Mycoplasmas, naturopathic view

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Systemic Mycoses: A Naturopathic Overview,Part 2

By: J Thiel, Ph.D., N.D.

ABSTRACT

Systemic mycoses are a growing problem. Understanding the various types can be helpful for health practitioners who are interested in natural interventions to help restore their infected patients back to health. This second part of a two-part article discusses selected forms of systemic mycoses, as well as naturopathic interventions the investigator has had clinical success with.

INTRODUCTION

As mentioned in the first part of this series, there are over 100,000 different species of fungi of which approximately 150 are known to be pathogenic to humans [1,2]. Those which are pathogenic have been classified into three broad categories: superficial, cutaneous, and systemic. Superficial mycoses normally are confined to the keratinized layer of the skin and its appendages [3]. Cutaneous/subcutaneous mycoses enter the skin and cutaneous tissue usually in a traumatized area (such as a wound); they usually remain localized, but can spread through the lymphatics to other sites. Systemic mycoses are medically believed to usually have a pulmonary inception, but can affect most areas of the body [1,4,5].

Systemic mycoses are saprocyctes that are usually innocuous, but become pathogenic when the host becomes abnormally susceptible to infection [1,5,6]. During the past 25 years there have been alarming increases in them [1,6,7]. Systemic mycoses can cause a tremendous variety of health problems including digestive difficulties (diarrhea, bloating, discomfort, flatulence, constipation, etc.), skin problems (rashes, dry skin patches, itching, etc.), bronchopulmonary disorders, fatigue, allergies, weight loss, fever, chills, malaise, and depression [1,5-9]; some of them may be risk factors in developing autoimmune disorders [10]. Medical interventions for systemic mycoses include various medications, surgery, and chemotherapy [1,5,6,11]. Progress in the diagnosis and medical treatment of many mycoses has been unsatisfactory [12].

Although there exists a tremendous amount of natural health literature regarding interventions to be considered for people with an overgrowth of Candida albicans [i.e. 13-22], the literature regarding natural interventions for other mycotic organisms is less available. The purpose of this paper is to discuss some of the natural interventions that this investigator has found helpful, in vivo.

NATURAL INTERVENTIONS

This section will discuss information on other commercially available natural interventions. Although independent scientific citations will be used when available, monographs and other data will be used to give possible efficacy for natural interventions if peer-reviewed scientific citations are not available. Specific brands are sometimes mentioned, as this is what this investigator has used (no company has paid the investigator to have them included). Other brands with similar ingredients will probably give similar results.

Biotin

Biotin is a water soluble vitamin and is found in many yeasts [23]. It sometimes seems to be helpful when Candida tropicalis, Rhizipus oryzae, or the superficial Trichophyton rubric is present. It may be of benefit because it is consumed by intestinal bacteria [23] and may have a "probiotic" [19,20] effect. It also may be helpful because biotin enzymes are involved in the metabolism of carbohydrates, lipids, and some amino acid residues [24]. The involvement as a co-factor in essential fatty acid metabolism seems to help the body defend against some microbes [25]. It has been claimed that biotin might work by preventing yeast from getting to a state that allows it to form tendrils [15]. A symptom that indicates that biotin may be helpful is complaints of patches of dry skin--Candida albicans can contribute to the dermatitis of biotin deficiency [26]; biotin has long been recommended by natural health professionals when dry skin is present [27]. Most take 600-1500mcg per day.

