There are all kinds of healthy bacteria living in our bodies (probiotics, for example), as well as other naturally occurring microorganisms, such as yeast. It's essential that these microorganisms stay in balance, because when they're out of whack they can lead to infections such as candidiasis, an overgrowth of the yeast Candida.
What Is Candidiasis?
Candida is a genus of yeast that naturally exists in the body in small amounts. There are several species of Candida, but the most common is Candida albicans. When Candida gets out of balance with bacteria in the body, it can lead to overgrowth and infection, known as candidiasis. Candidiasis of the skin, gut, mouth, throat, or vagina is usually easy to treat, but it can cause unpleasant symptoms. Invasive candidiasis is a serious but far less common infection deep in the body that can affect vital organs. (Source, Source)
Signs and Symptoms of Candidiasis
The signs and symptoms of candidiasis vary, depending on where the fungus is located in the body. Here's the breakdown.
If you've had a vaginal yeast infection before, you've had a form of candidiasis. Symptoms include:
- Itching and irritation in the vagina and vulva (that's the outside of the vagina)
- a burning sensation, especially during sex or urination
- redness and swelling of the vulva
- vaginal pain and soreness
- vaginal rash
- thick, white, odor-free vaginal discharge (think cottage cheese)
- watery vaginal discharge
Thrush (Candidiasis in the Mouth and Throat)
Also known as oral thrush and oral candidiasis, the symptoms are:
- white, slightly raised lesions on the tongue, inside of the cheeks, sometimes on the gums, roof of the mouth, and tonsils
- redness, burning, or soreness in the mouth that can be bad enough to impair that eating or swallowing
- bleeding if the lesions are scraped or rubbed
- cracking and redness at the corners of the mouth
- loss of taste
Cutaneous candidiasis, or skin candidiasis, occurs in the folds of the skin, including under the breasts and in the hair follicles. Symptoms include:
- bright red rash
- pustules (small bumps filled with pus)
- itching and burning
Candida is part of the normal intestinal microbiome, but if it occurs at high levels treatment may be needed. Indications of too much Candida in the gut can be found in the stool, and are:
- white, yellow, or brown mucus
- white, yellow, or light brown string-like substance
- froth or foam
Treatment of Candidiasis
There's a wide range of symptoms of candidiasis, so treatments are area specific (keeping the skin dry with absorbent powders in the case of skin candidiasis, for example). The most common means of treating candidiasis are:
- Antifungals, such as fluconazole, nystatin, and amphotericin B, kill or stop the growth of dangerous fungus in the body. They're used to treat vaginal yeast infections, thrush, esophageal candidiasis (Candida growth in the esophagus), as well as candidiasis in other places in the body.
- Probiotics may be a means of reducing symptoms of candidiasis, and they may also enhance the impact of antifungals. However, there isn't enough scientific research to consider them an alternative to conventional treatment.
- Echinocandins are antifungal treatments administered intravenously for the treatment of invasive candidiasis.
- Allymines, such as terbinafine and naftifine, and the benzylamine butenafine are antifungals used topically in the treatment of candidiasis on the skin and nails.
The Candida Diet
Candida overgrowth in the gut doesn't cause conditions such as ulcerative colitis and Crohn's, but if you have one of these conditions you are more likely to experience candida overgrowth. Some believe that symptoms such as fatigue, headache, and diminished memory can be attributed to the overgrowth of Candida, and so they opt for a diet that eliminates:
- foods high in sugar (candy, cookies, commercial cereals, some fruits, fast food, corn syrup, cane sugar, honey, agave, dairy products such as cheese, milk, and cream)
- foods with gluten (bread, beer, barley, pasta, processed lunch meats)
- foods that can aggravate gut inflammation (fried foods, sugar, soda, red meat, margarine, white bread)
While more research is necessary to determine whether there's a connection between diet and candidiasis, cutting down on sugar and white flour (and therefore most processed foods) can improve overall health. (Source, Source, Source, Source, Source)
While antifungal medications remain the first line of treatment against candidiasis, there are some common foods that possess antifungal properties, and may help fight fungal growth. Most research on these foods has been done in laboratories and while results have been promising, we don’t yet know whether eating these foods will help with Candida infection in the body.
- Garlic has both antiinflammatory and antifungal effects, particularly when it comes to Candida albicans.
