The Yeast Beast!

Hello darlings! My friends often call me up to ask about yeast infections, and they often have crazy ideas about them. I’m going to try to settle some of the punk myths and point y’all toward some true facts about your friend and mine, Candida.

To start off, there are four main bodily locations of yeast infections: mouth, the “vagina”, feet, blood. These are respectively called: oral thrush, ‘innie’ genital (sometimes called “vaginal”) yeast infections, athlete’s foot, and systemic yeast. There are also yeast infections of the skin in general, but that’s a different topic I’m not covering here. A lot of punks erroneously confuse one yeast infection for another!

These are all overgrowths of yeasts in the Candida family. It is normal and healthy to have some Candida yeasts growing in and on the body all the time. Remember when giant jellyfish were attacking Japan and Florida? (http://www.nature.com/news/marine-ecology-attack-of-the-blobs-1.9929) Yeast infections are a little bit like that. It’s normal for the ocean to have some jellyfish in it, but when some ecologic disturbance happens, or sometime just because, jellyfish bloom out of control and other fish are crowded out. That’s sort of what happens with yeast.

[EDIT: This may actually be the normal cycle of jellyfish and not aberrant. I still like the metaphor.]

It’s healthy and normal and all that jazz to have some yeast in and on the body all the time. It normally lives peaceably with its neighbors in small quantities. Every now and then, something upsets the balance and yeast blooms out of control and crowds everything else out. That’s when you have a problem.

Myth 1: Genital yeast can be cured by diet changes.

Genital yeast lives in the interior portion of AFAB1 genitals or of surgically constructed vaginas. The interior portions of the genitals, where yeast is most commonly a problem, are not connected to the intestines2. There is a wall of tissue and muscle between the intestines and the inside genitals. It’s part of what makes anal sex different from genital sex. It’s what keeps poop from coming out of the genitals. Yeast cannot walk through this wall. Yeast eats sugars, so many people claim that not eating sugar will cure a genital yeast infection. When you eat sugar, it goes through the mouth, to the stomach, through the intestines, and out as poop. In this journey, it does not normally pass through the genitals. Therefore, putting sugar in your mouth is not the same as putting sugar in the genitals. Unless you have severe untreated diabetes, the body’s blood sugar is well-regulated. Try this simple experiment if you do not believe me: eat a bunch of sugar, rinse your mouth with water, wait a while, lick your skin. Lick in several places. Does it taste like sugar? Spoiler alert; it won’t. So, it might be generally healthy to avoid sugar, but avoiding it will not “starve out” a yeast infection. That said, if you have a yeast infection, you may want to avoid putting sugar directly on or in your genitals (whipped cream, jelly, etc) until the infection is gone. If you have yeast in your mouth (called “thrush”), it makes sense to avoid putting sugar in your mouth.

Note, it is possible to have a yeast infection in both the intestines and the genitals at the same time, just like you can have say, a cold and also have pink eye, but it doesn’t mean they are the same thing or necessarily cause one another.

EDIT: I have gotten a lot of questions asking if the rise in blood sugar after eating gives sugar to the yeast. I have finally found a good answer! Here is the pathway: When a non-diabetic person eats, their blood sugar does rise. However, it will not rise above 180, even if they mainline glucose. This is because the body produces a hormone called ‘insulin’ in response to a rise in blood sugar. This insulin is like a ‘key’ that lets the sugar into the ‘locked’ cells of the body. Once the sugars are inside the body’s cells they are no longer accessible to yeasts. It is true that a small amount sugars may remain for a time in the fluid between cells, but it is not enough sugar to make a difference to the yeast. So, yes, there is a tiny amount of sugar that might theoretically become accessible to yeast after you eat, but even if it did, it is not enough to really feed the yeast, and definitely not enough to make a difference one way or another to the infection.

Take-Home message: Do Not attempt to cure a (non-oral) yeast infection through diet changes. It will not work and may cause other problems.

 

 Myth 2: Genital yeast infections are caused by eating bread, drinking beer, or otherwise ingesting yeasts.

The type of yeast that causes most yeast infections is Candida albicans. The less common infection-causing yeasts are other members of the family Candida. The yeasts used in beer and bread making are usually in the Saccharomycetaceae family. They are not the same. If you are MOSTLY eating bread and drinking alcohol, such as drunk punks who live on dumpstered bagels do, you may end up with yeast simply because this diet completely trashes the immune system along with the rest of the body. You may also end up with scurvy, which is way less romantic to experience than it might sound. The yeast that makes the infection is part of the normal flora of the body.

 

Myth 3: My genitals itch, I probably have systemic yeast (yeast in my blood).

Yeast infections can end up in the bloodstream of people with severely compromised immune systems, such as people with HIV/AIDS or people on chemotherapy. This is a serious, life-threatening condition called candidemia. If you have a severely compromised immune system, you hopefully do not need me to tell you it’s absolutely imperative that you do not seek out health opinions from blogs. Do what you know you should and see a professional health care provider. If you do not have the kind of severely compromised immune system that occurs with chemotherapy, HIV/AIDS, etc, and you aren’t in an intensive care unit in a hospital, you pretty much don’t have this issue. Keep in mind that my opinions are absolutely not medical advice, and I’m no authority on these things, and neither are most other punks! If you think you have this kind of condition, absolutely see a doctor or a physician’s assistant right now! Otherwise, calm down and try not to look up medical symptoms on the internet and then assume the worst.

 

Myth 4: Tea-tree oil is a gentle way to treat a genital yeast infection.

Tea tree oil applied to genital mucosa, especially when the tissue is irritated by yeast, hurts like the dickens. It burns and hurts and stings and it’s oil, so it’s hard to get it out of there once it goes in. If you’re into that kind of thing, more power to you. There are other treatments, both alternative and conventional that don’t hurt like crap. I’m not sure what you think “gentle” means, but to me, burning pain and gentle aren’t the same thing. I’d suggest other treatments instead. Tea tree oil is fine for yeast on the feet, also called “athlete’s foot”, where it might sting some, but the skin’s less sensitive and it’s easier to wash off if you can’t stand it.

 

Myth 5: Probiotics such as those in yogurt can cure a yeast infection.

Probiotics do a great job at preventing yeast infections, but they do not do much to cure them on their own. If you are on antibiotics, or otherwise feel the need to actively prevent an infection, by all means, use probiotics. If you already have an infection, you’re going to need to treat the infection you have before you can start preventing the next one. Keep in mind that the probiotics that live in AFAB and other innie genitals are NOT the same ones that live in the intestine, nor the ones in yogurt. Also, please see the above discussion of how the genitals are not connected to the intestine. The idea of eating yogurt is that somehow the bacteria will survive the entire intestinal tract and then “walk” from the anus to the genital opening, this is really unlikely and also you should generally be avoiding bacterial transfer in that direction. i.e., you should wipe front to back. Some recent evidence suggests the probiotics in yogurt aren’t the ones that are present in healthy innie genitals anyway. The best way to get probiotics into the genitals is to get suppositories made especially for that area.

 

Myth 6: I’ve been treating a yeast infection for months, they just take a long time to go away.

Yeast infections generally clear up in a matter of days. That is to say, less than one week. If you have been treating a yeast infection for longer than a week, you either: have a different kind of infection (such as a bacterial infection), or your treatment isn’t working and you need to try something else. I’d say, if you’ve been trying an herbal remedy, it’s time to try a conventional one. If you’ve been trying a conventional one, it’s time to see a professional for an accurate diagnosis. Don’t suffer for weeks or months! There is no need to do that. Anyone who tells you otherwise is in my opinion misguided and isn’t looking out for your interests. There is plenty of suffering in life already, and suffering from yeast is not some kind of punishment for sinfulness or whatever. For real, I think a lot of punks have a quasi-religious mindset that they deserve what’s coming to them. Point is, if your treatment isn’t working in a matter of days, it isn’t going to up and start working later.

 

Myth 7: My genitals are itchy. It’s yeast.

Maybe, but it could also be bacterial vaginosis or an STD. The symptoms are incredibly similar. The best way to tell is to swab the area, but the swab on a microscope slide, treat THE SLIDE (not the body!!!) with a strong base to lyse (pop) the human cells, and look at the slide under the microscope. If you have equipment and training to do that, neat! Why are you readin’ this? If you don’t (or if you do, honestly), the very best way to get diagnosed is to see a health professional that can actually look at the beasts and identify them. Want to know what’s rustling around your tent? Is it a possum or a raccoon? You can lie awake and guess all night, or you can get a flashlight and look at the darn thing. If you want to treat it as yeast first, be my guest, but if it doesn’t work, see a professional, you may need antibiotics or some such.

 

Myth 8: Yeast infections are not STIs (sexually transmitted infections).

