Category Archives: Yeast Infection Testing

There Are Many tests Which Will Determine Whether You Have A Candida yeast Infection Or Not. In My Book, The Candida Crusher, I Explain Many Different Tests You Can Do At Home – And Free Of Charge, Which Will Determine If You Have A yeast Infection or Not. There Are Also Many Laboratory Tests Which Will Confirm Or Not If You Have A yeast Infection. I Explain All.

Blood Testing, Yeast Infection Testing

Functional Candida Testing: ELISA Blood and Saliva Tests

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As outlined by several specialists, the ELISA candida fungus examination signifies by far the most trustworthy method of revealing candida albicans over-proliferation at this stage in time.

Once the candida yeast infection starts to cause disease in your body, it will begin to provoke an immune response, and one of the main effects of such a response will be the production of elevated levels of specific antibodies to candida.

Your white blood cells begin to make antibodies specific against the candida infection, and these antibody levels are measured by way of this test. Some say that it is not a good way to determine if you have an active and/or current candida infection, as the antibody levels can remain elevated for some time (in some cases, months or even years) after a bout of candida, and in some people, evan the slightest exposure can increase the antibody levels. Others say this does not really matter, because if your levels are high right now, it means that you still have an immune system which is very much being affected by candida. As the activity drops off, so should the level of antibody activity, but for some people they can remain high for several years.

The technique used to determine these antibody levels in the blood is called ELISA (enzyme-linked immuno sorbent assay), which is a very powerful and sensitive tool for the measurement of antibody levels in a person’s blood or saliva. The way this test is performed is that a small sample of the patient’s serum or saliva is coated onto a special plastic plate. The patient sample is diluted and anything in that blood or saliva sample is then grown on this plate.

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If any antibodies that recognise the candida are present in the sample they will strongly bind to the candida; all remaining sample that is not bound can then be washed away and a special substrate is added. This is a colourless solution that will cause to produce a coloured sample. This colour can then be very accurately measured by something called a “spectro-photometer”. If an exact known level of candida antibodies is accurately determined, then the colour that this produces can be used to produce a standard curve. A computer can then analyse the test sample’s colour to give an exact value of how many candida-specific antibodies were in the original sample, now how clever is that!

The Three Main Antigens – Delayed and Immediate Immune Markers

It is worth pointing out that there are three antigens which can potentially tag the candida specific antibodies in your blood; they are immunoglobulin G (IgG), immunoglobulin A (IgA) as well immunoglobulin E (IgE). Your body produces these three antibodies in order to fight the different strains of candida. Don’t confuse this Candida Antibody Test with the IgE/IgG ELISA Food Allergy Test, I’ll talk a lot more about food allergy testing in chapter 7, section 1, Understanding Diet And Nutrition.

The importance of this is that the IgG-type antibodies tend to reflect a long-term or an older, more established candida yeast infection. IgG can also reveal that your candida infection may be a lot more severe if this marker is elevated at the same time as the other two.

The IgE antibody represents a present or a more recent candida yeast infection. And an elevated serum (blood) IgA level indicates a more superficial infection, especially if the IgG and IgE levels are low to normal. An elevated IgA on its own will also tell you if the exposure is mainly limited to the mucus membranes (digestive tract, vagina and/or skin) and if you do a stool test (in the case of a CDSA as you will see in a minute) it will reveal a heightened immune response inside your digestive system, generally a food allergy, inflammation or even point potentially towards inflammatory bowel disease if the inflammatory markers are elevated in this stool sample as well.
So, if you can do an IgG/IgA/IgE candida antibody test than please do it. You will then know a lot about not only the direction the yeast infection is going in your body, but will also be able to gauge the severity of the response.

For example, was it bad a while ago (IgG) and now more recently your candida symptoms are not as bad? (IgE). The good thing about doing this test up front is that you will have established a baseline as well, meaning, a starting point for treatment.

Be Careful When Interpreting Allergy Test Results

I have read in the scientific literature that there have been occasions where IgA class antibody levels have been found in excess of one hundred times that seen in a normal population, particularly in those with a history of long-term antibiotic use and in those with recurrent and chronic bacterial or fungal infections. Having a strong family history of allergies can also make a person more likely to have a heightened level of the IgA class of antibodies in particular so careful case-taking is necessary when performing this test to uncover such a history.

One of the major drawbacks of relying solely on a blood test to diagnose candida is that in a small percentage of candida cases there may actually be evidence of an IgA deficiency in a patient, which could lead to a falsely lowered reading or a negative result. This problem may be compounded by the fact that such patients are more likely to suffer from recurrent bacterial or fungal infections of the very nature that are being tested. You should not rely solely on the outcome of any one single test, and it is best you verify a candida yeast infection by looking at several ways to assess your condition.

