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NMDC221 Session 8:
Immune System Disease
Part III
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Topic Summary
Immune System Diseases: Part III
o Nutritional management & consideration of drug-nutrient
interactions
o Measles
o Rubella
o Mumps
o Acute food poisoning
o Parasite associated diarrhoea
o Parasite associated chronic diarrhoea
o Candidiasis
o Mononucleosis (glandular fever)
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Measles
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Measles
o Measles is a highly contagious viral infection of the Paramyxoviridae
family with an incubation period of 8-14 days. Spread is via droplet
infection from 4 days before and until 2 days after the rash onset.
o The eventuation of serious complications and/or death is more likely
for malnourished children, adults or the aged.
o Complications include: stomach problems, pneumonia, ear
infections, sinus problems, convulsions (seizures), brain damage
and possible death.
(Kumar & Clark, 2009)
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Measles
Prodromal & Catarrhal (initial) stage
o Malaise, fever, irritability, conjunctivitis, excessive lacrimation,
oedema of the eyelids, photophobia, hacking cough, nasal
discharge.
o Koplik’s Spots (Onset: 1 – 2 days prior to rash): Small red irregular
spots with a blue-white center found on the buccal mucous
membranes opposite the second molars
Eruptive (secondary) stage
o Measles rash (Onset: 4 – 5 days into infection).
The rash will often manifest at the forehead
and then progress down the face, neck,
trunk and feet. Fades in about 1 week
(Kumar & Clark, 2009)
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Measles
Nutritional Objectives:
1. Ensure adequate rest and fluids.
Plenty of bed rest and fluids until the rash and fever
disappears (keep patient out of strong sunlight).
Consider the following dietary examples
• Light watery soup (Initially)
• Diluted fruit juices (Initially)
• Slowly increase solid food utilization as vitality
improves.
• Complication: Seek immediate medical attention
(Kumar & Clark, 2009)
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MeaslesNutritional Treatment
2. Support the immune system.
i. Vitamin A
o Children <24mths with measles complications (pneumonia and
diarrhoea) recovered more quickly, and has less URTI, when
administered vitamin A within 5 days of measles rash appearing
(Coutsoudis, Broughton & Coovadia, 1991)
o One study illustrated that some children( ≤ 24 months in New York
City) had low vitamin A levels when ill with measles, and these
children also appeared to have lower measles-specific antibody
levels and increased morbidity from measles and higher
hospitalisation rates (Frieden, Sowell, Henning, Huff & Gunn, 1992).
ii. Zinc
o Low zinc levels impact on the absorption & metabolism of vitamin A,
indicating co-supplementation (Christian & West, 1998)
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Measles
iii. Antioxidants
o Children with measles have higher oxidation markers
and lower levels of antioxidants (beta carotene, retinol,
alpha tocopherol, ascorbic acid and glutathione) than
healthy controls (Cemek, Dede, Bayiroglu, Caksen,
Cemek, & Mert, 2007)
iv. Blue-Green Spirulina
iv. Calcium - found in spirulina is an inhibitor of enveloped
virus replication, from a blue-green alga Spirulina.
(Hayashi, Hayashi, Maeda & Kojima,1996)
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Nutritional treatment
3. Provide anti-inflammatory support
Foods that have anti-inflammatory potential can reduce the
inflammation and fever that presents. These include garlic,
ginger, bromelain and turmeric (Srivastava, 1984; Kiuchi,
Iwakami, Shibuya, Hanaoka & Sankawa, 1992; Limiroli,
Ferrario & Bianchi, 2002; Chainani-Wu, 2003).
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MeaslesNutrient Dosage Therapeutic Actions
Vit C
(Ascorbic
acid)
1000-
10000mg
Immune activity, Antioxidant, Synergistic with glutathione &
vitamin E.
Vitamin A 5,000-
10,000iu
Supports vision, cell division and protects cell membranes.
Combats infection, maintain immunity & epithelial cell
differentiation & turnover. May enhance T-lymphocyte and
antibody responses. Reduces measles complications
Vitamin E 100-1,000iu Anti-Oxidant. Affects the expression & activity of immune &
inflammatory cells. Tissue repair and cell regeneration
Zinc 20-100mg Supports cell-mediated immunity. Immune function depends
directly on zinc status for production, regulation, activity &
equilibrium of both cellular & humoral immune responses.
Regulates T-lymphocytes, CD4cells, NK T cells, IL-2. Antioxidant
Tissue and cell repair.
