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Candida Case Submission

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Dear list,

 

I have a patient who is suffering from candida overgrowth and is on a diet

to control it. I don't have any experience with Candida and am treating her

now based on her symptoms and signs, but was wondering if anybody has any

experience dealing with candida, to kind of treat the tip (candida) as well

as the root, or just generally some strategies how to deal with this

problem.

Please find her symptoms and signs below:

 

1) Chief complaint

 

Candida overgrowth diagnosed a few months ago by a naturopath.

Food allergies to crab, other seafood, and mushrooms. Food allergy manifests

as a swelling of the tongue and throat and sometimes a rash on the lips

(urticaria).

Often a sinus reaction when eating breads, pastas, cheese.

Allergy to cats since 3 years.

 

2) Biomedical Dx and supporting lab tests

 

3) Relevant Medical History, include habits, diet, exercise, etc.

 

Salmonella in 1991. Amoebas treated with Flagyl/Fasigyn - 6 per day for 7

weeks - 3 times. She says her digestive system never really recovered.

 

Anit-Candida diet, cutting out carbohydrates, dairy (except yoghurt),

tomatos, eggplants, potatoes, etc.

 

4) questioning examination (subjective)

 

Stool: Highly changeable. At the moment every 2-3 days. Generally tendency

to hard stools.

Urine: Yellow.

 

MENSTRUATION:

Delayed menstruation.

Clotted menstrual flow

Painful menstruation (dull pain)

Pre-mentrual (emotional) discomfort: depression, sore, tender breasts,

distension of breasts.

 

Ocasionally pofuse discharge, white color, no abnormal smell.

 

SPLEEN/STOMACH

If she doesn't adhere strictly to her diet, abdominal distention and

tiredness after eating. Feeling of heaviness of the body.

Also pain in the stomach and intestine that is relieved with the application

of warmth. Pain is sometimes stabbing and sometimes dull.

She complains of cold toes and fingers, her boyfriend however says that she

is like a radiator, during the day and especially at night. During the

consultation her hands and feet were warm.

 

LIVER

Sometimes feeling of lump in the throat, difficulty in swallowing. Tendency

to sigh. Her mood and mental state are good in the moment due to a recent

job change that she is very happy with. She seems very sensitive, though,

and reflects a lot about herself, her life and the people around her. Maybe

a person who is very easily hurt. She said that all through her childhood

she was in emotional distress due to her mother's extreme jealousy of her

daughter. She does not seems to dwell on the past at all, though, and was

very open and cooperative during the consultation.

 

Blurred vision when tired, occasional floaters in the eyes. Tendency to

cramps (legs).

 

KIDNEY

Often sensation of cold in the back, cold knees.

 

 

5) pulse and palpation examination (objective)

Pulse: Weak (ruo). 78/minute.

 

6) tongue and observation examination (objective)

Dry lips.

Tongue: Red tip, thin slightly yellow coating, teethmarks.

 

7) the pattern(s) and treatment principles you chose, including your

rationale (unless this is your question) (assessment)

Liver qi stagnation with damage to liver yin/blood. Liver qi invading the

stomach.

 

8) herbs used (unless this is your question) (plan)

Combination of Xiao Yao San + Mudanpi and Zhi Zi (Liver qi stagnation with

blood vacuity and heat) and Zuo Jin Wan (invading the stomach), + Longdancao

and Dahuang for constipation.

 

9) other treatments or lifestyle changes

Peppermint tea as a drink.

 

I would really appreciate any help!

Thank you!

Karin

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on 10/16/00 8:16 PM, Karin Bischof at karinbischof wrote:

 

> Dear list,

>

> I have a patient who is suffering from candida overgrowth and is on a diet

> to control it. I don't have any experience with Candida and am treating her

> now based on her symptoms and signs, but was wondering if anybody has any

> experience dealing with candida, to kind of treat the tip (candida) as well

> as the root, or just generally some strategies how to deal with this

> problem.

> Please find her symptoms and signs below:

>

> 1) Chief complaint

>

> Candida overgrowth diagnosed a few months ago by a naturopath.

> Food allergies to crab, other seafood, and mushrooms. Food allergy manifests

> as a swelling of the tongue and throat and sometimes a rash on the lips

> (urticaria).

> Often a sinus reaction when eating breads, pastas, cheese.

> Allergy to cats since 3 years.

 

While it sounds like candida is a strong possibility, my first question is,

how was this diagnosed (tests)? Remember, candida is a symptom of a pattern

disharmony, not a disharmony in and of itself. Crab and other shellfish (I

assume that shellfish, not regular fish are the cause of the reaction) often

have toxins that could cause a reaction not necessarily candida related.

 

Sinus reaction to wheat products is clearly a sign of spleen qi vacuity

damp.

 

Allergic reaction to cat hair, kd qi vacuity, since in childhood, connected

to possible instability of defensive qi.

>

> 2) Biomedical Dx and supporting lab tests

>

> 3) Relevant Medical History, include habits, diet, exercise, etc.

>

> Salmonella in 1991. Amoebas treated with Flagyl/Fasigyn - 6 per day for 7

> weeks - 3 times. She says her digestive system never really recovered.

 

This is a significant factor. First, the salmonella poisoning, followed by

flagyl for 7 weeks! I see these cases a lot in my clinical practice. . . .

flagyl is a very strong drug, very bitter and cold, and damages the spleen

qi. It is no wonder the spleen/stomach didn't recover. This is the main

cause of yeast overgrowth. Simply, look at Li Dong-yuan's Treatise on the

Spleen and Stomach to learn theory to treat these chronic spleen damage

disorders.

