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The medical diagnosis of candida or yeast hypersensitivity has been for a long time one of the most contentious diagnoses in medicine. In the 1990s, doctors could actually lose their license for diagnosing and treating patients with candida. In fact, that happened to a New York City doctor, a very famous one. But holistic medicine has certainly advanced in the past two decades, and many functional medicine practitioners are diagnosing and treating, including myself, helping patients suffering with what we call candida or a yeast hypersensitivity.

My guest today is Dr. George Kroker. Dr. Kroker worked for, I believe over 30 years, maybe close to 40 years, at La Crosse Allergy Associates in Wisconsin, a very prestigious practice. Dr. Kroker and I have had conversations over the years because I’ve sought out his advice on treating patients with candida. So I’ve always relied on him as an excellent source, and I know that Dr. Kroker has helped thousands of patients with candida over the years. In fact, he has written one of the only chapters in a medical textbook, and I think it’s called Food and Allergy Intolerances, that I know that even exists on candida.

Main topics and discussion from podcast.

Candida Controversy & History

Dr. Mitchell:

Let’s go back to the candida controversy. As you’re well aware, again, as I said, now it’s a little bit more accepted, even though I still get so many patients come in in tears saying the doctor would tell them, “This doesn’t exist. It’s all in your head. You got a psychiatric disease,” the whole spectrum of things. I have my opinions, which I’ll bring up, but why do you think candida as a diagnosis has been so controversial and actually despised by the general medical community?

Dr. Kroker:

That is probably one of the most important questions I’ve struggled with over the years. I think there are probably two answers to that question or two reasons. Reason one is something called the Tomato Effect, and this was written about in JAMA in, I believe, 1984 by a husband and wife team. Dr. James Goodwin talked about the fact that the Tomato Effect in medicine holds back efficacious treatment. The tomato was a South American vegetable. It was brought from South America by the Spanish back to England. Everybody ate it. Over here in America, no one ate it, because they thought it, being related to the nightshade family, was deadly poisonous.

Dr. Mitchell:

Interesting. I never knew that.

Dr. Kroker:

And if you interviewed somebody at that time and asked them why they don’t eat it, they said, “Well, it’s common sense. It’s poisonous.” “Well, how do you know it’s poisonous?” “Well, we know that. That’s what we’re taught.” And in 1820, a man sat down, in Philadelphia, and ate a tomato, and everybody rethought things. So we’re taught in medical school, you were taught and I was taught, that candida is a usually harmless commensal organism that occasionally, if it overgrows, causes an infection. And that’s what we’re taught, and we think that’s all that it does. So when a doctor runs up against this issue, he or she says to themselves, “Well, we’re taught that it’s a harmless organism. It’s not a bad organism.”

And, therefore, that’s all that is. But as one lawyer friend of mine said, absence of evidence is not evidence of absence. In other words, just because it’s what we’re taught doesn’t mean it’s the only thing.

But I remember having a discussion with the head of our gynecology department at our Mayo-affiliated hospital and mentioning that with the extreme problem that everyone faces in their practice with vulval vaginitis, 300 women globally with the issue, I would be happy to come in and talk about allergy and its effect on the vaginal tract. And there was this blank look on his face that said, “I’ve never been taught that. I don’t know about this. This is a tomato that’s poisonous.” That’s reason one, and I think it’s a huge one.

Reason two, for us as allergists, and this almost deserves a separate podcast, allergists have abdicated their throne. We’re as close to infectious disease doctors than any other specialty. We should not be anatomically demarcated. The immune system, holistically speaking, affects a multitude of organs. And our infectious disease colleagues are less fixated on an organ than they are on the body overall.

Right. And how this organism can affect us. Imagine if you went into an infectious disease doctor and complained about a sore, red, swollen leg, and he or she told you they’re just interested in the throat and the eyes and the nose.

Dr. Mitchell:

Right. Which is what happens in medicine. We’ve become so specialized, departmentalized. Yeah.

