To quote Peter on Family Guy, “You know what really grinds me gears?”
People who say they have “candida” because they saw some stringy substances when they spit into a glass of water or because they have an array of symptoms that would create a differential diagnosis list that would make Dr. House’s head spin.
Before I get strung up by my toes, let me make one thing perfectly clear, there are patients that have fungal overgrowth in their intestines. But, if the only evidence you have is fatigue and stringy saliva, I beg you, please keep reading…
You’re Supposed to Have Mushrooms in Your Belly
I’m going to use the term candida and fungal interchangeably, even though, technically, it’d get into a square and rectangle discussion. Bear with me, it makes this a lot easier to follow if you don’t overthink the terminology.
As with commensal bacteria, there should be a certain number of fungal species in the gut, particularly certain Candida species.
These fungal species play many roles in the gut, including protecting the body from pathogens and regulating the immune system. Behold, the mighty mushroom…
When the Fungus Begins to Take Over
A typical scenario that could lead to fungal overgrowth and what I see commonly would be something along these lines:
Mary has an upper respiratory infection. She goes to the doctor and the doctor decides to treat her for 10 days with Levaquin, a broad spectrum antibiotic that kills lots of different bacteria (including the ones in Mary’s gut). Being a good patient and wanting to feel better, Mary takes all 10 days of her antibiotic, but over the course of several weeks she notices that she doesn’t feel so great. She’s having alternating diarrhea and constipation, she’s broken out in a rash that won’t seem to go away, she’s tired and can’t remember anything!
What happened to Mary? When she took the antibiotics, those antibiotics wiped out many of the beneficial bacteria in her gut. This opened the door for other microorganisms to grow in her gut. In her case, we could run some tests and we may very well see an inordinate amount of fungal species hanging out in her gut.
This could just as easily happen with bacteria taking over as with fungal species taking over. It is hard to say how common fungal overgrowth is, because often (especially in alternative medicine), a patient may get hit with a fungal overgrowth diagnosis based solely off of symptoms and risk factors, but those symptoms and risk factors are not exclusive to candida overgrowth.
Likewise, they may see some information on the internet that makes them think they have fungal overgrowth and find an article or YouTube video telling them to spit into a glass of water and watch it over a period of time and they do a kind of home diagnosis.
So, how does one tell if they really have fungal overgrowth?
How to Tell if You Have Fungal Overgrowth
Unfortunately, there’s not an easy trick or tell-tale sign that you have fungal overgrowth, even though, many self-proclaimed health gurus have claimed that you can. My favorite is the spittle test, which I’ve already alluded to. I can handle some pretty gross stuff, but spitting into a glass of water and watching it, just does not seem like a fun way to spend a Saturday morning.
Questionnaires like this one from Dr. William Crook, could potentially be helpful in teasing out some of the risk factors and symptoms of fungal overgrowth, but the fact is, most of the symptoms of fungal overgrowth, such as fatigue and numbness/tingling of the extremities could be linked to a number of issues. Likewise, the risk factors, such as a very standard American diet and chronic or prolonged antibiotic use, could lead to a whole host of gut issues.
Organic acids urine test combined with a comprehensive stool analysis is the most accurate method we have right now. Both of these tests have their limitations, but together they can tell a knowledgeable clinician a ton about what’s going on inside of your gut.
When it comes to this type of situation, it is best to follow the “test, don’t guess” policy. In order to get these, you will need to talk with your doctor or functional medicine clinician. If you feel like you need help in this area, I’d be glad to work with you. You can find more information on working with me here.
In my next post, I’ll talk to you about the Candida Diet and what everyone should know before they start it.