The same goes for many different complaints you may suffer from, regardless of any form of testing, as you may now understand that are many unknown variables which can account for a false positive or a false negative test result.

Mucosal Antigen Levels Versus Serum Antigen Levels

You can determine candida antibodies by either the blood, the stool or by the person’s saliva. Always remember that candida is in essence an infection of the mucosal surfaces of the body (mouth, digestive system, vagina, etc) and that saliva in this regard therefore represents a more suitable medium for the detection of these types of infections than blood samples.

Blood-based antigen levels will tell us that the infection is more systemic, meaning more widespread throughout the body, and can literally travel anywhere the blood can go, and high serum antibody levels are therefore much more indicative of major systemic infections. Now you can see why I recommend the serum antibody levels over the saliva levels for the reasons mentioned above.

ELISA (Blood) Test or Saliva Test Collection Requirements

Be sure to avoid all non-essential medications and ALL dietary nutritional supplements for at least a week before the blood is drawn (or saliva produced) before you complete this test. I am surprised how many patients I have seen over the years who take supplements and drugs and even antibiotics right up until they complete the food allergy (or any) test, what a waste of money. In addition, I would prefer that you eat and drink all the foods and beverages you desire. Yes, that’s right; eat what you feel like eating for a seven day period before this test, and the reason for this is to establish the true level of antigens in your body based on your cravings and desires. This instinctive diet will reveal what is really going on inside your body and will accurately reveal the antibody level based on the diet which your body is screaming out for.

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Your candida antibody levels will be a reflection of what “taste’s good” to you, and those with candida generally like or crave the sweeter foods. Every person’s treats are a little different, so eat what you really want to eat for seven days and then complete the test.

Unless you feel absolutely terrible for eating the foods you desire, just eat what you want to eat for about a week and then perform the test. As soon as you have completed the test then go back to the anti-candida diet you were before.

Yeast Infection Testing

Functional vs Conventional Laboratory Testing for Candida

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So here’s the deal. In a previous post we talked about conventional laboratory testing. But now I know you’re wondering, what’s the difference between functional and conventional laboratory testing and why does it matter when attempting to treat a Candida infection?

Functional laboratory tests are distinctive from traditional pathology based screening because it can uncover just about any alterations in the body’s function that are a difference contrary to the convention. Conventional medical testing on the other hand concerns itself primarily with assessing if there is any pathology (disease).

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Functional testing concerns itself with assessing any deviations from the normal healthy body which can then be rectified before pathology begins. Doesn’t this make sense? It sure does to me, yet most all medical practitioners concern themselves with disease and not wellness anyway, so testing for the function of the body becomes irrelevant because the person is not yet sick to actually require treatment.

This is critical because each person’s functional life is slightly different than the next person’s. While there are standard conventional norms for certain test results, or for blood pressure or heart rate, there are people who live quite comfortably with numbers that are slightly depressed or elevated – they’ve got their own normal functioning levels.

Depending on the particular functional test and their respective results, the main points which become relevant and which I raise with a patient after a careful consideration of their case-history along with their results are the following:

1. Diet modification
2. Lifestyle modification
3. Specific probiotic and nutritional supplementation recommendation.
4. Oral (or local) anti-fungal or anti-bacterial medications.
5. General supplements such as omega 3 fish oils and antioxidants.
6. Initiate detoxification protocols – when it is necessary and how.
7. Follow-up testing – when and which test.

The results of the functional tests, which I’ll cover in my next series of posts, are the results that really help me to determine what each of my patients needs for optimal recovery, but I never rely on testing alone.

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Yeast Infection Diagnosis, Yeast Infection Testing

Test Results Should Never Be Considered Exclusively

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Remember, it is more important in the end to consider the patient rather than purely the test results, and this is where some practitioners potentially get confused in my opinion. They believe that it’s all about the test results rather than the patient. But what if the results are incorrect or the integrity of the sample was compromised? I have seen this on numerous occasions when I have been asked to assist in interpreting results for a practitioner.

For example, with a hair analysis the patient submitted colored or dyed hair. With a food allergy test (blood), the patient was taking an antibiotic right up until the blood was drawn or omitted every single food they believed they had an allergy so that the results wouldn’t show them. With a stool test the patient was taking probiotics during the test. The examples go on and on.

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I worked alongside a British medical doctor in Australia some years ago who taught me a valuable lesson. This doctor had some of the best clinical skills of any doctor I have ever worked with. His bedside manner was impeccable and so was his ability to diagnose a patient. He always used to say that one should never get “paralysis from analysis” and not to rely a great deal on any test results in order to treat a patient.