Citricidal

Citricidal by bio/chem Research is a liquid grapefruit seed and pulp extract. The manufacturer reports find that using certain minimum concentrations (from 10ppm to 600pm) in-vitro is effective to inhibit various yeasts and fungi. Specifically MICs (minimum inhibitory concentrations in-vitro) reported are: Aspergillus niger 600ppm, Aspergillus fumigus 200ppm, Candida albicans 60ppm, Epidermophyton floccusum 200ppm, Keratinomyces ajelloi 200ppm, Monila albicans 10ppm, Saccharomyces cerevisiae 60ppm, Trichophyton mentagrophytes 20ppm, Trichophyton rubrum 200ppm, and Trichophyton tonsurans 200ppm [20]. This investigator’s clinical experience is that sometimes this product helps people with mycoses and sometimes it does not. Most complain about the taste, but when diluted in enough citrus juice, most will tolerate it; it has also become available in tablet form. "CITRICIDAL is environmentally safe with a low toxicity to man and animals. Studies indicate that the antimicrobial activity of CITRICIDAL is in the cytoplasmic membrane where the uptake of amino acids is prevented and disorganization of the cytoplasmic membrane and leakage of low molecular weight cellular contents"[20]. One study found that it seems to inhibit growth of many systemic mycoses [21].

Colostrum

Bovine colostrum appears to be indicated for some with stubborn mycotic infections. It may be because it contains IgA or because of other immune building factors [28]. It also appears to have somewhat of a probiotic effect [28,29] and has reportedly been helpful for some with ‘leaky gut syndrome’ [30]. Research suggests that colostrum’s leukocytes can be helpful in controlling infection with Candida albicans [29]. Sometimes (but by no means all the time), some who cannot tolerate dairy can still take colostrum for its immune enhancing properties. While it does not appear to be universally helpful for people with mycotic infections (and may be contraindicated), it can aid in some of the more stubborn cases.

Con-Lyph

Con-Lyph by Nutri-West was developed to help provide immune system support [17]. It is commonly taken by people with infections caused by various streptococci. This investigator has found it to be helpful when nocardiosis or actinomycosis is suspected. It contains lypholized bovine glandulars, herbs (such as shitake mushrooms), and other nutrients. Bovine glandulars have been shown to nourish the specific gland that they provide [31,32] and oral supplementation with bovine thymus has been shown to increase t-lymphocytes in humans [33]. Shiitake mushrooms supply lentinan, a water soluble beta-1,3 glucan polysaccharide which has been reported to enhance helper t-lymphocyte function, natural killer cell activity, and macrophages [34]. People usually take 3 to 6 tablets per day.

Dioxychlor

Dioxychlor by American Biologics is supplied in liquid form and contains a substance consisting of two oxygen atoms bound, not to each other, but to a third atom of chlorine. "This makes possible the release of the highly active form (of oxygen), nascent oxygen" [22]. It is similar in this respect to ozone and hydrogen peroxide. Chitin is one of the components of the fungal cell wall [6] and "Dioxychlor is slightly cytotoxic to Candida by inhibiting (1) the process whereby new cells are sealed by chitin during reproduction, during budding and (2) the formation of new tubes (mycelia) and internal cell walls during growth of the mycelial form" [22]. It is claimed to be effective in "even minute doses (1 to 5ppm)" against a wide range of fungi [35]. It is claimed to be effective against the mycelial form (or M-form) of Candida, but not so against the oval form (or Y-form) of Candida [35]. It is believed by some that the Y-form is not pathogenic to humans, but the M-form is [21,22]. This investigator seems to recommend it most frequently when Candida tropicalis or other non-albicans forms of Candida are indicated. Most people take 10-30 drops per day.

Electrical Stimulation

Although electrical stimulations have long been used by natural health practitioners [36], they have become a bit more popular since the publication of The Cure for All Diseases by Dr. Hulda [37]. Articles about her "zapper" and similar devices have been published in the non-medical press . These articles suggest that the use of such devices is lethal to a variety of microbes include systemic mycoses [37-39]. One published study found that electrical stimulation may make the cell wall more permeable so that nutrients provided through diet and supplementation may be more absorbable [40] An experimental study performed by this investigator found, when combined with nutritional interventions, the use of a zapping unit substantially helped 39.6% with a systemic mycoses and minimally helped the rest (60.4%) [41]. It may be that the use of electrical current somehow increases nutrient absorption [40,41], IgG response, or may mimic some of the body’s electrical signals [41,42]. Subjects normally hold the device for approximately 7 to 15 minutes with a 10 to 20 minute gap, then resume for a total of three rounds. Some people have instant results, but for most, its efficacy is not quickly apparent.