While yeast infections are not ‘truly’ STIs, they can be transmitted by sexual contact. Be sure to wash any toys, clothing items, or other stuff that comes in contact with your yeast infected area before sharing the items and also before using it again on yourself! You can theoretically re-infect yourself later. People do not commonly get yeast infections on their hands, but you may want to avoid having genital to genital contact while you have a yeast infection. (You should definitely avoid genital-genital contact until you get a professional diagnosis, because what if it turns out you have the clap and you told your sex partner/s that it was yeast?) You should also avoid mouth-to-genital contact, cases of thrush can be spread to genitals, and genital yeast can be spread to the mouth as thrush. Healthy adults do not commonly get thrush, so it’s fairly low risk but still possible to transmit yeast from genitals to mouths. If you have had sexual contact, you may all want to be treated for yeast infections before you have sex (with whatever parts have the yeast) again. If you have regular sex with someone, and you can’t figure out where you keep getting yeast infections from and you’ve been tested for diabetes and other stuff, you might want to consider the possibility that they have yeast and are giving it to you over and over! Also, some people just get yeast infections more commonly than others because everyone’s different! Sorry!

 

I hope that cleared some things up. If you have any questions or if you’ve heard any punk myths about yeast I haven’t included here, I’d love to hear about it!

1AFAB means “assigned female at birth”. I will be using the terms “AFAB genital yeast”, “innie genitals”, or “genital yeast” to refer to what some might call “vaginal yeast” because many people with this anatomic structure do not call it a vagina. Some people do call it a vagina, and that’s great too. Please keep in mind that there are yeasts of the outie-style genitals, but I will not be discussing those yeasts in this post!

2Sometimes they are. This is called a “vaginal fistula”, and believe me, you’d know it if you had one. If you do, you already know you should clearly consult a professional about your situation.

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On Showering

My friend Moxie Marlinspike relates in a zine a tale of going to see a doctor about a persistent skin rash. He explains to the physician that that the rash is somewhat itchy, but mostly it just won’t go away. What is it? What should he do? The doctor inspects, opens an alcohol wipe, scrubs. The ‘rash’ comes right off. “Dirt.”, she says.

These days, it seems not-bathing is the province of punks, homebums, the mentally impaired, and other peoples I generally hold in high esteem. People tell us we should bathe, we resist. Deodorant, soaps, perfumes, aren’t these products of a capitalist society? Aren’t we being sold a sad removal of our wild nature? Isn’t soap the first step into soul-crushing civilization?

Sort of, and also not at all. And, as is often the case, things get more interesting the more you look into them. Also, the more you look, the more our knee-jerk reaction lines up with the sorts of religious feeling that are just out of memory.

Let’s start with a glimpse into European history. In the book Q by Luther Blisset, our hero, a European radical, survives the Reformation fighting for his ideals, freedom, etc, and finally escapes to…. the pleasure of a hot bath. Indeed, bathing fell out of fashion in Europe sometime after the Roman empire and stayed out of fashion there (and in colonized america) until the mid 19th century. Logistical difficulties, the sinfulness of baths, and beliefs about the unhealthfulness of them kept them out of fashion for some time. Due to the high specific heat capacity of water, (which makes no small contribution to the possibility of life existing at all) the effort that goes into bathing in even mildly warm water without plumbing or electricity is immense, thus everyone but the super-wealthy just didn’t or couldn’t bother. With a few eccentric exceptions, even rich people avoided bathing, as it was considered unhealthful due to the disturbance of natural oils and not unreasonable fear of water-borne illness. Christians considered bathing downright because it was too sensuous. After all, ancient Roman baths were apparently full of the naked, oiled bodies of athletes, to speak nothing of erotic statuary.

Advances in electricity and plumbing allowed bathing to take place in private where sin (ahem, carnal pleasures) could be avoided and folks didn’t have to bathe in the same cold, dirty bathwater everyone else in the large family had just used. These advances gave rise to a new popularity in bathing. Eventually the whole cleanliness is next to godliness thing got applied to the body and smelling like a product became part and parcel of civility.  Touching the naked body while immersed in warm water nevertheless remained somewhat suspect. Reflect on cold showers vs. a bathtub-full-of-roses. So, bathing can be sinfully sensuous or purifying, it can be a communal act or a private one, it can be a public menace or a civic duty but this is a health column, so; is it healthy?

The shortest answer: wash below the wrists (your hands) and do it right.

(Weirdly, in our supposedly hygiene obsessed culture, precious few people wash their hands correctly. Doing it right means washing above the wrist, under the nails, and scrubbing for at least a full round of “row row row your boat”. It is informative to watch people in public bathrooms do a quick, bacteriologically ineffective, rinse of the fingertips. Whatever skin is going in the mouth directly or bringing food to the mouth, or touching other mucous membranes, ought to be cleaned quite regularly. Keep in mind washing the hands in clean, plain water with no soap is actually better at removing germs than using something like hand sanitizer.)

