Candida infections have been around forever. Females are definitely more aware of them than men, but recently there has been less awareness of chronic candida overgrowth due to the popularity of other recent discoveries such as lyme disease and Epstein-Barr.
Can you believe that the internet and media sources get caught up on a single topic? (I digress.)
One of the things I constantly remind patients and remind myself of is that often we have not adequately treated one of the basics of health such as yeast infections before we move on to less common and more esoteric conditions. So while years ago candida was a buzzword in the natural healing community, now it often goes overlooked. In fact, you could have lyme disease and EBV but have all of your symptoms coming from a fungal infection. Make sense?
Every day people come in asking for more labs and a new diagnosis, but really what they need is not a new diagnosis but a better or more consistent treatment plan.
Functional medicine patients today are in general over-diagnosed and under treated.
I’ll explain that more fully at the end of the article, but for now lets use candida as an example.
Lets say that you have common symptoms of yeast including brain fog, bloating, mild rashes, loss of muscle stamina, vaginal infection, sugar cravings, sinusitis, sulfurous body odor, eczema and loose stools or diarrhea. 8 out of 10 times in Arizona I see this protocol:
- probiotic (whatever “most powerful” and “highest CFU” the doctor chose this week)
- fish oil (did you know that effective doses of fish oil start above 3 grams per day? Think 1 bottle a week)
- vitamin d (because everyone thinks it cures all disease)
- diet (whatever dogmatic restrictive diet their doctor personally follows)
Let me just say that for chronic candida or any other condition, the above protocol is not a treatment plan. This is a shotgun of generally good things to take.
I had to get that rant/information out before we could speak specifically about chronic candida infections because if you have tried that protocol or any probiotic based protocol, you are missing the boat. You can read about my stance on probiotics here.
Non-specific Symptoms of Chronic Candida
There are many non-specific symptoms of chronic candida such as fatigue and malaise and even brain fog, but there are a few of these non-specific symptoms that seem to be more specific to chronic candida than others. In other words, if you have these symptoms, it is more likely, maybe even most likely that you suffer from chronic candida.
Bloat – Anytime a patient bloats I am considering candida. You know how you wake up with a flat tummy and then by bed time you look 6 months pregnant? Yeah, that kind of bloat.
Brain Fog – Brain fog is very often present in a chronic candida case. Not specific adhd or neurological symptoms but rather a forgetfulness or inability to think of things you know you should remember. These can be caused from other things too, but candida is big here.
Body Odor – Either an ammonia type smell, smelly urine or just “B.O.” are signs of candida infection. Candida releases a lot of toxins that lead to some unique smells that you may not like. If you are spritzing and spraying your body to keep it smelling acceptable in public, it might be candida.
Fingernails & Toe Nails – If you know you have toe fungus, then you need to treat both topically and internally. If your fingernails are brittle, yellow or discolored or have difficulty growing, you may have a candida infection.
Sweaty Skin – If you have rashes where your skin sweats such as armpits, knee pits, under your breast line, etc. then you may have candida. If the skin condition flares or gets worse with moisture or heat, then you may have candida.
Fun fact: The reason why everyone uses biotin for hair, skin and nails is because chronic candida infection depletes biotin in the body. Thus, most people don’t benefit as much from biotin once their candida infection is gone.
Lab Testing For Chronic Candida
The best test for yeast and candida is an OAT test. (We can order these for you across the country.) Basically the OAT test is testing for byproducts that are commonly elevated in chronic candida. As a side note, stool tests rarely catch candida infections and systemic candidiasis where it is in your blood stream in high quantities is relatively rare. That being said, if you have all the symptoms of candida or you have visible toenail fungus, then a lab test isn’t always necessary.
In my office I combine a patient history with the ASK method (Anderson Specific Kinesiology) to assess and then run labs when necessary or if I am treating a patient remotely.
