The Candida Expert

Fungal Arthritis

Fungal arthritis

Marta L Cuellar, Luis H Silveira, Luis R Espinoza

Annals of the Rheumatic Diseases 1992

Why This Article Matters

“There is never a lack of research or information available about the pervasiveness of fungal infections in our society today. There is however, a lack of awareness that this is an ongoing problem in society at all ages, as this research article demonstrates. Fungal infections can cause arthritis of any joint in the body. When treated properly, fungal arthritis cases improve and disappear. The use of antibiotics continues to be the primary cause of this problem, followed by, or in conjunction with steroid use. The best approach is to avoid these problems by avoiding use of these medications whenever possible.” – Dr. Jeff McCombs, DC

Excerpted from the research article:

Although healthy subjects may host fungal diseases, various predisposing factors that depress the immune system have been implicated in most patients developing fungal infections or fungal arthritis, or both. Alcoholism, cirrhosis, diabetes, tuberculosis, cancer, prematurity, treatment with corticosteroids, cytotoxic drugs, prolonged use of intravenous antibiotics, intravenous drug abuse, granulocytopenia, and marrow hyperplasia are among the predisposing factors. Neonates are the first group of patients in whom haematogenously originated Candida arthritis can occur. The illness is a hospital acquired disease of sick children with underlying diseases such as the respiratory distress syndrome, and gastrointestinal defects. C albicans, which is responsible for more than 80% of the reported cases, and C tropicalis are the species responsible for this disease. Arthritis is usually present with accompanying metaphysial osteomyelitis. Bone infection might originate from the infected synovium or via the metaphysical vessels. Polyarthritis occurs in most patients and the knee is the joint most often affected. Arthritis originated by haematogenous dissemination beyond the neonatal period is usually a complication of disseminated candidiasis in patients with serious underlying disorders or intravenous drug abusers. C albicans is again the causative organism in about 80% of cases, and C tropicalis is responsible for most of the remaining cases. Two distinct clinical presentations can be observed: (a) acute onset of constitutional and synovial symptoms (about two thirds of patients), with the aetiological diagnosis established within the first week, and (b) indolent presentation, with mild systemic and arthritic symptoms, and delay in the diagnosis for months or years.

Fungal arthritis is more prevalent than most doctors would realize.

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce, The Everything Candida Diet Book, and The Everything Guide To Autoimmune Diets.

The Medical Plague

The Medical Plague of antibiotic resistance is predicted to kill more than 300 million people by 2050. That’s more people within the next 35 years than the 75 million killed by the Black Plague. Is the Medical Plague set to become the Black Death of the 21st Century?

Beginning in 1999, the coming end of the antibiotic era was discussed behind closed doors in U.S. congressional committee meetings. Testimonies given in those meetings echoed the warnings of Alexander Fleming, the inventor of antibiotics, some 50 years earlier when he stated that misuse of antibiotics could lead to dangerous results. Based on fears of the end of the Antibiotic Era, in 2003 the FDA mandated that anyone receiving an antibiotic first be tested to determine if they had an infection that antibiotics were designed for and then to see if they had an antibiotic that was appropriate for each person. Since then, over 100 million antibiotic prescriptions a year have been written without following this federal guideline.

Dame Sally Davies, Chief Medical Officer for England, has stated that, “We are at the dawn of a post-antibiotic era… with almost all disease causing bacteria resistant to the antibiotics commonly used to treat them. We’ve clearly got it wrong, and I would argue that GPs do need more training. If we don’t take action, deaths will go up and up and modern medicine as we know it will be lost.” The warnings about the coming end of the Antibiotic Era have gone unheeded and we are now beginning an era where the misuse and unheeded warnings by the medical field have created the dangerous results foretold by Fleming. Dr. Arjun Srinivasan, associate director of the Center for Disease Control and Prevention,  has now stated, “We’re here. We’re in the post-antibiotic era. There are patients for whom we have no therapy.”

In spite of governmental concerns worldwide and decades of warnings about the end of the antibiotic era due to the development of antibiotic resistant strains, antibiotic use by medical doctors was found to have increased 36% worldwide from 2000 to 2010. Data continues to show that the majority of the antibiotics are still being prescribed inappropriately by medical doctors. With very little to offer their patients in the way of other options, medical doctors are adhering to the only thing that they know to do, give drugs. Perhaps it is not the doctors fault, as their training leaves them ill-equipped to handle most conditions without drugs. A common statement that you’ll hear from medical doctors is how unprepared they are by their schooling and training to handle the majority of the patients that they see. Frank Lipman, MD states, “I was shocked that my training was not very helpful for at least three quarters of them.”

Researcher, Dr. Jeffrey A. Linder, states, “We know that antibiotic prescribing, particularly to patients who are not likely to benefit from it, increases the prevalence of antibiotic-resistant bacteria, a growing concern both here in the United States and around the world.” In a study that looked at prescribing rates by physicians, Dr. Linder found that for acute bronchitis, “the prescribing rate for the correct antibiotic should be near 0%, yet they found the national antibiotic prescribing rate was 73%.” In cases of throat infections, only 10% were due to bacteria, yet antibiotic prescribing rates were 60%. Some MDs have continued to prescribe antibiotics to as many as 97% of the patients they see! Medical Plague, or not, it appears that the medical field is unlikely to change their ways and antibiotic-resistant deaths will continue to rise.

