The Yeast Connection: Women at Risk

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An interview with Elizabeth Crook and Carolyn Dean, M.D., N.D.

In 1984, Dr. William Crook published The Yeast Connection, a book that explained the subtle and frustrating effects that Candida yeasts can have on a woman's body. Dr. Crook's goal was to teach women how to better care for themselves and control yeast overgrowths.

Twenty years later, the American public is still largely unaware about Candida yeasts and their effects. Dr. Crook's last work, The Yeast Connection and Women's Health, published in 2003, is an updated resource for understanding the relationship between yeast and so-called "unexplainable illness."

Nutrition Health Review had a chance to speak with Dr. Crook's daughter, Elizabeth, and Dr. Carolyn Dean, an expert on yeast conditions.

Q. What is yeast?
A. Yeast are microorganisms that live, normally, in everyone's body. There are many different kinds of yeast, but Candida albicans can overgrow in the gut and in the whole body and can exacerbate a whole series of health complaints. Yeasts are part of the healthy flora and fauna in our bodies, and they grow in the warm, moist creases of our body.

When the good bacteria get killed off by repeated doses of antibiotics or other things, our flora and fauna become unbalanced through diets that are high in sugar and carbohydrates, by birth control pills, and by just the normal fluctuation of hormones that women have — although men and women can both be affected by candidal overgrowth. Candida can create weaknesses in the intestinal walls, and this allows toxins to escape and to create havoc in all types of places.

Q. Are there different types of yeast?
A. (Carolyn Dean): According to Bernard Rimland, Ph.D., who founded DAN! the autism network, there are as many as 30 or 40 different strains of Candida.

Q. Can men have yeast infestations?
A. Absolutely.

Q. Do men have problems with it as well?
A. They do have problems, but men tend to get yeast less often because — number one — of their physiology. They do not have the warm, moist places like the vagina, they do not have hormonal fluctuations, and they generally see doctors less often than women, so they tend to take fewer antibiotics.

However, men can have all of the same symptoms. They can have everything from headaches, depression, chronic fatigue, irritable bowel syndrome, and more obvious things like fingernail and toenail fungus or fibromyalgia. Many of the common complaints that are implicated with Candida can certainly affect men.

Q. Are we born with yeast, or do we pick it up at some point?
A. It's part of our natural healthy flora and fauna, but the problem comes when it overgrows, because the good bacteria that keep it in balance get wiped out from antibiotics or become out of balance because we are feeding the yeast with a whole lot of sugar. Yeast is problematic only when it is out of control.

Physicians have recognized vaginal yeast infections for years, and there are certainly lots of treatments on the market for them, but what is more controversial is when yeast actually gets into our system.

Q. Are doctors aware of yeast-related infections?
A. Many physicians, if they know about yeast, disagree with it. Many times, when people see the physician and have many complaints, such as feeling sick all over, and standard kinds of blood tests are run, yeast does not show up. So people will go from doctor to doctor and get set up with antidepressants. Many people who suffer from yeast do not know that this is their problem. That is one of the challenges, and their doctors do not see it.

Many times I hear, "Someone gave me a copy of The Yeast Connection, and as I read it, I read about myself. So I went back to my physician and asked him or her to help me or work with me on dealing with a yeast overgrowth or at least exploring whether yeast overgrowth could be a factor."

Q. What good can yeast do?
A. (Carolyn Dean): We presume that our body is born "perfect" and that Candida (the budding form) is part of that perfection. Then, what purpose does Candida yeast in budding form — not the tissue invasive form — have in the body?

People who think about these things say that the purpose of Candida is to digest simple sugars and alcohol. We know this to be true of many other types of "friendly" bacteria that digest simple carbohydrates, complex carbohydrates, fats, and proteins. For the most part, it works as a mutually beneficial relationship. We feed them, and in return they help to break down and digest food into a form that our body can assimilate. Because by the time foods are in the small intestine, they should be mostly broken down by gastric juices and pancreatic enzymes. If they are not beneficial, bacteria can go to work.

The same may be true for the Candida invasive state. The problem occurs when we eat excessive amounts of sugars and alcohol-containing foods; then, just like any substrate or ecological habitat, the yeast proliferates. So we overfeed the Candida flora and do not feed the other flora. Or we kill off other flora with antibiotics, and Candida overgrows and also feeds on a high sugar diet. As a result, other flora die off and Candida takes over our digestive system.

The ratio of candidal organisms to bacteria in the gut is supposed to be 1:1,000,000, but in many people it is the other way around.

Q. What are some of the types of yeast-related illnesses?
A. Well, clearly some things are directly linked, like vaginal yeast infections, but the reason that we use the words yeast connection is not necessarily because these things are caused exclusively by yeast. Yeast may be a triggering factor or a complicating factor for a whole host of conditions, ranging from depression, headaches, premenstrual syndrome, endometriosis, chronic fatigue syndrome, fibromyalgia, and vulvodynia (painful vulva).

Some of the most common conditions are food allergies and food sensitivities. One thing that happens, because of the leaky gut syndrome, is that the toxins filter through the intestine walls from the stomach, and all of that is going to be spread throughout your system. It affects different people in different ways.

Q. If you have a dormant problem, could too much yeast trigger something that normally might not flare up?
A. I'm not sure that I would put it that way. In some ways, we all have dormant problems. We all have conditions that may be triggered by various and sundry things. There are people who carry the breast cancer gene, but not everyone who has that gets it. But why not? What is it that triggers some people's genes to start acting up? I don't think we know that.

Q. How does yeast spread in the body?
A. Yeast grows as you feed it sugar. It just multiplies just like any other microorganism in the body.

Q. Can it be spread through interpersonal contact?
A. Not necessarily. I can have systemic yeast and that is not going to be contagious, but things like vaginal yeast can be infectious.

(Carolyn Dean): If a woman has vaginal Candida, she can pass on Candida to her partner.

Q. Are yeast problems difficult to identify?
A. They are very difficult to identify, because it is not just a question of drawing blood and looking for yeast. One of the best ways is to do an inventory of your own system. If you see repeated use of antibiotics of steroids, these can all be indications that there is a problem.

Q. What are the symptoms from some of the yeast illnesses?
A. Well, you might think of them not as yeast illnesses but as illnesses that may have a yeast connection, so that if you can clear up the yeast, you will most likely feel better. That does not mean that all of our health complaints will go away, but it means that a big component of what is triggering and exacerbating our condition will go away.

I mentioned some of those (headaches, premenstrual syndrome, chronic fatigue syndrome, interstitial cystitis, chemical and mold sensitivities, food allergies, and asthma). For many people, it is just feeling sick all over, tired, and foggy-brained.

Q. Are any symptoms unique to yeast illnesses?
A. (Carolyn Dean): The major symptoms seem to mimic medical diseases such as fatigue, headache, depression, suicidal depression, irritability, memory loss, menstrual problems, premenstrual syndrome, digestive disorders, skin problems, urinary disorders, muscle pain, impotence, respiratory problems, short attention span, hyperactivity, and learning difficulties. But what is fascinating is that these symptoms are all similar to those that are caused by low magnesium levels.

Q. Is there a time when people should suspect a yeast infection?
A. I think that if you are just feeling bad and not getting better, if you are trying things and nothing is working, if there is no physical diagnosis that your physician or health care practitioner can help you with, then it is worth checking out. The way to check that out is by looking at the questionnaire; if it turns out positive, you might want to begin by eliminating sugar and any fermented products from your diet and see if you start to feel better.

There are prescription antifungal medicines, as well, but those have to be prescribed by a physician.

Q. How serious can yeast illnesses get?
A. They can become very serious. We have seen letters from people who said that they lost weight down to dangerously low levels. There are people who have been hospitalized, and some have been placed in mental health institutions because they just feel so bad and couldn't find a way to get better.

