Article at a Glance
- Candida albicans is a type of yeast present in healthy intestinal tracts. However, Candida can become pathogenic and invasive after use of broad spectrum antibiotics, a high sugar diet, or an illness that suppresses the immune system.
- Diagnosing Candida overgrowth with lab testing is difficult. Experienced clinicians recommend a “totality of the circumstances” approach that factors in all symptoms and circumstances.
- Some mold species cross react with Candida.
- Candida overgrowth can be caused by allergy.
- Carbohydrates, and especially grains, can cause Candida to worsen.
- Oregano has been shown in a handful of studies to kill Candida, but it can also kill good bacteria. Since an imbalance in the microbiome is what causes Candida to spread, powerful antimicrobial herbals could make Candida worse.
- Supplements like Pycnogenol and Nrf2 activators like curcumin and sulforaphane will be a better option for some.
Candida overgrowth or infection is the hallmark of an overstressed immune system.
C. Orian Truss, M.D.
My Mother’s hair dresser is convinced she has Candida.
I was with a friend a few weeks ago in L.A. who casually dropped Candida as the reason she “really shouldn’t have ice cream.” Candida is a trendy diagnosis these days, but how often is it to blame for symptoms such as digestive upset, poor immune function, loss of sex drive, joint pain, and brain fog?
The Candida echo chamber
The internet is an echo chamber. If you’ve done any research before arriving here, you already know that sugar feeds Candida, and that a depleted microbiome, often as the result of repeated antibiotic use, allows Candida to spread and do damage in the gut, so I won’t recite all the basics in this post.
Instead, my goal is to shed light on some forgotten Candida treatment tips that may just strike at the foundation of yeast overgrowth for sensitive individuals. I will be highlighting an interesting paper, titled Restoration of Immunologic Competence to Candida Albicans, written by C. Orian Truss, M.D., that offers unique insights into the yeast overgrowth problem. Dr. Truss’ paper is especially appealing because it offers multiple theories of susceptibility to Candida, rather than one uniform / dogmatic rule. I also borrow from the research of Dr. Neil Nathan and his new book Toxic, which is a good read for anyone battling chronic pathogen related issues.
The Gene Food research team has a few light bulbs to offer as well, so here we go.
But before we get into the meat of treating Candida, let’s begin with the difficulty of diagnosing Candida overgrowth. As we will see, lab work can be hit and miss, and if you’re going to go on a Candida protocol, it’s probably a good idea to at least be fairly sure you’re dealing with yeast overgrowth before you start on an anti-fungal regimen.
In other words, work with professionals to get a handle on your lab work before jumping into a Candida protocol.
Diagnosing Candida Overgrowth
When people say they “have Candida,” what they mean is that they have, or believe they have, a Candida overgrowth. Candida albicans, or Candida for short, is a type of yeast that routinely populates the human intestinal tract. As with histamine, everyone has Candida in their body, it becomes a problem when lifestyle factors, such as years of drinking, use of broad spectrum antibiotics, NSAIDs, birth control, or even a high sugar diet cause depletion of our “good” gut bacteria which makes room for Candida to expand beyond its healthy borders.
What are the tests people use to diagnose a yeast overgrowth?
Home spit test
Less than scientific, but popular. First thing in the morning you spit into a glass of filtered water before eating or drinking anything, or even brushing your teeth. Wait 20 minutes to see if you find “strings” coming down from the water’s surface, which is thought to be a sign of Candida overgrowth.
Candida emits toxins into the body, and gliotoxin is one of them. When Candida is running amuck, gliotoxin levels can be elevated. (R) And guess what, gliotixin is an immunosuppressant. Multiple sclerosis patients often present with elevated gliotoxin. (R) However, there is controversy over whether Candida causes elevated gliotoxin levels. Some believe high levels of gliotoxin in the urine is a sign of mold exposure and colonization, with Candida present as one of a few fungal invaders.
Living in a moldy building will cause your gliotoxin levels to go up, and the folks that run one of the best known labs for testing gliotoxin don’t even list Candida as one of the causes for out of range results.
Although it’s a clue, you can’t 100% say you have Candida overgrowth just because you have elevated gliotoxin. Having said that, elevated gliotoxin does signal an issue with mold toxicity, so the protocol for healing will be similar, but not identical. Dr. Nathan and colleagues have different treatment protocols set up for the various mycotoxins found lurking in the human body.
IgG, IgA, and IgM Candida antibodies
Are Candida antibody tests reliable for diagnosing an overgrowth? Many on the internet seem to think so. And yes, you can test for elevated Candida antibodies, BUT 20-30% of healthy adults will test positive (presumably because Candida is commonly found in healthy individuals), so this isn’t necessarily a conclusive test either. (R) As with gluten sensitivity tests measuring for tissue transglutaminase antibodies, those with suppressed immune systems may show up with a false negative, if for example, their serum IgA levels are low.
Comprehensive stool testing can measure for yeast overgrowth, among other things.
