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.


Woman laying on couch with stomach ache

When H. pylori Met Candida: How They Team Up To Weaken Your Gut

If you have any sort of digestive problem—for example gas, bloating, inflammatory bowel disease (IBD), acid reflux, ulcers etc.—you’re probably wondering, why me? What’s causing me to suffer with bad indigestion or abdominal pain?

Some healthcare providers oversimplify the answer to that question. They try to blame all your digestive problems on one organism. For example, if you have acid reflux or ulcers, then Helicobacter pylori (H. pylori) must be the only organism to blame, right? 

Wrong. 

First of all, organisms like H. pylori, despite what you may have heard, aren’t always bad. Sometimes, they can actually benefit your health. 

It’s actually when H. pylori gets together with its friend Candida albicans that it causes the most trouble. 

Organisms that team up like this with other organisms may be called synergists or co-infections. 

What does that mean for your digestive health? It means that if you’ve got two different potential troublemakers (certain bacteria or fungi) living in your GI tract, it might spell more trouble than if you only had one. 

But it’s more complicated than that. Remember, most of the organisms or “good bugs” living in your gut are helpful or harmless. Scientists call them commensal bacteria. On the other hand, there is a small percentage that can be harmful, or pathogens. We will call those “bad bugs.” 

The kicker is that your gut health determines whether a bad bug can cause trouble or not. For example, if you have good gut health with plenty of healthy bacteria and their beneficial byproducts, even a few different bad bugs won’t cause trouble. An unhealthy gut, on the other hand, can make your GI tract more vulnerable to even one type of bad bacteria or fungi that makes its home there.

In this blog post, I’ll use H. pylori and Candida to paint a picture of an example of commensal organisms that can turn bad. I’ll also show you how the presence of these two organisms can make or break your digestive and overall health.

 

What Is H. Pylori Anyway?

H. pylori is a bacterium that colonizes the lining of the stomach. Its presence is linked to duodenal and peptic ulcers, gastritis (inflammation of the stomach lining), and gastric cancer. Stool tests have also detected it in people with ongoing indigestion and abdominal pain. That’s why a lot of doctors go after H. pylori as a standard peptic ulcer or stomach ulcer treatment. 

H. pylori really gets around. In fact, as many as 50% of adults carry this bacterium at some point in their lives but most have no symptoms. 

H. pylori isn’t always a nasty bug as I will explain why later. But it can be nasty sometimes. With my clients, I will use agents that fight back an H. pylori overgrowth when any of these conditions are present:

  1.  H. pylori overgrowth on testing.
  2. The presence of virulence factors. These are harmful substances that H. pylori makes to set up a home in the gut, avoid the immune system, and cause disease. Virulence factors increase the risk that H. pylori will cause digestive upset, ulcers, or cancers.
  3. Classic H. pylori symptoms such as ulcers, gastritis, upper GI bloating, acid reflux, acne, and more. When H. pylori overgrows in the gut, it tells me there is an underlying weakness. And while I do treat certain patients for it, at the same time I am asking the question: “Why?” Why did H. pylori take root and grow out of control?

What Causes H. Pylori?

H. pylori gains a foothold in your GI tract when levels of stomach acid take a nosedive. This can be a problem because when H. pylori turns bad, it can harm cells, cause inflammation, and damage the stomach lining.  Here are some of the things that can cause low stomach acid:

  • Drinking alcohol
  • Drugs used to treat acid reflux (proton pump inhibitors)
  • H. pylori itself
  • Smoking
  • Stress

 

H. Pylori: Not Always The Bad Guy

But here’s the thing about H. pylori: sometimes it’s actually your friend rather than your enemy. It has been co-evolving with us for millennia. At normal levels, H. pylori can be a commensal or friendly bacteria. While it has the potential to be a pathogen, it doesn’t cause disease in many people. In fact, it can:

  • Reduce allergies, asthma, and skin diseases like eczema, especially in children.
  • Lead to a lower risk of developing IBD. It does this by making some beneficial changes to the gut microbiome, the collection of bacteria, both good and bad, that live in the intestinal tract. This is why I often don’t want to get rid of H. pylori when I’m treating patients with inflammatory bowel disease.

Really, with H. pylori, what it comes down to is how many of these little guys do you have in your GI tract? And how virulent are they (meaning how likely are they to do damage)? 

It’s also important to treat any underlying causes that made it too easy for H. pylori to set up shop.

And then there’s the question of: are you also infected with Candida?

 

What Is Candida?

Candida is a fungus that hangs out in nearly everyone’s intestinal tract. It’s part of the microbiome and thus a commensal fungus. In fact, Candida species appear in 40% to 80% of normal stool specimens. 

However, when Candida goes from Jekyll to Hyde it can cause vaginal yeast infections and oral thrush. What is oral thrush? That’s when Candida builds up in the mouth and causes white sores on your tongue, lining of your mouth, gums, and throat. And that’s just the beginning. In functional medicine practice, I have seen Candida cause brain fog, fatigue, skin rashes, diarrhea, constipation, gas, anal itching, and joint pain.  

Just like H. pylori, Candida can be a harmless wallflower in the gut or it can be a deadly pathogen.

What causes Candida to turn from harmless to health-harming? Here are some common reasons for Candida gone bad:

  • Eating lots of sugary and processed foods 
  • Hormonal imbalances and birth control 
  • Stress
  • Taking antibiotics, which kill off the good bacteria in your intestines
  • Untreated diabetes
  • Weak immune system

 

When Candida Meets H. Pylori

Candida and H. pylori are good friends. In fact, H. pylori can make itself comfy and at home inside Candida. And once Candida teams up with H. pylori, things go south quickly.  Research found that if you’re infected with both these organisms you’re more likely to develop gastric ulcers or have more severe gastric damage than if you had H. pylori alone. Pairing up Candida with H. pylori also leads to a higher risk of peptic ulcer disease, hence the name “synergists.”

A lot of people have both of these infections at the same time. For example, in one study, out of 27 people positive for Candida, 18 were also positive for H. pylori. This is why I test for the presence of both of these organisms in my patients with GI problems. 

The partnership between Candida and H. pylori is just one example of how synergistic organisms can impact your health. Candida is a real social butterfly. It has a lot of friends besides H. Pylori. These include the bacterium Clostridioides difficile (aka Clostridium difficile, the microbe responsible for bloody diarrhea). I used the friendship between Candida and H. pylori because it’s one of the best ways to show you how organisms can pair up to make your health worse. 

 

Is Your Gut Ready To Face the Bad Guys?

In regards to GI issues, it’s really not about the “bad guy.” It’s all about whether you can tolerate the organisms that live in your gut. Some people with H. pylori and Candida have no symptoms at all. 

The most important factor in this equation is your gut health. If H. pylori and Candida are present in excess it means you’ve got an underlying weakness in your GI tract. And we have to get at the bottom of why the weakness is there.

The answers to four questions will let you know how well your body will deal with invasions by these organisms:

  • Are the good bacteria in your gut balancing out the bad bacteria?
  • How effective is your stomach acid and digestion?
  • How strong is your gut lining?
  • How well is your immune system working?

It’s not possible to answer these questions on your own. That’s why, if you have GI problems, it’s best to work with me or another functional medicine provider to order the right testing, pinpoint the root causes, and design a customized protocol just for you. 

Your path to better gut health begins with a free 15-minute troubleshooting call. During this chat, I’ll get to know more about what troubles you. If after the call you come on board as a patient, I’ll work with you to get rid of diarrhea, constipation, abdominal pain, gas, indigestion, acid reflux, and more. Book your call today and you can say goodbye to those frustrating, painful, and embarrassing GI problems and hello to great gut health! 


Woman standing outside in middle of small road

Everything You Need To Know About Candida Overgrowth (Part 2)

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, we’re going to cover the symptoms and root causes. Be sure to look for Part 3 (all about how I treat Candida in my practice!). 

Sugar cravings, brain fog, joint pain, fatigue… these are just some of the nonspecific symptoms often attributed to chronic Candida overgrowth. 

But the problem is these same, ambiguous symptoms can be caused by multiple conditions! So how do you know if a Candida diagnosis is really something you should pursue?

Today, I’m going to dig into the symptoms that send up red flags for Candida in my practice - and I promise, it’s a lot more than “exhausted mom craves dark chocolate before bed!”

I’m also going to talk about the risk factors and root causes that make a Candida overgrowth more likely.

Here, There, Everywhere: Candida Symptoms

The most striking characteristic of Candida is its complexity. While no two people with chronic Candida may have the *exact same* symptoms, they will all have a variety of seemingly unrelated symptoms - ranging from “annoying” to “life-altering.”

Here are just some of the places you might have Candida-related symptoms:

  • Central nervous system,
  • Gastrointestinal tract (digestive)
  • Genitourinary tract
  • Endocrine glands
  • Skin
  • Muscles and joints
  • Respiratory system

How could one condition cause so many different symptoms?

How Candida Can Mess With Your Whole Body

This gets kind of complicated, so I’m going to try and make it as simple as possible to understand. 

Candida can produce acetaldehyde and ethanol (AKA the same compound we drink in alcohol!) when the yeast in the gut ferment sugar and carbs. In fact, Candida can produce so much ethanol, it can cause your blood alcohol level to rise and make you drunk. (This phenomenon is called Auto-Brewery Syndrome).

Then, when the ethanol or acetaldehyde is oxidized, it requires that Nicotinamide adenine dinucleotide (NAD) be changed from its oxidized form (NAD+) to its reduced form (NADH). It’s basically like drinking a 6-pack daily - but without the fun part! 

(You may have heard about NAD as an anti-aging supplement. NAD is a really important cofactor and levels reduce over time, as we age. Some promising research suggests that raising NAD levels can reverse mitochondrial damage - aka the effects of aging!)

OK, here’s what all this means: chronic Candida causes the production of a bunch of alcohol inside your body. To get rid of the alcohol, NAD+ is converted to NADH. Over time, this leads to lower levels of NAD+ in the body - and that can lead to a cascade of symptoms.

Low NAD+ levels are linked to chronic illnesses like diabetes, heart disease, Alzheimer’s vision loss, and premature aging. Higher levels of NADH can lead to less mitochondrial energy production, lower levels of serotonin, and problems metabolizing proteins, fats, and carbs. 

But that’s not all...

Acetaldehyde produced by Candida can also impact the membranes inside your body. Membranes are the outer layers of cells and act as “gatekeepers” of your cells - keeping bad stuff out, letting good stuff in, and transmitting messages. 

When this happens to the cells in your gut, you develop “leaky gut” - aka increased intestinal permeability. Leaky gut causes by Candida can further complicate the symptoms caused by Candida.

If You Have Candida, You Might Also Have…

Here are some of the most common symptoms of Candida I see in my clinic:

  • Sugar cravings - yes, this one is “overplayed” but real! Candida will send signals along the gut-brain axis to make you crave more sugar
  • Allergies - Candida releases chemical mediators like histamine, leukotrienes, and prostaglandins that all lower your body’s white blood cells’ effectiveness. You might have rhinitis, chronic hives (urticaria), or asthma. Candida can also cause chronic stuffiness
  • Inflammatory Bowel Disease - individuals with high Candida burdens appear to be more prone to intestinal inflammatory diseases.
  • Carpal Tunnel Syndrome - this occurs as an effect of acetaldehyde.
  • Formaldehyde Sensitivity - formaldehyde is processed through the same detox pathways as acetaldehyde, and with that system overburdened, you may have trouble detoxing formaldehyde. 
  • Histamine sensitivity and intolerance - again, histamines are processed through same detox pathways as acetaldehyde. This can lead to food intolerances, rashes, and hives. 
  • Central Nervous System Symptoms - especially common is trouble with short-term memory, a result of acetaldehyde lowering the availability of acetylcholine (an important neurotransmitter)
  • Rashes - dermatitis, psoriasis, eczema, hives, jock itch, diaper rash are all common symptoms. Especially on nails, in skin folds, and in the area of the groin or genitals. 

 

Root Causes & Risk Factors for Candida

There’s no way I could cover every potential symptom of Candida, but if you read anything on the above list that was a little too familiar, keep on reading.

Now it’s time to talk about the most common risk factors and underlying causes for Candida overgrowth.

This is a BIG list, but I’m taking the time to write them all out because most people have multiple predisposing factors - and for each one you have, the likelihood of Candida becoming a problem for you increases. 

Risk factors are cumulative. That means, the more times you take antibiotics (for example), the more the ratio between opportunistic yeast and good bacteria shifts. Eventually, Candida levels will rise above a threshold and symptoms develop. 

#1: Antibiotics or Steroid Use

The number one cause of Candida overgrowth is prolonged use of antibiotics (especially broad spectrum). The worst offenders are penicillin, clindamycin, vancomycin, metronidazole, Cipro, keflex, zithromax, augmentin, bactrim and erythromycin. 

These drugs kill both aerobic bacteria and anaerobic bacteria. Anaerobes help prevent yeast colonization by inhibiting the ability of Candida to adhere to the gut wall. They can also lead to decreased digestive secretions and altered pH.  

Corticosteroids work by suppressing the immune system, so it’s understandable why can predispose to yeast! 

#2: Hormone Changes

Any change in hormone levels put you an increased risk for Candida overgrowth:

    • Oral contraceptive use has been shown to increase Candida in the oral microbiome , which leads to the gut (in fact, studies show that just brushing teeth 3 x daily reduced levels of Candida in the stool!)
    • Estrogen replacement therapy (for any reason)
    • Pregnancy not only causes increased levels of estrogen - but also causes natural immunosuppression and increased cortisol levels to keep the mother’s immune system from attacking the fetus. This creates an ideal environment for Candida to take hold!

#3: Diet

Candida thrives on a diet rich in glucose - the simple sugar found in foods like bread, pasta, and refined sugar. Dietary glucose is necessary to start the process of candida invading tissues.

But please know: this doesn’t mean the answer to Candida is simply a zero-sugar diet! More on this in Part 3!

Diabetes and high blood sugar also put you at increased risk for Candida overgrowth.

Finally, alcoholism - or even just frequent alcohol use - increases risk of Candida. Beer, wine, and other fermented alcohols promote Candida colonization, and all alcohol inflames the gut lining, making you more prone to inflammation, dysbiosis, and leaky gut.

In those already genetically prone to alcoholism, research has suggested that Candida overgrowth (and the Auto-Brewery syndrome it can cause) can even lead to a Candida-perpetuated form of alcoholism.  (Other research has also established the connection between intestinal fungal overgrowth and alcoholic liver disease.)

#4: Nutrient Deficiency

Nutrient deficiency goes hand-in-hand with some of the other risk factors listed here. Low stomach acid (which can be caused by antibiotic use, stress, antacids, or PPI drugs) can cause incomplete digestion of the food you eat. 

Poor diet (like too much sugar or refined carbs, and not enough fruits and veggies) can lead to nutrient deficiency, too. 

Iron, zinc, and biotin deficiency are all risk factors. Both too much and too little iron (anemia) can predispose you to Candida. Iron stimulates yeast overgrowth, but low iron can interfere with the white blood cell’s ability to function and fight infection.

#5: Environmental Factors

Pesticides like glyphosate have been shown to disrupt the microbiome, reducing beneficial bacteria that help to protect you from Candida overgrowth. 

High levels of stress dysregulate the HPA Axis, and can cause abnormally low or high cortisol levels. We know stress is associated with an increased risk of vaginal Candida - and I suspect if we studied it, we’d find it also tracks with gut Candida.

#6: Gut Health

If you already have altered bowel flora - aka dysbiosis - you’re at increased risk for Candida. 

Overgrowths of H. pylori and Streptococcus facilitate Candida overgrowth. 

This is why it’s so important to treat those other bacterial overgrowths and gut dysbiosis alongside Candida. If you’re trying to clear Candida without addressing overall gut health, it’s like chasing your own tail! (More to come on this topic in Part 3). 

#7: Impaired Immunity or Underlying Disease States

If you have Candida, overgrowth, it’s a major sign your immunity is decreased. Likewise, if you have known decreased immunity, you’re at increased risk of Candida. 

Conditions like thyroid dysfunction and diabetes can also predispose you to Candida overgrowth. 

Start Counting…

Most people have multiple risk factors and symptoms for Candida overgrowth. If you count up all your symptoms and potential risk factors, what number do you come up with?

If you have more than one or two, be sure you read Part 3 of this series, where we’re going to discuss how you can find out if you actually have Candida overgrowth - and if you do, what to do about it!

I’ll share the tests and protocols I use with patients in my own practice - so don’t miss Part 3!


Woman walking outside in bright field

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!


Happy woman outside in field with flowers

How To Treat Depression & Anxiety Holistically - Part One

Butterflies in your stomach before a first date. Sweaty palms before asking your boss for a raise. Grief when your dog dies. Crying over a breakup.

These are all normal and healthy moments of nervousness and sadness.

But then there’s a shift….

Laying awake at night with a pit in your stomach… when tomorrow’s just another Tuesday. Overwhelming sadness when everything is going OK. A feeling of despair you can’t shake…

These are signs of a more serious issue: anxiety and depression.

 

If you’ve ever experienced anxiety or depression, you’re currently dealing with them, or are supporting someone you love with one of these conditions all you care about is getting rid of them.

But it’s not always simple. Anxiety and depression are multifaceted issues. And that’s where the problem starts.

Doctors and practitioners want to put you onto one 2 paths:

  • Treat the brain. This is everything from antidepressants and anti-anxiety meds to talk therapy with a psychologist. On this path, anxiety and depression are seen purely as a mental health issue - so treatment focuses on your brain.
  • Treat the body. On this path, anxiety and depression are seen as symptom of a problem somewhere else in the body. Treatment often focuses on changing your diet (especially avoiding certain foods) and adding in exercise.

This gets me so frustrated!

Like nearly EVERY health condition, depression and anxiety are not problems of JUST the brain or JUST the body. There is a definite mind-body connection, and the best treatments (and prevention) for depression and anxiety treat both.  

In this series, I want to do some real talk about anxiety and depression. We’re going to dig into the root causes - everything from childhood trauma to candida - and the solutions that might be able to help you.

Nothing is off limits and I’m not going to vilify any one kind of treatment.

I hope this can be an open and honest discussion about anxiety and depression like you’ve never experienced before.

 

Trauma, Circumstance, and Perception in Anxiety and Depression

Before I dive into some of coexisting conditions I see around anxiety and depression (and the steps you can take to help treat it), I want to make a very important distinction. While I believe (and the research shows) things like compromised gut health and hormone imbalance can cause anxiety and depression, it’s not the case for everyone.

Trauma, circumstance and perception can all be root causes of anxiety and depression.

And even if eating a blood-sugar balancing diet DOES help you manage anxiety and depression, it doesn’t mean that your anxiety was just caused by eating too much junk food. The trauma was real. This is a very sensitive issue, so I want to make sure this is clear.

Here’s what I see a lot in my practice: when a woman has co-existing conditions like leaky gut or a hormonal imbalance, when trauma happens (and it happens to almost all of us to varying degrees), it’s more likely that the temporary stress of the trauma develops into the long-term problems of anxiety and depression.

How you perceive trauma is important too. What qualifies as a trauma to one person wouldn’t be for another person - and neither one is right or wrong. Your perception is YOUR perception. But, you can learn tools that can help change the way you perceive things.

(It’s the difference between seeing your mother-in-law’s comments as a personal attack against you or just a manifestation of her own insecurities that you can brush off.)

If you’re equipped with self-care practices and coping mechanisms before the trauma happens, you’re much more likely to avoid depression and anxiety.

This is where “treating the brain” is so important.

For those of you who are dealing with past trauma or very difficult circumstances, I’d suggest looking into EMDR and Brainspotting in addition to everything else I lay out in this post.

  • EMDR is shorthand for Eye Movement Desensitization and Reprocessing. It’s a kind of psychotherapy that combines aspects of traditional talk therapy with eye stimulus. Research has shown it helps you process through trauma much faster than talk therapy alone (think the work of 8 years of talk therapy in just a few EMDR sessions). It’s a recognized treatment by the World health Organization, the Department of Defense, and the American psychiatric Association. Learn more about it and find a clinician here.
  • Brainspotting is a therapeutic tool that can be used in conjunction with other forms of therapy. It works by accessing the autonomic and limbics within the central nervous system to help work through traumas - especially those that are not in the conscious mind (and therefore hard to talk about and treat). Learn more about Brainspotting and find a clinician here.