Q. Can a yeast illness be completely cured, or is there always some sort of residual illness?
A. Many people have reported that they have been restored to perfect health. I think that some people will always have to watch their intake of sugar and refined carbohydrates.

Q. So diet is important?
A. Diet is a huge factor. There are many good dietary supplements that can support people as they work with yeast, but we have found that in order to deal with things most effectively, you need to work with your diet. You should eat fresh, preferably organic vegetables. It is important to eliminate sugar, because sugar is what yeast eats. That's how you make beer and wine. If you keep on feeding these organisms sugar, they are going to keep growing. The odd thing is that the more you feed them, the more cravings you have. A craving for sweet and starchy foods is also a symptom.

The five steps in dealing with C. albicans are (1) eating a proper diet and performing exercise; (2) taking the right dietary supplements; (3) controlling chemical exposure, with care taken to avoid glues, paints, and solvents; (4) examining the emotional and spiritual issues that may cause stress; and (5) seeking the advice of a physician or health care professional.

Q. Are there any tests that can identify yeast illnesses?
A. (Carolyn Dean): Skin allergy tests for C. albicans can be useful. Stool testing to compare intestinal organism quantity can be helpful, and immunoglobulins G M, and A (IgG, IgM, and IgA) tests are somewhat useful.

Q. Does alcohol have an effect on the growth of yeast?
A. Well, some alcohol is fermented, and also alcohol gets processed as sugar, so it does need the yeast. Many times, if people can get their system clear and clean, they will be able to reintroduce some of these things back into their diet. You have to test a little bit to see if your symptoms resolve. If they do, you might want to back off again.

Q. Would people have a hard time with whole-wheat products, since they are more healthful than refined flour?
A. Well, if the whole-wheat products have yeast in them, there might be some difficulties. Many breads sold in markets have honey in them. As with all foods, you just have to read the labels and not the advertising copy. Something that may say "healthy" and "natural" might have cane juice in it or something. Cane is a natural substance, but it is sugar and it will be a problem.

Q. What are some common misdiagnoses of yeast-related illnesses?
A. The ones that first pop into my mind are mental health conditions. I think that when people feel sick all over and cannot get better and their blood work looks normal, they may well be told that "it's all in their head."

In the Yeast Connection, we talk about yeast-related illnesses; these are illnesses that are related to yeast overgrowth. We don't say "this is a yeast illness, as opposed to that."

Q. When was the first Yeast Connection published?
A. In 1984.

Q. What has changed since then?
A. I think that a number of things have changed. There has been a huge shift in individuals seeing themselves as active participants and partners with their health care professional. People do not have a notion that there is a silver bullet out there, and they understand that health is more complex than that and that it is more about diet. There has been a huge shift in the past 20 years with diets. When my father (Yeast Connection author William G. Crook, M.D.) wrote the Yeast Connection Cookbook IQ years ago, it was important to give people some sense of how to think about food and how the food they take into their body is going to make them feel.

I think that we are more knowledgeable and open about the increasing emphasis on the integration of our emotions with our physical wellbeing. I think that people now understand this relationship better.

I think that one of the shifts that we see, support, and promote is that individuals have their own feelings and intuitions about their bodies. We are coming to respect that, we hope. Intuition has been disrespected by mainstream medicine, and we have been told that the person with the answer is somebody out there in a white coat. Again, I think people are saying that they have a sense of what is wrong.

Elizabeth Crook is the daughter of William G. Crook, M.D., the author of the first Yeast Connection and Women's Health, and a pioneer in the field of Candida yeasts. Ms. Crook currently works on behalf of womens health issues as a consultant to physicians, nurse practitioners, nutritionists, and other health care professionals.

Carolyn Dean, M.D., N.D. is medical advisor on Yeast Connection and Women's Health. She is the author of two other medical books.

PHOTO (BLACK & WHITE): Elizabeth Crook

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