Candidiasis and Fungal Infections Naturopathic Protocol

Candidiasis and Fungal Infections Naturopathic Protocol

This Candidiasis and Fungal Infections Naturopathic Protocol is provided as information for patients of HealthMasters Naturopath Kevin Tresize ND as part of a treatment plan to assist patients with understanding of their treatment plan and should not be substituted for medical advise, diagnosis or treatment. It is important to note that this is a summary only and is intended to assist discussion between practitioner and patient as part of consultations. This Candidiasis and Fungal Infections Naturopathic Protocol may be changed to suit the individual requirements of the patient and should not be substituted for medical advice, diagnosis or treatment.

HealthMasters Naturopath Kevin Tresize ND

 

Definition: Candidiasis and Fungal Infections

Candidiasis is a general term for yeast and fungal infections, most commonly caused by several species of Candida, the most predominant being Candida albicans. Candida is a common commensal (non-pathogenic) organism in human microflora that can affect areas such as the (such as in the gut, genitals, skin, throat and mouth), however, opportunistic overgrowth is associated with a switch to pathogenesis, where it may trigger inflammation, immune suppression and localised tissue irritation and damage, including increased intestinal permeability and skin/mucosal irritation in affected areas.

Candida spp can be difficult to treat, as it forms a biofilm, allowing immune evasion. Also, fungal cell walls contain mannose glycoprotein, which is immunosuppressive, allowing it to locally adapt to the conditions of the host, playing a role in fungal persistence. Also, prolonged treatment with anti-fungal medications, can cause Candida spp to adapt and make it resistant to treatment.

Yeast/fungi infections may be difficult to identify and are often considered in differential diagnosis, yet are clinically significant. Human fungal diseases can occur due to direct infection or as a reaction to fungal toxins. Chronic latent, low-grade yeast/fungal infection is associated with loss of microbial biodiversity (such as with antibiotic use) or opportunistic overgrowth of organisms that stimulates overt and/or low-grade inflammation, immune suppression and/or loss of normal immune tolerance.

 

Aetiology (Cause) / Risk factors: Candidiasis and Fungal Infections

Candidiasis is a common infection, and risk and severity varies with different presentations. For instance, approximately 75% of women will contract candidiasis of the vagina during their lifetime, and 90% of people diagnosed with HIV/AIDS will develop a Candida infection. Severity ranges from mild, even asymptomatic, through to extremely severe in immune-compromised patients.

General risks to all types of candidiasis:

  • Diet (high sugar, high carbohydrate refined food diet) and lifestyle (alcohol, smoking etc.).
  • Obesity.
  • Immune-suppressed disease states (diabetes, HIV, Cushing’s disease etc.)
  • Medications (antibiotics, asthma inhalers, steroid medications, chemotherapy).

Plus specific risks:

  • Oral and digestive tract thrush: Age (infants and elderly more susceptible).
  • Skin (cutaneous) lesions: Increased risk with existing skin lesions, such as Dermatitis (e.g., contact or primary irritant, seborrheic, atopic) and psoriasis.
  • Genital candidiasis:  may be sexually transmitted, or passed between susceptible sexual partners.
  • Invasive yeast infection (systemic):  Increased risk if in hospital's intensive care unit (ICU), have had recent surgery, have a central line (catheter), have a weakened immune system.

 

Signs and Symptoms: Candidiasis and Fungal Infections

The primary subtypes are:

  • Fever, malaise
  • Oral candidiasis: Creamy white patches overlying erythematous buccal mucosa (thrush). Painful, macerated fissures at the corners of the mouth (perlèche)
  • Erythematous skin lesion (cutaneous disease): most commonly in the groin (jock itch), between fingers and toes, under the female breast, and in the axilla, also diaper (nappy) rash.
  • Genito-urinary candidiasis:
Vulvovaginal candidiasis (VVC) - Erythematous vagina and labia; a thick, curd-like discharge; and a normal cervix upon speculum examination
Candida balanitis - Penile pruritus and whitish patches on the penis
Candida cystitis - Many patients are asymptomatic, but bladder invasion may result in frequency, urgency, dysuria, hematuria, and suprapubic pain
Asymptomatic candiduria - Most catheterized patients with persistent candiduria are asymptomatic
Ascending pyelonephritis - Flank pain, abdominal cramps, nausea, vomiting, fever, chills and hematuria
Invasive yeast infection (in severely immune compromised patients): Large abscesses and diffuse micro-abscesses (disseminated candidiasis), Erosive lesions of the distal oesophagus and stomach (gastrointestinal candidiasis), Urinary tract infection (urinary tract candidiasis)

