In the last 18 years of being a nutritionist I have seen hundreds and hundreds of patients who consider themselves “riddled” with Candida, who follow anti candida diets in the hope that their considerable long list of unrelated symptoms will disappear. I have not written on this subject before mostly because at best it is controversial but also it’s endless. Most GP’s will not recognise Candida as a systemic illness, but a localised yeast infection in the mouth, genital area, or as fungal infections on the skin and scalp. In its extreme state, with lowered immunity Candida can present with serious life threatening symptoms, this was particularly seen in the 1980’s in Aids patients due to their extremely lowered immune systems. As Candida is an opportunist it will grow where it can. The question mark however is over whether humans can have an overgrowth of yeast in the gut and whether this can then migrate through the blood stream and cause systemic symptoms. Much of the so called “ME” or chronic fatigue syndromes seen in the 1990’s saw a plethora of therapists diagnose Candida as the one size fits all problem for patients with seemingly complex symptoms that were not responding to orthodox treatment. This month I will be covering the realities of what Candida is, and how it manifests, how to test for it, and what to do if you feel you are suffering with the condition.
What is Candida?
Candida is a genus of yeasts and is the most common cause of fungal infections worldwide. Many species are harmless commensals (living in a relationship in which one organism derives food or other benefits from another organism without hurting or helping). Commensal bacteria are part of the normal flora in the mouth. Systemic infections can occur in the bloodstream and major organs of immunocompromised patients. Candida albicans is the most common fungus that lives in the mouth and the GI tract. Antibiotics can promote yeast infections, including gastrointestinal Candida overgrowth, and potential penetration of the GI mucosa. While women are more susceptible to genital yeast infections, men can also be infected. Certain factors, such as prolonged antibiotic use, increase the risk for both men and women. People with diabetes or impaired immune systems, such as those with HIV, are more susceptible to yeast infections.
Treatment commonly includes:
– Nystatin
– amphotericin B, caspofungin, or fluconazole for systemic infections
– fluconazole or caspofungin for oral or esophageal infections
– topical azole for vaginal infections
How do you get Candida?
Almost everyone has Candida Albicans in their gut, and a proportion of us may have Candidiasis, (an overgrowth of Candida). Candida Albicans may start to cause trouble when there is some change in your body that allows it to overgrow. This change could be anything from a few courses of antibiotics, a prolonged diet rich in carbohydrates and sugar, or even something as common as a lengthy period of stress at work. So if you suspect that you have an overgrowth, the first place to look is your lifestyle to find what could have caused this imbalance. Antibiotics? Oral contraceptives? A diet high in sugar and carbohydrates? Alcohol and drugs? Stress? Or all of the above? Eliminating all of these risk factors is a crucial step in tackling your Candida problem. If you have diabetes or are immunosuppressed for any reason, you are certainly more susceptible to this condition.
Is Candida Always Bad?
Is Candida a bad thing? Ordinarily it isn’t – the Candida Albicans population is kept under control by the friendly bacteria in our gut. However, when your immune system is low, Candida can start to multiply and may quickly take over. Candida is such a difficult condition to diagnose because it can affect each sufferer in a different way, on a different part of their body, in a way that may even be unique to that person. For this reason, Candida is often misdiagnosed and the symptom is treated instead of the underlying cause. Patients often have to diagnose themselves because the symptoms of Candida are so confusing, and often the diagnosis is not accurate. For every 100 hundred people I see that tell me they have Candida only 10% actually do have this condition. Looking at the list of symptoms you can see why there is much confusion and misdiagnosis. This is the long list of symptoms that Candida may potentially cause, however as you can see many of these symptoms can be caused by other illnesses.
Inability to focus, Poor memory, Brain fog, Irritability, Anger, Dizziness, Depression, Crying spells, Panic attacks, Low libido, Persistent extreme fatigue, Hyperactivity, Cravings for sweets and alcohol, Insomnia, Poor coordination, Acid reflux, Bloating, Flatulence, Nausea, Diarrhoea, Constipation, Stomach cramps, Indigestion, Burping after meals, Mucus in stool, Hemorrhoids, Itching anus, Acne, Cysts, Hives, Night sweats, Psoriasis, Eczema, Dermatitis, Fungal infections of the nails & skin, Athlete’s foot, Body odor, Thrush, Swollen lower lip, Halitosis, Metallic taste in mouth, Bad breath, Canker sores, Bleeding gums, Cracked tongue, Persistent cough, Mucus in throat, Sore throat, Sinus congestion, Chronic post-nasal drip, Flu-like symptoms, Hay fever symptoms, Sinusitis, Asthma. Eye pain, Itchy eyes, Sensitivity to light, Blurred vision, Bags under eyes, Ringing in the ears, Ear infections, Recurring yeast infections, Recurring UTI’s (urinary tract infections), Cystitis (inflammation of the bladder), PMS & menstrual irregularities, Fungal rash, Frequent colds and flu, Allergies, Sensitivities to food, fragrances and chemicals, Inability to lose weight, Water retention, Weight loss.
