Candida-Yeast
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Yeast are a type of fungi and Candida is a type of yeast.  There are many strains of candida which can cause problems for humans, but C. albicans is by far the most common.  While there was a movement a number of years ago to attribute many systemic symptoms to yeast infections, evidence for this is slim.  Still, candida causes plenty of problems, many of which can probably be avoided or even treated with yogurt.  Sometimes, antifungal antibiotic agents are needed.  These can be purchased over the counter at any pharmacy.  Boric acid, vitamin C, and hydrogen perioxide are other effective remedies covered below.

Avoiding bread, oral sex, and the use of saliva in sex or masturbation reduces yeast infections of the vagina.  Minimizing the use of systemic antibiotics helps reduce yeast infections.

Antibiotic Diarrhea: Not Clearly Caused by Candida in Adults: In a German study of 395 adults, one quarter on antibiotics and with diarrhea, one quarter on antibiotics and without diarrhea, one quarter not on antibiotics but with diarrhea, and one quarter healthy controls found the lowest levels of candida in the healthy controls.  However no difference were found for the other groups except that the diarrhea group without antibiotics had less candida overgrowth. J Infect Dis. 2001 Oct 15;184(8):1065-9  

Boric Acid Capsules Better than Nystatin for Vaginitis: Boric acid 600 mg once a day in an intravaginal capsule in a DB study did better than nystatin 100,000 with 92% vs. 64% cure rate at 7-10 days. Patients found it better than "messy" vaginal creams, and self-made capsules containing boric acid powder are inexpensive (31 cents for fourteen). No side-effects or significant absorption of boron. Treatment of vulvovaginal candidiasis with boric acid powder. Van Slyke KK, Michel VP, Rein MF. Am J Obstet Gynecol. 1981 Sep 15;141(2):145-8. These capsules can also be inexpensively purchased.

Boric Acid Helps Refractory: In an uncontrolled, retrospective study of 141 women with positive vaginal cultures for the more difficult C. glabrata who hadn't improved with azole therapy were given topical boric acid, 600 mg daily for two to three weeks in capsules, led to clinical success and negative cultures in 68%. Three weeks of therapy was not significantly better than two weeks. In 27 (90%) of 30 women who were refractory to boric acid and azole therapy, intravaginal flucytosine cream used nightly for two weeks eradicated C. glabrata infection. Neither regimen was typically associated with adverse local effects. Jack D. Sobel, Wayne State University, Am J Obstet Gynecol. 2003;189:1297-1300. Ed: Boric acid is extremely cheap. It is a very safe powder used to kill cockroaches. It is put into a capsule and then placed intravaginally.  Flucytosine is quite expensive. 

Dental Cavities Linked to Candida: Higher levels of C. albicans were found in saliva, plaque, dental cavities and stools of 56 patients with severe caries as compared to 52 healthy controls. The highest prevalence was found in carious specimens and a strong correlation was observed between its presence in saliva, dental plaque, carious specimen and feces, usually with the same strains of candida. Carious teeth may be an ecologic niche for C. albicans potentially responsible for recurrent oral and non-oral candidiasis. Clonal identity of Candida albicans in the oral cavity and the gastrointestinal tract of pre-school children. Germany. Hossain H, Ansari F, Schulz-Weidner N, Wetzel WE, Chakraborty T, Domann E. Oral Microbiol Immunol. 2003 Oct;18(5):302-8

Diaper Rash Candidiasis From Amoxicillin: In a study of 57 Philadelphia children treated with amoxicillin for otitis media, there was a doubling of candida positive skin cultures and an increase in diaper rash due to candida. Amoxicillin and diaper dermatitis. Honig PJ, Gribetz B, Leyden JJ, McGinley KJ, Burke LA. J Am Acad Dermatol. 1988 Aug;19(2 Pt 1):275-9

Diaper Rash Almost Always Caused by Candida: In a study of 60 children with diaper rash, almost all had positive culture for candida and 10 also had positive culture of staph, E. coli, or strep. Candida--agent of the diaper dermatitis? Dorko E, Viragova S, Pilipcinec E, Tkacikova L. Folia Microbiol (Praha). 2003;48(3):385-8

