In 2002 Erin Delaney was living in Mexico with her partner and their infant daughter when she started feeling sick. “I was tired, moody, and in a fog,” Delaney recalls. She wondered if her feelings were due to the newfound stress of parenting, but over the next two years — as her baby grew into a bubbly toddler — Delaney felt further disconnected from her old, easygoing self.
When her family returned to the United States in 2004, she saw a holistic practitioner who asked her about her diet (not great), her stress level (high), and her history of food sensitivities (gluten). Ultimately, he diagnosed her with candidiasis.
Candidiasis is a fungal infection caused by the yeast Candida albicans, which is found in the dark, damp crevices of the body, especially the mouth, digestive tract, and vagina. It is sometimes called “candida” for short.
This microbial yeast is just one of thousands of yeast species that populate our environments and grow on sugar-rich surfaces, such as fruits. Baker’s yeast and brewer’s yeast, for example, both come from a species that grows on the skin of grapes.
In itself, candida is not a problem. “Normally, Candida albicans is a passive, friendly neighbor,” says functional-medicine physician Greg Plotnikoff, MD, author of Trust Your Gut. But ordinary health disruptions can trigger it to run amok, disturbing the harmonious balance of flora in the gut and creating a variety of problems.
In hindsight, Delaney was juggling multiple disruptions. “I was a new mom, in a new country, with a new baby,” she says. Thinking back on her time in Mexico, she also believes her diet made things worse.
“I’d always been careful to avoid gluten,” she says. “I couldn’t eat wheat without paying for it later with gas and bloating.” But life in Mexico, where pastries are abundant, often involved breads and sugary snacks.
On the advice of her practitioner, Delaney gave up wheat, dairy, and sweets, because yeast thrives on sugar. She also cut back on fruits and grains and ate more vegetables.
“Change didn’t happen overnight,” she says, “but within two to three months, the fog lifted. I was able to interact with my daughter again without feeling like I was seeing her through a glaze.”
Candida in Question
Candida overgrowth is a controversial diagnosis. Most conventional physicians doubt that too much of a particular yeast can cause the digestive and cognitive issues Delaney experienced, even as conditions such as thrush, diaper rash, and vaginal yeast infections are commonly attributed to yeast overgrowth.
Holistic-minded practitioners, meanwhile, have long suspected candida overgrowth is a possible trigger for a host of nonspecific symptoms, including fatigue, bloating, eczema, dandruff, sugar cravings, weight gain, and brain fog.
“Western medicine says because there is no test for [yeast overgrowth], it must not exist,” says fibromyalgia specialist Jacob Teitelbaum, MD, author of Beat Sugar Addiction Now! “But the best way forward if you have the symptoms is to treat them. If the problem goes away — and it usually will — that’s the most important evidence.”
Fungi make up less than 0.1 percent of the human microbiome, but they’ve carved out their own little piece of real estate: the mycobiome. (“Myco” means “related to fungi.”) Research on the mycobiome is still in its infancy, but 267 fungal species have been identified. One of the most abundant is candida.
To repeat: There is nothing inherently unhealthy about candida. The yeast is found in around 70 percent of the human population. As long as a person’s immune system and microbiome are healthy, candida usually lives peacefully alongside trillions of other organisms in the gut.
But when the microbiome is under stress, candida can become troublesome. It seizes any opportunity to spread into new territory, crowding out good bacteria and messing with the immune system.
Researchers are now seeing its fungal fingerprints all over such digestive ills as inflammatory bowel disease, irritable bowel syndrome, even chronic liver disease.
Exactly why Candida albicans is the delinquent of the yeast family (there are dozens of yeast species) is not well understood. But as research on the microbiome and mycobiome continues to indicate, the health of the gut plays a part in a huge range of issues.
“Gut health is the foundation of all health,” says Plotnikoff. “Anything and everything you can do to optimize gut health will be meaningful.”
If you suspect your health issues are related to candida, the following factors may be contributing to yeast overgrowth:
Taking antibiotics. These drugs are one of the most common microbiome disruptors. Antibiotics kill good and bad bacteria, but they don’t touch yeast. So, when antibiotics decimate the gut’s beneficial bacteria, candida is left to proliferate without their checks and balances. This may also be why women frequently experience vaginal yeast infections after a course of antibiotics. In one study, when researchers gave mice antibiotics, the amount of yeast in the mice’s guts leapt 40-fold.
How long it took for the animals’ microbiomes to recover depended on the type of antibiotic. Human studies show antibiotic-related damage to the microbiome can last as little as a week or as long as four years, depending on the drug.
Eating copious sweets. Yeasts eat sugar and release gas, which can cause digestive bloating when it happens in the intestine. The process is not unlike how yeast helps bread dough rise: It breaks down flour into its component sugars, gobbles the sugar, and releases carbon dioxide and ethyl alcohol into bubbles in the dough.
When yeast overgrowth is present, any refined carbohydrates you eat help feed the hungry candida in the gut’s neighborhood. The more candida consumes, the more gas it may release, and the worse you feel.
Having a leaky gut. Leaky gut occurs when partially digested microscopic food particles leak out of a damaged digestive tract and into the blood. The immune system attacks these particles, which can create food sensitivities and chronic inflammation. This distracted immune system can also lead to other issues.
“An imbalanced immune system may be less able to recognize and police candida overgrowth in the gut,” says functional and integrative practitioner Michael Ruscio, DNM, author of Healthy Gut, Healthy You. (For additional information about leaky gut syndrome, see “How to Heal a Leaky Gut”.)
Filling up on processed carbohydrates. Carbs from starchy processed foods (especially white breads, white pasta, and white rice) have long been implicated in candida overgrowth. Recent research found a correlation between carbohydrate intake and an “abundance of candida” in the gut.