Herbal Formulas

There are many formulas which contain substances often mentioned by natural health practitioners as helpful for Candida albicans [13-16] such as caprylic acid, citrus seed extract, n-acetylglucosamine, molybdenum, manganese, lacto bacillus bulgaricus, lactobacillus bifidus, pau d’arco, thyme, basil, goldenseal root, cloves, aloe vera, beet root, cinnamon, garlic, and oregano oil: normally subjects take tablets orally with meals. The lactobacilli help restore intestinal flora [18,19], caprylic acid appears to decrease IgG antibodies [53], garlic may increase natural killer cells [44], citrus seed extract appears to prevent the uptake of amino acids in the cytoplasmic membrane and cause leakage of low weight cellular contents [20], N-acetylglucosamine appears to be necessary for a portion of macrophage activation [45], molybdenum is a cofactor in detoxification [46] and acts as an anti-acetaldehyde nutrient [14], manganese can stimulate macrophage activity [47], pau d’ arco contains lapachol and xylodine which may be lethal to Candida albicans [48], and aloe vera has been shown to have antimicrobial activity against Candida albicans [49]. It is believed that the synergistic effects of the ingredients is effective in helping people recover from a variety of fungal infections. This investigator tends to recommend this type of combination most often when Candida albicans is suspected or present (such as when presented with vaginal yeast infections, though that is not a required sign). Most people follow label instructions.

Homeopathy/Isopathy

Homeopathic and isopathic remedies are often tried by people looking for natural interventions for various mycoses. Homeopathic remedies are based on the "law of similars" (like heals like) and are intended to stimulate the body to heal itself [50]. A variety of remedies are used for this purpose. In the case of "constitutional" homeopathic remedies (most of which are herbs or minerals referred to by their Latin name), the precise remedy is determined by careful assessment of symptoms. Since this is difficult, most lay people (and many health practitioners) rely on combination remedies which include a variety of remedies. Some of the most commonly used remedies (which are sometimes combined) are Astralagalus Campertris, Condurango, Echinacea Purpurea, Lycopodium Clavatum, Nux Vomica, Phosphorus, Phosphoricum Acidum, Phytolacca Decandra, Pulsatilla, Sepia, and Sticta Pulmonaria. For a complete symptomatic picture for each, please refer to a comprehensive homeopathic materia medica [e.g. 51].

Isopathic remedies are similar to homeopathic ones, in that they are dilutions that are intended to stimulate the body to heal itself. They differ from homeopathic remedies, because normally the subject takes a dilution of the particular substance (in this case some systemic mycoses) that is affecting them negatively. When isopathics are used for various diseases, they can be considered to be "nosodes" [50]. The most common remedies available for people with systemic mycoses include Aspergillus Flavus, A. Fumigatus, A. Glaucus, A. Niger, A. Terreus, Candida Albicans, C. Parapsilosis, C. Tropicalis, Cryptococcus (various), and Rhizopus (various). Many companies combine homeopathic and isopathic remedies into their formulas for people with systemic mycoses.

Man-Aloe (Ambrotose with Lecithin)

Formerly known as Man-Aloe and now renamed as Ambrotose with Lecithin by Mannatech can sometimes be helpful for some people who have multiple mycotic infections. It contains polymannans in a aloe vera gel, along with a proprietary complex containing eight monosaccharides (galactose, glucose, mannose, N-acetylneuraminic acid, fucose, N-acetylgalactosamine, N-acetylglucosamine, and xylose) in soy lecithin. Aloe vera has been shown to have antimicrobial activity against Candida albicans [49]. Aloe vera even contains some peroxide which has been reported to have efficacy against candidiasis [52]. The eight monosaccharides are essential for the formation of glycoproteins responsible for cell to cell communications [53,54], but several can be foods for various mycoses [2]. Mannose compounds may have effectiveness when deep-tissues are invaded by Candida albicans [55,56]; mannose compounds also appear to have positive effects on enhancing immune system response [57]. N-acetylglucosamine appears to be necessary for a portion of macrophage activation [45]. It is also possible that by ingesting these monosaccharides (some of which can be produced by yeast) that there is decreased tolerance in the body for yeast to remain, and hence their ingestion may lead to some type of immune response. Most people take between 2 - 6 capsules per day.

