Candida & Testing

Is Candida the culprit?

If you’ve been experiencing long-term fatigue, headaches, yeast infections, or other gastrointestinal issues like irritable bowel syndrome, you’ll most likely know how hard it is to pinpoint the root cause of the problem. If your doctor is unable to find the reason for your ailment and you are experiencing these symptoms, it’s time to consider Candida fungus as a possible cause. This fungus is always present in one’s body but reproduces very rapidly once an imbalance in your gut flora occurs.

Candidiasis is often overlooked by doctors because its symptoms are so similar to other conditions. This makes it difficult to diagnose without the help of a qualified naturopathic or functional medicine doctor.

What is Candida?

Candida is a genus of yeasts that are normally found in small amounts in the human body. They live on our skin and in our intestines.

It can also survive outside the human body. It is detected in the gastrointestinal tract and mouth in 40–60% of healthy adults. It is usually a harmless fungus, but it can become pathogenic in immunocompromised individuals under certain conditions. 

It is one of the few species of the genus Candida that causes the human infection Candidiasis, which results from an overgrowth of the fungus. For example, Candidasis is frequently seen in patients with HIV.

Candida albicans is the most common fungal species isolated from biofilms either formed on (permanent) implanted medical devices or on human tissue. C. albicansC. tropicalisC. parapsilosis, and C. glabrata are together responsible for 50–90% of all cases of Candidiasis in humans.

Candida Albicans is a type of yeast that is normally found in the gut. It is part of the digestive system and helps with nutrient absorption and digestion.

Candida tropicalis is a species of yeast that is closely related to Candida albicans. This pathogen thrives in low white blood cells environment (neutropenic hosts), where it may spread through the bloodstream to peripheral organs.

Candida Parapsilosis is often a major cause of sepsis and wound and tissue infections in immunocompromised people.

Candida Glabrata is a part of your natural microflora, gastrointestinal tract, the mouth, and the genital area.

Candida albicans has been the primary source of Candidemia in America, but recent years have shown a significant increase in cases linked to non-albican species that are mostly resistant to common antifungal drugs. In some areas, C. glabrata is now the most predominant Candida infection. However, since 2015 there has been an outbreak of infections caused by C. auris (better known as simply “Candida auris“), which is quickly becoming a leading cause of invasive candida infections across the United States (1).

When is Candida harmful to health?

When in healthy amounts and balanced with other bacteria in gut flora, Candida aids in nutrient absorption and digestion. Once the gut flora is out of balance, Candida starts overgrowing the healthy amounts and causes physiological symptoms. In the digestive tract, Candida can break down the walls of the intestinal lining and penetrate the bloodstream. It starts to release toxic byproducts directly into your bloodstream and causes systemic health problems, such as allergies and autoimmune diseases.

The same overabundance of released toxins can cause conditions like leaky gut syndrome.

The toxic following toxic byproducts are released:

  • Acetaldehyde
  • Ammonia
  • Uric acid, among the most common ones

Small amounts of Acetaldehyde are easily disposed of by the liver. In a situation with the Candida Overgrowth, the liver is unable to get rid of the ever-increasing amounts of Acetaldehyde and becomes overworked. This build-up of systemic toxicity can slow down various processes in your body, for example, energy storage.

Superficial vs Invasive Candida Infections

Superficial Candida Infections are limited to the surface of the skin or mucous membranes. They include thrush (a yeast infection of the mouth or throat), vaginal yeast infections, and nail bed infections.

Invasive Candida Infections occur when the yeast enters deeper tissues, organs or bloodstream. Invasive Candidiasis can be life-threatening, particularly for people with weakened immune systems.

Types of Superficial Candida Infections

Superficial Candida Infection is the Candida Overgrowth that doesn’t go into bloodstream or vital organs. This type of infection still produces unpleasant symptoms and requires treatment.

The most common types of superficial candida infections are:

  • Vaginal Yeast Infections
  • Oral Thrush
  • Cutaneous / Skin Candidiasis

1. Vaginal Yeast Infections

The fungus Candida albicans is responsible for most vaginal yeast infections. This fungus normally lives in small numbers on the skin and inside the vagina. But when the environment in or around the vagina changes, this fungus can grow too much and cause symptoms.

Changes in the environment of the vagina can be caused by:

  • Hormonal changes during the menstrual cycle
  • Frequently wearing tights
  • Eating too much sweets
  • Frequent intravaginal douching
  • Having unprotected sex / multiple partners

The common symptoms of Vaginal Yeast Infections are:

  • itching and burning in the vagina and vulva
  • redness and swelling in the vagina and vulva
  • a thick, white discharge that may resemble cottage cheese
  • pain during urination or sexual intercourse

Around 70-75% of women of childbearing age will experience VYI at some point in their lives, and 40-50% will suffer from recurrent infections. Usually, Candida albicans is the cause behind almost 80-90% of cases except for a minority (10-20%) that are caused by other non-C. albican species like Candida glabrata (2).

2. Oral Thrush

Oral thrush is a fungal infection that affects the mouth and throat. It is also known as Oropharyngeal Candidiasis. Oral thrush is caused by a type of yeast called Candida albicans. This yeast is normally present in the mouth, but it can overgrow if the conditions are right. Oral thrush can occur in people of any age, but it is most common in babies, young children, and older adults because their immune system is not as strong.

There are many reasons why someone may develop oral thrush. Some of the most common include:

  • a weakened immune system due to conditions such as diabetes, HIV/AIDS, or certain medications, such as steroids or chemotherapy
  • dentures, if not cleaned properly, can build up a film of bacteria and yeast that can cause oral thrush
  • smoking lowers the mouth’s ability to fight against infection
  • a dry mouth (Xerostomia) that could be caused by certain medications, such as antihistamines, or conditions such as Sjögren’s syndrome

The symptoms of oral thrush include:

  • white patches on the tongue and inside the cheeks
  • redness and soreness of the mouth and throat
  • difficulty swallowing, and loss of taste.

Around 5–7% of babies develop oral Candidiasis. AIDS patients have an estimated 9–31% chance of developing the condition, while cancer patients’ chances are close to 20%. In general, 30–45% of healthy adults carry candida organisms in their mouths (3).

3. Cutaneous or Skin Candidiasis

Cutaneous Candidiasis, also known as skin Candidiasis, is a fungal infection of the skin. It is the most common type of Candidiasis.

Cutaneous Candidiasis can occur on any part of the body, but it is most common on the face, neck, and trunk. Cutaneous Candidiasis usually does not cause serious medical problems. However, in some cases, the infection can spread to other parts of the body, such as the bloodstream or internal organs.

The most susceptible to cutaneous Candidiasis are people with:

  • diabetes
  • weakened immune systems
  • people who are taking antibiotics or corticosteroids

Much more often cutaneous Candidiasis develops in warm, moist, creased areas such as the armpits and groin. It is the most common cause of diaper rash in small children.

The following are the most common causes of cutaneous Candidiasis developing in the armpits and groin:

  • warm weather
  • tight-fitting clothing
  • poor hygiene
  • infrequent undergarment changes
  • the use of corticosteroids

The symptoms of Cutaneous candidiasis are:

  • Intense Skin Itching
  • Rash
  • Redness
  • Soreness
  • Scaling
  • Cracking of the skin
  • Blisters may also occur in some cases

Cutaneous Candidiasis is usually diagnosed based on the appearance of the rash. However, a skin biopsy may be necessary to confirm the diagnosis.

Types of Invasive Candida Infections

Invasive Candidiasis is a fungal infection that can occur when Candida yeasts enter the bloodstream and spread throughout the body. These infections are serious and can be life-threatening.

There are three main types of invasive Candidiasis:

1. Candidemia

This is a bloodstream infection with Candida yeasts. It can occur in anyone but is most common in people who are hospitalized or have other health problems that weaken the immune system.

2. Deep Candidiasis

This type of infection occurs when Candida yeasts invade tissues beneath the skin, such as the muscles or organs.

3. Invasive Candidiasis of the gastrointestinal tract

This is a rare type of infection that occurs when Candida yeasts invade the lining of the stomach or intestine.

The most susceptible to invasive Candidiasis are people who:

  • are hospitalized, particularly in ICU for more than several days
  • have had an abdominal surgery
  • in need of dialysis
  • require the use of a catheter

Up to 10% of bloodstream infections in hospitals are caused by the fungus Candida. This usually happens within 3 weeks of being admitted to an intensive care unit (ICU), but it can also occur outside of the hospital if you have a central venous catheter or are receiving cancer chemotherapy (4).

The symptoms of invasive Candidiasis:

  • fever
  • skin rash
  • overall body weakness or fatigue
  • unusually low blood pressure
  • strong muscle aches
  • vision changes
  • headaches and neurological deficits
  • abdominal pain

Although not common, there have been several outbreaks of invasive Candidiasis caused by C. parapsilosis infection reported over the years, including ones involving mostly neonatal intensive care unit patients that were likely caused by transmission from healthcare workers’ hands.