With medical doctors unable to offer any viable solutions, patients will have to seek out other alternative choices. Holistic practitioners become the best choice, but individual health practices will still be the best option for preventing illness and susceptibility to infections. Whole organic foods, exercises, rest, and involvement with family and friends. Correcting the effects of antibiotics through the Candida Plan can help to restore the vital link to health in the digestive tract. As John Knowles, Former President of the Rockefeller Foundation, has stated, “The next major advance in the health of the American people will be determined by what the individual is willing to do for himself.” This of course is true for all people around the world.

For those who think that taking care of themselves is too much to ask, the default system of care is the one that has created the Medical Plague. Good luck!

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

Posthospital syndrome is a term used to describe the vulnerability of a patient to a wide range of conditions after having spent any time in a hospital. What this means, is that instead of everyone coming out healthier, many come out in similar or worse shape than before. As William Osler, MD once said, “The person who takes medicine must recover twice, once from the disease and once from the medicine.”

Three decades ago, hospitals routinely kept patients for as long as their condition necessitated them to be there and receive care. In the 1980s, insurance companies stepped in and mandated that all patients be discharged from the hospital within 3 days, unless a doctor could justify longer care. This lead to many people being discharged before they were ready to go home, and often in less than healthy conditions. As a result, people often wound up back in the hospital within 30 days after discharge.

Now, the Affordable Care Act is going to penalize hospitals for readmissions, which will cause new policies that once again consider the patient last.

A large number of patients require readmission as a result of the effects of having received antibiotics in the hospital. This leaves them in a weakened state by destroying their natural beneficial bacteria, creating antibiotic resistant strains, and suppressing their immune systems.

Shockingly, another cause for re-admission is malnourishment. That’s right, people coming out of the hospital are suffering from malnourishment. Hospitals filled with doctors, nurses, and nutritionists are sending people home malnourished and vulnerable to infections. After decades of complaints, hospital food still isn’t any better and it does nothing to make patients healthier. Even though hospitals are staffed with nutritionists, people are leaving malnourished.

Other causes of Posthospital Syndrome readmissions include surgeries, catheters, antacid medications, steroids, sedatives, anesthetics, and pneumonia. Strangely enough, people who go to hospitals for pneumonia are most likely to have to go back for pneumonia.

Faced with a lack of coverage from insurance companies and penalties from the government, the most likely option that is going to come to the forefront is the use of more antibiotics during and after hospitalization.

In spite of government warnings about increasing levels of antibiotic resistance and predictions of 300 million deaths from antibiotic resistance by 2050, doctors are most likely to do what they’ve always done and hand out more antibiotics. With infections being one of the main reasons for readmission, doctors only know one thing to do for infections and that is to prescribe more antibiotics, three at a time if necessary.

While other options are being recommended, these options have already been recommended before and never followed up on.

In many cases, if you’re going to the hospital, chances are that you haven’t been taking care of yourself for quite a while. Now is the time to start taking control of your life and improving your health. The future of healthcare looks bleak and costly in many ways.

I recommend re-establishing a foundation for health in your body through the Candida Plan. What you do today will determine where you are tomorrow.

“The next major advance in the health of the American people will be determined by what the individual is willing to do for himself.” -John Knowles, Former President of the Rockefeller Foundation

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

Screen Shot 2015 04 25 at 10.33.23 AM 300x205 Antibiotics & Candida

Antibiotics & candida. The two go hand-in-hand. Nothing else is guaranteed to create a systemic candida fungal infection in the body as fast, or as effectively as antibiotics. Nothing else but antibiotics cause systemic fungal candida infections on a routine basis for hundreds of millions of people worldwide.

In spite of government concerns and warnings about the end of the antibiotic era due to the development of antibiotic resistant strains, antibiotic use was found to have increased 36% worldwide from 2000 to 2010. The development of antibiotic resistant bacteria is now estimated to kill 300 million people by 2050. The word “anti-biotic” means “against life” and only now are we beginning to see how true that is.

As dim as that outlook is, there is another, more pervasive effect from the use of antibiotics that typically goes unrecognized, the development of systemic fungal candida infections. Antibiotics & candida. The use of one creates the emergence of the other.

The emergence of fungal candida as a growing health problem dates back to the introduction of antibiotics in the 1940s. This is clearly outlined on PubMed, the free search engine of the United States National Library of Medicine that references over 23 million scientific articles and abstracts. A search for candida will reveal over 56,ooo research papers on this organism. On the right-hand corner of the page, a quick look at the “Results by Year” shows that research on candida as an infectious agent had zero studies in 1944, the year before antibiotics began to be introduced as an emerging medical therapy.

PubMed Candida 1 Antibiotics & Candida

From zero studies in 1940 to 2568 studies in 2014, over 56,ooo studies on candida have been cited on PubMed. As the use of antibiotics continues to increase, so will the number of studies. Antibiotics & candida, an inseparable pair.

In spite of the 56,000 studies on candida and ongoing research approaching 3000 studies a year, the medical field remains woefully uninformed about the magnitude and prevalence of candida in society. Critics cite an unwillingness of medical doctors to look at anything that might be deemed as a side effect of prescription medications, along with a general lack of knowledge regarding antibiotic pharmokinetics and human physiology.

As one pharmaceutical salesman told me, “Doctors don’t know anything about drugs unless we tell them, and we don’t tell them everything.”

