Candida Albicans is a common component of the gut microbiota, which includes about 66 genera of fungi, primarily candida species, and Saccharomyces. Along with being present in the gut, it is also on your skin, mouth, oral cavity, and vagina. It is typically kept in check by having a symbiotic relationship with other microbes in the gut, such as bacteria, viruses, and fungi. A disruption to our internal ecosystem by poor nutrition, medications, or disease processes can affect the healthy balance of our gut organisms and may lead to candida overgrowth.
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What is Candida Overgrowth?
Candida is a normal fungus present on your skin, oral cavity, vaginal tract, and gastrointestinal tract. This fungus can become more prominent when it grows beyond what is considered commensal, meaning a healthy part of our gut flora. Overgrowth may be associated with an imbalance in the gut flora and disruption to the immune system.
Candida Overgrowth Signs & Symptoms
It's important to note that overgrowth of candida in the gut can potentially spread throughout the body if not addressed. Awareness of symptoms early on is vital to overall health and well-being. Symptoms of Candida in the GI tract may include:
- Abdominal discomfort
- Diarrhea
- Bloody stool (rare)
- Bloating
- Mucus present in stool
- Fever
- Fatigue
4 Factors That May Contribute to Candida Overgrowth in the Gut
Many factors can lead to dysbiosis in the gut, which may affect the integrity of the intestinal tract and contribute to conditions like candida overgrowth. Here are some of the most common factors that may influence candida in the gut:
Lifestyle
Eating a diet high in processed foods, refined sugar, and excessive alcohol consumption can contribute to dysbiosis, potentially allowing candida to grow more in the GI tract.
Continuous higher stress levels can also affect the immune system and disrupt the gut microbiome, potentially creating an imbalance between the microbes in the GI tract, which may support the growth of opportunistic bacteria and fungi.
Medications
Steroids, antibiotics, proton pump inhibitors (PPIs), and immunosuppressive medications can impact your gut's integrity.
Steroids: While steroid-class drugs are meant to decrease inflammation, the side effects can also be significant. The chronic use of steroids can affect your immune system, potentially increasing the risk for fungal imbalances.
Antibiotics: These medications inhibit the growth of various pathogenic bacteria but can also affect commensal bacteria. Tetracyclines and macrolides, specifically, can create "collateral damage" by reducing beneficial bacteria alongside harmful bacteria in the GI tract. This may create an imbalance allowing microbes like candida to become more prominent.
PPI's: The increase in gastric pH brought on by the overuse of proton pump inhibitors can affect the gastrointestinal tract by weakening the barrier, which may increase your risk of gastrointestinal imbalances. PPIs are a potential risk factor for Small Intestinal Fungal Overgrowth (SIFO) in patients using them for unexplained gastrointestinal symptoms.
Immunosuppressive Drugs: These drugs intentionally affect your immune system to manage conditions such as organ transplants, HIV, cancer, and autoimmune conditions. While they may be necessary, a potential side effect is candida overgrowth.
Inflammatory bowel disease (IBD)
Inflammatory bowel disease (IBD), the umbrella term for Ulcerative Colitis and Chron's disease, can contribute to candida overgrowth. One study showed that chronic inflammation and treatments used for IBD, such as anti-TNFa agents, may lead to gastrointestinal changes. These changes may allow pathogens to penetrate the intestinal lining, potentially causing microbial imbalances like candida overgrowth.
Diabetes
Increased presence of candida spp. has been detected in both Type 1 and Type 2 diabetes. This may be due to a dysregulated immune system from poor glycemic control and elevated blood glucose levels. A lower immune system may create an environment in the gut that allows candida to grow more. Managing blood sugar by working with a practitioner could help support a balanced gut environment.
Functional Medicine Labs to Test for Candida Overgrowth
- GI-MAP stool test is a way to assess gut microbial flora. It tests both candida spp. and Candida Albicans, which can provide insight into gut inflammation, fungal presence, and other organism balances.
- The GI-Effects pathogen profile is an option that provides both an assessment and potential management options. This test can help determine which prescriptive and natural therapeutics may be effective in supporting your unique gut flora.
- A blood test alongside a stool test can provide a comprehensive picture. Looking at IgA, IgG, and IgM reactivity to candida can help determine if this fungus is associated with an immune response.
- If you are at risk for diabetes or have symptoms, running a diabetes panel testing these six biomarkers as a screening or management tool can be beneficial.
Conventional Approaches for Candida Overgrowth
Oral antifungals that fall under 'azoles' are commonly used drugs to manage candida imbalances. Fluconazole is one of the drugs used to address this condition. It works by inhibiting the Cytochrome p450 enzyme, which may affect fungal growth. It also creates changes in the cell membrane of the fungus, affecting the cells' permeability.
Other drugs used to manage candida overgrowth include Caspofungin, Terbinafine, and AMP B. There is also evidence that combining antifungals, such as an -azole drug, with one of the prescriptions mentioned above may result in better outcomes.
Functional Medicine Approaches for Candida Overgrowth
Approaches for candida overgrowth in the gut are similar to those for candida presence in other areas of the body. Addressing underlying factors is always a great starting place. Optimizing nutrition, utilizing natural therapies, and modifying your lifestyle may help support a balanced gut environment.
Nutrition
Candida overgrowth has been associated with blood sugar dysregulation, typically from high carbohydrate diets that impact conditions such as diabetes. A Candida Diet emphasizes low-sugar, anti-inflammatory foods to promote a healthy microbiome, support balanced inflammation, and enhance the immune system.
Herbs & Supplements
Caprylic Acid: has been shown to affect the cellular membrane of C. Albicans species. This research suggests it may be more effective if used as a combination approach with carvacrol and thymol. In this approach, caprylic acid may alter the cell membrane, allowing natural compounds like carvacrol and thymol to support the body's defense against the fungus.
Oregano (Origanum vulgare): may help address candida overgrowth by affecting the biofilm that develops over the mucosal and epithelial surface of the intestinal tract. These biofilms are a protective mechanism that organisms use to hide while they continue to multiply.
Berberine: a constituent in herbs such as Goldenseal, has properties that may support the body's defense against fungi. Studies of berberine suggest its potential effectiveness in addressing fluconazole-resistant pathogenic candida by altering cellular components.
Saccharomyces boulardii: is a yeast-based probiotic that may be effective in affecting biofilm. It has also been shown to support a balanced inflammatory response created by opportunistic presence.
Lifestyle changes
One way to support a balanced gut environment is to implement mindful choices. Reducing stress, taking probiotics, avoiding the overuse of antibiotics, maintaining a well-balanced diet, and avoiding tobacco and alcohol are all ways to support a healthy gut environment.
Mental Health Support
Maintaining healthy mind-body practices can also help support your gut microbiome. Your gut health has a bi-directional relationship with your brain through the gut-brain axis. This pathway can influence microbial balance and should always be supported when doing a gut health protocol. Behavioral medicine interventions such as relaxation therapy, Cognitive Behavioral Therapy, Gut-Directed Relaxation Training, and Biofeedback are all tools that have the potential to assist you through gut restoration.
Exercise
Implementing an exercise routine can help with many aspects of gut health, including support to detoxification pathways, boosting the immune system, reducing stress, and balancing blood sugar. Studies have revealed that exercise enhances beneficial microbial species in the gut, improving the diversity of the gut flora and commensal bacteria.
Sleep
Studies show that inadequate sleep can lead to immune changes and increased inflammatory markers. Establishing a sleep routine can help you best support a balanced gut environment.
Summary
Your gut flora's health depends on a symbiotic relationship between candida and other microbes such as bacteria, viruses, and fungi. When disruption occurs due to medication, disease processes, or inflammation, this may lead to imbalances such as candida overgrowth. Understanding how this can happen is the first step in supporting a balanced gut environment. If you experience chronic unexplained gut issues or suspect you have candida overgrowth, it is best to work with a healthcare provider who can run the appropriate tests and help develop a holistic plan.
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