A review of allopathic and holistic products, devices and therapies.

To clarify one thing before answering it is not the treatment of yeast infection but rather a fungal infection.  Candida is a dimorphic microbe meaning it can exist in two forms.  It can exist as a benign yeast or a pathogenic fungi. 

Every person has Candida as it is a natural and beneficial inhabitant of the body in its yeast form.  Not everyone has Candida overgrowth (candidiasis) though , which occurs in Candida’s fungal form.   In is fungal form Candida forms finger-like projections called hyphae that allow the Candida to dig in to and damage tissues.

Whether Candida exists as yeast or a fungus depends on the pH of the terrain the Candida is in.  In areas where Candida is naturally found beneficial acid forming bacteria known as flora are also found.  These are primarily the colon, sinuses, skin and vaginal cavity.  The acids produced by the flora turn off the Candida growth gene and keep the Candida in its benign yeast form.

When the flora are destroyed from antibiotics use or certain other drugs, illness, poor diet, etc. the pH of the tissues where Candida and the flora are found shift from the normally slightly acidic pH to an alkaline pH.  The shift from an acidic to an alkaline pH turns on the Candida growth gene and converts the Candida to convert in to its pathogenic fungal form.

Taking probiotic supplements such as Lactobacillus and Bifidobacterium help restore the natural acidic pH that keeps the Candida under control.

When trying to treat candidiasis people often make the mistake of trying to kill off the Candida with antifungal herbs, enzymes, oils, etc.   This rarely works and can actually make the problem worse in some cases.

The primary problem is that as long as the pH of the terrain remains alkaline all it takes in one surviving cell for the Candida to rebound since the alkalinity will keep the Candida growth gene turned on.

Antifungal herbs and oils generally pose the same problem since they rarely adjust the tissue pH back to the normal acidic pH.  A secondary problem with many antifungal herbs and oils is that they often also kill off the beneficial  intestinal flora that naturally keep the Candida under control.  Some of the worst offenders are the berberine containing herbs goldenseal, barberry and Oregon grape root. 

There are some herbs and oils though that can help knock back Candida due to their anti-fungal properties without damaging the flora.  Yucca root powder, Gynostemma pentaphyllum (jiaogulan) and unprocessed coconut oil are a few examples.

I have also seen discussions where products containing the enzymes cellulase and hemicellulase were being recommended to treat Candida.  The concept is that these enzymes will digest the cellulose and hemicellulose in Candida killing it.  There are several problems with this hypothesis. 

Cellulose and hemicellulose are partial components of Candida cell walls consisting of long chain sugar molecules (polysaccharides) made up of repeating glucose units.  As the cellulose and hemicellulose of the Candida cells are broken down in to glucose these glucose units simply become food for the surviving Candida cells.

A second issue with these products is that the flora feed on glucose from fibers by breaking the fibers down using cellulase and hemicellulase.  Fermentation of these fibers by the flora lead to the production of beneficial acids that among other functions help control Candida overgrowth and pathogenesis.   When people take cellulose and hemicellulase for Candida these enzymes do not digest the cellulose and hemicellulose in the Candida solely.  The enzymes also digest the fibers that the flora use for food producing more glucose that can feed the Candida.  In the process the flora are deprived of food decreasing their numbers.  This further reduces the natural acidity allowing the Candida to thrive even more and increasing the risk of the Candida converting in to its pathogenic fungal form.

The safest and most effective way of dealing with candidiasis is by restoring the natural acidic pH by rebuilding the flora so they once again become the predominant microbes. 

Both probiotics and prebiotics can be used to restore the flora.

Probiotics are actual sources of the beneficial bacteria such as capsuled bacteria, liquid Acidophilus,  live culture yogurts, fermented vegetables,  miso, tempeh, kefirs, etc.  These are best for the short term to jump start the growth of the flora.

For long term boosting the growth of the flora though I prefer prebiotics.  Prebiotics are fibers used by the flora as food sources and to generate the beneficial acids that keep the Candida under control.   Examples include brans, fructooligosaccharides (FOS), inulin, vegetable gums, etc.

The reason I prefer prebiotics  over probiotics for the long run is that there are literally thousands of different beneficial strains of flora in the human body.  Probiotic sources generally only contain between one to twenty different strains of beneficial bacteria.  This leaves several thousand strains of beneficial bacteria not being replenished when candidiasis is present.  Antibiotics and other flora destroyers never kill off all the flora though.  There are always survivors from different strains that can be built back up if properly fed.  Therefore,  prebiotics have the advantage over probiotics in the fact that prebiotics can restore the growth of all the flora rather than just replacing a limited number of strains.

The best probiotic source in my opinion are kefirs, which contain a much broader range of probiotic bacteria than supplements or yogurts.  And they are liver, active cultures.  Many people do not realize that most commercial yogurts do not have liver cultures despite having that claim on the label.  The cultures are killed prior to sealing the containers to prevent further fermentation of the sugars that would make the product less sweet and more acidic and would pop the tops off the containers from the carbon dioxide gas.

Drinking large amounts of kefir helps ensure sufficient bacteria will survive passage through the stomach to reach the safety of the intestines.  

Oral probiotics can also help with vaginal candidiasis.  There is no direct route from the intestines to the vaginal cavity though.  Vaginal flora actually come from the bacteria excreted during defecation and that remain on the perianal skin.  From there these beneficial bacteria migrate in to the vaginal cavity.  

Because of this it can be difficult to get enough of the bacteria to migrate to the vaginal cavity for quick relief from vaginal candidiasis.  Therefore, some women will insert kefir or other probiotic sources directly in to the vaginal cavity, which speeds up the process considerably.

A small amount of water kefir or coconut kefir is best for this purpose.  If these are not available then another option is to put some probiotic powder or open a probiotic capsule in to a small container.  Add just enough water to make a thick solution.  Then an eyedropper is used to suck up some of the solution, the woman lays on her back and squirts the liquid in to the vaginal cavity.  A small amount of the liquid is used so that it does not run out and the bacteria remain to re-colonize the tissues.  This is repeated several times a day.  This will normally clear up vaginal candidiasis within a few days.

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