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TABLE OF CONTENTS

COVER PAGE: Drawing of budding yeasts and filamentous hyphae.

DISCLAIMER: Patients are responsible for obtaining appropriate medical care for candidiasis. Other health problems can affect a patient’s response to antiyeast therapies.

INTRODUCING YCS: Products and services offered by Yeast Consulting Services.

BIOGRAPHY: Dr. Crandall’s education and professional experience in mycology research.

PART I: CONTROVERSY

TABLE OF CONTENTS: Packet contains letters, fact sheets, resources and reprints.

DEAR PATIENT: Letter explaining how to obtain testing and treatment for yeast infections.

DEAR DOCTOR: Letter asking physicians who care for Candida patients to be open-minded about new scientific developments in the field of candidiasis.

EVIDENCE FOR THE YEAST SYNDROME: Hall of Fame: Controlled clinical studies report statistically significant results for anti-Candida antibody and immune complex tests correlated with positive responses to nystatin. How to obtain full text journal articles.

ACADEMIC SKEPTICS: Hall of Shame: University physicians with no experience treating the yeast syndrome published poorly designed studies and negative papers lacking data.

MY POSITION STATEMENT: The medical profession should have predicted the existence of the yeast syndrome a priori based on published evidence about candidiasis and Candida allergy.

MY STORY: Why I wrote this Candida Information Packet.

PART II: SYMPTOMS

TYPES OF YEAST INFECTIONS: Definitions. Mucosal (acute pseudomembranous and chronic atrophic erythematous candidiasis). Cutaneous. Granulomatous. Disseminated. The yeast syndrome. Candidemia. Cell wall-deficient yeast protoplasts.

SYMPTOMS: Clinical signs and symptoms of candidiasis at various body sites including the vulva, vagina, urethra, bladder, penis, prostate, scrotum, mouth, esophagus, intestine, skin and nails.

PATHOGENESIS: How Candida causes disease: tissue invasion, latent intracellular yeast infection, digestive enzymes, toxic metabolites and immune reactions. Production of symptoms is explained at the cellular and molecular levels. How to distinguish between endogenous relapse and exogenous reinfection. Five electron micrographs show yeasts growing inside human cells. Figures.

SUGAR METABOLISM: Candida breaks down glucose into alcohol, acetaldehyde and acetic acid. These toxic products cause some symptoms of the yeast syndrome. Figure.

PART III: DIAGNOSIS

TEN STEP PROGRAM: Summaries of each step in a program of self-help and medical care for overcoming yeast infections and yeast allergies.

ALGORITHM: A flow chart or decision tree for treating superficial candidiasis. Figure.

QUESTIONNAIRE: Seven questions that help identify patients with fungus-related disease. Questionnaire was validated by a controlled clinical study of nystatin therapy. Typical Yeast Syndrome Patient: Table of symptoms and test results.

STEP 1. DIAGNOSTIC TESTS: Explanations of laboratory and clinical tests for yeast infections and yeast allergies. Test before treating! Laboratories: Table of labs that perform blood tests for anti-Candida antibodies, Candida antigens, immune complexes and Candida DNA; yeast metabolites in urine; microscopy and cultures on stool specimens. Resistant Yeasts: How to distinguish between yeast infections caused by resistant yeasts and yeast infections resistant to permanent cure. Table of laboratories that test Candida isolates for antifungal susceptibility. Diseases Mimicking Candidiasis: Similar symptoms unrelated to yeast. Unscientific Procedures: A to Z

PART IV: TREATMENT

STEP 2. ANTIFUNGAL TREATMENTS: Topical, oral (nonabsorbed and systemic), and intravenous antiyeast medications. Combination antifungal protocols. Topical Antifungals: Table of prescription and over-the-counter topical antifungal preparations for yeast infections of skin and mucous membranes. Oral Antifungals: Table comparing six oral antifungal prescription drugs. Nonabsorbed: nystatin. Systemic: Nizoral, Diflucan, Sporanox, Lamisil and Vfend. Justification: Letter to health insurance grievance committees justifying coverage for long-term oral antifungal therapy. Guidelines from the Physicians’ Desk Reference. Prescribing Guidelines: Efficacy, safety, cost, convenience, dosage, and treatment time for six oral antifungal drugs. Natural Remedies: Pros and cons of self-treating Candida infections with over-the-counter antiyeast herbal products and nutritional supplements.

STEP 3. PRECAUTIONS: Antifungal side effects. Contraindications. “Yeast die-off.” Drug interactions. Monitor liver function. Combination therapy. Follow-up.

STEP 4. ANTI-INFLAMMATORY DRUGS: Topical corticosteroids for itching and burning. Nonsteroidal anti-inflammatory drugs for arthritis and fibromyalgia. Antihistamines for allergies. Beta-(b)-adrenergic inhalers and leukotriene receptor antagonists for asthma.

STEP 5. IMMUNOTHERAPY FOR ALLERGY: Shots of Candida extract plus other allergens help build up your immunity to Candida.

PART V: PREVENTION

STEP 6. AVOID ALL RISK FACTORS: Medical, hospital, physiological, disease and transmission risk factors that make patients susceptible to yeast infections.

STEP 7. LIFESTYLE CHANGES: Tips for avoiding behavioral activities, sexual practices and birth control methods that cause candidiasis. Checklist Of Risk Factors: Conditions that cause yeast infections.

STEP 8. CANDIDA DIET: Restrict sugar and avoid yeasts and molds in foods and beverages. Myths and facts about the low carbohydrate diet and Candida.

STEP 9. PROBIOTICS: Supplements containing “friendly” bacteria restore normal intestinal flora killed by antibacterial antibiotics.

STEP 10. ANTIFUNGAL PROPHYLAXIS: Use an antifungal agent concurrently when taking medications that cause yeast infections. Take an antifungal agent intermittently to prevent yeast infections when risk factors are unavoidable.

PART VI: MANAGEMENT

WOMEN: Yeast infections of the vulva, vagina and urethra. Vulvodynia: Often develops after inadequate treatment of yeast vaginitis. Possible etiologies are residual inflammation, chronic atrophic erythematous candidiasis, Candida allergy and proliferation of nerve cells. Self-Treatment of Yeast Vaginitis: OTC sale of vaginal antifungals gives women access to prompt treatment. But self-diagnosis of yeast vaginitis is often wrong, and delays getting proper diagnosis and treatment. Don’t Microwave Your Underwear! Don't set your kitchen on fire in a misguided attempt to cure yeast vaginitis by sterilizing your panties.

MEN: Yeast infections of the penis, prostate, urethra and scrotum.

CHILDREN: Yeast infections in children: oral thrush, colic, diarrhea, constipation and diaper rash.

PART VII: APPENDIX

RESOURCES: Yeast-free Foods. Vulvodynia.

PHYSICIAN REFERRALS: Web sites of referral services that provide the names of doctors who treat yeast syndrome patients in the U.S. and other countries.

REPRINTS: Crandall, M. (2004) The Pathogenetic Significance of Intestinal Candida Colonization. International Journal of Hygiene and Environmental Health 207: 79-81. A letter to the editor rebutting a negative paper by Lacour et al. (2002).

Crandall, M. (1991) Allergic Predisposition in Recurrent Vulvovaginal Candidiasis. Journal of Advancement in Medicine 4: 21-38. An invited review article explaining how Candida allergy makes patients susceptible to yeast infections.

Copyright, 1996 to 2022, Marjorie Crandall, Ph.D.
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