Diarrhea: Not Clearly Caused by Candida in Children: In an Australian study of 107 children with diarrhea and 70 without, yeast species, predominantly candida, were identified in the stools of 43 children (39%) with diarrhea and 26 (36%) without diarrhea. The concentration of candida was positively associated with recent antibiotic use (p = 0.03) and with the presence of another enteric pathogen (p < 0.005), but not with patient age, nutritional status, or duration of diarrhea.  The authors concluded that candida does not cause diarrhea in normal children. Arch Dis Child. 2001 Apr;84(4):328-31

Gastrointestinal Candida Common: In a study of 258 Polish children, 42% had high levels of candida in their stools. Presence of fungi in stool of children. Med Dosw Mikrobiol. 2002;54(3):273-9

HIV Patients Usually Have Oral Candidiasis: Both pseudomembranous and erythematous oral candidiasis (OC) occur in over 95% of HIV-infected patients throughout the oral cavity, highly related to a reversed CD4/CD8 cell ratio. Attached gingiva would be a unique site of OC, only occurring in HIV-infected patients. Shanghai Kou Qiang Yi Xue. 2001 Sep;10(3):193-5

HIV HAART Treatment Cuts Oral Candidiasis 83%: In a Yugoslav study, 77% of all HIV positive patients had oral candidiasis at the beginning of the study. Those on HAART treatment for the HIV had a much larger decrease in candidiasis than those on lesser treatments. HIV Med. 2004 Jan;5(1):50-4

HIV: Chlorhexidine Rinse Helped HIV Child Against Yeast: A random assignment study with 11 of 12 children having at least a 50% reduction in oral yeast with a 0.12% CHX mouth rinse twice a day for 90 days suggests that the topical disinfectant CHX may be a promising agent for treating and preventing oral candidiasis in HIV-infected children. Efficacy of chlorhexidine gluconate rinse for treatment and prevention of oral candidiasis in HIV-infected children: a pilot study. Barasch A, Safford MM, Dapkute-Marcus I, Fine DH. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Feb;97(2):204-7

Nipple Candidiasis is Common: In a Canadian study of 105 women referred for breast feeding problems, 26% had a candida yeast infection. Nipple candidiasis was found to be associated with three factors: vaginal candidiasis (P = 0.001), previous antibiotic use (P = 0.036), and nipple trauma (P = 0.001). Physicians should be suspicious of nipple candidiasis; avoid antibiotics or use the shortest effective course; treat yeast vaginitis during the third trimester and after delivery aggressively; and treat mothers for nipple yeast if babies have oral or diaper candidiasis. Univ. Calgary. Nipple candidiasis among breastfeeding mothers. Case-control study of predisposing factors. Tanguay KE, McBean MR, Jain E. Can Fam Physician. 1994 Aug;40:1407-13

Nystatin No Help for Oral Candida in Elderly Cancer Patients: In a study of 52 patients, Clinical signs of oral candidiasis were observed in 31% of cases. High yeast scores were observed in 58% of the residents. There was an association between signs of oral candidiasis and high yeast scores (p < 0.001). Treatment with a nystatin rinse six times a day for two weeks caused no clinical changes nor reduced yeast scores. J Palliat Care. 2003 Summer;19(2):95-9

Sjogren's Syndrome Oral Candida Common: In a European study of 102 SS patients, cultures for candida were positive in 77%. The total stimulated salivary flow rate was inversely correlated with oral Candida load (r = -0.47; P </=.0001). Fungal load and candidiasis in Sjogren's syndrome. Radfar L, Shea Y, Fischer SH, Sankar V, Leakan RA, Baum BJ, Pillemer SR. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Sep;96(3):283-7. Ed: SS patients have dry mouth conditions similar to patients on some tricyclic medications. I would think that live-culture yogurt would lower the rate of yeast infection and lower the rate of cavities.

