Welcome to episode 463 of The Whole View! This week, Sarah and Stacy examine the science behind Candida cleanses and shed light on some of the misinformation and claims we see online.
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The Whole View, Episode 463: Is There Science Behind Candida Cleanses?
Welcome back to episode 463! (0:28)
Sarah always thought Candida cleanses wouldn’t align well with AIP. The sheer amount of food elimination makes it nearly impossible to get the variation needed for nutrient sufficiency.
She’s since has done tons of research regarding the science behind Candida cleanses and has dug up some surprising information that will debunk a lot of internet claims.
Just Thrive, Stacy and Sarah’s favorite probiotic for gut health support, is sponsoring today’s show! Get 15% off your purchase with code THEWHOLEVIEW at checkout.
A listener question inspired this topic! Olivia says:
I got diagnosed of candida, and my integrative doctor said to cut out honey or maple syrup for two months, knowing those are what I typically would use as a sweetener. When I look up the candida cleanse diet online, apparently fruits high in sugar and caffeinated drinks would be off the table also-not that my doctor recommended me to though.
I know Dr. Sarah would say that our body needs the nutrients in fruits too for various reasons, and blackstrap molasses are a superfood.
I am aware that even for healthy individuals, sweetener should only be consumed in moderation. However, for a Sjögren’s syndrome warrior now also diagnosed with candida, should I cut out maple, honey, molasses and fruits high in sugar even in moderation? Is AIP okay with candida? Are there any drawbacks of starving the candida with a cleanse to reset my microbiome before resuming on the recommended AIP lifestyle?
Alas, life of an autoimmune disease warrior!
What Is Candidiasis?
Candidiasis is essentially an overgrowth of yeast. (8:50)
Candida albicans is a species of yeast that is a member of the healthy microbiota, asymptomatically colonizing the gastrointestinal tract, reproductive tract, oral cavity, and skin of most humans (1, 64, 87, 97, 99).
It’s commonly found both on and in the human body and generally causes no problems.
Certain conditions, however, can lead to an overgrowth of this benign organism. The resulting infection is candidiasis.
The most common cause is alterations in the host-microbiota due to the use of antibiotics.
Research in mice suggests that bacteria in the gut usually out-populate yeast and other fungi by three orders of magnitude.
During antibiotic treatment (which can kill good bacteria in your gut in the process of attacking the invader making you sick), the gut yeast population skyrockets 40-fold. Typically, levels return to normal within eight weeks.
So the best thing you can is to support the recovery of the gut microbiome. Stacy and Sarah talked about this more in-depth in Episode 460.
People with a suppressed immune system and/or diabetes can be more susceptible to yeast overgrowth.
Chronic stress can also increase risk, as shown in the morning rise of salivary cortisol levels in women with recurrent vulvovaginal candid.
Yasmin et al. proved that increased dietary fat intake (39% of energy from fat), especially total fat, saturated fat, and monounsaturated fat, can increase vaginal pH and the risk of bacterial vaginosis.
High estrogen levels can also be a risk factor, which is why yeast infections are more common when women are pregnant or taking hormones.
Before making a lot of health changes to her lifestyle, Stacy suffered chronic yeast infections. Like many, she often thought of avoiding sugar such as carbohydrates.
Complications from C. Albicans Infection
C. Albicans infections can cause a spectrum of other complications. (19:26)
Vaginal yeast infections (which affect up to 75% of women at least once in their lifetime), superficial mucosal infections (such as thrush), and superficial dermal infections (like diaper rash and cutaneous candidiasis) are common results of C. Albicans Infection.
Cases of invasive candidiasis are very rare. It happens when blood or internal organs become infected and usually occurs in hospitalized patients. It has high morbidity and mortality rates (approaching 40% in some cases).
Candida albicans may also play a role in the persistence or worsening of some chronic inflammatory bowel diseases!
Some research has linked yeast, such as Candida, to a few gastrointestinal conditions including Crohn’s Disease and Graft-Versus-Host Disease.
With Crohn’s, researchers are careful to note there’s no evidence that fungi cause the disease. However, they do seem to aggravate the inflammatory response in mice. However, Crohn’s patients often have higher-than-normal levels of antibodies against components of Candida and other yeast.
But the associations between yeast and other gastrointestinal conditions are still just associations.
So far, no one knows whether the yeast plays a causal role or whether changes to yeast populations might be a consequence of the conditions.
Diagnosis of Candida Infection
Symptoms of the condition for oral and vaginal thrush may be diagnostic if there’s a history of previous candida infections, weakened immunity, and steroid or antibiotic use.
For vaginal yeast infections, your health care provider will perform a pelvic exam and take a sample of the discharge from your vagina.
In the diagnosis of oral thrush, the appearance of the lesions is characteristic. But your healthcare provider may also take a small scraping to examine under the microscope.
For suspected yeast infection on the skin or nails, your healthcare provider may use a blunt-edged instrument to scrape off a small bit of skin or part of a nail for examination.
For invasive candidiasis, healthcare providers will take a blood or tissue sample to see if it will grow Candida in a lab culture.
Blamed for Everything: the Science Behind Candida Cleanses
There is a trend towards blaming candida for everything. However, Sarah has found no science to support this. (27:55)
She adds there’s not a shred of science supporting Candida overgrowth as the root cause of society’s collective fatigue, insomnia, autoimmune diseases, food cravings, or acne.
Also, there is no evidence that Candida cleanses and anti-fungal drugs can cure any of these conditions.
