Commensal relationships exist when there is a balance between microbes and our body’s natural defences. If this balance is disturbed, like with antibiotics or a weak immune system, some microbes can take advantage. Candida is one type of yeast that can do this.
Many people will have suffered from “strep throat” where the bacteria Streptococcus leads to a throat infection. Candida infections happen in the same way. But remember, just like strep, candida is found in the body in normal healthy people, it’s only in certain conditions that it becomes infectious.
Infection from Candida and other yeast can occur in several places in the body, but in terms of the digestive system, it most commonly affects the mouth, throat and oesophagus (food pipe). Symptoms include a rash, throat pain or difficulty swallowing. It’s sometimes possible to see a white lumpy rash on the tongue.
Whereas Candida infections in the intestines are much less common, and symptoms like bloating, belching and indigestion may be related to many other different things. Still, Candida and yeast can overgrow in our guts if we lose our defence mechanisms. The two main defences we have against Candida infections are our immune systems and our microbiome.
Immune system
The immune system has specific cells that protect against Candida. For this reason, people who have weakened immune systems have an increased chance of developing an infection from Candida. For example, steroid medications or chemotherapy can shut immune systems down. This allows Candida and other yeasts to grow more easily.
Microbiome
The gut microbiome refers to all of the different organisms that live in our gut. These include bacteria, archaea, viruses, but also fungi like Candida. The good thing about having so many different types is that they are all in competition with each other, fighting for the same nutrients. In fact, some species of bacteria like Lactobacillus can inhibit Candida growth. But if the bacteria are killed off by antibiotics, then they can’t keep the yeast in check. Having a disrupted microbiome for other reasons, including inflammatory bowel disease, can also increase the chance of infection.
SIFO
You may (or may not) have heard of small intestinal bacterial overgrowth (SIBO). This is a condition where too many bacteria grow in the small intestine. It’s also possible to have excess fungi in the small bowel, called small intestinal fungal overgrowth (SIFO). SIBO and SIFO cause similar IBS-like symptoms, such as bloating, abdominal pain and nausea. One study found that 1 in 4 people with unexplained digestive symptoms may have SIFO. However, there is little research into its true prevalence because testing for SIFO can only be diagnosed by taking an invasive sample from inside the gut.
A brewery in your gut
Auto-brewery syndrome is a rare condition where yeast in the gut ferment sugars and convert them into ethanol. This can induce symptoms similar to being hungover, such as brain fog and fatigue. There is even a case report where someone with auto-brewery syndrome was charged with driving under the influence, but they hadn’t drunk any alcohol. Auto-brewery syndrome is diagnosed by ingesting the sugar glucose and measuring how much ethanol is released in blood afterwards. But this condition only seems to affect people chronic health conditions like diabetes or liver failure. In reality, yeast infections this severe rarely occur in healthy individuals.
Treating Candida
There is a lot of information online about diets and supplements for Candida, but there are no good studies to support their use.
The main issue is, without an accurate test for Candida or yeast overgrowth, following any restrictive diet or taking any unnecessary supplement might do more harm than good. Remember, there is no current test for Candida other than an invasive biopsy. Stool tests are misleading Candida is found in most healthy individuals and doesn’t necessarily mean there is an infection. At the moment, the best suggestion would be to follow a diet that promotes a healthy microbiome to keep all opportunistic microorganisms in check.
One that is filled with fibre, fermented foods, and low in ultra processed food starches and refined sugar. And if you are going to take any antibiotics, check out some probiotics that can help to reduce side-effects from