(Pzzorno & Murray, 2006)
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Rubella
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Rubellao Rubella (also known as German measles) is an airborne virus with an
incubation period of 14-21 days. The spread is via droplets before the
onset of the rash and while the rash is present.
o In children under 5 years of age the symptoms are mild or absent.
o Infection during pregnancy can cause miscarriages, stillbirths, or birth
defects.
(Kumar & Clark, 2009)
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Rubella
Prodromal (initial) stage
o Malaise, fever, mild conjunctivitis, lymphadenopathy.
Can present with Forchheimer spots – small petechial
spots on the soft palate. Splenomegaly can present.
Eruptive (secondary) stage
o Occurs within the first week of initial symptoms.
o Rash is pink to red and first appears on the forehead
then spreads to the trunk & the limbs.
(Kumar & Clark, 2009)
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Rubella
Nutritional Treatment
o Rubella is a self-limiting infection, and does not require
specific medical or nutritional management targeting the
virus itself
o Nutritional management revolves around general
immune support and convalescence
• Bed rest
• Adequate fluid intake
• Removal of refined and allergenic foods
• Inclusion of nutrient dense foods
(University of Maryland Medical Centre, 2006)
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Mumps
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Mumps
o Mumps is an acute systemic viral infection of the
Paramyxovirus family with an incubation period of 14 -
24 days. Spread is via droplet infection from 2-3 days
before the onset of parotitis and 3 days post.
o Prodromal (initial) stage
• Fever, headaches, malaise, lethargy, anorexia
o Inflammatory (secondary) stage
• Sore, swollen throat, difficulty swallowing, one or two
swollen parotid glands.
• Epididymo-orchitis
(Kumar & Clark, 2009)
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Image: Mumps
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Mumps
Acute Phase Management includes :
o Plenty of bed rest and fluids.
o Maintain adequate nutrition.
o Slowly increase solid food utilization as vitality improves.
o Support mouth health.
o Complication: Seek immediate medical attention
o Anti-inflammatory foods can be beneficial (volatile oil rich
herbs & spices, bioflavonoid rich foods)
(Kumar & Clark, 2009)
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Mumps
Nutrient Dosage Therapeutic Actions
Vitamin C
(Ascorbic
acid)
500-
5,000mg
Immune activity. Synergistic with glutathione & vitamin E.
Anti-oxidant
Vitamin A 5,000-
10,000iu
May enhance T-lymphocyte and antibody responses. Supports
vision, cell division and protects cell membranes.
Combats infection, maintain immunity & epithelial cell
differentiation & turnover.
Vitamin E 250-
1000iu
Anti-Oxidant. Affects the expression & activity of immune &
inflammatory cells. Tissue repair and cell regeneration
Selenium 25-
250mcg
Co-factor for glutathione peroxidase, essential for immune
proliferation. Potentiates the antioxidant effects of vitamin E
Zinc 20-100mg Supports cell-mediated immunity. Immune function depends
directly on zinc status for production, regulation, activity &
equilibrium of both cellular & humoral immune responses.
Regulates T-lymphocytes, CD4cells, NK T cells, IL-2.
(Pizzorno & Murray , 2006)
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Measles, Mumps, Rubella
Measles, Mumps, Rubella Management
o For all three conditions divide the treatment plan to
include short and long term immune strategies.
o Analgesics can be given to support pain
o Antibiotics can be given if secondary infections present
o Topical creams can be applied to aid the rash symptoms
(Kumar & Clark, 2009)
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Measles, Mumps, Rubella
Drug Action Side Effects Interactions
MMR Vaccine Live attenuated vaccine
generates cell-mediated
& anti-body responses to
create a strong
immunological response
(one dose). Utilized to
reduce the severity of the
symptoms that present.
Not given for treatment of
these viruses,
prophylactic agent.
Transient site
inflammation, fever,
headaches,
dizziness, malaise
& nausea.
None listed
(Kumar & Clark, 2009; Bullock & Manias, 2007)
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Acute Food Poisoning
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Food Poisoning
o A notifiable disease that is due to the ingestion of
infected water or food
o The noxious agents can be bacteria, parasites, viruses
or toxins. Most commonly caused by a staphylococcus,
E. coli or salmonella. Consider Hepatitis A infection
differential diagnosis.
o Symptoms include abdominal cramping, diarrhoea, fever,
chills, headache, nausea, vomiting, weakness.
