Medicine & Health 疗池

CANDIDIASIS

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by Dr. Mecherl Lim

MD (MA) Naturopath (ND), Holistic Kinesiology

Vaginal candida (genital candidiasis, or thrush) is an overgrowth of Candida Albicans, a yeast-like fungus that affects the area in and around the vagina, vulva and rectum.  In severe cases, the rash can spread to the thighs and buttocks.  About 30 percent of reproductive -age women have some candida in the vagina but only half of them have symptoms and around five percent have recurrent problems.

WHAT ARE THE SIGNS AND SYMPTOMS?

The early symptoms are redness, swelling and irritation.  In severe cases, the rash areas can become cracked, itchy and burning,m with a whitish or slightly yellow discharge and occasionally a sour milk odour.  There may be pain when urinating and during intercourse.  Men often carry the infection on the penis but may not have symptoms.  Symptoms in men usually include soreness, redness, itching and fissuring of the penis.

HOW IS IT DIAGNOSED?

A doctor takes a swab which is then examined in a pathology laboratory.  There is an also a medical blood test to see if the candida has spread throughout the body (known as systemic candidiasis) but my experience is that this test  is not conclusive and candida fungi may live in the human body without causing any apparent problems.

WHAT CAUSES IT?

The cause is primarily an overgrowth of Candida albicans, and it’s an increasing problem, with significantly more case caused by other species of Candida.

Conditions associated with candida include diabetes, pregnancy, suppressed immune function and the use of antibiotics or cortisone drugs.  Hormone changes tend to make women more susceptible to infection, which explains why candida occurs during pregnancy and with some oral contraceptives and hormone replacement therapy Temmerman  MI, Nelis HJ, ‘Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women’ American Journal of Obstetrics and Gynecology 187: (2002): 569-74.

Candida seems to occur more frequently among wearers of pantyhose and those who use marijuana, malnutrition, alcoholism, bath additives and vaginal deodorisers may increase the risk.  Sometimes women seem to get candida when they are severely stressed, depressed or not eating properly.  I have seen cases that may link to antacids and antidepressant drugs.

You can pass on the infection to your partner and this may cause him to reinfect you, even if he doesn’t appear to have any symptoms. Condoms should be used when infections are present.

Various resistant strains may result from the increasing use of short course antifungal medications, but I don’t know if resistant strains occur as a result of ineffective natural treatments. See your practitioner if you are experiencing side effects from any treatment or if the condition is worsening, otherwise, it’s generally advisable to complete the prescribed course.

HOW ALLOPATHY DOCTORS TREAT?

Medical/pharmaceutical treatments include over the counter and prescribed topical antifungal creams pessaries and ovules. Oral antifungal pharmaceuticals are prescribed when topical remedies have not been successful but these may not give a permanent “cure” in the majority of recurrent cases.

Boric acid pessaries. Basically, the treatment is 600mg of boric acid in a size of 0 gelatine capsule inserted in the vagina last thing at night for 10 to 15 days.  This treatment is 80 percent successful in eradicating Candida glabratta, a resistant strain.  Boric acid is a lethal poison at a dose of 15-20g and is never taken orally.  You absorb a little through the vaginal wall.  A pharmacy may be able to order in a course of boric acid pessaries.  This treatment  may irritate the area around the vagina and you may need to apply a soothing cream or almond oil externally just after inserting the pessary.

THE HOLISTIC APPROACH

First, get a medical diagnosis, because some similar symptoms occur in eczema and various infections.

  • Oral, antifungal medicinal
  • Oregon grape herbs
  • Grapefruit seed extract
  • Pau d arco
  • Goldenrod
  • Thuja
  • Myrrh
  • Echinacea
  • Aloe
  • Green Walnut Hulls
  • Goldseal
  • Corn Silk
  • Olive Leaf

Herbalists generally prescribe a selection of these and may include herbs to strengthen the immune or nervous systems, such as astragalus, cats claw or ginseng.

