What Causes Candida Overgrowth—and What Can You Do About It?

Get Gut Candida in Check With These 4 Steps

• What is Candida?|
• What Causes Candida Overgrowth in the Gut?|
• Healing Candida Overgrowth in the Gut: A 4-Step Process|
• Tackle Candida Overgrowth Naturally|

In the clinic, we frequently run into patients who’ve struggled with symptoms like gas, bloating, diarrhea, skin rashes, joint pain, and brain fog. Many of them, at some point along the line, have been diagnosed with Candida overgrowth based on stool or urine testing. They’ve been told to follow a strict diet and take various herbal supplements to kill the Candida. While I do use diet and supplements when treating Candida overgrowth, my big-picture goal is different. Rather than trying to eradicate Candida, I want to restore balance in the gastrointestinal (GI) tract so this yeast can peacefully coexist with our other gut inhabitants. 

Zooming out, we see that Candida isn’t always a bad guy. This fungi is actually a normal member of the GI tract, and it’s likely beneficial for us, as long as our other gut microbes keep it in check. But when our lifestyles and diets get out of balance, we tend to run into trouble, and this is when we can start to experience the signs and symptoms of too much Candida. 

So, let’s dive into what Candida is, the most common factors that take the gut off course, and more importantly, what we can do to right the ship. 

What is Candida?

Let me start off by clarifying that Candida overgrowth is not synonymous with invasive candidiasis. Invasive candidiasis is a severe infection, often hospital-acquired, that can lead to life-threatening complications if not treated thoroughly and promptly [1].  When I talk about “Candida overgrowth,” I’m referring to elevated levels of this type of yeast in your gastrointestinal tract, specifically your small and large intestines. But Candida can also overgrow in areas like your esophagus, genital area (yeast infection), and mouth (oral thrush). 

Now that I’ve got that housekeeping item out of the way, let’s dig into what Candida fungus is. 

As you’ve likely heard me say, your GI tract is home to a vast array of microbes. Bacteria make up the bulk of these inhabitants, but we also have around 200 types of fungus living in our digestive systems [2]. Many types of Candida live there, but Candida albicans seems to be the most common yeast species in a healthy gut [3]. 

You read that right: Candida yeast is supposed to be in your GI tract, and it’s also found on your skin [4] and in the vagina [5]. I know this may come as a surprise based on the alarmism that’s common around Candida, but research suggests it’s a normal member of our gut flora and not necessarily something we need to fear.  

So, why is social media abuzz with Candida-killing protocols? The devil is in the details. While Candida is supposed to be in the GI tract, it also needs to be kept in check—this is one responsibility of your commensal gut bacteria [6]. 

You’re probably starting to see the writing on the wall—if your gut bacteria are out of balance (dysbiosis), Candida notoriously takes advantage of the situation and starts to grow out of control. But it’s all about context: Rarely is Candida the root cause of gut imbalances [7]. It’s best to think of it more as a symptom of microbial dysbiosis in general. 

Now let’s talk about how to know if you have Candida overgrowth. 

How Do You Know If You Have Candida Overgrowth?

Diagnosing a Candida fungal infection can be somewhat tricky because there really aren’t any validated testing options for detecting too much Candida in the GI tract [8]. Direct sampling, which is an invasive procedure, is probably the most accurate option, but it isn’t practical. 

Many healthcare providers end up using stool and urine testing, and some even use various food sensitivity tests, but I want to make it very clear that none of these provide any useful information about your gut Candida levels [8]. 

Research does tell us that symptoms tend to correlate with overgrowths, so here are the most common symptoms to look for [1, 6]:

• Bloating
• Gas
• Constipation
• Diarrhea
• Skin lesions (and diaper rash, even in adults)
• Itching/burning
• Vaginal yeast infection with vaginal discharge (vaginal yeast infection)
• Leaky gut
• Joint pain
• Irritability
• Depression
• Brain fog

I should clarify that gut imbalances tend to happen together, so it’s likely not just Candida that’s responsible for your symptoms. Rather, it’s a skewed ecosystem that we need to target. To understand how I restore gut homeostasis in the clinic, let’s take a look at what typically causes Candida overgrowth. 

What Causes Candida Overgrowth in the Gut?

