I have been thinking about Candida a lot lately because it tends to be one organism, that left unchecked, can cause persistent issues in a patients.  I always say that every patient is different, and it’s so true.  I recently started treating an existing patient for Candida overgrowth (and I won’t give too much other background to maintain anonymity) but this is NOT what the patient originally came to me for.  What is interesting about this case is that along the way, the patient has done an amazing job listening to their body and was noticing certain foods causing issues.  We navigated through that and after realizing Candida could be a real issue, all the pieces fell into place in my mind.  I can’t emphasize enough how much of a puzzle complex cases are and it requires not only the doctor to be thoughtful throughout the journey, but it requires tremendous awareness and communication on the patient’s part, too.  Often times, the patient knows the experience better than the physician, but the physician often has the knowledge to help piece things together into a picture that makes sense and can be TREATED.  Without either person’s contribution, progress is often non-existent.

What is Candida?

Candida is a yeast known as Candida albicans. While everyone has Candida living in/on/around them, not everyone has an overgrowth.  The most common condition people are aware of including Candida overgrowth is a vaginal yeast infection.  However, you can have this infection in many other places including the gut, the ears, the mouth (thrush), sinuses etc.  It tends to love dark, warm, moist environments within a susceptible host.

Who gets yeast overgrowth?

This is often a condition we will see in people that have suppressed immune systems.  Immune suppression could be from AIDS, where seeing thrush is very common.  It could be immunosuppressants as in the case with Autoimmune patients.  Or, it could be a perfect window after antibiotic use, which is common.  Last, but not least, your primed for take over during pregnancy, too.  Why? Because your immune system is naturally dampened during pregnancy because of the mechanisms that don’t want you to attack too much foreign tissue that would include your baby.  (This is also often why an autoimmune condition will go into remission during pregnancy)

What are the symptoms of overgrowth?

Just wait.  These symptoms are common and often can be associated with other conditions, especially thyroid dysfunction.  That is often why this goes misdiagnosed and the patient doesn’t seem to improve. Patients can have just a few of these or all of the below.

• Brain fog
• Fatigue
• Itchy ears, vagina, anus
• Thrush
• Joint pain
• Sugar cravings
• Allergies
• Hormone issues
• Anxiety

What’s the treatment?

Conventional treatment of recurrent yeast infections is Diflucan.  However, this tends to enter a patient into a vicious cycle and never eradicates the problem.  They may go on cycles of this medication multiple times a year.  Alternative treatment focuses on starving the food sources of the yeast, rebalancing the microbial environment within the body (after all, healthy people have Candida, too…it’s just balanced), and addressing the tricks Candida has to hide from the immune system.

Alternative Foundations:

• low sugar/low carb diet
• probiotics
• antimicrobials (many are herbs like oregano)
• coconut oil consumption and application

Alternative Foundations are what most alternative care providers will prescribe; however, I have found there to be some critical additions to protocols if someone isn’t responding to traditional alternative recommendations.  These could be things to consider if you are treating Candida naturally but still seeing reoccurrence.

• biofilm disrupters via herbs or enzymes
• refrain from sex with your partner for a period of time and have them undergo treatment, as well.
  • I often see women get better and have another infection following intercourse.  Your partner is passing it back to you, and just doesn’t have the same symptoms
• enemas to reduce something known as a Herx reaction.
  •  As Candida begin to die, they release toxins that make people feel very ill.  This will often result in discontinuation, but can be drastically improved by backing down dosing or introducing enemas
• consider a low oxalate diet

Why would you worry about oxalates in the diet?

Admittedly, this is a new concept to me, but as I continue to learn, evolve, and treat more patients, I think it’s worth sharing information!  I have not toyed with this clinically, so take it for what it is, but I was listening to a very seasoned physician talk about this topic, and some very interesting patient puzzle pieces fell into place.  Foods high in oxalates are things like nuts, berries, spinach, and chocolate.  Candida impairs your ability to break down this component of these foods and produces a precursor to oxalates itself.  It can also take collagen and transform it into oxalates.   Oxalates are the very thing that cause painful kidney stones, and you need to be able to break these things down.  When people change their diet, often times they are making smoothies with spinach and nut milk, they are eating more greens, they use nuts as a snack, and they are increasing bone broth in their diet.  HELLO OXALATES!  This was interesting to me because my patient kept saying they had more itchy orifices when they ate cashews.  Everyone is different, so I just cut them out and moved on.  Looking back, this could’ve been a queue because in addition to using bone broth in the face of autoimmunity (what they originally came to me for), we could have been pushing the limits with oxalates.  Without addressing the Candida, we were noticing those symptoms!

What was so weird about your patient?

Hindsight is 20/20, but looking back, it sort of made sense all of a sudden.  A person presents with an autoimmune disease that can absolutely account for fatigue, brain fog, poor exercise recovery, mood imbalance and hormone issues.  However, the person has taken antibiotics which wipe out any balance that exists with your microbiome, then had a baby, which suppresses the immune system, and then gets an autoimmune disease.  This can be a common scenario, but what I did not take into account is that trigger of the autoimmune disease could very well have been the Candida overgrowth.  This person came to me not being completely open initially about the yeast symptoms (understandably so!), but brought them up when they were feeling better but those symptoms were persisting.  Maybe I missed the mark?  I don’t know.  The person then started to notice issues with cashews….(oxalates.) The patient would then notice symptoms improving and then they would reoccur after intercourse. This patient also had some strange depressive patterns, and Candida makes estrogen.  That how it puts a wrench in the hormone system.  HOW DID I NOT PUT THIS TOGETHER?!  After introducing a biofilm disruptor, treating the sexual partner, and addressing the Candida, now this person can officially say they are improved from autoimmunity (what they came to me for), and don’t have weird symptoms persistently because of a yeast overgrowth.

If I did not have constant communication with this person, I would never have tied all the dots.  People are complex and a case is like an onion.  It’s layers upon layers to get to the bottom and hopefully reaching recovery.  This takes time.  So, don’t give up! How much of the symptoms from my patient were from the Hashimoto’s and how much were from the Candida, I will never know.  But I don’t need to know.  I will carry this case (and tidbits like this from every case) into the next set of patients.  It’s part of the art of medicine and what I love about being a doctor.