 

Core Treatment: Candidiasis and Fungal Infections

Gut Pathogen Elimination Diet for microbial elimination and gut restoration – (refer to detoxification protocol)

Weeks 1 & 2 Reduce yeast overgrowth by modulating the gut microbiome and manage growth of yeast systemically, including Candida albicans.

Small Intestinal Bacterial Control - 2 capsules twice daily with food
OR
Antimicrobial Herbs for the Management of Dysbiosis - 1 tablet three times daily with food
PLUS
PLUS

Weeks 3-4 - detoxification support, protection and further maintenance of the digestive tract

Milk Thistle, Green Tea & Amino Acids for Optimal Detox - 1 scoop in 200mL water twice daily
PLUS
Detox Greens - 2 scoops in 200mL water twice daily 
PLUS
PLUS

 

Additional Considerations: Candidiasis and Fungal Infections

If associated with genito-urinary tract infections and cystitis

Chinese Herbal Support for Urinary Disturbances - Acute: 5 tablets 5 times daily, reducing gradually to 2 tablets three times daily as symptoms disappear
If with persistent infection or associated with poor immunity and recurrent infections
Cordyceps, Coriolus and Reishi for Immune Stimulation - Acute: 1 serve three times daily
Zinc with Vitamin C Powder - Acute: 1 serve three times daily
If associated with pain, irritation and swelling
High Potency Anti-inflammatory Herbs - Acute: 1 serve three times daily (up to 6 tablets per day)
High Purity, Low Reflux, Concentrated Fish Oil Liquid OR Capsules - 5 mL (1 serve) daily OR 2 capsules twice daily
If skin or nail infections:
See ‘diet, lifestyle and specific natural treatments’ -  See below 

 

Alphabetical Reference of Nutritional Support: Candidiasis and Fungal Infections

Formula Catch Phrase

Key Benefits

Antimicrobial Herbs for the Management of Dysbiosis

A potent herbal blend for the reduction and elimination of gut dysbiosis, utilising herbs such as pomegranate, myrrh and wormwood to ensure antimicrobial potency. This formula targets detrimental bacteria, yeast, fungi, worms and parasites, to be used for all states of generalised dysbiosis.

Chinese Herbal Support for Urinary Disturbances Chinese herbs for the treatment of urogential disturbances such as acute and chronic urinary tract infections in men and women. Reduces swelling, pain and inflammation, with antimicrobial activity.
Cordyceps, Coriolus and Reishi for Immune Stimulation These four clinically proven medicinal mushroom extracts each have demonstrated potency to enhance immunity. Supports the resolution of chronic, latent and/or recurrent infectious conditions.
Dandelion, Ginger and Meadowsweet for Healthy Digestion Digestive herbal formula to stimulate gastric, pancreatic and hepatic digestive secretions via bitter and pungent activity to normalise gut motility, correct appetite, optimise assimilation of nutrients and enhance elimination of wastes.
Detox Greens An herbal and nutritionally based powder to support gastrointestinal mucosal integrity, detoxification of heavy metals, alkalinity, healthy probiotic balance and enhancing kidney detoxification.
Glutamine & Boswellia (BosPure®) Boswellia) for Intestinal Integrity Glutamine, Boswellia and nutrients blend to manage the impact of dysbiosis biofilm on inflamed intestinal mucosa with prebiotic, antimicrobial and anti-inflammatory activity to manage the effects of candida overgrowth.
High Potency Anti-inflammatory Herbs Powerful anti-inflammatory herbs and nutrients, including BCM-95™ turmeric, BosPure® Boswellia, willow bark, ginger and quercetin are designed to rapidly reduce acute inflammation.
High Purity, Low Reflux, Concentrated Fish Oil Liquid OR Capsules Fish oils are consistently shown to benefit most chronic illnesses as they reduce inflammation. They specifically support cardiovascular health by maintaining healthy lipid profiles and blood pressure; and brain health by supporting neural function and reducing the impact of stress.
High Strength, Researched Probiotic Strains These scientifically validated strains including Lactobacillus acidophillus (NCFM®) and Bifidobacterium lactis (Bi-07) are formulated to maintain healthy flora and support digestive and immune health.
Milk Thistle, Green Tea & Amino Acids for Optimal Detox This formula is the central component for all detoxification programs. In a low carbohydrate rice protein base blended with milk thistle, gardenia and green tea it supports liver & gallbladder function and induces antioxidant and detoxification pathways. Also zinc and taurine enhances digestion and gut repair, amino acids support phase II detoxification and antioxidant status and prebiotics encourage a healthy gut microbial and digestive environment.
Small Intestinal Bacterial Control A combination of phellodendron with potent essential oils to target overgrowth of flora and biofilm persistence in the small intestines, associated with IBS, IBD, fatigue and systemic inflammation.
Strain Specific Probiotics for Gut Microbiota Restoration and Support Highly researched probiotic strains, Lactobacillus rhamnosus (LGG®), Saccharomyces cerevisiae (boulardii), Bifidobacterium animalis ssp lactis (BB-12®) have demonstrated the ability to disrupt pathogenic bacteria, protect commensal groups and encourage restoration in the event of disruption, enhance gastrointestinal mucosal integrity, and have a beneficial impact on gastrointestinal function.
Zinc with Vitamin C Powder Zinc and vitamin C are amongst the most critical nutrients in healthy immunity, as both are involved in wound healing, immune balance and boost resistance to infection.

 

Supportive Lifestyle Programs: Candidiasis and Fungal Infections

Supportive Lifestyle Program Description
Wellness and Healthy Ageing Program This program recommends a low glycaemic load diet with lifestyle recommendations for exercise, relaxation, intellectual stimulation and effective stress management – all factors associated with creating a low antigenic and anti-inflammatory environment – a healthy terrain for efficient immunity.
Gut Pathogen Elimination Program A four week program specially created for those who experience ongoing or extensive digestive symptoms, or who have been identified with an imbalance in their gut flora, which can negatively impact health and wellbeing. This program helps to restore healthy gastrointestinal function and rebuild a healthy intestinal microbial balance. 
Shake It Practitioner Weight Management Program There is growing evidence that obesity is a disorder of energy homeostasis, and that the metabolic set-point for overweight individuals is set to a higher level. The Shake It Practitioner Weight Management Program is a novel 3 phase program structure designed to prevent metabolic adaptation, reset the patient’s metabolic set point, and provide regular psychological breaks from active dieting to achieve sustained weight loss. The program provides supportive materials in order to implement behavioural change techniques and two diet options: Ketogenic (low carbohydrate, high fat), or Low fat (low fat, liberal carbohydrate).

 

Diet, Lifestyle and Specific Natural Treatments: Candidiasis and Fungal Infections

Diet

  • Enjoy a whole food diet based on fresh vegetables and fruit.
  • Sugar, sweets, soft drinks, fruit juices should be avoided as sugar encourages dysbiosis.
  • High carbohydrate foods such as grains, fruit, and starchy vegetables should be consumed sparingly or avoided initially.
  • Some people with Candida infections develop an intolerance to yeasts, and find avoiding yeasts and fermented foods helpful.  These include:
Bread, vinegar, pickles, alcohol, vegemite, mushrooms, cheese, processed meats (salami etc), peanuts and peanut butter and left overs.
Unsweetened natural yoghurt with live lactobacillus can be beneficial.
Foods should be cooked and easy to digest to minimise fermentable material in the gut.
Protein should be consumed at each meal.

 

Lifestyle

  • Patients should rest during infection as much as possible to support immune function
  • Avoid or minimise stress as much as possible, as this reduces immune activity.
  • Avoid synthetic clothing and underwear as this may increase likelihood of vaginal thrush developing.
  • If sexually active, treating both partners may be beneficial to avoid reinfection.
  • When taking antibiotics, supplement with Lactobacillus acidophilus; avoid broad-spectrum antibiotics unless necessary; practice good hygiene, including oral hygiene and thorough cleansing of genital areas; maintain appropriate weight; wear cotton or silk underwear; women should avoid douches (unless medically indicated), vaginal deodorants, and bubble baths; diabetics should adhere to treatments; wear rubber gloves if occupation requires keeping hands in water; keep skin dry.

Topical Treatments

  • Topical treatments include tea tree oil (Melaleuca alternifolia) or lavender essential oil (Lavandula species) 2-3 times daily. Apply full strength to skin infections, dilute for vaginal application and do not take internally. Discontinue if skin irritation develops.
  • Marigold (Calendula officinalis) Apply three to five times daily in a salve for rashes to soothe skin and mucous membranes.

 

In-Clinic Point-of-Care Pathology Tests: Candidiasis and Fungal Infections

Test Description
Spot antibody testing Tests antibodies for up to four different species of Candida – see appropriate manufacturer instructions.
Pathology Tests Depending on site of infection:
Mucocutaneous candidiasis For a wet mount, scrapings or smears obtained from skin, nails, or oral or vaginal mucosa are examined under the microscope; a potassium hydroxide smear, Gram stain, or methylene blue is useful for direct demonstration of fungal cells.
Cutaneous candidiasis Using a wet mount, scrapings or smears obtained from skin or nails can be examined under the microscope; potassium hydroxide smears are also useful.
Genitourinary candidiasis A urinalysis should be performed; evidence of white blood cells (WBCs), red blood cells (RBCs), protein, and yeast cells is common; urine fungal cultures are useful.
Gastrointestinal candidiasis Endoscopy with or without biopsy
Omega-3 Index Test A validated test that measures red-blood cell (RBC) EPA and DHA status to personalise supplemental and diet prescriptions, as well as identifying those at risk of health conditions associated with omega-3 deficiency. An Omega-3 Index in the desirable range of 8%-12% is an indicator of better overall health.

 

Pharmaceutical Treatments: Candidiasis and Fungal Infections

  • Topical Antifungals: over-the-counter antifungal powders, lotions, creams, sprays or shampoos are often the first line of pharmaceutical treatment.  For example, those that contain miconazole, clotrimazole, or similar ingredients.

  • Oral Antifungals: medications such as Sporanox (itraconazole) or Lamisil (terbinafine) may be taken for more severe fungal infections.  While these medicines may clear severe fungal infections, they can cause numerous side effects.

Specific medical treatments:

  • Imidazole antifungals—e.g., ketoconazole (Nizoral), miconazole (Daktarin), and clotrimazole (Canesten) are effective against several subtypes of candidiasis. Forms of administration include topical creams and shampoos, vaginal creams and pessaries. Some Candida species are developing resistance to imidazoles.
  • Triazole antifungals, such as itraconazole (Sporanox) and fluconazole (Diflucan,) are administered orally. Fluconazole is also administered IV.
  • Allylamine antifungals include terbinafine (Lamisil, also oral).
  • Polyene agents: nystatin (Nilstat), and amphotericin B (lozenge and IV forms)
  • Oral and IV agents are used for more severe or recalcitrant cases or where invasive fungal disease is present, such as systemic infection or oesophagitis. A variety of side effects may occur and there are known interactions with a variety of medications including antineoplastics, antihistamines, antiprotease inhibitors and antibiotics.
  • Creams are sometimes combined with low-strength corticosteroid for anti-inflammatory and antipruritic action.
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