The latest ways to diagnose and treat an increasingly common disease, which the medical profession still refuses to recognize.
I used to suffer from what the medical profession regards as a phantom illness, but which may end up being this century's most pervasive disease.After a prolonged period of stress and a patch of extraordinarily bad luck I'd developed a host of female problems everything from ferocious premenstrual tension and irregular periods to cystitis and almost constant vaginal infections.
As time wore on, my symptoms multiplied: eczema, hives and allergies to a load of food and chemicals; diarrhoea and an irritable bowel; insomnia and night sweats; and severe depression. I had felt powerless for so long that my body seemed to be reacting in parallel, caving in under any sort of microbial onslaught.
For nearly all of those three years I made the rounds of medical circles first the standard ones, then the periphery, with nutritionists and homoeopaths, and finally the very outer rim, from breathing specialists to bioenergeticists. By the autumn of 1986, I was hacking my way through the dense thicket of New Age therapies. I tried breathing from the abdomen. I had the negative emotions pummelled out of me via 'rolfing'. Somebody tried to diagnose me by subjecting my hair sample to radio waves. I ploughed through autogenic training, colon cleansing and even psychotherapy a mixture of Wilhelm Reich and what felt like being tickled on the face. I learned something about my relationship with my mother. But I did not, at any point, get better.
By the summer of 1987, a sense of hopelessness descended over me. The worst part of being chronically unwell without a diagnosis is that a lot of people don't believe you, or view your symptoms as imaginary, a puerile sort of attention getter. And in this land of stoics, if your illness isn't hard core, like cancer or leprosy, you are supposed to learn to live with it, to dysfunction quietly, without complaint.
In the end, I stumbled upon the diagnosis myself. As a last ditch effort, I began reading up on allergies and female problems, and one day came upon a newly discovered illness whose symptoms matched almost every one of mine. When my old doctor sneered at the possibility, I searched out a renown GP specializing in allergies and nutritional medicine, whose battery of tests and diagnostic sensitivity confirmed my own suspicions and rooted out other contributory problems.
What I had inside me was, essentially, thrush of the body, or "polysystemic chronic candidiasis". Candida albicans is a yeast that lives in the upper bowel of most of us without doing good or harm, kept in line by our immune systems and the friendly bacteria that coexist with it. But according to Dr. Orion Truss, the American internist and allergy specialist who first discovered this syndrome nine years ago, when the immune system is weakened and the good guy bacteria falls down in numbers, these yeast can start multiplying out of control, sending out toxins that eventually interfere with a range of bodily functions.
It can make the lining of your stomach and intestines "leak" larger protein molecules from undigested food into your blood stream, causing a host of food or chemical allergies. Or even create biochemical disguises, "imitating" your hormones the cause of my PMT and bouts of depression.
Truss among others links chronic candidiasis, more common in women than men, with recurrent vaginal thrush, arthritis, autism, asthma, psoriasis and even infertility. Dr. William Crook, an American expert in allergy and environmental disease, blames candida for hyperactivity in children. "It so severely debilitates the body that victims could become easy prey for far more serious diseases such as. . .multiple sclerosis," writes Dr John Trowbridge, an American GP specializing in candidiasis, in The Yeast Syndrome.
The root of the problem, says Trowbridge, is an immune system that isn't functioning at full throttle. Prolonged severe stress tends to have a depressant effect on the immune system, according to Dr Stephen Davies, chairman of the British Society for Nutritional Medicine and a specialist in what he terms "environmentally induced" disease. Another major culprit, he says, is the overprescribing of antibiotics, which wipes out all the good guy bacteria in the gut keeping the yeast in check. Drugs, environmental chemicals, our damp climate, nutritional deficiencies, refined carbohydrates and sugar, which yeasts thrive on, all play their part. Allergy and candida specialist Dr. John Mansfield says that one of the main culprits is the contraceptive pill, known to depress the immune system. Trowbridge postulates that one third of the population of all Western industrial countries have candida in some form. "We are," Davies sums up, "the first antibiotic generation."
