What CAN Candida Do?
FUNCTIONAL MEDICINE
Laurie Mueller
DC, CFMP
When most of us think of Candida, we think of a yeast infection, such as thrush in infants or vaginal yeast overgrowth in women. There is, however, another yeast problem that is highly prevalent but has gone unrecognized— Candida albicans yeast overgrowth in the gut.
In the realm of functional medicine, proper assimilation is paramount to correcting other imbalances and symptoms throughout the body. Thus, when the microbiome is out of balance, it has the potential to affect all other functions, from hormones to immunity to our mitochondria and energy. After all, the gut is where we absorb the nutrients that every cell in our body requires for function, and the MALT/GALT systems in our gut represent over 70% of the entire immune system.
Imbalance in our gut microbiome has been linked to a variety of issues ranging from expected GI issues, such as IBD, IBS, malabsorption, leaky gut, bloating, and discomfort, to other wider systemic manifestations of disease, such as obesity, type 2 diabetes, and atopy/allergic manifestations. Equally as important, imbalance can influence our neurologic function and affect memory, mood, and cognition, and they are also clinically and therapeutically relevant to a whole range of disorders, including migraines, alcoholism, chronic fatigue, fibromyalgia, and restless leg syndrome. Also, keep in mind with this discussion that leaky gut/increased gut permeability has also been correlated with the manifestation of autoimmune disease conditions, which is a profound connection.
The presence of these naturally occurring “bugs” is actually required normal, and healthy if in proper balance.
In this article, we will focus most specifically on Candida albicans. Along with a plethora of bacteria that inhabit the gut, Candida albicans yeast is a naturally occurring microbe that plays a vital role in digestion and nutrient absorption. The presence of these naturally occurring “bugs” is actually required, normal, and healthy if in proper balance.
What is relevant clinically is when these become out of balance. Candida is quite an opportunist, and when the conditions are right (or wrongly imbalanced as the case may be), will allow Candida to multiply, take over, and break down the wall of the GI tract to eventually lead to systemic manifestations.
Candida Overgrowth Might not Present with GI Symptoms
Candida overgrowth may or may not have GI symptoms. Certainly, some patients may have bloating, excess gas, or even have stools with frothy, foamy, or a stringy mucous component, but not always. What they may note is a variety of seemingly unrelated issues, such as unexplained fatigue/general malaise, frequent colds or flu-like symptoms, bloating, gas, new food sensitivities, diarrhea, constipation, brain fog, ADD, memory problems, poor concentration, sleep disturbances, mood swings, anxiety, depression, irritability, low libido, and skin issues that seem to come out of nowhere like unex-
plained rashes, eczema, psoriasis, acne, or nail fungus.
Patients may also have noted (usually when brushing their teeth) a subtle white coating on their tongue, and they may also report craving processed foods, especially carbohydrates, sugar, bread, pasta, or even have a strong craving for alcoholic beverages. All of these things feed the yeast. Some of these patients may have already received some type of vague alternative diagnosis such as CFS. Patients with these types of symptoms or diagnoses can often benefit greatly with a protocol to restore balance to the digestive tract.
What Triggered the Overgrowth?
The GI system can be thrown out of balance for a variety of reasons: stress, antibiotic use, a diet high in sugar and processed foods, use of oral contraceptives, medications, and excessive alcohol consumption, to name but a few.
Every patient is different. Certainly, many reached this stage by requiring antibiotics that killed off good bacteria along with the bad. This allowed yeast to take over. The balance was lost. Watch mindfully in children for this because there are so many kids who take increasing numbers of antibiotics. If a seemingly normal child has been on and off antibiotics (say, for recurring ear infections), and their parent says they are now exhibiting some issues of things like mood swings, ADD, concentration issues, GI issues, fatigue, etc., it may be of great benefit to follow a protocol for gut health quickly in that child. Of particular interest for adults is how high stress in twenty-first-century living can negatively affect our microbiome through the adrenal gland. These types of timeline details should serve as food for thought in your patient history.
Testing
History by itself may give you a good idea that Candida is a consideration. However, you can also consider other types of analysis, such as stool studies or organic acids in the urine. Fair warning that these can be expensive and often are not covered by insurance carriers. Stool studies for microbes and parasites are self-explanatory. In urine, we are looking for organic acid levels. Organic acids are chemical compounds that are products of mammalian metabolism and excreted in the urine. If something is there that shouldn’t be, it provides a great clinical clue about what is happening inside the body.
For example, arabinose, tartaric acid, and 3-oxoglutaric acid found during organic acid testing would highly indicate yeast overgrowth in the GI tract. One laboratory in particular found that tartaric acid levels in autistic children was extremely elevated, and in some cases up to 600 times. The only source of tartaric acid from the human body is yeast.
Organic Acid Testing (OAT) Yeast Indicators
Intervention Snapshot
There are several steps to help cleanse Candida from the GI and rebalance the gut. Note that if the infection is severe enough that a drug intervention may be helpful you may co-care with a physician that can prescribe a Nystatin-type product. Keep in mind, however, that once the prescription is finished, that if the patient does not follow the other steps, the infestation may very well reoccur.
1. Starve the yeast. Stop eating things that feed yeast; sugars and simple carbohydrates must be cut from the diet. This means sweets, alcohol, bread, and pasta. It may be prudent to cut out dairy and all gluten products since they tend to be inflammatory in many people. Protein, complex carbs, and good fats are what you want. Basically, an anti-inflammatory diet. Coconut oil may be helpful here as well. Do this with #2 below.
2. While starving the yeast, also supplement with products to kill them. If not on a prescription, a supplement such as caprylic acid will aid in breaking down the yeast cell wall. Caprylic acid may also be considered to aid the patient to keep the yeast at bay after the prescription is done (along with the dietary changes).
3. Continue those steps above to give the gut time to heal from damage. The patient must continue an anti-inflammatory diet. Now, we add supplementation of preand probiotics to feed and replenish the good bacteria/microbes in the gut flora.
There are many effective programs out there to help patients with the details of this process, but the nuts and bolts of most of them will encompass the steps above.
As your patients present to your office with varied or strange symptomatology, keep the gut and microbiome on your radar.
Laurie Mueller, BA, DC, CFMP served in private practice in San Diego, California. She was the post-graduate director at Palmer College from 2000-2010; served as the ACC Post Graduate subcommittee chair for 6 years; peer reviewed for the Research Agenda Conference, and wrote the informal role determination study that aided in the development of FCLB's guidelines for chiropractic assistants (CCCAs). Dr. Mueller currently works as a private eLearning consultant with a focus on healthcare topics and functional medicine through her company, Impact Writing Solutions LLC, and subsidiary www.CCCAonline.com. She is a clinician, an educator and an expert in online educational pedagogy.
References
1. Allergy and the gastrointestinal system Clin Exp Immunol. 2008 Sep; 153(Suppl 1): 3-6 G Vighi, * F Marcucci,‡ L Sensi,‡ G Di Car a, I and F Fratif
2. The Human Gut Microbiome in Health and Disease Parti IntegrMed (Encinitas). 2014Dec; 13(6): 17 22. Matthew J. Bull, BSc, PhD and Nigel T. Plummer, PhD
3. The Gut Microbiome and the Brain J Med Food. 2014 Dec 1; 17(12): 1261-1272. Leo Galland
4. Leaky Gut As a Danger Signal for Autoimmune Diseases Front Immunol. 2017; 8: 598. Published online 2017 May 23. doi: 10.3389 funmu. 2017.00598 Qinghui Mu,l Jay Kirby, 1 Christopher M. Reilly, 2 and Xin M. Luol, *
