This article is written by Jennifer McLaughlin, nutritionist and educator.
Candida albicans is a fungus that is commonly found in the digestive tract. In a healthy situation this fungus causes no problems or symptoms and is controlled by friendly bacteria, our immune system, and intestinal pH. But if any of these control mechanisms are compromised, the candida may begin to multiply and spread. Candida albicans produces toxins, and as candida colonies increase in number and size, the quantities of toxin increase as well. Lipski (2005) describes how these toxins are absorbed into the blood stream and affect our immune system, hormone balance, and thought processes causing an amazing variety of systemic symptoms that vary by individual.
Trowbridge and Walker (1986) describe the symptoms of Candidiasis as “feeling bad all over.” The list of major symptoms is long and includes multiple food allergies, fatigue, depression, poor memory, erratic vision, achy muscles or joints, abdominal pain, constipation, diarrhea, vaginal itch or burning, menstrual irregularities, loss of sexual desire or impotence, as well as prostatitis or endometriosis (Murray, 1997).
There are several candida questionnaires available that allow a quick and simple analysis of whether candida may be responsible for the poor health of an individual. Murray (1997), Crook (1986), and Lipski (2005) have similar questionnaires. Based on an individual’s responses to a series of questions regarding medical history and symptoms, the questionnaires interpret the results in terms of the likelihood that their health problems are yeast-connected. Although the questionnaires are certainly quick, easy, and useful; they do not provide a confirmed diagnosis. If an individual and their practitioner decide that they would like to confirm the diagnosis or simply tract the presence of candida through the treatment, a comprehensive stool and digestive analysis (CSDA) can provide this and other information that may help guide the treatment plan.
There are four primary factors that may lead to Chronic Candidiasis: altered intestinal flora, dietary factors, reduced digestive secretions, or a depressed immune system.
Altered intestinal flora leaves the intestinal wall susceptible to Candida overgrowth. The primary reasons for altered intestinal flora is the use of antibiotics, birth control pills, or
steroid medications (Lipski, 2005). These medications kill the bacteria in the large intestine that is controlling the candida population thus allowing the candida colonies to take over. These large colonies of candida damage the intestinal lining which may lead to leaky gut and multiple food allergies.
Dietary factors such as high sugar diets promote candida overgrowth. The primary nutrient for candida is sugar, therefore high sugar diets feed candida and may lead to overgrowth. Nutrient deficiencies often found in the standard American diet may also affect the immune system as discussed below.
Secretions of hydrochloric acid in the stomach and pancreatic enzymes in the small intestine normally help keep candida controlled by creating prohibitive environments (Rubinstein etc). Decreased secretions may therefore allow candida growth.
A depressed immune system can also lead to Candida overgrowth. There are many reasons that a person’s immune system could be compromised including the use of immunosuppressive drugs like corticosteroids, nutrient deficiencies, impaired liver function, or chronic disease. According to Murray (1997), people with candida overgrowth often have other chronic infections and while the immune system is weakened it will be difficult for a person to overcome any of these conditions.
The typical allopathic approach to treating chronic candida relies primarily on anti-yeast medications. A holistic approach begins by correcting any imbalances that may have contributed to the candida overgrowth, but may include anti-yeast medications or supplements as part of treatment. The difference between these approaches is that the anti-yeast medications are a short-term solution and may not protect from another candida overgrowth situation. The holistic approach involves lifestyle and diet changes to keep the yeast under control in the short and long term. The steps below outline a typical holistic approach to candida, although it will certainly vary by client and by practitioner. These steps are adapted from Murray’s approach proposed in Chronic Candidiasis.
Step 1: Identify and address predisposing factors.
With a physician’s guidance, discontinue use of antibiotics, birth control pills, as well as steroids and other immune-suppressing drugs.
A hydrochloric acid test or a step-wise increase in HCL supplementation can determine whether decreased HCL is a factor. Murray (1997) outlines this process on page 36 of Chronic Candidiasis. If a client has decreased HCL secretions, HCL supplements can be taken during a meal.
A CSDA can provide information as to whether adequate protease is being produced and pancreatic enzyme supplements are available if needed. Even if the CSDA does not report decreased enzyme secretion, pancreatic enzyme supplements may help with food allergies associated with candida by more thoroughly digesting food (Murray, 1997).
Step 2: Follow a candida control diet.
In general, consuming a whole foods diet comprised of organic produce and naturally raised animal products will provide maximum nutritional support thus providing the body with the means to heal itself. A whole foods diet will not contain additives, toxins, or processed ingredients thus allocating more time and nutritional resources to healing instead of removing harmful substances from the body. The candida control diet excludes three categories of food that I have detailed at the end of this step.
Vegetables should be the primary food while on the candida control diet. Vegetables are nutrient rich, provide antioxidants to support the liver and immune system, and contain fiber which will help keep move the bowels and clear toxins from the body. Almost all vegetables are included in the diet and should be consumed with every meal and snack. The only exception is mushrooms which are a fungus (see Exclusion #3). Potatoes, winter squash, and sweet potatoes tend to raise blood sugar quickly and should be eaten only in combination with other vegetables and a protein.