To demonstrate this point, Neil would regularly have his practice nurse draw blood from a patient and then send the blood samples from exactly the same person to two separate laboratories and, much to my surprise, the results that came back were different. This occurred on more than one occasion. The blood was the same, from the same patient, yet the results were different! I asked the doctor how this could be, and he said that there are many potential weak links in the testing chain, but the most common are:

  • If urine or stool was collected by the patient, how it was collected and handled.
  • How the sample was drawn and handled by the nurse at the doctor’s end.
  • The time and distance the sample travelled to the lab from the medical centre, and under what conditions the sample travelled in.
  • The handling of the sample by the nurse and in the laboratory.
  • The actual laboratory assay of the sample, i.e.; how they got the results.
  • The actual experience the lab technician (or perhaps the lack of).
  • The fact that some results belong to an incorrect patient; sad, but it happens.

The bottom line is not to rely exclusively on any test result. There are just too many variables why the test results may not be quite perfect but rather form a reasonably good guideline as to where to go as far as treatment is concerned. The other point I’d like to make is that the first test results obtained form a yardstick or baseline to compare subsequent results to.

I have found in some cases that a patient will come back in several years showing a similar result to those she originally presented with, a confirmation perhaps that the treatment was not vigorous enough initially or that she didn’t commit to the changes recommended to her diet and lifestyle.

In my next few posts I’m going to tell you of the different functional tests that are available to you to assess your yeast infection diagnosis as well as the advantages and disadvantages of these tests. I have used them all in my clinic for many years, and you may be familiar with some of these tests and not so familiar with others.

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Dr. William Crook, Yeast Infection Testing

Candida’s True Medical Pioneers

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Old paradigms die hard and new ideas are generally faced with opposition, obstacles and even ridicule. As humans we are not very open to change – a new idea or theory always faces opposition. Many scientists in the past have gone through criticism, ridicule and even incarceration.

In 1611, Galileo was subjected to inquisition in addition to criticism from his peers for his support of Copernicus’ idea that Earth revolves around Sun and not the other way around as was the belief at that time.  In 1840s, Ignaz Semmelweis was ostracized for insisting that the reason for high death rates in hospital maternity wards were because the doctors refused to wash their hands after studying cadavers in hospital morgues and went on to deliver babies with unwashed hands. Later, Louis Pasteur and his germ-theory (which proposed that diseases are caused by microorganisms) were ridiculed until Pasteur and hundreds of others proved it with advancement of new techniques in science. Gregor Mendel was only recognized as father of modern genetics almost a century after his death.

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These are not the tales of times gone by – even in these modern times there are several scientists and their ideas that have been ridiculed for a long time before they were proved to be right. Barbara McClintock, Stanley Prusiner, Dan Shechtman are few of the more recent ridiculed scientists whose ideas that were initially considered crazy finally got them a Nobel Prize after a long time.

While these seem like sad stories, criticism is also good in a way – criticism is the fire that can test gold. Pioneers of a field or an idea are the individuals who are the first to explore it. Pioneering ideas survive and pass the test of criticism and go on to become mainstream ideas. On the other hand, scientists and critics both are also humans and not every ideas/theory is “gold” and not every “fire” is good enough to test the gold. Despite this fact, new ideas of any kind should be listened to and debated upon without the background of distrust and prejudice.

Science by itself is not static – new ideas are tested rigorously according to what are believed to be the best testing tools of that time. These tools also change and may be replaced by better ones – and should also be constantly challenged and tested. Sometimes the knowledge and tools of the time are not advanced enough to match the idea of a scientist. Scientists who are criticizing an idea/theory are required to be constantly aware of this – but being humans, they also forget this sometimes.

Pioneers of candida overgrowth

So who are the true medical pioneers of candida? Dr. Orian Truss and Dr. William Crook were the first true pioneers in the discovery of the true extent of candida infections in the population.

Dr. C. Orian Truss graduated from Birmingham Southern College and Cornell University Medical College. He was Chief of Cardiology and Assistant Chief of Medicine at the US Air Force Hospital at Maxwell Field, Alabama. Prior to starting full-time private practice, he was an Instructor in Medicine at Cornell Medical College and University of Alabama Medical College. He was the first to suggest a possible link between many illnesses and the yeast Candida albicans. Starting from 1978, Dr. Truss wrote his ideas in a series of articles and  a book in 1983 entitled “The Missing Diagnosis” and made the suggestion that since the 1950s, the widespread use of antibiotics, combined with the universal use of the oral contraceptive pill and immune suppressing drugs like steroids (hydrocortisone, prednisone, cortisol and asthma preventative steroidal inhalers) coupled with a high carbohydrate type diet (such as bread, alcohol, processed and take-out foods) has caused a dramatic increase in yeast like overgrowths in the human population.

