Candidiasis

What is candidiasis

Candidiasis is caused by an overgrowth of a common yeast – candida albicans, the most prolific of the candida yeast genus. Iit is also caused by other varieties of candida, but they are rare.

Candid normally exists in the gastrointestinal tract, mouth and vagina (in women) without any adverse effects. It is only when this yeast becomes too prolific and there is an overgrowth of it, that it can cause a condition named candidiasis. Which is basically an overgrowth of the candida yeast.

Facts about candidiasis

• Some women who think they have thrush may have another vaginal disorder and should see their doctor for a definite diagnosis (never self-medicate)
• Candidiasis is a common condition in many people
• Most cases (around 90%) of candidiasis are caused by the candida albicans yeas, but not all
• People with depressed immunity tend to be more susceptible to getting candidiasis
• More than 50% of all women will develop vaginal candidiasis at least once in their life and mainly without any real identifying cause

Symptoms of candidiasis

Symptoms of candidiasis depend on point of infection

The most common symptoms of candidiasis depend on where in the body the infection is occurring:

• Intestine
• Mouth
• Penis
• Skin
• Vagina

If there is a more prolific infection, then it can affect the whole body and cause more generalised symptoms:

General candidiasis symptoms

• Cottage-cheese like patches inside the mouth (if the mouth has been infected with candida overgrowth)
• Diarrhea, constipation, bloating, gas or burping
• Fatigue
• Genital itching and burning
• Headache
• Itchy rash on penis (men)
• Mood swings
• Poor concentration
• Poor memory
• Skin rashes, patches, and blisters – in the groin, between fingers and toes and under the breasts (folds of the skin)
• Sugar craving
• Vaginal discharge like “cottage cheese”

Causes of candidiasis

Candidiasis can develop due to a number of reasons:

Antibiotics

One of the main reasons that causes candidiasis to develop in people (and especially in the vagina of women) is the overuse of antibiotics, especially prolonged use of antibiotics.

Antibiotics are used to prevent a bacterial infection from getting worse, but are also prescribed to people with a viral infection (flu), to prevent a more serious bacterial infection (pneumonia). The antibiotics kill off all the bacteria in the body – both the “bad” bacteria that are likely to cause infection and the “good” bacteria that are needed by the body for various process, especially in digestion and elimination. When too many of the “good” bacteria are killed, this could allow a proliferation of the candida albicans yeast to grow and cause symptoms associated with candidiasis.

Lowered immunity

People with lowered immunity are much more susceptible to developing candidiasis (or any other opportunistic condition) because their body is not able to fight the proliferation of the candida albicans yeast.

Lowered immunity means the the body’s defence systems (and “good” bacteria) are in low supply, so when the candida albicans yeast starts to overgrow, the immune system (and “good” bacteria) are not able to reduce their proliferation and as a subsequence, candidiasis and all the symptoms associated with this condition occur.

Prevention of candidiasis

Non-preventable risk factors

Candidiasis may be unpreventable in certain circumstances:

• Antibiotics – people sometimes need to take antibiotics, especially if they have a bacterial infection that could possibly become life threatening. The only known way to resolve a bacterial infection is to prescribe antibiotics and one of the known side effects of antibiotics is an overgrowth of the candida albicans yeast, especially in the vagina (for women) and penis (for men) and less commonly in the mouth. Candidiasis is a known side effect of antibiotic treatment, more so for people who are on long-term antibiotic therapy
• Bacterial infections – people with an existing bacterial infection may also have some lowered immunity due to the infection. The lowered immunity may result in a decrease in the “good” bacteria in the body, with a proliferation of the “bad” bacteria. This can allow the candida albicans yeast to overgrow without abate. In addition, people with a bacterial infection may also be taking antibiotics, which can further reduce the numbers of “good” bacteria and provide a perfect environment for the candid albicans yeast to overgrow and develop into candidiasis.
• Diabetics – people who have diabetes are more prone to developing candidiasis (and other opportunistic infections) because of their lowered immunity and inability of their pancreas (and the rest of their digestive system) to function normally. If there are insufficient “good” bacteria in the gastrointestinal system and there is a proliferation of the “bad” bacteria, this allows opportunistic yeasts such as candida albicans to overgrow, because the body’s immune system cannot control it
• Lower immunity – people who have lowered immunity, either from general immune system problems or through artificial lowering of immunity through the use of certain medications that suppress the immune system (AIDS/HIV medications, corticosteroids, chemotherapy) are more likely to developing candidiasis, as well as any other opportunistic infections, due to the suppression of their immune system’s function. If the immune system is impaired, it cannot stop (or even slow don) the overgrowth of any “bad” bacteria, viruses or yeasts and this allows the candida albicans yeast an opportunity to overgrow, proliferate and cause candidiasis
• People taking certain medications – people who are taking medications that suppress immunity (AIDS/HIV medications, corticosteroids, chemotherapy) are more open to developing candidiasis, as well as any other opportunistic conditions because these medications suppress and lower the functioning of the immune system, so that it cannot cope with the overgrowth of the candida albicans yeast. This is just an unfortunate side effect of the medications they are taking and is not easily prevented, although steps can be taken to reduce the risk

Preventable risk factors

There are ways to prevent candidiasis from occurring:

• Maintain a healthy weight – people who are very overweight are much more susceptible to an overgrowth of the candida albicans yeast (and any other opportunistic infections) because their gastrointestinal system is over-burdened due to their excessive weight. The best way to prevent candidiasis is to ensure weight is within a healthy range
• Probiotics – the only way to prevent candidiasis from occurring while taking antibiotics is to ensure that they are only prescribed for a bacterial infection (and not for a viral infection) and to eat plain yoghurt with live acidophilus cultures and possibly also take a probiotic supplement while on the antibiotics (but at different times)
• Healthy diet – people that have a very poor diet, that does not include enough of all the vitamins, minerals and other nutrients required for good health, are more prone to an overgrowth of the candida albicans yeast, because their digestive system is not functioning properly. Poor dietary choices overburden the gastrointestinal system and allow “bad” bacteria and yeasts to proliferate and cause a number of adverse symptoms. It is essential to follow a healthy diet that includes lots of fibre, plenty of fresh fruit and vegetables, wholegrains, some dairy, some oily fish and some meat and poultry and other proteins

Complications of candidiasis

There complications for untreated candidiasis are secondary opportunistic infections:

• Fungal infections – untreated candidiasis may enable other fungal infections to proliferation. The most common fungal infection that can occur is tinea (ringworm)
• Vaginitis – if vaginal candidiasis is left untreated, it can cause vaginitis, which is an inflammation of the vagina

When to see a doctor about candidiasis

If you have any of the symptoms of candidiasis, you will need to visit a doctor to confirm diagnosis of this infection.

If you have a partner, they will need to be tested and treated for this condition.

While candidiasis is not a very serious illness, it is important to consult your doctor for a definitive diagnosis, as it is not beneficial to self-diagnose and self-treat as many other infections can have similar symptoms and only a swab can confirm this condition and rule out others.

Diagnosis of candidiasis

Candidiasis is usually diagnosed by the following way:

• Medical history – the doctor will ask a series of questions about the onset, duration and severity of symptoms
• Physical examination – the doctor may also perform a visual physical examination of the affected area to determine if it a candidiasis infection is clearly obvious

If candidiasis is suspected after the doctor takes the medical history of symptoms or even if during the physical examination, the following test may also be done to confirm it:

• Medical swab – the doctor (or nurse) will take a swab from the affected area which will be tested to determine if the infection is from the candida albicans yeast

Conventional treatment of candidiasis

Conventional treatment of candidiasis involves a combination of a few strategies – lifestyle modifications together with medication:

Lifestyle modifications

There are a number of lifestyle modifications that are recommended to help reduce the risk of further symptoms:

• Probiotics – the friendly bacteria in probiotics makes the intestinal tract more acidic, inhibiting the growth of candida albicans, as well as producing hydrogen peroxide, which also kills the candida albicans and prevents overgrowth and reduces symptoms by promoting proper intestinal flora
• Tea tree oil – most conventional doctors recommend a vaginal douche with diluted tea tree oil can be used on the infected areas (only the vagina, penis and skin but definitely not the stomach or mouth) to quickly relieve symptoms, as it is a potent anti-fungal

Medications

There are a few different medications which can be prescribed, depending on the severity of symptoms and proliferation of the candida albicans yeast in the body:

• Anti-fungal medications – there are a variety of tablets sold in pharmacies which can be purchased without a prescription in Australia. There may be some side effects in some people, depending on the dose
• Creams with low-strength corticosteroids – topical vaginal creams can be used with corticosteroid tablets, which should only be taken over a short-term
• Topical vaginal creams and suppositories – these are also sold in pharmacies which have anti-fungal medication in this format; there may be some side effects in some people, depending on the dose

Most conventional treatments last from a few days to a number of weeks, depending on how resistant to treatment the candidiasis infection is. Be sure to take all medications exactly as prescribed as re-infection can occur with an even more resistant strain or another type of strain of the candida albicans yeast.

Alternative/complementary treatment of candidiasis

There are a number of alternative and complementary treatments which are useful in treating candidiasis and reducing symptoms.

Herbs

Certain herbs have been shown in studies to help alleviate the symptoms

• Echinacea – the herb echinacea has proven anti-fungal (as well as anti-bacterial and anti-viral) properties. Studies show that intake of echinacea can help improve the condition by reducing symptoms
• Garlic – the herb garlic is best if eaten fresh, cooked with food or taken as a supplement. Garlic has potent anti-fungal properties and can help to reduce some symptoms
• Pau d’arco – the herb Pau d’arco is a potent anti-fungal which can be used on the infected areas (only the vagina, penis and skin but definitely not the stomach or mouth) to quickly relieve symptoms
• Tea tree oil – diluted tea tree oil can be used on the infected areas (only the vagina, penis and skin but definitely not the stomach or mouth) to quickly relieve symptoms, as it is a potent anti-fungal

Vitamins

There are a number of vitamins which are useful in treating candidiasis and reducing symptoms:

• Biotin – the B cofactor vitamin, biotin (vitamin H) is effective in stimulating the immune system to return the flora balance that has been overgrown with the candida albicans yeast, back to healthy levels
• Vitamin A – the antioxidant vitamin A stimulates and supports the immune system to function more effectively and this helps to reduce the levels of the candida albicans yeast, which helps to reduce symptoms and returns the flora back to healthy levels
• B vitamins – the B vitamins (vitamin B1, vitamin B2, vitamin B3, vitamin B5, vitamin B6, vitamin B12, folic acid) all help to stimulate the immune system to function better and this helps to reduce overgrowth of the candida albicans yeast and returns the flora balance back to healthy levels
• Vitamin C – the antioxidant vitamin C stimulates and supports the immune system to function more effectively and this helps to reduce the levels of the candida albicans yeast, which helps to reduce symptoms and returns the flora back to healthy levels
• Vitamin E – the antioxidant vitamin E stimulates and supports the immune system to function more effectively and this helps to reduce the levels of the candida albicans yeast, which helps to reduce symptoms and returns the flora back to healthy levels

Minerals

There are a number of minerals which are useful in treating candidiasis and reducing symptoms:

• Selenium – studies show selenium increases resistance to candidiasis by boosting the function of the immune system to get rid of the bacteria more effectively and prevents proliferation
• Zinc – studies show zinc increases resistance to candidiasis by boosting the function of the immune system to get rid of the bacteria more effectively and prevents proliferation

Other nutrients

There are a number of other nutrients which are useful in treating candidiasis and reducing symptoms:

• Acidophilus – the friendly bacteria acidophilus, a helpful probiotic, makes the intestinal tract more acidic, inhibiting the growth of candida albicans, as well as producing hydrogen peroxide, which also kills the candida albicans yeast, prevents overgrowth and reduces symptoms by promoting proper intestinal flora
• Omega 3 fatty acids – the omega 3 essential fatty acids (DHA/EPA) help to reduce inflammation which is present in the area which has been infected with candidiasis through the overgrowth of the candida albicans yeast

Dietary modifications

Certain foods should be restricted (or even eliminated), while others need to be increased. The Candida diet may need to be adhered to for a minimum of 4 weeks, but could be recommended longer depending on how long symptoms have been experienced and how bad they are, after which the foods will be slowly introduced back into the diet (as long as they do not cause adverse effects):

• Confectionary – any type of “sweet stuff” including chocolate, ice cream and lollies should be avoided when treating candidiasis to get the best result, as candida growth is promoted by excessive sugar intake
• Fibre – foods high in soluble fibre should eaten each day to help improve and balance bowel flora. Suitable soluble fibres are: flaxseeds, oats and psyllium. The intake of these soluble fibres should be done gradually in people who are not used to eating so much fibre in their diet, in order to prevent adverse symptoms such as gas, bloating and constipation and ensure to drink a lot of water
• Fruit – most fruits are eliminated or greatly reduced on an anti-candid diet, as candida growth is promoted by excessive sugar (or glucose) intake
• Nuts – certain nuts, such as walnuts, contain beneficial omega 3 fatty acids, which assist with relieving inflammation associated with symptoms
• Oily fish – these fish (mackerel, salmon, sardine, trout, tuna) contain beneficial omega 3 fatty acids, which assist with relieving inflammation
• Processed foods – any types of processed foods will put extra stress on the body as they contain too much sugar and fat will assist the candidiasis to worsen
• Wholegrains – these foods contain fibre (to help bowel flora become balanced and healthier) and B vitamins which may be depleted in people with candidiasis
• Yeast containing foods – any fermented foods, such as cheese, tomato paste, vinegar should be avoided as the yeast inside them may stimulate further growth of the candida albicans yeast and worsen symptoms
• Yoghurt – plain yoghurt, especially if it has been fortified with acidophilus, will help to lower levels of candida albicans yeast and help to reduce symptoms

Lifestyle modifications

There are a number of lifestyle modification strategies that can be used to help reduce symptoms and prevent recurrence of candidiasis in the future:

• Avoid antibiotics – it is important to avoid taking antibiotics unnecessarily, as they can kill off both the “good” and “bad” bacteria (flora) and cause candidiasis in some susceptible people whose immune system (and digestive system) may not be functioning as optimally as possible
• Bottle feeding babies – mothers (and fathers) need to ensure that all parts of the feeding bottles are sterilised properly to prevent possible candida albicans overgrowth in the unsterilised bottles. Alternatively, breastfeed the baby as much as possible to prevent any issues with sterilisation of the baby bottles
• Cotton, linen or silk underwear – these natural materials allow the vaginal area to “breathe” and give less opportunity for the candida albicans yeast to overgrow and candidiasis to begin
• Good hygiene – women should always wipe from the vagina to the anus when going to the toilet, never the other way, as that can spread infection
• Vaginal douches – women should avoid using any type of vaginal douches or deodorants, as these can cause a disturbance of the acidity and flora balance in the vagina and can lead to candidiasis

Alternative treatments

There are no other alternative treatments recommended for candidiasis.

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with candidiasis

Self care strategies

There are a number of strategies you can use to help with reducing severity and incidence of symptoms:

• Good hygiene – women should always wipe from the vagina to the anus when going to the toilet, never the other way, as that can spread infection
• Natural underwear – if the candidiasis infection is a vaginal one, then natural underwear should be used to allow the vaginal area to “breathe” and give less opportunity for the candida albicans to overgrow. The best materials are: 100% cotton, 100% linen or 100% silk
• Probiotics – it is recommended to eat plain yoghurt that is fortified with probiotics to help re-populate the gastrointestinal system with “good” bacteria that can help with removing the candida albicans bacteria and reduce symptoms of candidiasis
• Reduce intake of processed foods – processed foods are usually high in sugar, which needs to be reduced as sugar helps to feed the candida albicans bacteria and helps to proliferate its growth to higher levels and makes symptoms worse
• Reduce sugar/confectionary intake – sugar (or confectionary) intake needs to be reduced as sugar helps to feed the candida albicans bacteria and helps to proliferate and overgrow to higher levels and this makes symptoms much worse

Caring for someone with candidiasis

Partner

If your partner has candidiasis, you can support them through the following strategies:

• Get tested – if your partner has candidiasis, especially if it is vaginal or penile, then you will need to also get tested to determine if you have the condition as well
• Probiotics – both you and your partner need to eat more foods rich in probiotics or even try a supplement, as that will help to repopulate your body with friendly flora, which can help with reducing symptoms more quickly

Friends

There are no specific strategies friends can use to help with support.’

Parents

If your child has candidiasis, you can help support your child with the following strategies:

• Fewer sweets and processed foods – your child will benefit from eating less sweets and processed foods, because these types of foods break down into glucose very quickly and help feed candida albicans so that it can grow and proliferate even more
• More natural foods – ensure your child eats more natural foods that have not been processed
• Probiotics – it is very beneficial for your child to eat more foods rich in probiotics or even try a supplement (but ask your doctor first), as that will help to repopulate their body with friendly flora, which can help with reducing symptoms more quickly

References

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• Crook, WG. The Yeast Connection: A Medical Breakthrough. Jackson, Tenn., Professional Books, 1983, 1984, 1986
• Enfert C; Hube B (editors) (2007). Candida: Comparative and Functional Genomics. Caister Academic Press. ISBN 9781904455134
• Jones T, Federspiel N, Chibana H, Dungan J, Kalman S, Magee B, Newport G, Thorstenson Y, Agabian N, Magee P, Davis R, Scherer S (2004). “The diploid genome sequence of Candida albicans”. Proc Natl Acad Sci U S A 101 (19): 7329-34
• Martin JM, Rona ZP. Complete Candida Yeast Guidebook. Three Rivers Press; 2nd Rev edition, 2000
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Last reviewed and updated: 14 May 2024