Grass-fed animal protein, pastured eggs, and sustainable seafood should be consumed daily to boost the immune system and nourish the body with nutrients only available from animal sources. Small amounts of animal fats are welcome in the diet. While most dairy is not allowed (see Exclusion #1); butter, ghee, and homemade yogurt that has fermented 24 hours contain no lactose and may be included.
Whole grains and legumes may be consumed, however breads and other processed grains contain simple sugars and should be avoided (see Exclusion #1). Raw, soaked or sprouted nuts and seeds are wonderfully nutritious and may be included (although peanuts and cashews should be avoided due to their high mold content, see Exclusion #3).
Water is an important element of this diet as it plays a vital role in delivering nutrients to cells and removing toxins from the body. Ten to twelve 8 ounces glasses of water a day is usually adequate.
Exclusion #1: While supporting the body with whole foods, starve the candida by removing refined and simple sugars from diet. This includes added sugars such as sucrose, glucose, maltose, lactose, fructose, agave, maple syrup, honey, and corn syrup, as well as white flour, white rice, milk and other lactose containing dairy products, fruits, fruit juices, and high-sugar vegetables juices such as carrot juice.
Exclusion #2: Sufferers of chronic candida often have multiple food allergies. These allergies need to be identified through an elimination diet or an allergy test. Once identified, these foods should be avoided initially and dealt with once the candida overgrowth is controlled.
Exclusion #3: Many practitioners recommend avoiding foods containing mold and yeast such as yeasted breads, fermented beverages, vinegar, and cheese. Although these foods don’t cause candida growth, people with chronic candida sometimes develop yeast and fungi allergies, which can impede recovery (Crook, 1986).
Step 3: Provide nutritional support.
A candida control diet will provide the body with a full spectrum of nutrients. However, many clients may be suffering from years of malnutrition or malabsorption and it may take time to adjust their diet completely. To help fill nutritional deficiencies, clients should take a high-potency full-spectrum vitamin and mineral supplement containing bioavailable nutrients. A good multi-vitamin will include several antioxidants, but additional vitamin C and E supplements may be appropriate as well. Essential fatty acids support cellular function and therefore whole body health. Although they are found in seafood, nuts, and seeds, a daily dose of cod liver oil or one tablespoon of flaxseed oil is also recommended.
Step 4: Support immune function.
A multifaceted approach is the best way to reestablishing proper immune function. While the candida control diet will provide necessary nutrients, stress and poor diet are usually the largest factors contributing to a depressed immune system (Murray, 1997). High levels of stress can impact immune function as well as nutrient absorption. If a candida sufferer is dealing with stress it will be important to remove stressors or learn to manage them. Daily deep breathing, relaxation exercises, and adequate sleep will support stress reduction and therefore increased immunity. In addition, research has shown that moderate exercise will also stimulate the immune system (Lutack & Bongiorno, 2006). Murray (1997) suggests at least 30 minutes of aerobic exercise four times per week.
Step 5: Take probiotics.
As candida is starved out or otherwise removed from the large intestine, we want health-promoting flora to replace them. A probiotic will provide a constant stream of these flora.
Step 6: Use appropriate anti-yeast therapy.
There are two main approaches to anti-yeast therapy: natural anti-yeast agents and prescription anti-yeast agents. Doctor’s Data (2011) is a clinical laboratory that provides stool analysis as well as helpful information regarding the effectiveness of several of
these agents. They have found the natural anti-yeast agents berberine, caprylic acid, tannic acid, and citrus seed extract to be the most effective. Lipski (2005) also adds garlic to this list. Doctor’s Data has also found nystatin, a prescription antifungal not absorbed into the body, to be effective as well as several prescription azole antifungals.
When the candida fungus dies it produces toxins that may aggravate symptoms initially. This “die-off” may be controlled a bit by following steps 1-5 for about two weeks prior to introducing an anti-yeast agent. Die-off will be more apparent in severe cases, so in the case of a more mild overgrowth, this two week window may be skipped or shortened.
Candida albicans may be difficult to diagnose initially if a practitioner is not aware of the diversity of symptoms associated with the fungus. However, once recognized and controlled, diet and lifestyle changes can keep candida overgrowth from recurring and will promote general good health thus keeping other diseases at bay as well.
Crook, William. The Yeast Connection: A Medical Breakthrough. (1986). Vintage Books: New York.
Doctor’s Data. (2011). Sample Patient: Yeast profile. Retrieved May 17, 2011, from http://www.doctorsdata.com/repository.asp?id=2255
Lipski, Elizabeth. Digestive Wellness (3rd Edition). (2005). McGraw Hill: New York.
Lutack, B. & Bongiorno, P. (2006). The exercise prescription. In Pizzorno, J. & Murray, M. (Eds.) Textbook of Natural Medicine (3rd Edition). Churchill Livingstone: St Louis.
Murray, M. Chronic Candidiasis. (1997). Three Rivers Press: New York.
Rubinstein, E., Mark, Z., Haspel, J., Ben-Ari, G., Dreznik, K., Mirelman, D., & Tadmor, A. (1985). Antibacterial activity of the pancreatic fluid. Gastroenterology, 88(4), 927-32.
Trowbridge, J.P. & Walker, M. The Yeast Syndrome. (1986). Bantam Books: New York.