Candida: Brain Fog, Fatigue, Sugar Cravings, Hypothyroidism

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.



Adrenal Fatigue: Understanding Cortisol

This is a condition that really doesn’t discriminate between healthy and unhealthy individuals.  I have had countless patients end up at my door with relentless fatigue when they believe they live a healthy lifestyle.  They workout, they don’t eat excessive carbs, they have successful jobs, and they take their daily supplements!  Then why are they SO tired all the time?!  These cases are almost always issues with cortisol production and the ability of the adrenals to keep up with stress.  Athletes especially can be affected by this issue because of overtraining, chronic stress, or lack of appropriate recovery.  Sometimes less is more, but let’s take a look at what actually happens in someone with adrenal fatigue.

Adrenal Glands: You’ve go these two little organs that sit on top of your kidneys that are responsible for releasing epinephrine and norepinephrine, aldosterone, cortisol, sex hormones, and precursors such as DHEA.  Cortisol is a steroid hormone that is responsible for all kinds of things in the body including:

  • mobilizing protein stores
  • water excretion and electrolyte balance
  • mobilizing fatty acids from adipose (fat tissue)
  • precursor to cortisone (and anti-inflammatory agent)
  • directing immune function
  • stimulation/inhibition of gene transcription
  • affecting bone calcium
  • affects behavior, mood, and hormones
  • affects numerous CNS biochemistry

Basically, it has a hand in tons of things.  Like most body chemistry, it is definitely not on an isolated island!  When stress levels are high, the demand for cortisol production goes up.  However, the building blocks are things like progesterone and pregnenolone which are needed for the production of other hormones.  When your body starts stealing these building blocks to keep up with stress, it will eventually let your other hormones like estrogen and testosterone suffer in order to keep up.  This is important because many people are known to have hormone imbalance, but if you never assess the adrenals, how do you know this isn’t the reason?  If it is, then the answer is not hormone replacement, the answer is stress reduction that will in turn lower cortisol demand.

When you start thinking about how important hormones are to the body, one may ask why on earth your body would make that kind of sacrifice?!  The simple answer is that our body is still expecting stress to be a short-lived event driven by a life or death incident.  In that moment, we would sacrifice anything in order to get out alive.  We never adapted a mechanism to take care of chronic stress.  Stress that never goes away. Stress that takes all we have.  Stress that leaves us feeling defeated at the end of the day and dread the start of the next.  Am I ringing any bells here?  Life is HARD these days!  We have all kinds of stress!  Work!  Kids! Relationships!  But, we also have stresses that people don’t think about like food sensitivities, sleep deficit, overtraining at the gym, and infections.  There are ALL stress to the body.

This is how people can function from day to day, still go to the gym, think they are doing it all, and still feel like crap.  When I run cortisol panels, it’s not uncommon for me to find cortisol levels that are in no way keeping up with the demand.  There are symptoms many complain about:

  • hypoglycemia
  • chronic fatigue
  • ligament/cartilaginous injuries
  • depression/anxiety (this one I see a LOT!)
  • insomnia
  • irritability
  • short term memory issues
  • pain that persists
  • poor wound healing and workout recovery
  • frequent colds
  • hypothyroidism (tons of my ladies out there have this along with adrenal fatigue!)
  • PMS
  • infertility
  • menopause symptoms (can we say hot flash club?!)
  • insulin resistance
  • fat around the trunk

The test for this is pretty simple, but it’s important to have it checked multiple times throughout the day.  So, many physicians will test it once.  That is not helpful unless there is pathology.  We are looking for optimal function.  Therefore, we want to see a high number in the morning and a gradual decrease until it bottoms out at night so you can go to sleep!  If we don’t see that, we need to assess where we are in order to know where to go from there.  In the early stages, people will make too much.  They usually don’t come in for help at this stage because they are “keeping up” as far as they’re concerned.  By the time we hit stage 2 or stage 3, we are starting to not be able to keep up and we start stealing those building blocks from other hormone pathways.  THIS IS USUALLY WHAT BRINGS THEM IN!  On top of fatigue, they now have stray hairs growing in random places, excessive fat that won’t budge, inability to recover from their workouts, trouble sleeping, up and down emotions, loss of sex drive.  At this point, we can’t just fix it with food, typically.  We need to “help your body over the hump” so it can catch up and produce enough cortisol again on its own.  This not only takes time, it takes lifestyle changes that may include cutting things out that are contributing to stress.  This is the toughest thing for patients to do.  If they don’t workout as much, say no to responsibilities, sleep more, etc, they feel LAZY!  You wouldn’t call a cancer patient LAZY!  This is taking care of yourself, and I can’t stress it enough (no pun intended).

If this sounds like you, and you like help, my door is open.  The saliva test I use to measure cortisol, DHEA, hormones, and melatonin is around $200 and it is done at home.  Doesn’t get much easier than that for a little piece of mind and direction.