(Merck, 2010; Kumar & Clark, 2009)
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Parasite Associated Diarrhoea
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Parasitic Diarrhoea
Helminths (threadworm, hookworm, dog tapeworm)
o Infection via ingestion (less commonly through skin
boring or through insect bites carrying infection).
Symptoms include;
o Anal itching worse at night, mild diarrhoea (threadworms)
o Mild respiratory symptoms, epigastric pain, nausea, mild
diarrhoea, iron deficient anaemia. In a well-nourished
person they may present as asymptomatic (hookworms)
o Abdominal discomfort, diarrhoea, anorexia. May be
asymptomatic (tapeworms)
(Kumar & Clark, 2009)
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Parasitic Diarrhoea - GiardiaProtozoa (Giardia)
o Giardia is a single celled protozoa ingested through drinking
contaminated water
Giardiasis symptoms
o Symptoms usually appear 1-2 weeks after infection. Can be
asymptomatic
o Bloating & cramping in the GIT, Watery & foul smelling diarrhoea
o Belching, Nausea, Anorexia (Merck, 2010; Kumar & Clark, 2009)
o CDSA
o Quite responsive to nutritional treatment consuming a whole-food
based, high-fibre, diet that is low in fat, lactose, and refined sugars.
Additionally, ingestion of probiotics and wheat germ may assists in
parasite clearance (Hawrelak, 2003)
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Parasitic Diarrhoea
Diagnosis
o Thorough travelling history, stool sample, presentation of
eggs or worm carcass around anus or in bedding
(Merck, 2010; Kumar & Clark, 2009)
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Parasite Associated Chronic
Diarrhoea
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Parasite Associated Chronic
Diarrhoea
o Unchecked, diarrhoea can lead to extensive losses of
water and nutrients essential for good health.
(Kumar & Clark, 2009)
o Check for food intolerances/allergies
o Check for inflammatory bowel disease (IBD), irritable
bowel syndrome (IBS) or bile acid malabsorption
o Determine if a bacterial, protozoan, helminth, viral or
fungal infection presents
o Check for concurrent drug therapies – antibiotics,
laxative abuse, metformin, chemotherapy agents
(Kumar & Clark, 2009)
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Parasite Associated Diarrhoea
Therapeutic Actions
1. Assess nutritional status
- Electrolyte replacement
o Maintaining hydration and electrolyte levels is a primary
concern with diarrhoea. Solutions providing glucose,
sodium and potassium are most indicated
2. Support Immunity
-Zinc
o Has an antimicrobial effect on enteric pathogens, and
therefore helps to resolve infectious diarrhoea
o Note: zinc deficiency can cause diarrhoea
(Pizzorno & Murray, 2006, p. 1806)
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Parasite Associated Diarrhoea
3. Microbiome support
-Probiotics
o Evidence supports their use in antibiotic associated
diarrhoea, travelers diarrhoea, bacterial overgrowth and
pediatric diarrhoea. May also have a role in prevention of
future episodes
o Lactobacillus rhamnosus GG, Saccromyces boulardii, L.
bifidus and Streptococcus thermophilus are all known to
be effective (Pham M 2008)
(Pizzorno & Murray, 2006; Mahan, Escott-Stump &
Raymond, 2012)
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Parasite Associated Diarrhoea
4. Mucous membrane support and repair
Glutamine
o Improves energy metabolism and stimulates
regeneration
o Prevents mucosal damage & prevents bacterial leakage
o Animal studies have demonstrated improved water and
electrolyte absorption
o Use in children significantly reduced the duration of
diarrhoea
(Pizzorno & Murray, 2006, p. 1806)
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Parasite Associated Diarrhoea
5. Dietary interventions
BRAT diet (Banana, Rice (white), Apple & Toast (white) or
Tea)
o Proposed by some to be very useful, and evidence
supports bananas and rice
o A modified version would be better as this diet is low in
protein, fat and nutrients
(Pizzorno & Murray, 2006; Durro & Duggan, 2007)
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Parasite Associated Diarrhoea
-Oral Rehydration Therapy
o WHO recommends this as the first line of therapy.