>

> Anit-Candida diet, cutting out carbohydrates, dairy (except yoghurt),

> tomatos, eggplants, potatoes, etc.

 

Most of the books on the anti-yeast or candida diets, in my opinion, go much

too far. The diets are too restrictive and end up weakening the patient,

and their spleen qi. Classifying all carbohydrates as bad is

over-simplification. There is a great difference between quinoa and jelly

donuts. I agree with eliminating dairy as it is cold and can cause

phlegm-damp. And some fermented foods are necessary, such as miso,

sauerkraut, and possibly yogurt, to rebuild the intestinal flora.

>

> 4) questioning examination (subjective)

>

> Stool: Highly changeable. At the moment every 2-3 days. Generally tendency

> to hard stools.

 

The changable stool. . . .can you clarify this? Changable stool sometimes

can mean residual chong/parasites, which can include yeast.

> Urine: Yellow.

>

> MENSTRUATION:

> Delayed menstruation.

> Clotted menstrual flow

> Painful menstruation (dull pain)

> Pre-mentrual (emotional) discomfort: depression, sore, tender breasts,

> distension of breasts.

 

Definate signs here of liver qi and blood depression, which is often part

of this pattern. The liver qi depression further weakens the spleen via

the ke cycle, making the pattern more intractable.

>

> Ocasionally pofuse discharge, white color, no abnormal smell.

 

I assume you mean vaginal discharge, or dai xia, or bai dai, white

discharge, which clearly is spleen qi vacuity dampness.

>

> SPLEEN/STOMACH

> If she doesn't adhere strictly to her diet, abdominal distention and

> tiredness after eating. Feeling of heaviness of the body.

> Also pain in the stomach and intestine that is relieved with the application

> of warmth. Pain is sometimes stabbing and sometimes dull.

> She complains of cold toes and fingers, her boyfriend however says that she

> is like a radiator, during the day and especially at night. During the

> consultation her hands and feet were warm.

 

The diet is not quite enough, she needs herbal medicine to build her spleen

qi transformation. There is also spleen qi vacuity cold in the abdomen, so

warming herbs such as gan jiang to scatter cold. It would be interesting to

see where the heat radiates from (upper body), as it is possible that there

is heat above, cold below, as often appears in these patterns.

>

> LIVER

> Sometimes feeling of lump in the throat, difficulty in swallowing. Tendency

> to sigh. Her mood and mental state are good in the moment due to a recent

> job change that she is very happy with. She seems very sensitive, though,

> and reflects a lot about herself, her life and the people around her. Maybe

> a person who is very easily hurt. She said that all through her childhood

> she was in emotional distress due to her mother's extreme jealousy of her

> daughter. She does not seems to dwell on the past at all, though, and was

> very open and cooperative during the consultation.

 

Clear signs of liver qi depression with mai he qi/plum pit qi. . . .some

liver qi counterflow with phlegm accumulating at the throat level. Plum pit

qi is connected with an inability to completely process negative situations

emotionally.

>

> Blurred vision when tired, occasional floaters in the eyes. Tendency to

> cramps (legs).

>

> KIDNEY

> Often sensation of cold in the back, cold knees.

 

Kd qi xu.

>

>

> 5) pulse and palpation examination (objective)

> Pulse: Weak (ruo). 78/minute.

 

How about more detail on the pulse. We would expect weak, but there has to

be more information available here.

>

> 6) tongue and observation examination (objective)

> Dry lips.

> Tongue: Red tip, thin slightly yellow coating, teethmarks.

 

This means that the tongue must be puffy to have toothmarks. Many of these

patients have sp qi xu, the yellow coat (at the back?) is damp heat

beginning to accumulate in the upper burner. Red tip is heart fire, from

yin fire rising upwards, and the heart fire in turn harasses the spleen

( " spleen vacuity is the result of hyperactive heart fire which overwhelms

earth " - Li Dong-yuan).

>

> 7) the pattern(s) and treatment principles you chose, including your

> rationale (unless this is your question) (assessment)

> Liver qi stagnation with damage to liver yin/blood. Liver qi invading the

> stomach.

 

This is part of the pattern. The complete pattern seems to be sp qi vacuity

damp, sp yang vacuity cold, heart fire, kd qi vacuity and liver qi

depression.

>

> 8) herbs used (unless this is your question) (plan)

> Combination of Xiao Yao San + Mudanpi and Zhi Zi (Liver qi stagnation with

> blood vacuity and heat) and Zuo Jin Wan (invading the stomach), + Longdancao

> and Dahuang for constipation.

 

This is too draining for the patient. . . .the spleen is damaged and weak,

to use bitter cold medicinals that are draining, like longdancao and da

huang will only weaken the condition.

 

A representative prescription you can look at would be tiao zhong yi qi

tang, with modifications. (pg. 95, Treatise on the Spleen and Stomach).

>

> 9) other treatments or lifestyle changes

> Peppermint tea as a drink.

 

Not too much.

 

 

All the best,

 

 

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Dear Z'ev,

 

thank you for replying in such detail!

 

>How about more detail on the pulse. We would expect weak, but there has

>to be more information available here.

 

Right guan position: Empty

Left guan position: Slippery

(gan ke pi)

 

Karin

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