This gap between science and medicine leaves patients to fend for themselves, which can produce beneficial results, but it may also leave them wandering without concrete answers while candida creates and contributes to more than 125+ diseases and imbalances within the body.

For those looking for the links between antibiotics & candida, there are over 10 different ways that antibiotics cause candida.


In 5 to 7 days, antibiotics can wipe out all the bacteria in the body. It then takes candida as little as 5 to 52 hours to spread systemically. No other drugs, with exception of chemotherapy, enable candida to multiply and spread so rapidly. Although several articles state that steroids, immunosuppressive drugs, and birth control pills will create candida, immunosuppression alone has not been found to create fungal candida. Only antibiotics via the mechanisms mentioned below will reliably create systemic fungal candida time and time again. Once that imbalance is established, it becomes permanent until it is reversed.

1) Antibiotics cause the loss of bacterial inhibition. Without 100 trillion bacteria present to crowd out and inhibit it, fungal candida grows unchecked.  This one of the most powerful inducers of fungal growth. (3) One of the main types of bacteria that inhibit candida are the Lactobacillus species. Once they are eliminated by antibiotics, fungal candida grows and spreads, and will then inhibit the the Lactobacillus species from recolonizing the intestinal tract later on.

2) Antibiotics cause a loss of nutrient competition (4). Without 100 trillion bacteria present, the competition for nutrients ceases to exist and fungal candida has more than enough food resources to fuel its growth.

3) Antibiotics alter intestinal pH. Fungal candida requires an alkaline pH for its growth. Many of the bacteria in the intestinal tract release acids to maintain a healthy pH in the acidic range. Antibiotics eliminate these acid-forming bacteria and this leads to pH changes that stimulate the conversion of candida from yeast to fungus. It is well established that a pH around neutrality (pH ~6·5) favours hyphal development (5) of C. albicans in vitro, while a low pH (pH <6·5) blocks hyphal formation and stimulates growth of the yeast form.

4) Antibiotics destroy bacteria that produce antifungal compounds (6) that help to inhibit and regulate fungal growth. Elimination of the Lactobacillus bacteria eliminates production of long and short-chain fatty acids that inhibit candida’s fungal conversion.(7)

5) Antibiotics disrupt the mucosal barrier of the intestinal tract. Mucins are proteins found in mucus that suppress the fungal invasion of candida. Antibiotics degrade mucins (9) leaving people vulnerable to the growth and spread of candida throughout the body.

6) Antibiotics directly stimulate yeast to fungus conversion. The tetracycline antibiotics have been associated with direct stimulation of fungal candida growth. (10)

7) Antibiotics suppress immune system responses which then enables fungal candida to evade the immune system and grow unchecked throughout the body. Suppression of immune cells is a frequent, if not constant, effect of antibiotic use, especially of those cells (neutrophils) that are most effective against candida. Erythromycin (11) and other antibiotics (12) suppress neutrophils and macrophages, the two most effective immune cells against fungal candida.

8) Antibiotics induce a shift in immune system responses that favor the growth of fungal candida. A Th1 immune is most effective against fungal candida, as well as viruses, parasites, and many bacterial pathogens. Antibiotics create a shift towards a Th2 immune response (13) that allows for the spread of fungal and other infectious agents.

9) Antibiotics eliminate bacteria that regulate immune responses. The microbiome helps to maintain and regulate immune responses (14) throughout the body.

10) Antibiotics suppress immune system responses. By suppressing the macrophages and the inflammatory response, the liver does not release acute-phase proteins which are necessary for preventing the spread of pathogenic organisms throughout the body. Three of these acute-phase proteins (Ferritin, Ceruloplasmin, & Haptoglobin) function by binding iron and making it unavailable for the growth pathogenic fungal candida. Without these proteins, candida has access to all of the iron that it needs to spread and grow. There are at least 3 separate iron uptake pathways in the pathogenic fungal form of candida.(15)

11) By killing off over 100 trillion bacteria, antibiotics cause the breakdown of the bacterial cells and a massive release intracellular bacterial components, like Peptidoglycans (PGN) that act directly on the cellular membrane of the yeast Candida Albicans (16) causing it to transform its normal yeast to its pathogenic fungal form.

Given that the effects of antibiotic use can persist for years and the development of fungal candida causes or contributes to a very long list of diseases and conditions, one must be prepared to reverse the effects of antibiotic use and reduce any negative side effects.

Taking probiotics while taking antibiotics has been shown to reduce some of the side effects and long-term consequences of antibiotic use. This approach was originally used over 60 years ago when antibiotics were first being used, but subsequently ceased to be recommended.

For anyone who has taken antibiotics, re-establishing a balanced gut and converting fungal candida back to its normal yeast form is a necessity. The Candida Plan is designed to accomplish this naturally without the use of drugs that create further imbalances and destroy immune cells. Reverse the effects of antibiotics & candida and live a healthy life.

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

1. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Van Boeckel, Thomas P et al.  The Lancet Infectious Diseases, Volume 14, Issue 8, 742 – 750.

3. Germ tube induction in Candida albicans. Shepherd, MG et al. Canadian Journal of Microbiology. 1980, Volume 26, 21-26

4. Control of Pathogens and Pathobionts by the Gut Microbiota. Hamada N et al. Nature immunology. 2013;14(7):685-690. doi:10.1038/ni.2608.

