One of the main, yet least frequently mentioned problems which occurs in nearly all patients suffering from digestive issues whether they be SIBO, IBS, Candida or the myriad other illnesses which have now been linked to gut dysbiosis, is that of ‘emotional issues.’ Although many patients suffer from anxiety or depression, (and many in fact more severely than they report), there is such stigma attached to these conditions that they often go unreported.

Many patients I have seen in my clinic over the years want to understand why they are experiencing personality changes and are seeking answers and solutions, but unfortunately for the majority of sufferers, any potential cause of their emotional issues remain unresolved and therefore few resolutions are found. For many, treatment generally involves pharmaceutical intervention while the cause remains unsolved.

Unfortunately, there are still health care professionals who automatically interpret mood changes of their patient as being clearly distinct from any physical issues their patient may be experiencing. When no link is associated with a person’s physical and emotional symptoms, a separate treatment may be provided to the patient to mitigate their individual problems.

As the number of people taking antidepressants continues to rise, for example in America the figure has risen from 11.2 million in 1998 to 23.3 million in 2010, and in Iceland a staggering ten percent of the population take some form of mood lifting drug, it transpires that unfortunately these drugs are prescribed (even in the absence of depression) when the patient is diagnosed with physical illness such as fibromyalgia, chronic fatigue or IBS. Because many patients are equally (or more) concerned about their physical problems, this can result in a reluctance to even mention issues relating to mood disorders, no matter how concerning they may be.

After almost thirty years of clinical naturopathic practice I have learned that many patients are quite aware that their emotional problems are somehow linked to those of their physical – but unfortunately their ‘unconventional’ views are not supported by conventional medical science. And, despite the best intentions of their medical doctor, these same patients do not want to be treated as if they have somehow lost the emotional capacity to cope with the practicalities of day-to-day living, but rather instead want answers as to how their feelings could possibly be affected by physical illness. These same patients, despite not being educated in mind-body medicine, are certain that both aspects of their illness are not only linked, but are very real.

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• Systemic Candida Yeast Infections
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I would like to reassure patients who suffer from symptoms commonly associated with gut dysfunction that the emotional effects of digestive problems are as real as physical symptoms the experience – the stomach cramps, the constipation, gas, or spasms – and this is because a person’s emotional state can influence the gut and cause digestive problems or conversely, what is happening in your digestive system can adversely affect the emotional state.

Because various emotional states can affect the gut and vice versa, some therapies that clinicians offer are effective in relieving the symptoms either way. However the emotional side of the illness does not exist in isolation. Often, because of the way the body reacts to stress, these treatments and therapies will only provide temporary relief and, more importantly, neither do they treat any underlying cause nor do they repair any physical damage that may have been sustained.

Historical Evidence Of Mind-Body Connection To Digestion

Firstly, let’s start with how digestive dysfunction can possibly affect how we are feeling or how we react to certain situations.

We have to appreciate that the gut-brain relationship is most certainly not a recent discovery, because the links between mood and digestive function have been noted for centuries. A famous observation was made by a physician called William Beaumont who wrote up his findings in 1833 after he had encountered the stomach injury incurred by a man who had been injured by a gunshot. Dr. Beaumont was a surgeon in the U.S. Army who became known as the “father of gastric physiology” following his research on human digestion.

The man, Alexis St Martin, had been left with a hole in his stomach which had only partially healed and which allowed Beaumont to observe what happened during the digestive processes. One important conclusion was reached when Beaumont discovered that St Martin actually produced less stomach acid when he experienced stress-related moods such as fear or anger. He discovered this by dropping food through the hole attached to a piece of string and retrieved only partially degraded remnants in comparison to the stomach acid produced when St Martin was in a relaxed state of mind which had an effect of more fully degrading the food.

In the early 1900s, knowledge of the brain and gut connection was further expanded upon when research relating depression to dysbiosis (referred to at the time as ‘autointoxication’) was quite possibly more extensive back then than it even is today. It was well recognized even by clinicians in general medical practice that disruption to gut micro-flora could not only present as physical ailments but also have negative effects on the mood. When it comes to the effects of digestion on mood, it is no better summed up than by Bond Stow M.D. in 1914 in the Medical Record Journal of Surgery and Medicine:¹

The control of man’s diet is readily accomplished, but mastery over his intestinal bacterial flora is not, the innumerable examples of auto-intoxication that one sees in his daily walks in life is proof thereof. They are the cases that present…malaise, total lack of ambition so that every effort in life is a burden, mental depression often bordering on melancholia, frequent attacks of indefinite abdominal pains due to flatulency, sudden attacks of acute diarrhea alternating with periods of acute constipation.

By the mid 1930s the interest into auto-intoxication had waned and only recently has medical science rekindled the flame of the gut-brain connection as it continues to evidence not only how dysbiosis can affect the mind but also how a person’s moods can adversely affect their gut. Dr. William Beaumont discovered long ago that negative states of mind could inhibit the production of stomach acid, thereby negatively affecting the gut, and he achieved this in an era when medicine still believed that digestion in the stomach was primarily a mechanical and not enzymatic process.

Amino Acids: The Building Blocks Of Neurotransmitters

What we have learned since is that there are numerous ways in which mood can be directly affected by digestive issues and not least is the significance of effective production of amino acids. Amino acids are basically derived from proteins in our diet and you may have heard it said that they are the ‘building blocks of neurotransmitters.’

Without neurotransmitters, which perform the action of transmitting signals between nerves or neurons, certain functions can be negatively affected and these include the release of mood hormones such as serotonin. It is interesting to note that research has discovered that around 95 percent of serotonin is in fact produced in the digestive system.²

A direct link is that poor digestion results in a lower absorption of proteins resulting in lower production of amino acids, which in turn will result in fewer neurotransmitters being produced. The end result is that lower levels of serotonin will mean that our mood suffers.

But the problem is a cyclical one and it also is not limited to mood problems but also those founded in the physical. What we have come to understand is that alteration of mood is no different to a physical problem such as stomach pain. They are both merely a symptom of an underlying problem rather than being individual illnesses occurring in isolation. For example, if a patient is suffering from depression due to a lack of sufficient amino acids, and there is no practical reason for that person to be depressed, then the likelihood is they may also be suffering from other nutritional deficiencies which in themselves may produce both physical in addition to psychological reactions. Treating the psychological problems either by natural or pharmaceutical medication or relaxation therapies may work to partially relieve some of the symptoms, but the underlying cause still remains a mystery, as do the majority of their apparent physically issues and any internal damage caused by the digestive dysfunction.

The whole situation then becomes compounded because we know that stress in itself produces digestive dysfunction and, even if we simply limit our understanding of it to the findings of Beaumont and St Martin, we can clearly see at least some of the problems which may arise. Yet still we are not taking into deep consideration the ‘fight or flight’ responses, or those of ‘rest and digest.’ Nor are we looking at the enteric nervous system, hormonal responses or adrenal gland fatigue.

Symptoms Are Our Best Teachers

Stress has the ability to reduce the way our digestive system functions on many different levels by way of the hypothalamic-pituitary-adrenal (HPA) axis. We all face small stresses on a daily basis in the form of any demands placed upon us. An inhibition of digestion will occur with even the smallest of stresses resulting in a drop in the production of digestive enzymes right through to constipation. The sympathetic nervous system (fight or flight) branch of our autonomic nervous system is responsible for allowing us to cope with just about anything life throws at us by activating all our body’s systems, priming them for action. Unfortunately, an active digestive and immune system are not important when we are under stress and essentially become de-activated. The parasympathetic nervous system (rest and digest) become activated as we rest up and relax, and in turn our body responds by improving virtually all aspects of the way we digest and absorb our foods. Our immune system restores, reducing inflammation and our ability to heal speeds up.

