Candida and Chronic Fatigue Syndrome

Candida over-growth and Chronic Fatigue Syndrome can both present with confusingly similar symptoms, such as long-term debilitating mental and physical fatigue, headaches, food intolerances, joint and muscle pain, and brain fog.

Other common symptoms which are much more specific to Candida include severe Pre-Menstrual Symptoms, depression, pain behind the breast bone, intolerance to strong odours, dandruff, athlete’s foot, visual disturbances, oral or genital thrush, an itchy anus and a feeling of bloating or flatulence.

Whilst I certainly do not believe that everyone who suffers from CFS/M.E. also suffers from a yeast over-growth, I have noticed that a significant proportion of the people I have treated for CFS/M.E. also have had food intolerances, bloating, thrush, or an itchy anus, and shown a positive result to a laboratory test for Candida.

Candida is a yeast which naturally lives in the human intestine, but under certain conditions the normally small Candida population can explode with serious consequences to health. From my experience, I would suggest that a Candida overgrowth may result from the immune breakdown in M.E., especially if the sufferer relies on sugar as an energy source (which ‘feeds’ the yeast) and/or coffee, which stimulates the release of blood sugars. However, although Candida alone clearly does not cause M.E., it mimics the symptoms so closely that distinguishing between the two can sometimes be difficult.

Whereas the underlying cause of M.E. still seems to escape us, the causes of Candida problems are much clearer. Once it has been established that there is certainly a yeast overgrowth, and this is resolved using herbal medicines, it leaves a much clearer clinical picture regarding what is needed to heal the M.E.

The causes of Candida
It often surprises people to find out that Candida lives in our gut naturally, alongside other microscopic bowel flora, without causing us any harm. It may even have the beneficial effect of helping to remove excess heavy metal toxins from our bodies. However, there are certain conditions which allow the yeast organisms to explode very quickly from a normally small population group into an enormous domineering fungal overgrowth. If you have ever seen fruit ferment into wine or bread rise, you get the picture of how quickly yeast can grow, given the right environment.
Once this happens, the yeast can actually change shape from a small non-invasive organism into its aggressive and invasive fungal form which develops root-like structures called mycelia, more of which later.

In my experience, the five major causes of Candida overgrowth include:
1) Depletion of the gut’s friendly bacteria, sometimes caused by long-term antibiotic treatment or gastric infection
2) A breakdown in the immune system, as in the case of M.E., chemotherapy or HIV
3) Excess female hormones for example, as a result of multiple pregnancies, HRT, the Pill, during a pre-menstruation phase or the menopause
4) High blood sugar levels caused either by a high sugar diet, stress or diabetes
5) Drug therapy – mainly antibiotics, steroids, hormone therapies, or immuno-suppressive drugs

How does it affect the body?
Once the yeast has changed into its aggressive fungal form, it penetrates the gut lining by secreting inflammatory chemicals which weaken the wall and allow the mycelia to pierce it, leading to a ‘leaky gut’. The leaky gut is like a hosepipe with large holes in it.

Normally the intestine breaks the food down into tiny particles which are then transported through little gateways in the gut wall into the bloodstream. However the leaky gut allows larger, undigested food particles to enter the blood stream. If the immune system doesn’t recognise these undigested food particles and assumes that they are a ‘foreign invader’, it immediately sets about forming anti-bodies to these foods, thus creating a food intolerance. Now the immune system is very busy fighting the Candida invasion into the blood stream, the food intolerances, and this alone can account for fatigue, allergic-type symptoms such as sinusitis or asthma, and brain-fog.

Furthermore, Candida is known to secrete toxins called mycotoxins, which can suppress the immune system further, as well as causing liver toxicity, headaches, and muscle pain. Once Candida has entered the blood stream, antibodies from the immune system combine with it to form antigen-antibody complexes, which when deposited in the joints, lungs or brain result in joint pain, asthma, depression and hormonal disruption.

Candida, being a yeast, thrives on dark, warm, wet and sugary environments. People with an overgrowth often have intense sugar cravings – you can think of this as the yeast demanding to be fed. In the warm moist gut, it ferments the sugars to produce symptoms such as flatulence and bloating, while the inflammatory chemicals released result in poor digestion and absorption, having the knock-on effect of further depleting the body as the sufferer is unable to benefit from nutritional nourishment. The fermentation has been known to give a positive reading to an alcohol breath test, even when the person has been teetotal for years. This high level of alcohol in the blood causes the person to feel hung-over and nauseous.

Eight steps to a greater health
Clearly, gut imbalances leading to Candida overgrowth is a complex problem which requires a multi-faceted approach to treatment, ideally under professional supervision.

1) Get the correct diagnosis
There are several methods of testing for Candida overgrowth, but the most accurate is the saliva or blood test. These measure your immune system’s antibody response to Candida yeast species, and so are able to tell you how severely you are being affected. The only problem can be if your immune system is so exhausted that it cannot raise the antibodies to the Candida, which will result in a false negative.

A stool analysis can also test for Candida, but is less reliable, as sometimes the Candida is so embedded in the gut wall that it does not come out in the stool and again, you might get a false negative. However, the advantage of a stool analysis is that it is also able to analyse your levels of beneficial gut flora (the ‘good’ bacteria), whether you also have a problem with other yeasts and parasites, if you have an inflamed intestine and how effectively you are able to digest and absorb your food. Unfortunately, in my experience the NHS is not interested in looking for Candida overgrowth unless you’re on immune suppressant medication, so most people need to pay privately for tests.

