Within the gut live about 1–2kg (2–4lb) of gut flora. These “friendly bacteria” have a variety of roles to play, including assisting in digestion, keeping unhealthy organisms at bay and ensuring that the gut lining remains healthy. The yeast organism Candida albicans can also inhabit the large intestine and does not usually cause health problems.
However, under certain circumstances, it can overgrow in the small intestine, leading to symptoms that include erratic bowel habits (constipation and/or loose bowel movements); wind and flatulence; abdominal bloating; anal itching; recurrent bouts of thrush (vaginal yeast infection); other fungal infections, including athlete’s foot or generalised itching around the groin and/or the inside of the buttocks; recurrent bouts of cystitis and/or problems with vaginal irritation; and cravings for sugar, sugary foods (such as chocolate, biscuits or cakes) or yeasty foods (cheese, bread, alcohol or vinegar). Candida overgrowth may also cause vague, unexplained health problems, such as fatigue, pain and mental distress.
The overlap between symptoms of gut flora disturbance and depression can be confusing for patients as well as practitioners. One of the major causes of yeast overgrowth is antibiotic therapy, which can kill the healthy gut organisms that normally help to keep yeast organisms such as Candida at bay. Other common underlying factors in yeast overgrowth include stress (which can upset the immune system), the consumption of yeast-encouraging foods, such as sugar, bread, cheese and alcohol, and taking the oral contraceptive pill or hormone replacement therapy (HRT).
Tests for Candida
If Candida is suspected, a nutritional therapist may arrange one of the various tests. Yeast analysis of stool samples can be tried, although it can be misleading because Candida is normally present in the large intestine. The blood can be tested for the Candida antigen – if positive, an ongoing yeast infection may be indicated.
Antibodies are substances the immune system produces in response to antigens. Two types of antibody, known as IgG and IgM, are usually measured in the blood. Raised levels of the antibodies specific for Candida may indicate a significant infection. A type of antibody known as secretory IgA is produced by the gut.Measuring the amount of secretory IgA made specifically against Candida can be a good guide to the presence of yeast in the gut.
Another test that examines gut fermentation is based on the principle that yeast tends to metabolise sugar into alcohol. After a blood sample is taken, a person is given a measured dose of sugar. One hour later, another sample of blood is taken. Both blood samples are then analysed for various fermentation products. The presence of these in significant quantity can point to the presence of excess yeast in the gut.
The anti-Candida diet
The cornerstone of the anti-Candida approach is a diet that helps starve yeast out of the system. Foods to be avoided include those that feed yeast directly and those that are yeasty, mouldy or fermented in their own right. Yeast-feeding foods to avoid include: sugar; sweetening agents, such as maple syrup, molasses, honey, malt syrup; sugar-containing foods, such as biscuits, cakes, pastries, confectionery, ice cream, sugared breakfast cereals, soft drinks and fruit juice; white flour products, such as white bread, crackers, pizza and pasta.
Yeasty, mouldy or fermented foods to avoid include: bread and other items made with yeast; alcoholic drinks, particularly beer and wine, which are very yeasty; gravy mixes (most contain brewer’s yeast); vinegar and vinegarcontaining foods, such as ketchup (which also contains sugar), mustard, mayonnaise and many prepared salad dressings; pickles, miso, tempeh and soy sauce (all are
fermented); aged cheeses, such as cheddar, Stilton, Swiss, Brie and Camembert (cheese is inherently mouldy); peanuts, peanut butter, and pistachios (tend to harbour yeast); mushrooms; dried fruits (these are intensely sugary and tend to harbour mould); prepared soups and prepackaged foods, which tend to contain yeast. Foods to eat freely on an anti-Candida diet include meat, fish, eggs, beans, pulses, vegetables, nuts (but not peanuts or pistachios), seeds, oats, brown rice. Views on whether fruit can be eaten on an anti-Candida diet vary. Some experts recommend complete exclusion, while others say you can eat it frequently. In general, one or two pieces of fruit a day will be well tolerated, although grapes are generally best avoided because they are very sugary and usually are covered in a mouldy bloom.
Supplements to overcome Candida
In addition to the anti-Candida diet, it may help to take specific supplements – probiotics, liver-supporting agents and antifungal supplements – to help restore the full functioning of the digestive system.
Probiotics contain gut bacteria. Those that contain both Bifidobacterium bifidus (the predominant bacterium
in the large intestine) and Lactobacillus acidophilus (the predominant bacterium in the small intestine) can help to restore the balance of organisms in the gut and help combat Candida overgrowth.
During the initial phases of an anti-Candida regime, it is quite common for the condition to get worse. Lethargy, fuzzy-headedness and flulike symptoms can start a day or so after the regime starts and generally last from a few days to a couple of weeks. Liver-supporting agents can help reduce these symptoms.Antifungal supplements can help to combat the Candida fungus directly. Oregano contains two important active ingredients, carvacrol and thymol. Studies have shown that oregano can inhibit the growth of Candida. In natural medicine, garlic is widely used in the control and eradication of Candida. Finally, grapefruit seed extract supplements are also useful as they have the ability to kill Candida in the body.