I can remember reading a book written by Dr. William Crook called “The Yeast Connection” in 1983, when my father bought a copy to try and sort his own digestive problems out. Dr. Crook was a medical doctor educated and trained at University of Virginia, The Pennsylvania Hospital, Vanderbilt and Johns Hopkins. He was a Fellow of the American Academy of Pediatrics, the American College of Asthma, Allergy and Immunology and the American Medical Association (AMA). He lived and practiced medicine in Jackson, Tennessee for almost 40 years. In 1979, Dr. Crook learned from Dr. Orian Truss about the relationship of the common yeast called Candida albicans with many illnesses. Being a good listener of his patients’ complaints and having an open mind to new ideas he got interested in chronic health complaints of his patients which seemed to be connected to yeast overgrowth.

To many involved in natural medicine, Dr. Crook was a mentor and a true role model. He was a passionate man who worked tirelessly to improve the public health, primarily by helping publicise the importance of food allergy and of candida yeast infection as causes of illness. As a pediatrician, Dr. Crook became interested in the idea that hidden food allergies were a triggering factor for conditions such as hyperactivity, learning disabilities, fatigue, bedwetting, migraine, colic and other common pediatric problems. After helping thousands of children overcome chronic conditions by means of an elimination diet, Dr. Crook then began to spread the word by writing books and articles on the subject. Many medical and natural medicine practitioners used his book “Tracking Down Hidden Food Allergies” as a blueprint for identifying food allergies in both children and adults.

Dr. William Crook is best known for his role in increasing public awareness of candida albicans yeast infections as a cause of chronic physical and emotional problems. Although Orion Truss, MD, is credited with alerting the medical profession to the yeast-illness connection, it was Dr. Crook’s landmark bestselling book “The Yeast Connection” that gave recognition to a condition which is as big today as it has ever been. Dr. Crook, passed away in October 2002, at the age of 85.

Intestinal candida overgrowth

The idea that candida can overgrow in the intestines, which came into being more than 35 years ago, is still considered controversial and you will find many clinicians and scientists arguing against the concept. However, the idea is not totally brushed under the carpet and the scientific evidence is being constantly monitored – in 2004, Robert Koch Institute from Germany carried out an objective review of the scientific studies in the field. In 2009, Schulz and Sonnenborn from Germany reviewed the data once again. Both these did not find conclusive evidence for the existence of intestinal candida colonization in people with normal immune system. The article by Schulz and Sonnenborn however includes the following key messages:

  • Candida in principle can be called a facultatively pathogenic yeast – meaning that it can cause disease under some circumstances but is not always disease causing.
  • A large number (102 to 104 candida/gram stools) are found normally in more than 50% of adult population – so such numbers cannot indicate intestinal candida overgrowth.
  • Depending on the stability of the mucosa, immune system and intestinal microflora, candida colonization may lead to:
    1. Superficial candida infections (of skin or mucosa)
    2. Invasive candida infection that is restricted to a particular area
    3. Invasive candida infection of the whole system
    4. Indications most commonly linked to candida colonization are irritable bowel syndrome (IBS) and some allergic reactions. There is no evidence of candida allergy syndrome in terms of epidemiology or treatment
    5. Modulation of intestinal microflora with probiotics can suppress candida colonization

It can be seen from these points that candida colonization is now considered possible. IBS and allergic reactions are being attributed to candida colonization and that candida colonization can be suppressed by probiotic use is accepted.

A few issues have been dogging the idea of candida overgrowth and some of these were also responsible for the American Academy of Allergy, Asthma and Immunology (AAAAI) to consider the work of Truss and Crook as experimental back in 1986. These issues are:

  1. How to find out that someone actually has increased growth of candida in their intestines when 50% of the population normally has really large number of candida in their guts?
  2. The issues proposed to be suffered by people with candida overgrowth could apply to almost all sick patients at some point of time as these are universal symptoms.
  3. As pharmaceutical antifungals were prescribed by Truss and Crook, there is a fear of development of antifungal resistant fungi.
  4. Additionally, there is also a fear of side-effects of antifungals
  5. AAAAI considered lack of published proof as lack of evidence

Points 3 and 4 that relate to the possible indiscriminate use of antifungals are valid points – pharmaceutical antifungals have these inherent risks associated with them and therefore must be used with caution if used at all. I do not recommend the use of pharmaceutical antifungals and instead suggest the use of broad-spectrum natural antifungals that do not have these side-effects.