Dr. Kroker:

So the typical allergist is not interested in fatigue, headaches, sugar cravings. They’re not interested in yeast vaginitis. They’re not interested in recurrent yeast infections. They don’t ask about it in their histories. We have, in a sense, abdicated where we were. We were once one of the… And if you look at… And I have a hobby of collecting old allergy textbooks, and if you read some of these 1920 textbooks, 1930 textbooks, they were a treasure trove.

Dr. Mitchell:

It’s probably a similar way of looking at it. I’ve always thought about this question a lot, too, because I’ve had to answer it a lot to patients, like, “Why doesn’t my doctor know about this?” and everything, too. And I said two things which were in my mind which were interesting. One, and it really goes back to the podcast I just did before with Dr. Fasano and celiac disease, doctors tend to not like when there’s too many symptoms. This sounds bizarre.

Dr. Kroker:

Oh, no. That is absolutely correct.

Dr. Mitchell:

But they don’t like when a patient comes in… And their typical answer would be one disease can’t give all of these symptoms, which is totally untrue. Because now we know, obviously, with celiac disease, it’s not just the gut. You could get arthritis. You can get asthma, all these things. So I think it overwhelmed a lot of doctors. And the other issue, which was really close to home with what I did… Because I trained during the AIDS epidemic in New York City, and my hospital was actually one of the research centers. So my department was actually allergy infectious disease and immunology. Again, I saw so many patients with AIDS that had oral candidiasis thrush or other opportunistic infections. I knew it, obviously, but that was just one extreme.

So again, going back to what you’re saying, there’s just so many symptoms that the doctors were uncomfortable moving out of their comfort zone. Or let’s say, “Oh, yes. I just do the ear, nose, and throat area,” whether it’s an allergist, an ENT, and not realizing that women, oh, they didn’t tell you or you didn’t ask, because they’re not going to always come out and say it, “I’ve had recurrent vaginitis. I have irritable bowel syndrome.” And this is all interrelated to what we’re going to get into today. So, yeah, I think the two of us are thinking alike about this. Yeah?

Dr. Kroker:

Yeah.

Dr. Mitchell:

Let’s get into… Because I’m really interested in this, because again, you were so early involved with this. How did you get indoctrinated into diagnosing candida? Did you mention you worked with… Was it Dr. Randolph with chemical sensitivities or somebody else?

Dr. Kroker:

Right. Randolph was a pioneer. He had one of the very first allergy fellowships at Harvard and worked at Mass General for quite a while,

Dr. Mitchell:

Oh, I didn’t know that. Wow.

Dr. Kroker:

A very interesting man. He taught me, as long as we talked about it a minute ago, he said, “In my experience, the more symptoms the patient has, the sicker they are and the more I need to listen.”

Dr. Mitchell:

That’s good advice. Yes.

Dr. Kroker:

The lesser number of symptoms, less. And he said it was frustrating for him, just like it was for you, when you see these other doctors around you just kind of push them away. So that was his experience, too.

1978, I had just taken my boards in internal medicine and was entering my fellowship. And a patient called me back, and she goes, “I just want you to know that I’m feeling really well now. My symptoms are better, headaches, fatigue, and all this stuff. And it’s not because of what you did. It was a doctor in Birmingham, Alabama.”

So I call this gentleman up. It was Dr. C. Orian Truss. I said, “I’m a young doctor. I’m on the phone here with you because I trust this patient and she is an excellent reporter. And she’s well, and I’m impressed. What did you do?”

And he told me the story. Then after that, I said, “Do you have any publications?” And he said, “No, but I’m coming out with one.” So I said, “Okay. Can you send it to me?” So he did, and that was, of course, the seminal article he wrote in ’78 on tissue injury related to candida albicans. We became pen pals for a while.

I had a patient in the hospital at that point who had a candida infection, but she also had a lot of symptoms that were beyond that. I ended up putting her on nystatin, and she got very mad at me. And I said, “What’s wrong?” and she said, “The only thing that’s ever worked as well for me to ameliorate my symptoms is a short course of steroids. And I asked you not to give me steroids.” I told her, “I gave you nystatin. I gave you a fungal medication.” She goes, “But I feel good. What’s the story?” So that is a nutshell of my interest in it. I got affiliated with Dr. Crook at allergy meetings after that.