Especially important in infants, children & the elderly or
anyone with vomiting and diarrhoea over 24 hours
WHO 2006
http://www.who.int/maternal_child_adolescent/documents/fch_cah_06_1/
en/
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Parasite Associated Diarrhoea
o Starchy carbohydrates & small amounts of fruit and
vegetables can be introduced next
o Lipids should be considered in the next stage, but
ensure digestive mechanisms for fat still functional
(Kumar & Clark, 2005; Mahan et al.2008)
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Parasite Associated Diarrhoea
o As the acute phase resolves, a low residue diet is
introduced (avoid maldigestion, foods that stimulate fluid
secretion or increase rate of GI transit).
o All sugars may need to be limited as they may worsen
osmotic diarrhea
o Low residue diet/Low fibre diet, available Medline Plus
http://www.nlm.nih.gov/medlineplus/ency/patientinstructi
ons/000200.htm
(Mahan et al. 2008)
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Parasite Associated DiarrhoeaNutrient Dosage Therapeutic Actions
Bifidobacterium
bifidus
L. Rhamnosus
10-40
Billion
org/day
Recolonize bacteria. Anaerobic pleomorphic rods (club
shaped organisms) that have the role in breaking down
dietary CH2O & interact directly with the host metabolism.
Glucosamine 600-
3000mg
Precursor to the ground substance/gap junctions for
epithelial cells
Soluble fibre 1tsp/bd Mucosal support/repair, Bulking agent. Mucopolysaccharide
Glutamine or
glutamic acid
500-
3000mg
Tissue repair, Restores gut wall integrity & normal intestinal
flora colonization (great with probiotics & zinc); substrate for
HCl production
Bromelain
pineapple
150-
400mg
Anti-inflammatory, Proteolytic enzyme, COX – 2
(Pizzorno & Murray, 2006)
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Parasite Associated Diarrhoea
Drug Action Side Effects Interaction
Antibiotics:
Quinolones
Bactericidal
(reduces
replication &
repair of bacterial
DNA).
Neurological is
most common:
Dizziness,
drowsiness,
restlessness.GIT symptoms, diarrhoea.Allergic responses: Photosensitivity, hypersensitivity, rash
B vitamins & Probiotic
interactions
Quercetin: may reduce drug
effectiveness (compete for
binding sites)
Calcium, Iron, Magnesium &
Zinc: reduced drug absorption.
Separate by 2 hours before & 4
hours after
Caffeine: May alter drug
metabolism
(Bullock & Manias, 2007; Braun & Cohen, 2010)
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Parasite Associated Diarrhoea
Drug Action Side effects Interactions
Antibiotics:
Macrolides
Bacteriostatic (inhibit bacterial RNA synthesis)Used for respiratory tract infections,. Including mycoplasma
CYP450 metabolism
GIT symptoms,
lethargy, dizziness,
headaches,
hypersensitivity
reaction (rash),
thrush (oral / vaginal)
B vitamins: concurrent
usage can reduce
absorption & bioavailability.
Vitamin B1 & B12 have
reduces bacterial
metabolism.
Probiotics: reduce drug
side effects
Nitroimidazole:
Metronidazole,
Tinidazole
Alters anaerobic
protozoan &
bacterial DNA
replication
Dark brown urine.
Dizziness, vertigo,
numb fingers & toes.
Confusion,
hallucination,
depression.
B vitamin & Probiotic
interactions
Avoid concurrent alcohol
consumption s it can cause
violent vomiting
(Bullock & manias, 2007; Braun & Cohen, 2010)
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Parasite Associated Diarrhoea
Drug Action Side effects Interactions
Anthelmintics:
Benzimadazole,
Albendazole
Not absorbed. Action in
GIT causing starvation,
immobilization & death of
helminths. Hookworm,
roundworm, whipworm &
some tapeworms.
Tapeworm cysts in the
liver can be treated with
Albendazole
Benzimadazole is not
systemically absorbed
so reduced side effects
(headache, dizziness,
abdominal cramps).
Albendazole can
increase liver enzymes
& is highly teratogenic
None listed
(Bullock & Manias, 2007)
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Parasite Associated Diarrhoea
Drug Action Side effects Interactions
Anthelmintics:
Pyrantel
Not systemically
absorbed. This drug
paralyses the worms
allowing for the
dislodgement and
excretion of the
parasites.
Poorly absorbed so
has reduced side
effects. These include
diarrhoea, vomiting,
cramping in the GIT,
nausea, drowsiness.
Avoid in individuals
that are dehydrated or
malnourished.
None listed
(Bullock & Manias, 2007)
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Candidiasis
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Candidiasis
o Candida albicans is one of 70 different species of
Candida yeast that resides in the mouth, throat, intestine
and genital/urinary tract of all humans.
o Candidiasis is excessive proliferation in the mouth,
oesophagus, intestines or vagina.
o Systemic candidiasis involves the over-proliferation of
Candida albicans throughout the body.
o In unchecked overgrowth, the yeast-fungal form converts
to a mycelial-fungal form that is able to break down the
protective barriers between the intestines and the blood.
