Candida overgrowth is one of the most common types of microbial dysbiosis. I have seen it at the root of a wide variety of health issues, including chronic digestive problems (leaky gut, diarrhea, constipation, acid reflux, small intestine fungal overgrowth etc), skin problems (psoriasis, eczema, acne, cheilitis, rashes, itching) chronic fatigue, autoimmune conditions, sugar cravings, mood swings, genital and oral yeast infections, chronic urinary tract infections, interstitial cystitis, and more.
Candida overgrowth can be very challenging to treat, and I have seen many patients who previously were treated with functional medicine and naturopathic herbal approaches that were not successful. Most treatments are either harsh or ineffective, and frequently fail to break the cycle of recurrence. Fortunately, Chinese Medicine holds powerful tools that have been used for centuries to address chronic dysbiosis. In my clinical practice I’ve had excellent results using these methods. I have helped many people to break free of chronic Candida overgrowth, and in this article I’ll cover how my approach works, things you can do at home, and ways I can support you further.
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Candida and the Human Microbiome
Candida albicans is a fungal organism (more specifically a yeast), one of the many naturally occurring microbes that lives in and on us. The human body is an ecosystem, also referred to as the human microbiome, with trillions of microorganisms like bacteria, fungi, and viruses calling it their home. Populations of microbes in the human microbiome ebb and flow based on many factors like diet and lifestyle, antibiotics, medications, introduction of new microorganisms, and competition between microbes. Some of the microbes in our ecosystem are obviously beneficial to human health, some are neutral, and some can be harmful or problematic. Candida falls into the last category. It’s normal for everyone to have some amount of Candida in their body, and it’s found all over the body, in the digestive tract, on the skin, in the vaginal flora, etc. When the population is controlled and in balance with the rest of our microbiome ecosystem, it doesn’t cause issues. But when the population gets too large it starts causing problems. When we experience a population shift in our microbiome that favors pathogenic or harmful microorganisms, we refer to this as a state of dysbiosis.
How do you know if you're dealing with Candida?
The best approach in my opinion is to consult an experienced Chinese Medicine practitioner. There are blood tests and stool tests that can provide some information, but these are not definitive. A positive blood or stool test showing high levels of Candida is typically accurate, but Candida can still cause many problems when numbers are below the "normal" range threshold. Below is a common list of symptoms that can manifest as a result of chronic Candida overgrowth. You may have just a few symptoms, or you may have many. This list is not exhaustive.
Common symptoms of Candida overgrowth:
Thick coating on the tongue, which can be white, yellow, or grey
Lower GI symptoms - loose stool, diarrhea, constipation, IBS
Upper GI symptoms - nausea, heartburn, bloating, gas, small intestine fungal overgrowth (SIFO)
Sugar cravings
Mood swings
Fatigue
Brain fog and difficulty concentrating
Chronic vaginal yeast infections
Chronic UTIs
Vaginal dryness
Prostatitis
Itching
Reddened skin, flaking, cracking
Acne, eczema, psoriasis, jock itch
Chronic sinus infections
What causes Candida to get out of control?
Candida overgrowth is typically systemic, so even if the symptoms only appear in one place, the Candida population in the whole body is usually overabundant. It’s like the tip of an iceberg, or maybe more accurately like the fruiting body of a mushroom where we see the above ground manifestation but 90% or more of the fungus exists underground. It’s important to understand the factors affecting both local and systemic Candida overgrowth.
In the study of ecology, organisms which aggressively colonize new territory are called pioneer species. A typical example would be when a forest burns or is clear-cut, certain grasses, plants and trees will dominate the early stage of regrowth. Pioneer species thrive on disturbance, and similar to pioneer species of plants, Candida is a pioneer species of the human microbiome. When there is disturbance, it colonizes new ecosystem space quickly and aggressively. Candida also has a number of baddie friends like E. coli and Gardnerella who thrive in similar conditions, which is why Candida overgrowth can contribute to larger scale dysbiosis.
Antibiotics are one of the most common causes of Candida overgrowth. When we take antibiotics, they not only kill the pathogenic bacteria they were prescribed for, they also wipe out beneficial bacteria indiscriminately. But they don’t affect yeast or fungal organisms. So during a course of taking antibiotics, as the drug lays waste to the bacterial colonies in your microbiome, Candida takes the opportunity to colonize the newly open territory. Once the new territory is colonized, Candida does everything it can to keep control of its newly acquired kingdom.
Antibiotic herbs can also lead to dysbiosis and chronic Candida. Many people believe that because herbs are natural, they cannot cause harm. This is very much not true. Herbs are inherently safer and more gentle than drugs, but they still need to be used appropriately to achieve a good result. An herb that kills bacteria is an herb that kills bacteria, it does not choose between “good” and “bad”. Long term or excessive use of antimicrobial herbs or substances like berberine, goldenseal, raw garlic, oregon grape, grapefruit seed extract (GSE), colloidal silver can all lead to dysbiosis.
Sugar is the food of choice for Candida albicans and consumption of excessive sugar and carbohydrates in any form (this includes fruit and fruit juice) can lead to Candida overgrowth. The higher the blood sugar level, the more food there is for Candida to thrive on. People dealing with unstable blood sugar levels from Diabetes or pre-diabetes are more likely to experience Candida overgrowth. Sugar cravings are frequently a sign of Candida overgrowth, as the Candida organism releases chemicals that affect our body and brain chemistry - it’s doing what it needs to get food to survive.