Urine Organix Dysbiosis Test
Candida releases over 70 different toxins. One of these is D-Arabinitol, which the Urine Organix Dysbiosis test measures for. (R)
Practical testing considerations
Since none of the methods for diagnosing Candida listed above are 100% foolproof, most clinicians believe we should use a “preponderance of the evidence” analysis when diagnosing Candida.
If you have intense sugar cravings, digestive issues, aching joints, positive labs for leaky gut, and elevated gliotoxin on top of it all, we can make an educated guess that there is an issue with your gut health, and Candida could be one of the contributing factors.
Also, as I mention above, the dietary protocol for treating Candida and for treating mold is often very similar, with many people struggling to detoxify from mold exposure turning to a low amolyse diet. Amolyse is an enzyme that converts starch to sugar, and sugar is what we want to avoid when beating back fungus. Side note: this does not mean a ketogenic diet is the answer. Some studies indicate Candida can thrive on ketones.
Ok, so you’ve run the gauntlet of tests and believe you could be suffering from an issue with yeast. What do you do to treat the problem?
Avoid sugar to beat Candida
You know this one, this is the obvious first step. Don’t eat sugar or refined grains, and limit carbs, especially fruit (although, with the exception of bananas, fruit isn’t limited on the low amolyse diet). All of these sugars feed the yeast and may worsen symptoms.
Against that somewhat obvious dietary advice, let’s get into our list.
Candida treatment options
The purpose of this list is to address, what for some people, will be the root cause of their yeast problems. Ask yourself: why has Candida reached unhealthy levels in your gut? Taking a supplement like oregano may beat back some of the yeast for a time, but will it stop the process that gave rise to the infection in the first place? We want to rip up the yeast overgrowth at the roots so it won’t come back.
Have your home tested for mold
Many molds that do not exist within the body have some degree of cross antigen-icity with Candida albicans. Patients often notice aggravation of symptoms in environments characterized by a high count of mold spores.
We’ve given him a little flack on the blog over what Bulletproof coffee does to some people’s lipid markers, but this is an area where Dave Asprey is to be congratulated. He has been sounding the alarm on the dangers of mold for years now with documentaries like Moldy. It was Dr. Truss’ paper that first turned me on to the idea that Candida is cross reactive with other species of mold, so if you’re having issues with Candida, it could be a problem with the air in your home, or even the air in your city. For example, Austin, where I live, has sky high mold count at most times of the year. Based on Dr. Truss’ theory, Candida symptoms can fluctuate based on mold exposure, so do a thorough audit of your environment. Of course, mold if is not limited to the air, it is also found in trace amounts in grains as well, which leads us to our next option for treating Candida, a grain free diet. (R)
See also: Are you allergic to Austin?
Many patients are allergic to the cereal grains, while others exhibit an abnormal response to carbohydrate in the glucose tolerance test. Carb restriction may eliminate such food antigens from the diet, and also may correct the excessive insulin response that results in hypoglycemia.
Dr. Truss mentions allergy to cereal grains as a potential cause of Candida overgrowth, again citing the potential for mold in these crops, that are grown in bulk, and then stored in bulk, where mold can grow. If this seems like a bridge too far, keep in mind that celiac disease is an autoimmune reaction to grains, and it’s on the rise, with incidents of celiac rising by 400% in the last 40 years.
Consider this article from the government of Manitoba about the deleterious effect of mold in grains on the health of livestock. High mold levels in feed are blamed on the loss of livestock, and are a known cause of disease. The equation is essentially how much tainted grain can a cow eat before the microbiome of the rumen (it’s stomach) is disrupted, resulting in disease.
It is also undisputed that mold inhabits our human grain supply, it’s just another area where government regulators tell us what are “safe levels.” Ochratoxin A, a sinister mold toxin, has been found in our breakfast cereal. (R)
This is an easy test to run – cut out all grains for a month and see how you feel. If the issue goes beyond grains to an “excessive insulin response” as Dr. Truss argues, perhaps it’s worthwhile to look at markers like HbA1c, or a glucose tolerance test to see how the body is reacting to glucose immediately after a high glycemic meal in what is known as the “post prandial” period.
Allergy drops or shots
Many Candida infections are secondary to allergic responses of the mucous membranes of the respiratory tract, urethra and bladder.
Candida becomes invasive most often in two regions of the body: the intestinal tract and the vagina, or urogential area. Guess what? This is also where mast cells, the cells that release histamine, are found in highest numbers. Mast cells don’t just release histamine, they release an inflammatory cocktail of immune cells to combat invaders. However, when these substances are chronically released, they cause inflammation.
In essence, Dr. Truss is saying that the process of local mast cell degranulation, over long periods of time, weakens tissue, which invites Candida. Toxins released by the yeast degrade the immune system further, which makes the local infection more difficult to combat. The idea of Candida being “invited” into a region of the body is not without precedent, even on this blog. I recently wrote a men’s health post on prostatitis which featured a study finding that many young men who believe they have prostatitis actually have yeast infections, and it’s E. Coli that allows the yeast to spread to the bladder and prostate in the first place.
