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Author Topic: Letter of Medical Necessity
abigail
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Member # 14936

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At work, I have deferred some of my income to medical expenses (I have a high deductible and copays). I can include OTC items like cough syrup, etc. I seriously doubt that the probiotics I buy are going to go through (the government has determined what goes through and what doesn't so...); however, if I submit letters of necessity for an item signed by my doctor, they said it will work. I am planning on writing the letter up and just having my doctor sign it. Does anyone have a sample letter of necessity handy for probiotics? I'm hoping somebody has already been down this road. Thanks for reading this.

--------------------
Dying is easy. Living is harder.

Posts: 257 | From owensboro kentucky | Registered: Mar 2008  |  IP: Logged | Report this post to a Moderator
Tincup
Honored Contributor (10K+ posts)
Member # 5829

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Actually... that is one I've seen approved when no others were.

Here is some literature to send in with your letter. I have not broken it up into our kind of readable stuff... small lines... so it can be copied and pasted to your document as is.

Good luck!

[Big Grin]


''There are many factors that may contribute to Candida proliferation in the intestines. The primary contributing factor is the use of oral antibiotics (esp. tetracycline). It is common knowledge that antibiotics, especially over a period of time or with repeated uses, will eliminate much of the normal microbiota of the gastrointestinal tract. However, there are consequences of the elimination of these important bacteria that compete with other organisms for mucosal epithelial cellular receptor sites. It is recognized by the medical community as a whole that as a result of the elimination of the normal flora defense mechanism, yeasts are allowed to grow excessively in the gut. They may also extend and proliferate in the skin with antibiotic use (Ross). In obviously immunosuppressed patients, antibiotic use often has extreme or even fatal consequences from Candida proliferation due to elimination of the normal flora.

``Antibiotics, which are powerless against yeasts, but destroy bacteria, allow yeasts residing in the gut to grow unregulated. The imporatnat ecological factors of the gut are often overlooked due to lack of understanding of gastrointestinal immunity. Antibiotics may also allow various strains of bacteria resistant to the specific antibacterial drug to grow excessively, leading to bacterial overgrowth.''

Candida has also been suggested to play a part in creating what is called a "leaky gut," an unfavorable increase in intestinal permeability. Undigested macromolecule food particles and toxins are allowed to pass directly into the body creating a host of problems. This creates havoc with the immune system when these particles trigger an immune response sensitizing the individual to normally harmless molecules. When this happens, the individual is suggested to become "environmentally sensitive," responding to various harmless inhalants in the environment the person is exposed to as well as various foods. These reactions do not create typical allergic symptoms. Because of the strain on the immune system to break these undigested molecules down, the body's ability to defend against Candida may be further weekend, creating a cycle. These particles may also pass through the blood/brain barrier, be mistaken for neurotransmitters, and produce other mental symptoms that may create a misdiagnosis of neurotic disorder. Research is currently being done at the National Institute for Health to this end.''

``Candida has been found to produce 79 distinct toxins. These toxins have been shown to cause massive cangestion of the conjunctivae (eyelid area), ears, and other parts of the body in rats (Iwata). It is these toxins that are also suggested to be responsible for many of the symptoms that Candida sufferers have as well as the "die off reaction."

``James G. Kane, Jane H. Chretien, and Vincent F. Garagusi of the Infectious Disease Service , Department of Medicine, Georgetown Universtiy Hospital, Washington, D.C. reported on six cases of chronic, persistent, diarrhea, sometimes associated with abdominal cramps, caused by candida. Five of the individuals had no underlying condition and the symptoms lasted as long as three months until treatment was begun. Blood tests were unremarkable and they report that yeast in stools was best identified by direct microscopic observation.''

The Chronic Candidiasis Syndrome- Intestinal Candida
and its relation to chronic illness. The OAM 1996-1997, all rights reserved.

`````````````````````````````````````````````````


J Oral Pathol Med. 2007 Oct;36(9):528-32.


Oral manifestation of chronic mucocutaneous candidiasis: seven case reports.
Liu X, Hua H.

Department of Oral Medicine, School and Hospital of Stomatology, Peking University, Beijing, China.

BACKGROUND: Chronic mucocutaneous candidiasis (CMC) is a rare disorder characterized by persistent or recurrent candidal infections of the skin, nails and mucous membranes or by a variable combination of endocrine failure as well as immunodeficiency. Oral clinicopathological features of CMC have seldom been described in detail. METHODS: Seven patients with CMC were reported in the study. The clinical and histological findings, etiological Candida species, immunological evaluation, and therapeutic pattern of oral lesions, were analyzed. RESULTS: Long-standing whitish hyperplastic and nodule-like lesions with exaggerated deep fissure were the typical and characteristic oral manifestations presented by all patients. The tongue was the most common site affected. Histologically, no obvious distinction was found between CMC and other forms of candidal infection. Abnormal proportions of T-lymphocyte subsets and positive titers of autoantibody were observed in three subjects (42.9%) and one patient (14.3%) respectively. Meanwhile, four subjects (57.1%) showed decreased albumin and increased globulin, three cases (42.9%) had high levels of ESR. But no iron deficiency was found. Candida albicans was the microorganism isolated from these patients. CONCLUSIONS: Multiple and widespread candidal infectious lesions can be observed on the oral cavity of CMC patients. Hyperplastic and nodule-like lesion with irremovable whitish patches and deep fissure are the most common oral manifestations of these patients. Dentists, otolaryngologists and pediatricians should be familiar with the clinical appearances of CMC to make an accurate diagnosis. Potential systemic disorders should be concerned to avoid the reoccurrence of oral candidiasis.

``````````````````````````````````````````````

Additional abstracts and references:

Iwata, K.; Yamamoto, Y. Glycoprotein Toxins Produced by Candida albicans. Proceedings of the Fourth International Conference on the Mycoses, PAHO Scientific Publication #356, June 1977.

Quiralte, J.; Blanco, C.; Esparaza, R.; Castillo, R. Carrillo, T. Nasal Candidiasis in an Immunocompetent Patient. Allergologia et Immunopathologia. 21(6):227-8, 1993 Nov.-Dec. 


