Yeast Infection Dietary changes that may be helpful: Lifestyle changes that may be helpful:

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1 Yeast Infection Yeast infections are one of the most common reasons that women consult healthcare professionals. Yeast infections result from an overgrowth of a species of fungus called Candida albicans. The hallmark symptom of vaginitis caused by a yeast infection is itching of the external and internal genitalia, which is often associated with a white discharge that can be thick, curdy, or like cottage cheese. Severe infections lead to inflammation of the tissue and subsequent redness, swelling, and even pinpoint bleeding. Dietary changes that may be helpful: Some nutritionally oriented doctors believe that a well-balanced diet low in fats, sugars, and refined foods is important for preventing vaginal infections caused by candida. In one controlled study, avoidance of sugar, dairy products, and artificial sweeteners resulted in a sharp reduction in the incidence and severity of candida vaginitis.1 Many nutritionally oriented doctors advise women who have a yeast infection (or are predisposed to such infections) to limit their intake of sugar, fruit juices, and refined carbohydrates. Lifestyle changes that may be helpful: Yeast infections are three times more common in women who wear nylon underwear or tights than in those who wear cotton underwear.2 Additional predisposing factors for candida infection include the use of antibiotics, oral contraceptives, or adrenal corticosteroids (such as prednisone).

2 Underlying health conditions that may predispose someone to candida overgrowth include pregnancy, diabetes mellitus, or HIV infection. Allergies have also been reported to promote the development of recurrent yeast vaginitis. In one study, when the allergens were avoided and the allergies treated, the chronic recurrent yeast infections frequently resolved.3 In most cases, sexual transmission does not play a role in yeast infection. However, in extremely persistent cases, sexual transmission should be considered, and the sexual partner should be examined and treated. Nutritional supplements that may be helpful: Lactobacillus acidophilus is a species of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help to maintain the vaginal ecosystem by preventing the overgrowth of unfriendly bacteria and candida. Lactobacilli produce lactic acid which acts like a natural antibiotic; these friendly bacteria also compete with other organisms for the utilization of glucose. Lactobacillus acidophilus can be taken orally in the form of acidophilus yogurt,4 or in capsules or powder; it can also be administered intravaginally. Many women find relief using an acidophilus-yogurt douche daily for a few days or weeks, depending on the severity of the infection.5 Three capsules of acidophilus or one-quarter teaspoon of powder can be taken one to three times daily. Acidophilus can also be taken preventively during antibiotic use to reduce the risk of candida vaginitis.6 7

3 Boric acid capsules inserted into the vagina have been used with great success as a treatment for yeast vaginitis. In one study of 100 women with chronic yeast vaginitis who had failed to respond to various over-the-counter or prescription antifungal medicines, 98% successfully treated their infections with boric acid capsules, inserted into the vagina twice per day for two to four weeks.8 Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions. Herbs that may be helpful: Topically applied tea tree oil may be useful for some women with vaginal yeast infections. It can be diluted and used as a douche or used as part of a coconut oil-based suppository (with 2% tea tree oil).9 For more serious or persistent infections of the cervix or vagina, however, a healthcare professional should be consulted. Concentrations of tea tree oil as strong as 40% may be used with caution as a vaginal douche. Garlic has been shown to inhibit the growth of Candida albicans.10 Although controlled studies in humans have not been done, many doctors of natural medicine recommend garlic for individuals with yeast infections. For people who have no aversion to the odor, one whole clove of raw garlic can be chewed daily. Otherwise, odorcontrolled, enteric-coated tablets standardized for allicin content can be taken in the amount of 900 mg per day (providing 5,000 mcg of allicin), preferably divided into two equal doses. As an alternative, 2 4 ml of a tincture

4 may be taken three times per day. For health maintenance, one-half of the therapeutic amount is adequate. Another herb recommended for yeast infections is pau d arco. This South American herb s active constituents have powerful anti-yeast actions.11 However, these compounds are also somewhat toxic, and the amount needed to kill yeast is apparently greater than the amount contained in most herbal supplements. Many doctors of natural medicine recommend that individuals with recurrent yeast infections take measures to support their immune system. Echinacea, which has the capacity to enhance immune function, is often used by people who suffer from recurrent infections. In one study, women who took echinacea experienced a 43% decline in the recurrence rate of yeast infections.12 However, echinacea is not a substitute for anti-yeast medication. The essential oil of cinnamon contains various terpenoids that are believed to be responsible for cinnamon s medicinal effects. Important among these compounds are eugenol and cinnamaldehyde. Cinnamaldehyde and cinnamon oil vapors are extremely potent antifungal compounds.13 In a preliminary study in individuals with AIDS, topical application of cinnamon oil was effective against oral candida infections (thrush).14 Are there any side effects or interactions? Refer to the individual herb for information about any side effects or interactions.

5 References: 1. Horowitz BJ, Edelstein SW, Lippman L. Sugar chromatography studies in recurrent candida vulvovaginitis. J Reproduc Med 1984;29: Heidrich F, Berg A, Gergman R, et al. Clotting factors and vaginitis. J Family Pract 1984;19: Kudelco N. Allergy in chronic monilial vaginitis. Ann Allergy 1971;29: Hilton E, Isenberg HD, Alperstein P, et al. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med 1992;116: Neri A, Sabah G, Samra Z. Bacterial vaginosis in pregnancy treated with yogurt. Acta Obstet Gynecol Scand 1993;72: Eschenback H. Vaginal infection. Clin Obstet Gynecol 1983;26: Vincent J, Voomett R, and Riley R. Antibacterial activity associated with Lactobaccillus acidophilus. J Bacteriol 1959;A78: Jovanovic R, Congema E, Nguyen HT. Antifungal agents vs. boric acid for treating chronic mycotic vulvovaginitis. J Reprod Med 1977;36: Pena EO. Melaleuca alternifolia oil. Uses for trichomonal vaginitis and other vaginal infections. Obstet Gynecol 1962;19: Hughes BG, Lawson LD. Antimicrobial effects of Allium sativum L. (garlic), Allium ampeloprasum L. (elephant garlic) and Allium cepa L. (onion), garlic compounds and commercial garlic supplement products. Phytother Res 1991;5: Guiraud P, Steiman R, Campos-Takaki GM, et al. Comparison of the antibacterial and antifungal activities of lapachol and beta-lapachone. Planta Med 1994;60: Coeugniet E, Kuhnast R. Recurrent candidiasis: Adjuvant immunotherapy with different formulations of Echinacin. Therapiewoche 1986;36: Singh HB, Srivastava M, Singh AB, Srivastava AK. Cinnamon bark oil, a potent fungitoxicant against fungi causing respiratory tract mycoses. Allergy 1995;50: Quale JM, Landman D, Zaman MM, et al. In vitro activity of Cinnamomum zeylanicum against azole resistant and sensitive candida species and a pilot study of cinnamon for oral candidiasis. Am J Chin Med 1996;24: