Candida And Thyroid Autoimmunity
Published May 27 2014
Candida albicans are inhabitants of the skin, mucous membranes, gastrointestinal tract, and genitourinary tract. They usually live commensally without causing harm. However, in certain situations they can invade tissue, causing both acute and chronic disease in the host. In some cases Candida can become life-threatening. Although many people develop yeast infections, for reasons I’m about to discuss, a Candida infection is commonly found in autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.
The gastrointestinal tract and vagina are common sources of a Candida infection, and it seems that the infection of vaginal candidiasis is related to infection of intestinal candida (1). This is important to understand, as it’s a common reason why the recurrent rate is high after vaginal treatment. Treatment needs to be aimed at addressing both the intestinal and vaginal Candida infection. And as I’ll discuss numerous times in this article, ultimately the goal should be to improve the health of the person’s immune system.
As for what causes a Candida infection, I mentioned how Candida usually lives commensally without causing harm. One of the reasons for this is because they are kept in check by the good bacteria in the gut. However, if something disrupts the gut flora, such as taking antibiotics, then this can set the stage for a Candida infection. Other potential causes of a Candida infection include oral contraceptives (2) (3), chronic stress (4) (5), and glucocorticoids (6) (7). Cigarette smoking can also play a role (8). And as I’ll discuss shortly, having an autoimmune condition can make one more susceptible to developing a yeast infection.
The Challenge of Diagnosing A Candida Infection
It can be a big challenge finding out if someone has a yeast infection. Unfortunately there is no single test that is completely accurate in detecting a Candida infection. For years I have used stool testing to help detect the presence of a such an infection, but false negatives are possible. One can test the antigens produced by Candida species, although they are often rapidly cleared from the circulation so that antigen detection tests frequently lack the desired level of sensitivity (9). D-arabinitol is a metabolite of most pathogenic Candida species, and measuring serum D-arabinitol allows for the prompt diagnosis of invasive candidiasis (10). In addition to measuring D-arabinitol through the serum, it can also be measured through the urine as part of an organic acids test. However, although testing for D-arabinitol might be the most accurate method of testing for a yeast infection, false negatives still remain a possibility.
Symptoms Associated With A Candida Infection
Not everyone who has a yeast infection will present with overt symptoms. However, sometimes a person might be experiencing symptoms which are due to the yeast infection, yet they don’t think it’s caused by this. Part of the problem is due to the testing dilemma I briefly discussed before, as someone might receive a test for a Candida infection and because it comes back negative will assume they aren’t infected. But a yeast infection can lead to symptoms such as fatigue, brain fog, joint pain, a bladder infection, gastrointestinal disturbances, a decreased sex drive, and even allergies and inflammation.
What Is The Ideal Diet For Candida?
Since yeast thrive on sugars and simple carbohydrates you want to make sure to minimize your consumption of these foods. In fact, you want to completely cut out refined foods from your diet. As for fruits, this remains controversial, as some sources recommend to cut out all fruits from the diet, although in many cases it is fine to eat a small amount of low glycemic fruits, such as blueberries and raspberries.
One of the big problems is many people eat too many carbohydrates. And even if one eliminates the refined foods and sugars and minimizes their consumption of fruit, if you eat a lot of grains, or starchy foods such as potatoes, then this also can make it difficult to control the Candida infection. And so you definitely want to minimize your consumption of grains (this includes gluten free grains), and for many people it’s a good idea to go on a grain free diet during this time.
For more information on what foods to avoid I would visit www.thecandidadiet.com. I don’t agree with all of their recommendations, but it gives a pretty good idea about what foods encourage the growth of yeast.
Can A Candida Infection Trigger An Autoimmune Response?
As far as I know, there currently aren’t any clinical trials showing a direct correlation between a Candida infection and any type of autoimmune condition. However, this doesn’t mean that there isn’t any evidence that Candida can potentially trigger an autoimmune response. First of all, certain animal studies show that candidiasis can result in NF-kB activation (11). I’ve discussed the role that NF-kB and pro-inflammatory cytokines play in autoimmunity in my blog post entitled “The Role of Cytokines In Autoimmune Thyroid Conditions“.
A few small clinical trials showed evidence that a Candida albicans infection can lead to the development of auto-antibodies (12) (13). More research definitely needs to be conducted in this area. In his book Nutritional Medicine, Dr. Alan Gaby mentions another possible mechanism of candida-induced autoimmunity, as he talks about how the acetaldehyde produced by Candida can bind to serum proteins to form acetaldehyde-haptenated proteins. Dr. Gaby goes on to state that “haptenization of proteins could result in loss of functional activity and may induce antibody formation, potentially leading to the development of autoimmune disease”. (14). A hapten is an antigenic compound, and haptenization involves the reaction of this antigenic compound with a carrier protein, and this in turn causes an immune system response. And so according to Dr. Gaby the acetaldehyde produced by the Candida will bind with proteins in the blood, and this in turn can trigger an autoimmune response. There is also evidence that a Candida infection can lead to a leaky gut (15). And as I’ve discussed numerous times, a leaky gut is a common trigger for autoimmunity (16).
Although there is a possibility that Candida can lead to the development of Graves’ Disease and Hashimoto’s Thyroiditis, one also has to consider the opposite possibility. In other words, having a compromised immune system might make someone more susceptible to developing a Candida infection. In my opinion this is far more common.
Either way, if someone with Graves’ Disease or Hashimoto’s Thyroiditis has a yeast infection, then the goal remains the same. Overall one will want to do what is necessary to cure the yeast infection, and at the same time improve the health of the person’s immune system. Because even if we knew for certain that a Candida infection was an autoimmune trigger and led to the chronic activation of NF-kB, controlling the yeast infection by itself won’t improve the health of the immune system. One would want to remove the trigger, and then do things to downregulate NF-kB, which I’ve discussed in previous blog posts and articles
Natural Treatment Methods for Candidiasis
Just as is the case with other types of infections, there are natural supplements and herbs which can help with the management of a Candida infection. Below I have listed some of the more effective natural treatment methods. However, one needs to remember that while taking things to eradicate a Candida infection might be necessary, the primary goal should be to improve the health of the immune system. This will not only help with the current yeast infection, but it will also help to prevent the reoccurrence of a Candida infection.
Oregano oil. Numerous studies have demonstrated that oregano oil can be effective in the treatment of a Candida infection (17) (18) (19). However, one needs to keep in mind that higher doses might need to be taken for four to six weeks in order for it to be effective.
Saccharomyces Boulardii. There is also plenty of evidence which shows that S. Bouldarii can be effective in treating a Candida infection (20) (21) (22). Some people are hesitant to take S. Boulardii because it is a type of yeast, and it would seem to be contradictory to take any type of yeast when someone has a yeast infection. However, one needs to keep in mind that not all yeast are the same, and so I wouldn’t hesitate to recommend this to most patients who have a Candida infection. If someone is taking anti-fungal medication it is best to take S. Boulardii separately (about 4 hours later), as it can potentially interfere with its efficacy (22).
Garlic. I love garlic (see my article entitled “Can Garlic Benefit Thyroid Health?“), as it can be beneficial for numerous pathogens. And there is evidence that fresh garlic extract can be effective in the treatment of a Candida infection (23) (24).
Berberine. Berberine can also be effective in eradicating Candida albicans. In fact, berberine and fluconazole can work synergistically against fluconazole-resistant Candida albicans (25) (26).
Caprylic Acid. There is also some evidence that caprylic acid can be effective in the treatment of a Candida infection (27). This is one of the reasons why consuming coconut oil can be effective against yeast, as it contains caprylic acid, along with capric acid and lauric acid. On a side note, coconut oil also has antimicrobial activity against other types of pathogens as well (28) (29). One can also take a separate caprylic acid supplement.
Other Natural Treatment Options For Candida. Green tea has many benefits, and it can inhibit the biofilm formation of Candida albicans (30). There is also evidence that pomegranate husk and Pau D’ Arco (Tabebuia avellanedae) can also help with a Candida infection (31). Curcumin also has anti-Candida activity (32).
Sometimes natural treatment methods aren’t effective in controlling a Candida infection. When this is the case then taking antifungal medication might be necessary. The obvious goal should be to use the medication to control the yeast infection, and then address the cause in order to prevent recurrent infections. Nystatin is commonly used to treat Candida infections. Dr. Alan Gaby recommends one-eighth of a teaspoon (suspended in an ounce of water) four times per day for five days, and then increasing to one-quarter teaspoon four times per day. He recommends Nystatin powder over tablets, as he says that the powder is more likely to kill Candida in the mouth, esophagus, and stomach.
Fluconazole (Diflucan) can also be effective in treating a Candida infection. Fluconazole might work quicker than Nystatin, although side effects are more common. And so if someone chooses to take medication I usually would recommend starting with Nystatin, and if this doesn’t work (remember that it might take at least 3 to 4 weeks before noticing an improvement) then to make the switch to Fluconazole.
When Candida die they release different metabolic by-products, which results in numerous “die-off” symptoms. Ethanol is one of the toxins produced by Candida albicans, and acetaldehyde is a metabolite of ethanol, and can lead to symptoms that resemble a “hangover”, such as vertigo, nausea, vomiting, and headaches. Some other symptoms people might experience include swollen glands, bloating, gas, and a change in bowel movements. These symptoms usually self-resolve within a few days, although in some cases they will take a week or two to improve. To help increase the clearance of these toxins I would recommend drinking plenty of water, and to do things to help increase glutathione production such as take N-acetyl-cysteine, lipoic acid, or milk thistle.
In summary, Candida infections are common in people with Graves’ Disease and Hashimoto’s Thyroiditis. Although it is possible that a Candida infection can trigger an autoimmune response, more research needs to be conducted in this area. However, there is no question that having a compromised immune system can make one more susceptible to such an infection. When someone has a yeast infection they want to eat a diet that is very low in sugar, and either consider taking natural anti-fungals such as oregano oil, garlic, and/or berberine, a probiotic such as Saccharomyces Boulardii, or medication such as Nystatin. Just remember that both natural anti-fungals and medication don’t do anything for the underlying cause of the yeast infection, and so this needs to be addressed as well.