The recent emergence of Candida auris has caused outbreaks of infection worldwide. This is likely because this new species can colonize human skin and persist in hospital settings. Of great concern, C. auris is often resistant to antifungal medications and some disinfectants used in healthcare settings cannot kill it.

Testing for Candida

Candida Yeast Overgrowth is a chronic condition that doesn’t have a straightforward way to test for it.

Unfortunately, doctors tend to overlook Candida imbalances as the symptoms are too numerous and vague. Many doctors do not consider the effects of gut biome imbalances on your health.

This results in Candida Overgrowth being largely overlooked or misdiagnosed for another disease that may or may not have a relation to Candida issues.

Naturopathic doctors focus on whole-body approach. Alternative medicine focuses on using natural resources and a more holistic approach to health care to prevent, diagnose, and treat illnesses.

While conventional medical professional tends to look for symptoms within their area of expertise, which makes it even harder to diagnose cases of Candida Yeast Overgrowth. There is a high likelihood that your doctor will address the symptoms of your problem. However, the root cause could stay undiagnosed for years while causing multiple unpleasant symptoms and affecting your quality of life.

Over the recent year, an increasing number of medical professionals are beginning to pay attention to Candida-related issues and order gut disorder comprehensive analyses for diagnosis. If you have difficulty or are unable to find a doctor willing to look at these tests, consider going to a local integrative doctor or naturopath.

Labs Tests

1. Comprehensive Digestive Stool Analysis

Comprehensive Digestive Stool Analysis is a simple test that can be performed to assess the health of an individual’s digestive system. The test involves taking a sample of the person’s stool and then analyzing it for various indicators of digestive health.

It’s done in the comfort of your own home. The stool samples should be collected over 3 days, so that you end up with 3 stool samples that you send to the lab for analysis. You need to have 3 samples because it will provide you with the “average” sample reading. Yeasts are often not found evenly dispersed in stool samples, meaning that what may not appear in one sample but could show up in the next or even the following sample. Getting the average result from 3 samples will prevent you from having a negative result and a high probability of accurate test results.

This test is good at detecting various Yeast infections, including Candida, as well as the imbalances of good gut bacteria, such as Lactobacillus or Bifidobacterium.

The test is also useful for identifying dysfunctional microflora, which can affect food and nutrient absorption.

Alternatively, it can point out a potential parasite infection, especially if you travel a lot and eat raw foods.

2. Urinary Indican Test

While not directly testing for a Candida Yeast infection, Urinary Indican Test can identify gut dysbiosis, potentially caused by Candida.

It looks for Indican which is a by-product of the dietary breakdown of tryptophan, an amino acid.

Generally, indican levels are low in healthy individuals. However, increased levels of indican may signify the presence of small intestinal bacterial overgrowth or gut dysbiosis.

The following factors can increase the likelihood of testing positive for high levels of Indican:

  • sugary foods
  • refined foods
  • alcohol
  • stress

That’s why this test requires following a set of rules several days before taking it. They are:

3-4 days before the test – avoid taking bile, digestive enzyme, probiotic and iodine supplements

1 night before the test – avoid alcohol, eat a high-protein meal

The urinary indican test is often administered by naturopaths or functional medicine doctors to help quickly assess the level of dysbiosis in a patient. The whole test takes only 15 minutes.

3. Candida Antibodies Test

The Candida Antibodies test is used to detect the presence of antibodies to Candida, which are a type of white blood cells. This test is typically used to diagnose or rule out infections, such as Candidiasis.

It’s important to note that there are three antigens that can potentially identify the Candida-specific antibodies in your blood. They are immunoglobulin G (IgG), immunoglobulin A (IgA) and immunoglobulin E (IgE). Depending on the levels of each of these antibodies, the test can tell if you currently have Candida Overgrowth and how long.

Higher levels of immunoglobulin G (IgG) tend to indicate the long-term nature of the yeast infection. While higher levels of immunoglobulin E (IgE) point out to a more recent yeast infection.

This is a blood test that can be done in a lab or with an at-home kit, depending on your state.

This test can be ordered as a standalone test, or together with Comprehensive Stool Analysis to get more reliable results.

4. Organic Acids Urine Test

The Organic Acids Urine Test measures the levels of over 70 different metabolites in your urine. These metabolites are byproducts of cellular metabolism and can provide insight into how well your body can produce energy, detoxify, and absorb nutrients. The organic acids urine test is conducted to determine the presence of excess organic acids in a person’s urine.

Candida albicans create organic waste products that are not naturally present in the human body. The high levels D-arabinitol is the main yeast and fungal dysbiosis marker in the urine. D-arabinitol is a metabolite of Candida and a high level of this marker usually indicates invasive Candidiasis. D-arabinitol is produced when yeasts rapidly grow in the low-oxygen environment of the small intestine, typically from dietary carbohydrates.

