Abstract

Pathological Candida albicans proliferation is common in the immune suppressed; AIDS patients and those on immunosupressive drug regimes being two notable examples. However, the vast majority of patients suffering from chronic vaginal Candida albicans proliferations (Thrush) do not fall into either of these categories. They are women with apparently normal immune systems, women that have fallen into what is often described as the "Candida Vicious Cycle".

In a five month study, one strain of Grifola frondosa (Maitake) was examined for it’s ability to reduce symptoms in women with normal immune systems suffering persistent, chronic vaginal Candida infections. Twenty-two women were invited to take part in the study and were followed up at monthly intervals to monitor changes in their symptoms. Nine women withdrew from the study after the first month. Thirteen continued until the fifth month. All respondents remaining in the study showed improvement in the severity of their symptoms. The range of improvement was between 7% and 80%. The results suggest that the a strain of Grifola frondosa (Maitake) has a role in the control of chronic vaginal Candida albicans proliferation (Thrush) in normal women.

Introduction

Candida albicans is a yeast like fungus which is part of the normal flora of the human digestive tract, skin, and vagina. In a normal, healthy immuno-competent individual, it does not cause any problems. Indeed, it is part of the balanced community of microbes which ensure proper digestion and absorption of nutrients. If the balance in this community becomes disturbed, the Candida organism can begin to dominate the floral community, to proliferate. It is the organism dominating the floral landscape, not the presence of the organism, that results in the commonly experienced symptoms associated with vaginal Candida (thrush). The most commonly reported symptoms relating to vaginal Candida (thrush) are excessive discharge, itching, and intense soreness, often described as a burning sensation. Other commonly reported symptoms are fatigue and low mood.

Candida proliferation can be caused by a compromised immune system, which in turn may be due to stress, poor nutrition, lack of exercise or adequate rest, pollution, smoking, alcohol consumption, HIV infection, cyto-toxic cancer therapy, and or steroid therapy.

The immune system is one of the guardians of a balanced floral community. It ensures that no one organism dominates the scene. When the immune system flags, aggressive organisms such as Candida albicans tend to seize control and overgrow their rightful place in the floral community.

Antibiotic use can also cause proliferation of Candida albicans. Antibiotics destroy commensal bacteria in the body (but are not effective against fungi), thereby disturbing the normal balance of mucosal flora. As it’s bacterial neighbours are wiped out by antibiotics, vacancies in the floral landscape are created. Candida albicans proliferates to fill the formerly occupied spaces.

Many women suffering from chronic vaginal Candidiasis are caught in the "Candida Vicious Cycle" which involves immune suppression and antibiotic use. Here is the cycle. The stress of modern living cause depressed immune function. Depressed immune function results in bacterial infections requiring antibiotics. The antibiotics disturb the floral balance. With bacterial neighbours absent and depleted immune function in place, Candida albicans proliferates. To worsen the situation, Candida albicans produces immune suppressive substances. The additionally depressed immune function leaves the patient more vulnerable to bacterial infection. Additional antibiotics are required. Around and around the cycle goes.

Vaginal Candida proliferation affects many women, impacting significantly on their daily lives. Approximately 200 women responded to the announcement of this study and all reported that allopathic treatment previously undertaken only brought short term relief and did not end the cycle. The anti-fungal creams only had an effect when applied and did nothing to insure the condition would not return. This cycle is widely recognised, and as of yet, there is no effective treatment available aimed at ending it. The hope of the research team is that one strain of Grifola frondosa, that produced by the Yukiguni Corporation, will prove to be a valuable tool in combating chronic Candida albicans proliferations and may play a role in ending the cycle via general well being stimulation.

Research has shown that traditionally used medicinal mushrooms have a positive effect on general health. Grifola frondosa, in particular, contains many essential vitamins and minerals as well as a host of compounds that stimulate the body to improved health. In animal studies it has been shown to act as the following:

• immune system stimulator
• anti-tumour agent
• anti-fungal agent
• anti-viral agent
• anti-bacterial agent
• hypoglycaemic agent
• hypolipodemic agent
• hypotensive agent

Most of the research focusing on Grifola frondosa has examined its ability to stimulate animals immune systems. It has been found to increase immune cell counts, the activity of the those cells, and to stimulate the production of cellular mediators.

Grifola frondosa contains compounds which specifically inhibit or destroy Candida albicans. It is thought that the several phytochemicals found in Grifola frondosa weaken the cell wall of the Candida albicans organism and make it more vulnerable to neutrophil attack. Researchers suspect that it is effective because of this two fold action i.e. direct attack on the offending organism by phytochemicals contained in the mushroom and stimulation of the immune system attack.

As the "Candida vicious cycle" starts with poor immune function, an agent that stimulates impaired immune function could go a long way to break the chain. The objective of this study was to begin examining Grifola frondosa as such a potential cycle breaker.

Purpose

This five month clinical investigation was designed to provide a preliminary assessment of the effectiveness of Grifola frondosa (Maitake) in the treatment of persistent vaginal Candida albicans proliferations. Assessment criteria for the "effectiveness" of this treatment regime include both short and long term relief of specific symptoms such as itching (I), discharge (D), and soreness (S). The object was to determine if the documented immune stimulating powers of Grifola frondosa could break the cycle of persistent vaginal Candida albicans proliferations.

Materials

The Maitake tablets for this study were obtained from HCR of London. Each tablet contains 270 milligrams (mg) of the dried mushroom Grifola frondosa var. Yukiguni (Maitake) plus 10 mg Vitamin C.

The vaginal cream used in this study, also from HCR of London, was developed by Douglas Schar and consisted of infused oil of calendula officinalis and the essential oil of Rosmarinus officinalis in a base cream.

Methods

Potential candidates were identified from respondents to an article in the June 1998 issue of Woman’s Own magazine. All applicants were preliminarily screened by the HCR Medical Coordinator, Ms. Ros Christian. Ms. Christian is a trained nurse with more than 20 years experience in allopathic medicine and six years experience in complementary medicine.

Through a combination of screening of applicant letters and preliminary telephone interviews, Ms. Christian made an initial selection of women to participate in the study. The women selected :

• were pre-menopausal
• had active symptoms of Vaginal Candida proliferation of long duration
• had no known mushroom allergy
• displayed a willingness to commit to the study

The women selected were not:

• insulin dependent diabetics
• women receiving anti-cancer or steroid therapy
• suffering from low blood pressure
• pregnant

Those initially accepted into the study were then asked to fill out a detailed medical questionnaire (designed by Ms. Christian) to assess the severity of three specific symptoms (D, I, S) and record any other symptoms volunteered by each potential study participant. Responses were based on a scale of 0 to 5, with "0" indicating no symptoms and "5" indicating an intolerable level of distress. The results of these interviews were then reviewed by the entire study team (R. Christian, D. Schar, Dr. A. D. Turner.) and final selections were made. In total 22 women were accepted onto the study. There was no control group instituted for this evaluative study.

The selected patients were provided a six-week supply of Grifola frondosa var.Yukiguni (Maitake) tablets (i.e., 504 tablets) plus one 30-gram jar of cream. All study participants were instructed to gradually increase their daily dosage of Grifola frondosa var.Yukiguni  (Maitake), beginning with two tablets per day (0.54 grams) for two days, and then increasing their dosage by two tablets per day until reaching the recommended 12 tablets per day. The cream was used daily on an as needed basis for the first month of the study.

Each patient was contacted by telephone in the first two weeks of the trial to be certain that they understood the treatment regime and had no further questions or adverse reactions to any of the medications.

The first treatment data were collected by telephone in the fourth week of the trial, and subsequent data was collected (by telephone) at four-week intervals (see Table 1). In addition to the symptoms shown in Table 1 (D, I, S), other individual symptoms were tracked on a monthly basis. However, this data has not been presented in this preliminary report.

Results

Of the 22 candidates initially chosen for the trial, 13 remained in the program for the designated six months. This attrition rate can be attributed to the following causes:

• One due to pregnancy;
• One due to lowered blood pressure;
• One participant disappeared;
• Six due to digestive changes following taking Grifola frondosa (Maitake)

Although most of the above explanations are self-explanatory, the last category requires further discussion as it is of clinical relevance.

Six women taking part in the study described flatulence and change in bowel habit following taking Grifola frondosa var. Yukiguni. Grifola frondosa contains large quantities of mannitol, a sugar noted for its laxative and flatulence producing effects. Some people, when first taking Grifola frondosa (Maitake), describe an increase in gastro-intestinal activity. For some this is more disturbing than to others. As the effects of Grifola frondosa var. Yukiguni on the Gastro-intestinal tract was not the subject of this study, women experiencing this effects were dismissed from the study.

