candida

It Takes Two To Tango: Testing Your Household for Candida Overgrowth and Common Bugs

You’ve done a full lab work-up with a functional medicine provider and found out you’ve got an overgrowth of some bugs. Maybe Helicobacter pylori (H. pylori), Candida albicans, and protozoan gut parasites like Giardia.   

You follow your doctor’s treatment program to get rid of these infections. The only problem? The infections stubbornly refuse to go away and your health problems continue.

So why, oh why, won’t your tests and health conditions clear up?

The problem could be someone else living in your household. Maybe it’s your lover. Maybe it’s your child. Maybe it’s another relative who shares utensils and dishes with you. 

The point is, they could be infected, too. And even if you follow your doctor’s recommendations to the letter, if the people living with you are infected but doing nothing about it, you could get re-infected over and over.

The key to getting rid of the unwanted organisms in your body and feeling better is to have everyone in your household tested. 

In this blog post I’ll share the story of one patient I’ll call Carla and her boyfriend, Neal.  I insisted Neal get tested to see if he had the same organisms that infected Carla. When he was tested, the results were interesting, to say the least.  

 

Carla’s Story: Resolving Pain and Other Problems

Carla’s symptoms began more than 10 years ago, although her health problems became extreme a year ago. She complained of excruciating neck and back pain that became worse a week before and during her period.  

She had extreme fatigue and a history of vaginal and urinary tract infections and now felt a frequent urge to urinate. She also struggled with diarrhea and bloating.  Autoimmune disease ran in her family, specifically her mother. 

To find out what was happening to Carla, I ordered tests. These showed she had a mild H. pylori infection. She had low levels of beneficial bacteria like Clostridia and Faecalibacterium prausnitzii. This indicated she had gut dysbiosis, a condition where the good bacteria in the intestines are outnumbered by the bad bacteria.  

She also had mildly elevated levels of the protozoan parasite Giardia intestinalis, as well as some yeast.  

 

The Big Breakthrough in Pain Relief

One of the big breakthroughs in Carla’s case came when we tested her amino acid levels. Her levels of the amino acid homocysteine were very low. Normally, doctors get concerned about high homocysteine levels, since homocysteine is a red flag pointing toward cardiovascular disease risk and inflammation. 

In Carla’s case, since she wasn’t making enough homocysteine that meant she didn’t have enough of the amino acid methionine, which is recycled from homocysteine.

Methionine is essential for a process known as methylation, which regulates many processes in the body. Methylation is involved in the way your body processes estrogen and histamine. It regulates brain chemicals known as neurotransmitters. And you need healthy methylation to detoxify those pesticides, herbicides, or pollution you’re exposed to while eating, drinking, or breathing.    

When your methionine levels are low, you don’t make enough of another important substance known as S-adenosylmethionine (SAMe).  

I gave Carla SAMe and guess what happened? Her pain almost completely resolved! The pain now only showed up right before her periods. She was in tears while she was on the phone with me, saying she had “got her life back.”

That was major progress. But we still had to get the pain to go away completely and to improve gut health, because there was likely an autoimmune component to her problems. That’s when I suggested that we order the same tests for her boyfriend. 

 

Fungi and Parasites and Bacteria, Oh My!

So why did I insist Neal get tested? It’s because not everybody who has an infection with a pathogenic microbe actually has symptoms. It’s a concept called, “asymptomatic carrier.” People can have H. pylori or Candida and because they have no symptoms, they would never know they had it- until they get tested. 

Whether or not a person has symptoms from a pathogenic bug is determined by a few factors. It has to do with how robust and resilient our immune systems are and how a bug interacts  with our genetics and our health history. Someone who has leaky gut or autoimmune issues from other causes is going to have a much higher tendency to be symptomatic.

Likewise, someone who has any microbiome destruction is less resilient. It’s like an equation. It depends on how resilient we are versus how pathogenic is the bad microbe.

If you’re sick and your sexual partner isn’t, that can still mean that they have  Candida or H. pylori. Candida can be a reservoir for H. pylori, which is why H. pylori is known to be sexually transmitted. H. pylori can live vaginally inside the Candida.

So, if you have oral sex (blush! blush!), guess what?  Your partner has Candida in their mouth and now they  give it to you after you’ve finally gotten rid of your vaginal yeast problem. Or you could give your partner H. pylori. Not the kind of gifts you want to give each other!

H.pylori infects at least 50% of people, but that doesn’t mean it’s normal. Although it can be asymptomatic, it causes so many problems in so many people that when possible, especially when treating kids, I make sure we do our best to get rid of the infection.

Carla’s boyfriend Neal didn’t have any specific H. pylori or Candida symptoms but he did have some health problems that served as red flags.

He had colon issues including diverticulitis. In this condition, pouches in the colon known as diverticula become inflamed and sometimes infected. This leads to abdominal pain, nausea, fever, and changes in bowel habits.  

He’d also had his gallbladder removed. The gallbladder produces bile, which kills bacteria and fungus.

So it wasn’t surprising that his tests revealed some problems.

 

Testing Carla’s Partner for Intestinal Pathogens

It turns out Neal and Carla had a lot in common. Neal’s test results were similar to Carla’s. He had Giardia. He also had a moderate amount of yeast. In addition, he had a protozoan parasite known as Endolimax nana

Like Carla, he also had H. pylori. And like Carla he had low levels of beneficial bacteria in his GI tract. At the same time, he had high levels of opportunistic bacteria that can lead to an imbalance between the good guys in the gut and the bad—in other words intestinal dysbiosis. We see this a lot in people who have had their gallbladder removed because they lose the protective effect of bile against infections.

 

Treating for H. Pylori and Parasites

Based on their test results, I treated Carla and Neal in much the same way. Their H. pylori wasn’t particularly pathogenic, meaning they had less harmful strains. Their symptoms also didn’t match what I might see in someone who has a bad H. pylori infection. 

So instead of treating it like an H. pylori overgrowth, I took a more proactive stance. I had them take PyloGuard probiotic to stop H. pylori from going out of control and causing more problems. When H. pylori is left unchecked it can cause gastrointestinal inflammation and symptoms like reflux, gastritis, ulcers, and more. 

PyloGuard is a specific probiotic called  Lactobacillus reuteri DSM 17648 known to inhibit H. pylori. It’s an easy-to-take H. pylori treatment—just open one capsule per day in water and sip it. This approach will help you reduce  H. pylori naturally.   

I also treated both of them for parasites, giardia, and yeast. 

 

Looking to the Future

We’re not done with treatment yet, but we’re seeing a lot of improvement. Carla says her energy is much better and her brain fog has decreased. She had more improvements in her pain after she started taking progesterone. She is a different person.

Prior to beginning the parasite program, Neal complained that his respiratory tract seemed congested. He noticed less congestion after beginning the program.

When Carla first arrived in my office, she was a mess and was at the end of her rope. Now, she’s feeling so much better, which gives her hope and motivates her to take further steps. When you feel even a little bit better you want to keep going. 

As treatment progresses with Carla and Neal, stay tuned for more updates on their progress. 

 

We’ll Help You and Your Loved Ones

If you’re feeling sick and not getting any better, it’s a good idea to have your household members and sexual partner tested and treated, too. You don’t want to keep getting re-infected.  Book a free 15-minute troubleshooting call with me to find out the best course of action. 

If after the call you come on board as a patient, I’ll order the right tests for you and your loved ones, check for common parasites, Candida, and H. pylori if warranted, and get rid of the root cause of your health problems. That way, we’ll restore your energy and make you feel like yourself again. Your loved ones will also reap the rewards of this approach.


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Everything You Need To Know About Candida Overgrowth (Part 3)

In Part 1 of this series, I covered what Candida is (and isn’t) and how it could be present in your body. In Part 2, I covered the symptoms and root causes. Today, we’re going to talk testing for and treatment of Candida. 

So, you’ve read Parts 1 and 2 of this series. You understand what Candida overgrowth is, and (I hope!) you even understand HOW it can cause so many systemic symptoms.

And if you’ve made it here to Part 3, you probably suspect that chronic Candida overgrowth is something you could be dealing with.

Today, I want to share how I work with patients in my clinic who present with Candida symptoms. I hope this is helpful to you - and please don’t forget that I’m here for you! My passion in life is supporting women through health challenges like Candida overgrowth so they can overcome them and get on with the stuff that really matters in life!

If you want to learn more, book a free 15 minute consult with my team by clicking here. 

Testing For Candida Overgrowth

“Don’t guess, test” is one of my mantras for life.

There are some instances where guessing is perfectly fine  - but when it comes to something as vital as your health, why mess around??

Testing is more accurate and affordable than ever before. It ensures we know exactly what we’re dealing with - and aren’t wasting time, money, and energy on the wrong treatments.

With a condition as diverse as Candida overgrowth, testing is especially important. The same symptoms could be caused by hormone imbalances, gut dysbiosis, HPA axis issue, SIBO and more… so bottom line: don’t guess, test!

In my clinic I use a few different tests (depending on the patient).

    1. Stool Tests - not all stool tests can pick up Candida, but advanced ones like the GI-Maps and Genova GI-Effects can. I like to order a comprehensive stool test on all my patients because it can reveal a ton about your overall health - not just candida!
    2. Organic Acids Panel - This test (I like the Organix test from Genova) looks for D-arabinitol, a specific marker for  invasive candidiasis. Some other organic acids panels look for arabinose as a marker instead, but I don’t like those, as they can easily give false positives based on what you’re eating. Organic acids tests are another of my favorite tests because of the breadth of information they can provide (and they’re totally non-invasive!)
    3. Blood testing - antibodies in your blood can show past or current level of candida overgrowth… but can’t tell you which. (I rarely use blood testing).
    4. Culture sample - you can take scrapings from the vaginal mucosa, vulva, oral cavity, etc and culture it to identify candida. (Again, I don’t usually use this testing myself). 

 

 

And this is important - be sure you test BEFORE you complete any treatment for candida. If you’ve recently treated candida, your test will probably come back negative - but that doesn’t mean you don’t have any remaining yeast - especially if it is invasive. 

Before You Go Any Further...

When you have Candida overgrowth, your white blood cells produce antibodies to fight the candida called IgE immunoglobulins, which also cause allergic reactions.

More IgE is made every time you have another yeast infection flare. When the IgE reacts against the Candida, it causes the release of histamine. Histamine makes your blood vessels dilate and can cause swelling, redness, itching, and burning (in super fun places like the vagina, sinus, and gut).

When you treat the candida, killing it causes the yeast to release antigens, causing an increase in IgE…  which means more histamine symptoms (itching, burning, redness). 

Basically - all of this was to say: you’re very likely to experience die-off symptoms when you treat candida! 

The bummer is that this WHOLE process weakens your immunity. The increased levels of histamine suppress your white blood cell mediated immunity and inhibit the production of T cells. 

This means that supporting your immune system during Candida treatment is absolutely necessary! You must protect and support immunity ON TOP of changing your diet, using antifungals, and doing leaky gut repair. 

Don’t forget your immune system in this process!

How I Treat Candida Overgrowth

Step #1: Clean Up Your Microbiome

Before you treat Candida, you need to clean up other gut infections. A stool test can identify which bacteria overgrowths or parasites you’re dealing with. If you don’t get a handle on this first, your Candida treatment won’t be effective!

Probiotics and prebiotics can also help. Lactobacilli bacteria can inhibit the growth of candida albicans (I like the Femecology formula by Vitanica). Both oral supplementation and vaginal use can help. 

 Step #2: Adapt Your Diet

Most people don’t need to go on a super-restrictive, very low-sugar diet - but most people do need to make SOME changes.

A yeast-free, carbohydrate restricted diet alone won’t cure candida overgrowth. In a study of those with chronic candida, diet and anti-fungals was shown to be the most effective treatment (compared to diet and antibiotics, or diet alone). In fact, antibiotics and diet combined had the WORST outcomes!

For my patients, I recommend:

  • 80 grams or less of carbohydrates daily (avoiding refined and processed carbs entirely)
  • Avoid dairy (except ghee, butter, and some cheeses)
  • Avoid yeast in foods (like kombucha, alcohol, and apple cider vinegar)
  • Avoid all refined sugar
  • Avoid alcohol

Step #3: Antifungals

To get rid of Candida overgrowth, you must use an antifungal that can kill the yeast overgrowth. 

In certain cases, I have seen clients gain greater success by combining natural antifungals with prescription antifungals like Nystatin or Difllucan, for limited periods through the extended herbal treatment period. Nystatin is not absorbed outside of the gut (it is local, not systemic), so it’s a good choice. Most systemic antifungals (like Diflucan) can cause elevations in liver enzymes. If you’re using a systemic antifungal, you need to have liver testing before starting and every 2 weeks of treatment.

But there’s also plenty of evidence that Candida is becoming resistant to antifungal drugs - just like bacteria are becoming resistant to antibiotics. Yikes!

That’s why, I always use a well rounded botanical protocol alongside prescription antifungals to help prevent resistance. 

The 2 keys to remember when using natural products like garlic, caprylic acid, undecylenic acid, lauric acid from coconut, lactoferrin, propolis, specific enzymes, and essential oils like oregano and cinnamon:

 

  • Treat long enough! 7-10 days of treatment is not enough. It might clear some symptoms - but you need at least 8 weeks of treatment (sometimes more) to truly clear Candida overgrowth.
  • Use the right dosage! If you take natural products in the wrong amounts, you won’t only not get better - but you risk damaging your microbiome. Don’t mistakenly believe they are safe at any dose because they are natural--I’m looking at you, oregano! I highly recommend working with a professional (like me) to get the right doses.

 

Step #4: Hyphae Interrupters

Remember the “roots” Candida can grow called hyphae? A good Candida protocol should also include something to help hyphae release from the gut wall.

In my practice, I like to use undecylenic acid. It’s a fatty acid obtained from castor bean, and it helps disembed hyphae from the intestinal wall. 

Treating Tough Cases

Truthfully, I think every case of Candida is a “tough case.” Most of my patients need the specialized support I can provide after working with Candida overgrowth for years to get better. 

For those with repeat vaginal Candida, monthly mid-cycle treatment can help (alongside systemic treatment). We use vaginal treatments for 3 days, and often for 3 more days prior to the start of your period, for 3-9 months to help stop the yeast cycle.

And for those with a history of Candida, we take preventative measures if they have to use antibiotics, corticosteroids, PPIs, or are following an elemental diet (as a treatment for SIBO). Preventative antifungals can help keep Candida at bay!

Need Help With Candida?

We’ve covered a LOT in these 3 articles (make sure you read parts 1 and 2 as well!) and I know you might be feeling overwhelmed.

Are you uncertain if Candida overgrowth could be an issue for you? Not sure what the next step should be? I get it! 

My job as a clinician is to take all this complicated stuff and make it easy for you to get better. No more confusion, just results.

I’d love to work with you. Don’t be shy - book a free 15-minute consult with my team. It’s a no-obligation way to see if we can help you. I hope to chat with you soon!


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Everything You Need To Know About Candida Overgrowth (Part 1)

Depending on who you ask, Candida overgrowth is either entirely made up or the root of all disease. 

Some experts claim as much as 90% of people have chronic candida overgrowth and it causes a gamut of health issues from weight gain to cancer. Others say it’s only an issue in acute cases like oral thrush or vaginal yeast infections (which can be easily treated and eradicated). 

So what’s the truth?

As with most things, the truth is somewhere in the middle. Chronic candida is a research-backed condition, but that doesn’t mean everything you’ve heard about it is true. 

As a functional medicine practitioner, I’m interested equally in what the research has shown and what my patients are experiencing. In this series, I’m going to share everything I know—both from research and anecdotal experience—about candida overgrowth with you. 

This will be a multi-part blog post. Today, we’re going to focus on what Candida is (and isn’t) and how it presents.

 

Part 1: What The Heck Is Candida?

First of all, you need to know that 99% percent of the time, when you hear “Candida,” it refers to Candida albicans. 

Other species do exist (C. glabrata, C. krusei, C. tropicalis and C. parapsilosis for example) but C. albicans is the most common. For the rest of this post, know that I’m talking about C. albicans when I say “Candida.”

OK—moving on.

Candida is normally a commensal fungus that lives in your oral, gastrointestinal, and genital tracts and is part of the “world of microorganisms” that live inside your body and make up the microbiome. 

“Commensal” means that Candida gets nutrients from you without causing any harm. Your body recognizes the Candida as a “friendly” fungus and doesn’t mount an immune response against it. 

As a commensal fungus, Candida is very common: approximately 80% of healthy people have commensal Candida living in their mouths, guts, and vaginas. In fact, it’s completely normal for Candida colonization of the vagina to increase in puberty as hormonal shifts make the vagina even more hospitable to fungal growth.

The main point is: Candida isn’t all bad! For most people, it’s just part of a healthy microbiome.

But that can change when Candida shifts from “commensal” to “pathogenic.” 