D-arabinitol is a sugar found in sweet fruits. To avoid any false positive test results, it is best to strictly avoid these foods for 24 hours before urine collection.

At Home Tests

1. Saliva Spit Test

This is a much less reliable home test that can be used to determine if you have Candida Yeast Infection It’s done by spitting in a cup of water first thing in the morning after you wake up.

Because of how often it can test false positive solely due to the thickness of your spit and not directly related to Candida, you need to follow several rules before taking this test.

You need to avoid taking supplements, eating dairy, and staying well hydrated 7-10 days before the test. Another suggestion is to eat everything you want (except the dairy) the week leading up to the test to establish the true levels of bacteria in your body.

Once you have eliminated dairy and properly hydrated for 10 days, follow these steps:

  1. When you wake up, before drinking or brushing your teeth, fill up a glass of water at room temperature
  2. Spit a dime-sized saliva gently into the glass of water
  3. Check back after 45 minutes and look for one of the following:
  • “Strings” coming down from the saliva into the middle of the glass
  • Cloudy saliva dripped to the bottom of the glass
  • Opaque specks of saliva floating in the middle of the cup

If your Spit Test comes out positive, it’s best to start looking into other methods of testing for Candida Overgrowth and a good time to visit a doctor.

2. Sugar Craving Test

A yeast infection is often characterized by an intense craving for sweets. That’s because yeasts, and Candida, in particular, feed off sugars. The more sugar they consume, the more they crave it. If you’ve noticed that your cravings have become much stronger, there’s a high likelihood you have a Candida Yeast Infection.

Usually, the sugar cravings appear together with one or more Candida Yeast Triggers, such as taking antibiotics, oral contraceptives, or increased levels of stress.

By taking my sugar craving test, you will be able to figure out if an overgrowth of Candida is causing your cravings. All you have to do is stop consuming anything sweet for 3 days.

That includes stopping eating any sweets or pastries, foods with added sugars, alcohol, dairy, and even fruits. Check the nutrition labels of anything you are planning to eat during those 3 days. The foods should have zero natural or added sugars. Even though it seems nearly impossible to cut out all the sugars, this test will reveal the level of true cravings you have for sweets. The stronger the craving is, the higher the likelihood that you have Candida Overgrowth. If you failed the test altogether, consider verifying this test with the more reliable methods previously mentioned.

Candida Symptoms

1. Recurring Yeast Infections and UTI’s

If you keep getting urinary tract infections, it’s a sign that there is something wrong with your microbiome. Candida thrives on gut biome imbalances and starts multiplying once given a chance.

Bacteria like E. coli is the most common cause of UTI’s. Although not widespread, Candida can also lead to a urinary tract infection­­ (UTI).

UTIs are a very common infection in women, with 40% of women in the United States developing one at some point throughout their lifetime. The infection occurs in women with or without comorbidities, such as age, diabetes or a weakened immune system (1).

Male yeast infection is less common but possible.

The symptoms of a vaginal yeast infection are itching, burning, and a creamy white vaginal discharge.

But what about a man? When men do have symptoms, they may experience itching or burning on the tip of the penis or under the foreskin, redness, soreness, discharge, and pain during urination.

The symptoms of a UTI include a strong urge to urinate, frequent urination with an empty bladder, pain or burning during urination, cloudy urine, and blood in the urine.

One thing to note is that Candida albicans can spread to other parts of your body.

Even though your vaginal infection might have disappeared, you may continue to experience reinfection in the same area until you eliminate the cause of Candida Overgrowth.

2. Oral Thrush

The mouth is particularly vulnerable to Candidiasis, with oral thrush being incredibly common. In its mild form, it is often undiagnosed until it becomes quite severe. An intestinal Candida infection often occurs at the same time as oral thrush.

It’s most common in newborns, older adults, and people with a weakened immune system.

People who do not regularly brush their teeth or have removable dentures are also more likely to develop the infection (2).

The common symptoms are:

-Red lesions in the mouth that bleed easily

-White patches on the tongue, inner cheeks, and sometimes on the roof of the mouth

-Cracking at the corners of the mouth

-Pain when swallowing

-Loss of taste

-Dry mouth

If you only have a mild case of oral thrush, you might see only a thin white coating on your tongue. You can use a tongue scraper to remove it, but it will likely come back quickly.

In more extreme circumstances, it can spread to the esophagus and lead to pain or difficulty swallowing.

3. Joint Pain

Candida albicans can cause joint pain because they produce toxic byproducts.