NATURAL TOPICAL REMEDIES

Various natural pessaries and ovules are available, including tea tree oil, golden seal, calendula or lactobacillus.

Caution: Topical medical and natural remedies can aggravate, so always test everything- first on the inside of the elbow and, if this is OK, apply a tiny portion around the vaginal area. I don’t recommend douching because this depletes natural vaginal secretions and may upset the bacterial balance. Do not persist with natural therapies if they don’t work within one week because, aside from the pain and stress, you develop a secondary infection.

HOW CAN YOU PREVENT IT?

Candida feeds on sugars and like warm, dark, moist places.

  • Avoid all refined sugars and obviously high-sugar foods such as cakes, fruit juices and dried fruits.
  • Wear cotton undies and avoid tight jeans and trousers.  Very tight trousers cause heat and may rub the vaginal tissue, causing slight damage and making it more prone to infections. (Very tight clothes can also cause a backache and may contribute to pelvic congestion and varicose veins.) Perhaps at home wear a skirt and no undies to keep the area reasonably cool and reduce sweating.
  • Wipe from front to back after going to the toilet.
  • Urinate before and after sex.
  • Use minimal soap in the vaginal area, buy a product that is unscented and ph balanced.
  • The incidence of candida is higher in the tropics, so perhaps plan cool climate holidays.
  • If you are taking antibiotics ( a common cause of candidiasis), use Dr Mecherl PROFLOR A, contains Lactobacillus GG, Lactobacillus Plantarum, Lactobacillus acidophilus NCFM, & Rhamnosus LGG, Colostrum.because these strains seem to work more effectively to offest antibiotic side effects.  I suggest two or three doses daily of the Proflor A as far away in time as possible from the doses of antibiotics. The will ensure that a least for part of each day you have some healthy bacteria in your system. Continue with the Proflora A for a week after you finish the antibiotics.  One trial indicated that Lactobacillus was not effective, but this is not my experience and it may depend on the strain.  Two trials have indicated plain yoghurt may be helpful as preventive but check the labels for sugar content.

DIET

Some of my patients advise they have overcome recurring vaginal candida by following a strict diet that avoids not only sugars but also all the following foods.

  • All yeast bread, rolls, doughnuts and any product or supplement that contain yeast.
  • All cheese, including cottage, ricotta and soy cheese
  • Pickled and smoked foods, including corned beef and bacon
  • Beer, wine, ginger beer, sherry, port
  • Vinegar and any food that contains vinegar
  • Mushrooms
  • Soy sauce, tamari, miso, tofu
  • Vegemite, Marmite, Bonox, stock cubes
  • Dried and canned fruit
  • Melons and peanuts (because of their natural moulds)
  • Leftover foods.

However, this dietary program doesn’t make sense to me because there’s no evidence that one particular fungus, mould or fermentation process will cause a detrimental overgrowth of another fungus. In fact, some practitioners recommend yoghurt, miso, a little vinegar, olives and traditional coleslaw as part of a preventive program.  However, if you are desperate you may want to try this avoidance program for one month, evaluate, and then reintroduce the items one at a time in small quantities. Some women report they can tolerate some of these foods in small quantities.

HERE ARE MY DIETARY RECOMMENDATIONS :

  • Use whole grains because these are not readily converted to glucose and have other advantages: rice fibre, for instance, contains gamma-oryzanol, which is somewhat antifungal.
  • Some culinary herbs have antifungal properties, so use these generously in your cooking. The list includes cinnamon, thyme, turmeric, rosemary, garlic, mustard, oregano, lemongrass and winter savoury.
  • Foods in the cabbage family are recommended.

GOOD ADVICE :

For persistent or severe vaginal candida get practitioner help because the infection needs to be eradicated.

Dr Mecherl Lim

An Intuitive Medical Practitioner in Alternative Medicine (MD) (MA), Naturopath (ND), Holistic Kinesiology (HK), and Functional Medicine (FM)

Next  No 53 Issue : ENDOMETRIOSIS

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Image courtesy of Brooke Lark