And I encourage everyone - whether or not they’re dealing with anxiety and depression - to get started on the inner-work that makes you more resilient to trauma. It can be as simple as beginning a meditation practice or finding a counselor.

 

A note on antidepressants and anti-anxiety medications: I believe antidepressants and antianxiety medications can be life saving for some people. They also have serious side effects and address the symptoms over the root cause. No one other than you and your doctor can decide if medication is the right step for you. But, whether or not you use medication as part of your treatment, I encourage you to explore treating the coexisting conditions and root causes I share about in this post.

 

Gut Health and Depression

When I hear about depression and anxiety, I immediately think about gut health. I rarely (I mean rarely!) see a patient with symptoms of depression and anxiety who doesn’t have some sort of gut health problems.

And intuitively, it makes sense. We feel our emotions in our guts just as much as we feel them in our mind - the “stomach in your throat” feeling, butterflies in the stomach, a “gut punch” when you get bad news, needing to go to the bathroom when you’re anxious or nervous.

We also know that 90% of the body’s serotonin is actually produced in the gut - not the brain - and that other important mood chemicals are made in the gut, too.

Irritable Bowel Syndrome (IBS) is also closely associated with depression and anxiety.

In my practice, I see 2 kinds of gut health problems contributing to anxiety and depression over and over again: leaky gut and candida overgrowth.

 

How Leaky Gut Leads To Depression & Anxiety

One of the most famous studies on gut health and depression was conducted in 2008: “The gut-brain barrier in major depression.”

This study is famous (and still cited all the time) because the researchers made some amazing discoveries.

First, they concluded that “There is evidence that depression is accompanied by an activation of the inflammatory response system and that proinflammatory cytokines and lipopolysaccharide (LPS) may induce depressive symptoms.”

In layman’s terms, that means:

  • Inflammation is one cause of depression
  • There is evidence that leaky gut may cause symptoms of depression

The study measured antibodies produced by the body’s immune system against lipopolysaccharides (LPS) in depressed patients and in controls (without symptoms of depression). LPS are large molecules of dead cell wall of the gram-negative enterobacteria  - also called endotoxins. LPS should NOT be in the bloodstream. If LPS are present in the bloodstream, it means the tight junction of the gut have become loose (aka leaky gut).

The researchers found that the immune markers against the LPS bacteria in the gut were much higher in depressed patients than in the control group.

This means that the depressed group had more leaky gut and gut microbiome dysbiosis than the control group.

In fact, researchers concluded that patients with major depression should be tested for leaky gut. (And I’d argue, anyone with any symptoms of depression or anxiety - not just major depression!)

What causes leaky gut?

LPS are dead bacterial cell walls - and generally having high levels of them in the bloodstream indicates dysbiotic flora in the gut in addition to leaky gut. This can too much of the wrong bacteria, too little of the right bacteria, or too much or too little bacteria in the wrong place.

Leaky gut can also be caused by parasites, SIBO (Small Intestine Bacterial Overgrowth), yeast overgrowth (more on that to come), and untreated food sensitivities and intolerances.

Food sensitivity symptoms are usually an immune system response to foods we eat. The reaction creates inflammatory compounds that get into the bloodstream, circulate, and can create anxiety, brain fog, depresion, and fatigue.

Low nutrient status can also contribute to depression. When food isn’t properly absorbed in the gut (due to dysbiosis or leaky gut) the body doesn’t have the “nutritional building blocks” like amino acids, folate, vitamin B6 and more it needs to create the chemicals to control mood. This can cause depression and anxiety.

 

Yeast Overgrowth, Depression

Other than leaky gut, the most common gut health problem I see in relation to anxiety and depression is candida overgrowth. Candida is a kind of yeast that almost all people have present in their body. Candida is responsible for thrush in babies and yeast infections in women. In normal amounts it is healthy - but it’s when it overgrows that it causes problems. And the way candida impacts depression is especially interesting!

Candida is a yeast - which means it produces alcohol (ethanol) and acetaldehyde (the chemical responsible for the main symptoms of hangovers!) Both these chemicals are toxins to the body.

In a normal healthy person, (who hasn’t been drinking!), there should be little to no alcohol in the bloodstream. But if that person has an overgrowth of Candida, the alcohol produced by the yeast is entering the bloodstream - we call this “auto brewery syndrome” and it literally makes you drunk.

In a study conducted by doctors at Biolab in London, UK, a number of chronically unwell patients were tested for blood ethanol levels an hour after ingesting a sugar solution. The study found the patients consistently had high blood levels of ethanol which the researchers concluded came from small intestinal yeast overgrowth.

And - even worse - when candida is well established, it transform into the fungal form its branching (hyphae) “feet” can penetrate the intestinal wall.This creates literal holes in the gut, enhancing leaky gut syndrome and allowing more alcohol and acetaldehyde into the bloodstream.

What does that do to you?

Ethanol metabolism…

  • Interferes with energy metabolism; this results in fatigue & muscle aches
  • Causes hypoglycemia or "low blood sugar"
  • Creates nutritional deficiencies

Then the ethanol is converted into acetaldehyde which…

  • Is responsible for most of the symptoms of a hangover
  • Causes dilation of blood vessels in the brain which result in the characteristic severe headaches
  • Is toxic and inflammatory to the brain’s neurons
  • Binds glutathione - the body's main antioxidant - thus increasing oxidative stress and allowing free radicals to damage cells throughout the body. Without enough glutathione, the liver can’t detox properly
  • Increases the release of adrenaline, causing heart palpitations, anxiety etc. Panic attacks become more common.

What causes candida to overgrow?

All of these factors make your body more hospitable to the overgrowth of candida:

  • Antibiotics
  • Oral contraceptive pills
  • High sugar/starch alcohol diets
  • Stress
  • Having other GI infections, or
  • Having immunosuppression related to adrenal fatigue

Candida overgrowth can be treated - but the root cause that began the overgrowth must also be addressed!

 

Action Steps For Healing Gut Issues

The first step to healing gut issues is to find out exactly what is going on.

I don’t like to “guess and check.” For patients in my clinic, I always start with specific stool tests for parasites, dysbiosis, and yeast overgrowth. For SIBO, I test using a lactulose breath test.

Once we identify exactly what issues are occuring, we tackle them - treating parasites and pathogens, and then using diet and supplements to heal leaky gut. Gut mucosa heal rapidly when the aggravating factors are resolved! On average, my patients see big changes in as little as 3 weeks.

 

Coming Up: Hormones & Toxins

I hope reading Part 1 of this post has left you feeling empowered - and maybe even hopeful. If gut issues are contributing to your anxiety and depression, treating them can help you take a big step forward.

In Part 2 of this post, I’m going to address two other major factors in anxiety and depression: exposure to toxins and hormone imbalances. There’s still a lot left to cover!

 

I’m passionate about helping women uncover the root causes of their health problems and address them naturally. If you’re dealing with anxiety or depression, I’d love for you to book a free 20-minute root cause symptom analysis  consultation with my team. These appointments are TOTALLY free, and there’s no obligation to book any further appointments. See what time slots we have open here.