Candida most likely plays a role in the overall health and well-being of the GI tract, but this symbiotic relationship is based on balance. If things start to become one-sided, a whole host of negative consequences can arise. But why does your gut ecosystem get out of balance in the first place? For most of us, we can distill it down to seven main contributing factors:

1. Acid-lowering medications—Normally, you need an adequate amount of stomach acid to kill excess bacteria and fungi, and to also prevent them from seeding (populating) the rest of the GI tract. Acid-lowering medications raise the pH of your stomach contents, which can encourage bacterial and fungal overgrowths downstream [9]. 
2. Chronic stress—Chronic stress suppresses your immune system, which is like the police force of your GI tract. Part of its job is to maintain microbial balance, but chronic stress makes it less effective at preventing unwanted microbial overgrowth [10, 11, 12].
3. Antibiotics—Antibiotics kill bacteria, but many of your gut bacteria are important for keeping your fungus levels in check. When you lose beneficial bacteria during antibiotic treatment, Candida levels can start to rise [13].
4. Sedentary lifestyle—People who exercise regularly tend to have more gut bacterial diversity and a healthier gut microbial profile than people who aren’t active. Gut diversity and beneficial bacteria make it easier to keep Candida levels where they should be [14].
5. Alcohol—Alcohol intake, especially high amounts, may increase inflammation in your gut, contributing to microbial dysbiosis that may allow Candida to multiply unchecked [15, 16]. 
6. Diets high in fat, sugar, and processed foods—Consuming a Western-type diet that’s low in nutrients and high in fat, sugar, and ultra-processed foods may increase your risk of leaky gut, which may encourage microbial overgrowths and dysbiosis [10, 17].
7. Smoking—Tobacco smoke may push the gut microbiome into a state of dysbiosis, which may allow for fungal overgrowth [18].

I want to reiterate that all of the above risk factors—not just Candida overgrowth—can contribute to dysbiosis in the gut. If you’ve been diagnosed with Candida overgrowth, it’s easy to fall into a cycle of fear and desperation where you’ll do anything to kill the Candida. You may try over-the-counter ointments, suppositories, creams, or prescription treatments. But just targeting Candida won’t likely lead to complete healing. 

The takeaway here is that instead of making Candida the fall guy, we need to address total gut health to restore balance in the gut microbial ecosystem. 

The great news is that we have many natural options for getting your gut health back on track. If you’ve been struggling with the symptoms of Candida overgrowth, my book, Healthy Gut, Healthy You, walks you through a step-by-step gut-healing protocol to restore vibrant gut health. But you can start your journey to feeling better today by following some simple therapeutic strategies, so let’s discuss.

Healing Candida Overgrowth in the Gut: A 4-Step Process

Rather than zooming in on Candida itself, we need to intervene upstream in order to change the milieu further down in the GI tract. Since an unhealthy diet, sedentary lifestyle, and unmanaged stress have a huge impact on gut health, this is where I like to start. 

Step 1: Diet and Lifestyle

In my experience in the clinic, diet is unquestionably the most impactful intervention for improving your gut health (and overall health). When it comes to Candida overgrowth, there seems to be quite a bit of confusion about what type of diet is best. Most of the patients I see with Candida symptoms have either read online about or been encouraged to follow an extremely low-carbohydrate meal plan, but this isn’t necessary in most cases. 

While I’m not firmly planted in any one dietary camp, I tend to recommend the Paleo diet, at least initially. The Paleo meal plan reduces or eliminates many problematic foods (like processed ingredients, added sugars, unhealthy fats, and common problem foods like dairy, gluten, and soy) that may promote inflammation, gut dysbiosis, and Candida overgrowth [19, 20, 21, 22, 23, 24]. By removing these foods, your gut ecosystem can begin to come back into balance, and you can gradually expand your diet to one that works best for you. That said, any diet that eliminates processed foods and added sugar will likely help you get on the path to better gut biome balance.  

While you’re working on your diet, it’s important to move your body. Exercise can increase gut microbial diversity, and more healthy gut bacteria means better control of Candida [25]. If you’re new to exercise, start off by walking as much and as often as you can. Once you get that foundation in place, you can begin to experiment with other types of cardiovascular training and resistance training. 

Exercise can also help you reduce stress [26, 27, 28], which, when unmanaged, can weaken the immune system and negatively affect your gut health [11, 12]. Because stress is such a normal part of daily life, I recommend implementing a daily stress management technique in addition to exercise. A short daily meditation, yoga practice, or spending time in nature can help to restore a balanced stress response and improve gut-related symptoms [23, 29, 30, 31, 32]. 

Once you’ve got your diet and lifestyle dialed in, if you still have Candida overgrowth symptoms, it’s time to trial probiotics.

Step 2: Probiotics

Probiotics have pleiotropic effects, meaning they act in a variety of ways to restore balance in the gut. They’re antibacterial, antifungal, anti-inflammatory, anti-leaky gut, and they promote a healthy gut immune response making them the perfect option for Candida overgrowth symptoms [1, 2, 33]. It’s not just me saying this—scientific research supports the use of probiotics for fungal overgrowth, and they seem to be as effective as common antifungal medications (like fluconazole, miconazole, and nystatin) [34, 35]. 
You may be wondering if you need a specific probiotic for Candida, and the answer is no. After reviewing the scientific data, it’s very clear that there’s no need to search for a specific strain of probiotic; rather, it’s best to use a multi-strain approach [36, 37, 38]. In the clinic, we use a triple-therapy protocol, meaning we recommend all 3 categories of probiotics in combination. Essentially, that means taking a blend of Lactobacillus and Bifidobacterium strains, plus Saccharomyces boulardii (a beneficial yeast), plus soil-based probiotics (typically Bacillus species) for 2–3 months.