Of the 13 patients remaining in the study, the overall average improvement in symptoms was 45%, based on a range of 7% to 80% improvement. The specifics were as follows.

• 76% to 100% improvement: 1 patient;
• 51% to 75% improvement: 5 patients;
• 26% to 50% improvement: 4 patients;
• 1% to 25%: three patients:3 patients;
• No improvement: 0 patients.

Two patients have been entirely clear of all symptoms for between two to four months, and seven more patients have been entirely clear of at least one symptom for two or more months. With one exception, all of these patients originally reported at least one symptom to be "intolerable" (5) or "very troublesome" (4) at the beginning of the trial, but only one symptom (D) of one patient has been reported as "4" or "5" after six months of treatment with Grifola frondosa var. Yukiguni.

Tables 2, 3, and 4 summarise the data by symptom (D, I, and S, respectively), and the overall average per cent improvement by symptom is summarised below:

taking Grifola frondosa for Thrush over the 5 month study

5 = Intolerable

Discharge (D)

0% = None 20% = Mild 40% = Moderate 60% = Troublesome 80% = Very Troublesome 100% = Intolerable

(84%) 11 patients improved by an average of 47% (0% to 100%);

( 8%) 1 patients saw no change;

( 8%) 1 patient worsened by 40%.

Itching (I)

0% = None 20% = Mild 40% = Moderate 60% = Troublesome 80% = Very Troublesome 100% = Intolerable

• (76%) 10 patients improved by an average of 52% (0% to 100%);
• (16%) 2 patients saw no change;
• ( 8%) 1 patient worsened by 20%.

Soreness (S)

100% = Intolerable

In Summary

(76%) 10 patients improved by an average of 62% (20% to 100%);

(16%) 2 patients saw no change;

( 8%) 1 patient provided no data on soreness.

Discussion

The intent of this study was to determine if Grifola frondosa var. Yukiguni impacted vaginal candida proliferations. Of the women remaining in the study, 84% had a 50% reduction discharge, 76% had a 50% reduction in itchiness, and 76% had a 62% reduction in soreness. The women’s conditions markedly improved while they were taking the tableted mushroom powder. Whereas these women’s conditions had previously been static, with the addition of the Grifola frondosa var. Yukiguni, the conditions began to shift in a positive direction. All of the women involved in the study have chosen to continue taking the herbal medicine beyond the end of the study. This is a recommendation in and of itself.

These results raise several important issues that need discussion. Firstly, the result was favourable enough that additional research is warranted. A more comprehensive study of Grifola frondosa var.Yukiguni and vaginal Candida albicans proliferations is now being formulated. The next study will include vaginal and microscopic examinations. The research team feels this additional data will provide a better picture of how this particular herbal medicine impacts the condition.

The researchers involved in this study were looking to see if Grifola frondosa var.Yukiguni could end the Candida albicans vicious cycle. The conclusion has been that the study was not long enough to make this determination. In all cases, when the study ended, the women were gradually improving. They appeared to be on the mend and were moving towards a disease free state. They had not yet achieved it when the study came to a close. The next study will need to be of one if not two years duration if We are to achieve an answer to this primary question. The Candida problem does not go away overnight, this much We have learned.

Another interesting point is this. The fact that Grifola frondosa var.Yukiguni had a favourable impact on the condition refutes a medical myth floating around the world of alternative medicine. Some practitioners feel that women suffering from thrush should avoid all mushroom products as the consumption thereof will "worsen" their condition. In the thirteen women studied in this study, the opposite was observed. The use of a mushroom product improved chronic vaginal thrush. It would pay to add that many of the anti-fungal creams used by the allopaths’ are derived from ground dwelling fungi. The notion that consuming fungal products will worsen chronic vaginal thrush is highly suspect and this study makes this point. If anything, this study suggests We should look towards the fungal world for a drug that could end the Candida problem.

This research group is conducting another study at the moment, a study looking at the effects of Grifola frondosa var. Yukiguni in HIV infection. The patients in this study, suffering from Candida albicans proliferation, all have experienced an improvement in symptoms and signs while taking Grifola frondosa var. Yukiguni. This result underscores the importance of continuing research which examines Grifola frondosa as a possible addition to an anti-Candida albicans regime. There is much more to know, however, that which we have seen suggests we need to know more.