Olive Leaf

Olive leaf formulas helps some who suffer from mycotic infections. Olive is considered to be a general microbial [58]. Specific reports include its effectiveness on Candida albicans and Candida krusei [59]. It has also been reported that olive leaf extract can kill so much yeast that it can overwhelm the body’s eliminative capacity [59]--this can happen with other natural interventions as well, thus it rarely makes sense to take too much of any specific natural substance. Several companies, such as Nature’s Sunshine make a olive leaf extract standardized at 12% oleuropein; most people take 2-4 capsules daily.

Oxygen Therapies

Oxygen therapies are sometimes helpful [52]. These interventions can include food grade hydrogen peroxide, ozone, or complexes such as Dioxchlor (previously discussed) or Stabilized Oxygen by Water Oz. These interventions are based on the premise that since systemic fungi are of the plant, as opposed to animal, kingdom that direct contact with oxygen can be lethal. While some feel that food grade hydrogen peroxide is directly helpful [37,52,60], it may not be strong enough when yeast infections affect the mouth [37]. At least one type of phagocyte disorder reduces production of hydrogen peroxide and increases the risk of Aspergillosis [28], thus this suggests some possible efficacy for its ingestion. Highly diluted, it has been reported to clean the vaginal tract of women with candidiasis [52], though this investigator has no clinical experience recommending it that way. Most use of direct ozone interventions is done outside the U.S. [52], thus this investigator does not have extensive clinical experience with many of them. Stabilized Oxygen from Water Oz is somewhat similar to Dioxychlor by American Biologics. It supplies sodium chlorite drops as first discovered in 1929. It is highly alkaline (pH 12-13) which makes it appealing for use when Zygomycetic organisms are suspected. It is a "`liquid concentrate of electrolytes’, that are made available to your body in a molecular form which are released upon contact with stomach acid" [61]. The chlorite molecule is believed to be used as a substrate for a variety of enzymes that improve cell oxidation [61]. The manufacturer believes that it is more "stable" than hydrogen peroxide since instead of releasing gas in the stomach it releases molecular oxygen [61]. This investigator has found that 10-20 drops three times per day can be helpful for people with fairly entrenched mycotic infections.

Since many systemic mycoses enter the body through the respiratory tract it may make sense to remove them from the air of some people. Ozone based air filtration systems may be able to do this [52]. A study performed by Twin City Testing found that 99% of Candida albicans and 66% of Aspergillus niger were removed from the air within 4 hours of use [62]. Although this investigator’s clinical experience is insufficient to determine if these type of units actually reduce the incidence or duration of infection by systemic mycoses, it seems logical that they should be considered as a possible intervention when systemic mycoses are present.

Probiotics and Fructo-Oligosaccharides

Some products contain combinations lacto bifidus acidophilus and fructo-oligosaccharides with pysillum husk and oat bran. At least one company recommends it to cleanse "intestinal toxicity" from a variety of causes [63]. Lacto bifidus acidophilus has a "probiotic effect" [18,19], as do fructo-oligosaccharides [64]. Specifically, oligosaccharides stimulate the growth of lactic acid producing bacteria [65] which help metabolize ingested chemicals and other toxins in the digestive tract [64]. Pysillum husk and oat bran are excellent sources of dietary fiber [66,67]. Pysllium and oat bran have been shown to be able to reduce plasma cholesterol [67]. It is of interest to note that combining a cholesterol lowering medication (fluvastatin) with medications for the treatment of Candidia species (flucanazole) and Cryptococcus neoformans (itraconazole) had "both synergistic and additive effects...this combined fungicidal activity was confirmed by time-versus-killing studies" [11]. This may be because Aspergilli normally does not respond to the usual medical interventions for Candidiasis [5]. It may also be that substances with cholesterol lowering properties may have some efficacy when dealing with various Aspergilli, which is consistent with this investigator’s clinical experience. This investigator has sometimes found this type of product to be helpful when Candida albicans, Candida tropicalis, or various Aspergilli are suspected.