5. A characterization of pH-regulated dimorphism in Candida albicans. Buffo, Jeremy et al. Mycopathologia. 1984, Volume 85, Issue 1-2, pp 21-30

6. Antifungal activity of lactic acid bacteria: Factors affecting production and stability of antifungal compounds of Lactobacillus plantarum, and effects of the antifungal compounds on growth and aflatoxin production by Aspergillus spp. Bianchini, Andreia.(January 1, 2010). ETD collection for University of Nebraska – Lincoln. Paper AAI3398388.

7. Regulation of Candida albicans Morphogenesis by Fatty Acid Metabolites. Noverr MC, Huffnagle GB. Journal of Infection and Immunity.2004 Nov; 72(11): 6206–6210.

8. Mucins Suppress Virulence Traits of Candida albicans. Kavanaugh NL et al. mBio. Nov. 2014, Volume 5, No. 6,e01911-14

9. Influence of antibiotics on intestinal mucin in healthy subjects. Carlstedt-Duke B. et al. European Journal of Clinical Microbiology.1986 Dec;5(6):634-8.

10. Characteristics of Yeasts Isolated from Processed Poultry and the Influence of Tetracyclines on Their Growth. Feb. 1959. Walker HW, Ayres JC.

11.Experimental Study of Antibiotic-Induced Immunosuppression in Mice. II. Th, Ts and NC Cell Involvement. Comp Immunol Microbiol Infect Dis. 1983;6(4):301-12.

12. The influence of antibiotics on phagocytic and bacteriocidal activity of rabbit peritoneal macrophages stimulated by filtrates of cultured t-lymphocytes. Sacha PT et al. Medycyna Doswiadczalna Mikrobiologia.1999;51(3-4):399-412.

13. An oral introduction of intestinal bacteria prevents the development of a long-term Th2-skewed immunological memory induced by neonatal antibiotic treatment in mice. Sudo N et al. Journal of the British Society for Allergy and Clinical Immunology.2002 Jul;32(7):1112-6.

14. The gut microbiome shapes intestinal immune responses during health and disease. Round JL, Mazmanian SK. Nature Reviews Immunology. May, 2009, 9, 313-323

15. Haemin uptake and use as an iron source by Candida albicans: role of CaHMX1-encoded haem oxygenase. Santos, Renata et al. Microbiology, Volume 149, No. 3, 579-588.

16. Bacterial peptidoglycan-derived molecules activate Candida albicans hyphal growth. Wang Y, Xu X-L. Communicative & Integrative Biology 1.2 (2008): 137–139

Are your bacteria smarter than your doctor? Absolutely!

Some bacteria are naturally resistant to antibiotics. This comes from past exposures and the subsequent development of resistance. These bacteria are called persisters. They are unaffected by all antibiotics, and theoretically lie dormant in the body.

Other bacteria produce their own anti-antibiotics – “The bacteria produce compounds, called cephalosporinases, which inactivate and destroy certain antibiotics such as penicillin derivatives and cephalosporins, protecting themselves and other beneficial bacteria that live in close proximity.

Yet, other bacteria develop resistance as soon as they are exposed to antibiotics. This has been known for over 70 years. Experts have warned about the end of the antibiotic era for at least 15 years and are now proclaiming that it is here.

Dr. Arjun Srinivasan, associate director of the Center for Disease Control and Prevention, has stated — “We’re here. We’re in the post-antibiotic era. There are patients for whom we have no therapy.

Now, a predicted average of 10 million people a year will soon die as a result of antibiotic resistance. Thought Ebola was bad? This is much worse.

Overuse of antibiotics is one of the main causes. Doctors routinely overuse and abuse antibiotics. The Chief Medical Officer for the UK, Dame Sally Davies, states that, “There is evidence that some GPs are dishing out more than they need to for medical clinical disease. ‘We’ve clearly got it wrong, and I would argue that GPs do need more training. If we don’t take action, deaths will go up and up and modern medicine as we know it will be lost.”

It would be nice if doctors read the science on antibacterial resistance, or even just the daily headlines would do, but that doesn’t seem to be the case as antibiotic prescriptions are increasing, not decreasing. “The number of antibiotic prescriptions increased by 32% in community settings by non-GPs such as dentists, while prescriptions for inpatients in hospitals rose by 12%.”

Of course, the MDs blame the patients for holding their feet to a blazing fire until they succumb and write prescriptions for antibiotics. A few of the MDs with integrity actually accept the blame and studies show that it isn’t the patients fault, in case anyone had a doubt about this.

Bacteria are smarter than doctors. They have had millions of years more experience in this area than doctors have had with antibiotics. Mother Nature has been challenging bacteria with safer forms of antibiotics for years.

In comparison, man’s antibiotics are a mutant, Frankenstein-like imitation that are pieced together in an attempt to imitate Mother Nature, but instead end up wreaking havoc all across the planet.

Just as Nero played his violin while Rome burned, so to do doctors continue to overprescribe antibiotics while millions die.

So why do doctors continue to prescribe antibiotics in the face of dire warnings and a mounting body count? Simple, they have no other answers. It’s not as if they had a thousand other safe choices, like say a holistic healthcare practitioner does. Sadly, it’s practically the only thing they have to offer. They belittle and ostracize anything and everything that isn’t “medicine”.

So, yes, bacteria are smarter than doctors, but are they smarter than a 4-year old? That’s another blog post.

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

Use antibiotics, Get Candida! It’s as simple as that. It’s what I’ve been saying for a couple of decades, now. It takes a while for science to catch up to what is already known by many people through observation and personal experience. The University of Chicago  study below is a good example of that. It’s good to finally see science demonstrating what we already know about candida and antibiotics – “Take antibiotics and you’ll get candida!”

Although a well-functioning human intestine teems with a variety of microbial life, serious illness, long-term intravenous feeding, and multiple rounds of antibiotics wipe out much of this diversity. Inspection of 16S rRNA sequences from stool samples showed that the guts of five healthy volunteers harbored at least 40 bacterial genera. In contrast, in five of the 14 ICU patients in the study, 90 percent of the bacterial sequences were from just one taxontypically a known pathogen, such as Enterococcus or Staphylococcus.

(What we see here is antibiotics wiping out 100 trillion bacteria, leaving only the antibiotic resistant strains behind. Although this article implies that only long-term ICU patients have this problem, other research studies have consistently shown that the very same effect happens within 5 to 7 days of antibiotic use. These resistant strains are known pathogens that can cause illness and death, especially without the 100 trillion bacteria there to stop them.)

When a patient spends a long time in ICU, “the gut undergoes near-complete ecologic collapse,” said study coauthor John Alverdy, a gastrointestinal surgeon and researcher at the University of Chicago’s Pritzker School of Medicine. In response to the “slash and burn” use of antibiotics, among other factors, “it’s like the Amazon rainforest. It falls apart.

(I think “near complete collapse” says it all. The entire system is affected. It’s not just the bacteria. It’s everything.)

The 16S rRNA sequences were specific to bacteria, but culture analysis also showed the presence of the fungus Candida albicans or C. glabrata in most patients.

(Use antibiotics, get candida! It’s what we’ve been saying for decades. It’s backed by Candida Facts –

“It was so surprising that we found just two-member communities—only Candida and multidrug-resistant bacteria,” said microbiologist and study coauthor Olga Zaborina.

(Use antibiotics, get candida! The odds of developing serious conditions is very high, or at least the 120+ candida-related conditions that we know about –

“They actually considered the fungal component of the microbiome, which has been routinely ignored in hundreds of microbiome studies
,” said Michael Lorenz, a microbiologist at the University of Texas Health Science Center at Houston who was not in involved in the study. “So the finding that there are these interactions between the bacterial and fungal components is one that people should be very aware of.”

(People are continually puzzled as to why MDs don’t know anything about candida. MDs rely on science to inform them and ignore the real-life experiences and complaints of their patients. MDs treat disease, not patients. This distances them from ever knowing more about what’s really tang place on a daily basis. As we see here, science on the other hand, hasn’t even been looking many times.)

To mimic the conditions in an ICU patient’s gut, the researchers grew the microbes in the presence of an opioid. Opioids often enter the gut in critically ill patients as part of a stress response, and are known to interact with the quorum-sensing signals that regulate bacterial virulence. Indeed, in two Candida-bacteria combinations, opioid treatment shifted bacterial behavior from commensal to pathogenic, killing a substantial proportion of worms.

I think the take-away here is that stress + candida kills. I actually think that’s oversimplified, as many other factors come into play.)

…the study “gives clinicians important information that they’re to get the gut back to health as fast as they can. The quicker they can re-establish normal communities in the gut, the better it will be for the patient prognosis.”

(Sounds like everyone needs a Candida diet –

While Alverdy and Zaborina continue to explore the antivirulence potential of phosphate treatment, they suggested that reconstituting a patient’s original community of gut microbes might be the best medicine. Before entering intensive care for organ transplants or other major procedures, patients may soon set aside their own healthy stool to be used for a future fecal transplant.

(It’s better than medicine, because it’s not medicine!)

Many people like to use testing to prove that they have fungal candida, but as I’ve repeatedly stated, it’s not necessary, as science shows that antibiotic use guarantees that you’ll have a systemic fungal infection within hours of using antibiotics. 

Intensive Loss of Gut Bacteria Diversity –

A. Zaborin et al., “Membership and behavior of ultra-low-diversity pathogen communities present in the gut of humans during prolonged critical illness,” mBio, doi:10.1128/mBio.01361-14, 2014.

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

Patient Q and A

Here’s today’s Q&A with a patient that helps to address some commonly asked questions:

Do you think its possible to completely get rid of candida and be able to eat normal again?

Yes, that’s possible. We’ve see it all the time. The Plan helps to restore and develop a better sense of health and healthy eating within the body. Energy levels lift, inflammation decreases, and a host of other improvements can take place. People tend to have a re-born, or new-born sense, of what it feels like to be healthy and naturally have an aversion to foods that don’t make them feel that way. Some people however, go back to the eating habits that made them lose energy and don’t feel as well as they did on the Plan. Fortunately, they now have a new reference point and often decide to return eating they way that made them healthy on the Plan. If “eat normal again” means eating foods that helped create the problem, it also depends on how your body now responds to those foods. Such “normal” foods are mostly not a healthy choice.

I have always been able to eat all foods and sugar without problems, but when i got candida it completely destroyed my life and only able to eat a couple of foods.

