Perhaps one of the most common pathogens to cause infections in people with autism, ME/CFS, and a number of other health challenges is yeast, often called Candida (which is one kind). Yeast cells live in all of our bodies as part of our microbiome, and are usually kept in check by the balance of microbes and by our immune system. However, when the gut biome becomes disturbed, or our immune system becomes unable to fight adequately, yeast can grow out of proportion and lead to an opportunistic infection. Many mainstream doctors will say that it is pointless to test for yeast because everyone has it, but they are missing the point that testing can be much more sensitive and accurate than a simple "yes/no".
There are so many symptoms of yeast that it is hard to list them all, and can make identifying a yeast infection by symptom challenging, since there can be so many potential causes of these symptoms. However, some symptoms are more common than others, and taken together with risk factors looking at a person's symptoms is often the first step. Yeast can be local or systemic. Local symptoms may be a rash on the skin, usually in a skin fold or somewhere moist. Vaginal yeast infections are common and cause itching and burning. Yeast in the GI tract may appear as white, stringy threads in the feces that look like melted cheese. You may also see small white balls or patches on and around the anus and in the feces, as well as a bright red ring around the anus and redness between the butt cheeks.
Signs of systemic infection include emotional reactivity such as rages and crying fits, episodes of laughter that seem out of the blue, difficulty sleeping, night terrors, spaciness, rigidity, limiting of food choices, GI distress, urinary leaking or accidents (including bed wetting), sensory sensitivities (especially sensory avoidance), headaches, sore throat, sinus infections, congestion, mucousy stools, teeth grinding, constipation, nausea, vomiting, sinus infections, bad breath, rough skin or "sandpapery" rash, peeling skin (especially around fingernails and on feet), craving sugars and simple carbs, gas, and bloating, among many others.
Options for treatments for yeast:
A note about yeast "die-off" (also called a healing reaction or Herxheimer reaction)- when a person begins to kill yeast, they often experience unpleasant symptoms and feel worse at first. This is because the dying yeast is taxing the person's detoxification systems, which have already been taxed by the presence of the yeast. The degree to which a person experiences this depends on a number of factors, including how much yeast they had in their system to begin with, how quickly the yeast is dying, and how robust their detoxification systems are naturally. Epsom salt baths can ease the discomfort of die-off by supporting detox. Activated charcoal can be taken 30 to 60 min after taking an anti-fungal treatment to "mop up" the toxins from the dying yeast in the gut, sparing the body from having to process it. Because die-off can be stressful to the body, many people choose to ease into yeast killing slowly enough to keep the symptoms of die-off mild and manageable. This can mean starting with low doses of anti-fungal treatments or making dietary changes slowly over a period of time.
Diet- modifying the diet is usually the first-line defense in addressing yeast. In simple terms, this means removing sugar and simple starches from the diet. There are about a million versions of the anti-yeast diet, which you can easily find via a google search. Many have their advantages and reasons for eliminating certain foods. Be aware that many of these diets have been "watered down" to make them more appealing to people and easier to do, but at the expense of effectiveness. Any diet that includes sugars or starches such as sweet potato, rice, or corn will not be very effective. There is a lot of disagreement about whether honey is a problem or not and this seems to be very individual. Honey is itself anti-fungal, meaning it kills yeast. Most honey from supermarkets in the US is altered, however, and can be diluted with other sugars, including HFCS. So you will need to figure out for yourself if honey works for you. Yeast will happily feed on what is difficult for our own bodies to digest, which means that many complex carbs such as beans and grains can be major yeast feeders. The stricter and more effective anti-yeast diets eliminate many if not all of these foods.
