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.