- Olive oil may be helpful in controlling Candida growth, particularly when it is resistant to fluconazole.
- Cayenne pepper contains a compound known as CAY-1, which contains fungicidal elements and can enhance the efficacy of antifungals such as amphotericin B and itraconazole.
Holistic Approaches to Candida Treatment
Antifungals are the first line of treatment for Candida infections, but alternative health practitioners suggest other treatments that may be useful. These include supplements (not regulated as medicine by the Food and Drug Administration) and probiotics. Some supplements can interact with medications, so be sure to speak with your health care provider before you add any to your candidiasis treatment. (Source)
- Sodium ascorbate, a vitamin C supplement, may have an antifungal effect on Candida infections.
- Vitamin B complex has been shown to be an effective means of treating complicated vulvovaginal candidiasis when used alongside antifungals.
- Milk thistle (also known as silymarin) may act as an antifungal agent and has not been shown to have negative side effects.
- Caprylic acid, or capric acid, inhibits the formation of yeast and may be effective in treating yeast infections.
- Berberine may also reduce the lifespan of Candida biofilm (a layer of cells that has formed a colony in which microorganisms can survive) and could be helpful in treating candidiasis when it's resistant to fluconazole.
- Calendula has been shown to have antifungal properties, and when used by those with vaginal yeast infections, calendula cream was an effective treatment.
- Clove and thyme oils may help prevent formation of Candida biofilm.
- Cinnamon and lemongrass, in oil form, have demonstrated antifungal effects on candidiasis.
Probiotics are beneficial bacteria that occur naturally in the body and aid in digestion, as well as helping to maintain a balance of not-so-good bacteria. While probiotics aren't yet considered an alternative to antifungals, studies indicate they may be helpful in boosting the effectiveness of antifungals and in relieving candidiasis symptoms.
- Strains of the probiotic lactobacillus may be useful in treating recurring vaginal yeast infections.
- Bifidobacterium has been shown to inhibit Candida growth.
- Further research is needed, but there is an indication that probiotics may also help in the treatment of thrush.
- Prebiotics provide food for the gut's microorganisms, and occur in foods with fermentable soluble fibers, such as oats, beans, apples, and asparagus. It's possible that a mixture of pro and prebiotics, also called synbiotics, might be a good antifungal regimen for candidiasis.
Side Effects of Antifungals
Depending on the dosage, the kind of antifungal you're prescribed, and where the fungus is located, you might experience side effects.
- Creams, sprays, lotions, and shampoos don't typically have side effects, but if they occur, they may include itching, burning, and redness.
- Oral antifungals can cause mouth soreness, nausea, stomach pain, loss of appetite, and rash, among other symptoms.
- Injections are administered to those with severe candidiasis infections, and come with intense risks and side effects, such as kidney problems and hypotension.
Antifungals and Drug Resistance
Antifungal resistance occurs when antifungal medications stop working against fungal infections. Candida albicans can evolve to be resistant to antifungals, but this is more likely to occur with other Candida species. Some species of fungi, such as Candida auris, can become resistant to all antifungals currently in use.
Antifungal resistance may happen as a result of:
- a compromised immune system. Those with cancer, AIDS, and autoimmune disorders are more likely to develop the kind of serious fungal infections that can lead to antifungal resistance.
- overuse or misuse of antifungals. It's essential to take antifungals as prescribed so they have the best chance of working.
- spontaneous resistance. Sometimes antifungals stop being effective suddenly and the reason is unknown.
If antifungal resistance does occur, a health care provider may:
- prescribe a combination of antifungals, rather than a single drug (this is often done anyway to try to prevent resistance)
- change to a different group of antifungals, which is challenging with species of Candida that are resistant to multiple antifungals
- prescribe use of an antifungal for a longer duration
The Bottom Line on the Strongest Candida Killers
While Candida occurs naturally in the body, under the right circumstances it can overgrow and cause infections in the gut, mouth, vagina, and other areas. Most Candida infections are easy to treat with antifungal drugs, which are the most effective line of defense. However, research is being done to learn more about the relationship between Candida overgrowth and diet, as well as probiotics and supplements. Given the possibility of antifungal resistance and the side effects of some antifungals, a combination approach to treatment may be most successful.