How To Test For Candida + Exactly What To Do If You Have It
My 34-year-old patient Margaret was struggling with weight-loss resistance, moodiness, and fatigue—which made her feel pretty miserable. At first I felt puzzled, since Margaret had a good diet, exercised regularly, and seemed to do everything required to maintain a healthy weight.
Then one day she casually mentioned that she craved fruit. For the last seven months, Margaret had been following Weight Watchers, a popular weight-loss program that assigns zero points for fruit. In other words, she could eat all the fruit she wanted and often did. That excess sugar—yes, even in Weight Watchers–approved fresh fruit—fed Margaret’s yeast overgrowth, which caused her to crave more sugar.
A few tests revealed she had candidiasis, a form of yeast-predominant dysbiosis (a gut imbalance between favorable and unfavorable microbes, in this case, an overgrowth of yeast in her gut). While about 20 species of Candida yeasts can create problems, the most common1 is Candida albicans. As a medical doctor who specializes in gut health, I see how Candida and yeast overgrowth triggered by things like chronic stress, sugar overload, or antibiotics can contribute to or exacerbate numerous problems including inflammatory bowel diseases2 and leaky gut3.
Your best protection against yeast overgrowth is a normal acidic stomach pH. Unfortunately, many of my patients use acid-blocking medications, have vagal nerve dysfunction, or have an H. pylori infection—all of which make their stomachs less acidic and create fertile ground for problems like candidiasis.
Candida overgrowth and the toxins secreted by this excess yeast wreak havoc throughout your body, leading to a host of seemingly unrelated symptoms and conditions. Among them include fatigue, mental fog, anxiety, mood swings, muscle and joint pain, itching, histamine intolerance, and rashes. Many patients like Margaret also experience bloating, sugar cravings (for any type of sugar, whether starchy carbs or "healthy" foods like fruit), and abdominal pain.
Is there an accurate test for Candida?
Many candidiasis symptoms overlap with other common health problems, making it difficult to diagnose based on symptoms alone. So while none are perfect, I utilize a few tests to diagnose yeast overgrowth and rule out other culprits when symptoms are too vague or could be caused by more than one source:
1. Stool testing:
I often do stool testing on my patients via microscopy and culture. Specialty labs can analyze stool for yeast overgrowth.
2. Serum testing:
Just like for food sensitivities, a practitioner can test for IgG, IgM, and IgA antibodies to Candida. Candida immune complexes, which are basically antibody molecules stuck together by Candida antigens or proteins, may also be detected.
3. Candida DNA test:
This is done by polymerase chain reaction (PCR) and is a very sensitive test for the presence of up to five different species of Candida in the bloodstream. While some practitioners use it for candidiasis, this test also shows promise in detecting other overgrowth in yeast dysbiosis.
4. Stool PCR testing:
This test uses DNA amplification to identify microorganisms in your gut, including Candida and anaerobic bacteria previously very difficult to isolate.
5. Microbial organic acids testing:
D-arabinitol is a metabolite of the 5-carbon sugar arabinose that can be detected in the urine. Candida species produce arabitol, which is absorbed and then converted to arabinose by the liver. The kidney secretes the final metabolite. If it’s high, it suggests gut yeast overgrowth.
Like I said, none of these tests are perfect. I normally decide which one(s) to use based on the specific circumstances and the individual patient's symptoms.
So you have Candida, now what?
Just like no test proves comprehensive, eliminating candidiasis will also differ for every patient. Here are the strategies that work well for many patients:
1. Eliminate sneaky sugar sources.
If you have any form of yeast overgrowth, I recommend eliminating sugar—including "healthy" sugars like honey and fruit sugar—for six months or possibly longer. Margaret loved fruit, so I had her switch to low-sugar ones like berries or avocado with no more than two servings daily.