The real problem starts with antibiotics and how they can permanently alter the composition of the body’s bacterial flora. That can sometimes be the bigger problem. Fungal candida is a just part of the problems that antibiotics create. Restoring healthy intestinal flora, correcting fungal candida, boosting and restoring the correct immune responses and balance, detoxifying the body, etc., are all involved. With a balanced flora and immune system, the body has a greater ability to adapt and compensate for eating unhealthy foods. That doesn’t make those foods okay to eat, or healthy, it just means that you’re less likely to exhibit symptoms when eating those foods. They will still damage and create imbalances in your body that may take years to show up. When the body’s balance is destroyed by antibiotics, you have a lesser ability to compensate and adapt to eating unhealthy foods. The body’s immune system develops allergic responses that can take months, or even years to release in some cases, even if healthy eating habits are restored. Doing as much as possible to balance the whole system will often produce faster results. A lack of symptoms doesn’t mean that certain foods aren’t problematic. It can also mean that your body’s feedback mechanisms aren’t functioning very well. Many people live most of their lives in this state, eating and drinking anything they want, only to end up with cancers or other diseases (McDonald’s serves 60 million people a day). They go to their doctors and tell the docs that they never had any problems or symptoms. The MD doesn’t know anything about physiology or how the body functions, and therefore can’t offer any explanation, only meds. Those diseases developed over years, decades of poor habits.

What are your experiences with patients, are most people able to get rid of candida completely?

I have found that restoring fungal candida to its normal yeast form is not that difficult when approaching the body as a whole. Some of the other issues that are created by antibiotics and fungal candida in combination may take longer. Proper immune system balance can be an area for some people where lingering symptoms often occur. Immune system dysregulation that creates inflammation and all that goes with that is a common area sometimes.

I don’t have more questions but will get back to you after the 16 weeks and give you a update.

I would recommend letting us know how you’re doing so that we may offer some suggestions along the way, if needed. Some issues commonly caused by candida such as blood sugar imbalances, low levels of HCL, constipation, etc., can be addressed along with the Plan and improve your results.


Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

The truth about antibiotics isn’t something that you’re likely to find out about from any doctor or institution. The truth about antibiotics has been so buried beneath decades of arrogance and misinformation, that even they don’t know it.

Ever since the days of Alexander Fleming, who is credited with the discovery of antibiotics, misinformation and misunderstanding have surrounded the use of antibiotics. Doctors continually regurgitate information to their patients that has no basis in science, even as Sir Fleming did when accepting his Nobel Prize, warning against the emergence of untreatable infections as a result of improper antibiotic use in 1945.

Doctors will tell you must take your full prescription of antibiotics in order to avoid creating antibiotic-resistant strains that could eventually become untreatable. This is untrue. This falsehood was more likely created by a pharmaceutical marketing team than it was by a scientists, as it doesn’t have any basis in science. Antibiotic resistance is created by using antibiotics, period. That’s it. Nothing more other than using them. The concept of antibiotic resistance being caused by not enough antibiotics, or not taking them long enough, is pure fiction. This was an inaccurate understanding from the very beginning which still persist today in our “modern” world.

Every living thing on the planet has an imperative survival impulse to keep on living. Microbes have been here much longer than humans and can adapt much quicker, going through an entire generation in as little as 12 minutes, while humans can take 100 years. If you try to kill a microbe, it uses one, or several, mechanisms to adapt and survive. It then passes on this survival information to other microbes, again via several mechanisms. Because of this, antibiotics have a built-in obsolescence, or warranty if you will. You can only use them for so long before they wear out. Sort of like a tire. Eventually, you’re going to be placing yourself at risk by continuing to use them. Science knows this. Medicine doesn’t seem to.

It has been shown that antibiotic-resistance develops while you are taking antibiotics. The old point of view as promoted by Sir Fleming was that not using a high enough dosage to try and kill microbes would lead to them developing resistance. Science tells us that just the opposite is true, where using high doses or combinations of antibiotics, actually increases how quickly antibiotic-resistance develops. From a scientific standpoint, this makes sense. Bigger guns lead to faster responses to survive.

Unfortunately, medicine embarks on a tale of fantasy when talking about antibiotic resistance. The concept of not enough or not long enough is rooted in arrogance. It views microbes as inanimate sitting targets that only need to be knocked off the shelf by a shotgun blast. It views our chemical antibiotic creations as superior to microbes, when in fact, they represent the limitations of man’s mind, not it’s greatest possibilities.

Microbes have at least 360x more genes than humans, giving them the upper hand in the battle for survival. In the human body, they outnumber us by 10 to 1. Science has come to describe man as a “super-organism” whose survival is dependent on these microbes. Medicine however, treats them like a disposable waste. Antibiotics will wipe out almost all the bacteria in the body within 5 to 7 days, and it can take months for these populations to restore themselves, but never to their original make-up as antibiotics permanently alter that. During that time period, we are subjected to the antibiotic-resistant strains we created, immune system dysregulation, and a host of other anomalies including being more susceptible to other infections such as fungal candida.

We now know that if we upset the balance of our microbial flora, we are prone to obesity, diabetes, neurological disorders, cardiovascular disease, and cancers. That isn’t stopping our use of antibiotics however, as prescribing rates are increasing and deaths continue to escalate. According to the World Health Organization in 2009, antibiotic resistance is one of the top three threats to human health on the planet. Antibiotic-resistance kills more people than AIDS on a yearly basis. The truth about antibiotics never seems to include these facts.

Some bacteria are never affected by antibiotics. These are called persisters. They exhibit multidrug tolerance.

Antibiotic resistance will always develop as long as antibiotics are in use. Using them wisely, means not using them very often. Most authorities state that 50% of their use is unnecessary. Let’s start by using 50% less and see where that gets us. Any amount is better than where we’re headed.


Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.


Healthcare isn’t healing when the interests of the patient are placed second to the interests of the doctor. This often happens in practice-centered models of care, instead of patient-centered models of care. The goal of the practice-centered model is to increase the practice size and make money, while the goal of the patient-centered model is to make the patient healthy. When the doctor is more concerned about protocols, procedures, and billing, the patient often suffers.

Antibiotic prescription practices are one example of this. Doctors have found that the number of patient visits increases with the prescription of antibiotics. Prescribing antibiotics can fill the waiting room and avoid losing the patient to another doctor down the street who’ll willingly fill a prescription for the patient. This enables the doctor to make more money and fulfills the goal of the practice-centered model. Unfortunately, the patients are more likely to receive antibiotics when they don’t need them and end up with rebound infections of antibiotic-resistant ‘superbugs’.

The practice-centered model is directly linked to the increase in antibiotic resistance worldwide, as some doctor’s are prescribing antibiotics to 98% of their patients. According to the World Health Organization, antibiotic-resistant infections are now one of the top three threats to human health on the planet. In spite of warnings on the overuse and misuse of antibiotics, doctors continue to increase the number of prescriptions that they write.

Respiratory infections such as bronchitis and the common cold should have a prescribing rate that is close to 0%, yet patients receive antibiotics 70% of the time and even higher in children. One study found a prescribing rate as high as 98% for respiratory infections.

The majority of doctors blame patient pressure as the reason they over-prescribe antibiotics and other medications, but when patients are asked about pressuring doctors, as was done in a recent survey by Populus, only 6% said that they would pressure doctors into giving them antibiotics. While patients may be to blame partly (6%) for the problem, it appears in surveys that 94% of the time, the blame rests with the doctor.

How can there be such a difference between the doctor’s and the patient’s  perception of the same event? An overwhelming number of patients are stating that they don’t ask for antibiotic prescriptions, while an overwhelming number of doctors state that they do.

In my experience, doctors rush to give antibiotics as a cure-all. It’s a knee-jerk response that enables the doctor to keep moving throughout his day without actually taking the time to educate the patient or discover the underlying cause of the patient’s complaint. By doing so, they fail to follow federal guidelines as laid out in a 2003 FDA Mandate to perform culturing and susceptibility testing. Many give antibiotics as a way to suppress symptoms alone, by suppressing the immune system responses that produce those achy, flu-ish, feverish symptoms we have been entrained by commercials to recognize as sickness, which are actually a sign of a healthy immune system response.

It makes sense that the practice-centered model is one reason for the discrepancy between the doctor’s and the patient’s perceptions. The lens that doctor’s are looking through observes patient behavior in terms that facilitate increasing their practice and income stream. When doctors are questioned more thoroughly on this topic, they often state that if they don’t write the prescription, the patient will just go down the street to the next doctor and he will lose the business, so why shouldn’t he just write the prescription. Doctors justify their prescriptions by describing “subtle hints” and “certain looks” they receive from their patients as reason enough. Hardly sufficient justification for placing anyone at risk.

Measures to halt the over-prescription of antibiotics have included asking doctors to tell their patients to wait 7 days first before using antibiotics, as most infections resolve themselves within that time period. Doctors state that patients don’t like to hear this and the doctor doesn’t want to appear unsympathetic to their needs, so the prescription pad comes out. This highlights a second factor in over-prescribing practices, a doctor’s perception. If the doctor thinks the patient wants a prescription, then he writes the prescription.

Another study in 2003 the Journal Of Family Practice found that parents rarely insisted on antibiotics. This study pointed out that how parents communicate their concerns was many times the determining factor of whether or not antibiotics were prescribed. It was also noted that parents who came in and told the doctor that their child had a bacterial infection, were more likely to receive antibiotics. It leads one to wonder exactly what were all those of years of medical school for?

The patient-centered model needs to replace the practice-centered model. The patient’s health should be a higher priority than the doctor’s rush to keep moving and fit as many people as possible into his schedule, and his practice goals. Doctor’s need to be educated about patient care and management. The doctor needs to see himself as a guide and facilitator of the patients health and not just as a dispensing machine. He needs to have a solid belief in his role as a doctor, and perhaps more guidance and education on how to fulfill that role.

Antibiotics are only one dilemma facing today’s doctors, and the entire world for that matter. There are other areas where healthcare isn’t healing, as well. It’s unclear as to where the solution will come from, as government regulation has failed to curb bad practices and doctor’s haven’t responded to decades of warnings. My guess is that the patient will have to make the right choice for themselves. My prayer is that they do.

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

Antibiotic risks are greater than the benefits? In this 2008 study from Brigham and Woman’s Hospital and Harvard, the researchers clearly state that “For an individual patient, the risks are greater than the benefits and the discussion should stop there.”

Despite little microbiological reason to think they would be helpful, antibiotic prescribing for predominantly viral acute respiratory infections remains nearly as popular as ever. Acute bronchitis in adults is an instructive example. According to guidelines and performance measures, the right antibiotic prescribing rate is close to zero percent.1, 2 However, in the United States, physicians prescribed antibiotics to 77% of adults with acute bronchitis in 1995, 59% of adults in 2000, and 67% of adults in 2005 (unpublished data from the National Ambulatory Medical Care Survey and National Hospital Medical Care Survey [NAMCS/NHAMCS]). Together, acute respiratory infections other than pneumonia account for 50% of antibiotic prescribing to adults and 75% of antibiotic prescribing to children.3

Microbiology aside, clinicians may prescribe and patients may use antibiotics with the thought of reducing symptoms or preventing complications. Research does not bear out these rationales. Systematic reviews from the Cochrane collaboration have found marginal to no benefit of antibiotics for the common cold, acute otitis media in children, maxillary sinusitis, sore throat, and acute bronchitis.4–8 Recent randomized controlled trials that carefully measured patient symptoms found no symptomatic benefit of antibiotics for acute bronchitis or sinusitis.9, 10

So, for most acute respiratory infections, there appears to be little benefit to antibiotics. However, if the risks to individual patients are minimal, then it might make sense to use antibiotics for acute respiratory infections. However, evidence of the risks of antibiotics continues to increase. Depending on the antibiotic, 5% to 25% of patients will develop antibiotic-associated diarrhea.14 Clostridium difficile is an increasingly recognized adverse event following antibiotic treatment. Quantifying the risk per antibiotic exposure is challenging, but the antibiotics most commonly associated with C. difficile are clindamycin, cephalosporins, and fluoroquinolones.15 About 2% of patients who take an antibiotic will develop a skin

reaction.16 About 1 in 5000 patients who receive an antibiotic will have an anaphylactic reaction.17

In addition, in studies examining adverse drug events, antibiotics keep emerging as a common culprit. Penicillins are one of the most common causes of adverse drug events in ambulatory practice.18 Antibiotics are the second most common cause of adverse drug events in the elderly.19 Antibiotics are one of the most common causes of adverse drug events following hospital discharge20 and adverse events from antibiotics often cause hospital admissions.21 Antibiotics are one of the most common classes of medication associated with malpractice claims.22

In this issue of Clinical Infectious Diseases, using the NAMCS/NHAMCS and National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance (NEISS-CADES), Shebab and colleagues add the risks of an emergency department visit for an adverse drug event from antibiotics. They found that antibiotics are responsible for nearly 20% of emergency department visits for adverse drug events and caused 10.5 emergency department visits for adverse drug events for every 10,000 outpatient visits at which an antibiotic was prescribed. Because the NAMCS/NHAMCS only captures antibiotic prescribing that occurs in the context of a visit, Shebab are likely undercounting antibiotic prescribing. However, the authors are also undercounting adverse drug event emergency department visits as well: the sensitivity of the NEISS-CADES for detecting adverse events is around 45%.23 What is most striking is that the risk of antibiotics – especially sulfonamides and clindamycin – is comparable to insulin, warfarin, and digoxin, medications that are perceived as relatively dangerous.

Of course, in looking at only emergency department visits, Shebab and colleagues are detecting the tip of the iceberg. Many more patients are having mild adverse drug events that led them to seek non-emergency ambulatory care or to simply stop the antibiotic. Strom has noted that the present US drug safety system focuses on rare effects of new drugs instead of common adverse effects of older drugs.24 Indeed, according to the US Food and Drug Administration Adverse Event Reporting System (AERS) – a collection of voluntary reports – antibiotics do not emerge as a top cause of serious adverse drug events.25 However, depending on several factors, estimates of the sensitivity of the AERS system are as low as 0.3% and there has been widespread agreement that it takes too long to identify problem drugs and quantify risks of older drugs.

Shebab and colleagues rightly point out that antibiotic-associated adverse events are happening when antibiotics are taken as prescribed and as intended; the only error for many antibiotic prescriptions is that they are prescribed at all. If as many as half of antibiotic prescriptions are unnecessary, what interventions work to reduce inappropriate antibiotic prescribing? Clearly finger wagging in the medical literature is not working. Potential interventions to decrease inappropriate antimicrobial prescribing for acute respiratory infections include physician education, physician audit and feedback, patient education, multidimensional interventions, delayed antimicrobial prescriptions, health information technology solutions, and financial or regulatory incentives. Unfortunately, most interventions result in only modest absolute reductions in inappropriate antimicrobial prescribing, on the order of 10%. A recent systematic review found that multidimensional interventions involving physicians and patients appear more effective than clinician educational interventions, which, in turn, were more effective than interventions that used audit and feedback.27 However, for acute bronchitis, even successful interventions in the US have only reduced the antimicrobial prescribing rate to about 40% to 50%.13, 28, 29

When considering an antibiotic prescription, physicians may feel a need to balance individual benefit with the societal risks of increasing antimicrobial resistance.30 This is not necessary. First, “treating” a viral illness with antibiotics does not make microbiological sense. Second, the benefits of antibiotics for most acute respiratory infections appear to be shrinking in the literature. Third, the real risks of antibiotic prescribing are becoming clearer. The article by Shebab and colleagues is part of growing evidence that antibiotics have greater risks than previously appreciated. For everything we do, we have an obligation to weigh and clearly spell out benefits and risks for our patients. The decision and discussion about antibiotic prescribing should focus on benefits and risks for the individual patient. Physicians should be comfortable telling the following to their patients with most acute respiratory infections: “For your infection, there is about a 1 in 4000 chance an antibiotic will prevent a serious complication, a 5% to 25% chance it will cause diarrhea, and about a 1 in 1000 chance you will wind up in an emergency room from a bad reaction to the antibiotic.”

For most acute respiratory infections antimicrobial resistance is irrelevant. For an individual patient, the risks are greater than the benefits and the discussion should stop there.

Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce and The Everything Candida Diet Book.

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