Candida Albicans Infection

What Is Candida Albicans Infection?

[dropcap]C[/dropcap]andida albicans infection, called candidosis or candidiasis, is an opportunistic invasion of mucous membrane or skin by candida albicans, an endogenous yeast found in 40 to 80% of normal human beings. A former name for this small, budding fungus is monilia albicans.

Opportunistic means that yeast living on mucosal and skin surfaces does not invade (infect) unless these tissues become unhealthy and therefore cannot protect themselves.

Q: How does candida albicans cause infection?

A: Candida albicans lives on the mucosal surfaces and skin in most people without causing infection (colonizes) because of our normal defenses against invasion. In fact, candida albicans is a very effective colonizer of humans. For example, Russell and Lay found that 47% of 1-month-old infants were orally colonized with candida albicans, and 49% were colonized with other fungi.

During growth within the intestinal tract, the organism senses pH (acidity), oxygen, carbon sources, and the presence of surfaces allowing it to optimize gene expression for a particular environment. With these mechanisms for sensing, candida albicans is able to efficiently colonize humans in infancy.¹

Lowered host defenses allow yeast already present on mucosal and skin surfaces to take advantage and can grow rapidly, becoming pathogenic (disease producing) so that infection results.

Infection is characterized by superficial, irregular white patches on mucosal surfaces and possible invasion of the bloodstream by a filamentous form (thread-like structures) that can rapidly develop.

Candida albicans is unique among oral pathogens in its ability to invade cornified layers of stratified squamous epithelium of the tongue, mouth surfaces, hard and soft palate, esophagus, and gut. Stratified squamous epithelium is the tough surface cells that ordinarily protect underlying tissues from damage or invasion by microbes.

Candida albicans is also capable of invading the lungs and causing pneumonia and septicemia, which is the spread of infection into the bloodstream.

Here is a time honored simple do-it-youself test for infection of the mouth or throat: First thing in the morning before brushing your teeth or eating, fill a small see through glass with water then gently spit onto the surface. If after an hour the spit remains on the water surface, it is unlikely you have candida in the mouth. If it grows legs downward, it indicates that yeast is growing. If the spit sinks to the bottom, you have this problem. Yeast in the mouth can quickly travel down the esophagus and into the gut.

Medical diagnosis. Difinitive diagnosis for the oral cavity is made by your clinician by swabbing the areas of your mouth and/or throat and viewing under a microscope for evidence of candida.

Infections of the esophagus and gut require inspection by gastroscopy or endoscopy procedure and the taking of samples to be examined under microscope. This examination also give the opportunity to rule out other problems. Barium swallow can show the extent of infection and any disfiguration of the esophagus that results.

What Is Candida Albicans Infection In Celiac Disease and/or Gluten Sensitivity?

• Relationship between candida and celiac disease. Candida albicans infection is an associated disorder of celiac disease and gluten sensitivity.

• Relationship between candida and inflammation. Inflammation of mucosal surfaces caused by gluten damages the barrier system that normally keeps yeast from invading AND this yeast is easily able to take advantage of the this highly favorable condition to invade inflamed tissues. This applies to ALL forms of gluten sensitivity.

Candida albicans is both a successful commensal (normal) organism and pathogen of humans that can infect a broad range of body sites. The transition from commensalism to parasitism requires a susceptible host but it is also an active process. Gene expression of C. albicans is regulated by an interplay between host and pathogen and at least one transcriptional program associated with the yeast-to-hyphal transition. This not only allows immediate adaptation to changing environmental conditions, but also prepares cells for subsequent steps of infection.²

• Relationship between candida and nutritional deficiencies. The body requires adequate nutrition to both build and repair mucosal surfaces and to resist infection. Malabsorption due to celiac disease deprives mucosal surfaces of necessary nutrients, resulting in a barrier system that is unable to protect against invasion by yeast.
• Relationship between candida and transglutaminase. The organism appears to be a trigger in the onset of celiac disease. The virulence factor of C albicans-hyphal wall protein 1 (HWP1) contains amino acid sequences (chains) that are identical or highly similar to known celiac disease-related alpha-gliadin and gamma-gliadin T-cell epitopes. HWP1 is a transglutaminase substrate (substance acted on), and is used by C albicans to adhere to the intestinal epithelium (lining of the intestinal wall).³

The N-terminal domain of Hwp1 is unique. It is composed of an acidic, degenerate amino acid repeat rich in proline and glutamine.⁴ These amino acids are those found in gluten.

Furthermore, tissue transglutaminase and endomysium components could become covalently linked to the yeast. Subsequently, C albicans might function as an adjuvant that stimulates antibody formation against HWP1 and gluten, and formation of autoreactive antibodies against tissue transglutaminase and endomysium.³

How Prevalent Is Candida Albicans Infection In Celiac Disease and/or Gluten Sensitivity?

Candida albicans infection has increased frequency in untreated celiac disease patients.³

What Are The Symptoms Of Candida Albicans Infection?

Candida albicans infection is marked by these symptoms:

• In the MOUTH (thrush) and throat by superficial, irregular white patches causing these symptoms:

Dry Mouth – Discomfort or Burning Pain of Tongue, Roof, Tonsils, Soft Mucosa Including Insides of Lips and cheeks – Hoarseness (impaired voice) – Sour Mouth.  May be Cracking at the Corners of the Mouth (cheilosis).

• In the ESOPHAGUS causing these symptoms:

Difficulty Swallowing – Discomfort, Pressure, or Pain beneath the breastbone that worsens with swallowing – Epigastric Pain or Pressure (pit of stomach) – Indigestion – Nausea – Loss of Appetite – Possible Vomiting – Possible Fever and Chills.

• In the GUT causing these symptoms:

Abdominal Pain – Bloating –  Diarrhea or Constipation – Rectal Itching – Nausea – Loss of Appetite – Possible Vomiting – Possible Fever and Chills.

• In the NERVOUS SYSTEM causing these symptoms:

Fatigue that is worse after eating – Headaches – Mild Memory Problems – Depression – Brain Fog (cloudy thinking) – Aggravated PMS (premenstrual sybdrome) – Mood Swings – Anxiety – Memory problems – Sensitivity to Chemicals such as perfume – Allergies.

• In the LUNGS by infection causing pneumonia.

• In the BLOOD by infection causing septicemia, called candidemia.

• In METABOLIM causing uncontrollable sugar and other carbohydrate cravings including alcoholic drinks. Cravings are caused by yeast because yeast MUST HAVE sugar to grow. Craving beer and foods derived from yeast fermentation processes including vinegar products like mustard. Inability to lose weight.

• In SKIN and MUCOUS MEMBRANES including:

• Fungal Infections of the Skin.
• Fungal Infections of the Nails.
• Fungal Infections of the Scalp.
• Fungal Sinus Infections.
• Vaginal Candida Infection (same organism that causes thrush).

In the URINARY BLADDER causing these symptoms:

Urinary Frequency – Suprapubic Pain – Urgency – Difficulty Urinating – Possible Blood in the Urine.

How Does Candida Albicans Infection Develop In Celiac Disease and/or Gluten Sensitivity?

• Candida albicans infection results from any of these conditions:

1) Dysbiosis, which is the disruption of normal flora (microbe population) in the digestive tract.

2) Lowered resistance to infection. This includes treatment of a disorder such as bronchitis or an auotimmune disease with inhaled or oral corticosteroids.

3) Local mucosal or skin inflammation, which damages the natural barriers preventing invasion by yeast.

4) Malnutrition that lowers your defenses against invasion, especially iron, vitamin A, vitamin C, and omega-3 fatty acid deficiencies. Low stomach acid can be a cause of these deficiencies before or after elimination of gluten due to poor digestion.

Does Candida Albicans Infection Respond To Gluten-Free Diet?

Yes. Celiac disease-related infection responds to treatment and nutritious gluten free diet. However, along with this diet it is necessary to 1) starve out the yeast in all parts of the body affected starting with the mouth, 2) heal the gut, and 3) rebalance the microbe populations in the gut.

1. Kill the yeast by these general measures:

a.) Starve them. Do NOT eat the food they make you crave, including ANY nutritional sugar (for example, cane sugar, honey, fructose, palm sugar, rice syrup, maple syrup and candy) or carbohydrate (for example, ANY grain products whole or refined such as bread, cookies, pies, pizza, buns, pretzels, potato chips, tacos), beer, dried fruits, more than one fresh fruit per day until healed (except grapefruit and lemon).

b.) Get rid of them. Rinse your mouth with ordinary peroxide to kill the organisms then flush with water. Next gargle with baking soda water (1 teaspoon to a half glass of water) to neutralize acidity because yeast love acid. Brush your tongue with pure baking soda to instantly remove thrush.

c.) Chew fresh oregano leaves because they kill yeast and use them in cooking. Also use fresh garlic and onions. See other herbals below.

d.) Try the supplement called pau d’arco tea or extract which is traditionally used to kill yeast in the body.

e.) See your doctor for medications such as Nystatin and Diflucon for severe gut cases.  All vaginal yeast infections require anti-fungal medication to kill the yeast although vinegar douches may keep it under control. As for all drugs, pay attention to possible side effects.

f.) Use good hygiene. Candida is contagious to other people and easily spreads to other parts of your body. For this reason,

1. Always wash your hands thoroughly before preparing food, eating, brushing your teeth, and after using the toilet. Candida from the mouth easily spreads to vaginal and urinary tracts.

