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Monday, November 17, 2008

Clinical gut candidiasis tests

Note: This is only to promote awareness. May not be wholly accurate and not intended as advice.

Gut dysbiosis cannot be ruled out as a factor in bloodborne odors at this stage of understanding the problem, and one of the main suspects suggested is candida albicans. At the moment the 'system' does not believe in 'gut candidiasis' (despite the common problem of 'thrush'), so does not have any sensible tests for it. To give an insight into how the system makes up rules, heliobacter pylori was not accepted as the main likely cause of stomach ulcer cases until 1994 (10 years after the famous paper where the researcher gave himself a stomach ulcer and cured it with antibiotics), and giardia as a pathogenic parasite until relatively recently.

This post will look at clinical tests that are available, not including 'self-diagnosis' from questionnaires or various supposed 'home tests' such as the 'spit test'. However, you have to wonder if having external signs of candida, especially after 'attacking its base' (in the gut), may be a reasonable sign of a gut infection. Posts about each section in more depth will be done at a later date.

1. Ethanol blood test : It is currently thought that candida is the only likely gut pathogen that produces ethanol, so it seems testing the blood for ethanol may be a way of testing. Currently the only lab who seems to use this approach is Biolab in London. The amount of ethanol indicating overgrowth is 100's or 1000's times less than a drink-drive legal limit, so it's unlikely a $10 breathalyzer would detect anything (in fact 99.9% certain), but technically you can't be sure that someone with an enormous candida overgrowth isn't 'over the limit'. There have been one or 2 court cases where the defendant claimed they hadn't drunk (much) and that candida was the cause. The Biolab test also tests for fermentation alcohols said to be produced by certain bad bacteria too.
Interpretation
Increased ethanol with no methanol and only slight increases in other alcohols suggests yeast overgrowth.Increased ethanol with some methanol present and only slight increases in other alcohols suggests that there may have been ingestion of alcohol in the 24 hours prior to the test. An increase in a range of alcohols, but not ethanol, suggests a bacterial dysbiosis in the small intestine, possibly due to malabsorption. Similarly raised levels of short chain fatty acids, with normal or nearly-normal blood alcohols, suggests increased bacterial fermentation in the colon, probably secondary to mild small intestinal malabsorption. Diarrhoea or poor fibre intake decreases levels of short chain fatty acids in this test.
example:
biolab gut fermentation page
biolab gut tests page; including gut fermentation profile
biolab 1990 research paper: Gut Fermentation (or the "Auto-brewery") Syndrome: A New Clinical Test
biolab 1993 paper: Abnormal Gut Fermentation reveals deficiency of B Vitamins, Zinc and Magnesium

2. Stool sample: Most 'functional medicine' influenced labs test for candida in a stool sample. Until recently they all had to culture it from a stool sample, but now it looks as if they will move on to testing for candida DNA evidence in the samples (metametrix has already moved on to this technique). In a perfect world it would be easy to blindly recommend these tests, but as an outsider, it's unclear the rates of false positives and negatives. For those who base their medical 'beliefs' on the 'official medical experts and system', here is a recent finding on the official systems' competence at detecting C Difficile.
examples:
metametrix GIEffects Stool DNA test
genovadiagnostics.com CDSA2 test (add-ons available)
genovadiagnostics.com yeast culture test

3. Urine test(organic acids):
These tests look for what are regarded as candida metabolism metabolites in urine. Tartaric acid being one. Usually this sort of test includes the type of organic acids tested by the official system, but also many other organic acids, including dysbiosis markers.
examples:
metametrix.com Organix Dysbiosis-Urine test
genovadiagnostics.com organic acid & dysbiosis marker urine test

4. Immune response test (the ELISA test). These look for a response (antibodies) from the immune system to candida. Its hard to gauge how accurate this is. There are 2 or 3 responses usually measured : IgG & IgM and sometimes IgA (associated with secretory fluids)
examples:
Immunolabs 'public' site: www.betterhealthusa.com
UK tester: www.cambridge-nutritional.com (tests IgG & IgM)
www.genovadiagnostics.com: IgG, IgM & IgA

One way the group could learn about the typical profile of a bloodborne body odor or halitosis sufferer in the future would be controlled trials with these sort of tests, in this case looking at the state of the gut. Ultimately, to profile the syndrome(s), we will likely have to help ourselves rather than relying on 'the system'. We would also likely learn which of these tests is most accurate too. The best way would be if the labs sponsored a small trials. But individuals can also do these tests if they wish.

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