“Get off of processed foods and focus on whole, fresh, unadulterated food,” says Ruscio. “It’s a necessary exercise for everyone.”
Overdoing the alcohol. Candida loves booze. Scientists at the University of California San Diego found not only that fungi thrived in the intestines of mice exposed to high doses of alcohol, but that the inflammation created by the spawning fungi sped up the onset and progression of alcohol-related liver disease.
Being a woman. Although both men and women experience candida overgrowth, women are more likely to suffer from yeast-related conditions, probably because yeast thrives in the presence of estrogen.
How to Bring Candida Back in Line
After six years of freedom from candida-related issues, Delaney began suffering from chronic yeast infections. Her doctor prescribed several rounds of an antifungal drug, which would tamp down the infection for a week or so. But it always came roaring back.
“Honestly, I didn’t want to change my patterns, and I wasn’t ready to give up sugar again,” she explains. “But then I realized I had to change things up or I’d never get rid of [the infection].” Sure enough, when she returned to the same protocol she’d followed years earlier, the issue resolved.
If recurrent yeast infections, unexplained fatigue, eczema, food sensitivities, brain fog, or nonspecific gut issues, such as gas, bloating, or constipation, are a problem for you, it may be worth trying a few tricks known to counter candida overgrowth.
“There is a lot you can do with self-diagnosis,” says Plotnikoff. “But if these don’t work, seek the guidance of a health practitioner.”
To combat candida, experts recommend these four DIY strategies.
1. Starve the yeast.
Sugar feeds yeast, so eliminating the food source is a critical first step.
“Some people can kill off candida overgrowth by eliminating sugar for two to three months,” says -Teitelbaum. This includes all added sugars, which are hidden in processed-food ingredient lists under many names. (For a list of sugar aliases, see “61 Names for Sugar”.)
If symptoms persist, he recommends a more stringent yeast-free diet for four to six more weeks, which may involve eliminating fruit as well.
As far as other foods to avoid, Ruscio recommends noticing your triggers. “Some people don’t do well with dairy,” he says. “Others don’t do well with gluten.” He suggests working through the common food allergies and sensitivities; this should get you pretty close to finding your best plan.
2. Triple up on probiotics.
The next best step to reduce candida is to take a quality probiotic supplement. This will add beneficial bacteria to the gut to support its recovery.
“If you suspect you have candida overgrowth, I would stop the diagnostic road right there and try a good probiotic protocol,” says Ruscio, pointing to studies showing that probiotics can work just as well as prescription antifungals in treating yeast. “Most people will see an improvement.”
Ruscio recommends a three-tier approach: a Lactobacillus and Bifidobacterium blend, the probiotic yeast Saccharomyces boulardii (for more information, see “Protective Yeasts” at below), and a soil-based probiotic.
“A one-legged stool supports balance, but it’s a very wobbly balance. Using three different probiotics is adding two more legs to your stool, which gives greater balance to the entire ecosystem.” (For more on probiotics, including considerations about SBOs, see “Everything You Need to Know About Probiotics”.)
3. Cook with candida killers.
Garlic and turmeric both have antifungal properties that naturally inhibit candida overgrowth.
The best candida fighter in the kitchen, however, is coconut oil. Its medium-chain fatty acids combat candida in the gut, killing it within 30 minutes of exposure. When researchers added coconut oil to the diet of mice, it significantly lowered the amount of colonizing candida in just four days. And coconut oil appears to alter the metabolism of candida left behind, rendering it less harmful.
4. Take gut-supportive supplements.
Glutathione, a key antioxidant, plays an important role in the immune system’s ability to clear fungal infection from the body, says Plotnikoff.
Glutathione-rich foods include avocado, asparagus, squash, spinach, grapefruit, and melon. You can also take an N-acetyl L-cysteine (NAC) supplement, a key precursor to glutathione.
Other candida-killing supplements include caprylic acid and berberine, a compound found in herbs. Caprylic acid destroys candida’s protective cellular membrane (called a biofilm); berberine has antibacterial and antifungal properties.
A recent study found berberine effective against drug-resistant candida. Specifically, it damaged biofilms and accelerated the death of candida cells. Teitelbaum suggests taking 200 to 500 mg of berberine three times daily for six weeks, and then as needed.
All these strategies support overall gut health while keeping any possible yeast overgrowth in check.
“Treating candida takes commitment, but it’s not insurmountable,” says Ruscio. “If you find the right lifeline and hold on tight, you can pull yourself out of most gut issues.”
Saccharomyces boulardii (S. boulardii for short) is a live yeast that fights candida overgrowth in two important ways. First, it breaks down the protective biofilm that forms over the fungus. Second, because the place in the gut reserved for yeasts is relatively narrow, S. boulardii squeezes out candida.
“Candida is trying to crowd out other similar organisms because they are trying to survive in their [limited] ecological niche,” says functional and integrative practitioner Michael Ruscio, DNM. He notes that S. boulardii doesn’t colonize the gut but does have beneficial antimicrobial and anti-inflammatory properties.
If you must take antibiotics, take S. boulardii at the same time, says functional-medicine physician Greg Plotnikoff, MD. He describes it as saving seats for friends on the bus.
“If the bus is full of friends (good bacteria), we are happy. But when antibiotics clear the bus of friends, hostile riders (like candida) can take their seats. Because S. boulardii is a yeast and therefore untouched by antibiotics, it serves as a placeholder, saving the seats on the bus for the good bacteria post antibiotic.”
This originally appeared as “The Candida Connection” in the May 2020 print issue of Experience Life.