Silver Therapies

Many have claimed that silver compounds, colloidal or otherwise, are lethal to microbes of many types, including systemic mycoses [15,19,68,69]. It has been claimed that, "It is a catalyst, disabling the particular enzyme that all one-celled bacteria, fungus, and virus, use for their oxygen metabolism which means they suffocate" [69]. The supporters tend to note their belief that colloidal silver was classified as a pre-1938 drug by the FDA and that medical uses of silver continue to this day [68,69]. Others feel that silver is simply a "basic nutritional mineral" [15,68]. This investigator has found silver occasionally to be a helpful nutrient for people with systemic mycoses, but has not found it to be universally lethal to systemic mycoses in-vivo. This investigator’s clinical experience seems to suggest that it primarily helps people with mild candidiais and superficial mycoses (which, in comparison, tend to be relatively mild [3]). Most people take 1 to 6 teaspoons per day. It is sometimes used topically by some people with superficial mycoses.

Vita-Mineral

Food multiple vitamins, such as Vita-Mineral by Doctors’ Research, seem to help some who suffer from a variety of mycotic infections. This may be due to the vitamins, minerals, and/or essential monosaccharides it contains, or the fact that it contains beta-glucans, naturally occurring superoxide dismutase, and Saccharomyces cervisiae (baker’s yeast). According to W. Crook, M.D., perhaps the nation’s best known expert on Candida albicans, "yeasty foods don’t encourage Candida growth...Eating a yeast-containing food does not make Candida organisms multiply [13]. Some people, though, are allergic to the cell-wall of yeast, so Vita-Mineral has had the Saccharomyces cervisiae cell-wall enzymatically processed to reduce this unlikely occurrence. Vita-Mineral contains 2mg of superoxide dismutase and 50mcg of beta-glucans per tablet, both of which have been reported to have some efficacy when Candidiasis is present [70-72], this may explain why some with yeast infections report improvement after taking products with enzymatically-processed Saccharomyces cervisiae. Folate deficiency may facilitate epithelial invasion of Candida hyphae [73]. Animal studies suggest that copper deficiency appears to reduce the ability to kill ingested Candida albicans [74], selenium deficiency appears to increase reproduction of Candida albicans [75], and zinc deficiency increases the likelihood of Candida infection [76]. Others report that riboflavin, vitamin B6, vitamin C, iron, magnesium, biotin, and vitamin B12 play some role in dealing with Candidiasis [77,78]. Most take one to two tablets per day. Many take it on a permanent basis to support their immune systems to reduce the probability of recurrence--it is usually taken with other supplements when yeasts are active.

Whole System YST

According to Dr. Don , product co-developer, Whole System YST by Nutri-West was developed to help clean the body of waste materials produced by fungi. It contains ox bile, red beet root, tillandsia, chlorella, wheat germ. Ox bile and red beet root seem to be helpful for gallbladder support [19]; bile consumption may have some efficacy for hypercholesterolemia [79]. Tillandsia has strong absorptive properties [80], chlorella may provide nutrients to improve immune response [81], and wheat germ supplies B complex nutrients [78]. This product is often the product of choice when Aspergillosis is suspected. Most take 4-6 tablets per day.

