asthma, but the importance of fungal allergy was underestimated for a long time. A mouldy house or even a walk in the woods in autumn can be enough to cause symptoms.
Fungi mainly cause respiratory and skin complaints. Fungi play a role in 5% to 20% of people who suffer from allergies. Because of the moderate quality of fungal-allergy tests, a diagnosis of ‘fungal allergy’ can be missed.
A study conducted by the Global Allergy and Asthma European Network in 16 European countries showed that in cases of fungal allergy, ‘Alternaria alternata’ is the cause in 12% of cases; allergies to Penicillium and Aspergillus are also common.

Treatment of Candida species

If there are more than 4,000 yeast cells per gram of stool (4 × 10³), treatment may be considered. Treatment is the same for the different yeasts.
Once Candida cells have established themselves in the mucous membrane of the intestine (or of the mouth and vagina), it is difficult to eradicate them permanently. High values are seen more readily in people with a weakened immune system and diabetes.
Treatment consists of a combination of diet and medication.

Medication

In cases of severe yeast overgrowth, nystatin is recommended; this medicine is available on prescription. Nystatin has relatively few side effects. It can also be supplied sugar-free by Wauters natural pharmacy. After a few days, the yeasts may already have disappeared. However, they can return. Some patients feel better for as long as they use this medicine; it can be used for a prolonged period. In cases of abnormal gut flora and increased yeasts, probiotics such as Lactobacillus rhamnosus GG can be used. Saccharomyces cerevisiae type boulardii is a yeast available as a supplement. Sometimes yeast overgrowth is the result of another, deeper underlying cause, for example infection with an intestinal parasite. If this is the case, the underlying cause must be treated.

About Darmklachten.nl