Point 1 refers to lack of technology that could discriminate fungal overgrowth from normal fungal microflora. As you will read later in this article, new, modern methodologies are being applied now and have been successful in such a discrimination, for example, in patients with Crohn’s disease.

Point 2 – yes, the symptoms are generally universal. However, as Dr. Crook put forward in the diagnostic criteria, a lot many of these symptoms should occur at the same time for it to be considered yeast overgrowth issue.

As to point 5 – a lack of experimental evidence at a time when the idea had only come out is but natural! Experimental evidence takes time – scientists need to take these ideas and perform experiments. Biological experiments also take time as a good experiment needs to be designed well, needs to weigh all the possibilities that can occur with differences in individual biology and the experiments by themselves need time to conduct, repeat, and analyse.

You may have come across criticism of Dr. Crook for refusing to perform controlled experiments and arguing that he is a clinician, not a researcher. Well, performing controlled experiments is a skill which is learned by researchers and not clinicians. It is as dangerous to ask a clinician to perform an experiment as asking a lawyer to perform a surgery. It is important that people who have been trained in these skills carry out the work. So there was nothing wrong – it was, in fact, very honest and ethical of Dr. Crook to refuse to perform the experiments and he accepted that he did not have the skills required for proper research work.

Of course, as with anything, there are people who want to make a quick buck off an idea. These are the people who promise a quick cure to those who have been suffering for years without any treatment helping them. The swindlers have no knowledge or experience and base their products/treatment plans on half-baked ideas that they have picked off the books, newspapers, or the internet. The lure of a quick cure has led to many people being swindled (of course they find no relief from such cures) and consequently gave a bad reputation to the idea of candida-overgrowth. In absence of solid scientific proof of the concept, this aids the skeptics in their disbelief of the concept.

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Recent status on candida overgrowth research

There is a continued small but growing body of scientific evidence coming from researchers now concerning this condition. As better tools become available, the currently available evidence will serve a base on which new data can be obtained. There are many candida overgrowth related studies being carried out in cells and in mice and in humans. Let us look at a few of the more recent human studies that point towards the existence of candida overgrowth.

Patients with medically unexplained symptoms have elevated antibodies to candida: A 2007 research by Lewith and colleagues from the UK studied patients with unexplained symptoms who scored high on a modified Fungus Related Disease Questionnaire (FRDQ-7). They found that these patients had significantly high levels of antibodies to candida as compared to a control group that did not score high on the modified FRDQ-7. However, they do mention that having higher antibodies by themselves may not be able to correctly predict who will get such unexplained symptoms and that further studies are needed in this respect.

Candida colonization is seen in patients with gastrointestinal disease: A review article from 2011 by Carol Kumamoto from USA cites many studies that have showed clearly that diseases like Crohn’s disease, ulcerative colitis and gastric ulcers all have candida colonization associated with intestine and stomach mucosa as compared to healthy people.

Issues with proper movement of the gut and overuse of antacids that work through proton pump inhibition are both risk factors for small intestinal bacterial or fungal overgrowth: Research group of SSC Rao from USA have showed in 2013 that when there were issues with the movement of the gut or when people used PPI type antacids a lot, they were 50% more risk for them to get candida colonization and overgrowth in the small intestine.

Fungal dysbiosis is seen in patients with mucosal inflammation in Crohn’s disease: In 2014 a research was published by the Chinese scientists Li and colleagues. They studied patients with active Crohn’s disease. They surgically obtained samples from the inflamed and non-inflamed regions of the patients’ intestines. Using DNA sequence analysis they found that fungi in the inflamed and non-inflamed areas of intestines had different fungi. Candida albicans and Candida tropicalis were found in abundance in inflamed mucosa but were absent in non-inflamed mucosa. Apart from candida, other fungi like gibberella, alternaria and cryptococcus were more in inflamed mucosa compared to non-inflamed mucosa. This is the first report that characterized fungal microbiota in the inflamed regions of intestine as compared to non-inflamed regions.

Thus, slowly, but surely scientific evidence is emerging for the proposition by Dr. Truss and Dr.Crook – a proposition which was based on observation of thousands of patients, listening to them and finding a pattern in their microbiological and biochemical tests. Dr. Truss and Dr. Crook laid the foundation of the concept of candida overgrowth. There are scientists working in the field, building up on their pioneering work, finding and using newer and better tools and methods in their studies and hopefully with these, there will be more scientific evidence forthcoming in the years to come.