Woman sitting on steps

What Working With A Functional Medicine Practitioner Is Really Like (Patient Case Study)

You’ve been to the doctor. He runs some tests and he says nothing’s wrong.

But you know you’re not you right now. Maybe you’re dealing with digestive problems that have taken the fun out of eating. Every dinner out is a potential threat.

Or maybe it’s your hormones that seem off. Your once predictable cycle is suddenly erratic. You feel like you’re in puberty all over again.

Or maybe you’ve never had a happy gut or healthy hormones. The doctors have thrown up their hands. They can give you The Pill or suggest you try a fiber supplement, but that’s all they’ve got for you.

You’ve always trusted your doctor - but right now it feels like there is nothing they can do to help you.

Where do you turn?

This story is how so many women end up looking for a Functional Medicine Practitioner. I know it well, because this is my story, too.

 

What Is Functional Medicine?

Functional medicine is an evidence-based approach to health that focuses on finding the root cause of health problems. Functional medicine looks at the body as one system - meaning that is something is “wrong” in one area of the body, it is likely having an impact on other parts of the body, as well.

Functional medicine incorporates both Western and Eastern approaches - the latest technology and ancient wisdom.

The #1 misconception about Functional Medicine is that it denounces modern medicine in favor of healing crystals and water fasts. Not true!

Listen, I won’t knock anything until I try it - including crystals and fasting - but the majority of work I do with clients in my clinic is much different than that. You might not know that though, because you’ve never seen a FMP before!

 

What Is It Really Like To Work With A Functional Medicine Practitioner?

Today, I want to walk you through the process of working with a Functional Medicine Practitioner. I’ll share one of our amazing patient’s own journey (yes - including test results!) so that you can understand what it’s really like to work with a FMP.

Before anything else, I always do a free 15-20 minute prospective patient interview. This is just a chance for us to connect (without any pressure) and be certain we’re a good fit for working together. From there we’ll go to official first step: the case review appointment.

The case review is like a deep-dive interview. I want to know as much about you as possible. I might even ask some questions about your childhood! Here I’m looking for clues as to the root causes of what is troubling you now.

Next, we’ll order some testing  - depending on your unique symptoms and history. I don’t want to waste your time or money, so we’ll only order the tests that are relevant for you.

Once test results are in, we’ll meet again to develop a treatment plan. You’ll implement the plan (usually diet & lifestyle changes, plus supplements) and we’ll have check-ins to see how you’re progressing and if we need to make tweaks to the plan.

Finally, we’ll re-test to check your progress. (This is the best way to know treatments are really working.)

I’m excited to share this story with you - let’s dig in!

 

Step 1: Marina’s Case Review

Marina met with Amelia, one of the clinicians who works in my practice, in January.  At her first meeting, we learned a lot about her!

She was 22 and was working as a paramedic with her local fire department. She wanted to become a helicopter medic (how badass is that?) but was struggling with health problems that were holding her back. Digestive problems and brain fog were zapping her of the energy she needed to go back to school.

First, Marina told us about what was going on right now: serious digestive problems. She was having oily stool, undigested food in her stool, and couldn’t tolerate eating meat at all unless she took her “meat pill” - a prescription anticholinergic medication. The digestive problems were wearing her out, and she was dealing with brain fog.

Then we went back in time: when did her health problems start?

Marina told Amelia that when she was younger, she had developed a cyst on her heart. Her doctors had treated it with back-to-back rounds of antibiotics.

As a side effect of the antibiotics, she developed neuralgias (a kind of nerve pain that causes severe pain) and vertigo. The vertigo led to 3 concussions in a row and she was ultimately diagnosed with a Traumatic Brain Injury (TBI).

It was at this time that the digestive problems started, too. Bloating, nausea, food intolerances, and fat malabsorption (which was causing the oily stool).

Her doctor told her the digestive symptoms were just Irritable Bowel Syndrome (IBS) and gave her the prescription for the “meat pill.” That was all he could offer.

6 years after the cyst on her heart, and Marina was still dealing with the repercussions of it. That’s how she came to see us.

Based on her history of antibiotic use and her current symptoms, we suspected Mishana was dealing with a gut infection. We suggested she start with a GI-MAP - a comprehensive stool analysis that can test for many gut infections at once.

 

Step 2: The Test Results Are In

Marina agreed to the test, and a few weeks later, results were in:

Pathogen test results

Pathogen test results

Pathogen test results

Pathogen test results

 

Marina tested positive for:

  • C. difficile
  • Enteroinvasive E. coli/Shigella
  • Enterotoxigenic E. coli LT/ST
  • Salmonella
  • Entamoeba histolytica
  • Enterococcus faecalis
  • Streptococcus spp.
  • Candida spp.
  • Chilomastix mesnelli
  • With relative elevations in other markers

You might be thinking these test results are crazy - but it actually isn’t that uncommon! Even in the United States, gut infections and parasites are fairly common. And if you have used antibiotics or have a compromised microbiome for some other reason (like you’ve been eating the Standard American Diet) you are more susceptible to picking up gut infections.

Why don’t doctors test for these infections?

Some Western-medicine doctors do - but many others don’t. They either wrongly believe that gut infections are unlikely or they think they are “non-symptomatic” infections - meaning they don’t cause problems, and don’t need to be treated.

In my experience, (both personally and with my patients) clearing gut infections makes a huge difference in how you feel.

For Marina, we started treatment with a prescription anti-parasitic, alongside a natural bacterial protocol. After she completed those treatments, we used a prescription anti-fungal. Finally, we completed a re-seeding protocol with both probiotics and prebiotics (the most important step after any type of clearing treatment!).

After treatment, I always recommend re-testing to be sure that all the infections have cleared. Feeling better is a great indicator that infections have cleared - but it can’t replace seeing the results on paper!

 

Step 3: The Second Test Results:

Pathogen test results

Pathogen test results

Pathogen test results

 

Pathogen test results

 

 

As you can see from the results - Marina was able to clear all her gut infections!

(Note: She did have some low beneficial flora that we worked on next.)

The results on paper back up what Marina experienced day to day: her digestion has improved. No more bloating or food intolerances.

Not just that, but after years of brain fog, Marina is finally thinking clearly again. She was even able to pass her paramedic cardiac program and enroll in medic school.

Now that the infections are cleared, Marina is working on improving her habits  - especially around eating foods that support gut health and getting enough sleep - so that the infections don’t have a chance to come back. I’ll keep working with her to make sure she keeps improving.

 

It’s Black, White, & Gray

I like to say that I look for “black, white & gray” results with my clients.

I want the black and white stuff - the test results that prove the treatments we’re using are working. And I know those results are important to you, too.

But I also want the “gray” - I want to hear that you’re going out to dinner with your boyfriend and you don't get sick, that you’re finally able to be back in school, that you don’t have to press snooze five times every morning before you drag yourself out of bed.