Oral Candidiasis Very Common in Elderly: In a French study of 110 randomly-selected nursing home patients, the oral cavity was colonized by Candida spp in 67% of cases. The distribution of the strains showed that C. albicans was the most frequently identified strain, followed by C. glabrata; of the 73 patients with at least one strain of Candida spp., 47 had a clinically diagnosed candidiasis (64.4%). The wearing of dentures was not statistically linked with the development of oral candidiasis. Colonization of the oral cavity by Candida species: risk factors in long-term geriatric care. Grimoud AM, Marty N, Bocquet H, Andrieu S, Lodter JP, Chabanon G.  J Oral Sci. 2003 Mar;45(1):51-5

Oral Candiadiasis Common in Diabetics: In a study of 405 diabetes and 268 controls, Candida pseudohyphae and oral soft tissue manifestations of candidiasis were 4-5 times more prevalent in subjects with diabetes than in controls. The presence of Candida pseudohyphae was significantly associated with cigarette smoking (OR 2.0), use of dentures (OR 1.5), and poor glycemic control (OR 9.0). Of diabetics, 15% had clinical manifestations including median rhomboid glossitis, denture stomatitis, and angular cheilitis. Univ Pittsburgh. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 May;89(5):570-6

Otitis Media (Chronic) Can be Fungi: In a microbiology study of 102 ears with chronic suppurative otitis media for aerobes, anaerobes, and fungi, 44% were pure cultures, 33.3% were mixed, and 18.6% had no growth: 74% were aerobes, 25% fungi, and only 0.9% anaerobes. Pseudomonas aeruginosa (22.5%) was the most common isolate, followed by Staphylococcus aureus and the Aspergillus species. Ann Otol Rhinol Laryngol. 1997 Aug;106(8):649-52; Many similar reports exist of otitis externa.

Polysystemic Symptoms Helped by Nystatin, Diet: A large variety of systemic symptoms have been attributed to yeast infections. 116 adults were treated in a DB PC study with anti-fungal nystatin or placebo with half of each group also on a sugar- and yeast-free diet.  Those on the nystatin had a highly significant decrease in symptoms.  Those on the low yeast diets also improved. Effectiveness of nystatin in polysymptomatic patients. A randomized, double-blind trial with nystatin versus placebo in general practice. Santelmann H, Laerum E, Roennevig J, Fagertun HE. Fam Pract. 2001 Jun;18(3):258-65

Polysystemic Symptoms Not Helped by Nystatin: 42 women with histories of vaginal candidiasis and symptoms similar to the proposed systemic fungal hypersensitivity (fatigue, premenstrual tension, gastrointestinal symptoms, and depression) were treated in a 32 week DB PC crossover study of both vaginal and/or oral nystatin. No difference was found in physical and depressive symptoms. Univ. Alabama. A randomized, double-blind trial of nystatin therapy for the candidiasis hypersensitivity syndrome. Dismukes WE, Wade JS, Lee JY, Dockery BK, Hain JD. N Engl J Med. 1990 Dec 20;323(25):1717-23 

Skin Candida Increases Dramatically in Infant During Antibiotic Treatment: In a Georgetown University study of 25 infants treated with 10 days of amoxicillin, the number of positive cultures of perineal and sternal skin increased from 4 to 18 with a 14 fold increase in yeast density. The number of bacterial culture were almost cut in half but recovered within two weeks after the antibiotic was stopped. The effects of amoxicillin therapy on skin flora in infants. Brook I. Pediatr Dermatol. 2000 Sep-Oct;17(5):360-3

Vaginitis Treated with Live Yogurt: In a DB random study , eating 150 ml (5 ounces) of live culture yogurt daily for four months was associated with decrease infections and increase lactobacillus cultures of rectum and vagina. Arch Fam Med 1996 Nov-Dec;5(10):593-6. Similar study found 1/3 the level of infections during six months of yogurt orally. Ann Intern Med 1992 Mar 1;116(5):353-7

Vaginitis in College Co-eds Linked to Bread and Sexual Behaviors: A University of Michigan study of 138 Co-eds and 78 of their partners determined that the strain on Candida was irrelevant. Female risk factors for recurrent vulvovaginitis were recent masturbation with saliva (hazard ratio [HR], 2.66), recent cunnilingus (HR, 2.94), and ingestion of two or more servings of bread per day (P < .05). The woman's age at first intercourse, lifetime number of partners, and frequency of vaginal or anal intercourse in the previous month did not predict recurrence. Male risk factors associated with recurrence in his partner were masturbation with saliva in the previous month (HR, 3.68; 95% CI, 1.24 - 10.87). J Women's Health. 12/2003