If you don’t feel like diet, lifestyle, and probiotics are enough to get you across the finish line, you may want to consider an elemental diet.

Step 3: Elemental Diet

If you still have Candida overgrowth symptoms, it’s very likely that you have inflammation in your GI tract. An elemental diet will help to quell that inflammation and allow for healing and regeneration.

An elemental diet is a hypoallergenic, anti-bacterial, anti-inflammatory meal replacement that can help improve a myriad of GI and other conditions [39, 40, 41, 42]. The elemental diet works essentially by giving your small intestine a rest from digestion, which helps it repair and restore a healthy immune system response. 

While we don’t have much research on using an elemental diet for fungal overgrowth specifically, we do have good data that shows its benefits for other GI health conditions like inflammatory bowel disease [40 43] and small intestinal bacterial overgrowth [39]. Knowing that, it’s probably safe to assume that an elemental diet could be helpful for rebalancing Candida. 

One note of caution for people with oral Candida infections (or thrush, when Candida grows out of control in your mouth, causing soreness, white patches on the tongue, red swelling in the corners of the mouth, and inflamed mucous membranes): The sugar in an elemental formula may be problematic for thrush, so I wouldn’t recommend using an elemental diet in this case. 

The final step to consider when treating Candida overgrowth involves the use of antimicrobials.

Step 4: Antimicrobials

Antimicrobials include a variety of plant extracts or medications (like antibiotics and antifungals) that can knock out bad bacteria and other infectious microbes [44]. You may be thinking, why not just start with antimicrobials to get rid of Candida? In our experience in the clinic, starting out with antimicrobials may set you up for failure in the long run. 

I’ll use a garden analogy to paint this picture. When planting a garden, you need good soil, water, sunshine, and healthy plants, all of which add nutrients to the soil and help prevent weeds. 

When you imagine your gut, you can think of your diet as determining the richness of the soil, which is like your intestinal walls. Your lifestyle (exercise and stress management) is like the sun and water that provide the garden (your gut) with the conditions it needs for success. Probiotics are like the plants you bring in to support the soil and prevent weeds. If you try to get ahead of potential weeds by adding herbicides before tending to the soil quality and caring for the plants you want, you’re going to kill the good stuff in the soil and set your new plants up for failure. 

Similarly, if we start off by targeting Candida with antimicrobials (herbicides) first, the likelihood of long-term success is poor because we haven’t targeted the root cause (insufficient soil, water, sunshine, or healthy plants). The takeaway here is that if you add herbal antimicrobials before you enrich your soil and put in plants, when you do put in the plants, they won’t grow.

When it’s time for them, I tend to recommend herbal antimicrobials more than pharmaceutical ones. The herbal types are less likely to produce unpleasant side effects [45] or antimicrobial resistance [46, 47, 48], or negatively disrupt the gut microbiome [49]. Herbal options can treat gut infections and overgrowths, including Candida [48], SIBO (small intestinal bacterial overgrowth) [50, 51], and H. pylori [52], plus the digestive distress that comes with them. 

If you’re interested in more detail, check out this video outlining my 4-step guide to get rid of Candida:

Tackle Candida Overgrowth Naturally

Candida is a natural resident of the gut microbiome. It normally lives harmoniously with our other gut microbes, but an out-of-balance diet and lifestyle can cause it to overgrow. Symptoms like bloating, gas, diarrhea, skin issues, vaginal yeast infections, and depression may all point to Candida overgrowth. 

But it’s important to understand that Candida is rarely the sole cause of these types of symptoms—if you suspect Candida, it’s likely a sign of an unhealthy gut ecosystem overall.

Medication use, chronic stress, a sedentary lifestyle, smoking, and a poor diet are all root causes of Candida overgrowth, but also of gut dysbiosis in general. Rather than immediately targeting Candida with medications or herbal antimicrobials, it’s important to zoom out and use the right therapeutic supports in the right order. Start with diet and lifestyle, and layer in probiotics and an elemental diet if needed. And if you still need some additional support, herbal antimicrobials may give you that final push toward a balanced gut. 

If you traverse through this process and still feel unwell, we’d love to help you on your journey.  Check out my book Healthy Gut, Healthy You for my complete Great-in-8 gut healing protocol, or contact us at the Ruscio Institute for Functional Health to schedule an appointment. 

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