Candida can cause severe asthma

Candida is all over the web, deemed responsible for chronic fatigue and brain fog, but did you know Candida infection is also involved in asthma and can actually cause severe asthmatic conditions associated with high death rates?

Candida albicans growing on Sabouraud agar

Candida albicans growing on Sabouraud agar (Photo credit: Wikipedia)

What is Candida?

Candida albicans is a yeast, or fungus, commonly found on our body and in our digestive system. It is usually harmless but an imbalance in the gut microflora can result in Candida albicans transitioning from commensal to invasive and proliferating out of control (see my previous post presenting symptoms of candida overgrowth, or candidiasis, and the scientific evidence in support of a diet helping to treat the condition). In addition to visible yeast outbreaks on the skin, tongue or genitals, candida overgrowth can become systemic in particular in immunodepressed individuals, and cause symptoms difficult to identify, such as chronic fatigue, headaches and joint pain.

What is asthma?

Asthma is a chronic inflammatory lung disease, characterized by reversible airway obstruction and bronchospasms  (constriction of the muscles around the bronchioles). Asthma affects more than 25 million people in the United States (about 8% of the population). Asthmatic symptoms include wheezing, coughing, chest tightness and shortness of breath. Although exact causes are not known, asthma is considered to result from the combination of an inherited predispostion (atopy) and exposure to environmental irritants, such as molds, smoke, dust, or effortful exercise.

There is no known cure for asthma. Treatment focuses on daily management of asthmatic symptoms and prevention. Long term treatment generally involves daily use of corticosteroids or other drugs, which all involve side effects. For immediate relief, inhaled short-acting beta2-agonists are often prescribed in addition to the daily medicine. Preventing asthma involves identifying triggers and eliminating them.

How is Candida related to asthma?

Elevated levels of airborne fungus and yeast have been associated with an increased severity of asthma attacks, leading to more emergency visits and deaths. Hypersensitivity or allergy to Candida albicans has been established in some cases of chronic asthma, with improvement of symptoms after hyposensitization treatment. A recent study investigating the relationship between Candida and status asthmaticus (SA), an acute severe asthma that responds poorly to conventional treatment, has found an overwhelming presence of Candida albicans in the lower airways of patients suffering from the condition. The study also showed that Candida infection in mice induced asthma-like allergies. Other studies report the beneficial effect of anti-fungal therapies on asthma, reinforcing the notion of fungi as an important cause of severe asthma.

The conundrum

Vicious cycle: 1. Many asthmatic individuals use corticosteroids on a regular basis to reduce asthma symptoms, and take antibiotics for temporary relief. 2. Corticosteroids and antibiotics increase the risks of Candida overgrowth by depressing the immune system and by reducing the commensal microflora, respectively. 3. Candida infection can lead to increased asthma severity.

Are there options?

Specific dietary restrictions have been suggested to help fight Candida overgrowth, however, I could not find specific evidence of an effect of a Candida diet on asthma.

Nutrients proven to help improve asthma symptoms include Vitamin C (Cantaloupe, citrus, kiwi, mango, papaya, broccoli, brussel sprouts, cauliflower, green and red peppers, spinach), Vitamin D (salmon, mackerel, tuna, mushrooms, milk, egg yolk, cheese), omega-3 fatty acids (cold-water fish, such as salmon, nuts and flax seeds).

It might be beneficial to combine these nutrients with foods proven to have anti-candida activity such as garlic, essential oils from thyme, clove and turmeric (curcuma).

References used in this article

Mak G, Porter PC, Bandi V, Kheradmand F, Corry DB. Tracheobronchial mycosis in a retrospective case-series study of five status asthmaticus patients. Clin Immunol. 2013 Feb;146(2):77-83. doi: 10.1016/j.clim.2012.11.005. Epub 2012 Nov 27.

Gumowski, P., Lech, B., Chaves, I., Girard, J.P. Chronic asthma and rhinitis due to Candida albicans, epidermophyton, and trichophyton. Ann. Allergy, 59 (1987), pp. 48–51

Porter, P., Susarla, S. C., Polikepahad S. et al. Link between allergic asthma and airway mucosal infection suggested by proteinase-secreting household fungi. Mucosal Immunol., 2 (2009), pp. 504–517

Denning, D.W.,  O’Driscoll, B.R., Powell G. et al. Randomized controlled trial of oral antifungal treatment for severe asthma with fungal sensitization: the Fungal Asthma Sensitization Trial (FAST) study. Am. J. Respir. Crit. Care Med., 179 (2009), pp. 11–18

Targonski, P.V.,Persky, V. W., Ramekrishnan, V. Effect of environmental molds on risk of death from asthma during the pollen season J. Allergy Clin. Immunol., 95 (1995), pp. 955–961

Copyright (see copyright page): © “Food, Science and Health” (FoodScienceHealth.com) by Barbara Cerf-Allen, 2013 All Rights Reserved

Disclaimer: I am not advocating any of the above mentioned diets, nor am I making any claim about their usefulness for your specific condition. I am not a medical doctor and I am not giving medical advice. This blog is about sharing scientific information and my personal anecdotal experiences.

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