2) Starve the Candida
One of the best ways to start treating yeast overgrowth is by going onto the ‘Candida diet’ for one month before you follow the rest of the program. In this way you starve and weaken the yeast, starting to kill it off gradually, and thus lessening the die-off effects.

By raising blood sugar levels, you are feeding the yeast, so you need to starve the yeast by completely avoiding foods with refined carbohydrates and sugar. In addition, people with a Candida overgrowth often become intolerant to foods with yeast in, (finding that they provoke brain fog and tiredness) due to the antibody reaction mentioned earlier. Yeast-containing foods need to be avoided until you’re better, while your intake of protein, extra virgin olive oil, salads and vegetables, and complex carbohydrates should be increased. It can also help to avoid non-organic foods, as these often contain high levels of antibiotics, pesticides and hormones.

Many people understandably feel that the Candida diet is an awful regime, but investing in a well-illustrated Candida cookbook can make all the difference, and really, it is just a very healthy diet to follow.

3) Take anti-fungal medications
Your doctor may prescribe anti-fungal drugs such as nystatin, although some may not feel this is justified if you don’t have the more obvious symptoms of ongoing thrush etc. However, you can use a wide range of very effective herbal and nutritional remedies such as Oregano, Pau D’Arco, Cinnamon, or Caprylic acid, which have been shown to have anti-fungal actions. In treating Candida, I usually use two or three natural anti-fungals at once and frequently alternate them to maximise effectiveness.

4) Heal the leaky gut
Herbal teas such as Calendula and Chamomile can be drunk, as these have been used traditionally to stimulate the healing of the intestinal lining, whilst nutritional supplements such as L-glutamine and MSM provide the necessary building blocks for the healing process. The gut lining can take at least three months to repair. Given that food intolerances will slow down healing, a laboratory food intolerance test is also advisable.

5) Re-populate the gut with friendly bacteria
The two major probiotics or ‘friendly’ gut bacteria which help keep intestinal yeast in check are lactobacillus acidophilus and bifidobacterium. Don’t be tempted to use cheap probiotic drinks as found on supermarket shelves. These contain the minor gut bacteria and are usually in a very sugary liquid – perfect for encouraging fungal growth. Other cheap probiotic supplements have been shown to be made up of dead or ineffective bacteria. Make sure you buy from someone reputable.

6) Boost the immune system
In Candida, as with M.E., we have one part of the immune system which is overactive, resulting in inflammatory conditions such as muscle and joint pain and food intolerances, and the other side which is depressed, resulting in a poor response to the yeast challenge. Herbs such as Echinacea, Astragalus or Sutherlandia are used by medical herbalists to stimulate and rebalance the immune system.

7) Detoxify the liver
Herbs such as Burdock, Dandelion root, Ginger and lemon juice are traditionally used to encourage the flow of bile, which flushes toxins out of the liver to be released in the stool. Other foods such as celery, fennel, parsley and watercress encourage toxins to be eliminated via the kidneys. Hot Epsom salt baths also encourage the elimination of toxins via the skin, while therapeutic massage helps to shift toxins into the lymphatic system and the kidneys for elimination. Drinking lots of water is absolutely imperative to facilitating the detoxification process.

8) Aid the digestive process
Digestive enzyme supplements support the digestion and absorption of food, and in doing the work for the digestive system, give it the rest it needs for recovery. A sluggish bowel means that any toxins released are able to seep back into the system, thus prolonging the die-off effect as well as contributing to tiredness and headaches. To offset this problem, mix two tablespoons of linseeds (whole or crushed) daily with some live plain yoghurt (providing you are not dairy intolerant), to facilitate regular and easy evacuation of the stools.

A word about die-off
The bad news is that as the yeast dies, it releases its toxins into the blood stream, which can leave you feeling like you have a bad hangover. This die-off period can last between three days and two weeks. However, if your liver and bowels are working at optimum, you will be able to get rid of the toxins more quickly, and with a careful treatment program, the die-off may even be avoided. This is one of the reasons why I always recommend seeking professional help if you want to tackle suspected Candida problems.

Where do you go from here?
If you do suffer from both Candida and Chronic Fatigue Syndrome/M.E., treating the Candida can help to reduce many of the collective symptoms. By clearing the toxic load on the body, relieving the immune system of the yeast over-growth and food intolerance burden through anti-fungal medicines and diet, and boosting the immune system with herbs and probiotics, you have contributed significantly towards helping the body to heal.

Realistically, getting Candida under control takes between 3 and 18 months, depending on how severe it is. While you would need to stick to the diet for some time, most people can gradually re-introduce fruit and enjoy the occasional sweet treat as they start to feel better. Once the Candida is under control (this may be confirmed through another Candida test), you can set about tackling the M.E. by continuing to treat the immune, endocrine and nervous systems, and by using adaptogenic herbs to build stamina.

Chronic Fatigue Syndrome and Candida overgrowth are both fairly complicated, and I strongly recommend professional treatment both for support as well as access to professional remedies. However, both Candida and M.E. very definitely require the patient’s input in terms of sticking to the diet, and making sure that you get the rest needed to recover - because if these two areas are not adhered to, even the best treatment program will be sabotaged.