2. Use a fresh washcloth each day for your face and a separate one for your body.

3. Wash your clothing and especially your sheets, towels, and washcloths in hot water. Use bleach if you can.

4. Wash all eating utensils in the hot water cycle of your dishwasher otherwise, use disposable cups as long as you have the infection in your digestive tract.

5. Regularly wash all spigots and sinks with bleach or other disinfectants that kills fungi.

6. Regularly wash all doorknobs and railings with disinfectant.

2. Heal inflammation and leaky gut by eating only non-inflammatory foods below and using L-Glutamine supplement.

3. Correct dysbiosis by re-establishing healthy microbe populations in the gut and keeping them healthy with sufficient fiber from vegetables, nut, and seeds. Study results show that probiotic bacteria reduced candida numbers in the oral cavity of the elderly and increased specific secretory immune response against these yeasts.⁵

6 Steps To Improve Candidiasis In Celiac Disease and/or Gluten Sensitivity:

• [dropcap]1[/dropcap]Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:

[box type=”shadow” ]Treatment. This condition responds to the complete elimination of gluten, which is the required treatment that improves both candidiasis and gut health.

• Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.
• A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.
• Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.

Correct Your Individual Nutritional Needs.

• Eat foods that can replenish missing nutrients. Find them under NUTRIENT DEFICIENCIES.
• Take nutritional supplements as needed. Find them under NUTRIENT DEFICIENCIES.

Recovery. You should begin to feel better within a week and notice more energy as inflammation subsides and the  absorbing cells that make up the surface lining of your small intestine are better able to function.

• Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.
• Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.⁶
• The intestinal lining may take up to a year to heal.[/box]

• [dropcap]2[/dropcap] Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).

[box type=”shadow” ]Here Are Major Inflammatory Food Types That Reduce Healing:

• Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.⁷
• Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
• Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.⁷
• Fats. Limit deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.⁷.
• Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.⁷
• Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
• Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.⁷
• Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.⁷[/box]

[box type=”shadow” ]Here Are Important Anti-Inflammatory Food Types to Promote Health:

• Fruits. Limit to one a day, with exception of lemons and grapefruit. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens. Candida produces toxins.
• Non-Starchy Vegetables. Eat freely. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes all greens like lettuce, kale, Swiss chard, turnip greens, red beet greens, and onion, broccoli, garlic, Brussel sprouts, cauliflower, and summer squash.
• High Quality Complex Carbohydrates. Limit to one a day. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
• Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil. Cocoa is good, too.
• Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources include tuna, salmon, cod, and other cold water fish. Plants sources include flax, chia seeds, canola oil.
• Supply normal microbes needed for colon health and health of the body such as plain yogurt and kefir with no sugars added. Use nothing with yeast.
• Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
• Protective Herbs and Spices.  See below #6 below for examples.[/box]

• [dropcap]3[/dropcap] Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

 

 

• [dropcap]4[/dropcap] Manage Your Medications Safely:

[box type=”shadow” ]

Certain prescription drugs cause deficiencies of  vitamin A, iron, vitamin C, and omega-3 fatty acids that promote Candidiasis.

Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

 This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS

• Pepcid®, Tagamet®, Zantac® deplete Iron, Vitamin A.
• Magnesium and Aluminum Antacid preparations (Gaviscon®, Maalox®, Mylanta®) deplete Iron, Vitamin A.
• Alka Seltzer®, Baking Soda deplete Proteins when taken with food or within 2 hours of eating.

ANTIBIOTICS disrupt intestinal permeability.

• Gentomycin, Neomycin, Streptomycin, Cephalosporins, Penicillins deplete Vitamin C.
•  Tetracyclines deplete Iron.

ANTI-INFLAMMATORIES disrupt intestinal permeability.

• Corticosteroids (Prednisone, Medrol®, Aristocort®, Decadron) deplete Vitamin C.
• Aspirin and Salicylates deplete Vitamin C, Iron.

CHOLESTEROL DRUGS

• Colestid® and Questran® deplete Vitamin A, Iron.

DIURETICS

• Loop Diuretics (Lasix®, Bumex®, Edecrin®) depletes Vitamin C.

FEMALE HORMONES disrupt intestinal permeability.

