Scientifically Named in This Article:
But Also Referred to as:
Terminology varies with different schools of medicine and differing theories of cause. The acronym "CFIDS" will be used in this article to refer to a clinical syndrome which crosses the boundaries and involves, more or less, all of the above.
By Elmer M. Cranton, M.D.
Mount Rogers Clinic, Trout Dale,
Virginia
&
Mount Rainier Clinic, Yelm, Washington
INTRODUCTION
A wide variety of symptoms, as listed above, of a seemingly unrelated nature affect widely diverse parts of the body and are postulated in this paper to be caused, at least in part, by overload of the immune system and immunologic dysfunction. Stressed-out and malfunctioning immunity is described as an important and correctable common denominator in all of the above conditions. Chronic fatigue and nervous tension are almost always present.
The treatment plan described in this paper has been developed by the author over many years and has brought relief to hundreds of patients who had been diagnosed with the syndromes listed above. Benefits have often been dramatic and sometimes complete after attempts with many other therapies had failed.
The occurrence of CFIDS is increasing exponentially in industrialized nations throughout the world. Chronic immune dysfunction is epidemic. That increase in the latter part of the twentieth century parallels a proliferation of stressful burdens to immunity from increasing environmental, nutritional, and pharmaceutical lifestyle factors.
These symptoms, although increasingly seen, are often misdiagnosed as neurotic or psychosomatic. Many different diagnostic terms are used to describe this collection of symptoms. A common denominator in all of those syndromes, however, collectively referred to as CFIDS, has been shown to be immunologic dysfunction, often accompanied in women by hormonal imbalance. Premenstrual symptoms and fertility problems are often related.
Great improvement in hundreds of patients has followed the treatment program described below.
This paper and its program of therapy would be termed unproven and anecdotal by most physicians. Conclusions are based on the author's personal observations and success in treating hundreds patients with CFIDS. Many of those patients had failed to respond to multiple other treatment programs. What is described here is from direct experience with many patients. Much was learned from the patients themselves and not from medical schools or elaborate scientific research. But this regimen of treatment has been found to work in practice. It is safe and inexpensive, relative to the cost of the many unsuccessful treatments, which most patients had previously tried.
All patients do not respond. Nothing in medicine is one hundred percent effective. The scientific basis for the observations, recommendations, and conclusions in this paper is hypothetical. Double-blind, placebo controlled studies have not been done to prove or disprove that observed benefits are coincidental or purely "placebo effect." Many physicians would consider the recommendations in this paper as experimental at best and pure quackery and exploitation at worst. Medical insurance policies often refuse to reimburse the costs.
The most frequent and incapacitating symptom in patients with CFIDS is chronic fatigue, without an evident cause. Depression or other difficulty with mental function is commonly present. Physical examination and laboratory tests are seldom abnormal and cannot be used to make a diagnosis.
Adverse reactions to many nutritious foods (so-called food allergy) are common. Sensitivity to chemical fumes, perfumes, solvents, and other substances is also common. Respiratory allergy, nasal and sinus congestion, and hay fever may be present. Stomach upset, digestive problems, urinary tract symptoms, and musculoskeletal pains are common.
By using a variety of techniques to remove stress from the immune system, and by keeping that stress to a minimum for several months, many patients who have suffered prolonged symptoms have found relief. An effective treatment program and a scientific mechanism of action are outlined in detail below.
Small amounts of yeast and other fungal organisms compose a normal part of the body's microflora. They are well tolerated by those with healthy immunity. If they increase in number, however, they create additional stress to the immune system.
It a medical fact that a healthy person will react allegically to Candida albicans, a common yeast, formerly called Monilia. Using a clinical test for normal immunity, the doctor injects a small amount of Candida yeast extract under the skin and observes for a raised, red allergic reaction. If that reaction does not occur, the patient is diagnosed as "anergic," meaning that the immune system is not functioning. In other words, the body will always react allergically to Candida yeast unless immunity has become paralyzed or stressed-out. That fact proves that the presence of yeast in the body creates stress to immunity.
For purposes of simplification, all species of yeast and fungus, which grow in the human body, may be lumped together in this paper and simply called "yeast."
A large number of pharmacological, dietary, environmental and life-style factors now exist which encourage increases in yeast to occur in people living in industrialized countries. When that yeast overgrowth becomes massive, it is easily diagnosed as an infection and treated appropriately with anti-fungal medicines. Often, however, yeast overgrowth, especially in the large intestine, is not adequate to diagnose an infection, but is quite enough to overburden the immune system.
A treatment program using a combination of prescription medicines to eliminate yeast from the body, combined with other strategies, which remove stresses from the immune system, has been developed by this author to successfully treat CFIDS. This program has helped hundreds of patients who were previously unresponsive to other therapies.
Yeast overgrowth appears to be partly iatrogenic (caused by the medical profession) through the widespread and often excessive prescribing of antibiotics and cortisone medications. A diet high in sugar also promotes overgrowth of yeast. The highly refined and chemicalized diet common in industrialized nations is also deficient in many essential vitamins and minerals needed by the immune system. Chemical colorings, flavorings, preservatives, stabilizers, emulsifiers, etc., all add to stress on the immune system.
Effective treatment for CFIDS consists of (1) three different anti-fungal medicines, taken together; (2) avoidance of commonly eaten foods to which the immune system is often sensitized; (3) avoidance of environmental pollutants, fumes, food additives, etc.; and, (4) supplemental vitamins, minerals and trace elements to strengthen immunity. That program will relieve stress from the immune system while providing nutritional support. It is necessary to continue treatment for several months. This allows normal immunity to recover and allows normally present bacteria to repopulate the digestive tract after yeast have been eliminated.
In 1985, a more technical version of this article was published in a medical journal. Much new information about effective therapy has been gained since that time and is included here in lay language, as much as possible. Most of what the author knows about this condition has come directly from experience treating patients. The existence of and treatment for CFIDS is still considered controversial in medical schools and most medical centers.
OCCULT FUNGAL PATHOGENS:
Yeast and fungal infections of the skin, mouth, nails, vagina, and digestive tract have long been recognized and are obvious to diagnose, but a relationship has only recently been recognized between yeast colonization (which is often sub-clinical and otherwise not apparent) with a wide variety of disabling symptoms.(1-8)
Yeast and molds belong to a broader family of plant life called fungus. Mildew, bread mold, and mushrooms are other types of fungus. All yeast are fungi (plural of fungus) but all fungi are not yeast. The terms "yeast" and "fungus" and "mold" are often used interchangeably.
The widely present single-cell fungus organism (a yeast), Candida albicans (formerly called Monilia), exists quite normally in low concentrations on the skin and inside the digestive, respiratory and reproductive organs. Because Candida is a normal constituent of human micro-ecology, the mere presence of the yeast, Candida albicans is not sufficient to make a diagnosis of "infection."
A healthy person with a normal immune system can tolerate small amounts of Candida. However, yeast and fungi release many bioactive substances into the body, which increase to exceed tolerance as yeast increase. These substances are variously toxic, allergic, and hormonal in nature.
Substances released by yeast into the body include:
1) Allergens, which react classically, causing symptoms of itching, hives, skin rashes, nasal congestion, cough, bronchitis, irritable bowel, and asthma. More than 70 distinct allergic molecules have been found to be produced by Candida albicans.4
2) Fungal poisons (mycotoxins) include aflatoxin, ergot poisoning and mushroom poisoning. The list of other known mycotoxins is very long and not widely recognized.9 Dr. Iwata, in Japan, has identified many such toxins produced by Candida albicans, which poison the nervous and immune systems.10 Acetaldehyde (similar to formaldehyde) is also secreted by Candida albicans and is one probable cause of yeast-related symptoms.11 Immune system abnormalities have long been associated with Candida.12 Incurable diseases of unknown cause, presumed immunologic, such as psoriasis and multiple sclerosis, have been reported to improve, sometimes dramatically, following anti-fungal therapy.13-14
3) Hormonally active molecules are also produced by Candida. Symptoms related to the female reproductive system, including PMS, cystic breast disease, infertility, and reduced sex drive, have been reported to improve following treatment with anti-fungal medications. Those observations are evidence for interference with normal hormonal function by yeast and fungus overgrowth.
There are many different strains of Candida albicans. Different strains produce widely different toxins, allergens and hormone-like substances. Patients also vary widely in their sensitivity and response to those substances. This results in a wide diversity of ill-defined yeast-related symptoms in CFIDS. The neurotic nature of many complaints has delayed widespread recognition of this clinical syndrome. Response to therapy of CFIDS following anti-fungal medications provides evidence for a direct causal relationship between yeast and symptoms.
Many physicians are not aware of the lasting adverse effects caused by many routinely prescribed medications such as antibiotics. Antibiotic therapy for minor colds and runny noses is a common practice. We live in an age when many people receive multiple courses of broad-spectrum antibiotics throughout life or are injected with long-acting corticosteroid medicine for joint or muscle pain.
Once established, sub-clinical colonization with yeast in the body may persist unrecognized for many years. Antibiotics, such as tetracycline, cause great increases of yeast in the colon after only a few days.
Yeast is well recognized to cause vaginitis in women and diaper rash and thrush in infants. Yeast and fungus are also common causes of other skin infections including athlete's foot, jock itch, ringworm, paronychia, intertrigo, anal itching, seborrhea (dandruff), tinea versicolor and onychomycosis (causing fingernail and toenail deformities). Such diseases are rarely considered serious, although many women troubled by persistent or recurrent vaginitis would state otherwise.
It is not widely recognized that those conditions often occur in patients with previously weakened immune system, resulting in lowered resistance to yeast infection. The most common and overlooked site for yeast proliferation is the large intestine. Constipation is commonly caused by yeast. Yeast in the colon release large amounts of allergens, toxins and other hormonally active substances into the circulation, without raising a suspicion of where the problems are coming from.
IF THIS IS SO COMMON, WHY IS IT NOT MORE WIDELY RECOGNIZED?
It is common in the history of medicine that clinical acceptance of a safe and effective therapy may not occur until an accepted scientific rationale is found to fully explain observed benefits.15 Highly effective therapies have been rejected in the past, sometimes for decades, merely because they were innovative and did not fit with currently accepted theories.16
Clinical experience and observation of benefit should be the "gold standard" on which patient care is based. Patients should not be deprived of a safe and effective treatment only because the scientific basis has not been fully researched and proven.(16,17) If thorough medical evaluation shows no other plausible cause for symptoms of CFIDS, a trial of anti-fungal therapy with dietary and environmental avoidance of potentially offending substances can cause no harm.
There are no definitive tests to diagnose CFIDS in advance of treatment. Response to therapy, as described in this paper, is the only practical way to confirm a treatable condition, which would otherwise remain untreated.
HISTORY
In the late 1970's Dr. C. Orian Truss, an allergist from Birmingham, Alabama, first published and lectured on the wide variety of CFIDS symptoms associated with the yeast, Candida albicans.4-6,11 Dr. Truss successfully treated many hundreds of chronically fatigued, allergic and depressed, seemingly neurotic patients. His patients experienced great improvement following prolonged treatment with oral nystatin, an anti-yeast medicine. Dr. Truss' patients suffered with a wide variety of symptoms which had often not responded to many other treatments.
Patients of Dr. Truss' who improved with his therapy reported the following types of medical histories:
1. Having been treated, sometime many years previously, for acne with prolonged courses of tetracycline or other antibiotics.
2. Multiple courses of antibiotics for urinary tract infections, sore throats, ear infections, bronchitis or sinus trouble;
3. Use of oral contraceptives;
4. Treatment with cortisone-type medicines or injections.
Dr. Truss was the first to describe this syndrome of "yeast-related illness," characterized by the following symptoms, with varying severity and in different combinations (I now classify these symptoms more broadly as CFIDS):
1. Nervous symptoms, including fatigue, headache, dizzy spells, anxiety, "nervous tension," panic attacks, depression, schizophrenia, insomnia, irritability, impaired memory and "spaced out" feelings. Complaints of nervousness, depression and unexplained fatigue were the most commonly present symptoms.
2. Reproductive tract symptoms, including premenstrual syndrome (PMS), infertility, cystic mastitis (painful breast lumps), pelvic pain, painful intercourse, recurrent vaginitis, prostatitis, reduced sex drive and impotence. Patients had often received repeated courses of antibiotics for infections of the bladder or prostate.
3. Digestive tract symptoms, including unexplained and chronic abdominal pain, canker sores in the mouth, esophagitis, indigestion, heartburn, constipation (often alternating with diarrhea), anal itching, gas, bloating, spastic colon, and intolerances to common foods. Multiple surgical procedures had sometimes been performed, without benefit until anti-yeast therapy was prescribed. A persistent coating on the tongue was a common finding.
4. Other chronic and resistant symptoms, including unexplained muscle and joint pain; arthritis; headaches; visual disturbance; difficulty thinking, remembering and concentrating; recurrent sore throats; swollen or painful glands (lymph nodes); low grade fevers of unknown origin; sensitivity to heat or cold; hair loss; numbness or tingling in the face or extremities; persistent nasal congestion; cough; and respiratory allergies. Many patients were abnormally sensitive to a variety of environmental exposures, including tobacco smoke, perfumes, sprays, formaldehyde, petrochemical products, exhaust fumes and other odors. They became "spacey" or felt ill breathing the smells in shopping malls, fabric stores or shoe stores. They reacted adversely to many common and nutritious foods, especially the grains and milk products.
Much to their distress upon seeking medical advice, victims of CFIDS are often told, "Your physical examination and laboratory studies are all normal. Your symptoms are 'psychological'." In other words, "you are imagining your illness." Physicians and family alike would consider such patients to be "hypochondriacs." Many victims of CFIDS would go from doctor to doctor, year after year, with no benefit.
William G. Crook, M.D., a pediatric allergist from Jackson, Tennessee, published confirmatory reports to support Dr. Truss' original observations.2,3,7,8,15
Patients included all age groups and both sexes. Children with learning disabilities, dyslexia, hyperactivity, attention deficit disorder, food allergies, drug abuse and a variety of delinquent and emotional disorders, had often received repeated courses of antibiotics for recurrent ear infections, bronchitis and other conditions--including prolonged courses of tetracycline for acne.
Even patients who had been committed to mental hospitals have been helped by anti-fungal therapy. Other puzzling immunologic diseases, including multiple sclerosis, rheumatoid arthritis and lupus erythematosus, have responded better when attention was given to reduction of yeast and immune stress. A wide spectrum of allergic disorders, from classical hay fever to chronic, delayed-onset type of food allergy and petrochemical sensitivity, have improved following anti-yeast therapy.
The use of allergy injections has been eliminated in many cases. Injection therapy has never been of much help in food allergy. Avoidance and anti-yeast therapy are the most effective long-term programs. Tolerance to previously offending foods and exposures is usually improved after several months of anti-fungal therapy.
DIAGNOSIS
Unfortunately, there exists no reliable laboratory test to prove or disprove the presence of CFIDS. Yeast and fungus are normally present in everyone. Because of the ubiquitous nature of yeast, cultures and microscopic smears are not of much use.
A thorough examination prior to therapy is important to insure that another otherwise treatable condition is not being overlooked. Response to a course of therapy will then confirm or refute the diagnosis of CFIDS. Many laboratory tests are available to assess antibodies and immunity. In practice, however, those laboratory tests do not predict which patients will respond to this therapy. Because testing is expensive (and often too new for routine reimbursement by medical insurance) a trial of therapy may be the most reliable and also the most cost-effective way to diagnose and manage CFIDS.
The most reliable predictor of response is the typical past medical history of the patient and symptoms. In addition to the factors described above, a diet high in sugars, including natural sugars such as fruits, fruit juice and honey, etc., is common. Yeast grow more rapidly in the presence of sugars and simple carbohydrates. Symptoms often worsen following sugar intake. So-called "hypoglycemia" frequently has an element of CFIDS and will improve following anti-yeast treatment.
Adverse and allergic reactions to prescription and non-prescription medications, chemical fumes, solvents, perfumes, shopping-mall odors, and even nutritional supplements are a common complaint. Presence of those symptoms increases the likelihood of benefit from this therapy.
Response to treatment remains the most reliable way to confirm or disprove a suspected diagnosis of CFIDS. Diagnosis can only be suspected from the medical history, after other types of illness have been excluded by a thorough medical evaluation and by lack of response to other therapies.
COEXISTING VIRAL INFECTION
Persistent and chronic viral syndromes have been well-documented in patients with CFIDS. Those include Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Coxsackie-B, and other viruses. Laboratory tests are available for many viruses, and both alpha interferon and interleukin-2 (IL-2) tend to be elevated in the presence of viral replication. It is postulated that some symptoms of CFIDS may be caused by increased alpha interferon and IL-2.18-21
If immunity is impaired, increased susceptibility to viral infection is expected. Many viruses normally lie dormant throughout life. They only become active if the body's defenses are weakened. For the most part, the only good defense against viral infections is a healthy immune system. The treatment program described below can benefit CFIDS by removing immune stress, allowing immunity to become stronger. Although chronic viral syndromes and CFIDS may co-exist, not all patients with CFIDS have viral problems.
The presence or absence of a diagnosable viral syndrome does not seem to alter potential benefit from this therapy. Viral testing is also expensive and is therefore not routinely performed prior to therapy.
Both viruses and fungal organisms create stress to the immune system. It is therefore quite probable that one can predispose to the other. Any treatment which strengthens natural immunity can improve either condition. In that way anti-fungal therapy may hasten recovery from a chronic viral syndrome.
1. DIETARY MEASURES:
During the first three months or so of treatment a so-called "Cave Man Diet" is recommended. William G. Crook, M.D. lists dietary instructions in detail in the book DETECTING YOUR HIDDEN ALLERGIES. This book can be ordered for $10.95, plus $3.50 postage from Wellness Health and Pharmaceuticals, 2800 South 18th St., Birmingham, AL 35209. VISA and MasterCard orders are accepted by phone, 1-800-227-2627.
The recommended diet begins on Page 73 and continues to page 90 in that book. This book contains a wealth of valuable information. Bear in mind, however, that after two months on the triple anti-yeast medicines, many foods that would have previously caused symptoms will be well tolerated.
Simple carbohydrates are limited. Even natural sugars, fruits and fruit juices are reduced, since they promote the growth of yeast. Many nutritious foods, which are more stressful to the immune system, are eliminated. Equally nutritious but rarely eaten foods are substituted. Foods eliminated for several months include milk products (all dairy and everything containing dairy products) and all grains (including wheat, corn, rye, rice, barley, etc.) and most other commonly eaten foods. Of the so-called "junk foods," chocolate, cola, candy, pastries and other sweets are eliminated. Food intolerances can be quite individual but the eliminated foods have been the most common food allergens in clinical practice. Regardless of the reason, this program works in practice.
The following foods should be minimized:
1. Refined and simple sugars, including table sugar, honey, syrup, molasses, fruit juices and dried fruit. Small servings of unsweetened fresh fruit may be consumed in limited amounts--up to three moderate servings per day.
2. Breads and bakery products, which contain wheat, rye, corn and yeast, are eliminated. Rice, oats and barley are somewhat better tolerated, but most patients respond better if they avoid all grains for several months. Potatoes are better tolerated as a substitute for grains. Sweet potatoes and yams are least reactive.
3. Other foods which are stressful to the immune system and will slow recovery include mushrooms, chocolate, cola (even diet cola drinks), chemical flavoring, coloring and sweeteners, and alcoholic beverages. An occasional patient must temporarily restrict all carbohydrates to as little as 50 grams per day before improvement begins. As improvement progresses, intake of unrefined, complex carbohydrate may then be increased to a more desirable level.
The most frequently eaten foods are those which are most likely to cause or aggravate symptoms. The immune system becomes sensitized by prolonged and repeated exposures. Symptoms may be triggered by either protein and carbohydrate foods. Fats are less likely to be bothersome. Sensitivity should be highly suspected to favorite foods, especially if they are craved and eaten frequently. Sensitivities to foods can best be diagnosed by testing for provoked symptoms after strict dietary elimination until symptoms improve.
In order to consistently relieve and then provoke food-related symptoms, elimination must be preceded by a few weeks of daily consumption. Sensitivity tends to fade with avoidance.
Sensitivity most often occurs to a number of different foods simultaneously, making diagnosis difficult. All of the reactive foods and environmental exposures must be avoided for long enough for symptoms to fade before provocative testing can be done.
Impaired immunity predisposes one to food and chemical sensitivity, and so-called food allergy might be best considered a symptom of CFIDS and not the primary problem. All potentially reactive foods should be avoided during the period of treatment with anti-fungal medicines. This will remove as much stress as possible from a disordered immune system. Continued intake of just one reactive food, which has not been eliminated, can mask reaction to another food, which is being added back. Only after most if not all symptoms have been relieved is it possible to test for food allergy. The so-called "Rare Food Diet," also known as the "Cave Man Diet," has clinically been most successful in relieving symptoms.
Various types of blood and skin tests are promoted for food allergies, but false-positive and false-negative results are common. The only reliable test for sensitivity to a specific food or chemical is consistent improvement following elimination and reoccurrence of symptoms following a challenge. Onset of symptoms after exposure to a food allergen may not occur until hours or even days later, and sometimes requires multiple exposures.
Food allergies tend to change as diet is changed. They are often not "fixed" allergies. The foods, which are eaten most, are most likely to cause symptoms. Sensitivity to those foods slowly fades after elimination. Allergic foods may again be tolerated after several months of avoidance while previously "safe" foods may begin to cause symptoms, as their frequency of consumption is increased.
Rotation of dietary foods, avoiding repeated consumption of botanically related foods more often than every fourth day, is sometimes helpful for severely allergic patients. After a course of anti-fungal therapy, especially the triple medicine therapy recommended in this paper, reactive foods are often better tolerated.
The small traces of bakers yeast or other types of yeast which occur in food are often well tolerated, while the foods themselves, such as dairy or grain products, may cause symptoms. It is a common misconception that yeast in foods are the problem.
Patients with any type of allergy may discover that they feel better and have fewer allergic symptoms if they continue to limit consumption of milk products, wheat and corn throughout life. If eaten infrequently, they often do not cause problems.
2. MEDICATION:
Yeast and fungi develop resistance to anti-fungal medicines, and a significant percentage of yeast and fungi in the body at any given time will be resistant to any one specific medicine. In clinical practice, it has been much more effective to combine several anti-fungal medicines simultaneously. Two and preferably three of the following medicines are given together for two months or longer. The following medicines require a physician's prescription:
A. Nystatin: Brand names include Nilstat, and Mycostatin (available in powder, tablet, suspension, suppository and capsule forms). Generic forms of nystatin are also available but they tend to be bitter and impure. Only the pure powder is free of chemical colorings, additives, and allergens.
The powder, taken directly into the mouth, is more effective, and eliminates yeast in the mouth which can seed the intestine. The usual dose of nystatin powder is 1/2 teaspoon four times daily (which is equivalent to 4 tablets containing 500,000 units each four times per day). This is twice the dose customarily prescribed by most physicians. Nystatin is not absorbed from the digestive tract in any significant amount and is an extremely safe medication, even at higher doses. This recommended dosage is what works best in practice.
Nothing should be taken by mouth for 20 to 30 minutes after taking the nystatin powder. This allows a coating to remain in the mouth and upper digestive tract long enough to eliminate yeast in those locations. Prolonged administration is usually necessary--several months (occasionally a year or more) before full benefit is achieved.
The "rare-food diet" is maintained throughout the period of anti-fungal therapy and for several weeks thereafter. Gradual improvement is usually observed during the second and third month of therapy--although sometimes sooner. This program requires patience. After improvement plateaus out, and symptoms are much improved, medicines are discontinued.
If symptoms return, anti-fungal medicines may again be prescribed and offending foods eliminated until improvement persists without medication. Rapid and persistent improvement has been experienced much more frequently when two or three anti-fungal medicines are given together. When improvement is maintained for at least a month without medication, a more normal diet may gradually be resumed, testing each added food for sensitivity as described above.
Eliminated foods are added back one at a time to test for continued sensitivity. Directions are contained in the book, DETECING YOUR HIDDEN ALLERGIES, by Dr. Crook.
If antibiotic therapy should become necessary for treatment of well-documented and serious bacterial infection, which would not otherwise resolve, it is advisable to subsequently resume the anti-yeast program for a month or more, but only after antibiotics are discontinued. Administration of anti-fungal medication simultaneously with antibiotics could theoretically promote the growth of resistant fungal organisms against which no therapy would be effective.
Broad-spectrum antibiotics such as ampicillin, tetracyclines, and the cephalosporins are more likely to cause yeast overgrowth. Treatment with topical antibiotics on the skin or the use of less potent antibiotics, such as penicillin-VK, sulfisoxazole, and nitrofurantoin, are not as likely to reactivate yeast overgrowth.
Nystatin powder should be stored in a refrigerator if kept for a prolonged period, although a few weeks at room temperature will not cause a problem. Nystatin slowly takes on a bitter taste at temperatures higher than 80 degrees Fahrenheit. Nystatin should not be exposed to high temperatures or left in a parked automobile on a hot, sunny day. Taste and bitterness normally vary somewhat from batch to batch. Nystatin is one of the least toxic of prescription drugs. It is safer to use than most non-prescription products. Nystatin merely coats the interior of the mouth, throat, esophagus, stomach and intestine, preventing yeast from multiplying.
Mild side effects may occasionally occur during anti-yeast therapy, including nausea and skin rashes. Most such symptoms are the result of yeast die-off and not from the nystatin itself. Some patients may experience a temporary increase in the symptoms of CFIDS, such as fatigue and depression during the first few weeks of treatment with anti-fungal medicines. This phenomenon has been attributed to a yeast "die-off" effect or Herxheimer's-like reaction and long-term benefits are not reduced. If the medicine is stopped too soon, yeast can easily recolonize.
Nystatin powder is preferred over tablets, capsules and suspensions because the pure powder contains no chemically derived coloring agents, binders, flowing agents, sugar or other potential allergens. The powder begins its work in the mouth and coats the upper digestive tract. Tablets and capsules do not dissolve until they reach the stomach or lower and are therefore less effective. Commercially available suspensions marketed for the treatment of thrush contain very little medication, which is suspended in a solution of sugar. The pure powder is much more effective.
Nystatin powder is best placed on the tongue dry by inverting a half-teaspoon measuring spoon in the mouth and tapping the spoon against the upper teeth, then allowing the powder to mix with saliva. Then rub it into the tongue and swish it around for several minutes in contact with the tissues in the mouth and throat, before swallowing. Doses as high as 1 or more teaspoons, 4 times daily, have been used safely.
Nystatin powder possesses two advantages over tablets and capsules. It is less expensive and, it is effective against yeast in the mouth, throat and esophagus where the tablets and capsules have no effect. Patients with symptoms of sore tongue, canker sores, indigestion and heart burn (hiatal hernia or esophagitis) improve more quickly following treatment with nystatin powder--providing evidence that yeast overgrowth is at least partly responsible for those symptoms.
If saliva is not adequate, a small sip of water or juice may be used to swish the powder into the mouth, making a paste to coat the gums and tissues. Small children may object to the taste unless a small amount of fruit juice or applesauce is used to mask the taste of medicine. The more concentrated the nystatin, the more effective it will be.
Female patients may improve more rapidly with the simultaneous use of small doses of an anti-yeast vaginal cream, one-half applicator or less once daily at bedtime, when symptoms of vaginitis are present. Some yeast are normally present on vaginal tissues and even small numbers may increase symptoms in a highly sensitized patient. Keeping yeast colonization to a minimum throughout the entire body for several months lowers stress on the immune system and allows gradual recovery.
Vaginal creams and suppositories all contain a chemical preservative, which is potentially allergenic. It is possible for the creams themselves to cause allergic symptoms which mimic yeast. If Sporanox or Diflucan is used together with nystatin, as described below, vaginal therapy is usually not necessary.
B. Sporanox (generic name itraconazole): Is taken by mouth in capsule form and is fully absorbed in the upper digestive tract. Because it is all absorbed, Sporanox is not as effective for reducing yeast inside the intestinal cavity, which has no blood circulation. The usual dose is one or two 100-mg capsules taken once daily with the largest meal of the day. Absorption is better with food in the stomach.
Sporanox is indicated in preference to Diflucan (described below) when skin or nails are affected by yeast or fungus. Sporanox is concentrated to a greater extent in skin and nails.
C. Diflucan (generic name fluconazole)is very similar to Sporanox. Diflucan seems to work somewhat better when vaginal yeast is a symptom. Concentrations of Diflucan in body fluids are somewhat higher than Sporanox but Diflucan is not concentrated as much in skin and nails. Otherwise, in practice there does not seem to be much difference between Diflucan and Sporanox. It probably does not make much difference which one of the two medicines is used.
Either Sporanox or Diflucan is used as one of the three anti-fungal medicines administered in combination. But Sporanox and Diflucan are never prescribed together.
D. Amphotericin-B is an anti-fungal drug which, like nystatin, is very safe and not absorbed systemically when taken by mouth. (An injectable form of amphotericin-B is quite toxic, however, and its use is restricted to treatment of life-threatening systemic fungal infections.)
The oral form of amphotericin-B is very safe and non-toxic. Amphotericin-B is a more potent anti-yeast medicine than nystatin. Oral forms of pure amphotericin-B are not presently available at pharmacies in the United States. It has been approved by the FDA for use by mouth and was marketed in the U.S for many years in combination with tetracycline. That product was named Mysteclin-F.
Amphotericin-B in pure form for oral administration can still be obtained at pharmacies in many other countries (often without a prescription). It is sold in France, on prescription only, under the brand name Fungizone, in 250 mg capsules. In Germany the prescription form is called Ampho-Moronal, as 100 mg tablets.
Patients recover more quickly and often remain well without further medication when amphotericin-B is combined with nystatin and Sporanox therapy. The French form of amphotericin-B is a powder inside 250 mg capsules. The capsules can be opened and emptied into the mouth four times daily, along with the nystatin, and mixed with the nystatin powder in the mouth.
Amphotericin-B can be obtained by mailing a prescription with payment to a pharmacy in France. The doctor can provide full instructions. Normally customs inspectors will allow a three-month supply of this medicine to come into the country by return mail for personal use.
E. "Triple therapy", the simultaneous daily administration of nystatin powder, amphotericin-B and either Sporanox or Diflucan, for at least two months, has led to lasting improvement in a large percentage of patients who had previously been resistant to therapy. Patients should continue all three medicines for two months and then continue with the dietary restrictions for another month, or for as long as progressive improvement continues to accrue.
INJECTION THERAPY
Skin testing with allergens and injection therapy with extracts containing reactive pollens, molds and dust is sometimes helpful, but allergies often resolve following this anti-yeast program alone, without the need for injections. Injections have not been found to be of use in food allergy. The use of triple anti-yeast therapy, and the complete program described in this paper, have eliminated the use of skin testing and injection therapy. The same is true of other type of neutralization therapy or sublingual therapy. If this treatment plan restores more normal immunity, the allergies are no longer a problem and other types of therapy become irrelevant.
Stresses to the immune system are additive. Once a threshold for tolerance is exceeded, adverse reactions tend to occur to many different substances. When the immune system becomes stronger, the threshold for tolerance increases and so-called allergies are less likely.
Think of the immune system as a tired pack horse, which has been forced to carry an excessive load for many miles. When it finally collapses it is greatly weakened. It will not be able to tolerate a normal load until the load is removed and it is nursed back to health. The same principle applies to the immune system. By eliminating yeast, fungus, potentially allergic foods, chemical exposures, perfumes, insecticide residues, etc., from the body, the load has been greatly reduced. After a period of rest, often requiring several months, immunity recovers to the point that a more normal diet and life-style can once more be enjoyed.
OTHER TREATMENT MEASURES:
Non-specific supportive measures include:
A. A healthy, active life-style, a nutritious diet with avoidance of refined and processed foods and avoidance of tobacco and excessive alcohol are important. A good attitude also speeds recovery.
B. Nutritional supplementation with a balance of high-potency, hypoallergenic, yeast-free multiple vitamin, mineral, trace-element, and anti-oxidant products, will insure optimal intakes of essential micronutrients and boost immunity. Many nutrients that are essential for immunity (such as B-complex, selenium, zinc, vitamin C, vitamin E, and many others) are marginal to deficient in the diets of many Americans. Also, DHEA 25-50 mg/day has been shown to help boost immunity.
C. Avoidance of petrochemicals, fumes, perfumes, hair-sprays, insecticides, exhausts, and other potentially reactive substances, which stress immunity, will speed recovery. Careful avoidance of insecticide fumes and residues, which are quite toxic, and avoidance of musty, moldy areas in the environment, both at home and at work, will also assist recovery.
DISCUSSION
CFIDS does not have a single cause such as Candida albicans or Epstein-Barr virus. Disordered immunity is the underlying common denominator, with many contributing causes, all adding together until a threshold is exceeded. All people normally have Candida albicans in their bodies. A positive skin test for allergy to Candida is a medical test for a competent immune system. Every person is sensitized.
Every person harbors a host of inactive viruses. Healthy immunity keeps them inactive. Only when immunity is impaired do Epstein-Barr and other viruses leave dormancy and multiply. Yeast and viruses are kept in their proper place without symptoms if immunity is adequate.
For those reasons cultures for yeast, blood tests for yeast antibodies, skin tests and viral studies have thus far not been very useful in the diagnosis or treatment of CFIDS. If symptoms are typical, a trial of therapy is the easiest and most cost-effective way to determine if benefit will result. The form of treatment described in this paper has helped hundreds of patients who previously did not benefit from other types of treatment.
The most common pitfall of this therapy is loss of patience, lack of persistence and stopping therapy before full improvement is realized. Initial benefits often take two to three months to begin. The so-called yeast "kill-off" effect and "withdrawal" from favorite and addictive foods may initially make symptoms worse. Patients become discouraged.
Patients who have been sick for a long time and who have failed to find benefit elsewhere are the ones who will be motivated to follow this program for the months required to achieve lasting benefit.
REFERENCES
1) Zwerling MH, Owens KN, Ruth NH: "Think yeast"--The expanding spectrum of Candidiasis. The Journal of the South Carolina Medical Association 1984, September; 454-456.
2) Crook WG: The coming revolution in medicine. Journal of the Tennessee Medical Association 1983; 76(3):145-149.
3) Crook WG: Yeast-connected immune system disorders: A commonly and usually unrecognized cause of chronic illness. Journal of Holistic Medicine 1984; 6(1):38-48.
4) Truss CO: Tissue injury induced by Candida albicans: Mental and neurological manifestations. The Journal of Orthomolecular Psychiatry 1978; 7(1):17-37.
5) Truss CO: Restoration of immunologic competence to Candida albicans. The Journal of Orthomolecular Psychiatry 1980; 9(4):287-301.
6) Truss CO: The role of Candida albicans in human illness. The Journal of Orthomolecular Psychiatry 1981; 10(4):228-238.
7) Crook WG: The Yeast Connection. 1986; Future Health, Inc., P.O. Box 846, Jackson TN 38302; 336pp.
8) Crook WG: Depression associated with Candida albicans infections. JAMA 1984; 551:2928-2929.
9) Ciegler, A (ed): Microbial Toxins, Vol VI, Fungal Toxins. Academic Press, New York, 1971.
10) Iwata K, Uchida K, Yamaguchi H, et al: Studies on the toxins produced by Candida albicans with special reference to their etiopathologic role, in Iwata K (ed): Yeast and Yeast-like Microorganisms in Medical Science. University of Tokyo Press, 1976, pp184-190.
11) Truss, CO: Metabolic abnormalities in patients with chronic candidiasis: The acetaldehyde hypothesis. The Journal of Orthomolecular Psychiatry 1984; 13(2):66-93.
12) Witkin SS: Defective immune responses in patients with recurrent Candidiasis. Infections in Medicine 1985 May/June:129-132.
13) Rosenberg EW, et al.: Crohn's disease and psoriasis, letter. New England Journal of Medicine 1983; 308(2):61.k
14) Crutcher N, et al.: Oral nystatin in the treatment of psoriasis, letter. The Archives of Dermatology 1984; 120: 435-436.
15) Crook, WG: Is remote disease connected with Candida infection a tomato? JAMA 1985; 2891-1892.
16) Goodwin JS, Goodwin JM: The tomato effect, rejection of highly efficacious therapies. JAMA 1984; 251(8):2387-2390.
17) Stollerman GH: The gold standard, editorial. Hospital Practice 1985 January 30:9.
18) Hamblin TJ, Hussain J, Akbar AN, et al.: Immunologic reasons for chronic ill health after infectious mononucleosis. {Br Med J} 1982; 287:85-88.
19) Du Bois RE, Selly JK, Brus I, et al.: Chronic mononucleosis syndrome. South Med J 1984; 77:1376-1382.
20) Straus SE, Tosato G, Armstrong G, et al.: Persistent illness and fatigue in adults with evidence of Epstein-Barr virus infection. Ann Intern Med 1985; 102:7-16.
21) Editorial. Enervating illness and Epstein-Barr virus. Lancet July 19, 1986; ii:141-142.
|
I promise you will get a personal answer your message -- click here to send me a personal message
|
SUBSCRIBE: The Wednesday Letter is a free electronic monthly newsletter written and published by Karl Loren. You can view more than 50 back issues of this publication by clicking here. The Wednesday Letter subscription list is maintained on a secure server, no name is ever given or sold to anyone, and it is never used except for this Newsletter. It is automatically published on the Tuesday night just before the first Wednesday of every month. You can subscribe to this free monthly electronic letter by entering your eMail address and name below. You will then automatically receive a request for confirmation, sent to whatever address you have entered. If you do NOT receive this confirmation request, then you will not be subscribed. There may have been an error with your address and you should resubmit. The letter is never sent twice to the same address -- so you do not have to worry about a duplicate subscription. When you receive this confirmation request you must reply to it, or your subscription will not become active. No one can subscribe your name, and address, without you being notified, and if you get an unwanted notice of subscription you only need to DO NOTHING and the subscription will NOT be active.
REMOVAL: You can remove yourself from the subscription list in several different ways. Click here to read about this entire newsletter system. Every edition of The Wednesday Letter is delivered to your address with YOUR name and address in view on the letter, with a link that allows you to remove THAT name from the subscription list. If you try to send this removal message from an address different from the one you used to send in your original confirmation, then you will get a warning notice first, sent to the subscription address, asking you to confirm that you want to be removed from the list -- by replying to THAT request for confirmation, you will then be automatically removed. Thus, no one else can unsubscribe you, from some other computer, without your knowledge. But, if you send in the unsubscribe notice from the same machine used to receive the Letter, then the removal from the subscription list is automatic.
Personal Message: When you send a personal message to Karl Loren, you will receive a personal reply as per his instructions. Karl pledges that every personal message will get a personal answer. When you provide your mail address, we will send you free information including our free catalog and a cassette tape lecture by Karl Loren about heart disease, no charge, by mail, even if outside the US. You can select particular information you would like to receive, along with the free cassette tape and catalog.
You can reach Vibrant Life in many ways, including by mail to Vibrant Life, 2808 N. Naomi St., Burbank, CA 91504. Within the US and Canada, use the toll free number: (800) 523-4521, the local number: (818) 558-1799, the FAX: (818) 558-7299, eMail to kimberly@oralchelation.com or any one of the hundreds of message forms throughout the 50 web sites. Vibrant Life normally ships the same day we get an order. There are message forms on each of the 100,000+ pages on this and other sites where you can communicate with Vibrant Life. Check out our companion site, at: http://www.oralchelation.net where Karl's 2000 page book is published. Karl Loren is the author and webmaster for this BOOK, as well as for another web site about ORAL CHELATION. His personal philosophical articles are at PHILOSOPHY.
Copyright © April 25, 2008 2:38 AM by Karl Loren on behalf of Vibrant Life, ALL RIGHTS RESERVED. Permission is granted for non-commercial downloading, copying, distribution or redistribution on two conditions: One, that some form of copyright notice is included in every copy distributed or copied, showing the copyright belonging to Vibrant Life, Burbank, CA, at www.oralchelation.com . The second condition is that the material is not to be used for any purpose contrary to the purposes and objectives of this site. This permission does not extend to materials on this site which are copyrighted by others.
|
I promise you will get a personal answer your message -- click here to send me a personal message
|
SUBSCRIBE: The Wednesday Letter is a free electronic monthly newsletter written and published by Karl Loren. You can view more than 50 back issues of this publication by clicking here. The Wednesday Letter subscription list is maintained on a secure server, no name is ever given or sold to anyone, and it is never used except for this Newsletter. It is automatically published on the Tuesday night just before the first Wednesday of every month. You can subscribe to this free monthly electronic letter by entering your eMail address and name below. You will then automatically receive a request for confirmation, sent to whatever address you have entered. If you do NOT receive this confirmation request, then you will not be subscribed. There may have been an error with your address and you should resubmit. The letter is never sent twice to the same address -- so you do not have to worry about a duplicate subscription. When you receive this confirmation request you must reply to it, or your subscription will not become active. No one can subscribe your name, and address, without you being notified, and if you get an unwanted notice of subscription you only need to DO NOTHING and the subscription will NOT be active.
REMOVAL: You can remove yourself from the subscription list in several different ways. Click here to read about this entire newsletter system. Every edition of The Wednesday Letter is delivered to your address with YOUR name and address in view on the letter, with a link that allows you to remove THAT name from the subscription list. If you try to send this removal message from an address different from the one you used to send in your original confirmation, then you will get a warning notice first, sent to the subscription address, asking you to confirm that you want to be removed from the list -- by replying to THAT request for confirmation, you will then be automatically removed. Thus, no one else can unsubscribe you, from some other computer, without your knowledge. But, if you send in the unsubscribe notice from the same machine used to receive the Letter, then the removal from the subscription list is automatic.
Personal Message: When you send a personal message to Karl Loren, you will receive a personal reply as per his instructions. Karl pledges that every personal message will get a personal answer. When you provide your mail address, we will send you free information including our free catalog and a cassette tape lecture by Karl Loren about heart disease, no charge, by mail, even if outside the US. You can select particular information you would like to receive, along with the free cassette tape and catalog.
You can reach Vibrant Life in many ways, including by mail to Vibrant Life, 2808 N. Naomi St., Burbank, CA 91504. Within the US and Canada, use the toll free number: (800) 523-4521, the local number: (818) 558-1799, the FAX: (818) 558-7299, eMail to kimberly@oralchelation.com or any one of the hundreds of message forms throughout the 50 web sites. Vibrant Life normally ships the same day we get an order. There are message forms on each of the 100,000+ pages on this and other sites where you can communicate with Vibrant Life. Check out our companion site, at: http://www.oralchelation.net where Karl's 2000 page book is published. Karl Loren is the author and webmaster for this BOOK, as well as for another web site about ORAL CHELATION. His personal philosophical articles are at PHILOSOPHY.
Copyright © April 25, 2008 2:38 AM by Karl Loren on behalf of Vibrant Life, ALL RIGHTS RESERVED. Permission is granted for non-commercial downloading, copying, distribution or redistribution on two conditions: One, that some form of copyright notice is included in every copy distributed or copied, showing the copyright belonging to Vibrant Life, Burbank, CA, at www.oralchelation.com . The second condition is that the material is not to be used for any purpose contrary to the purposes and objectives of this site. This permission does not extend to materials on this site which are copyrighted by others.