In a small clinical trial, researchers at the University of Alabama recruited women who had repeated vaginal yeast infections and also other vague symptoms like brain fog, allergies, and digestive issues. They split them into groups and gave them different combinations of antifungal drugs or sugar pills.
Although the antifungal drugs did control vaginal yeast growth and symptoms, they did not improve the subjects’ other symptoms any more than did the sugar pills.
There’s also a trend towards diagnosing candida overgrowth based on symptom questionnaires. However, for a proper diagnosis, you need to do testing!
What most people end up doing if they or their doctor suspect Candida goes on this “Candida Cleanse.”
The Science Behind Candida Cleanses
Stacy remembers years and years ago she and Sarah talked about real detoxes. (29:45)
She also notes a lot of what we see in regards to fads comes down to predatory marketing designed to make us feel inferior and pressure us into buying expensive products.
The most common advice for a Candida Cleanse is to limit sugar and carbohydrates, avoid yeast and fungus-containing foods, and increase your intake of probiotic foods.
Sarah wants to go through these claims one by one to see what the science behind Candida cleanses says.
Low-Carb and Low-SugarThere is no science to support the idea of eliminating fruits and starchy vegetables for candida.
In a 1999 interventional study, researchers in Germany tracked the habitual carbohydrate intake of 28 healthy people. They found how many carbs they ate bore no relationship with the numbers of Candida growing in their bodies.
When the researchers put the subjects on high-sugar diets, they didn’t see a corresponding increase in Candida growth either.
So, the popular idea that sugar causes Candida overgrowth and limiting sugar will cure you of it doesn’t have much science in support of it. In fact, some research directly challenges it.
A 1984 study found cutting down on the consumption of dairy products, table sugar, and artificial sweeteners reduced the incidence and severity of Candida vulvovaginitis and yeast infections in women prone to them.
A 2009 study found that fat was the culprit, not carbs! However, it suggests we need further research to clarify the mechanism of the relationship between dietary fat intake and increased risk of BV.
“Starving” the candida by eliminating fruits and starchy veggies means starving good bacteria too.
For a lot of people, a candida cleanse means eliminating refined grains, added sugars, and eating more veggies and ferments. Eliminating all those things is going to make you feel better regardless of candida, which is why you think it’s helping!
2: Avoiding Yeast-Containing Foods
The yeast is commonly eliminated foods is a completely different type of yeast than what causes Candida!
Brewers and baker’s yeast are both Saccharomyces cerevisiae. It’s a relatively neutral yeast from a gut microbiome perspective but can actually inhibit the growth of Candida!
Fermented foods tend to contain Saccharomyces boulardii, which is a very important probiotic yeast that can also inhibit Candida growth.
Sarah gets asked all the time about mushrooms with candida and there is no science to support avoiding mushrooms. If anything, the science points to mushrooms being potentially very helpful!
Adding a probiotic to your regimen, on the other hand, is a very good idea when dealing with Candida.
The beneficial bacteria in yogurt and other fermented foods may help keep the candida population in check.
Probiotic supplementation during or after antibiotic use may also help reduce the risk of antibiotic-related yeast infections.
Lactobacillus species are well-known to reduce the ability of Candida albicans to infect cells and induce inflammation and stimulate the production of antibodies. (Find more information here and here!)
Research shows probiotics can help with bacterial vaginosis as well!
One 2009 study found combining antifungal therapies with a probiotic supplement (Lactobacillus rhamnosus GR-1® and Lactobacillus reuteri RC-14®) presented even better results.
Additionally, a 2013 paper showed that eating yogurt can reduce the proliferation of Candida in both the mouth and the vagina.
Antonio et al. found agreement between Lactobacillus species in the rectum and vagina, suggesting that the rectum may serve as a potential source of vaginal colonization.
It’s All About the Microbiome
Once again, we come full-circle to the gut microbiome. (1:02:30)
Sarah goes even more in-depth into the gut microbiome in her Gut Health Guidebook.
The AIP is really great for the gut microbiome! AIP eliminates foods like nuts, seeds, A2 dairy (especially fermented), rice, oats, corn, legumes. Sarah notes none of these are as important as the nutrient-dense foods incorporated into the AIP
This is why it’s so important to support gut health.
Make sure you are consuming enough veggies, fruits, and mushrooms. Each family is independently beneficial, so treat them as their own food groups! (See episodes 281, 286, 304, 307, 335, 346, 373, 392, 424, 435)
Be sure to focus on nutrient density, especially vitamin A, vitamin D, and minerals. Our gut bacteria can make most of the B vitamins and K.
Fermented foods (like wild-fermented kraut, kefir, kombucha) are amazing probiotics that support your gut.
Lifestyle choices are just as important! Sleep, activity, and stress management have a bigger impact on overall health than we realize.
Consider adding a Bacillus-based probiotic like Just Thrive to your regimen as well. (Again, use the code THEWHOLEVIEW at checkout for a 15% discount!)
Sarah reminds listeners that she and Stacy are not medical professionals. So it is very important to speak with your doctor for a proper diagnosis. (1:05:04)
Many of the claims found online are not supported by the science of Candida cleanses. That’s not to say there aren’t dietary changes you can make to help with the infection.
To answer Olivia’s question- yes, AIP is comparable with Candida. However, be sure you’re not cutting out fruits, veggies, and other nutrient-dense foods that have no science-backed reason to eliminate.
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Thanks for listening and we will see you next week!