Dr. Mitchell:

Right. Just for the listeners, those are the two giants in the field that Dr. Kroker’s alluding to. Dr. Truss, he wrote a book, I think, called The Missing Diagnosis.

Dr. Kroker:

Correct. And he had all his articles.

Dr. Mitchell:

And then William Crook wrote the underground bestseller The Yeast Connection, which is so many patients carry it around. But most doctors, if they saw a patient walk in with it, would show them the door. And I don’t mean coming in. I mean going out, right? Am I correct?

Dr. Kroker:

That is absolutely correct. He popularized, if you would call it that, the whole concept to the layperson. His books had nice illustrations in them. He came out with cookbooks.

One of the books I really like, I’d just like to hold this up for the listeners to see, too, is the Candida Cure by Ann Boroch. She was a naturopath in California who I knew well, unfortunately passed away, and really took a lot of Dr. Crook’s work. I think she had spoken with him to try to again make it understandable for the layperson so it’s not such an overwhelming issue.

Candida Causes

Dr. Mitchell:

So, Dr. Kroker, if you were going to explain to somebody listening to this who thinks they might have this, how would you explain candida. That’s a big question and why it becomes a problem because we all naturally have some yeast Candida in our intestine. So where do things go wrong? How would you explain to someone who’s considering, saying, “I think I have Candida. I heard about this. I have a lot of these symptoms.” What would you say to them?

Dr. Kroker:

I would say the analogy would be; in order to have a fire, you would have to gather wood and strike a match. So there are three parts to this issue.

Part one is, have you had on an occasion, to grow a significant amount of Candida in your history? And you know that classically one of the biggest contributors to the Candida issue is recurrent antibiotic usage. That’s question one.

With that is steroid medication in bursts, repeatedly. Trust in some of the early authors 40 years ago talked about birth control pills. My experience with the newer pills, it’s just not as much of an issue. And of course, a lot of sugar ingestion. Those things will grow a lot of Candida in an individual.

The second thing is, do you have physical signs of yeast overgrowth? Is your tongue coated? Do you have itching under the arms with a little rash or yeast vaginitis recurrently in a woman, balanitis in a man, genital itching, intense bloating after meals. So those would be signs that you physically have got some yeast growing.

Dr. Mitchell:

By the way, just to interrupt for a second. The symptoms that you’re describing, as you can imagine too, a lot of patients are reluctant or a little bit embarrassed to even mention these symptoms. I think that’s why it’s so important that a doctor is on the lookout and listening carefully, because patients are sometimes embarrassed to report some of these symptoms.

Symptoms of Candida

Dr. Kroker:

That is so important Dean. That is worthwhile commenting on myself and that is, until I started to ask women in an allergy clinic, “Do you have problems with recurrent yeast vaginitis?” I was astounded by the number of positives I got on that story. And yet they wouldn’t volunteer that information, either because of personal modesty, or more likely in my case, “Hey, he’s an allergist. He’s interested in my nose and throat, and I’m in here for my cloth and I’m not going to tell them about these other issues.”

And it was very interesting in my practice Dean, when I would ask women about yeast issues, like that in the vaginal track, they wouldn’t know…, “Nobody’s ever asked me that before”, other than their gynecologist. So the first thing is, have you had symptoms set up to contribute to yeast? The second one is, do you have physical symptoms of yeast or incident? And the third is, what are your symptoms?

And Dean, you know this better than I probably, but some of the hallmark symptoms of candida are intense fatigue, feelings of flu-like illness without flu, bloating and gas, like we just mentioned, intense sugar cravings. This is something people also don’t mention unless you talk to them about it. This is not a sweet tooth people know it’s different. And people will get up in the middle of the night and go to the store. I had one woman who threw it all out when she read the yeast connections said, “I’m just going to do it.” And she lasted a day or two.