Candida and your diet
As many of you who read my articles will know the modern diet is high in sugar. Since yeast needs sugar to thrive and multiply, a reduced sugar diet may reduce some symptoms. This would also include high GI foods that convert to quick release sugar eg white rice and alcohol. A healthy immune system should be able to keep Candida at bay. However, a diet rich in sugar may depress your immune system, leaving it vulnerable allowing the Candida yeast to proliferate. The anti candida diet eliminates mouldy, yeast containing foods, which can include sauces, coffee, tea, packaged and processed food. However I have a problem with anti candida diets and after nearly twenty years of seeing my patients suffering I think its time to speak out. A diet is a diet, so fundamentally any diet you are on, you have to be on for life otherwise the problem is still there, this goes for weight loss as well. The anti candida diet has made many of my patients feel unwell in the long term, mental health issues can rear due to the fundamental lack of all B vitamins in the diet, which can lead to anxiety, depression and quite frankly neurosis. I have seen women who are eating nothing but rice cakes and tahini in the fear that every food contains sugar – even the humble baked bean becomes a no-no! When you reach this point you have to ask yourself what is really happening. If you do have a candida infection, and I say “if” get that eradicated first. A yeast free diet does not eradicate the yeast already present. It is also a whopping leap to say that the anti candida diet is the magic bullet. Removing junk food, processed food, sugar, coffee etc may make you feel better anyway just because you are now on a healthier diet. However when you get to the stage of not being able to eat a bowl of porridge as it feeds the yeast as a patient told me last week, we know we have gone too far. I have also specifically not talked about alternative ways to eradicate Candida, ie grapefruit seed extract, caprylic acid etc because mostly they don’t work.
What do to if you suspect you have Candida?
The first point is to get a proper diagnosis with proof that this is indeed what your symptoms are due to, and no this does not mean getting hooked up to vega machines and other such nonsense. There are now orthodox blood and stool tests which can be used to detect Candida and more often than not they are negative. If the symptoms are mostly gut related it may be an intestinal permeability issue which is a totally different problem and needs to be treated by a professional.
Overview of Candida
As I have said, I have issues with so called Anti Candida diets. Patients swear by them and how much better they feel. However this could be nothing but coincidence for many people because if you change your diet from a high sugar, high carbohydrate, junk food diet to a diet low in sugar, you may very well feel better anyway. Blood sugar will be balanced, certainly there is now scientific evidence that a high sugar diet can “feed” a yeast overgrowth – this often happens in diabetes. The problem is unless you stick to an anti candida diet all your life, the problem is still there. In my clinics, the figures speak for themselves. For every 100 people who are convinced they have candida, only ten really do have this which is proven with a stool or blood test. That is a very low proportion. What they find is that the bloating, gas, wind, aching, brain fog may indeed come from intestinal permeability or Small Intestinal Bacterial Overgrowth, lactose intolerance, fructose intolerance, low gut flora, bad intestinal bacteria, parasitic infections, or an underactive thyroid. The problem with the symptom list is they are very similar.
I would love to tell my patients that lactose intolerance gives you a blue finger, SIBO gives you a purple finger, Candida gives you a green finger and parasitic infections give you a red finger. Unfortunately the problem with diagnosis is that all the symptoms they present are fairly non specific and similar. Find the cause, don’t treat the symptoms is always my motto. You simply cannot be on a diet for the rest of your life, be it weight loss, GAPS, FODmap, specific carbohydrate, or anti candida – you need a life. If indeed you do have candida then this needs to be eradicated. So if you have done, or are on an anti candida diet, and doing ok but as soon as you stop, the symptoms come back, something somewhere is wrong.
If you suspect you have Candida or are interested in being tested please contact Kate Arnold on 01323 737814 or email her at katenut @aol.com www.katearnoldnutrition.co.uk
