The second facet of the treatment is to diminish the amount of yeast present. This is what Western medicine is so good at accomplishing. Nystatin powder is the most commonly used pharmaceutical for initial treatment of intestinal yeast. Nystatin itself is made from a culture of certain bacteria and it will actually kill yeast. It is not readily absorbed through the intestinal mucosa, so basically it just handles the gastrointestinal yeast. Since it is most often given as pure powder dissolved in water, it will also kill some of the yeast in the oral cavity when it is gargled. A solution can be used to wash the sinuses as well by dissolving nystatin in saline solution and using a dropper or inhaling the solution. For men with candidiasis and recurrent prostatitis or genital or skin symptoms of yeast, or for women with recurrent cystitis or other systemic symptoms, I may prescribe a stronger antifungal agent called ketoconizole, brand name Nizoral. This is effective for most yeast problems, but it can be irritating to the liver, so its use must be watched closely. For people who do not respond well to Nystatin or other natural remedies, Nizoral may be indicated. The usual dosage is one 200 mg. tablet daily for three to six weeks if it is well tolerated. A new Nizoral-related drug, fluconazole, or Diflucan, is now available and, though expensive, may be a slight improvement over Nizoral. Other "azole" drugs are available from many European countries and Canada. These include clotrimazole, miconazole, tinadazole, and econazole. They have similar systemic antifungal action (most are also mild amoebicides), are less expensive, and are also less toxic on the liver.

During yeast treatment, symptoms may arise secondary to killing the yeast. This occurs most with Nystatin, at times with the natural therapies, and only occasionally with the systemic medicines. The symptoms might include headache, fatigue, a mild flulike syndrome, or an exacerbation of already existing symptoms. It may be helpful during "die-off" periods to clear the colon every two or three days with a water enema or have a colonic irrigation every week or two for several treatments. Adding some Nystatin to the water to introduce it directly into the colon may help clear some more yeast.

Natural remedies that help to reduce yeast by killing it or by interfering with its growth include caprylic acid, fresh garlic and garlic extract, and the herb, pau d’arco, or taheebo. Caprylic acid is a natural fatty acid extracted from coconut oil. It interferes with the growing and duplicating process of the Candida albicans does not actually kill yeast, but it is effective in reducing intestinal yeast levels. It must be used for a fairly long period. I often prescribe the caprylates to follow a two to three month course of Nystatin and use a caprylic acid product such as Caprystatin or Capricin for a few months also. The length of treatment for yeast depends on the degree of the problem, the response to the treatment, and the results of tests.

Garlic has been shown to kill some yeast in sensitivity tests in the lab. It can be added to the treatment regimen and often helps. Two capsules several times daily is the usual dosage, though good garlic may have a blood-pressure-lowering effect at that amount, which may detrimentally affect some people. Goldenseal root also has some antifungal properties. Pau d’arco, a Brazilian tree bark, has become a very popular herb in the treatment of yeast, allergies, and other immune problems. It can be taken in capsules, or tea made from the bark can be drunk several times daily. It seems to tonify or strengthen the gastrointestinal tract and may help reduce yeast.

The third facet of the yeast treatment involves restoring the colon to its natural state, mainly by reimplanting lactobacillus bacteriae. Acidophilus primary products used. There are a couple of other bacteria that are also helpful in the gut and used in some formulae. Lactobacillus bifidus, a cousin to provide some colon support in the adult. Streptococcus faecium, a friendly form of strep bacteria, also adds a helpful function by replacing the once-present yeast.

A formula that contains all three of these bacteria is produced and marketed by Klaire Laboratories in Southern California. This high-quality, milk-free product called Vital-Plex can be taken as a supplement during the yeast treatment. Another product that has been well researched is DDS-1, produced by UAS Laboratories. It is available in powder, capsules, and tablets. Studies at the University of Nebraska and Michigan State University have shown acidophilus DDS-1 to have many positive effects, as described by Keith Sehnert, M.D., in "The Candidiasis Syndrome, Old Problem, New Mystery." This acidophilus in the colon can produce acidophilin, which has an antibiotic effect on a number of potentially pathogenic colon bacteria. It also has been shown to inhibit growth of Candida albicans yeast. This product, as do most effective acidophilus cultures, helps restore bacteria that produce many B vitamins, including B2, B3, B6, B12, folic acid, biotin, and pantothenic acid. DDS-1 has also been shown to produce enzymes that help in digestion of proteins and milk sugar (lactose), and through its effect on fat metabolism, it has a mild cholesterol-lowering potential. Other research has revealed that DDS-1 and other lactobacilli may have antiviral effects with some viruses (herpes is one example) and anticancer effects, especially in the colon. I have seen lactobacillus treatment reduce the severity and recurrence of cold sores, genital herpes outbreaks, and canker sores, which may be a result of its correcting chemical or acid-base imbalance. By replacing putrefying bacteria in the mouth, throat, and upper intestinal tract, it has been seen to resolve bad breath as well as many symptoms of gastrointestinal upset, helping people’s guts "feel more settled."

DDS-1 Lactobacillus acidophilus is discussed at such length here because it has been studied more extensively than others. However, there are other lactobacillus products that likely have similar effects, and these are being researched as well. Potency of the product is likely important. Many cultures now contain billions of live bacteria per dosage, rather than the few million that were once common. This should make them more effective, since the higher counts will allow a greater number of bacteria to actually reach the colon. Replacing the diminishing yeast with these physiologically active bacteria will help restore the colon’s normal functions. Yeasts in the colon use up nutrients, rather than making additional ones, and they ferment foods, often leading to gas, bloating, abdominal discomfort, and flatulence. Reimplanting the colon with friendly bacteria helps to reduce many of the intestinal and digestive symptoms of candidiasis.

There are a number of other supplements that can help in treating the yeast syndrome. Supplemental hydrochloric acid with meals followed by digestive enzymes after eating can often help us to better break down and utilize our protein, fats, and food in general to make available the amino acids, essential fatty acids, and mineral micronutrients we need for healing. And they help to relieve digestive symptoms and make it easier for us to obtain the energy from the food. Healing the intestinal wall is an important part of clearing the candidiasis symptoms and reducing food reactions. Flaxseed or evening primrose oil and certain herbs can help with this.

For nutrient supplementation, a general multiple is used as a base, with some additional antioxidants to help handle certain toxic by-products, avoid immune suppression, and improve immune function. Organic germanium may be used to aid in this immune support and to improve the gut mucosa. Vitamin A, beta-carotene, and vitamin C are useful in the regulation of the yeast and support of the immune function. Extra magnesium is also a part of the program. Less zinc is suggested than in other programs, at least initially, as it possibly stimulates the Candida growth. Extra B vitamins, including biotin, provide support by replacing some of those lost because of the diminished colon bacteria that produce them. Coenzyme Q10 has been shown to have positive effects in yeast treatment as well.

Some of the nutrient oils may be used in the treatment of the yeast problem. In addition to garlic oil and the caprylic acid formulas, essential fatty acids (EFA), fish oil (EPA), and evening primrose oil (EPO) may be helpful, along with vitamin E. A product I have used that incorporates all of these oils is Samolinic, made and distributed by the Key Company. I might suggest a product such as this or separate portions of some of these oils if there seem to be many inflammatory or allergic symptoms.

The type of herbal treatment suggested for the yeast condition depends mostly on the other, coexisting problems. If there are premenstrual symptoms, diuretic herbs or female tonifying herbs may help (see the Premenstrual Syndrome program later in this chapter). With intestinal symptoms or upset, soothing digestive herbs may be helpful. Peppermint or chamomile teas are beneficial; capsules containing slippery elm bark and comfrey root powder can help heal the intestinal lining. Goldenseal root powder in short courses (one or two weeks) strengthens the mucous membranes, but it also stimulates liver detoxification, which can cause an increase in symptoms. Pau d’arco is a tonic herb that is often used in yeast treatment. Thyme oil has also been claimed to reduce yeast growth, but I have no experience with that.

Evaluating and treating the yeast syndrome is a real challenge for both doctors and patients. It takes patience and can often require a very long therapy as the body uses its very sensitive biofeedback process to let us know what is working. Often, Nystatin or other antifungal products must be taken for years, but usually will produce, within a few months, a marked change in the symptoms and a reduction in colon yeast colonization and blood antibodies to the yeast. Many people experience a profound and positive change in their health with proper diagnosis and treatment of this condition. However, we must also be careful not to overtreat and turn this medical concern into nothing more than the latest "fad" of the 1980s, as the medical profession would like. Yeast awareness is here to stay, and doctors and patients must be even more careful in their use of antibiotics, birth control pills, and the immunesuppressive corticosteroids.