So those are some issues. There are other symptoms of course. People can have migraines, increase in mold sensitivity. They’ll begin to notice mold more than their spouse or other people.

Dr. Mitchell:

Yes. Which is obviously a bigger and bigger issue too with all these floods and weather changes and humidity. That to me also is definitely an alert. When they’re telling you, “I walk into a moldy building or basement and my symptoms, my headaches and all these other things, come back.”

Dr. Kroker:

Right. One of the things that was in the PowerPoint that I had had a log is this idea that increasing mold exposure, amplifies Candida symptoms. An increase in Candida can amplify mold symptoms.

TAKE OUR CANDIDA SYMPTOM QUESTIONNAIRE

Testing for Candida

Dr. Mitchell:

Yeah. I think I really learned that from your group. When I visited Dr. David Morris over 20 years ago. The amount of mold allergy that you guys were seeing was really incredible. Even in New York back, 20 years ago, it wasn’t appreciating what an issue is… Today in my practice, mold allergy and mold toxicity are things that I’m having to deal with more and more.

I want to ask you something you mentioned in your article, in the textbook, which I do all the time. Maybe it’s because of our backgrounds in allergy, I do the Candida skin tests. I want to explain how I tell patients and I want to get your take on this. When I tell patients that I’m going to test them… Because people also, they come in, “I want to get tested for Candida.” So I said, “Okay.” I said, “Unfortunately, there aren’t a lot of great tests.” I think the history and the questionnaire from Crook, and that other seven questions, are things about whether you’ve been on antibiotics, corticosteroids, birth control. I think all are super important and obviously, probably have the most weight.

So I put the intradermal skin test for Candida, and I also use Trichophyton on the patient, and we wait about 10 minutes and then I look at the reactivity. And if there’s what we call swelling or induration of certain amount beyond what I put in under the test, we’ll consider it a positive. And then I go into my explanation of the patient’s saying to them “Look, I use this test”… It was interesting. Forty years ago, I’m dating myself now, when I was a resident at the hospital in New York City at the height of the AIDS epidemic. This was really before we had very sophisticated T cell test that was readily available. You couldn’t get it right away.

So we would do the skin test on patients that we were concerned might be immune compromised with HIV. And the way I explained to my patients, I said, “These are the three scenarios. The one scenario, which is the worst one, is that if we do the skin test on you immediately, and there’s no reaction and 48 hours later there’s no reaction. That’s pretty bad. That’s what we call anergy, meaning you are having no immune response. And we would worry about you might be immune compromised” That could be an AIDS patient, a chemotherapy patient.

The next patient is the kind of patient you rarely see in life anymore. The “perfect person” so to speak, that you do the skin test, there’s no immediate reaction. But 48 hours later, they do get a reaction because we all have some Candida in our system. It’s called a delayed cell response.

And the third situation is… A lot of the patients that I’m seeing that I’m essentially confirming Candida, is that we do the skin test and they have an immediate reaction, almost like if I did an allergy skin test. And then 48 hours later they’re going to react, which I tell them to be prepared. But if they have also a delayed reaction, where they come in a week later and their arm is still pretty red or swollen, I said this also. And to me it at least helps guide me until we have more sophisticated tests. So is that something you use? Patients always worry about stool testing and the spit testing for Candida.

Dr. Kroker:

I would say 90% of what you said is exactly what I say to patients. I say it maybe a little bit differently. I will have patients who have an immediate reaction to Candida, as you mentioned, and no delay and or slight delay. There are people who may have chronic urticaria. They may have something else.

In my chapter, I talked about people who have chronic urticaria and positive prick testing to Candida, responding to Nystatin and responding to diets. There’s articles in the British Journal of Dermatology on that. But the people that have no immediate reaction and an extremely strong delayed reaction are the people, in my experience, that are most likely to be really sick from Candida. Those are the people that you’ll do the skin test on and they’re disappointed. And then the next day, or usually 48 hours later, it begins to swell.

So the skin is essentially giving you the barometer, the same way it does for allergy in a way, other… Think about when people have wheezing, you’re not going to down to their lung to test if they’re allergic to cats, you do a skin test or blood test.