 

Here’s What Happens When Candida Breaks Bad

Under specific conditions, Candida can shift from it’s normal commensal state to a pathogenic state, overgrow, and cause symptoms. 

This happens in two ways:

#1 Candida Changes Form

Under certain circumstances (like a change in temperature or acidity) Candida can go through a process called “morphogenesis” and change form from one your body recognizes as friendly to one it sees as an enemy. The result is an immune response from your body toward the new form of candida. This is also when candida can grow “roots” - aka hyphae - and start burrowing into intracellular space. 

#2 Your Body Starts Reacting To Candida

The Candida doesn’t always have to change form for a response to happen. In vulvovaginal candidiasis (vaginal yeast infection), the Candida that’s normally present in the vagina doesn’t necessarily change form (although that can also happen) - but the tissue of the vagina creates an immune response against the Candida. 

This means that the symptoms are caused both by Candida changing form AND your body changing how it reacts to the Candida. 

 

Acute vs. Chronic Candida Overgrowth

Acute Candida overgrowth is called candidiasis. This is the typical vaginal yeast infection or oral thrush, but can also cause infections in the esophagus and intestines. 

The acute form results in an overgrowth of yeast on mucosal surfaces (like your mouth and vagina), but that’s not all. During active infection, Candida can grow hyphae, which are like roots that can burrow into intracellular spaces. With hyphae, Candida can invade deeper tissues and grow inside the epithelial cells. There, they release products of fermentation and enzymes that kill the tissue cells. The result are the white patches that characterize candidiasis (the white is actually dead cells, not clumps of Candida colonies!).

Acute candidiasis is often treated with a short course of antifungal drugs or herbals. But if the treatment is incomplete, the yeast in the epithelial cells won’t be totally eradicated… leading to chronic Candida overgrowth symptoms. 

In the chronic form, the Candida is inside the epithelial cells, instead of just on the surface of the cells. The yeast is “dormant” but still releasing antigens that trigger inflammation, and can result in red and inflamed tissues. 

The low-grade inflammation caused by chronic Candida can cause pain, tenderness, burning, and more. This is especially common with vaginal yeast infections.

 

A Closer Look At Vaginal Yeast Infections

About 75% of women will be diagnosed with a vaginal yeast infection at least once in their lives, and Candida is the cause of about 40% of all vaginitis cases. A vaginal yeast infection is probably the most common type of acute Candida overgrowth or candidiasis. 

They’re most common in women of reproductive age because they have higher estrogen levels - and estrogen promotes yeast in the vaginal tissues. (Side note: this is also why oral contraceptives increase your risk of yeast infections—they contain synthetic estrogen. More on this to come!)

The symptoms are all too familiar to most women: Itching, redness, burning, white discharge, painful intercourse, yeasty odor, and painful intercourse from tissue irritation. It can also lead to vaginitis and urinary tract infections (UTIs). 

The worst part, however, is that yeast infections can become a vicious cycle for women, as the antibiotics used to treat UTIs and vaginitis make women MORE susceptible to yeast infections recurring. 

We know that repeat infections can lead to vulvodynia (vaginal pain and tissue irritation) that makes sex painful and everyday activities (like wearing yoga pants and using tampons) uncomfortable. The vulvodynia may very well be caused by the low-grade inflammation of chronic Candida leading to irritated vaginal tissue cells. 

But complications from vaginal yeast infections are just one way candida overgrowth can impact your life. 

In Part 2 of this series, I’m going to dig into the symptoms chronic candida can cause—and I’m going wayyy beyond just “sugar cravings!” You’ll also learn what the risk factors and predisposing conditions for Candida are. 

 

Recap: Candida Overgrowth

Because this is  an intense topic, I want to give a really quick recap before we wrap up this first part of the series.

Here are the main points:

  • “Candida” usually refers to Candida albicans
  • Candida is a normal, healthy yeast (type of fungus) that lives in about 80% of peoples’ microbiomes
  • In certain circumstances, candida can overgrow and change form, causing two types of Candida overgrowth problems:
    • #1 Acute Candida Infections - like vaginal yeast infections and oral thrush 
    • #2 Chronic Candida Overgrowth - low-level, long-lasting candida overgrowth, often a result of incomplete treatment of an acute infection

OK—that’s all for now! I’ll see you back here for Part 2, where we’ll go over the symptoms and root causes of Candida overgrowth in-depth!