Vaginitis: Vitamin C Vaginally Helped: In a 6-day DB PC study of 100 women with non-specific vaginitis (discharge, fishy odor, and presence of clue cells), vitamin C vaginal tablets (250 mg) was given once a day. Two weeks after the end of treatment significantly more patients were still affected by non-specific vaginitis after placebo (36%) vs. 14% with vitamin C. The clue cells disappeared in 79% after vitamin C vs. 53% on placebo. Bacteria disappeared in 77% on vitamin C vs. 54% placebo, while lactobacilli reappeared in 79.1 and 53.3%, respectively. Efficacy and safety of Vitamin C vaginal tablets in the treatment of non-specific vaginitis; A randomised, double blind, placebo-controlled study. Petersen EE, Magnani P., Freiburg D-79106, Germany. Eur J Obstet Gynecol Reprod Biol. 2004 Nov 10;117(1):70-75.

Vaginosis: Yogurt Intra-vaginally Cures Bacterial Vaginosis Quickly: In a Turkish study of 22 1st trimester pregnant women, 10 ml of a commercially available live Lactobacillus acidophilus yogurt introduced vaginally with a 10 cc syringe without a needle by the women themselves once a day for 7 days and again on the 14th day found that the symptoms of bacterial vaginosis were gone by the 3rd day in every women and 86% had none of the four classic symptoms(foul-smelling discharge, vaginal pH more than 4.7, presence of clue cells in the vaginal discharge, and foul odor caused by the addition of 10% potassium hydroxide to the vaginal discharge (i.e., positive amine test)) six weeks after starting treatment. Alternative treatment for bacterial vaginosis in pregnant patients; restoration of vaginal acidity and flora. Tasdemir M, Tasdemir I, Tasdemir S, Tavukcuoglu S Arch AIDS Res. 1996;10(4):239-41. Ed: The intra-vaginal approach of 2 teaspoons of live yogurt seems a much more direct, rapid, and efficient approach to establishing colonization of lactobacillus in the vagina than the oral approach. Others have used lactobacillus in in tablet or suppository form have shown clinical efficacy as a treatment for vaginal infections.  Univ Washington. Am J Health Syst Pharm. 2001 Jun 15;58(12):1101-9.  However, live yogurt is much less expensive and is readily available.

Vaginosis Helped by Hydrogen Peroxide: In a 7-day study of 30 cc of hydrogen peroxide intravaginally once a day, after three months of follow-up, 89% of women were still well. The treatment helped reestablish a normal flora in 100% of cases as well as eliminated clue cells and established normal pH in 98%. Utilisation of hydrogen peroxide in the treatment of recurrent bacterial vaginosis. Cardone A, Zarcone R, Borrelli A, Di Cunzolo A, Russo A, Tartaglia E. Minerva Ginecol. 2003 Dec;55(6):483-92

Vaginosis Helped by Mucoadhesive Vaginal Gel: In a 12-week DB PC study of 45 non-pregnant women with bacterial vaginosis (BV) were enrolled in the trial, patients treated with mucoadhesive vaginal gel (MVG, Miphil(c)) 2.5g daily for the first week and then every 3 days for the following 5 weeks at week 6, 93% of women in the MVG group were clinically cured vs. 6% for placebo (P=0.0001). At week 12, 86% of MVG treated women remained cured vs. 8% (P=0.0001). Successful treatment of bacterial vaginosis with a policarbophil-carbopol acidic vaginal gel: results from a randomised double-blind, placebo-controlled trial. Fiorilli A, Molteni B, Milani M. Milan, Italy. Eur J Obstet Gynecol Reprod Biol. 2005 Jun 1;120(2):202-5.

Vaginitis and Vaginosis: Yogurt, Boric Acid Help Treat Vaginal Candidiasis and Bacterial Vaginosis: A University of Washington review reports Lactobacillus recolonization (via yogurt or capsules) shows promise for the treatment of both yeast vaginitis and bacterial vaginosis with little potential for harm. Boric acid can be recommended to women with recurrent vulvovaginal Candidal infections who are resistant to conventional therapies, but can occasionally cause vaginal burning. Common complementary and alternative therapies for yeast vaginitis and bacterial vaginosis: a systematic review. Van Kessel K, Assefi N, Marrazzo J, Eckert L. Obstet Gynecol Surv. 2003 May;58(5):351-8