Candida Overgrowth: A Doctor's Guide on How to Get Rid of Candida
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Health Concerns

The Sneaky Yeast You Probably Didn’t Know You Have

March 26, 2020

There’s a strain of yeast that’s good in small doses, but can throw your body off balance if you have too much. Here’s what you should know about Candida.

Your body contains millions of microbes, including bacteria and fungi. Some are good, some are bad, and some are dose-dependent. When the balance of this delicate ecosystem is undone, early research is showing it can be associated with things like weight gain, cardiovascular diseases, and autoimmunity.

Candida is just one of those microbes that can impact your health. Candida itself isn’t bad. In fact, our bodies need a certain amount of Candida to stay healthy and balanced; short- and long-term health issues only arise with Candida overgrowth — when Candida grows out of control. Read on to learn more. 

What is Candida?

A common question we hear is: Is Candida a yeast? Candida, or Candida albicans, is a member of the fungal family, but is typically referred to as a yeast, according to Stephanie Wallman, D.O., a board-certified family medicine physician specializing in functional medicine at Parsley Health in New York City. It naturally coexists alongside other microorganisms in several areas of your body, including the skin, mouth, throat, gastrointestinal (GI) tract and vagina. In healthy amounts, Candida helps you maintain a healthy balance of microorganisms in these different areas, as well as support your immune system, aid in digestion, and promote vitamin and mineral absorption from food, says Kelly Johnston, R.D.N., M.S., a health coach at Parsley Health in New York City.

However, if your body has an overgrowth Candida (known as Candida overgrowth or candidiasis), it can throw the various ecosystems in your body out of balance. The result: A host of not-so-pleasant symptoms (more on these shortly). 

Chances are you’re already familiar with a few different types of Candida overgrowth. For example, an overgrowth of Candida in the mouth is known as thrush, while overgrowth in the vagina is known as a yeast infection. There are a few other ways Candida overgrowth can manifest, though.

Common symptoms of Candida overgrowth

Your signs and symptoms will vary depending on the cause of Candida overgrowth. However, the more common Candida overgrowth symptoms and signs include: 

  • Skin changes (like acne and eczema flares)
  • Bowel issues (like constipation and diarrhea)
  • Mood changes (like brain fog, anxiety or depression)
  • Inability to lose weight
  • Fungal infections of the skin and nails

In addition to these symptoms, Candida overgrowth causes a strain on your immune system, making you more likely to get sick, Dr. Wallman says.

Causes of Candida overgrowth

There are many different diet, lifestyle and medical factors that can cause Candida to grow out of control.

Use of antibiotics

If you recently took antibiotics, you may be at a higher risk for Candida overgrowth, because antibiotics clear out the bacteria that help keep Candida in check, according to chapter 18 of Polymicrobial Diseases. Without this bacteria, Candida is free to multiply.

A diet high in processed foods and sugar

You may also be more likely to develop Candida overgrowth if you eat a high-sugar, high-carbohydrate diet. “Candida and yeast feed off of sugar, so foods that are higher in sugar and starch will feed yeast further,” Johnston says. 

A weakened immune system

Candida overgrowth often strikes when you’re recovering from an illness, while the immune system is still weak. “Candida is opportunistic, so if it sees a little crack in the armor, it’s going to take advantage of that weakness,” Dr. Wallman says. And if you use an antibiotic while you’re sick, that’s like a double-hit, she adds.

Stress

Too much stress can create changes in the gut environment and the microorganisms that live there. If your intestine is already imbalanced — due to diet, use of antibiotics, or other factors — being under a lot of stress could make this imbalance worse, and help fuel the overgrowth of yeast like Candida, Johnston explains.

Hormonal imbalances 

According to Dr. Wallman, things that affect your hormones (like hormonal birth control) can worsen Candida overgrowth. In particular, women with higher levels of estrogen (including pregnant women) are at a higher risk of a Candida overgrowth yeast infection “The imbalance in the natural estrogen and progesterone ratio sets the stage for candida growth,” she explains. “Studies have been able to positively associate an increased amount of estrogen in the body to an increased incidence of vaginal candidiasis.” Estrogen essentially acts like fertilizer for Candida, says Dr. Wallman, and researchers are still studying exactly how estrogen triggers Candida growth.

How is Candida overgrowth diagnosed?

If you experience any of the symptoms of Candida overgrowth, visit your doctor. Your doctor will review your symptoms and ask about your lifestyle and medical history, as there are usually clues to your diagnosis. At Parsley Health, doctors use a root-cause approach to get to the bottom of issues like Candida overgrowth instead of just treating the symptoms.

Aside from more obvious visual clues like skin rashes and fungal infections, recent use of antibiotics, high stress, and a high-sugar, high-carb diet could lead your doctor to suspect Candida overgrowth. The most common type of Candida overgrowth test is a stool test to find out what types of yeast — including Candida — may be overgrowing in your GI tract. 