This is where you always need to distinguish between, what is the test measuring? Is it measuring a quantity of yeast. Is the yeast present or not, and how much? And my experiences with the IgG antibody with Candida, it’s more measuring quantity of yeast or a marker of a significant amount in the past, rather than something else.

I got a lot of my IgG tests in house and I find them useful, in the sense that almost everyone with Candida related illness does have a high score. But, I’ve seen patients who don’t have the reaction and the illness from Candida, also have a positive IgG test, almost as a marker that they’ve held it for a while and they have had an exposure to it, of significance.

These are people that say, “Wow I took this broad spectrum antibiotic, and I got the worst stomach ache afterwards and bloating and gas. And my doctor gave me a couple Diflucan or Fluconazole, and he gave me some Acidophilus and I feel better now.” And you run a blood test and you see, oh my gosh, their IgG level is 110 or something, it’s high. The skin test, what’s unique about it is it’s measuring the entire immune response, the whole thing from beginning to end. And you’re introducing Candida into the dermis. You’re giving an injection of a foreign protein and you want to see what the immune system does with that. I think at this point the two things I tended to use the most, whereas you pointed out a questionnaire or a good detailed history is number one. And number two would be the skin test.

Treatment for Candida

Dr. Mitchell:

Let’s talk, let’s move on to treatment for candida. I think that’s so important too. And again, I’ve learned from you in your lectures and, but again, it’s a little bit of an art of medicine as well too. I think you’ve even mentioned too, that one of the gold standards for quote diagnosis, as you just kind of almost mentioned in the story before, is actually the response to treatment.

And again, you guys were the forefront of treating the whole candida hypersensitivity syndrome, which I like to call it. But just out of curiosity too, so when you get a, let’s say a couple of different scenarios. Let’s say a woman that comes in with chronic vaginitis. Now she’s been to her gynecologist, she’s taking maybe one or two Diflucan. And she got maybe better temporarily, but then she relapses. Nobody ever put her on oral nystatin.

How do you treat those patients? I mean, again, a woman for two years chronic vaginitis. And then you confirm it’s candida so you get a new swab. Do you put them on the Diflucan for just two weeks? Do you put them on it for a continual basis for a few months? Do you do the combination with nystatin? I want to get the Dr. Kroker approach.

Dr. Kroker:

The problem isn’t candida, the problem is the vaginal tract is an immunological organ. I try to have a woman think of this exactly the same as the respiratory tract. How is that affected? It’s affected by irritants, allergens and infections. And with the vaginal tract, you can have a scenario where… And I had this happen and I related it in one of my lectures. A woman eating Clementine oranges at Christmas because it’s a holiday food. She begins itching on day one. There’s still oranges left in the refrigerator on day two, eats more. Now she’s getting a discharge, but it’s clear. And she’s itching.

What’s been happening here is that she has, in the vaginal tract, produced some IgE, which is released histamine. And the histamine induces the macrophages to release PGE2 which in turn causes impaired lymphocyte, proliferation, that’s candida. And the third day she’s got a candida infection.

The immune system got suppressed and she had an infection as a result of something dietary. It can happen also, as strange as it sounds, with mold. And I’ve seen this too, where a person will get mold exposure, begin to itch vaginally, get a clear discharge, and get candida. So you have that.

I do my skin testing, find what she is sensitive to, and begin her on immunotherapy. Now, what you’ll find in the literature are case reports about resolution of candida-related illness in these individual’s immunotherapy. So what you end up doing is just saying different organ, but same principle. You’ve got an immunologically reactive organ with mass cells and mucosa and discharge. And you’re going to treat it with… Yeah, and using anti-histamines is fine. You may in fact get some results with that too.

Dr. Mitchell:

Before we get to the immunotherapy which I think is important, I want to hear more of your thoughts about that. What about decreasing the load with antifungals? I mean, as I said, do you feel that’s important to restore the microbiome balance?

Dr. Kroker:

It’s hugely important.

Dr. Mitchell:

Okay.