(Kumar & Clark, 2009)
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Candidiasis
Contributing Factors:
o Medications: antibiotics, OCP & steroids
o Diet high in refined sugar, high GI foods, milk & dairy
products, yeast containing foods - Candida albicans
proliferates by consuming and fermenting simple sugars.
o Underlying food sensitivities
o Decreased digestive secretions & impaired liver function
o Impaired immunity
o Type 1 Diabetes
o Stress: compromises immune system by creating the
breakdown of protective host factors
(Kumar & Clark, 2009)
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Candidiasis
Signs & Symptoms:
o Candida albicans produces acetaldehyde from sugar
metabolism. This can produce neurotoxic symptoms;
• fatigue & malaise
• immune system malfunction, allergies & chemical
sensitivity
• depression, irritability, poor concentration
o Digestive disturbances present including bloating,
cramps, altered bowel motions, halitosis
o Thrush; both oral and genital
(Kumar & Clark, 2009; Pizzorno & Murray, 2006)
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CandidiasisNutritional Treatment
o Eliminate added sugars
o Nutritional anti-fungal foods i.e. garlic
o Identify and eliminate intolerant foods
o Support HCl production
o Support gut immunity and mucosal repair
o Liver detoxification and facilitate complete bowel elimination
o Support lifestyle and reduce psychological stress
o Daily physical activity to support normal immune and metabolic
function
o Check sexual practices – cross infection in susceptible individuals
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CandidiasisTreatment Plan
1. Support proper digestive function.
E.g. Betaine hydrochloride (with protein rich meal)
o Gastric HCl, pancreatic enzymes and bile all inhibit the
growth of C. albicans
o Apple Cider vinegar
o Antioxidants
2. Encourage healthy immune function
o Improve immune response; support membranes.
o Conjugated linolenic acid, vitamin A, vitamin E, zinc are
all required by T cells
(Pizzorno & Murray, 2006, p. 577)
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Candidiasis
Nutritional Treatment
3. Liver Support
o Poor liver function is a risk factor for C. albicans
overgrowth
o Damage to the liver is linked to immune suppression
o Choline, betaine and methionine should be used to
improve liver functions such as bile synthesis, fat
metabolism and detoxification
o Maintain adequate bowel elimination
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CandidiasisTherapeutic Actions
4. Microbiome status
Probiotics & Prebiotics
o Saccharomyces boulardii reduces adhesion of C.
albicans to human intestinal cells (Murzyn et al, 2010)
o Lactobacillus rhamnosus for reducing C. albicans
adhesions to cervical and vaginal cells (Coudeyras et al,
2008)
o Oral candidiasis demonstrated reduced prevalence with
Lactobacillus spp and Propionibacterium freudenreichii
treatment (Hatakka et al, 2007)
o Prebiotics are also indicated to improve elimination and
provide a fuel source for beneficial bacteria
(Pizzorno & Murray, 2006, p. 578)
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Candidiasis
Therapeutic Actions
Caprylic acid
o Has demonstrated anti-fungal actions on C. albicans
Garlic
o The allicin in garlic shows significant antifungal activity
Propolis
o Has several useful properties indicating its use:
antifungal, immune enhancing, improve effectiveness of
antifungal drugs
(Pizzorno & Murray, 2006, pp. 579-580)
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Candidiasis – Nutrient GuideNutrient Dosage Therapeutic Actions
Betaine HCl 100-400mg / Meal Raises stomach acid
Probiotics 10 -40 billion/org
day
Modulate immune system reactivity. Competitively
inhibit candida albicans. Provide SCFA
Sacchromyces
boulardii
200-750mg S. boulardii mediates responses resembling the
protective effects of the normal healthy gut flora
(Kelesidis T, Pothoulakis C 2012).
N-acetyl
Glucosamine
600-3000mg Synthesis of mucopolysaccharides,
glycosaminoglycan's & collagen (strength &
resilience of connective tissue).
Zinc 10-100mg Collagen & protein synthesis cofactor, Immune
function (T Lymphocytes CD4 Cells, NK T-Cells, IL-
2, SOD an Metallothionin), wound healing.
Enhances cell-mediated immunity. Anti-oxidant
effect
(Pizzorno & Murray, 2006)
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Nutrient Dosage Therapeutic Actions
Vitamin A 1000-5000iu Stability of cell membranes, Mucopolysaccharide synthesis.
Anti-oxidant effect Immune support
Vitamin C 500-
5,000mg
Increases lymphocyte production (neutrophils,
lymphocytes, NK cells), antibodies (IgA, IgG, IgM). Adrenal
support
Chromium 100-300mcg Supports carbohydrate, lipid & protein metabolism. Nucleic
acid synthesis and gene expression
(Pizzorno & Murray, 2006)
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Candidiasis
Drug Action Side Effects Interaction
Azole antifungal
Miconazole,
Viriconazole,
Fluconazole
Fungistatic that blocks
the production of fungal
cell membranes &
increase the
intracellular hydrogen
peroxide levels via
enzyme inhibition
Gastro-intestinal
disturbances including
nausea, abdominal
pain, diarrhoea when
taken orally.
Fluconazole has been
found to have the
potential added effects
of skin rash and
reversible hepatic
damage.
None listed
(Bryant & Knight, 2007)
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Epstein Barr Virus and
Cytomegalovirus
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EPV and CMV
o Epstein–Barr virus and cytomegalovirus are members of
the human herpesviruses that have an extremely high
sero prevalence in all populations studied.
o The initial infection is usually asymptomatic, or causes a
febrile illness, but can rarely manifest itself
neurologically.
o These viruses are increasingly important in the modern
era of immunosuppression, whether due to AIDS or in
the transplant or cancer chemotherapy population, and
their reactivation gives rise to a wide spectrum of
neurological diseases (Tselis, 2013).
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o A febrile pharyngitis with cervical lymphadenopathy was
described late in the 19th century.
o Due to the very high peripheral mononuclear cell counts
was defined in 1920 by Sprunt and Evans and called
“infectious mononucleosis”
o Primary EBV infection is often asymptomatic, especially
in children. In young adults, the infection causes a febrile
pharyngitis with prominent cervical lymphadenopathy
and significant fatigue and malaise.
o Recovery is usually complete within a few weeks,
although cases lasting several months have been
reported (Tselis, 2013).
Epstein Barr Virus
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Epstein Barr Virus
o Mimics of EBV IM include primary CMV disease, human
herpes virus 6 disease (HHV6), acute retroviral
syndrome, secondary disseminated syphilis, and acute
toxoplasmosis.
o Other manifestations of EBV IM include severe tonsillitis,
splenomegaly, hepatitis, myocarditis, pneumonitis,
interstitial nephritis, and haemolytic anaemia.
o These are uncommon, but point to the diversity of clinical
manifestations of acute EBV infection (Tselis, 2013).
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Cytomegalovirus
o Initial infection is usually asymptomatic or results in a
self-limited mononucleosis like syndrome with fever,
malaise, and sweats.
o Signs of hepatitis are noted in about a third of the
patients and there is less pharyngitis and only minimal
cervical adenopathy.
o The heterophile antibody test is always negative and
helps to differentiate CMV-associated IM (CMV IM) from
EBV IM (Tselis, 2013).
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Investigations
o The Mono spot test detects heterophile antibodies.
"Heterophile" antibodies are antibodies that react with
the cells of other species of animals.
o A full blood count (FBC) is used to determine whether
the number of WBCs is elevated and the presence of
atypical WBCs.
o If initially negative and still suspected may test again a
week or so later.
o People with –ve mono tests and non reactive
lymphocytes may be infected by CMV or toxoplasmosis.
o CMV tests involve CMV IgM and IgG
EBV and CMV
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Therapeutic aims based on improving immune function
and restoring health.
Nutrient Dosage Therapeutic Actions
Vitamin C 500-
5,000mg
Anti-inflammatory, antioxidant, connective tissue synthesis
& maintenance
Zinc 10-100mg Involved in the enzymatic control of anti-oxidant system,
wound healing, white blood cell control and is anti-viral
Garlic 2-25gm Antiviral activity (Daka, 2009)
Glutamine 1-5gm GIT support, mucous membrane trophorestorative,
improves gut immunity and IgA levels (Osiecki 7thed,p.91)
Vitamin E 100-1000iu Anti-inflammatory, Anti-oxidant, enhances T helper cell
synthesis, stabilizes cell membranes
Reishi
mushroom
6 to 12 g Extracts possess both immune-stimulating and antiviral
properties (Lindequist et al. 2005; Maheshwari et al, 2012)
(Pizzorno & Murray, 2006)
© Endeavour College of Natural Health endeavour.edu.au 61
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© Endeavour College of Natural Health endeavour.edu.au 66
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