For Marina, we definitely got the black and white and the gray - and I am so thrilled to see her thriving again after years of struggle.

I hope this has helped you understand what it really is like to work with a Functional Medicine Practitioner. And if you’re ready to take the next step forward in your health, I’d be honored to work with you. You can book a free prospective patient interview anytime here.


can a uti cause bloating and constipation

Acid Reflux and Chronic Urinary Tract Infection; Totally 'Unrelated' Symptoms With the Same Root Cause?

One of the principles of Functional Medicine is finding and treating the “root cause.”

But sometimes, it isn’t as simple as finding one root cause and getting rid of it. Most of my clients have multiple health concerns - and multiple causes behind them. Helping them is about peeling back the layers and addressing each one as we go.

For my client Jane, peeling back the layers was exactly what we needed to do! She came in because she was experiencing tightness in her chest caused by acid reflux - and we wound up working through multiple gut infections, addressing vaginal dryness,  and putting interstitial cystitis (a condition that causes chronic bladder pain like a urinary tract infection) into remission.

Every time we treated another “layer” Jane felt better than before.

Today, Jane wants to share her story in her own words. If you’re considering pursuing help with a Functional Medicine Practitioner like me, I hope this story helps you better understand the process of working with a practitioner.

Jane’s Story

About three years ago, I started dealing with some bloating. Then, I’d occasionally have constipation - not all the time, but enough that I noticed it. I had a colonoscopy and the results came back normal. I started taking a probiotic. The bloating and constipation just became kind of a general annoyance I was living with.

But then I started feeling tightness and pain in my chest. That was really scary. I went to the doctor right away, but the tightness and pain weren’t heart-related. That’s when I realized they were actually a digestive issue. I decided to go see a physician at my regular clinic, and they told me it was acid reflux, prescribed Prilosec, and referred me to a GI doctor.

Luckily I had read enough about Prilosec to know I didn’t want to take a proton-pump inhibitor. Instead, I decided to get a second opinion from a Functional Medicine Practitioner - that was Brie.

 

Working With Brie

From the start, Brie was very thorough. She took a really detailed history that helped me connect some dots about what had started all my digestive symptoms in the first place. The past summer, I’d had a urinary tract infection and taken a course of antibiotics. Then in the fall, I went traveled out of the country and had to take a course of the antibiotic Cipro for traveler’s diarrhea. That's when the bloating and constipation became worse and the other acid reflux symptoms started.

But she wasn’t just interested in the acid reflux - Brie asked questions about my overall health. When I told her I was experiencing vaginal dryness, urinary pain, and low libidio, she took me seriously. My doctor had diagnosed my with interstitial cystitis - basically pain in my reproductive organs for no reason.

Brie explained to me how the antibiotics had killed the good bacteria in my gut as well as the bad. She recommended stool testing and a breath test for Small Intestine Bacterial Overgrowth (SIBO), as well as hormone testing. She also recommended I cut out dairy and gluten temporarily to give my system a break, since those foods are common gut irritants. She also recommended some supplement that would soothe my gut and help with symptoms until we got the test results back. All this happened at our very first meeting!

 

The Test Results Came In

The test results came back a few weeks later - they showed low cortisol, low estrogen, H. pylori, low beneficial flora, and a few overgrown bacteria (citrobacter, pseudomonas). Plus, I had both methane and hydrogen type SIBO and was under-producing pancreatic enzymes.

It was a lot to take in and I was so glad I had Brie to help me understand what the results meant. She saw how everything was connected.

Brie explained that the H. pylori infection was likely causing the acid reflux, and that the SIBO was probably the cause of the constipation and the uti bloating. My hormone problems were tied in to all of it and causing the vaginal dryness, urinary pain, and low sex drive.

It was a relief to know there was a reason I was feeling the way I was feeling  - especially because my symptoms had gone into a flare as we waited for the test results. I remember going to visit a friend for a few days and having to come home early because I was just so uncomfortable.  

Brie started my on a supplement protocol for 6-8 weeks for both the H. pylori and the SIBO. I kept avoiding gluten & dairy, too.

After I finished the first supplement protocol, we re-tested. The H. pylori was gone! The SIBO levels had come down, but it wasn’t completely gone. On the second stool test, I also had positive results for some other common gut infections and parasites, including candida overgrowth. Brie explained that all of this was normal - the first protocol of supplements had helped destroy the “biofilm” - the protective cover the bad bacteria use to protect themselves and hide. With the biofilm gone now, we could see other parasites and better treat the SIBO, too.

By, then my acid reflux was totally gone and I was feeling pretty good gut-wise. But I was still struggling with the vaginal dryness and hormone symptoms.  And, what I initially thought was a bladder infection turned out to be Interstitial Cystitis. The “UTI” pain didn’t respond to normal treatments, and the pain turned chronic. Can a UTI cause bloating and constipation?

 

Putting Interstitial Cystitis Into Remission

My hormone symptoms were slowly improving as my gut healed - but Brie also suggested using a plant-based bioidentical estrogen replacement. She also had me use vaginal DHEA, a vaginal probiotic, and some herbs. Those helped me feel better right away.

Brie also explained that two of the bad bacteria that the tests had shown were overgrown in my gut - proteus and citrobacter - were related to the Interstitial Cystitis, too. As we treated those, my symptoms disappeared completely.

Brie suggested I work with a pelvic floor therapist, too. That helped me relax some overly tight muscles that were contributing to the pain.

 

Changing My Diet

Brie suggested I follow a gluten and dairy-free, low-FODMAP diet. It helped me a lot in the beginning, but I was anxious to reintroduce more foods as soon as I could.

After a few months, I was able to reintroduce beans and some other legumes, which I hadn’t been able to tolerate for years, and I really missed. I am now back to eating all fruits and veggies, and I can even add in a little gluten here and there. That makes me feel good!

 

Where I Am Now

After working with Brie, I feel great for the first time in years.

I came to see her because of the acid reflux - but she opened my eyes to a lot of problems I had been writing off as “normal” or just “part of getting older.”

Gut-wise, I am feeling so much better now! After having given up gluten and dairy for years, I’m finally able to experiment with adding them back into my diet again now.  

The interstitial cystitis pain is gone now, too. I didn’t realize how much the pain held me back from enjoying life - I even cancelled an overseas trip because of it!

I’m so happy to be where I am now with my health. I’m following a maintenance protocol now and continuing to meet with Brie occasionally to make sure I’m doing the right things moving forward.

Working with Brie has made a huge difference for me, and I wish more people could have access to it! I hope my story helps to spread the word.

 

Do You Need Help, Too?

Jane had amazing success - she cleared multiple gut parasites, fixed her digestion, reversed interstitial cystitis, and was even able to reintroduce foods she hadn’t eaten in years.  

Why was she so successful? Because she dedicated herself to working through the process of Functional Medicine. She didn’t give up even when it got complicated - and neither did I!

I hope reading Jane’s story has helped you understand better understand the process of working with a Functional Medicine Practitioner like me.  