Dr. Kroker:

The issue is one where I’m often faced, clinically in my practice, with people who we have done that stuff, but they’re not well because the immunological aberration.

Dr. Mitchell:

Good point.

Dr. Kroker:

… Both of those things are incredibly important.

Dr. Mitchell:

They are? Okay. Because I think that… It seems to me, let’s say in the vaginitis cases, which I’m going to go more into with Dr. Sobel, it seems like the gynecologists are stopping way short of what’s really needed. And what I found to be a great friend in treating candida, which again, I learned from you guys and from the work of Dr. Crook and Anne Borak was being on Nystatin longer while you’re doing the immunotherapy. Because as you know too, immunotherapy takes time to work.

Dr. Kroker:

Oh yeah.

Dr. Mitchell:

We have to always explain to the patients it’s like weightlifting. You get to start with your two pound weights and you go to your four pound weights. And people are impatient, they want results yesterday.

Dr. Kroker:

Well, there’s a gynecologist I’ve worked with who’s a professor of medicine, a professor of ob/gyn at the university of Iowa. And she called me one day and said, “I’m seeing your patients in follow-up and their yeast infections have gone. Can I work with you?” And I said, “Great.” So I had this relationship with this individual for about 10 years. And she would send me patients who had seasonal vaginitis.

Dr. Mitchell:

Really?

Dr. Kroker:

She had one woman who every spring would get yeast vaginitis, every spring like clockwork. She sent that individual. I had` one woman that you will be fascinated by who came in to see me, and she goes, “There’s something with this candida thing.” And I said, “What happened?” And she goes, “I had a yeast infection. My doctor gave me one fluconazole pill. My vaginitis went away, but my sinus has opened up for the first time in years. Then they shut again by the third day.”

So she goes, “I don’t understand it. I hear you’re into candida issues, but I was totally flummoxed by that. I didn’t expect the scientists to do anything. What’s going on?”

Dr. Mitchell:

So explain to the listeners, and I probably can learn from this as well too. But I also, I’ve been doing sublingual immunotherapy since I trained with you guys 20 years ago, for the environmental allergies. I just started doing for the foods, which is really exciting. I know you guys really led the way on that too. Like the peanut and other dangerous foods, which is super exciting.

Tell me about the candida. Because most patients they ask me now. Because I understand when we treat someone for environmental allergy, whether it’s grass, trees, ragweed, it’s an external thing. We’re giving them very low doses in the beginning building up to higher doses. And they’re building up what we believe is blocking antibodies, et cetera. How does the candida, we believe sublingual treatment work? Can the same concept, you’re building up some blocking candida antibodies? I mean, how do you see?

Dr. Kroker:

It probably works with the Type IV immune mechanism. And sublingual immunotherapy works via different mechanisms, via the dose you give and the frequency you give.

I tell patients if I’m using doxycycline I might use one dose if you have acne. And if we have mycoplasma, I might use another dose. It’s a different illness and you customize the dose. So I found early with Dave that if I had a patient who had a strong, delayed reaction on their arm to dilution number three, and I treated them with three, they would be one sick puppy.

So you have to back off on your dose and treat the first negative wheel, in a sense, that doesn’t give you a strong, delayed reaction. And this individual has a Type IV reaction. Dave pioneered the work with nickel allergy.

So it can be used for a cellular type response. And it works very well for them. Now again, if you have somebody who has an IgE mediated Type I exclusive reaction and their skin test does not show a strong delay, the little delay that’s normal, and then a strong, positive, you do your standard dose.

Candida Diet

Dr. Mitchell:

And you think that over several months they’re building up some type of protective immunity, so that… Because I’m going to get to my next question. Because the biggest question a lot of patients they ask and I understand this. They’ll say, “How long do I have to be on this candida yeast free diet? This is tough.” You know what I mean, not only are you avoiding gluten products because wheat is one of the triggers and sugar, but there’s certain things too that also elevate the blood sugar like rice.

