By now, almost everyone knows that we live side by side, as it were with microorganisms.
There are an estimated 100 trillion or so of them living in, on and around us. In every nook and cranny, every fold and crevasse. In your ears, your eyes, mouth and digestive tract and more.
Most aren’t dangerous. Your body requires the majority of them to carry out normal functions which help to keep you healthy. However, some can cause infections when they begin to multiply uncontrollably.
The candida fungus is one of these potentially harmful organisms. Up to 15% of hospital-based, bloodstream infections are due to different species of candida fungi. These types of infections have a mortality rate of 5-71% depending on the patient population (1)
Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida (2). There over 20 different species of candida yeasts that can cause infections in humans. Most infections are caused by candida albicans.
Candidiasis that develops in the mouth or throat is called “thrush” or oropharyngeal candidiasis. Candidiasis in the vagina is commonly referred to as a “yeast infection.” Invasive candidiasis occurs when Candida species enter the bloodstream and spread throughout the body.
It’s important to note that you don’t catch candidiasis, it’s not an infectious pathogen like the flu virus. The fungus is already there, it’s always been there. Candida must earn the right to live in and on us. Other harmless organisms compete for space and resources and by doing so, keep the candida population in check.
- overuse of antibiotics
- steroids and other immuno-suppressants that weaken the immune system
- douches and vaginal sprays (which change the acidity or pH of the vagina)
- HIV/AIDS, weakened immune system
- medical treatments
- chemotherapy and radiation
- high alcohol consumption
- diet high in refined carbs and sugar
- elevated stress
When it comes to systemic (whole body) infection, the source (main reservoir) and cause of candidemia (candidiasis) has been the subject of considerable debate. Some experts suggesting the gastrointestinal tract and others, the skin as the main origin of infection.
Studies strongly suggest though, that the gut is the main source of candida that leads to candidemia. Studies that have supported the skin as a source for this infection are surprisingly incomplete (8, 9). Yet another reason to do what you can to have the healthiest gut possible.
Candidiasis mouth infection is oral thrush (10). Like other areas of your body, you have a small amount of candida living in your month without causing harm. Oral thrush is typically mild and rarely causes issues but can be problematic in those with weakened immune systems.
Candidiasis mouth infections are typically white looking, with bumpy patches on the tongue, inner cheeks, tonsils, back of throat and gums (11, 12). In advanced cases, it can spread to the esophagus, a.k.a. as esophageal candidiasis or esophageal thrush. This can make eating, and swallowing food and beverages very painful and challenging.
Since candida is everywhere, it’s also found in the vaginal tracts of most women and candidiasis of the vagina is common (13).
It’s also possible to get a candida-related urinary tract infection (UTI). They are common in the elderly, hospitalized patients and like candidiasis in general, UTIs from candida are more common in those with a weakened immune system (14, 15).
As a urological disorder, candidiasis in men may show up as a UTI, separate from the usual bacterial type. An important consideration when assessing urinary tract symptoms.
Be sure not to ignore any signs or symptoms of a possible UTI infection such as a burning feeling when you urinate, a frequent urge to urinate, cloudy, dark or strange-smelling urine and pain or pressure in your lower abdomen.
Fatigue and tiredness
One of the more common symptoms of this yeast infection is fatigue. It’s not fully understood why, or even if candida causes fatigue but those with candida overgrowth often experience significant tiredness.
It’s been suggested that prolonged candidiasis of the gut might be a major contributor to chronic fatigue syndrome (16), and therefore a lack of energy in general.
One explanation for fatigue may be due to nutrient deficiencies (17). The infection can impact eating. If there’s candidiasis of the mouth or esophagus, eating and swallowing can be painful and may lead to decreased eating and ultimately nutrient deficiencies. Candida overgrowth of the gut can cause a decrease in appetite as well.
Another way candidiasis causes fatigue may be related to the associated stress and elevated cytokines from the immune system trying to fight the infection (18, 19). Cytokines are protein molecules that promote inflammation. As well, those with candida overgrowth typically have the infection because their immune system is weakened (20). Impaired immune function, infection, inflammation and fatigue go hand-in-hand.
The sinuses are a perfect breeding ground for infections. They’re dark, moist and there’s lots of cracks and crevasses for things to hide in. This explains why sinusitis is so common in the general population (21, 22).
Longer term infections of the sinuses are believed to be fungal in nature. Most viral and bacterial infections tend to be relatively short lived. One study found that those with chronic sinusitis had fungal infection (23, 24, 25, 26). If this is the case with yourself, consider being swabbed and checked for a fungal infection.
Treatment is tricky, antibiotics don’t work like they do for bacterial infections. Surgical removal of the thick fungal debris and muci in the infected sinuses is the most effective way to treat acute fungal sinusitis (AFS). You need to literally clean out the source and help your immune fight the good fight. If the fungal population is too dense, your immune system can’t keep up.
Steroids may be given before and after the surgery. Recurrence of AFS is not uncommon and patients may require additional surgeries. Immunotherapy and anti-inflammatory therapy may also be used to eliminate the fungal colonies (27).