Magnavita, N. Mucocutaneous candidiasis in exposure to biological agents: a clinical case. Medicina del Lavoro. 84(3):243-8, 1993 May-Jun. (in Italian) 


Gutierrez, J.; Maroto, C.; Piedrola, G.; Martin, E.; Perez, JA. Circulating Candida antigens and antibodies: useful markers of candidemia. Journal of Clinical Microbiology. 31(9):2550-2, 1993 Sep. 


Walsh, TJ.; Lee, JW.; Sien, T.; Schaufele, R.; Bacher, J.; Switchenko, AC.; Goodman, TC.; Pizzo, PA. Serum D-arabinitol measured by automated quantitative enzymatic assay for detection and therapeutic monitoring of experimental disseminated candidiasis: correlation with tissue concentrations of Candida albicans. Journal of Medical & Veterinary Mycology. 32(3):205-15, 1994. 


Switchenko, AC. Miyada, CG. Goodman, TC. Walsh, TJ. Wong, B. Becker, MJ Ullman, EF. An automated enzymatic method for measurement of D-arabinitol, a metabolite of pathogenic Candida species. Journal of Clinical Microbiology. 32(1):92-7, 1994 Jan. 


Hussain, G.; Galahuddin, N.; Ahmad, I.; Galahuddin, I.; Jooma, R. Rhinocerebral invasive mycosis: occurrence in immunocompetent individuals. European Journal of Radiology. 20(2):151-5, 1995 Jul. 


Cater, RE., 2nd Chronic candidiasis as a possible etiological factor in the chronic fatigue syndrome. Medical Hypotheses. 44(0):507-15 Jun. 1995 


Crook, WG. The Yeast Connection Professional Books, Jackson Tennessee 


Crook, WG. The Yeast Connection and the Woman. Professional Books, Jackson Tennessee 


Widder, RA.; Bartz-Schmidt, KU.; Geyer, IL.; Brunner, R.; Kirchhof, B.; Donike, M.; Ileinmann, K. Candida albicans endophthalmitis after anabolic steroid abuse (letter). Lancet. 345(8945):330-1, 1995 Feb 4. 


Ross, VE.; Baxter, DL. Widespread Candida Folliculitis in a Nontoxic Patient. Cutis. 49(1):241-243, 1992 April. 


Cater, RE. Somatization disorder and the chronic candidiasis syndrome: a possible overlap. Medical Hypotheses. 35:126-135, 1991. 


Kroker, GF. Chronic Candidiasis and Allergy. In: Brosteff J.; Challacombe SJ.;eds. Food Allergy and Intolerance. London:Baillierre Tindall, 1989: ch. 49.

Kirkpatrick, CH.; Smith, TK. Chronic mucocutaneous candidiasis: immunologic and antibiotic therapy. Annals of Internal Medicaine. 80: 310-320, 1974. 


Dismukes, WE., Way, JS., Lee, JY., Dockery, B.K., Hain, J.D. A randomized double-blind trial of nystatin therapy for the candidiasis hypersensitivity syndrome. New England Journal of Medicine. 323:1717-23, 1990. 


Bennett, JE. Searching for the yeast connection. New England Journal of Medicine. 323:1766-67, 1990. 


Zwerling, MH., Owens, KN., Ruth, NH. Think yeast-the expanding spectrum of candidiasis. Journal of the South Carolina Medical Association. 80:454-456, 1984. 


Truss, CO. The Missing Diagnosis. (out of print) Avaiable for $8.95 + $5.00(1st class U.S., Canada) or $2.50(4th class U.S. only) shipping and handling by writing: The Missing Diagnosis, P.O. Box 26508, Birmingham, AL 35226 
Truss, CO.

The role of candida albicans in human illness. Journal of Orthomolecular Psychology. 10:228-238, 1981. 


Truss, CO. Tissue injury induced by candida albicans. Journal of Orthomolecular Psychology. 7(1) 


Truss, CO. Restoration of immunologic competence to candida albicans. Journal of Orthomolecular Psychology. 9(4) 


Truss, CO. Metabolic abnormalities in patients with chronic candidiasis: the acetaldehyde hypothesis. Journal of Orthomolecular Psychology. 13(2):66-93 


Bodey, G., Fainstein, V., Garcia, I., Rosenbaum, B., Wong, Y. Effect of broad-spectrum cephalosporins on the microbial flora of recipients. The Journal of Infectious Diseases. 148:892-897, 1983. 


Giuliano, M., Barza, M., Jacobus, N., Gorbach, S. Effect of broad spectrum antibiotics on composition of intestinal microflora of humans. Antimicrobial Agents and Chemotherapy. 202-206, 1987. 


Gracey, M., Burke, V., Thomas, J. Stone, D. Effect of microorganisms isolated from the upper gut of malnourished children on intestinal sugar absorption in vivo The American Journal of Clinical Nutrition. 28:841-845, 1975. 


Eras, P., Goldstein, M., Sherlock, P. Candida infection of the gastrointestinal tract. Medicine 51(5):367-379, 1972. 


Trowbridge, J.P., Walker, M. The Yeast Syndrome. Bantam Books. New York, 1986. 
Hotopf, Matthew.

Seasonal affective disorder, environmental hypersensitivity and somatisation. British Journal of Psychiatry. 164: 246-248, Feb. 1994. 


Keith, Sehnert W. Candida-related complex (CRC), a complicating factor in treatment and diagnostic screening for alcoholics: A pilot study of 213 patients. International Journal of Biosocial and Medical Research. 13(1):67-76, 1991. 


Rogers, Sherry A. Healing from the inside out: The leaky gut syndrome. Let's Live. 63(4):34-38, Apr 1995. 


Neuro-Immunophysiology of the Gastrointestinal Mucosa. Annals of the New York Academy of Sciences. 664, 1992 


Shorter, RB. Kirsner, JB. Gastrointestinal Immunity for the Clinician.

Grune & Stratton, Inc., Orlando, FL. 1985 
Murray, F. Acidophilus fights fungal infections. Better Nutrition for Today's Living. 56(5):54-55, May 1994 


Palmer, CA. A yeast for all reasons or is candidiasis the hidden enemy? Nutrition Today. 28(3)24-29, May 1993 


Yeast can destroy friendly bacteria. USA Today: The Magazine of the AMerican Scene. 122(2585):6-7, Feb. 1994 


Hentges, David J. Human intestinal microflora in health and disease. Academic Press: NY, 1983 
Hill, MJ. Role of gut bacteria in human toxicology and pharmacology. Taylor & Francis: Bristol, PA, 1995. 


Rowland, IR. Role of the gut flora in toxicity and cancer. Academic Press:San Diego, 1988 


Brostoff, J. Challacombe, SJ. Food Allergy and Intolerance. Bailliere Tindall: Philadelphia. 


Winner, HI. Hurley, R. Symposium on Candida Infections. E & S Livingstione LTD: London, 1966 


James, J. Warin, RP. An assessment of the role of Candida albicans and food yeasts in chronic urticaria. British Journal of Dermatology. 84:227-237, 1971 


Schinfeld, JS. PMS and candidiasis: study explores possible link. The Female Patient. 12:July 1987 


Witkin, SS. Defective immune response in patients with recurrent candidiasis. Infections in Medicine. May-June 1985 


Resseger, Charles S., D.O. or Norwalk, OH. Conversations with 
Giannela, RA. Broitman SA. Zamcheck, N. Influence of gastric acidity on bacterial and parasitic enteric infections: a perspective. Annals of Internal Medicine. 78: 271, 1973 


Gordon, JE. Chitkara, ID. Wyon, JB. Weanling diarrhea. American Journal of Medical Science. 245:345, 1963 


Mackowiak PA. The Normal Microbial Flora. New England Journal of Medicine. 307:83, 1982 


Freter, R. Interactions between mechanisms controlling the intestinal microflora. American Journal of Clinical Nutrition. 27:1409, 1974 


Bartlett, JG. Antibiotic associated pseudomembranous colitis. Rev Infect Dis. 1:123, 1979 
Freter, R. Brickner, H. Botney, M. et al. Mechanisms that control bacterial populations in continuous flow culture models of mouse large intestinal flora. Infectious Immunology. 39:676, 1983 


Shedlofsky, S. Freter, R. Synergism between ecologic and immunologic control mechanisms of intestinal flora. Journal of Infectious Diseases. 137:661, 1978 


Renfro, L. Feder, HM Jr. Lane, TJ. Manu, P. Matthews, DA. Yeast connection among 100 patients with chronic fatigue. American Journal of Medicine. 86(2):165-8, Feb. 1989. 


Schlossberg, D. Devig, PM. Travers, H. Kovalcik, PJ Mullen, JT. Bowel perforation with candidiasis. Journal of the American Medical Association. 238(23):2520-1, Dec 5, 1977. 


Schwartz, RH. Knerr, RJ. Candida esophagitis during treatemnt for adolescent acne vulgaris. Pediatric Infectious disease. 1(5):374, Sep-Oct, 1982. 


Jayagopal, S. Cervia, JS. Colitis due to Candida albicans in a patient with AIDS. Clinical Infectios Diseases. 15(3):555, Sep. 1992. 


Minoli G. Terruzzi V. Butti G. Frigerio G. Rossini A. Gastric candidiasis:an endoscopic and histological study in 26 patients. Gastrointestinal endoscopy. 28(2)59-61, 1982. 


Tortora, G. Funke, B. Case, C. Microbiology. New York: Benjamin/Cummings Publishing Company, 1995. 


Saltarelli, Cora G. Candida albicans: The Pathogenic Fungus. Hemisphere Publishing Company: Philadelphia, 1989. 


Segal, Esther; Baum, Gerald L. Pathogenic Yeasts and Yeast Infections. CRC Press: Ann Arbor, 1994. 


Jenzer, Martin, M.D. or Rochester, NY. Conversations with. 
Nelson, Robert S. Bruni, Hamilton C. Goldstein, Harvey M. Primary gastric candidiasis in uncompromised subjects. Gastrointestinal Endoscopy. 22:2, 92-94, 1982. 


Chan, Stephen, PhD, of SUNY College at Brockport, NY. Conversations with. 
Discussions with patients that have been treated with antifungal and diet therapy. 

Candida & Psoriasis in Dermatological Diseases
(in addition to above)


Skinner, RB. Jr. Rosenberg, W. Noah, PW. Psoriasis of the palms and soles is frequently associated with oropharyngeal Candida albicans. Acta Dermatological Venereol Supplement. 186:149-150, 1994. 


M buslau, Menzel I, Holzmann H. Fungal flora of the human faeces in psoriasis and atopic dermatitis. Mycoses. 33:2, 90-4, Feb. 1990. 


Soyeur U. Kilic H. Alpan O. Anti-Candida antibody levels in psoriasis vulgaris. Cent. Afr. Journal of Medicaine. 36: 8, 190-2, Aug. 1990. 


Baker BS. Powles AV. Malkani AK. Altered call-medicated immunity to group A haemolytic atreptococcal antigens in chronic plaque psoriasis. British Journal of Dermatology. 125: 1, 38-42, Jul 1991. 


el-Maghrabi EA. Dixon DM. Burnett JW. Characterization of Candida albicans epidermolytic proteases and their role in yeast-cell adherance to keratinocytes. Clinical Experimental Dermatology. 15: 3, 183-91, May 1990. 


Senff H. Bothe C. Busacker J. Reinel D. Studies on the yeast flora in patients suffering from psoriasis capillitii or seborrheic dermatitis of the scalp. Mycoses. 33:1, 29-32, Jan 1990. 


Orkin VF. [The characteristics of the clinical picture of candidiasis of the skin and mucous membranes in patients with chronic dermatosis] - Russian. Vrach Delo. 5, 78-80, May 1992. 


McKay M. Vulvar dermatoses: common problems in dermatological and gynecological practice. British Journal of Clinical Pract. Sym. Supplement. 71: 5-10, Sep 1990. 


Noah PW. The role of microorganisms in psoriasis. Semin Dermatology. 9:4, 269-76, Dec 1990. 


Haneke E. Fungal infections of the nail. Semin Dermatology. 10: 1, 41-53, Mar 1991. 


Rosenberg, EW. Noah PW. Skinner RB. Microorganisms and psoriasis. Journal of the National Medical Association. 86:4, 305-10, Apr 1994. 


Meinhof W. [Intestinal colonization with Candida albicans and its effect on chronic inflammatory dermatoses]-German. Hautarzt. 46:8, 525-7, Aug 1995. 


Buslau L. Hanel M. Holzmann H. The significance of yeasts in seborrheic eczemna. Hautarzt. 40(10):611-3, Oct. 1989. - German 


Henseler T. [Mucocutaneous candidiasis in patients with skin diseases] - German. Mycoses. 38 Supplement 1:7-13, 1995. 


Kemeny L. Ruzicka T. Dobozy A. Michel G. Role of interleukin-8 receptor in skin. International Archives of Allergy and Immunology. 104: 4, 317-22, Aug 1994. 


Squiquera L. Galimberti R. Morelli L. Plotkin L. Milicich R. Kowalckzuk A. Leoni J. Antibodies to proteins from Pityrosporum ovale in the sera from patients with psoriasis. Clinical Experimental Dermatology. 19: 4, 289-93, Jul 1994. 


Oranje AP. Dzoljic-Danilovic G. Michel MF. Aarsen RS. van Joost, T. [Is juvenile seborrheic dermatitis a candidiasis? Studies of a possible link with microbial infections.] - German

Tijdschrift voor Kindergeneeskunde. 55(3):87-92, Jul 1987. 



Candida and Diarrhea

Burke, V., Gracey, M. An experimental model of gastrointestinal candidiasis Journal of Medical Microbiology. 13:103-110.

Gupta, T., Ehrinpreis, M. Candida-associated diarrhea in hospitalized patients. Gastroenterology. 98:780-785, 1990. 


Danna, P., Urban, C., Bellin, E., Rahal, J. Role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients. The Lancet. 337:511-514, 1991. 


Bishop, R., Barnes, G. Depression of lactase acitivity in the small intestines of infant rabbits by Candida albicans. 


Kane, J., Chretien, J., Garagusi, V. Diarrhoea caused by Candida The Lancet. 335-336, 1976. (Immunocompetent) 
Garagusi, VF.

Chretien, JH. Diarrhoea caused by Candida.(letter) Lancet. 1(7961):697-8, Mar 27, 1976. 
Letter in Lancet in response. Enweani IB.

Obi CL. Jokpeyibo M. Prevalence of Candida species in Nigerian children with diarrhoea. J Diarrhoeal Dis Res 12(2):133-5, Jun, 1994. 
Gut flora in normal and disordered states. Chemotherapy. 5-15, 1995. 


Vogel LC. Antibiotic-induced diarrhea. Orthop Nurs 14(2): 38-41, Mar-Apr, 1995. 


Koffi-Akoua G. Ferly-Therizol M. Kouassi-Beugre MT. Konan A. Timite AM. Assi Adou J. Assale G. [Cryptosporidium and candida in pediatric diarrhea in Abidjan.] Bull Soc Pathol Exot Filiales 82(4): 451-7, , 1989. 


Ngan PK. Khanh NG. Tuong CV. Quy PP. Anh DN. Thuy HT. Persistent diarrhea in Vietnamese children: a preliminary report. Acta Paediatric Supplement. 381: 124-6, Sep, 1992. 


Siregar CD. Sinuhaji AB. Sutanto AH. Spectrum of digestive tract diseases 1985-1987 at the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital, Medan. Paediatr Indones. 30(5-6): 133-8, May-Jun, 1990. 


Talwar P. Chakrabarti A. Chawla A. Mehta S. Walia BN. Kumar L. Chugh KS. Fungal diarrhoea: association of different fungi and seasonal variation in their incidence. Mycopathologia. 110(2): 101-5, May, 1990. 


Omoike IU. Abiodun PO. Upper small intestinal microflora in diarrhea and malnutrition in Nigerian children. Journal of Pediatric Gastroenterolog Nutrition 9(3): 314-21, Oct, 1989. 



Immunosuppressed
Hirschel B. [AIDS and gastrointestinal tract: a summary for gastroenterologists and surgeons] Schweiz Med Wochenschr. 120(14): 475-84, Apr 7, 1990. Gage TP.

Eagan J. Gagnier M. Diverticulitis complicated by candidal pylephlebitis. South Med. Journal 78(10): 1265-6, Oct, 1985. 


Caselli M. Trevisani L. Bighi S. Aleotti A. Balboni PG. Gaiani R. Bovolenta MR. Stabellini G. Dead fecal yeasts and chronic diarrhea. Digestion. 41(3): 142-8, 1988. 


Zhen DL. [Analysis of the causative organisms in adult acute infectious diarrhea encountered in the past 12 years]. Chung Hua Nei Ko Tsa Chih 21(9): 540-2, Sep, 1982. 


Lorenz A. Grutte FK. Schon E. Muller B. Klimmt G. [Fungal infection of the small bowel mucosa.] Mykosen. 27(10): 506-10, Oct, 1984. 


Candida and Antibiotics

[Clinical evaluation of a new oral penem, SY5555, in the pediatric field.] Japanese Journal of Antibiotics. 41-8, Jan, 1995.

Elmer GW. Surawicz CM. McFarland LV. Biotherapeutic agents: A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. Journal of the American Medical Association. 275(11): 870-6, Mar 20, 1996. 


L Berkhof I. van Dusseldorp M. Swanink CM. van der Meer, JW. A diet for chronic fatigue caused by Candida albicans?.

Nederlands Tijdschrift Geneeskunde. 135(43):2017-2019, Oct 26, 1991.

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abigail
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Member # 14936

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Well, I guess then I will go over to CVS and see if my debit flexible spending card works on Culturelle. That would be GREAT! Thanks TC.

--------------------
Dying is easy. Living is harder.

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abigail
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It didn't work. Is there a certain brand that does?

--------------------
Dying is easy. Living is harder.

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bettyg
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adding this link to my newbie package for future use, and wanting to read it, so i'm breaking it up for neuro lyme patients like me [Smile] betty


quote:
Originally posted by Tincup:
Actually... that is one I've seen approved when no others were.

Here is some literature to send in with your letter. I have not broken it up into our kind of readable stuff... small lines... so it can be copied and pasted to your document as is.

Good luck! [Big Grin]
*********************

''There are many factors that may contribute to Candida proliferation in the intestines. The primary contributing factor is the use of oral antibiotics (esp. tetracycline).

It is common knowledge that antibiotics, especially over a period of time or with repeated uses, will eliminate much of the normal microbiota of the gastrointestinal tract.

However, there are consequences of the elimination of these important bacteria that compete with other organisms for mucosal epithelial cellular receptor sites.

It is recognized by the medical community as a whole that as a result of the elimination of the normal flora defense mechanism, yeasts are allowed to grow excessively in the gut.

They may also extend and proliferate in the skin with antibiotic use (Ross).

In obviously immunosuppressed patients, antibiotic use often has extreme or even fatal consequences from Candida proliferation due to elimination of the normal flora.


``Antibiotics, which are powerless against yeasts, but destroy bacteria, allow yeasts residing in the gut to grow unregulated. The important ecological factors of the gut are often overlooked due to lack of understanding of gastrointestinal immunity.

Antibiotics may also allow various strains of bacteria resistant to the specific antibacterial drug to grow excessively, leading to bacterial overgrowth.''


Candida has also been suggested to play a part in creating what is called a "leaky gut," an unfavorable increase in intestinal permeability.

Undigested macromolecule food particles and toxins are allowed to pass directly into the body creating a host of problems.

This creates havoc with the immune system when these particles trigger an immune response sensitizing the individual to normally harmless molecules.

When this happens, the individual is suggested to become "environmentally sensitive," responding to various harmless inhalants in the environment the person is exposed to as well as various foods.

These reactions do not create typical allergic symptoms.

Because of the strain on the immune system to break these undigested molecules down, the body's ability to defend against Candida may be further weekend, creating a cycle.

These particles may also pass through the blood/brain barrier, be mistaken for neurotransmitters, and produce other mental symptoms that may create a misdiagnosis of neurotic disorder.

Research is currently being done at the National Institute for Health to this end.''


``Candida has been found to produce 79 distinct toxins. These toxins have been shown to cause massive cangestion of the conjunctivae (eyelid area), ears, and other parts of the body in rats (Iwata).

It is these toxins that are also suggested to be responsible for many of the symptoms that Candida sufferers have as well as the "die off reaction."


``James G. Kane, Jane H. Chretien, and Vincent F. Garagusi of the Infectious Disease Service, Department of Medicine, Georgetown University Hospital, Washington, D.C. reported on six cases of chronic, persistent, diarrhea, sometimes associated with abdominal cramps, caused by candida.

Five of the individuals had no underlying condition and the symptoms lasted as long as three months until treatment was begun.

Blood tests were unremarkable and they report that yeast in stools was best identified by direct microscopic observation.''


The Chronic Candidiasis Syndrome- Intestinal Candida and its relation to chronic illness.

The OAM 1996-1997, all rights reserved.
`````````````````````````````````````````````````

J Oral Pathol Med. 2007 Oct;36(9):528-32.


Oral manifestation of chronic mucocutaneous candidiasis: seven case reports.
Liu X, Hua H.

Department of Oral Medicine, School and Hospital of Stomatology, Peking University, Beijing, China.

BACKGROUND: Chronic mucocutaneous candidiasis (CMC) is a rare disorder characterized by persistent or recurrent candidal infections of the skin, nails and mucous membranes or by a variable combination of endocrine failure as well as immunodeficiency.

Oral clinicopathological features of CMC have seldom been described in detail.


METHODS: Seven patients with CMC were reported in the study.

The clinical and histological findings, etiological Candida species, immunological evaluation, and therapeutic pattern of oral lesions, were analyzed.


RESULTS: Long-standing whitish hyperplastic and nodule-like lesions with exaggerated deep fissure were the typical and characteristic oral manifestations presented by all patients.

The tongue was the most common site affected.

Histologically, no obvious distinction was found between CMC and other forms of candidal infection.

Abnormal proportions of T-lymphocyte subsets and positive titers of autoantibody were observed in three subjects (42.9%) and one patient (14.3%) respectively.

Meanwhile, four subjects (57.1%) showed decreased albumin and increased globulin, three cases (42.9%) had high levels of ESR.

But no iron deficiency was found.

Candida albicans was the microorganism isolated from these patients.


CONCLUSIONS: Multiple and widespread candidal infectious lesions can be observed on the oral cavity of CMC patients.

Hyperplastic and nodule-like lesion with irremovable whitish patches and deep fissure are the most common oral manifestations of these patients.

Dentists, otolaryngologists and pediatricians should be familiar with the clinical appearances of CMC to make an accurate diagnosis.

Potential systemic disorders should be concerned to avoid the reoccurrence of oral candidiasis.
``````````````````````````````````````````````

Additional abstracts and references:

Iwata, K.; Yamamoto, Y. Glycoprotein Toxins Produced by Candida albicans.
Proceedings of the Fourth International Conference on the Mycoses, PAHO Scientific Publication #356, June 1977.

Quiralte, J.; Blanco, C.; Esparaza, R.; Castillo, R. Carrillo, T. Nasal Candidiasis in an Immunocompetent Patient. Allergologia et Immunopathologia. 21(6):227-8, 1993 Nov.-Dec. 


Magnavita, N. Mucocutaneous candidiasis in exposure to biological agents: a clinical case. Medicina del Lavoro. 84(3):243-8, 1993 May-Jun. (in Italian) 


Gutierrez, J.; Maroto, C.; Piedrola, G.; Martin, E.; Perez, JA. Circulating Candida antigens and antibodies: useful markers of candidemia. Journal of Clinical Microbiology. 31(9):2550-2, 1993 Sep. 


Walsh, TJ.; Lee, JW.; Sien, T.; Schaufele, R.; Bacher, J.; Switchenko, AC.; Goodman, TC.; Pizzo, PA. Serum D-arabinitol measured by automated quantitative enzymatic assay for detection and therapeutic monitoring of experimental disseminated candidiasis: correlation with tissue concentrations of Candida albicans. Journal of Medical & Veterinary Mycology. 32(3):205-15, 1994. 



Switchenko, AC. Miyada, CG. Goodman, TC. Walsh, TJ. Wong, B. Becker, MJ Ullman, EF. An automated enzymatic method for measurement of D-arabinitol, a metabolite of pathogenic Candida species. Journal of Clinical Microbiology. 32(1):92-7, 1994 Jan. 


Hussain, G.; Galahuddin, N.; Ahmad, I.; Galahuddin, I.; Jooma, R. Rhinocerebral invasive mycosis: occurrence in immunocompetent individuals. European Journal of Radiology. 20(2):151-5, 1995 Jul. 


Cater, RE., 2nd Chronic candidiasis as a possible etiological factor in the chronic fatigue syndrome. Medical Hypotheses. 44(0):507-15 Jun. 1995 


Crook, WG. The Yeast Connection Professional Books, Jackson Tennessee 


Crook, WG. The Yeast Connection and the Woman. Professional Books, Jackson Tennessee 


Widder, RA.; Bartz-Schmidt, KU.; Geyer, IL.; Brunner, R.; Kirchhof, B.; Donike, M.; Ileinmann, K. Candida albicans endophthalmitis after anabolic steroid abuse (letter). Lancet. 345(8945):330-1, 1995 Feb 4. 


Ross, VE.; Baxter, DL. Widespread Candida Folliculitis in a Nontoxic Patient. Cutis. 49(1):241-243, 1992 April. 


Cater, RE. Somatization disorder and the chronic candidiasis syndrome: a possible overlap. Medical Hypotheses. 35:126-135, 1991. 


Kroker, GF. Chronic Candidiasis and Allergy. In: Brosteff J.; Challacombe SJ.;eds. Food Allergy and Intolerance. London:Baillierre Tindall, 1989: ch. 49.

Kirkpatrick, CH.; Smith, TK. Chronic mucocutaneous candidiasis: immunologic and antibiotic therapy. Annals of Internal Medicaine. 80: 310-320, 1974. 


Dismukes, WE., Way, JS., Lee, JY., Dockery, B.K., Hain, J.D. A randomized double-blind trial of nystatin therapy for the candidiasis hypersensitivity syndrome. New England Journal of Medicine. 323:1717-23, 1990. 


Bennett, JE. Searching for the yeast connection. New England Journal of Medicine. 323:1766-67, 1990. 


Zwerling, MH., Owens, KN., Ruth, NH. Think yeast-the expanding spectrum of candidiasis. Journal of the South Carolina Medical Association. 80:454-456, 1984. 


Truss, CO. The Missing Diagnosis. (out of print) Avaiable for $8.95 + $5.00(1st class U.S., Canada) or $2.50(4th class U.S. only) shipping and handling by writing: The Missing Diagnosis, P.O. Box 26508, Birmingham, AL 35226 
Truss, CO.

The role of candida albicans in human illness. Journal of Orthomolecular Psychology. 10:228-238, 1981. 


Truss, CO. Tissue injury induced by candida albicans. Journal of Orthomolecular Psychology. 7(1) 


Truss, CO. Restoration of immunologic competence to candida albicans. Journal of Orthomolecular Psychology. 9(4) 


Truss, CO. Metabolic abnormalities in patients with chronic candidiasis: the acetaldehyde hypothesis. Journal of Orthomolecular Psychology. 13(2):66-93 


Bodey, G., Fainstein, V., Garcia, I., Rosenbaum, B., Wong, Y. Effect of broad-spectrum cephalosporins on the microbial flora of recipients. The Journal of Infectious Diseases. 148:892-897, 1983. 


Giuliano, M., Barza, M., Jacobus, N., Gorbach, S. Effect of broad spectrum antibiotics on composition of intestinal microflora of humans. Antimicrobial Agents and Chemotherapy. 202-206, 1987. 


Gracey, M., Burke, V., Thomas, J. Stone, D. Effect of microorganisms isolated from the upper gut of malnourished children on intestinal sugar absorption in vivo The American Journal of Clinical Nutrition. 28:841-845, 1975. 


Eras, P., Goldstein, M., Sherlock, P. Candida infection of the gastrointestinal tract. Medicine 51(5):367-379, 1972. 


Trowbridge, J.P., Walker, M. The Yeast Syndrome. Bantam Books. New York, 1986. 
Hotopf, Matthew.

Seasonal affective disorder, environmental hypersensitivity and somatisation. British Journal of Psychiatry. 164: 246-248, Feb. 1994. 


Keith, Sehnert W. Candida-related complex (CRC), a complicating factor in treatment and diagnostic screening for alcoholics: A pilot study of 213 patients. International Journal of Biosocial and Medical Research. 13(1):67-76, 1991. 


Rogers, Sherry A. Healing from the inside out: The leaky gut syndrome. Let's Live. 63(4):34-38, Apr 1995. 


Neuro-Immunophysiology of the Gastrointestinal Mucosa. Annals of the New York Academy of Sciences. 664, 1992 


Shorter, RB. Kirsner, JB. Gastrointestinal Immunity for the Clinician.

Grune & Stratton, Inc., Orlando, FL. 1985 
Murray, F. Acidophilus fights fungal infections. Better Nutrition for Today's Living. 56(5):54-55, May 1994 


Palmer, CA. A yeast for all reasons or is candidiasis the hidden enemy? Nutrition Today. 28(3)24-29, May 1993 


Yeast can destroy friendly bacteria. USA Today: The Magazine of the AMerican Scene. 122(2585):6-7, Feb. 1994 


Hentges, David J. Human intestinal microflora in health and disease. Academic Press: NY, 1983 
Hill, MJ. Role of gut bacteria in human toxicology and pharmacology. Taylor & Francis: Bristol, PA, 1995. 