So I was just curious how, based on Cook’s work and and other people about the diet. Because it seems that the candida diet hasn’t changed in decades. Do you let people have more leeway if they have been on the treatment for a while? Because I know like Marjorie Crandall and I know she knows you. She’s a PhD researcher, and she feels that the candida diet is a little bit over the top after a while. Which is nice for some patients because again, they just feel so restricted. So I was just curious your approach, how do you counsel the patients about the diet?

Dr. Kroker:

This gets into, unfortunately or fortunately, it gets into the art of medicine, your own experience, the person you’re dealing with.

I think that, what we’re trying to do and I explain this to the patient, is that strong reaction you had on your skin to candida indicates that you’re having a lot of inflammation from the yeast organism, a tremendous amount.

You’re overreacting and your immune system is like the TSA. They should sort people and attack the bad people and let the safe ones go through. You should probably you have some candidae in your system. You know you do. Your sister, brother do too. You should have no reaction like this. When you take this reaction down, we should see it here on the skin become a little better. If we see that you’re feeling better, the next step would probably be, on special occasions, to have a little something that you enjoy with your family. Not daily. I don’t think I advise them. now where the art of this comes in is let’s make two different people. And the first person is compliant and doing everything right. The second person is living in a moldy house, has an abusive husband or an abusive spouse, is highly stressed, working too hard. How are they going to do with a little leeway on their diet?

Dr. Mitchell:

Really important point. One of the things I just want to make the listeners to know, also too, because I share this with patients. It gets them to smile a little bit too. And I tell them, unfortunately, stress is like eating 10 cookies. Your body doesn’t know the difference. The cortisol shoots up. I don’t know exactly that’s true, but essentially we know that stress elevates your cortisol, which again, elevates your blood sugar and that whole cascades. So I think you’re bringing out such an important point because again too, a lot of the times it seems it’s always the perfect storm. It’s like a patient may have been on antibiotics earlier in their life. And now why five, seven years later, they weren’t on antibiotics that much, but obviously their microbiome changed, but now they’re going through a divorce or there was a death in the family and, or they lost their job. And I think the stress, whatever, has changed their microbiome even more. And now the candida is coming out in various ways.

Dr. Kroker:

I tell patients the issue isn’t trying to control candida completely. The issue is to try to control candida reasonably and to get the immune system as well-functioning as we can so that what little candida, but necessary candida can have, it’s not going to affect you.

Closing Statements

Well, we have discussed so many things. I’m going to just summarize for the listeners some of the key points that candida hypersensitivity is a real condition that is frequently overlooked by conventional physicians, including gynecologists, gastroenterologist, dermatologist, even allergists. Rebalancing your system, your microbiome with a yeast free diet, low in sugar, the proper usage of antifungal medications can be very important.

And as Dr. Kroker mentioned, some of the things that some specialists use, sublingual immunotherapy, also could probably be very helpful to these chronic difficult cases. Dr. George Kroker, I want to thank you so much for your contribution today on this misunderstood condition and all the work you’ve done. I hope maybe also the listeners will be on the lookout because what I’ve just found out from Dr. Kroker, he’s working on some of his writing pieces. I used to enjoy a lot of his renaissance allergist blog. I think he has some really interesting insights. So thanks again for taking the time for being on.

About the Author – Dr. Dean Mitchell, M.D.d

Dr. Dean Mitchell, M.D.

Dr. Dean Mitchell M.D. is a Board-Certified and Immunologist based out of NYC. He graduated from the Sackler School of Medicine and completed training at the Robert Cooke Allergy Institute in New York City. He is also a Professor of Clinical Immunology at Touro College of Osteopathic Medicine, a fellow of the American Academy of Allergy, Asthma and Immunology, and the author of Allergy and Asthma Solution: The Ultimate Program for Reversing Your Symptoms One Drop at a Time. Dr. Dean Mitchell, M.D. has also been featured in The New York Times, The Huffington Post, Fitness Magazine, Dr. Oz and News NY 1. Dr. Mitchell also hosts the podcast The Smartest Doctor in the Room – a combination of a lively, personal and in-depth interview with top healthcare specialists.

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