The short answer: It depends. Generally speaking, washing your body whether in part or as a whole is a good plan whenever there is stuff on your body that you don’t want there.

The long answer: Wash your hands for sure, and showering isn’t a bad idea either, just use a mild soap. Soot, smog, train grease, germs, dead skin, fungi, and all manner of things settle on the skin throughout the day. City and town life is a sooty business, arguably less so than during the early days of industrialization, when soot was so rampant that it blacked out the skies over london and caused a huge increase in rickets because the sun couldn’t reach children’s skin, the children didn’t make vitamin D, and calcium wasn’t deposited in the bones in sufficient quantity. Country life is dirty business too, animal poop, dust, and dirt are everywhere. Whether in town or country, numerous itch-causing fungi would love to live on your skin, and not washing gives them the green-light. They won’t hurt you per se, but they’ll itch a lot and you can pass them on to others, which is not at all cool. This is where not-showering can harm your health: if you are itchy from a fungus or dead skin buildup, you’ll scratch at your skin, especially in your sleep. The scratching leads to small cuts. Bacteria get in the cuts and you can end up with all manner of stuff, from small pimples to full blown MRSA. So, not showering doesn’t hurt you per se, but it can lead to some pretty gnarly skin infections not-so-indirectly. Also, the skin is always growing, not unlike rat teeth. The skin can use some help shedding itself from time to time, the same way a rat has to chew on stuff or its teeth grow through its chin. Showering does a good job of keeping things balanced for people in this regard. For a happy medium, give yourself a good rub-down without soap in the shower, or in a body of water. This removes most of the dirt and leaves your skin-oils intact, since oil and water don’t mix. For those readers who use shampoo and soap all the time, consider using it only every other shower, to keep from over-drying the skin. Try out some really old-fashioned sensuous, potentially sinful communal bathing! While you’re soaking, consider the historic relevance of the recently popular Moroccan-themed bathroom decor. Whatever you do, cut down on time spent having the runs, colds, the flu, and the like by learning about and practicing proper hand washing!

Happy bathing!

Hello!

Hello everyone! Here it is at last, Musts for Crusts! This blog is the modest brainchild of several years and many conversations. I hope the format will be alright, I have considered zines, newspaper columns, books, and everything else under the sun. After careful consideration, I’ve decided to throw caution and good taste to the wind and write the darn thing in the easiest, free-est way I know how, on the internet!

It turns out that health care is difficult to navigate, especially for people who are trans, or punks, or crust punks, and/or radicals. Often, (and perhaps this is even more the case for overworked clinicians in free clinics) medical workers seem to expect their patients to trust their advice on the basis of their authority. This method glaringly fails radical patients. This blog is an attempt to bridge that gap; I think of it as a form of medical translation.

Folks are always calling me for subculturally sensitive opinions about medicine, health, and hygiene and it’s high time I started researching in earnest and writing these opinions down. I hope to translate medicine, health, and hygiene to fit the lifestyles, needs, and desires of radicals. Please don’t hesitate to send in questions, concerns, or suggestions!

It is very important to keep in mind that ALL of the information I will be writing is strictly opinion and NOT necessarily medical fact. It should not be used to diagnose or treat any disease! I actually, seriously mean that. I have enough experience reading medical jargon and medical studies as a pre-medical student and the child of two medical professionals and enough experience traveling and generally being a radical and a punk that I feel able to take on the role of translator between these two worlds. I will post links to primary sources when possible so you can be informed. I am not a medical professional and may well get things wrong. Absolutely check with your medical provider before changing anything you’re doing. I’m not just saying that because I think I have to, I really, really, really believe it. I think medical professionals are great; I am trying to become one! I respect their experience and knowledge and think you should too, even though they can be difficult to get along with or understand. The internet is not a good place for medical information generally speaking, I know we all know this. I also know we seek to fill in gaps in our understanding as we are able to. So, be smart, be discerning, seek the advice of a professional BEFORE taking any of mine, and let me know what you think!

For consideration:

“I saved a man’s life once,” said Granny. “Special medicine, twice a day. Boiled water with a bit of berry juice in it. Told him I’d bought it from the dwarves. That’s the biggest part of doct’rin, really. Most people’ll get over most things if they put their minds to it, you just have to give them an interest.”
Terry Pratchett, Equal Rites

“Be skeptical, ask questions, demand proof. Demand evidence. Don’t take anything for granted. But here’s the thing: When you get proof, you need to accept the proof. And we’re not that good at doing that.”
Michael Specter