• Oral Contraceptives (Norinyl®, Ortho-Novum®, Triphasil®, and others) deplete Vitamin C.
• Oral Estrogen/Hormone Replacement (Evista®, Prempro®, Premarin®, Estratab® and others) deplete Vitamin C.[/box]

• [dropcap]5[/dropcap]Nutritional Supplements To Help Correct Deficiencies:

[box type=”shadow” ]

The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.

• Multivitamin/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.
• Vitamin A as prescribed following blood test for status.
• Iron as prescribed but do not take at same time as other minerals because they compete for absorption.
• Vitamin C as prescribed following blood test for status.
• Fish oil as prescribed for EPA and DHA omega-3 fatty acids.

Storage Note: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet – not in the bathroom or on the kitchen table.[/box]

• [dropcap]6[/dropcap]Manage Natural Remedies: 

[box type=”shadow” ]Hydration:

• Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
• If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
• Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
• What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.[/box]

[box type=”shadow” ]Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

• Raspberry.
• Carrot is also a cleansing digestive tonic.
• Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
• Redbeets also stimulate and improve digestion and are easily digested.
• Cabbage also stimulates and improves digestion and is also a liver decongestant.
• Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
• Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

• Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
• Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
• Parsley also relieves indigestion.
• Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.
• Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

• Cloves are also antispasmodic.
• Nutmeg is also useful for indigestion.
• Ginger.[/box]

[box type=”shadow” ]Exercise Helps:

Exercise improves circulation and rids the body of toxins.

• Walking is aerobic exercise that reconditions the whole body to improve stamina. Read more about Exercise and Fitness.
• Weight training builds muscle. Read more about Exercise and Fitness.
• Stretching improves flexibilty. Read more about Exercise and Fitness.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. [/box]

What Do Medical Research Studies Tell About Candida Albicans Infection In Celiac Disease and/or Gluten Sensitivity?

RESEARCH STUDY SUMMARIES

“Effects of probiotic bacteria on Candida presence and IgA anti-Candida in the oral cavity of elderly.” This study evaluated whether the consumption of the probiotic Yakult LBz(®) (Lactobacillus casei and Bifidobacterium breve) was able to influence on the specific immunological response against Candida and on the presence of these yeasts in the oral cavity of 42 healthy aged individuals.

Saliva samples were collected before and after the probiotic use for 30 days, 3 times a week. The samples were plated in Dextrose Saboraud Agar with chloramphenicol, the colony-forming units (CFU/mL) were counted and the Candida species were identified. Anti-Candida IgA analysis was conducted using the ELISA technique. ANOVA and Student’s t-test were used for normally distributed data and the Wilcoxon test was used for data with non-normal distribution.

The results showed a statistically significant reduction in Candida prevalence (from 92.9% to 85.7%), in CFU/mL counts of Candida and in the number of non-albicans species after consumption of the probiotic. Immunological analysis demonstrated a significant increase  in anti-Candida IgA levels. In conclusion, probiotic bacteria reduced Candida numbers in the oral cavity of the elderly and increased specific secretory immune response against these yeasts, suggesting its possible use in controlling oral candidosis.⁵

Sources:

1. Rosenbach A, Dignard D, Pierce JV, Whiteway M, Kumamoto CA. Adaptations of Candida albicans for growth in the mammalian intestinal tract. Eukaryot Cell. 2010 Jul;9(7):1075-86. doi: 10.1128/EC.00034-10. Epub 2010 Apr 30. [↩]
2. Hube B. From commensal to pathogen: stage- and tissue-specific gene expression of Candida albicans. Curr Opin Microbiol. 2004 Aug;7(4):336-41. [↩]
3. Nieuwenhuizen WF, Pieters RH, Knippels LM, Jansen MC, Koppelman SJ. Is Candida albicans a trigger in the onset of coeliac disease? Lancet. Jun 21, 2003;361(9375):2152-4. [↩] [↩] [↩]
4. Staab JF, Bahn YS, Tai CH, Cook PF, Sundstrom P. Expression of transglutaminase substrate activity on Candida albicans germ tubes through a coiled, disulfide-bonded N-terminal domain of Hwp1 requires C-terminal glycosylphosphatidylinositol modification. J Biol Chem. 2004 Sep 24;279(39):40737-47. [↩]
5. Mendonça FH, Santos SS, Faria Ida S, Gonçalves e Silva CR, Jorge AO, Leão MV. Effects of probiotic bacteria on Candida presence and IgA anti-Candida in the oral cavity of elderly. Braz Dent J. 2012 Sep-Oct;23(5):534-8. [↩] [↩]
6. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
7. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩] [↩]