Ear Problems in Children and the Yeast Connection

by William Crook, M.D.

During over 40 years of pediatric and allergy practice, thousands of children with otitis media sought help from me and my pediatric associates.  Problems in some of these children were difficult for us to manage and frustrating for the parents and the children.  Yet, I can recall only a rare child who developed mastoid infections, or other complications.

Antibiotics save lives.  No doubt about it.  Yet, during recent years I've begun to feel that antibiotics may be causing unexpected, untoward effects.  And they seem especially apt to cause problems in children who take repeated or long term courses of these medications for ear infections.  My concern about today's management of middle ear problems is shared by other professionals, and in a guest editorial in the Annals of Allergy, Raoul Wientzen, M.D., a Georgetown University Infectious Disease specialist, said:

"Seventy percent of children by three years of age will have suffered from a single bout of OME (Otitis media with effusion) and 33% of children will have experienced repetitive bouts of OME.  Fully half of acute care visits to pediatricians in this country in some way involve the diagnosis, treatments and follow up management of OME."

In this continuing discussion, Wientzen said that much had been learned about he causes, the diagnosis and the treatment of these problems, but he also said, "Much has not!"

Wientzen also said that more than one million tympanostomy (ear) tubes are placed in children's ears each year in the U.S.; yet, by contrast, European physicians have not felt that this procedure significantly improves the prognosis of middle ear fluid over the long run.

More About Ear Problems in Infancy and Later Hyperactivity

In a May 1987 report published in Clinical Pediatrics, Randi J. Hagerman, M.D., and Alice R. Falkenstein, M.A., M.S.W., from the child Development Unit, The Children's Hospital and Department of Pediatrics, University of Colorado heath Sciences Center, Denver, Colorado, and Yeshiva University, Psychology Department, New York, New York, published the results of their study which showed the infants who had repeated bouts of ear problems were prone to develop later hyperactivity.  Here's their abstract of the article.

"An association between the frequency of otitis media in early childhood, and later hyperactivity, is reported in this study.  The subjects were 67 children referred to a child development clinic for evaluation of school failure.  Ranging from 6 to 13 years old, all the children demonstrated specific learning problems, and 27 were considered hyperactive by two or more raters.

Sixteen of the hyperactive children were treated with central nervous system stimulant medication.   In retrospect, there was positive correlation between an increasing number of otitis media infections in early childhood and the presence and severity of hyperactive behavior.

Ninety-four percent of children medicated for hyperactivity had three or more otitis infections, and 69% had greater than 10 ear infections.  In comparison, 50% of nonhyperactive school failure patients had three or more infections and 20% had greater than 10 infections.   Twenty-two of 28 children (79%), known to have more than 10 infections, experienced recurrent otitis before one year of age."

In the discussion section of the article, these authors pointed out that not all hyperactive children   have a history of early otitis and not all patients with recurrent otitis become hyperactive.  They speculated on possible reasons for this association, and they said:

"Further investigation is necessary to evaluate etiologic aspects of this association."

In my opinion, repeated antibiotics given for ear infections set up a vicious cycle which includes recurrent infections and nervous symptoms of various types.

Concluding Comments

Candida isn't "the" cause of ear disorders in infants and children.  Yet, the response of Wesley and other of my pediatric patients, along with reports from Drs. Truss, Shambaugh and other physicians, suggest that a low-sugar diet and oral powered Nystatin could relieve much suffering and lessen the cost of managing ear problems in young children.

Other measure which may help include: the avoidance of tobacco smoke (and other indoor chemical pollutants); the use of elimination/challenge diets to identify sensitivities to milk and other foods; nutritional supplements, including soluble Vitamin C powder; 100 to 250 mg. three to four times daily (If loose stools or other digestive symptoms develop, the amount of Vitamin C can be reduced); Kyolic odor-free liquid garlic extract, five to ten drops, three times daily; zinc sulfate liquid, 5 mg. once daily.

The Yeast Connection to Autism

In The Yeast Connection, I told the story of Rusty, a 5-year-old child who had been troubled with recurrent ear infections and hyperactivity during the first two years of life.  Yet, his developmental milestones were normal until the age of 2 1/2 at which time specialists at a university center made a diagnosis of "pervasive developmental disorder with symptoms of autism".