Despite the existence of what Davies claims is a wealth of "clearcut clinical trials", Truss's theories have been met by scepticism among more conservative practitioners. Harley Street gastroenterologist Dr. David Silk, for instance, considers it "a myth being perpetrated by charlatans".
The problem, as the New England Journal of Medicine rightly pointed out last December, is that the syndrome "has lacked an unambiguous definition. The symptoms attributed to the chronic candidiasis syndrome overlap those of other syndromes, including depression and the chronic fatigue syndrome."
Many readers of WDDTY have had to endure the ridicule or patronizing dismissal of the medical profession. "I discussed with my GP the possibility that my ill health might be caused by thrush," wrote one woman with symptoms similar to mine. "He actually laughed at my theories and informed me that I was merely clinically depressed as a result of emotional stress. I have had a course of anti depressants and am not much better, plus I now feel I have been labelled a neurotic hypochondriac."
If that's the case, thank God for placebos. My treatment consisted of taking large doses of a well tolerated drug called nystatin, plus a batch of supplements and a very restrictive healing diet of fresh unrefined food designed to 'starve" future yeast colonies and build back up my impaired immune system, a process that in my case took a year and in many others can take up to two. There are many alternative ways to treat candida with or without drugs (see box). About a month after I'd started, my dry cleaner asked me if I'd had a face lift.
Another reader wrote in with an even more dramatic story: "In November last I had been off work for two months and I could not walk up a flight of stairs unassisted. This morning I went for a four mile run before breakfasting and setting off for work."
The reason doctors don't believe us is that they claim there aren't enough scientific studies published in the medical literature to prove that candida overgrows in the bowel and spreads throughout the body. Furthermore, there have been no long established tests to definitively diagnose a patient; candida is usually isolated by the patient's clinical history long term use of antibiotics or the Pill and symptoms like persistent vaginitis or digestive problems.
This universal scepticism was fuelled by a study published in The New England Journal of Medicine of 42 women who supposedly met the criteria for candidiasis and who had a history of vaginal candida infection.
The conclusion: nystatin did not reduce symptoms over 32 weeks any better than a placebo.
Nevertheless, the study was widely criticized largely because it only isolated one component of treatment the drug and did not take such vital factors as diet into account. The entry criteria for who was considered a proper candida patient was also muddy.
As the May issue of the Townsend letter for Doctors pointed out, not all 42 subjects had all 15 systemic symptoms at the start. "For enrollment, women were required to have only three of five clinical features thought to be especially common in candidiasis hypersensitivity syndrome," wrote Marjorie Crandall, founder of Yeast Consulting Services in California, who systematically attacked the study for a range of oversights. Subjects were only selected on anecdotal evidence, not after being tested; the number of subjects was too small to test the large number of treatment regiments used; few patients out of the batch experienced any one symptom, making it impossible to establish statistical significance. Self help remedies were not monitored; women given antibiotics or becoming pregnant two predisposing factors to yeast infections were not dropped from the study.
Despite numerous studies carried out privately by various physicians and researchers, to date, there has never been the kind of large scale double blind study that would entitle candida to enter the medical textbooks, says Dr William Crook, author of The Yeast Connection.
Part of the trouble is that most medical studies are conducted in America by drug companies or funded by the US government. But nystatin, the staple of candida control, is 40 years old and no longer patented. "Anybody can make it, so there's no money in it," says Crook.
In the meantime, many others will continue to suffer until the medical profession begins to take candida seriously, starting with all those supposedly insignificant chronic ailments like thrush women are always complaining about.
Doctors need to examine how their attitudes toward patients with immune system disorders will affect their eventual recovery. The latest research shows that a sense of hopelessness is one of the attitudes that most contributes to the advancement of immune compromised disease, says Dr Davies. "Once a patient is in a state of chronic candidiasis, the medical professionals who tend to pooh pooh that disease can actually have a negative healing effect." Getting somebody to take you seriously could literally be half the battle.