Other medications like corticosteroids and immunosuppressive therapies contribute to Candida overgrowth. Immunosuppression limits our immune system from controlling pathogenic growth of Candida, and many steroid drugs also interfere with our body’s ability to effectively control blood sugar. Steroid drugs are used frequently to manage autoimmune conditions, asthma, and allergies. Corticosteroid medicines have their place, but they are currently being over-used in medicine. In 20 years we’ll look back on corticosteroid use just like we are looking back now on opioid painkillers and seeing the errors of over-prescribing. Corticosteroids in the form of nasal sprays and topical ointments are available over-the-counter and are also over-used without a prescription.
Getting Rid of Candida: Don't Press the Red Button
Our default reaction with any microbial baddie is to respond with a scorched earth, nuclear approach. On first glance it seems simple to just kill it and be done with it. But remember that Candida and other pathogenic pioneer species thrive on disturbance. And no matter the potency of the antifungal drug or herb, you will never kill it all with an approach like this. Like a cockroach surviving nuclear winter, some amount Candida will still be there in the end, ready to recolonize. It takes a holistic, systems level approach to sustainably reduce Candida populations to a healthy level and keep them in check. For the very infrequent Candida infection, using antifungal drugs can be a reasonable thing to do. But in most cases of chronic Candida, using a nuclear strategy with drugs or popular antifungal and parasite cleansing herbs will not yield long term success.
In Chinese Medicine we have a concept called Zheng Qi, translated as upright Qi or righteous Qi. This represents the normal and healthy functioning of all our body systems, immune system, and organs. Then we have Xie Qi, or evil Qi, which represents any pathogenic influence, but especially infectious pathogens. When dealing with an infection, the outcome of the battle between Zheng Qi and Xie Qi is how we end up feeling. When the Zheng Qi wins, we feel good.
Nuclear killing strategies damage the Zheng Qi. They may destroy or weaken the pathogen, but they also cause collateral damage along the way. Sometimes that is necessary to do, but when used frequently the damage to the Zheng Qi weakens our body overall and sets us up for a cycle of recurrent infection. This happens whether the nuclear strategy employed uses antifungal drugs, or harsh herbal medicines like Oregano Oil, Pau D Arco, Black Walnut, Neem, Clove, Quassia, Tea Tree oil, Gentian etc. These harsh herbal medicines have toxic properties, which is how they exert antifungal effects so they can kill Candida, but they also damage the Zheng Qi. To use more familiar language, the toxic properties in many of these commonly used antifungal or parasite cleanse herbs can result in stress or damage to the liver and kidney organs, for example.
When treating chronic dysbiosis of any kind, including Candida overgrowth, it’s important to use herbs that do not harm the Zheng Qi and which are safe to take long term if needed. This leads me to the methods that I have used to safely and effectively help many people deal with chronic yeast infections - Expulsion and Competitive Exclusion.
Expulsion refers to the method of using herbs that drive out the pathogen, but do not harm the Zheng Qi. The core of the methods I use come from the Chinese Medicine strategy for treating Gu Syndrome, or chronic parasitic infections. This ancient treatment method was renewed in popularity by Dr. Heiner Fruehauf, a modern Chinese Medicine doctor and scholar. This method uses complex formulas that change the terrain of our body’s microbiome, so that beneficial organisms can thrive, and pathogenic organisms have a difficult time doing so. I use the term expulsion because rather than relying on harsh herbs that cause lots of collateral damage, we rely on herbs that are fundamentally gentle but function to drive the pathogens out. Many of them are strongly aromatic herbs like Zi Su Ye (Perilla), Jin Yin Hua (Honeysuckle), and Cang Zhu (Atractylodes). They make your body a nice place to be for you, but not a nice place for the target pathogens to be. In addition to gentle anti-parasitic herbs, this approach also uses specific tonic herbs that help strengthen your body’s Zheng Qi, so that your immune system is better equipped to deal with pathogenic organisms on its own.
For this aspect of addressing chronic Candida overgrowth, I have seen excellent results using intensive Chinese herbal medicine treatment. I typically use a combination of capsule formulas when dealing with Candida overgrowth. In some instances I may need to use a custom granule extract or draft formula instead, but I have had consistent success with capsules.
Competitive Exclusion refers to the introduction of beneficial microorganisms to compete for ecosystem space and push out, or exclude, pathogenic organisms like Candida. In the simplest terms, this means you take probiotics to add more beneficial organisms into your microbiome so they can outcompete the Candida. There are many oral probiotics to choose from, one that I recommend is Klaire Labs Lactoprime probiotic. Adding probiotic foods to the diet like live fermented kimchi, sauerkraut, pickles, water kefir etc is another good way to improve the intestinal flora. Using probiotics to treat chronic Candida is much more effective when combined with Chinese herbal medicine treatment which helps suppress Candida populations and allows the newly introduced probiotics some breathing room and provides available ecosystem space for them to establish a healthy population.
Starvation: Carbohydrate Restriction to Control Candida
Discussion of Candida would not be complete without addressing the Candida Diet. This approach uses starvation, laying siege to the Candida fortress by cutting off its food supply. It can be effective, but it is very hard to control Candida with the Candida Diet alone. Candida requires sugar and carbohydrates to live. If you can comfortably exist on a diet of meat, fat, leafy green vegetables, and very little carbohydrates - you might be able to control Candida with diet alone. For most people, this is unrealistic. Most people have better success with an approach that includes moderate reduction of sugar and carbohydrates, Chinese herbal medicine treatment, and probiotics. This approach is a more comprehensive siege, involving cutting off some of the food supply, but also sending some fireballs, some smoke, and foot soldiers into the Candida castle.
You can get my help with Chinese herbal medicine treatment for Candida overgrowth through my online herbal clinic. You can choose from capsule formulas, granule extracts, or draft powders. Our process provides easy to access individualized care. Just take a few minutes to complete our online intake, and get customized herbal medicine delivered to your door. Interested? Learn more about my herbal clinic here.
Sincerely, Sean Dugan L.Ac.
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