Flashback Friday: Is Candida Syndrome Real?

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Despite its “extensive…use in the brewing and baking industry,” only about 5%—1 in 20—healthy people have anti-yeast antibodies in their bloodstream, whereas in people with Crohn’s disease, that number is more like 60 or 70%. Most people with Crohn’s have antibodies that react to regular baker’s, brewer’s, or nutritional yeast—which are all just different forms of a yeast known as Saccharomyces cerevisiae.

But that baker’s/brewer’s/nutritional yeast had never been directly implicated in Crohn’s. Maybe the antibodies are a direct reaction to it—or, maybe a reaction to another yeast altogether, and the antibodies are just mistakenly cross-reacting with regular yeast. And, indeed, five years later, it was discovered that antibodies against Candida, a totally different kind of yeast, the yeast that causes thrush and vaginal yeast infections, can cross-react with Saccharomyces. So, maybe baker’s/brewer’s/nutritional yeast was just an innocent bystander all along?

For nearly 30 years, we’ve known that antibodies to Saccharomyces are linked to Crohn’s disease. But, instead of bread, beer, and nooch leading to Crohn’s disease, maybe Candida is causing the Crohn’s disease and the antibodies. Or, hey, maybe Candida is the innocent bystander, and exposure to food and beverage yeast is the real culprit. You don’t know until you put it to the test.

Take Crohn’s patients, remove yeast from their diet, and see if they get better. If they do, then indeed, it was the culprit. But if they don’t, then maybe it was something like this, where Candida is the real cause.

Before I get to the study, let me just first bust some Candida myths. Candida is a normal constituent of our gut flora. Get some Candida in your bloodstream though, and it can cause a life-threatening infection. But it’s normal to have some Candida hanging around in your mouth or colon. It’s location, location, location. Just like having stool bacteria in our colon is normal, but stool bacteria in our blood or a wound would be bad.

Because of the ability of Candida to cause problems in the wrong location, or in people who are immunocompromised, a Candida syndrome theory arose, linking the presence of Candida to all sorts of health problems, which led to “mycophobia”—fungalphobia—this “false interpretation” that the finding of Candida in your mouth or stool is evidence of some kind of infection, rather than just being totally normal. And, if you think the authors are being a little overdramatic with their phobia talk, just google Candida, and you’ll see.

Not only is it normal to have Candida in your gut; you apparently couldn’t get rid of it even if you wanted to. Give people powerful antifungal drugs, and you can drop levels down, but they pop right back up again as soon as you stop them. And, this whole concept of sugar feeds yeast; so, going on a low-sugar diet doesn’t make much sense—since, unless you’re lactose-intolerant or something, sugars should get absorbed high up in the small intestine, and never make it down into the colon. And indeed, there appears to be “no correlation” between Candida counts and sugar consumption. You can put people on a high-sugar diet by adding an additional 14 spoonfuls of sugar to people’s diets, and still not see an effect. Of course, there’s lots of reasons to cut sugar from your diet based on science, but Candida does not appear to be one of them.

There does not appear to be good evidence that the so-called “Candida-syndrome” exists at all. But, oh, those are fighting words. “Few illnesses have sparked as much hostility between the medical community and…[the believing] lay public.” The medical community has dismissed purported sufferers as emotionally disturbed, or just plain crazy. Of course, you can’t just come out and call them crazy. “Psychiatric diagnoses need to be presented gently.” For example: “Some patients prefer to” believe their mental illness is caused by the Candida, in which case, doctors may just pat them on the head, so they’ll take their pills. Patients who self-diagnose with Candida apparently “only infrequently relinquish their illness,” some to the extent that they attempt to use their yeast “as a drunk-driving defence.” I wasn’t drinking, your honor; my yeast was just self-brewing beer in my guts.

The whole concept of Candida syndrome is officially derided by the American Academy of Allergy and Immunology as “speculative and unproven,” offering “no…proof…no…proof…no proof…no proof.” The “[presumption] that the ubiquitous [Candida] has [some] toxic effect on [our] system [is] without a trace of…scientific proof.” You want no proof, someone wrote in response, how about the millions of unnecessary tonsillectomy surgeries doctors did? Don’t get me started on the radical mastectomies. At least putting people on low-sugar diets isn’t disfiguring people. Though some anti-Candida therapies can be “potentially dangerous.” Antifungal drugs might breed resistance, and can have side effects. Nystatin’s not so bad, but ketoconazole can damage your liver. And indeed, there are reports of people being treated for what may be a fake diagnosis ending up in quite dire straits because of it. So, it’s important to know if the syndrome actually exists. So, researchers decided to put it to the test.

Super simple study. Give some people some “stool-tubes” to take samples, ask them a bunch of questions about the symptoms they have—headaches, stomachaches, tiredness—all the typical Candida syndrome symptoms. And, they found no relationship to whether or not they had Candida growing in their gut. So, no “[h]ints of…Candida-syndrome could…be found.”

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Image credit: Tess Watson via Flickr. Image has been modified.

Motion graphics by Avocado Video.