2. Cook with coconut oil.
Caprylic acid is one of three fatty acids in coconut oil (capric acid and lauric acid are the other two). It has antifungal properties that help kill off excess Candida. Don’t believe the recent American Heart Association hype: A few tablespoons of extra-virgin organic coconut oil daily is perfectly healthy. Margaret loved cooked vegetables in coconut oil so she did that regularly, and to get its therapeutic benefits I also had her take caprylic acid as a supplement.
3. Implement these herbal, plant-based antimicrobial powerhouses.
The nutrients I used to treat Margaret’s candidiasis included oregano oil, Berberine, garlic (I use Allimax Pro, a highly concentrated garlic extract with potent anti-yeast activity), and digestive enzymes. I recommend working with a trained practitioner to monitor efficacy and dosing of these and other nutrients.
Like many patients, I immediately saw the impact stress had on Margaret’s gut health. Chronic stress elevates cortisol—a hormone that dampens your immune response while spiking blood sugar and inflammation—and creates the perfect storm for Candida to flourish. Margaret learned to prioritize stress management once she saw the wide-ranging problems it created.
5. Mind your liver.
Alcohol and stress are among the culprits that compromise liver health, contributing to Candida’s health effects by inhibiting your detoxification abilities and zapping your immune system. All together, that creates fertile ground for Candida overgrowth. I asked Margaret to give up red wine for a month ("It’s only a month!" I assured her), and eventually she did a medically supervised detoxification plan to rejuvenate her liver.
You’ll want to foster more good gut bugs and fewer bad bugs with a professional-quality prebiotic-probiotic blend, along with lots of fermented foods like sauerkraut and kimchi. Patients also love my coconut water kefir (check out the recipe below). I highly recommend working with a practitioner to determine the right time to repopulate. But remember to go slow. Adding fermented foods too soon in the treatment plan can actually cause uncomfortable die-off symptoms.
Among its many benefits, regular exercise helps with detoxification, improves lymphatic drainage to remove waste products, balances blood sugar, and knocks out stress—all indirect ways to improve your gut ecology. Margaret hated the gym, so I had her start out with some brisk walking and a few yoga classes every week.
Simply put, the way to reverse yeast overgrowth is to eat a low-sugar, low-starch diet while taking probiotics and anti-yeast herbal remedies.
Even the healthiest foods can contribute to Candida overgrowth. Here are a few to keep an eye on. For more ways to boost your gut health, check out my recipe for a coconut water kefir below:
Coconut Water Kefir
Makes 4 cups
- 3 tablespoons water kefir grains*
- 4 cups pasteurized coconut water
- 1 cup fresh strawberries or blueberries (optional)
- ½ cup fresh lemon juice (optional)
Place the water kefir grains and the coconut water in a jar. Cover the jar loosely with a lid or cheesecloth and allow the kefir grains to culture the coconut water for ideally 24 to 36 (and no longer than 48) hours at room temperature. Once the culturing is complete (the mixture will have thickened), remove the kefir grains with a slotted spoon and store in a separate glass container filled with filtered water and a teaspoon of sugar to keep the kefir grains alive and active. You may drink the kefir by itself, but for an added twist, puree the cultured coconut water with the berries and lemon juice in a blender to your desired consistency. The coconut water kefir will last 1 to 3 weeks in the fridge; when blended with the berries and lemon juice, it will last for 2 to 3 days in the fridge. Serve cold.
*Water kefir grains can be found in natural-food stores or online. With proper care, the culture can be used indefinitely to create probiotic-rich kefir. Your grains will not grow as quickly in coconut water as they will in a nice bath of nutrient-rich sugar. Refresh and reactivate the kefir grains in sugar water (¼ cup sugar in 4 cups water) for 24 to 48 hours between batches. The sugar water will keep the grains healthy long-term.
Vincent M. Pedre, M.D., medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. He completed his bachelor’s degree in Biology at Cornell University before attending the University of Miami School of Medicine and completed his residency in Internal Medicine at the Mount Sinai School of Medicine. He has appeared on the Martha Stewart Show and ABC and is the author of Happy Gut: The Cleansing Program to Help You Lose Weight, Gain Energy, and Eliminate Pain. Dr. Pedre is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture.