Is modern life making you ill?

Fungal infections, some drug-resistant, are increasing. Are Western diet and medicines to blame?

Fatigued, dizzy, depressed or irritable? Can't sleep, no sex drive, and suffering with eczema or psoriasis? You could be one of an increasing number of people suffering with chronic fungal infection caused by candida.

Fatigued, dizzy, depressed or irritable? Can't sleep, no sex drive, and suffering with eczema or psoriasis? You could be one of an increasing number of people suffering with chronic fungal infection caused by candida.

New research shows that human fungal diseases are on the increase worldwide. It is estimated that there has been a twelvefold increase in less than a decade, and so concerned is the American government that it has quadrupled spending on research. Some of the increase is due to the use of antibiotics, some to the growing number of medical conditions and treatments that compromise the immune system. But the causes of other, sometimes fatal, outbreaks in otherwise healthy people, including children, are a mystery.

There are estimated to be around one million different fungi in the world, and 300 of them are known to cause disease in humans, 15 of them on a regular basis. But delegates to the British Society for Medical Mycology's annual meeting next month will be told that on average five new fungi a year that have never before been a problem are now causing diseases in humans.

"We used to think of fungi as plants, but they are really on their own and more closely related to humans because of their metabolic machinery. They are self-replicating life-forms with asexual and sexual reproduction, and with an ability to eat and digest complex nutrients,'' says Dr David Denning, consultant in infectious diseases and senior lecturer at Manchester University.

Although fungal diseases are still outnumbered by those caused by viruses and bacteria, fungi are fast catching up and in some areas already account for one in 10 hospital infections. Fungal infections are more difficult to treat than bacterial infections, take longer to cure, and kill more than 1,000 hospital patients a year in the UK.

"Fungi account for a growing number of hospital-acquired infections and have become common among Aids patients. Isolated outbreaks of other fungal diseases in people with normal immune systems have also occurred recently,'' said Tom Martin of the US National Institutes of Health.

Although athlete's foot, cradle cap and fungal nail infections are all caused by fungi, it is internal problems, ranging from thrush to infections of the brain and lungs, that are the main health threats.

The most common family of fungi that infects humans is candida, responsible for vaginal thrush as well as oral thrush in babies and Aids patients. In patients with poor immune system responses, it can also get into the blood and cause fatal septicaemia. Around 70 per cent of women will get vaginal thrush at some time, often as a consequence of being treated with antibiotics for cystitis. The antibiotics, many of them, like penicillin, based on the bacteria-killing chemicals found in fungi, kill off natural bacteria, creating space for fungi to move in.

Another condition linked to candida and known as chronic candida or candidiasis or yeast syndrome is characterised by a collection of ME-like, non-specific symptoms as diverse as depression, burning eyes, constipation, endometriosis and infertility. It's thought that a change in the balance of the yeast-like fungus in the body may be responsible for the symptoms.

But one of the problems with diagnosing chronic candida is that there is no definitive test. Symptoms are non-specific, and even evidence of candida itself is not proof that it is to blame. "We all have candida living inside us. However, there need to be additional factors which cause the number of yeasts to increase to such an extent that they threaten our health,'' says Gill Jacobs, author of Beat Candida Through Diet.

Triggers that can cause this increase and upset the natural balance, she says, include antibiotics, stress, the pill, HRT, steroids, stress, and a carbohydrate-rich diet. One theory is that this chronic condition is not so much the direct effect of the yeast fungi, but an allergic reaction of the body to candida.

Chronic candida is usually tackled by a three-pronged strategy - stopping ingestion of moulds in people with allergies, stopping yeast multiplying in the body, and making the body an unpleasant place for the growth of fungi. Many suggested remedies centre on dietary changes, mostly aimed at cutting back on sugar, alcohol, carbohydrates and yeast products. Candida sufferers often have extreme cravings for the very foods that irritate their condition. Once they know this, many can tell instinctively which foods they must avoid.

Cheese and other fermented products, including wine and vinegar, are a significant cause of mould, and so too are peanut butter, jelly and dried fruits. Keeping soft foods such as crackers and cereals in the fridge after opening inhibits mould growth and stops ingestion of fungi. Antibiotics should also be avoided.

A number of natural products, including garlic, caprylic acid and gentian violet, can also be used as natural anti-fungals. More powerful anti-fungal drugs are available on prescription. Gill Jacobs says that nutrient supplements are also important: "Nutrients beneficial for building up immunity are vitamins C, E and A, selenium, zinc, iron, copper, folic acid, vitamin B12 and B6, magnesium and calcium.''

Although as many as one in 30 people suffer with some form of chronic candida, their symptoms are rarely life threatening. The more serious fungal infections affect people with impaired immune systems, including patients who have had transplants or chemotherapy, who have Aids or have been treated in intensive care units. But there is also an increase in unexplained cases affecting otherwise normal, healthy people, including children.

"Every year, five fungi never previously known to have caused human disease are found to do so. Half are in people with damaged immune systems, half in people with normal immune systems, and we simply do not know why,'' says Dr Denning. "We don't know why, for example, a little girl playing on her uncle's ranch in Texas caught a fungal infection which went into her sinuses and eyes, making her blind and killing her. We don't know why a fungus called Candida catenulata, found in dairy products including camembert, that had never infected humans before, was recently found in blood stream of a woman with cancer.'' Other cases include that of a farmer who had an outbreak of nodules on his arm after being infected with fungi from rotting wood, and a 24-year-old leukaemia sufferer who was found to have a mushroom not previously involved in human disease growing in his lung.

For doctors, the increasing cases of fungal infection mean that new treatments are having to be designed. Rates of infection are soaring, so much so that in some parts of America coccidioidomycossis is now considered endemic. But most worrying of all are the reports of some studies showing that species of candida have already developed a resistance to one of the main drugs used against it.