A stressful life, when it comes to digestive function, is self-perpetuating and can lead not only to deeper levels depression and anxiety but also multiple physical problems such as irritable bowel syndrome, an increased likelihood of SIBO or Candida infections, food allergies, leaky gut, auto-immune disorders, etc. If the patient’s stress remains chronic, long-term and unmitigated, these stress-related gut problems can result in chronic long-term poor health for the patient. In my clinical experience, most all patients who present with “incurable” digestive problems and who have been to many doctors will also present with HPA dysfunction. Unfortunately in most all of these cases the patient was treated separately for their mood disorder, and little to no stress-related mind/gut connection was explained, thereby allowing the patient to understand the true nature of their multiple health problems. I explain to patients that symptoms are our best teachers, and not enemies to be “conquered” with pills, fad diets or surgery.

What Can We Do?

Clearly, individual patient-focused treatments and relaxation therapies can help significantly. Yet since we no longer have to face physical dangers and be aware and alert every waking minute of the day, how can we positively influence our gut on a daily basis? More to the point, why are our bodies inappropriately reacting in the way they are and what can we do to make a positive change?

Almost one hundred years ago (1919) W.C. Alvarez was quoted in JAMA³

In sensitive people the brain is profoundly influenced by afferent impulses coming from a distended, underactive, or unduly active bowel.

Alvarez’s observation, although apparently simplistic, can be applied not only to the bowel but also how the gut, and subsequently the brain, responds to our internal mechanisms and environment as a whole.

Most people now are aware of the body’s physical states of fight or flight (sympathetic response) and rest and digest (parasympathetic response). As mentioned previously, the sympathetic response controls our body when we are required to be in a state of awareness and activity and the other (the parasympathetic response) when we are going about our normal daily routine and are more in a state of relaxation. In practice only one of these systems, which are automatic, is focused on at any given time. And, because they are automatic and react to the tangible environmental signals both inside and outside our body, it means we can’t mentally talk ourselves out of a stressed or anxious state.

Yet patients are being told that the modern world is conducive to stress, that multi-tasking is important and that success is dependent on working hard and long hours. Eating over computer screens, working at night, continual social media, mobile phone & email intrusions are today’s norms, and we can understand how these situations can potentially produce negative moods – but just how do such influences switch on our inherent fight or flight mechanisms, after all, in today’s age we are not facing life or death situation running away from dinosaurs.

Let’s for a moment examine at a typical stress-related scenario in a little more detail and try to understand exactly how our hectic 21st century lifestyle contributes to digestive, immune, and ultimately emotional problems. Once we become enlightened and aware of what is happening with our stress (HPA) mechanism we can at least make small steps to amending our actions and behaviours.

The Office Worker

For example, think of an office worker who spends long hours hunched over a computer and consider the body posture. You will find that the upper half of the torso is bent forward. The chin is tilted downward and the mouth is often closed with the jaw muscles tensed. The arms are relatively taut, the shoulders drawn closely together and the chest area becomes narrowed. Breathing is shallow and faster than it should be. Concentration is apparent even in the expression.

For many who work in an office this is a well-recognized body posture and one that you will, if you are reading this on a computer, perhaps be doing right now! This is a stance, which, although sitting, is otherwise reflecting a body preparing for a fight. The focus is on the larger muscle groups and the extremities and blood is being pumped to these areas. Your eyes and brain are alert, your neck and shoulders are tensed and, I would guess, your teeth may even even be clenched – even though there is no physical aggressor in sight! Already the digestive system is being affected because the focus is not on rest and digest but fight or flight. Currently your digestion is not functioning at optimal levels because blood is being diverted away from the gut towards the larger muscles and your digestive enzyme output is dropping off. Without being aware of any obvious external stressors, your body is switching mode from rest and digest to fight or flight.

Now compare this stance against the same person leaving the office and going straight to the cinema to watch a comedy. This person’s upper torso is angled backwards; her shoulders have a tendency to being more relaxed and wide. The chest is expanded and the chin is up, with eyes open. There is little physical tension in her facial expression. The arms are relaxed, the breathing is easy and a little deeper, and the blood pressure is a little less. This is the mind, body, and digestive system in rest and digest mode.

People Are Our Biggest Sources Of Stress

After having studied the effects of stress on my patients in the clinic for many years, I’ve come to the conclusion that some of the biggest stresses we face as humans involve our relationships with other people, particularly those we are close to, and many people can relate to the fact that there is one person they know like a son, an ex-partner, an employer or employee, a mother-in-law or daughter-in-law, etc.; that may be causing them stress right now, ranging from mild and occasionally right through to the severe and extreme.

I’ve noticed that most people consider the physical stresses to be the most toxic to the body, like chemicals such as heavy metals for example, but I believe that it is the continual low-grade emotional stress that causes us the most harm in the long-term. These kinds of stress continue on and on often going unnoticed and sit in the background of our mind, sometimes for years or even decades and slowly wear down the ability of our body’s HPA axis to help us recover from all kinds of illness, whether it is a recurring acute or an unremitting chronic health condition. These kinds of intangible stresses tend to be covert and are hidden from our view, virtually un-diagnosable by most doctors and are accepted as being a “normal part of our lives”, unlike parasites, gluten, mercury, candida or microwaves, and the many more overt stressors we generally accept as being the real culprits.

As our HPA axis becomes increasingly compromised, our digestive and immune system becomes incrementally compromised as well, and this is generally how we become increasingly hypersensitive to foods and substances in our environment, we develop less resistance to many different types of infectious diseases like urinary tract infections, skin infections, respiratory infections, etc., we have an increased tendency to developing an auto-immune disease like ulcerative colitis, Crohn’s disease, rheumatoid arthritis, Grave’s disease, etc.; and finally we can even be prone to developing one of the many different types of cancer.

It the accumulation of the many and varied different types of stresses which tips the balance, however – the “straw that broke the camel’s back”. And if we can recognize stress for what it is and deal with these different stresses in our lives, whether they are emotional, mental or physical, than we will be in a much better position to avoiding falling victim to a functional digestive problem, because our resistance will be able to remain high and our susceptibility will have the ability to remain low. These continual internal or external low-grade emotional stress responses cause a strain particularly on our glands of stress, the pituitary, ovaries, thyroid and adrenals, and once these powerful endocrine glands become compromised, our susceptibility to virtually any health condition increases significantly.

Related articles:

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• Stress is Often Caused by Relationships with People
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Awareness And Small Steps Can Lead To Huge Changes

By raising awareness of what we do as individuals on a daily basis and how those actions, the physical actions, can affect our digestion, we can make at least some small adjustments. By understanding that some of our biggest stressors in life are the relationships we have with people we are closely associated with, and learning that we can change how we feel about this person, adapt to the relationship or discontinue the relationship if it is just too toxic, we will be in a better position to reduce the impact of these hidden forms of stress in our lives.

We have all been told time and again to take regular breaks from our computer, to go for a walk at least once per day to reverse the sitting disease that is becoming increasingly prevalent in our society. For many this is not an immediately practical solution, but provided you are aware of the effects rather than just the advice, then on an individual basis you can positively affect posture and attitude wherever possible. We also know that our children are advised to leave the computer alone regularly and to ‘get some fresh air,’ and now we are becoming aware of why this is not only good physical advice, but also good advice for improving our children’s digestion, health, mood and behaviour.

By providing examples of the differences between these simple scenarios, it becomes much clearer to see that if the body is placed into a sympathetic fight or flight mode on a regular daily basis, even without getting stuck in traffic jams, dealing with irritable teenagers or an even grumpier boss or ex-partner, we are physically telling our body that we are in a stressful situation and it reacts accordingly. The long-term impact of stress on our children has yet to be felt but on adults we are now realizing how such simple, everyday scenarios are impacting on our lives.