Brain fog. An expression that mainstream medicine HATES. That’s just a lay term for the lack of clarity or a sense of fuzziness that anyone can experience when they’re unwell.
Brain fog isn’t a medical diagnosis or condition. It’s a symptom of other medicals issues; a type of cognitive dysfunction.
It’s nothing to be scared of. When the body experiences inflammation from an overactive immune system or infection, it releases cytokines (protein molecules that promote inflammation).
Inflammation – from any cause – can cause you to mentally process information slower than normal. It can feel like confusion, lack of concentration, feeling mentally sluggish with a lack of focus (28, 29). Brain fog is linked to depression and depression is linked to inflammation (30)
Systemic or gut infections, including candidiasis, can lead to gut inflammation, movement of a gut toxin, LPS, and other food proteins into the blood leading to inflammation and “brain fog”. Once the infection is cleared, brain fog tends to as well.
Far from conclusive, but it’s been suggested that candida overgrowth may contribute to mood disorders and anxiety. Candidiasis infection may also lead to treatment resistance mental health disorders (31, 32).
If true, this may be due to the role of candidemia on promoting systemic (whole body inflammation). Increased inflammation is associated with higher rates of depression and worse anxiety (33, 34, 35, 36, 37).
It’s an interesting and curious prospect which reinforces the need to address both your gut, brain and mental health – the gut brain axis – together. You can’t have the health of one at the expense of the other.
It’s not a simple as saying you have “good” and “bad” bacteria in your digestive system. Normally the balance between health and disease is maintained when there’s an ideal amount, proportion and variety of gut microorganisms.
Even so-called “good” bacteria can be a problem if they overgrow.
In this case, candida albicans overgrowth is normally prevented by the presence of other gut bacteria. Under certain conditions, the candida population can explode. Certain gastrointestinal diseases and disorders are associated with candidiasis such as colitis, gastric ulcers, duodenal ulcers, and Crohn’s (38).
It’s a vicious cycle. Digestive disorders and diseases can increase the risk for candida overgrowth. In turn, the inflammation that comes with these gut diseases promotes candida albican colonization (38). Addressing any infection is key but managing any existing gut disease is equally crucial if you want to reduce the risk for candida overgrowth from reoccurring.
It’s next to impossible to diagnose candidiasis of the gut by symptoms alone. Dysbiosis regardless of the cause will usually show up with the usual suspects such as constipation, diarrhea, nausea, gas, cramps, flatulence and bloating. Stool testing is needed for to make that diagnoses.
Skin and nail fungal infections
Typically a strong immune system, and other bacteria that live in and on you, prevents the overgrowth of candida but this can run amok. This is true with your skin and nails as well.
Candidiasis skin infection, as well as, the nails is a common occurrence. While candida can grow anywhere, it thrives in those areas that are warm and most such as the armpits and groin. These areas are more at risk than say your arms, legs or chest.
While there are different species of fungi, candida is a common cause of athlete’s foot-like and toenail infections (39). It is also associated and seen in those with psoriasis (40). Treating psoriasis with an cortisone cream can help, but if candida is present, you’ll need more for optimal relief.
The main symptom of candidiasis skin infection is a rash. The rash causes redness and bad itching. In some cases, the infection can cause the skin to become cracked and sore. Sometimes blisters and pustules may also occur.
Candida can enter your blood stream and travel throughout your body. Typically an overgrowth in the gut can enter the blood stream when your gut barrier isn’t working well. This is referred to as gut barrier dysfunction, a.k.a. “leaky gut“. However, candida overgrowth at any site can be a source for systemic infection (affecting the whole body).
Although fungal infections of the joints are infrequent, they can happen. When the yeast travels to your joints, it can lead to pain and “candida arthritis” (41). When this happens, it’s due to what’s called “acute disseminated candidiasis” where a generalized candida infection spreads to other parts of the body (42).
Candidiasis treatment typically involves an anti-fungal medication.
The best way to help reduce it’s recurrence is to address any underlying risk factors for it. Eating the right foods helps to prevent candida overgrowth and helps to maintain a good balance of gut bacteria (43).
From a diet point of view, thinking of the risk factors above, it’s best to moderate alcohol intake. Follow standard recommendations to limit alcohol to 1 standard drink per day for women and 2 for men. Reducing your intake of refined carbohydrates, refined and added sugars is another important approach.
Best way to support your gut bacteria so they can keep candida in check is to eat dark green leafy greens and to get regular sources of prebiotic fiber. There’s also some evidence that the antimicrobial effects of caprylic acid can help too.
Candida is the most common cause of fungal infections in humans.
Depending on the location and type, symptoms can help you determine whether you have an overgrowth of Candida or if it’s something else. Knowing this will help you and your health care provider make a clearer diagnosis.
The most common signs of infection include oral thrush, recurring genital yeast infections, digestive issues and fungal infections of the skin and nails. Be sure not to ignore these and seek medical attention.
It’s important to treat candidiasis early to prevent it from spreading and causing more serious complications.