The stool test reveals how much of different types of yeast were found in your stool using a scale of one to four. A reading of one or two indicates a healthy amount of yeast, while a reading of three or four signals overgrowth. You may find you have more than one type of yeast overgrowing in your GI tract, or your lab results may indicate something else that warrants further testing. “Candida doesn’t always exist in isolation, so we keep a close eye out for things like small intestinal bacterial overgrowth SIBO,” Dr. Wallman says. (Read more about SIBO here.) 

Overgrowth of Candida can also weaken the lining of your gut, leading to increased gut permeability, Dr. Wallman notes. This is known as leaky gut syndrome, a serious condition in which bacteria from the gut is able to pass into your bloodstream. In fact, many Candida overgrowth symptoms are similar to those of leaky gut syndrome, and the two conditions often co-exist. So, if you have leaky gut syndrome, your doctor will customize your protocol to address both conditions. 

“Once we know what we’re treating, and depending on the severity of the infection, we develop a gut-healing protocol that addresses not only restoring the balance of the yeast, but supports the gut lining, as there was likely damage done from the overgrowth,” Dr. Wallman says. 

How to get rid of Candida overgrowth

If you’ve been diagnosed with Candida overgrowth, there are a number of lifestyle changes and supplements or medications you can take to get things under control. An effective Candida treatment includes:

1. Cutting back on unhelpful foods

As we’ve already seen, eating refined, high-sugar foods allows Candida to thrive. Research published in Memorias do Instituto Oswaldo Cruz reveals that cultured Candida cells flourished when glucose (a simple type of sugar) was added. (On the other hand, fructose, a slow-digesting sugar found in fruits, limited Candida growth.) “So, if you’re eating a lot of foods that are high in sugar and starch, you’re going to fuel that Candida more,” Johnston says. Your first step is to cut back or eliminate these foods completely. 

At Parsley Health, patients go through a two-week elimination diet where they cut not only refined carbs and sugars, but other foods that may fuel Candida overgrowth, such as starchy fruits and vegetables, grains, beans and any foods or drinks containing yeast (e.g., alcohol, vinegar, sauerkraut, kombucha). After the two-week elimination period, patients systematically re-introduce these foods back into their diet over the course of four to six weeks to see if any were making their symptoms worse. 

According to Johnston, the two-week elimination period can be tough. “If someone has Candida overgrowth, their body is not going to be happy with this [elimination diet],” she says. You may experience mood swings and a worsening of other symptoms at first, but after two weeks, you’ll feel better. 

If you want to try an elimination diet, be sure to partner with a health coach or registered dietitian who can create a personalized program for you and monitor your progress.  

2. Focusing on sleep, exercise, and stress reduction

There are other lifestyle factors besides diet that affect your gut health. “We think about the buckets of stress, movement, and sleep,” Johnston says. “If these things are not optimized, meaning you’re not getting enough sleep, you’re getting very little exercise, you’re feeling extremely stressed, those things can further exacerbate Candida and cause an imbalance in the body.” 

Namely, factors like sleep, exercise and stress all impact your gut microbiome (the balance of microorganisms that live in your digestive tract). If your gut microbiome is already imbalanced, stacking less-than-optimal sleep, movement and stress patterns on top of it can worsen the imbalance. 

To increase your chances of balancing out Candida, make sleep, movement and stress reduction a priority. 

Aim to get at least seven hours of sleep per night, as recommended by the National Sleep Foundation. Find a calming activity you can do an hour or two before bed to help lower stress and get your body ready for sleep. Johnston recommends meditation, journaling, reading, taking a hot bath or shower, and easy movement like yoga, stretching or walking.

Light exercise like yoga and walking are also great ways to get movement during the day, especially if you’re eliminating or cutting back on sugar and carbs. “You might feel really low-energy in the beginning if you’re adjusting to a lower carbohydrate diet,” Johnston says. So, you might prefer to do restorative exercise like yoga, Pilates, and light walking over higher intensity exercise during your Candida overgrowth treatment.   

3. Using supplements

In addition to diet and lifestyle changes, Dr. Wallman often recommends using herbal supplements like oregano oil and garlic extract to help restore the balance of the yeast. “The herbal supplements have a lot of anti-yeast and antifungal properties to them,” she says.  

Dr. Wallman will also often add a friendly yeast called Saccharomyces boulardii (S. boulardii) to her patients’ program, as this probiotic helps create balance. “It won’t necessarily lower the Candida, but it will increase the competition so the Candida doesn’t grow out of proportion,” she explains.

What’s more, research published in FEMS Microbiology Letters found that S. boulardii prevented Candida from attaching to cultured intestinal cells, and lowered inflammatory cell response. 

4. Adding medication when needed

While diet and lifestyle changes radically increase your chances of decreasing Candida, sometimes, Candida overgrowth calls for stronger measures: “When the growth is significant, we use all the tools at our disposal and treat the overgrowth with prescription-strength antifungals,” Dr. Wallman says. The antifungals are similar to what you might take to treat an infection, only you take them at a slightly lower dose for a longer period of time, she adds. 

You stand the best chance of balancing out your gut if you take a multi-pronged approach that addresses a variety of lifestyle changes—like sleep, stress, and movement—and incorporates supplements and prescription medications when needed.

Parsley Health is the only medical practice that leverages personalized testing with whole body treatments.

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