Another area of disagreement is about fermented foods. For some people these can be very beneficial in fighting yeast, as they provide probiotics, as well as other factors that support gut and immune function. They also contain metabolites of bacteria and yeast, depending on the type, which can be too much for a system already burdened with internally-produced metabolites, so may exacerbate symptoms. These foods can also be a problem for people with histamine sensitivity. Many people who address yeast through diet find that they also need to avoid high mold foods, which include tomato, berries, dried fruits, nuts, mushrooms, and ferments including vinegar. Tolerance of fruit in a yeast fighting diet also varies from person to person. In general, a more paleo-type diet is best. If you are very serious about fighting yeast, the best two diets are the Specific Carbohydrate Diet and the GAPS Diet. The Body Ecology Diet (BED) is also popular and an option for people who need or want to eat fewer animal foods, but is less based on science.
Enzymes- There are several enzymes available that break down the yeast wall and kill it. These are easy to use and can be very effective, if taken on an empty stomach (if taken with food they will simply digest the food instead). These include Candex, Candidase, and No-Fenol. No-Fenol was actually developed to aid in the tolerance of foods high in phenols, but it contains an enzyme that does this by breaking down plant cell walls and many users found that if taken on an empty stomach it seems to have similar action as Candex and Candidase. From the manufacturer's site "xylanase is the major component of No-Fenol, and is an enzyme used to breakdown the structural components of plant cell walls, which are primarily very complex carbohydrates." (Note about Candex and Candidase- Candidase includes a protease enzyme as well, which helps break down the "innards" of the yeast cell after it dies. Some people find this helpful in reducing the symptoms of die-off while others don't, like many things involving yeast, this seems to be very individual).
Probiotics- yeast exists in our bodies as part of complex ecosystems and can cause problems when those systems become disrupted or altered. Probiotics help to restore the systems so that the yeast can be kept in check naturally by the body again. Probiotics can also be very effective in the short term to kill yeast by out-competing it. For this reason they should be started at low doses and worked up slowly. For yeast in the sinuses, a probiotic capsule can be opened and put directly in the mouth or gargled before bed. There is as much disagreement about which probiotics are best, and how best to use them, as there is about dietary options. Many people find that products that include prebiotics such as inulin- which are meant as "food" for the probiotics- can cause problems. Some popular and effective probiotics include: VSL #3, BioGaia, BioKult, saccharomyces boulardii (often used in conjunction with other probiotics), Florastor is a popular brand of s. boulardii, Custom Probiotics (which are apparently grown on corn), Therelac, ThreeLac and FiveLac, Primal Defense (which is made of soil-based organisms), and ProBio by Enzymedica. Probiotics products often contain allergens such as dairy and corn so always be cautious. Also, some people react to strep strains, such as s. thermophilius (which is found in yogurt), and which are commonly found in probiotic supplements (they are usually beneficial but can trigger PANDAS in some people).
Medications- the primary two pharmacological meds used to kill yeast are Nystatin and Diflucan. The primary difference between the two is that Diflucan is systemic, while Nystatin stays in the gut and acts locally. Because Diflucan is absorbed into the bloodstream and acts systemically, there is a concern that it may negatively affect the liver if taken for long periods of time. These meds are generally used for at least 3 months at a time in order to assure that enough yeast is killed to keep it from coming right back once the med is stopped.
Herbs and Supplements: there are many, many substances taken to kill yeast. Some of the most common and effective ones include raw garlic, coconut oil, berberine (also called Oregon Grape Extract), uva ursi, GSE (grapefruit seed extract), caprylic acid (derived from coconut oil), biotin (a B vitamin that keeps yeast from changing into it's more pathogenic forms), CytoFlora, oil of oregano, olive leaf extract, tea tree oil, manuka honey, calendula, gentian violet (often used for oral thrush in nursing mothers and babies), goldenseal, pau d'arco, and turmeric.
More on the microbiome:
This piece from NPR gives a good overview of the origins and importance of the microbiome in our health, as well as some of the factors that can disrupt it.
A new study shows that there have been major changes in the human microbiome in very recent times.
More on yeast:
Hyperactivity, ADHD and the Yeast Connection