If you’re inspired and ready to start your own journey, you can book a free, no-obligation Prospective Patient Interview with my team. During this 20-minute appointment, we’ll learn about you and discover if you’re a good fit for working with us. 


Woman sleeping in chair

How I healed from 6 years of severe insomnia-- and you can too!

It is estimated that up to 50% of adults in the US  are  affected by insomnia, with up to 60 million having chronic sleep trouble. Twenty percent of Americans report that they did not wake up feeling refreshed on any of the past seven days. These numbers are staggering, when you think about the incredible number of studies proving that adequate, good quality sleep is essential for disease prevention, mood, and brain function.

I went through a time in my 20’s where I simply couldn’t fall asleep. For hours, I would lay awake, tossing and turning, getting angry and frustrated at my increasing alertness. After a while frustration would turn to worry…..  “how am I going to function tomorrow….I need to be up at 7 to make it to work/class/etc”,   “Am I ever going to be able to fall asleep naturally again in my life?”

I seriously believed that I had forgotten how to do something that I had taken for granted my entire life up until that point. To just. Go. The. F. To. Sleep.

Sleep Matters

When my clients mention that their sleep is less than optimal, I take it seriously. No matter what the main health issue is, if you aren’t sleeping well, the body and mind just can’t repair fully. Lack of sleep makes us inflamed, stressed, shifts our hormones for the worse, and impairs blood sugar balance. Our levels of patience, concentration, and creativity suffer. That word or name we are grasping for remains elusive as we struggle to communicate our thoughts.

Studies show that we tend to make poor food choices the next day.  Poor sleep can even lead to weight gain, without a change in diet.  Difficulty falling asleep, or staying asleep, inevitably leads to being less than fully awake and refreshed during the daylight hours—  for years; I felt like I was half of myself. And that’s no way to live.

Finding My Root Causes

Resolving my insomnia required a pleiotropic (multi-faceted) approach. Testing and supporting my adrenal hormones was the first step:

Cortisol Results

(This is a saliva panel from before I used the DUTCH Adrenal test for assessing the HPA axis in my practice. You can see that my morning cortisol was super high right when I woke up, suggesting that it had been high at night.)

However, it turned out that I also had  three  parasites and candida overgrowth causing inflammation, which had to be addressed before my adrenal hormones and bio-rhythms could repair. (And this was despite not having many digestive symptoms at the time!)

Test 1

Test 1 Results

Test 2

Test 2 Results

Test 3

Test 3 Results

The inflammatory compounds from parasites and yeast in my gut, were neurotoxins.  Exposure to these in my bloodstream was creating inflammation and oxidative stress in my brain that contributed to sleep and memory problems.

Metabolism Markers

And my progesterone levels were lower than my post-menopausal grandmother’s would have been! (Progesterone production takes a back seat to cortisol production when your body is reading that you are under constant stress... *or inflammation).

To make things worse, my estrogen was through the roof. This relative excess of estrogen to progesterone is called Estrogen Dominance , and can make life in a woman's body fell like...well...a pain in the ass! (Think PMS, breast swelling and tenderness, heavy menstrual bleeding, fibroids and cysts, or weight gain around the hips and thighs....oh, and did I mention insomnia?)

Sex Hormones

Addressing each of these issues, over a period of about a year, gradually brought about a shift in my insomnia. Even after the first month of treatment, sleep started to come easier and easier.  And it just got better and better from there.   I felt like I had gotten my life and myself back!

5 Steps to better sleep

Modern life, with our artificial lights, tablets and screens, digital notifications, and indoor living give our bodies the exact opposite of the signals we need to promote sleep.  While testing and treating these or other underlying causes for any case of insomnia may be necessary in the long run, we just can’t “out-supplement” diet and lifestyle.

Taking steps to set yourself up for success during the day, and early evening, is essential for anyone who’s sleep is less than optimal. There are many things you can do on your own, to give your body and mind every chance of sinking into a deep, restful sleep, naturally.

Sleep Tips

Sleep is one of the most important aspects of improving hormone balance and repairing body systems, from the brain to the digestive tract. Here are additional tips to facilitate this process:

Tip 1: Train the brain to feel sleepy & awake at regular times:

  • Set fixed times for bedtime and rise-and-shine- As much as possible, keep to this schedule, even on weekends, regardless of how much sleep you got the night before.
  • Avoid daytime naps- as this reduces your sleep drive at night.
  • Keep the lights off -If you have to get up during night to use the bathroom do not turn on the light. Use a small nightlight so that you can see enough to move safely.
  • Sunlight Exposure- get at least 30 minutes per day, sunglass free. Even in a cloudy sky, the natural spectrum light is bright enough to trigger your brain with a powerful signal that it is daytime. Natural light exposure helps establish healthy sleep/wake hormonal rhythms—it has only been recently that we’ve spent the majority of our lives indoors, under artificial lights. It’s essential to do this in the morning, within the first hour of being awake.  For any kind of insomnia, it’s best to wake and go to bed at the same time every day.  However, if you wake at 7 AM most days, but 9 on weekend, set your daily time outside to be 9:15-9:45 to ensure consistency, grab a mug of tea, and head out the door.

Tip 2: Develop a strong mental association between your bedroom & sleep:

  • Use the bedroom only for sleep (or sex)- don’t read or watch TV in bed.
  • Get into bed only when you are sleepy- If you are unable to fall asleep, get up and go into another dimly lit room, rather than lying in bed awake.

Tip 3: Avoid being over-stimulated at bedtime:

  • Avoid Alcohol – it may help you fall asleep, but all the sugar in the alcohol will cause a rapid rise and subsequent drop in your blood sugar which will cause you to wake up. Even low-sugar alcohols like vodka can disrupt your sleep pattern, causing lighter sleep or frequent waking. Avoid alcohol within 3 hours of bedtime, and avoid it completely if you are struggling with insomnia.
  • Ditch the Caffeine- Did you know that even a morning cup of joe at 7 AM can disrupt your sleep? This is especially true in people who have genetic caffeine processing issues, due to gene SNPs such as COMT.  The “caffeine kick-back effect” is more common than you would think! Avoid caffeine completely if you are having sleep problems. Avoid it after 2 PM as a general rule, even if you don’t suspect you are overly sensitive to its effects.
  • Slow Mental activity -stop doing active mental work at least 1 hour prior to bedtime. This includes surfing the web, watching Netflix or movies, emailing, Facebooking, or texting. We all need wind-down activities to switch out of “doing” and “problem solving” mode. Earlier in the evening, meditation, yoga, books, audiobooks, and yes, at the very least, even watching a TV show or playing a game on your Ipad is fine (assuming you are using precautions to avoid blue-light listed below)—anything that helps you switch into relaxation mode and away from the whir of  thoughts and pace associated with wakefulness.
  • Get Moving!- Exercise at least 30-60 minutes every day. Even walking works.
  • Avoid Blue light Exposure— Have you ever noticed that the light near the end of the day, around sunset, is naturally warmer with more reds and pinks? Blue light from screens inhibits melatonin production by signaling that it is day time. Our brains respond to dimmer light and warmer light by winding down activity, but you need at least 2 or more hours of these lighting conditions prior to bedtime for optimal relaxation.
    • Install apps on electronic devices that dim blue light and use warmer spectrum tones,  such as f.lux on Mac,  Nightshift for iPhones, or Twilight on Android.
    • Dial down the brightness on dimmer lights, screens, and digital devices.
    • These apps do a fairly good job, but if you are more sensitive to light and the apps don’t cut it, also consider buying a pair of blue-blocking glasses (around $10-15—-yep, these come in a ton of super-groovy styles now that they’ve caught on). Some people even install amber-colored light bulbs such as these around the house.