Making children or adults perform strenuous exercise is not the answer, because physical exertion can also be interpreted by the body as a significant stress in its own right, but helping them to be aware of situations which we never consider as being problematic not only assists in the learning of cause and effect, it can lead to amending behaviours and thereby taking a positive step towards improving our own health and the health of those we care about.

When it comes to your gut making you happy, it is important to realize that simple, everyday activities and emotional responses can trigger it into making us unhappy as well as happy, and by understanding how these triggers work and by making small, personal adjustments we can reduce anxiety and depression and mitigate the symptoms of dysbiosis and mood disorders, which cause so many people so much distress.

References

1. Stow B: Metchnikoff’s basic principle – intestinal antisepsis through biological aids – attested by the Bacillus Bulgaricus. Med Record 1914, 86:233-36.
2. Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being. Adam Hadhazy February 12, 2010. https://www.scientificamerican.com/article/gut-second-brain/
3. Alvarez WC. Origin of the so-called autointoxication symptoms. JAMA. 1919;72:8–13. doi: 10.1001/jama.1919.02610010014002.
4. Cortisol & Candida Connection: What you need to know. Eric Bakker ND September 04, 2015. https://www.yeastinfection.org/cortisol-and-candida-connection/

You may have heard people say, “Oh everybody has Candida! It’s no big deal.”

Welcome to the world of common misconceptions regarding Candida. I would like to offer some real-world information based on my 27 years’ experience as a naturopathic physician to help you understand what Candida is and why it should not be taken lightly if it goes rogue.

It’s true that everybody has Candida, a naturally-occurring yeast that lives in your body alongside other organisms, including beneficial bacteria. When your body and immune system are healthy with a harmonious balance of these organisms, Candida isn’t a problem. The “good bacteria” feed on Candida and are able to keep it in check.

However, if your general health or immunity are compromised and this natural balance is disrupted, Candida can grow out of control and cause a variety of yeast and fungal infections, eventually leaving you feeling so ill that you can barely function. That is when is can become a “big deal” with potentially serious and costly consequences.

Over the years, I’ve consulted with thousands of people who felt their lives were being ruined by a variety of disorders that turned out to be from Candida overgrowth (candidiasis), commonly known as yeast infection. Because symptoms of candidiasis can mimic those of unrelated disorders, misdiagnosis is often a problem.

Despite the growing body of information available today, too many people remain unaware of the potentially debilitating health issues that can arise from untreated candidiasis and choose to either ignore it or opt for a “quick-fix solution” that promises to “easily” eradicate the problem. The truth is that successfully treating candidiasis is not that easy, especially once it advances to a chronic level. Early diagnosis and a well-rounded course of treatment are your best bet for regaining good health more quickly and staying there.

Of the 150-plus species of Candida, six are frequently associated with human infections:

1. Candida Albicans

This is the most common species to cause yeast infections, responsible for about 50% of all candidiasis occurrences. Candida albicans is opportunistic in nature, so if your immune system is compromised, or your “good bacteria” population is reduced by antibiotics, high stress levels, excessive “bad” carbohydrate intake or hormonal imbalance, Candida albicans will seize the opportunity to overgrow, wreaking havoc in various parts of your body.

Common symptoms include fatigue, bloating, flatulence, anxiety, depression, vaginitis, itchy skin, impaired memory, poor concentration, and a “foggy” brain. Left untreated, Candida albicans overgrowth can lead to systemic infection via the bloodstream, allowing numerous disease processes to occur.

There are various treatments to reduce Candida albicans overgrowth, including prescription and over-the-counter antifungal medications, herbal supplements, natural remedies, healthy dietary and lifestyle changes.

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2. Candida Tropicalis

The second most common species, Candidat tropicalis is believed to be responsible for up to 30% of Candida bloodstream infections (candidaemia). Overgrowth usually occurs in the gastrointestinal tract and on the skin of people with diabetes mellitus, leukemias and lymphomas, causing an array of issues including diarrhea, excessive gas, stomach cramps, and skin irritations including relentless itching, eczematous rashes and hives. Candida tropicalis can also cause vaginal candidiasis, symptomized by intense vaginal itching, abnormal thin watery discharge, pain when urinating, redness and swelling of the outer genitals. Overgrowth can also cause nervous system disorders resulting in depression, anxiety, headaches and memory loss.

While Candida tropicalis is not as aggressive as Candida albicans, it’s becoming more resistant to antifungal drugs such as Flucytosine, making it more difficult to treat. Fortunately there are several new generation antifungals that have been found effective when combined with a balanced treatment regimen including supplements and dietary/lifestyle modifications.

3. Candida Glabrata

With the increased use of immunosuppressive agents, mucosal and systemic infections caused by Candida glabrata have increased significantly in recent years, according to NIH.* Estimated to be involved in 10-30 percent of yeast infections, Candida glabrata can cause oral thrush, which presents as creamy white, slightly raised lesions in the mouth. This can result in painful or difficult swallowing, or fever if the infection spreads beyond the esophagus. Thrush can affect anyone, though it occurs most often in babies, toddlers, older adults, and people with immune deficiencies. Left untreated, thrush can spread to other parts of the body including the lungs and liver of immunocompromised people.

Treatment modalities include various antifungal agents combined with supplements, nutritional and lifestyle modifications.

4. Candida Parapsilosis

Candida parapsilosis is believed to be involved in up to 30 percent of Candida infections, notably nail and tissue infections, and fungemia (fungal blood infection). Candida parapsilosis can cause severe flu-like symptoms, chronic fatigue and systemic infections, most often in immune-impaired people. Its high resistance to antimicrobial drugs is causing concern in hospitals, primarily in Europe. As with the aforementioned species of Candida, a comprehensive treatment approach is necessary to regain good health.

5. Candida Krusei

A rare species, Candida krusei accounts for approximately 1% of candidiasis, and is usually associated with infant diarrhea and sometimes systemic candidiasis. Although it’s resistant to Fluconazole, Candida krusei can be successfully treated with antifungal medications including Amphotericin B. in addition to a holistic regimen.

6. Candida Lusitaniae

Another rare species responsible for about 1% of Candida infections, Candida lusitaniae has been linked to several cases of candidemia blood infections, as well as systemic candidiasis, including sepsis and pyelonephritis, a potentially serious kidney infection. Fluconazole is an appropriate choice as first-line therapy for Candida lusitaniae, combined with dietary and lifestyle modifications.

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There’s no “magic pill” or instant solution for beating candidiasis, despite such commonly advertised claims targeting today’s instant-results mentality. The only way to win the battle is with a diligent multifaceted approach that addresses the root problems and corrects them over time. Candidiasis can be beaten if you’re persistent with your treatment and make the lifestyle changes necessary to accelerate your recovery. It’s up to you.

You can read more about candida eradication protocol here.

Cortisol is a steroid hormone that is produced by our adrenal glands which sit atop our kidneys. The normal levels of cortisol in people, who are not stressed, rarely exceed 15-20ug/dl and are only at these levels for a few hours at the most.

Back in 1971, Weitzmann and colleagues from USA described the normal pattern of cortisol secretion into blood over 24 hours through their study of 6 normal people. The 24 hour sleep-wake cycle can be divided into 4 distinct phases. An episode is where there is secretion of cortisol. There is a sharp rise in cortisol during each episode, followed by slow, smooth decline.

a) Phase 1: Minimal secretion – 6 hour period (4 hours before and 2 hours after sleep) where there is negligible to no cortisol secreted.

b) Phase 2: Preliminary nocturnal secretory episode – 3 hour period from 3^rd to 5^th hour of sleep. Here there is only one episode of cortisol secretion.

c) Phase 3: Main secretory phase – 6^th, 7^th, 8^th hours of sleep and 1st hour after waking up. Three to five secretory episodes occur during these 4 hours. Almost 50% of cortisol secretion for the day happens during this phase.

d) Phase 4: Intermittent waking secretory activity – 11 waking hours where there are several (4-9) episodes of cortisol secretion but where the levels of cortisol secreted are lower than in phase 3.

There are three conditions that trigger the release of cortisol:

• Low blood glucose – like during fasting or after a night’s sleep
• Feeding
• Stress

This article will talk more about cortisol, its importance in our body and how it relates to candida infections.

Cortisol and the stress-response system

We share our world with various living and non-living things and environmental forces which we may or may not have control over. We sometimes feel threatened by any of these and we need to respond to these in a manner that ensures our survival. It is not a surprise, therefore, that our bodies come fitted with a central stress-response system.

Our stress response system is known as the hypothalamic-pituitary-adrenal (HPA) axis. The hypothalamus is a part of our brain that links our nervous system to the hormonal (endocrine) system via the pituitary gland which is a small pea-sized protrusion sitting at the bottom of hypothalamus. Adrenals are thumb sized glands on the top of the kidneys.

When we are stressed (or are fasting, or sleeping in the night), the hypothalamus produces a hormone called corticotrophin-releasing hormone (CRH). CRH goes to pituitary gland and asks it to produce another hormone – the adrenocorticotrophic hormone (ACTH). ACTH is released into the blood which then travels to the adrenal glands and tells them to produce cortisol apart from mineralocorticoids like aldosterone, and dehydroepiandrosterone (DHEA).

Things that can cause us stress (stressors) are majorly of two different types:

1. Physical stressors – like very hot or cold temperatures, injury, pain, or starvation. When we have low blood sugar, cortisol stimulates the release of fatty acids which get converted into glucose.
2. Psychological stressors which are related to perceiving a threat, for example, events, situations, comments etc.

When we are threatened or when we perceive a threat, our stress-response system kicks in and our bodies respond to the stressor– physical or psychological – in different ways to protect us. Once the threat is gone, the response returns back to normal.

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Two important functions of cortisol are energy regulation and mobilization.

• It regulates energy by choosing the right type and quantity of molecules (carbohydrate, fat, protein). When body needs energy and no food is available, it stimulates production of glucose. When glucose is in excess it stimulates conversion of glucose to glycogen which is stored in the liver for times of need.
• It mobilizes energy by using the body fat and providing it to hungry tissues. When we are stressed, cortisol provides the body with energy from non-glucose molecules like proteins and fats through a process called “gluconeogenesis” (Gluco= sugar, neo=new, genesis=production; which means production of new sugar) which takes place in the liver. It can also move fat from storage depots to the abdomen and help fat cells grow and mature.

Cortisol and candida

Cortisol allows candida colonization in a couple of ways.

1. Cortisol increases blood sugar: Cortisol stimulates gluconeogenesis – production of sugar. In a normal person, cortisol also balances this by triggering conversion of glucose to glycogen when glucose is in excess. However, when we are chronically stressed and there is chronic production of cortisol,

2. Cortisol impacts our immune system: Dhabhar and McEwen from USA showed that under acute stress that lasts for a short time, our immune system is boosted by cortisol and when the stress become chronic the immune system is suppressed by it. These researchers think that a boost in immune function during acute stress is body’s way to prepare it for any injuries sustained during the acute period of stress. On the other hand, suppressed immune system due to chronic stress makes a person susceptible to infections. Our immune system appears to behave a different way when there is constant secretion of cortisol. A glucocorticoid-resistance model proposed by Miller, Cohen and Ritchey in 2002 has since increasingly found evidence in other research studies. When we have a constant secretion of cortisol, our immune system becomes insensitive to cortisol.

Our immune cells which normally express receptors to cortisol – when the receptors bind cortisol it is a signal that the immune function, especially functions that cause inflammation should be reduced. So what do these cells do in chronic cortisol condition? They need to protect the body in some way. So they stop/reduce the production of these receptors. This results in constant low-grade inflammation. Candida can easily take advantage of this low grade inflammation – it can use the slight tissue damage and slowing down of tissue repair to its advantage. A study published in 2008 by Jawhara and colleagues from France showed that inflammation of the gut promotes candida colonization.

A telltale sign of chronic stress is a lower than normal morning levels of cortisol in the saliva. After a long time of chronic stress and cortisol secreted continuously, our body’s reaction to external stress fails – our cortisol secretion reduces to normal or below normal levels. This is called as “blunting of cortisol response”. So our body at this stage refuses to react to a threat, for example, an infection. This gives a chance to opportunistic organism like candida to gain access to our tissues to establish. Ehrstrom and colleagues from Sweden showed in 2005 that women with chronic vaginal candida infection had lower than normal morning levels of salivary cortisol.

3. Cortisol affects our gut microbes: Cortisol can alter gut-permeability and barrier function. This way it can contribute to change in gut microbe composition. Change in gut microbes can lead to increased colonization by opportunistic pathogens like candida.

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What can be done to maintain healthy cortisol levels?

Stress is a part of life and we cannot avoid it. What we can do is to avoid becoming chronically stressed. This we can do only if we are consciously aware of being stressed. This can only happen if we give ourselves some time. You cannot work towards solving a problem if you are unaware of the problem. So a good start is to find out if you are on a problem path. Once you have realized this, you can make small changes in your lifestyle that will increase the quality of your life, reduce stress and avoid the dangers of high cortisol running in your blood. Here are a few tips:

• Relax: While small amounts of stress can be beneficial, you need to give yourself time to recover from the stress and the increased cortisol levels. Spanish researchers Cea Ugarte and colleagues showed in 2010 the beneficial impact of controlled breathing exercise on cortisol levels. You can do some breathing exercises that can relieve your stress. Also, Tai-chi has been shown to have cortisol lowering effect. Compared to physical exercises, mind-body exercises like tai-chi or yoga are more effective in handling stress.
• Get good quality sleep: Poor sleep has been shown to result in much increased cortisol response to psychological stressors and physiological stressors. Worse your sleep worse will be your problems with cortisol, higher the risk of candida infections and lower the chances of recovery from any existing candida infection.
• Exercise regularly: A 2008 research study by Hill and colleagues from USA showed that while low-intensity exercises caused a reduction in circulating cortisol levels, medium and high intensity exercise actually increased them! So beware, light exercise is good for you to reduce cortisol due to daily stresses, but if you overdo it, you may actually increase your problems instead of reducing them.
• Stop your caffeine intake: There is evidence that caffeine intake can increase the cortisol levels in blood. Lovallo and colleagues from USA showed in 1996 that the response to caffeine was very much stress-like. So, if you are already stressed, coffee is not going to help in any way.
• Stop alcohol: Although alcohol is known to relieve anxiety, there is a strong association between alcohol use and increased cortisol levels. So, if you are looking to reduce/prevent your stress and cortisol related issues, you really need to give up on alcohol.
• Stop smoking: Smoking tobacco also increases the blood cortisol levels acutely and so it follows that you must stop smoking.
• Good balanced diet: There is some evidence that caloric dieting (dieting to reduce calories) actually increases the cortisol levels. US researchers Tomiyama and colleagues showed in 2010 that dieting may be deleterious to psychological well-being and biological functioning due to increased outputs of cortisol. High and low zinc intake in food has been reported to cause changes in adrenal secretions. Zinc seems to acutely and temporarily inhibit cortisol production as was showed by a preliminary study by Brandao-Neto and colleagues from Brazil in 1990. So, a deficiency of zinc can cause your cortisol to stay high. Additionally, poor nutrition can cause hormonal imbalance through various mechanisms. So, it is important to have a good and balanced diet in order to make sure that your hormones, including cortisol, stay in balance.
• Probiotics/prebiotics usage: Microbes also exert an effect on the circulating cortisol levels. A study by Schmidt and colleagues from UK which was published in 2014 described the effects of prebiotics, which increase the population of good-bacteria in the gut, on circulating cortisol levels in healthy volunteers. The study found that the prebiotic Bimuno-galacto-oligosaccharide reduced the salivary cortisol awakening response and also changed the emotional processing to positive. CanXidaRestore is one of the best probiotic+enzyme blend out there that you can incorporate in your diet.

I have seen several patients in particular who find it almost impossible to stay away from alcohol yet who have digestive issues, skin complaints and fatigue. This to me is saying that you have a money problem yet you keep taking on more credit with the bank and continue a gambling habit. Of course you have a problem, and the cause is right under your nose but you are either in denial or you just can’t be bothered. I can’t think of any food or beverage more destructive for the candida patient than alcohol.

It never ceases to amaze me when I read many different blog sites, e-newsletters, e-books and other sources of information with regard to candida yeast infections, that most practitioners (and their patients) completely overlook one of the biggest maintaining causes (probably the # 2 dietary cause) of on-going yeast infections – alcohol. Now that I have your full and complete attention, listen up if you have candida and drink wine, beer or spirits please STOP!

There is plenty of scientific evidence that alcohol is harmful to health. It is in fact classified as a cancer causing agent in humans by International Agency for Research on Cancer (IARC) based on studies in humans, animals and studies on mechanisms by which alcohol can cause cancer. Apart from cancer, alcohol consumption is related to 60 different diseases and conditions which include:

• lung disease
• heart disease
• reproductive disorders
• mental and behavioural disorders
• and also cause problems in the developing foetus.

When we drink alcohol, it is broken down in the liver where an enzyme known as alcohol dehydrogenase converts it into acetaldehyde. Then another enzyme breaks it down further into acetate, which gives our cells energy. The problem is that the body’s ability to convert acetaldehyde is undermined when there is more acetaldehyde in your body than the enzyme you can produce. High levels of this chemical remain in the body and can cause a kind of poisoning which not only does physical damage but can very much distort mental perceptions. A majority of alcohol’s harmful effects are due to the acetaldehyde. If you think that it is only alcoholics or people with a high level of toxicity who would get these effects, well ask yourself if you have ever had a hangover. Hangover is the first obvious sign that you have acetaldehyde accumulated in the body.

Related articles:

• Oral Yeast Infection (Oral Thrush) Symptoms, Causes & Treatment
• Fatty Liver And Candida Infection: Is it Connected?
• Candida Yeast Overgrowth And Carbohydrates
• Everything You Need To Know About Candida Glabrata
• Candida Patients And Low Blood Sugar Issues
• Feeling Fatigue, Low Immune System And Mood Instability

An additional factor to consider is alcohol sensitivity. A review article that was published in 1987 by Goedde and Agarwal discusses alcohol sensitivity where people who have a certain genetic makeup are deficient in the enzyme that converts acetaldehyde to clear it from the system. This results in acute alcohol sensitivity symptoms (flushing response) even by drinking very low amounts of alcohol.

Apart from this, if you are a woman, alcohol causes tissue damage more rapidly compared to men. Eriksson and colleagues from Finland published a research in 1996 which showed that acetaldehyde levels rise much more when women take alcohol during the high estrogen phases of the menstrual cycle. The same is also true for women who take oral contraceptives.

You may think that a little alcohol might be alright – but it is not known how little is little enough. A 1994 review of 10 years of research by Frank Holloway of USA concluded “a variety of factors may influence sensitivity to alcohol effects from time to time, person to person, and/or situation to situation”. Another 1992 review by Pedro Catarino from UK had commented “The idea that there is a safe level of alcohol consumption below which there are no adverse effects remains simplistic when based on the evidence we have accumulated to date. What is safe for one individual may not be for another – safety continues to be a relative matter in any discussion of alcohol use.”

On this matter, the World Health Organization (WHO) says, “This might not be the answer people want to hear, but there is no safe level for drinking alcohol. Of course there is lower-risk drinking, but WHO does not set particular limits, because the evidence shows that the ideal situation for health is to not drink at all.”

There is evidence that candida also produces acetaldehyde. It is able to use both alcohol and sugars (further reading – candida and sugar connection) for its energy needs and in turn produces acetaldehyde. Now, consider this situation:

• You are suffering from candida and candida produces acetaldehyde in your body.
• Your liver enzyme is continuously trying to clear the acetaldehyde produced by candida by converting it.
• You then go ahead and have alcohol. Your body converts alcohol to acetaldehyde.
• You will now not have enough enzyme to convert the acetaldehyde that is produced from alcohol breakdown by your body! Acetaldehyde will accumulate and cause toxicity.

You can read in details about how and why acetaldehyde can harm you – especially so if you are also suffering from candida infection here.

Remember, alcohol of any kind is bad for your candida infection. Anything that contains ethanol is!

Do all the arguments that you find on the internet make sense?

You will find a lot of conflicting information on the internet. You will also find arguments that say that it is ok to drink alcohol while on a candida diet. The arguments also seem logical by themselves. But let us look a couple of the arguments out there and find out how much they stand against evidence:

1) “The liver does not metabolize alcohol into sugar. On the contrary, most people will experience a dip in their blood sugar (glucose) levels when consuming alcohol. Alcohol is eventually broken down by the liver into acetate, and finally into carbon dioxide and water—not sugar.”–by David J. Hanson, Ph. D

It is true and is known for a long time that the liver does not metabolize alcohol into sugar – it produces acetaldehyde which is eventually broken down to acetate which is used by the cells for energy. It is also true that most people will experience a dip in blood sugar levels on consuming alcohol.

But does that mean that alcohol can actually function to your advantage by decreasing blood glucose and not allowing candida to grow? There are a few facts you should consider:

• Candida can actually use ethanol as its energy source. Some strains of Candida albicans can use ethanol more effectively than others and produce acetaldehyde. Even Candida glabrata which is also involved in causing candida infections can utilise ethanol to produce acetaldehyde. So if you drink alcohol and think that it does not matter to candida, it does – it makes candida very happy!
• Well, if you think that drinking alcohol will cause a reduction in your blood glucose level and thereby not be good for candida and thus good for you, think again. Why do you want to forget (or ignore) acetaldehyde that is produced from ethanol and the harm it can cause? If you are a candida sufferer, you are at an even higher risk of acetaldehyde accumulation as described earlier. So, yes, alcohol may reduce your blood sugar that candida likes for a meal, but beware, you are inviting an even bigger evil than sugar – acetaldehyde! Also, candida will love to use alcohol as its energy source if you are running low on blood glucose.

2) “Enjoy a drink because candida cannot feed with alcohol. Ethanol is a candida waste, it is not food for candida. Rum, Vodka, etc. Even beers if you aren’t allergic to yeast and gluten intolerant, you can drink them safe. Chose light beers to limit the carbohydrates amount. Alcohol is going to give calories to you. It is a MYTH you cannot drink during a candida diet. So, enjoy!!!!”

WOW, this one is simply WRONG. I suppose that by now you can already see yourself how wrong this is. Yes, sugars are broken down to ethanol by candida – but ethanol is not really a waste! As mentioned earlier, candida will be as happy to use ethanol as sugar. Another enzyme from candida converts ethanol into acetaldehyde and yet another enzyme converts acetaldehyde to acetate to give candida energy. So, ethanol is not good for candida – it is FOOD for candida. But if you drink any alcoholic drink when you have candida infection, you are inviting trouble as acetaldehyde is very reactive and it can interact with your molecules while candida converts it to acetate. Some candida strains are slow or deficient in this conversion and can cause acetaldehyde to accumulate and cause harm.

Another reason why you should not drink when you have candida infections is that alcohol affects your gut in many different ways – some of which may cause candida related harm. Let us have a look at few of these effects described in an article from 1997 by Bode and Bode from Germany and how these could potentially relate to candida issues:

• Alcohol injures the mucosal membrane: If you have candida infections, this will only help candida to grow deeper into the tissues.
• Alcohol interferes with absorption of nutrients: Nutrient (vitamin and mineral) deficiency could put you at a higher risk for candida infections.
• Alcohol causes dysbiosis: There is evidence that drinking alcohol causes change in the bacterial microflora in your gut. This changed bacterial growth produce endotoxins and inflammation. You know very well that one of the major causes of candida overgrowth is dysbiosis.
• Alcohol increases the permeability of the gut: This allows larger molecules like toxins produced by microbes and other chemicals to pass through the gut into the bloodstream. This can cause injury to your liver because these toxins in the blood stimulate inflammatory response. Also, candida by itself is known to increase the permeability of the gut resulting in food allergies. Having alcohol can actually aggravate your food/other allergies even further.
• Alcohol with over 15% alcohol decreases your bowel function: Because of this the digested food remains longer in the intestines which could cause microbes to start degrading it causing bloating and gas. Increased permeability of the gut may allow the degradation products to get into your bloodstream.

The Solution

You know the solution, STOP all alcohol completely and watch what happens to your digestive system and bowel motion. You can also take CanXida supplement – you can find more about it on canxida.com. You will be most surprised to see a change over seven to ten days, I guarantee it. If this happens, and it will (unless you also eat lots of take-out and processed foods) you are on your way to great health.  Congratulations, you are finally in what I call the “wake-up” mode. You have seen the light and will not only be decreasing your population of intestinal yeast, you will be improving your health in ways you didn’t think were possible – that skin rash will go, that itchy groin will go, that vaginal discharge will go, and many other signs and symptoms of a candida yeast infection will go.

Trust me; you will wonder why you didn’t see the light years ago. Don’t kid yourself – one glass a week is enough to keep you in the candida zone. If you are serious about eradicating a condition which has been bugging you for years, you will only know if the condition is caused by alcohol be stopping it. You can also get my book CandidaCrusher where I go in detail on how you can eradicate candida once and for all.

List of some frequently asked questions about candida and alcohol.

Related articles:

• Always Disconnected & Dizzy: Is It Candida?
• Alcohol Causes Many Yeast Infections
• 12 Tips for Improving Your Bowel Function – Part 2
• Candida Yeast Infections And Drunk Disease
• Is Yakult Good for Candida?
• Is Pumpkin Seeds Allowed If I Have Yeast Infection?

Does drinking alcohol cause candida?

Yes, drinking alcohol can cause candida through various mechanisms described in this article.

Does sugar alcohol affect candida?

Yes. Read more here.

Can alcohol worsen my candida if I drink it?

Yes, it can definitely worsen your candida. Candida can use alcohol as food and grow.

Is there any alcohol that doesn’t feed candida so I can drink once in a while if I am on candida diet? Or all types of alcohol are bad for candida?

All types of alcohol are bad for candida – if there is ethanol in your drink, it is bad for you.

Can I drink alcohol after I got rid of my candida overgrowth?

If you wish to avoid getting candida in the future, you should completely avoid alcohol as it can not only promote dysbiosis, attachment and penetration of candida, but also act as fuel for candida to grow on.

Can I drink Vodka?

No. Vodka has high amounts of alcohol, so you cannot drink it on a candida diet.

Does isopropyl alcohol kill candida?

Yes, 70-90% isopropyl alcohol can kill candida. Isopropyl alcohol, like ethanol kills microbes, but only at these very high concentrations.

Can alcohol kill candida?

Alcoholic beverages cannot kill candida as they do not have high enough concentration of ethanol.

What is alcohol challenge test? Is it good to detect candida overgrowth?

The “alcohol challenge test” is a test which checks if you have production of alcohol in your gut. A few cases were reported where people had all the symptoms of being drunk without having drunk any alcohol. This was attributed to the yeast growing in the system and was termed as the “auto-brewery” syndrome. This can be caused by alcoholic fermentation of carbohydrates in the gut by both bacteria (Neisseria and Clostridium) and yeasts (like the Brewer’s yeast – Saccharomyces and Candida) that have an overgrowth in the gut.

Basically, you fast for at least 3 hours before the test and should not have taken alcohol for 24 hours and then are fed glucose. Blood samples before and after feeding glucose are taken and tested for ethanol.

As this test can come out to be positive because of many different organisms it is not a very reliable test for candida overgrowth.

What about alcohol free wine/beer for candida is that okay?

No, they are not, especially if you are allergic to yeasts. Although the yeast may have been thoroughly filtered out, the compounds that yeast produces will still be there. Non-alcoholic wines and beers also contain small amounts (less than 0.5%) of alcohol. But if you are on a candida diet, the candida will absolutely love the little alcohol that you give it.

Are spirits or gin okay?

No, they are not as they contain large amounts of ethanol.

Is alcohol not allowed because it can cause die off?

No, this is not true. Drinking alcohol will not cause die-off. Alcoholic drinks cannot kill candida as they do not have enough ethanol to have the microbe killing effect.

Alright, so you have read somewhere that one reason that candida is bad for you is that it produces a certain aldehyde which is harmful to your health. This article will give you in-depth information on what aldehydes are, how they are connected to candida, how they affect us, what does scientific research say about these, what can you do about it and much more.

Aldehydes in our lives

Aldehydes are compounds naturally present in living systems.

Aldehydes are present in our food in small amounts. For example, benzaldehyde is the compound that gives bitter almonds their flavour, cinnamaldehyde is responsible for the typical flavour of cinnamon, and vanillin is the aldehyde from vanilla beans that gives vanilla its characteristic flavour.

Aldehydes are also present in essential oils and give them their anti-fungal, anti-inflammatory and calming therapeutic properties at high dilutions. If the concentration of aldehydes is high, then it can sometimes cause irritation and sensitivity due to the reactive nature of aldehydes – for example, cinnamon bark and lemon grass have higher percentage of aldehydes and a higher dilution of these must therefore be used.

Some aldehydes perform essential functions, for example, retinal is an aldehyde which combines with the protein opsin in the retina of eye and forms rhodopsin. Rhodopsin is the main compound involved in process of vision.

Aldehydes vary in smell – most of the smaller ones smell like rotten fruits while most of the larger ones are pleasant smelling and are used in perfumery. Others may have a not so pleasant smells, like butyraldehyde that smells of rancid butter.

Related articles:

• Causes of Candida Overgrowth Infection
• Are Biofilms Resistant To Antibiotics?
• Metabolites, Mycotoxins, and Acetaldehyde – What Are They?
• Vaginal Yeast Infection: Causes, Symptoms and Treatment
• Always Disconnected & Dizzy: Is It Candida?
• Is Onion Good For Yeast Infection?

Formaldehyde is the simplest aldehyde and is formed in nature in the early stages of plant decomposition in soil. It is naturally present in foods and fruits in small amounts. It is a very reactive compound, is used in dyes, insecticides, as embalming fluid, and in some medicinal drugs.

And that brings us to acetaldehyde – one of the not so very nice aldehydes, especially when you are exposed to it in high amounts. Acetaldehyde is naturally present in fruits and foods, but can also be added as a flavour in foods. One of the ways that we ourselves produce acetaldehyde is when we drink alcohol – the alcohol is converted to acetaldehyde by our liver. It is this acetaldehyde that causes the symptoms of hangover. Other ways in which we get exposed to acetaldehyde is through the indoor climate (building materials, cooking, cleaning goods etc.), smoking tobacco and cannabis (which could be responsible for addiction), and plastic usage.

It is acetaldehyde which also has a connection with candida and is one of the sources of exposure to those with chronic candida infections. Although acetaldehyde is short-lived in our body and quickly gets broken down into acetate, it still has the ability to cause cell and tissue damage. Acetaldehyde causes mitochondria to not function properly and this in turn compromises the breakdown of acetaldehyde. Thus, as acetaldehyde accumulates the ability to break it down further it decreases causing a chronic cycle of accumulation and damage. Acetaldehyde can also react with other molecules like protein and enzymes and change their structure and function.

Harmful effects of acetaldehyde

Acetaldehyde is harmful to us in many different ways. As it is very reactive, it can harm us in several ways – it is toxic, is an irritant of skin and mucosa, causes damage to organs and tissues, and is also a possible carcinogen for humans. Some of the more systemic effects of acetaldehyde are:

Cardiovascular effects: A review article published in 2010 by Guo and Ren discusses how harmful acetaldehyde is to the heart. It causes enlargement of heart chambers (cardiac hypertrophy), disturbs contraction of heart, and is associated with abnormal heartbeat and blood pressure. Guo and Ren also discuss how acetaldehydes are involved in production of free radicals which indirectly decrease antioxidant defences of our body leading to oxidative damage. A 2010 review by de la Monte and colleagues from USA describes how malondialdehyde (MDA) which is formed by oxidation of fatty acids is itself a component of the atherosclerotic plaque (plaque build-up in the arteries), and can also modify LDL. Both MDA and acetaldehyde also react with various proteins and form complexes which release pro-inflammatory and adhesion molecules involved in causing atherosclerosis.

Liver damage: The review by de la Monte and colleagues also describes the effect of acetaldehyde on liver. One mechanism by which acetaldehyde causes liver injury is by forming complexes with liver proteins. Our body recognizes these complexes as foreign and produces antibodies against them. The antibodies then work against the liver damaging it. Additionally, the complexes that acetaldehyde makes with the cell-skeleton proteins cause derangement of liver cell structure and thereby liver function. Acetaldehyde complex accumulation also leads to scar tissue formation in the liver followed by liver fibrosis or cirrhosis. The atherosclerotic nature of acetaldehyde can also cause the blocking of the blood vessels important for blood supply to the liver thereby causing liver disease.

Blood cell and clotting mechanism dysfunction: The review by de la Monte and colleagues also describes the possibility that acetaldehyde can cause destruction of red blood cells (RBCs) by making complexes with proteins of the RBCs. Again, these complexes are considered foreign by our body and our body launches attack against them (and thus against the RBCs). Destruction of RBCs can cause anaemia and iron accumulation in the liver causing liver injury. An article from 1987 by Baraona and colleagues from USA showed that acetaldehyde can also be transferred by RBCs from liver to other tissues causing widespread damage. Furthermore, acetaldehyde inactivates several blood-clotting factors as reviewed in the article by de la Monte and colleagues.

Neurotoxicity: de la Monte and colleagues in a study published in 2011 showed some evidence that acetaldehyde can cause oxidative stress induced neuronal injury as was also shown by experiments carried out by the same group of researchers and presented at a meeting in 2007.

Vitamin deficiency: Acetaldehyde can also be a culprit behind causing certain nutritional deficiencies. In 1983, Takabe and Itokawa, researchers from Japan, showed in rabbits that vitamin B1 gets depleted when acetaldehyde is administered to them. In 2013, Catazaro and Brecher from USA published their research on the impact of B-complex vitamins on acetaldehyde based blood clotting dysfunction. They found that vitamins B1, B6 and B9 could reduce the effect of acetaldehyde on blood clotting dysfunction. This is because these vitamins react with acetaldehyde and form a complex. Thus, it follows that if there is acetaldehyde in the system, it will bind very easily to free vitamins and the vitamins will not be available to perform their own function leading to vitamin deficiency. Vitamin B1 is very essential for nerve function and neurotransmission. Chronic B1 deficiency (which occurs in alcoholics and is related to acetaldehyde) can produce psychological symptoms and reduction in short term memory.

Folic acid deficiency has also been linked to acetaldehyde mediated oxidation damage. Way back in 1989 Shaw and colleagues from USA demonstrated that folate is destroyed by acetaldehyde in this manner. Folate deficiency can also result in neuropathy apart from other effects.

Other effects: There are many other harmful effects of acetaldehyde also discussed in the review by de la Monte and colleagues – induction of cell-suicide, behavioural and physiological effects like memory impairment and sleepiness, and promotion of cancer in people dependent on alcohol.

Considering that acetaldehyde is so harmful to us, it becomes imperative for patients with candida infection to know more about a possible relationship of candida with acetaldehyde and what can be done to avoid issues with acetaldehyde.

Acetaldehyde and candida – is there really a connection?

Back in 1984, Truss came up with a hypothesis and indirect evidence that candida could ferment sugars to acetaldehyde. He carried out metabolic studies on 24 patients with chronic candidiasis and tried to correlate the symptoms with toxic effects of acetaldehyde. The interesting part about his hypothesis is that it can correlate these two and perhaps also provides a chemical link between yeast fermentation and metabolic abnormalities in patients with yeast susceptibility. Truss did mention that direct evidence will be needed to prove this hypothesis.

However, looking at literature since 1984, one cannot find any detailed studies on this connection. This lack of scientific evidence does not mean that there is no substance to the hypothesis, but that this line of thought has not been followed up rigorously by the scientific community. One of the reasons could be that chronic gastrointestinal overgrowth of candida is not widely accepted by the mainstream medical community.

New evidence, however, is coming up from scientific work that does point towards existence of this condition. For instance, a 2012 research by Gong and colleagues from China found a particular strain of Candida albicans in 60% of the 111 patients they tested for indigestion but only in 14.8% of 162 healthy individuals tested. Rao and colleagues in 2013 and 2014 showed that impaired movement and contraction of digestive organs and overuse of a certain type of antacids (proton pump inhibitor) are risk factors for fungal overgrowth in small intestine and that fungal overgrowth (including candida) can cause chronic gastrointestinal symptoms.

Well then, you would ask, is there any scientific evidence of candida producing acetaldehyde in conditions other than gastrointestinal overgrowth of candida?

In 1999, a report published by Finnish scientists, Tillonen and colleagues studied salivas of 55 people based on salivary acetaldehyde produced from ethanol. They divided the people into high acetaldehyde-producing and low acetaldehyde-producing groups. They found that 78% of high acetaldehyde-producing salivas had yeast colonization as compared to only 47% of low acetaldehyde-producing salivas. They then isolated candida albicans from these salivas and checked for their acetaldehyde producing ability by adding ethanol to their growth medium. They interestingly found that the candida from high acetaldehyde producing salivas produced significantly more acetaldehyde as compared to candida from low acetaldehyde producing salivas. This clearly showed that some strains of Candida albicans can produce more acetaldehyde from ethanol than others.

In 2008, Rautemaa and colleagues, also from Finland, published results of similar experiments with Candida albicans strains isolated from Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) patients. APECED is a genetic disease where there is autoimmunity to various tissues accompanied with candidiasis. Many of those suffering from this disease also get oral cancer. The researchers could show that Candida albicans from these patients produced large amounts of acetaldehyde in presence of glucose (at a concentration found in foods and drinks and the concentration which has also been found to increase candida biofilm formation and adhesion in mouth), but not in non-patient controls. Interestingly, all Candida albicans strains isolated from the patients as well as non-patient controls were able to produce high amounts of acetaldehyde from alcohol (at a concentration that can be found in mouth after social drinking or in other fermented products).

Rautemaa and colleagues also published an article in 2009 where they reported their studies on acetaldehyde production from ethanol and glucose by 30 candida species other than Candida albicans. They found in their experiments that while all candida isolates produced large amounts of acetaldehyde from ethanol, only Candida glabrata could produce acetaldehyde from glucose. They concluded that oral infection with candida species could lead to the production of acetaldehyde from both ethanol and glucose.

Thus, there is good evidence that candida species can produce acetaldehyde by feeding on alcohol or sugar. There is also clear indication that Candida glabrata which was earlier considered non-pathogenic is now found in many candida infections – especially in vaginal candida infections. It seems possible that infection with Candida glabrata could put you at a higher risk of getting acetaldehyde poisoning as this candida can utilize sugar to form acetaldehyde.

The interesting thing is that a 2006 study by Ehrstrom and colleagues from Sweden showed that there is no difference in the levels of glucose in vaginal secretions in patients suffering from recurrent vaginal candidiasis and women without any candidiasis. So it cannot be the glucose in the vagina that can be used by candida to form acetaldehyde. Donders and colleagues from Belgium had showed in 2002 that women who had recurrent vaginal candida infections also had impaired glucose tolerance (higher levels of glucose in blood than normal) without being diabetic. It is a possibility that women with vaginal candida infections may get the infection from the bowels due to close proximity of vagina and anus. Thus, a lower glucose tolerance combined with vaginal candidiasis could indicate presence of pathogenic candida (and possibly Candida glabrata) in the gut.So what has impaired glucose tolerance got to do with acetaldehyde? Well, everything. Low glucose tolerance means high glucose in blood – and high glucose in blood would mean candida in the gut has more glucose available to convert to acetaldehyde.

Now, very interestingly, in 1981, TIengo and colleagues from Italy had showed in rats that acetaldehyde inhibited insulin which was produced in response to glucose in the blood. The question is whether the glucose intolerance seen in women with candida infections is actually an effect of suppression of glucose-induced insulin by acetaldehyde produced by candida? In that case it is likely that infections with glucose utilizing candida are able to support their overgrowth by producing acetaldehyde from glucose, the acetaldehyde in turn inhibits insulin which results in higher levels of glucose in blood and again candida can use more glucose to grow. More research is needed by the scientific community in this regard to say anything for sure. However, it does seem like a possibility that when a person has Candida infection, sugar and alcohol intake can actually lead to production of acetaldehyde (by candida in the gut), which can result in glucose intolerance which in turn can aggravate your candida issues.

So, yes, there does seem to be a correlation between candida and acetaldehyde. Candida infections may put you at a higher risk for acetaldehyde related toxicity.

So what can be done to avoid acetaldehyde issues?

What does science say?

A systematic review of double blind random controlled trial for prevention or treatment of hangovers (which are caused by acetaldehyde accumulation) was published in 2005 by Ernst and colleagues from UK and Netherlands. They analysed studies on natural agents like borage, artichoke, prickly pear and a yeast based preparation and conventional agents tropisteron, propranolol, tolfenamic acid and fructose or glucose. Although there were encouraging findings for borage, a yeast based preparation and tolfenamic acid, only one controlled study was available for each and also the sample size was small with unvalidated symptom scores. Overall, they actually found no compelling evidence that any of the interventions studied were any good for treating/preventing hangovers.

A 2011 article by Rautemaa and colleagues from Finland demonstrated in laboratory that the acetaldehyde produced by candida from ethanol was reduced by 84% by xylitol – a sugar alcohol used as a sweetener. Xylitol seems to do this is by suppressing the activity of the enzyme that converts ethanol to acetaldehyde. These results need to be confirmed with animal/human trials. Also, it is worth remembering that artificial sweeteners may be linked to glucose intolerance as was showed in 2014 by Elinav and colleagues from Israel. They found that the artificial sweeteners saccharin, sucralose and aspartame changed the gut microflora which caused glucose intolerance. Another study published in 2013 on xylitol was conducted by Japanese scientists Tamura, Hoshi and Hori which showed that xylitol affected the intestinal flora of mice. Thus, even though xylitol seems like and may also be proven in the future to be effective in reducing acetaldehyde produced by candida from ethanol, one should be wary of the side-effects of xylitol intake. This is especially relevant for people with candida infections as dysbiosis is already a problem for them and they would not want to make the problem worse – xylitol intake could actually result in worsening of candida infections.

Vitamins may have an effect on reducing the impact of acetaldehyde. Ren and colleagues from USA published an article in 2004 which showed that vitamin B1 supplementation can prevent cardiac dysfunction, protein damage and cell suicide of heart muscle cells caused by acetaldehyde. They showed that other vitamins of B group did not have this effect.

Related articles:

• Can Amoxicillin Cause Yeast Infections?
• How Molybdenum Can Help Fight Against Candida Yeast Infection
• Everything You Need To Know About Candida Auris
• Recurring Ringworm: Can It Be Candida?
• Is Alcohol Consumption Connected to Candida?
• 6 Most Common Types of Candida

What other sources on internet say?

You will find plenty of information on the internet regarding many different products that claim to be effective in clearing acetaldehyde from the blood and preventing the acetaldehyde related harmful effects, especially where it concerns candida. There is not much of scientific evidence about most of these agents.

One of these is, for example, molybdenum. It is true that molybdenum is required for the activity of aldehyde oxidase – a liver enzyme that can break down acetaldehyde to acetic acid and allow its removal from the body. However, genetic and nutritional deficiencies of molybdenum are very rare as molybdenum is found in most foods and molybdenum amount required is very small. Department of Health, UK suggests taking a varied and balanced diet should be able to give you all the molybdenum you need. Unless you have a serious genetic disorder, you are very unlikely to have molybdenum deficiency.

What is the logical thing then to do to prevent acetaldehyde build-up?

Do not drink, especially if you have candida infection: Even if you do not have candidiasis, acetaldehyde can be an issue if you drink heavily. Even if you do not drink heavily, but have the genes that do not allow you to metabolize and break down acetaldehyde fast enough, you are at a higher risk of acetaldehyde toxicity. Now if candida comes into the equation, it increases your risk as candida can very easily metabolize alcohol to acetaldehyde.

Take a well-balanced and varied diet: This will help you get all the minerals and vitamins needed to detoxify acetaldehyde.

Do not try to kill candida very fast: This will prevent accumulation of candida toxins by allowing the body to get rid of them as they are formed. If you kill candida very fast, it is going to overwhelm your liver which serves the cleaning and detoxifying function which will lead to acetaldehyde accumulation apart from other toxins.

Keep your liver healthy: Prevent liver disease, drink lemon juice which increasingly is being shown to have detoxifying activity, sleep well and enough – there is some evidence that sleep deprivation can cause disturbed liver function and liver injury.

Listen to your body: Finally, learn to listen to your body. Start with simple things like stop eating when you get a signal you are full (and not try to eat up every tasty morsel on the plate), go to bed when the body tells you it is bedtime (and not stay up late because your favourite TV serial is on), don’t take coffee or sugar to keep yourself awake during work hours – work on your nutrition and you will find that you do not feel less energetic during work hours, drink water – not just when you are extremely thirsty (when you are extremely thirsty, you are already dehydrating). Listening to your body’s signals will reduce your stress hormones and toxic accumulations.