Acetaldehyde isn’t the only metabolite that Candida albicans creates that can lead to negative symptoms. Uric acid is another toxin produced by Candida albicans that affects joints.

If uric acid accumulates to high levels and kidneys can keep up filtering it out, it may cause gout.

Gout is a painful condition when tiny sharp crystals form around the joints. These crystals can lead to inflammation, stiffness, and pain in the joints (3).

It can cause repeated pain attacks until the problem is solved. In the long run, too much uric acid can damage your tendons and joints.

Much less common is Candida Arthritis (4). This condition typically is a result of long-term Candida Overgrowth.

Although bone and joint infections are not especially prevalent, they can still be complicated to treat. Additionally, you will often need medications that can only be given to you by a doctor (5).

4. Tiredness and Depression

Candida albicans diminish nutrient absorption by good gut bacteria. Rather than aiding symbiotic gut flora, Candida robs them of essential nutrients for its own growth.

This results in nutritional deficiencies of:

  • vitamin B6 (6)
  • magnesium
  • essential fatty acids

Vitamin B6 aids in the metabolism of protein, fat, and carbohydrates. This vitamin is also necessary for the creation of red blood cells and neurotransmitters. There are 3 main neurotransmitters in the brain, they are dopamine, norepinephrine, and serotonin.

Serotonin is a mood booster, largely found in the gut. Candida Overgrowth has the ability to suppress Serotonin levels, resulting in a low mood.

Low levels of Dopamine are associated with symptoms of depression (7). Acetaldehyde, Candida’s toxic metabolite, binds with dopamine. Thus, it brings Dopamine to low levels.

Fatigue is a common symptom of magnesium deficiency brought by Candidiasis (8). Magnesium is involved in the majority of the body’s metabolic reactions, making it an essential nutrient. One of its most important roles is in energy production, so low magnesium levels can result in fatigue or feeling tired.

Magnesium also helps calm the brain. It regulates the nervous system, keeping us from feeling overly anxious or hyperactive during normal activities. In other words, magnesium can help us feel more relaxed during everyday life.

Candida albicans can also lead to deficiencies in essential fatty acids. This is because Candida inhibits the production of enzymes needed to convert short-chain fatty acids into longer chain fatty acids. This results in a deficiency of:

  • Omega-3 fatty acids
  • Omega-6 fatty acids
  • Omega-9 fatty acids

These essential fatty acids have been shown to be important in the treatment of depression. In one study, patients with major depressive disorder who were treated with omega-3 fatty acids had a significant reduction in symptoms compared to those who were treated with placebo (9).

These are the 3 most common nutrient deficiencies caused by Candida Yeast Overgrowth, but the list is non-exhaustive and includes deficiencies of iron, vitamin A, B12 among others.

5. Chronic Sinusitis

In the past, doctors believed that bacterial infections were the primary cause of all chronic sinus problems. However, newer research has found that this may not be accurate. Although bacteria are primarily responsible for acute (short-term) sinus issues, many cases of chronic (long-term) sinusitis may actually be fungal infections.

According to Mayo Clinic researchers, the main cause of most chronic sinus infections is an immune system response to fungus. Using new methods of collecting and testing, the scientists discovered fungus in 96% of the patients’ mucus! (10)

Despite this discovery, doctors continue to prescribe antibiotics as the first choice of treatment.

While antibiotics are effective at treating acute (short-term) sinusitis, they work only temporarily for long-term chronic sinusitis sufferers. This is because acute sinusitis is mostly caused by bacterial infection. Whereas, chronic sinusitis is caused by a fungal infection as demonstrated in the study. Antibiotics can worsen the symptoms of chronic sinusitis because they wipe off any bacteria in your body, good or bad, and allow the fungus to proliferate even further.

Antifungal medications can help with chronic sinusitis symptoms, but they won’t resolve them once and for all. To prevent sinusitis from recurring, the gut flora imbalance needs to be addressed. If the imbalance is caused by Candida Yeast Overgrowth, it can be corrected with an anti-candida diet and the right supplements, which are antifungals and probiotics.

6. Digestive Issues

If you have digestive issues that your doctors are not able to address, you may want to suspect Candida Overgrowth. It’s a problem caused by gut flora imbalances that cause create a wide range of symptoms such as:

  • Bloating and flatulence (lots of gas)
  • Indigestion (food sitting in the stomach) and heartburn (caused by particular food groups)
  • Alternating, persistent constipation and diarrhea
  • Cravings for sweets, bread and high-carb foods

Candida Overgrowth is often accompanied by other gut diseases, such as Crohn’s disease, ulcerative colitis, and various types of gastric ulcers (11).