On a comprehensive treatment program which included Nystatin, a special diet and the avoidance of chemical pollutants, the child improved significantly - even dramatically - although he continued to experience developmental problems.

I also told the story of Duffy Mayo, a California child with autistic-type behavior who improved on anticandida therapy.  Duffy's story was described in the Los Angeles Times, and subsequently he was featured on Charles Kuralt's TV program "American Parade".

Other Reports of Yeast-Connected Autism

On a number of occasions beginning in the early-80s, Bernard Rimland, Ph.D., head of the Autism Research Institute, Sand Diego, California, told me of reports he had received of other autistic children who had improved following anticandida therapy.

During the late 1980s, I saw several more children in my practice with autistic-like symptoms who improved on a sugar-free, special diet and Nystatin.  And during the early 90s, I received dozens of phone calls and letters from parents of autistic children.

Almost without exception, autistic symptoms in these children first appeared during the second year of life following repeated ear and other infections.  I heard many similar reports at national conferences on autism (Indianapolis, 1991; Albuquerque, 1992, Stamford Connecticut, 1993; and St. Louis, 1994).

I realize that autism, like many other chronic and often devastating disorders, may develop from many different causes.  Yet, I feel that autism which first appears during the second year of life, is many children, yeast connected.  Here's a report I received from Elizabeth Smith (not her name) on November 16, 1993, which is typical of the stories I've heard from any parents.

"My 6 1/2-year-old daughter, Melissa, was a normal healthy child during her first year of life.   She was bright, alert and she passed all of her developmental milestones with flying colors.  Yet, she was troubled by a series of ear infections.  All were treated with amoxicillin and other broad-spectrum antibiotic drugs.  Her autistic symptoms began to appear at the age of 16 months.

I recently heard and red that a number of parents of children with late-onset autism improved following the use of a sugar-free special diet and the antiyeast medications Nystatin or Diflucan.  I'd like further information."

In responding to Elizabeth, I told her that based on the reports I'd received from many sources, late-onset autism was often yeast related.  In our continuing discussion, I asked:

"Is your physician kind and caring - even though skeptical of the yeast connection?  If your answer is "yes", I'll send you a packet of information which you can share with the physician.  Then ask him/her if s/he will work with you and Melissa."

On December 23, 1993, I received a letter from Elizabeth.  Here are excerpts:

"Dear Dr. Crook, I want to thank you for all your help.  It's mad a big difference in our lives.  Melissa is doing fine.  We upped the Diflucan to 50mg. a day and give her acidophilus three times a day as you suggested.

When we first started the Diflucan, she told us through facilitated communication that her mind started clearing up.  For about three days, she talked about it getting clearer.  At that time, she said it was very clear.

A week later she had an ear infection and was put on an antibiotic, Augmentin.  Her mind immediately started "fogging up" Melissa was very upset, but improved when we upped the dos of Diflucan.  Here are some of the changes we've seen since we started the Diflucan:

She now sleeps through most nights and she's calmer.  Her dad and I are really enjoying that.   Comments from teachers have also noted these changes.

She's told us "things don't move around when I try to look at them."  Her coloring has improved and her desire to color has increased.  And she loves to color.  As a matter of act, for the first time, my walls, countertops and anything close has been colored on.  Yet, it's hard to complain because it's so great to have her coloring.

She has also increased her eye contact.  She tells me that since my face isn't moving around, it isn't as scary.  So she says "I like to look at your fact now."

In her long letter, Elizabeth included comments about Melissa's reactions to various foods:

"Sensitivity to common dietary ingredients bother her; especially sugar, orange juice, popcorn and carbonated drinks.  Also, peanuts and fresh yeast bread.  These foods make her feel bad, even agitated.

She now seems to be able to experience pain - she didn't in the past.  Her eardrums would burst and she never complained of pain, now she knows if her ears hurt."

More Support For the Yeast Connection to Autism

During the 1960s, Bernard Rimland, Ph.D., published a book on autism.  The purpose of the book was to show that this devastating disorder is not caused by the failure of the parents to provide the infant and young child with loving care.  Instead, he pointed out that autism develops because of biological disturbances which affect the child's nervous system.

In the 1970s, Rimland established the Autism Research Institute.  Through this institute he has provided information about the biological causes of autism to professionals and nonprofessionals, including parents all over the world.  He also publishes a newsletter and collects and disseminates information packets and books.

In October 1994 issue of Autism Research Review International, he included a 2-page review, "Parent Ratings of the Effectiveness of Drugs and Nutrients." Here are excerpts from this report.

"The parents of autistic children represent a vastly important reservoir of information on the benefits and adverse effects ... of the large variety of drugs and other interventions that have been tried with their children ...  the data presented in this paper have been collected from the more than 8700 parents who have filled out questionnaires designed to collect such information.

The 31 drugs listed first were prescribed by the child's physician in each case.  Note that Ritalin, the drug most often prescribed is near the bottom of the list.  Only 26% of the parents reported improvement, while 46% said the child got worse on Ritalin."

I studied the graphic charts in the report and I was delighted to see that Nystatin ranked higher than any other prescription drug.  Of the 208 children who were given one of these medications, 49% found that the child was "better" on the medication and only 4% said the child was "worse".  the better/worse ratio was over 12 to 1.

By contrast, none of the other drugs showed a better/worse ratio of more than 2.7 to 1 and many prescription mediations, including Ritalin, which was given to 1,661 children, showed a better/worse ratio of 1.5 to 1.  (this means that twice as many children were made worse by Ritalin as those who were helped)

The ratio of Cylert, which was given to 294 children and Dexedrine, which was given to 629 children, was also less than 0.5 to 1.

My Comment

This study does not "prove" that the manifestations in all autistic children are yeast-related and/or that antifungal mediations provide a "quick fix".  yet, based on the reports I've received, as well as the research data gathered by Dr. Rimland, I feel that all autistic children should be given prescription antifungal medication and a sugar-free diet as an integral part of their management program - especially those children:

Rimland's data also showed that nutritional supplements, especially high doses of vitamin B6 and magnesium, provided significant help to many autistic children.

Why Autism May Be Yeast Connected

There appear to be several mechanisms.  One of these appears to be the direct effect of Candida toxins.   In a report describing his studies on Candida toxin in mice, Kazuo Iwata, a Japanese mycologist, commented:

"Canditoxins produced unique clinical symptoms.  Immediately after ... intravenous injection (of toxin) animals exhibited ruffled fur and unsettled behavior.  Toxicity was so acute and severe that the majority of treated animals succumbed  ... within 48 hours.   Within 10 minutes after being given a dose of toxin, the animals became unsettled and irritable; had congestion of the conjunctiva, ears and other parts of the body and finally developed paralysis of the extremities."

In a paper published in another journal describing his research studies on mice, Iwata commented:

"When injected into uninfected mice, Canditoxin exerted toxic manifestation in spleen lymphoid cells ... This indicates the possibility that ...  the toxin produced in the invaded tissues may act as an immunosppressant to impair host defense mechanisms involving cellular immunity."

A second way Candida may be related to autism is through the disturbance of the normal balance of microorganisms in the intestinal tract.  When this occurs, the protective membrane lining the intestines is weakened.  As a result, food allergens are absorbed which may cause adverse reactions in the nervous system.

 

This article is copied by permission from Dr. Crook's new best seller THE YEAST CONNECTION AND THE WOMAN.  Dr. Crook has written several books some of them being - The Yeast Connection, Tracking Down Hidden Food Allergy, Help For the Hyperactive Child, Chronic Fatigue Syndrome and the Yeast Connection, Solving the Puzzle of Your Hard to Raise Child, and Detecting Hidden Food Allergies.

Dr. Crook received his education and training at the University of Virginia, the Pennsylvania Hospital, Vanderbilt and John Hopkins.  He is a Fellow of American Academy of Pediatrics, the American College of Allergy and Immunology, the American Academy of Environmental Medicine and a number of the American Medial Association, and the American Academy of Allergy.

Dr. Crook has been referred to as a "preventive medicine crusader" who says "The road to better health will not be found through more drugs, doctors and hospitals.  Instead, it will be discovered through better nutrition and changes in lifestyle."

Dr. Crook can be reached at the International Health Foundation, PO Box 3494, Jackson TN 38303.  or at his site