Zymex

Zymex by Standard Process was developed before most natural health practitioners were familiar with systemic mycoses. "The effect of Zymex in promoting favorable intestinal flora contributes materially ... As an intestinal detoxificant, it is especially indicated in cases of diarrhea following antibiotic therapy" [82]. An old clinical test for its application was a stool pH of 6.8 to 7.0. This is one of the original "probiotic" [18,19] supplements. Each capsule contains: defatted wheat germ, lactose, calcium stearate, and enzymatically processed tillandsia and beet root. This product is "an enzyme complex from special cultures of lactic acid forming microorganisms"[82], which one assumes is from the tillandsia and beet root. Wheat germ supplies B complex vitamins [78]. This investigator tends to recommend it to people who have unsuccessfully attempted to self-treat Candida albicans (and mutated forms are suspected), as well as when diarrhea or other digestive difficulties are encountered. Most people take two capsules per meal.

DISCUSSION

Large populations are exposed to pathogenic fungi [9]. It should go without saying, but one does not have to have a vaginal discharge for a systemic mycotic infection to be present. Mycotic infections are often overlooked or improperly diagnosed as something else [1,83]. In spite of under diagnosis, reports of systemic mycotic infections are on the increase [1,84].

The widespread use of various medications for the treatment of candidiasis has resulted in an increased amount of candidemias caused by resistant non-Candida abicans strains [84]. As there are side-effects and medicine-resistant strains of Candida species, it is apparent that medicine is not winning the battle against systemic mycoses [11,84]. Is the answer, as advocated by some, the development of a broad-spectrum anti-fungal drug [12]? This investigator is concerned that the development of such broad-spectrum drugs may result in new resistant mycotic strains. Since the drug of choice for nearly forty years for severe invasive fungal infections (Amphotercin B deoxycholate) has side effects (including toxicity [12]), side effects from any new drug would also be a reasonable concern. Also, as the use of anti-Candida medications seem to increase the incidence of Aspergillosis in those who take them [5], this type of "side-effect" from newer anti-fungal agents is possible.

Regarding side effects, it needs to be noted that natural interventions can have side effects as well (such as gastro-intestinal upset), some quite serious; though, as a general rule, they tend to be of a temporal nature and not severe. Caution must be exercised by the health care practitioner who engages in utilizing natural interventions for people with systemic mycoses. This paper has not attempted to list possible cautions for the use of the products as it is assumed that health care professionals have access to such cautions from other sources. Allergic reactions can, and do, occur. Also, nearly any substance, natural or otherwise, can have undesirable effects when taken to excess.

It needs to be emphasized that it is difficult to say precisely when a specific intervention (natural or drug-based) will be helpful. The particular mycotic strain is usually not known at the time of the appointment and false negatives in response to laboratory tests are common [1]. Laboratory tests, signs, symptoms, health history, allergies, diet, preferences, and duration of complaints are all factors to be considered. Even if laboratory tests confirm a particular type is active, the specific strain number is rarely ascertained. There can exist a tremendous amount of variability among the strains themselves (mutations are also common) [85]. Also, there are differences in humans and as well as their responses to natural interventions. This investigator has found that if a subject does not respond substantially from a single natural intervention, then multiple interventions may be advisable.

Completely eliminating all mycotic organisms is essentially impossible since many are present in healthy people [1]. Avoiding excess use of antibiotics [1,19], cleaning the air [62,64], keeping a positive balance of intestinal flora [18,19], incorporating appropriate dietary changes [13-16], and maintaining a strong immune system [1,28,86] are all factors which can limit their ability to grow and cause various symptoms. The amount of time it takes for effective natural interventions vary considerably, with some people improving in days to others taking many months before noticing significant improvement. This investigator has noted that the road to improvement can be a rocky one with many ups and downs before the body’s immune system regains fuller control.

There are undoubtedly many other effective natural interventions for systemic mycoses which this paper has not covered. Research involving various other phytochemicals [87], essential oils, boric acid, and fatty acids have shown promise [78,88-90]. Also, the substances mentioned earlier probably have many mechanisms of efficacy which this paper has not described. It is this investigator’s hope that this paper will encourage other researchers to share what they have learned regarding effective, in vivo, natural interventions with the clinical community.

REFERENCES