Its Not Just Candida
Many years ago science only knew of candida albicans as the most common fungal infection of the body. While systemic candidiasis was rare, it was the only thing we knew of. Remember that if you read my SIFO article, there still aren’t many good labs for small intestine fungal overgrowth.
That being said, today we know much more about candida and its various forms. So while the common term was candida infection, now chronic candida can really be considered chronic fungal infection as they all act in similar fashions. Different species of fungus create different presentations, but overall the treatment is going to be similar. Jock itch is different from vaginal candidiasis but the category of treatment is still going to be fungus.
This purpose of this whole section is to simply point out that a candida blood or stool test isn’t going to be enough to definitively tell you if you have some form of chronic candida infection.
If there ever was a contributor to fungal infection in the body that all of my patients deny, its this. Most if not all of my patients are 100% sure they don’t have mold in their house. After all, we live in Arizona…right? Wrong.
Mold exposure is going to be one of the top reasons why you may have recurrent fungal problems in your body. Either your body is fighting of the mold you are breathing or you may have some of the house mold deep seated in your body. Mold exposure can be at home or at your place of work. Some sensitive individuals will even react to it in the gym. (All gyms have some mold. Seriously.)
Mold experts generally agree that completely detoxifying from mold can take anywhere from 3 months to 3 years. So avoiding mold exposure in the first place is going to be critical.
More Fungal Infection
There are a few other signs of fungal infection in your body to pay attention to. Chronic sinusitis is often fungal not bacterial.
Chronic history of interstitial cystitis is a sign of fungal infection. Frequent UTI infections with burning can be candida. Skin issues on the hands that form pustules or peeling are often fungal. Unexplained vertigo or balance issues are often fungal. Thick phlegm at the back of your throat can be candida. There are still more signs, but they usually present themselves as a high level of toxic release.
Chronic Candida and Attachment Issues
Its not you that has the attachment issues its your candida 😊 So when we discuss candida it is important to understand that fungal organisms have specific way in which they attach themselves to your body. So when you have a serious candida infection its not just sitting there waiting to be destroyed, but rather it is embedded in your tissues and is resistant to elimination.
While the research isn’t robust there has been some research on the use of biotin to treat candida. It is believed that it helps the candida to “detach” or stop transformation into more aggressive forms. One of the more convincing arguments that supports the idea of taking biotin for candida infections is that about 1 in 100 people have a genetic biotinidase deficiency. That means that you may not be able to recycle biotin at the same rate as other people. If you are one of these people, then taking biotin will greatly enhance the anti-fungal protocol results. For biotin I recommend 10-20mg per day in combination with anti-fungal herbs.
One of the reason the anti-fungal herbs are so important is because candida actually uses biotin to help grow. So if you are someone that takes biotin regularly and you aren’t using immune support or antimicrobials regularly, you can actually induce candida overgrowth. Glowing skin, hair and nails…but at what cost? Remember though, its not about eliminated all fungal organisms, its about balance. What we find is that the most problematic fungal infections are like the weeds in your yard. They grow faster than the grass and can thrive in more diverse situations than the soft well-maintained grass we all want.
Fungal Infections and Suppressed Immune Function
While I won’t get into too many of the immune system details here, we need to accept the fact that most candida species are commensal. This means that you NEED them. Its 2020, so by now we all know the benefits of a healthy gut and a balanced microbiome, which is what makes it hard to do. We need perfect balance inside our bodies of good bacteria, fungus, parasites and viruses in order to feel well.
The only system that can help us do this is our immune system. No magical pill or probiotic is going to fix a candida imbalance. You will have to rely on your immune system to do this for you.
Things that stop suppress your immune system include but are not limited to stress, blood sugar imbalances, hormone imbalance, birth control pills, hormone replacement therapy, steroids like prednisone, other infections, food sensitivities, heavy metal toxicity and chronic fatigue due to overexertion.
You will notice that I mention hormones multiple times. The reason is because we see chronic candida infection is affected by female hormones. Therefore, women suffer from yeast infections more than men. This study (3) from 2014 suggests that women using estrogen replacement therapy are predisposed to “severe and persistent” vaginal candidiasis. (Yes, this applies to bioidentical hormone replacement therapy also.)
Back to the immune system, we need a balance in the immune system to make sure that we can both fight off candida overgrowth as well as allow the good fungal organisms to exist in their natural environment.
Candida Anti-Fungal Diet Myth
I will save the large part of this discussion for another time, but the key to understand here is that based upon my clinical experience of well over 1000 cases of candida fungal infections, I would suggest that you can’t simply diet candida away. What happens is that you go on the latest “candida diet” and you feel a lot better. But somehow every time you eat carbohydrates again, then it comes back. This is because in most scenarios the candida overgrowth was simply decreased. Its my opinion that if you don’t combine diet with a supplement protocol for candida that you will be forever on a highly restrictive diet.
As an example think about how everyone is doing a carnivore diet and most feel better. They are avoiding the problem that their digestion doesn’t work properly by not eating most foods. More optimal would be to eat more foods and still feel great.
Candida Support Protocol
While there is no one-size fits all protocol for candida, there are definitely some staples in my office that we use. If you actually come to our office you will find a highly individualized plant to treat candida, but if you are looking for my tried and true go-to resources, here is what I like to use.
Two Candida Anti-Fungal Herbs
Chinese Coptis – (link) 3 to 6 capsules per day depending on severity
Morinda Citrifolia – (link) 9 to 12 capsules per day depending on severity
Hormone & Chemical Detox Support
Artichoke Extract – (link) 3 Capsules per day (my favorite liver support)
Andrographis Immune – (link) 3 Capsules per day for slow and steady immune support
Thorne Biotin – (link) 2 to 3 capsules per day to enhance metabolism and enzymes (especially if you have brittle nails or hair loss)
If you are dealing with recurrent candida infections it is important to stay on a protocol for 6 to 9 weeks in order to not only eradicate the most accessible yeast organisms, but also so that the natural herbs for candida can work their beneficial properties deep within the cells as well as allowing the immune system time to rebuild and prevent future yeast infections.
Most Common Pitfalls In Treating Chronic Candida Infections
- The first is using the wrong supplements. I joke with my patients that if their last practitioner had just used the right supplements they wouldn’t have had to be in my office :) The truth is that knowing what herbs kill candida effectively is critical. In this aspect it takes a doctor that has “practiced” on patients rather than someone that researched what the newest fungal supplements are.
- The wrong dosage. There are times when the standard dosages simply don’t work. Higher dosages in certain cases can be very important to resolution. This can vary based upon your doctors experience. Working with someone to use a good strong dose that is SAFE is important here. The second problem in dosing is that everyone wants to buy a supplement with 10 ingredients that kill candida. What almost always happens here is that there isn’t enough of the active herb in order to treat the fungal overgrowth. That is why you will see in my protocols I prefer to use singular herbs in combination rather than a product with a variety of herbs in a low dose.
- The wrong timing. If you have chronic candida or anything that has been around for more than 6 months, then don’t expect things to heal and stay away within a single round or office visit with your doctor. A weekend candida cleanse and few days of supplements isn’t going to cut it for a deep seated candida infection.
- You are using probiotics. Using probiotics while trying to fight candida can prevent you from getting results. Whenever I am dealing with infection, there is a standard “no probiotic” policy in my office.
- The wrong diet. If you want to treat candida quickly, you need to stop eating as much sugar for a period of time. If you are reading this article and you are new to eating vegetables and healthy meats, then its time you got on that to start healing. A vegetarian only diet must be extremely vegetable oriented in order to keep the body from developing constant fungal overgrowth.
If you are looking to treat a chronic candida infection for the first time, then you may feel in over your head. Finding a functional medicine doctor that is holistic in your area that knows what to look for and more importantly knows what herbs and remedies they should use to treat a chronic candida infection is a good first step.