Rowland, IR. Role of the gut flora in toxicity and cancer. Academic Press:San Diego, 1988 


Brostoff, J. Challacombe, SJ. Food Allergy and Intolerance. Bailliere Tindall: Philadelphia. 


Winner, HI. Hurley, R. Symposium on Candida Infections. E & S Livingstione LTD: London, 1966 


James, J. Warin, RP. An assessment of the role of Candida albicans and food yeasts in chronic urticaria. British Journal of Dermatology. 84:227-237, 1971 


Schinfeld, JS. PMS and candidiasis: study explores possible link. The Female Patient. 12:July 1987 


Witkin, SS. Defective immune response in patients with recurrent candidiasis. Infections in Medicine. May-June 1985 


Resseger, Charles S., D.O. or Norwalk, OH. Conversations with 
Giannela, RA. Broitman SA. Zamcheck, N. Influence of gastric acidity on bacterial and parasitic enteric infections: a perspective. Annals of Internal Medicine. 78: 271, 1973 


Gordon, JE. Chitkara, ID. Wyon, JB. Weanling diarrhea. American Journal of Medical Science. 245:345, 1963 


Mackowiak PA. The Normal Microbial Flora. New England Journal of Medicine. 307:83, 1982 


Freter, R. Interactions between mechanisms controlling the intestinal microflora. American Journal of Clinical Nutrition. 27:1409, 1974 


Bartlett, JG. Antibiotic associated pseudomembranous colitis. Rev Infect Dis. 1:123, 1979 
Freter, R. Brickner, H. Botney, M. et al. Mechanisms that control bacterial populations in continuous flow culture models of mouse large intestinal flora. Infectious Immunology. 39:676, 1983 


Shedlofsky, S. Freter, R. Synergism between ecologic and immunologic control mechanisms of intestinal flora. Journal of Infectious Diseases. 137:661, 1978 


Renfro, L. Feder, HM Jr. Lane, TJ. Manu, P. Matthews, DA. Yeast connection among 100 patients with chronic fatigue. American Journal of Medicine. 86(2):165-8, Feb. 1989. 


Schlossberg, D. Devig, PM. Travers, H. Kovalcik, PJ Mullen, JT. Bowel perforation with candidiasis. Journal of the American Medical Association. 238(23):2520-1, Dec 5, 1977. 


Schwartz, RH. Knerr, RJ. Candida esophagitis during treatemnt for adolescent acne vulgaris. Pediatric Infectious disease. 1(5):374, Sep-Oct, 1982. 


Jayagopal, S. Cervia, JS. Colitis due to Candida albicans in a patient with AIDS. Clinical Infectios Diseases. 15(3):555, Sep. 1992. 


Minoli G. Terruzzi V. Butti G. Frigerio G. Rossini A. Gastric candidiasis:an endoscopic and histological study in 26 patients. Gastrointestinal endoscopy. 28(2)59-61, 1982. 


Tortora, G. Funke, B. Case, C. Microbiology. New York: Benjamin/Cummings Publishing Company, 1995. 


Saltarelli, Cora G. Candida albicans: The Pathogenic Fungus. Hemisphere Publishing Company: Philadelphia, 1989. 


Segal, Esther; Baum, Gerald L. Pathogenic Yeasts and Yeast Infections. CRC Press: Ann Arbor, 1994. 


Jenzer, Martin, M.D. or Rochester, NY. Conversations with. 
Nelson, Robert S. Bruni, Hamilton C. Goldstein, Harvey M. Primary gastric candidiasis in uncompromised subjects. Gastrointestinal Endoscopy. 22:2, 92-94, 1982. 


Chan, Stephen, PhD, of SUNY College at Brockport, NY. Conversations with. 
Discussions with patients that have been treated with antifungal and diet therapy. 

Candida & Psoriasis in Dermatological Diseases
(in addition to above)


Skinner, RB. Jr. Rosenberg, W. Noah, PW. Psoriasis of the palms and soles is frequently associated with oropharyngeal Candida albicans. Acta Dermatological Venereol Supplement. 186:149-150, 1994. 


M buslau, Menzel I, Holzmann H. Fungal flora of the human faeces in psoriasis and atopic dermatitis. Mycoses. 33:2, 90-4, Feb. 1990. 


Soyeur U. Kilic H. Alpan O. Anti-Candida antibody levels in psoriasis vulgaris. Cent. Afr. Journal of Medicaine. 36: 8, 190-2, Aug. 1990. 


Baker BS. Powles AV. Malkani AK. Altered call-medicated immunity to group A haemolytic atreptococcal antigens in chronic plaque psoriasis. British Journal of Dermatology. 125: 1, 38-42, Jul 1991. 


el-Maghrabi EA. Dixon DM. Burnett JW. Characterization of Candida albicans epidermolytic proteases and their role in yeast-cell adherance to keratinocytes. Clinical Experimental Dermatology. 15: 3, 183-91, May 1990. 


Senff H. Bothe C. Busacker J. Reinel D. Studies on the yeast flora in patients suffering from psoriasis capillitii or seborrheic dermatitis of the scalp. Mycoses. 33:1, 29-32, Jan 1990. 


Orkin VF. [The characteristics of the clinical picture of candidiasis of the skin and mucous membranes in patients with chronic dermatosis] - Russian. Vrach Delo. 5, 78-80, May 1992. 


McKay M. Vulvar dermatoses: common problems in dermatological and gynecological practice. British Journal of Clinical Pract. Sym. Supplement. 71: 5-10, Sep 1990. 


Noah PW. The role of microorganisms in psoriasis. Semin Dermatology. 9:4, 269-76, Dec 1990. 


Haneke E. Fungal infections of the nail. Semin Dermatology. 10: 1, 41-53, Mar 1991. 


Rosenberg, EW. Noah PW. Skinner RB. Microorganisms and psoriasis. Journal of the National Medical Association. 86:4, 305-10, Apr 1994. 


Meinhof W. [Intestinal colonization with Candida albicans and its effect on chronic inflammatory dermatoses]-German. Hautarzt. 46:8, 525-7, Aug 1995. 


Buslau L. Hanel M. Holzmann H. The significance of yeasts in seborrheic eczemna. Hautarzt. 40(10):611-3, Oct. 1989. - German 


Henseler T. [Mucocutaneous candidiasis in patients with skin diseases] - German. Mycoses. 38 Supplement 1:7-13, 1995. 


Kemeny L. Ruzicka T. Dobozy A. Michel G. Role of interleukin-8 receptor in skin. International Archives of Allergy and Immunology. 104: 4, 317-22, Aug 1994. 


Squiquera L. Galimberti R. Morelli L. Plotkin L. Milicich R. Kowalckzuk A. Leoni J. Antibodies to proteins from Pityrosporum ovale in the sera from patients with psoriasis. Clinical Experimental Dermatology. 19: 4, 289-93, Jul 1994. 


Oranje AP. Dzoljic-Danilovic G. Michel MF. Aarsen RS. van Joost, T. [Is juvenile seborrheic dermatitis a candidiasis? Studies of a possible link with microbial infections.] - German

Tijdschrift voor Kindergeneeskunde. 55(3):87-92, Jul 1987. 



Candida and Diarrhea

Burke, V., Gracey, M. An experimental model of gastrointestinal candidiasis Journal of Medical Microbiology. 13:103-110.

Gupta, T., Ehrinpreis, M. Candida-associated diarrhea in hospitalized patients. Gastroenterology. 98:780-785, 1990. 


Danna, P., Urban, C., Bellin, E., Rahal, J. Role of candida in pathogenesis of antibiotic-associated diarrhoea in elderly inpatients. The Lancet. 337:511-514, 1991. 


Bishop, R., Barnes, G. Depression of lactase acitivity in the small intestines of infant rabbits by Candida albicans. 


Kane, J., Chretien, J., Garagusi, V. Diarrhoea caused by Candida The Lancet. 335-336, 1976. (Immunocompetent) 
Garagusi, VF.

Chretien, JH. Diarrhoea caused by Candida.(letter) Lancet. 1(7961):697-8, Mar 27, 1976. 
Letter in Lancet in response. Enweani IB.

Obi CL. Jokpeyibo M. Prevalence of Candida species in Nigerian children with diarrhoea. J Diarrhoeal Dis Res 12(2):133-5, Jun, 1994. 
Gut flora in normal and disordered states. Chemotherapy. 5-15, 1995. 


Vogel LC. Antibiotic-induced diarrhea. Orthop Nurs 14(2): 38-41, Mar-Apr, 1995. 


Koffi-Akoua G. Ferly-Therizol M. Kouassi-Beugre MT. Konan A. Timite AM. Assi Adou J. Assale G. [Cryptosporidium and candida in pediatric diarrhea in Abidjan.] Bull Soc Pathol Exot Filiales 82(4): 451-7, , 1989. 


Ngan PK. Khanh NG. Tuong CV. Quy PP. Anh DN. Thuy HT. Persistent diarrhea in Vietnamese children: a preliminary report. Acta Paediatric Supplement. 381: 124-6, Sep, 1992. 


Siregar CD. Sinuhaji AB. Sutanto AH. Spectrum of digestive tract diseases 1985-1987 at the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital, Medan. Paediatr Indones. 30(5-6): 133-8, May-Jun, 1990. 


Talwar P. Chakrabarti A. Chawla A. Mehta S. Walia BN. Kumar L. Chugh KS. Fungal diarrhoea: association of different fungi and seasonal variation in their incidence. Mycopathologia. 110(2): 101-5, May, 1990. 


Omoike IU. Abiodun PO. Upper small intestinal microflora in diarrhea and malnutrition in Nigerian children. Journal of Pediatric Gastroenterolog Nutrition 9(3): 314-21, Oct, 1989. 



Immunosuppressed
Hirschel B. [AIDS and gastrointestinal tract: a summary for gastroenterologists and surgeons] Schweiz Med Wochenschr. 120(14): 475-84, Apr 7, 1990. Gage TP.

Eagan J. Gagnier M. Diverticulitis complicated by candidal pylephlebitis. South Med. Journal 78(10): 1265-6, Oct, 1985. 


Caselli M. Trevisani L. Bighi S. Aleotti A. Balboni PG. Gaiani R. Bovolenta MR. Stabellini G. Dead fecal yeasts and chronic diarrhea. Digestion. 41(3): 142-8, 1988. 


Zhen DL. [Analysis of the causative organisms in adult acute infectious diarrhea encountered in the past 12 years]. Chung Hua Nei Ko Tsa Chih 21(9): 540-2, Sep, 1982. 


Lorenz A. Grutte FK. Schon E. Muller B. Klimmt G. [Fungal infection of the small bowel mucosa.] Mykosen. 27(10): 506-10, Oct, 1984. 


Candida and Antibiotics

[Clinical evaluation of a new oral penem, SY5555, in the pediatric field.] Japanese Journal of Antibiotics. 41-8, Jan, 1995.

Elmer GW. Surawicz CM. McFarland LV. Biotherapeutic agents: A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. Journal of the American Medical Association. 275(11): 870-6, Mar 20, 1996. 


L Berkhof I. van Dusseldorp M. Swanink CM. van der Meer, JW. A diet for chronic fatigue caused by Candida albicans?.

Nederlands Tijdschrift Geneeskunde. 135(43):2017-2019, Oct 26, 1991.


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viva
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Abigail,

I don't know the details of your medical spending plan, but mine allows either buying approved meds with the debit card, or buying with cash and submitting the receipt by mail or on-line, and then gettinig reimbursed.

If your plan allows for this, could you pay cash for the probiotics and then request reimbursement? This would also give you the option of ordering probiotics on-line, which widens your choices.

Just an idea...

Viva

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