Consider this case study of Interstitial Cystitis (IC) being successfully treated with an allergy protocol. For those who don’t know, IC is a chronic inflammation of the bladder, which usually occurs in women. The case study called IC “one of the allergic disorders of the urogenital system,” and that is exactly Dr. Truss’ point: traditional allergy can inflame tissue which invites Candida. This leaves allergy shots and drops, or moving to a location where no airborne allergens are present, as options for treating Candida.
Address thyroid issues
Endocrine or other metabolic abnormalities may impair the immune response, hypothyroidism being a common example.
Again, another one that makes sense in light of what happens when people develop a thyroid issue, which are autoimmune conditions. When the immune system is attacking the thyroid, presumably, it is also causing inflammation, just as chronic mast cell activation does with traditional allergy. The resulting weakening of the immune system invites the spread of pathogenic bad guys like Candida, which are also immunosuppresants.
Skip the Oil of Oregano
Repeated courses of antibiotics and birth control pills, often punctuated with multiple pregnancies, lead to ever increasing symptoms of mucosal infections in the vagina and gastrointestinal tract.
Avoid oregano? Thought it was great for Candida? Well, that’s what the echo chamber would have you believe, but the data isn’t overwhelming in favor.
For a reliable anti-fungal, Nystatin seems to be the best option, both spray and pill form according to Dr, Nathan.
If you’re first looking to go the nutraceutical route, my thinking is don’t do more damage to an already depleted gut with an “herbal broad spectrum antibiotic” that will continue to destroy the good bacteria along with the bad. It was the antibiotics that got you into this mess in the first place, so why take more?
Oil of Oregano has shown some limited promise in treating Candida in vitro, but it doesn’t stop at attacking fungus, it’s a powerful antimicrobial agent across the board.
An oregano supplement has the potential harm healthy flora in your gut, and for this reason, it could actually make a Candida problem worse over the long term.
However, despite the fact that the “internet echo chamber” has concluded that oregano is a must have for fungal overgrowth, there aren’t a ton of studies that show efficacy. For example, the Dr. Axe article referencing oregano oil’s ability to kill Candida cites to this study. However, that study mentions oregano’s potency as an antimicrobial, but Candida isn’t listed as one of the pathogens successfully targeted:
dictamnus (oregano) essential oil and its main components were effective against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Listeria monocytogenes, Salmonella Enteritidis, Salmonella typhimurium, Saccharomyces cerevisiae, and Aspergillus niger.
Dr. Axe’s primary experience with Candida seems to be as an effective yeast overgrowth treatment for his mother, which is fantastic, but not enough to up the science score. This comprehensive Candidiasis page on the University of Maryland Medical School website doesn’t even mention oregano as a natural treatment for Candida. Tea tree oil, probiotics, garlic and others are all mentioned. Not to say that oil of oregano doesn’t kill Candida, it might, just suggesting you tread with caution as oregano can also kill “friendly” bacteria as well, and it’s the friendly bacteria that are there to keep Candida in check in the first place. As always, check with your health care provider before starting or stopping any supplement regimen.
The best Candida supplements
Remember, everyone has Candida in their system — the goal is to strengthen a depleted immune system so it doesn’t overgrow its borders.
Supplements to treat Candida
Instead of oregano, I would opt for immune-boosting antioxidants like pycnogenol and glutathione, and combine them with Nrf2 activators such as sulforaphane and curcumin.
There is a dual role here. First, Pycnogenol, which is French Maritime tree bark extract, is an excellent immune system booster that has also shown promise as an anti-fungal. (R)(R) See also: antimicrobial activity of Pycnogenol
Next, activation of the Nrf2 pathway, which put simply, is a pathway that turns on the body’s detoxification genes, such as GSTP1, will help to step up the ability to clear the toxins generated by Candida. Candida’s toxic byproducts are part of what suppress the immune system. Through emission of toxins like acetaldehyde, Candida puts added strain on the liver, making production of endogenous antioxidants, like glutathione (stimulated by Nrf2), all the more important. So, in essence, although Nystatin is probably best, the “all natural” protocol is zero sugar, an immune-boosting antioxidant, and supplements that help to detoxify the body.
Another option here is taking glutathione or NAC directly. The idea is to stimulate detoxification pathways in the body that will allow for the clearance of excess toxins that have been building up, but NAC in particular also has the ability to clear Candida biofilms. In his e-book, Mold and Mycotoxins, Dr. Neil Nathan also lists S. Boulardii as a good binding agent if gliotoxin levels are elevated.
Even though his treatment protocols are offered in the context of dealing with mold toxicity, Dr. Nathan may be on to something as the data for S. Boulardii killing Candida is greater than for oregano. (R)
A big part of treating a Candida overgrowth will be to avoid sugar like the plague, especially at first.
Beyond that, I hope this article and Dr. Truss’ work offered up some relatively novel theories as to why some people may be prone to developing a Candida overgrowth in the first place. Although the science score is low because these theories are new, and largely based on clinical experience, I hope they will be useful for someone out there looking for clues to unravel their own health mystery.