Based on the research studies of Iwata and Witkin in the 1960s and 1970s, and the clinical observations of Dr. Truss, superficial yeast infections may adversely affect the immune system, which, in turn, may adversely affect many different parts of the body. Yet, I'd never thought about the yeast relation to asthma until a physician friend added a note to a Christmas card I received in the early 1990s that said, "One of my patients with intrinsic asthma showed a marvelous response to Nizoral."
My interest in the yeast connection to allergies increased when I read two 1994 abstracts published in the Journal of Allergy and Clinical Immunology. One of these abstracts cited the observations of Belgium researchers who described the favorable response of some of their asthmatic patients to (ketoconazole) Nizoral. They found that four out of five of their asthmatic patients treated with this antifungal drug improved, while four out of five of the placebo group did not improve.
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| Candida And Allergies |
A second abstract, published by researchers at the University of Virginia, described a study of 10 patients with asthma and associated fungal infections of their feet. In a randomized study, they found that eight of the ten asthmatic patients were able to reduce their steroid dosage with no adverse reactions to fluconazole (Diflucan), in a dose of 100 mg. daily, were noted in any of the 10 patients, including "those maintained on fluconazole for up to two years."
In a June 2002 phone visit with Dr. George Ward, the senior author of the 1999 Virginia study, he told me that fluconazole may help an occasional patient with asthma who does not have a skin fungal infection. He also said, "When it works, it works very well ... It never caused problems in my patients, and I do not hesitate to use it ...
There are patients with asthma who have a fungus problem, and it hasn't been realized enough for most physicians to be comfortable with it ... I think that physicians will come to realize that it can be a therapeutic agent when they've looked at everything else. I certainly agree that fungi have something to do with asthma.
Further support for the fungal connection to asthma was presented by Talal Nsouli, M.D., a Washington, D.C. allergist/immunologist at the 1999 annual conference of the American College of Allergy, Asthma and Immunology. Dr. Nsouli described the response of a 36-year-old man with "unstable, severe, recalcitrant, corticosteroid-dependent asthma," who also had multiple brown skin lesions (over an inch in length and width) on his back and chest. RAST testing was positive and skin testing was strongly positive to Candida albicans. Here's an excerpt of their summary:
We started the patient on a trial of fluconazole for three weeks and clotrimazole topical cream for eight weeks. This resulted in an unanticipated dramatic and striking improvement of his asthmatic condition, as we were able to gradually taper him off systemic corticosteroids without deterioration of pulmonary function. His skin lesions cleared. He has not had any emergency room visit or hospitalization for the last two years. We conclude that dermatomycosis (a fungal infection of the skin) should be considered as a possible allergenic trigger in patients' unexplained recalcitrant intrinsic asthma.
EARLIER REPORTS ON THE CANDIDA-ASTHMA CONNECTION
In reviewing the medical literature I found that the relationship of Candida albicans to asthma was noted by Itkin and Dennis (The National Jewish Hospital in Denver) almost 30 years ago. In the introduction of their paper, these investigators said:
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| Candida And Allergies |
It is the scientific aim of the allergist to reduce the number of patients who must be classified as suffering from "asthma of unknown origin." It is the purpose of this paper to describe three years of experience with provocative bronchial challenge by inhalation as a tool in establishing Candida albicans as a significant allergen ... in patients suffering from severe asthma. To find out more, you can check out Candida And Allergies.