Tip 4: Create an environment supportive to sleep.

Your room should be:

  • Dark- cover LED lights on bedside clocks, consider blackout blinds. An eye-mask with cup shaped or curved nose pieces can work just as well.
  • Cool- Your body naturally cools off when you sleep, and if your room is too hot, it can be hard for your body to give off its heat. Around -65°F is ideal for most people.
  • Comfortable- use a comfortable mattress and pillow that is supportive to your neck, depending on your sleeping position. Consider using a “side sleeper” pillow for under your neck when sleeping on your side. Consider using a body pillow to hug and put between your knees to align your back and shoulders at night. I personally love the PharMeDoc C-shaped body pillow for side sleeping as it supports both neck and hips. Yes, it is marketed for pregnancy (and is a must have for pregnant women!)—but it’s great for non-pregnant people who like to sleep comfortably too!
  • Quiet –Some people swear by reusable silicone earplugs like these for the best noise cancellation.  I prefer the super soft foam kind so they aren’t uncomfortable.  You can use them several times before they lose their “squish” and look a little grubby—then toss ‘em and grab a new pair. These plugs block out even my husband’s snoring on the loudest night!
  • You can also use a white noise machine, if you don’t like the feeling of having something in your ears. Different people prefer different sounds. I don’t use one of these, but patients have told me good things about them.

 

Tip 5: Eating for healthy sleep

  1. Stop Munching- avoid being too full at bedtime. No food for at least three hours before sleep, unless you suffer from severe hypoglycemic issues.
  2. Don’t Under-eat:  Hunger and low blood glucose can give you insomnia and can wake you up in the middle of the night. Most people’s bodies naturally help them to eat the right amount, but if you’ve been intentionally trying to lose weight, or restricted eating because of digestive or other health issues, your appetite signaling can easily get off, and so can your sense of what is enough food. If you’re not sure that you’re eating enough try this:
    • Use an online calculator like this one to figure out your approximate caloric need.
    • Use a food tracking app such as  MyFitnessPal to keep track of your calories for a few days.
    • If you’re under-eating, bumping up your calories may be the silver bullet solution to help you sleep deeper and fall asleep easier.
  3. Eat high nutrient foods, especially minerals: Mineral deficiencies (like calcium, magnesium or potassium) are a common factor with insomnia. The best way to ensure high nutrient content is to eat a variety foods each week, including fruits, lots of above ground veggies, root veggies and tubers of different colors, animal proteins, liver or other organ meat, seafood, and bone broth. If you don’t eat dairy be sure to get plenty of calcium containing leafy greens, and or herbs that are high in calcium to supplements, Many people need supplemental magnesium as well. Even on an otherwise healthy, whole foods, Paleo type diet, you can still have deficiencies of essential nutrients if you are eating the same foods day in and day out.
  4. Eat enough carbs: Carbs are super important for sleep, in several ways.
    • You need dietary carbohydrate in order to produce melatonin in your brain. Melatonin counters cortisol, among other things. Without enough melatonin in your brain, sleep isn’t happening!
    • People with Adrenal Fatigue may have insufficient cortisol levels to stabilize their blood sugar for long periods of time. I notice that people with low cortisol often suffer on low carbohydrate diets, because their body can’t shift into carb generation mode in the liver (which is where your body sources stored carbs between meals). When your blood sugar drops while you’re sleeping, adrenaline kicks in and you wake up out of a dead sleep, wondering what is going on. To avoid this, consume more of your carbs at your evening meal, close to bed time.
    • Each person’s carbohydrate need varies widely based on activity level and baseline metabolic rate. It can also differ at different phases in life. Depending on age, gender, activity level, pregnancy status, and weight maintenance goals, people need anywhere from 50-350 grams daily. With sleep difficulty, I recommend that my clients not go below 75 grams daily. The only way to know what is right for you is to experiment and observe.
    • Again, take activity level into consideration —if you are training for a triathalon, 50 grams per day is simply not going to cut it. If exercise looks like a walk to the mailbox daily, you aren’t going to need above 150 grams. Adjust these levels until you find the right fit for you.

Tip 6: Develop An evening ritual helps prepare your body/mind for sleep.

Here are some possibilities to choose from:

  • Journal- If you are someone who lays awake thinking of your to do list, get it all out on paper before-hand. Planning for the next day by writing a brief list can help short-circuit the mental spinning. Alternately, write down what you are grateful for that day, or journal. Consciously release and hurts or resentments you are feeling.
  • Have a cup of herbal tea (e.g. “Sleepy Time”)
  • Have a bath with Epsom salts—start with 1 cup in a warm (but not overly hot) bath. Add relaxing essential oils like lavender, chamomile, sandalwood, or vetiver if you enjoy these.
  • Use a diffuser in your bedroom & use lavender essential oil before bed.
  • Do some gentle stretching, or yoga. I personally love using my foam roller to roll out kinks and knots.
  • Try progressive muscle relaxation--this has been shown to help reset cortisol rhythm. There are many version of this available on Youtube, such as this one.
  • Do “4-7-8” breathing:
    • Breathe in through nose for 4 counts
    • Hold your breath for 7 counts
    • Exhale through mouth for 8 counts
    • This combination of count ratio slows heart rate and relaxes the sympathetic nervous system.

Do the same ritual every night, as you are training your body and mind to unwind from the day and giving it the message that it’s time for sleep.

Tip 7: Supplement Support:

Ideally, supplements should only be used after the above steps are being taken consistently. But tossing and turning night after night can really put a damper on your mood, not to mention your glucose control, sugar cravings, weight, hormone balance, and overall health. There is no one sleep supplement that works for everyone, and these are just several recommendations that are generally safe for people to experiment with on their own.

If you are still struggling, work with your practitioner to identify key issues that are at play with your insomnia, such as hormone imbalances, parasites, inflammation, neurotransmitter issues, toxicity, sleep apnea, or other causes.

Consider:

  • L-Theanine- 200-400 mg
  • Magnesium- up to 1200 mg, in divided doses daily. Use the chelated forms for best tolerance.
  • Liposomal CBD- 1ml-4ml before bed.
  • Calming Herbs – Lemon balm, Passion flower, Valerian root (like this blend)

Looking for further help with improving your sleep? We'd love to help you!