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Probiotics for Candida: What You Need to Know

The human body hosts a variety of microorganisms (bacteria, fungi, viruses), known as the microbiota. The microbiome varies depending on the environment, which can be external (on the skin) or internal (in the gut). It plays an important role in maintaining human health. In modern times, opportunistic infections — diseases caused by microorganisms that typically coexist harmlessly as part of the normal intestinal flora — are becoming more prevalent.

What is the most common cause of fungal infections?

One of the most common causes of fungal infections is yeast-like fungi of the genus Candida. It is a microscopic fungus that can affect the skin and mucous membranes of people of all ages. The main symptoms of candidiasis (infection caused by Candida) include itching of the affected area, white patches (in the case of oral thrush), thick white discharge (in the case of vaginal yeast infections), and gastrointestinal issues such as bloating, constipation, and diarrhea.

Species of Candida are most often found in the oral cavity, gastrointestinal tract, and vaginal system of healthy individuals. Although more than 150 Candida species have been identified, Candida albicans (C. albicans) are the most associated with human infections. C. albicans, account for 80–90% of all human infections and, more specifically, 80% of human candidiasis. In addition to C. albicans, the prevalence of other non-albicans Candida species (NACs) (e.g., C. parapsilosis, C. glabrata, C. tropicalis, C. krusei) is increasing worldwide.

The human mycobiota (community of fungi) including the Candida group, together with the microbiota, are essential players in the maintenance of human immune physiology and general gut health. Therefore, targeting the gut myco- and microbiota is a novel and promising strategy for maintaining overall gut health. Current microorganism-based therapies such as probiotics (including both bacterial and fungal strains) show significant effects on the human mycobiome directly or in combination with other clinical treatments.

What causes Candida overgrowth?

Candida infections have become increasingly aggressive in recent years and have a major impact on human health, infecting millions of people each year. Despite the successes of the pharmaceutical industry, the range and effectiveness of anti-fungal drugs are not sufficient to solve the problem of candidiasis. In addition, pathogenic fungi (fungi that cause diseases) can develop resistance to these drugs, which can lead to the emergence of 'super fungi' — fungi that are resistant to commonly used anti-fungal drugs.

Overgrowth of Candida species typically occurs due to an imbalance of microorganisms combined with a weakened host immune system. A microbial imbalance called dysbiosis can be caused by antibiotic usage that leads to wiping out beneficial bacteria that help keep Candida colonies within a safe range.

Diet is another important factor in Candida overgrowth. It has been shown that there is a positive correlation between the abundance of C. albicans in the stool and high carbohydrate consumption; in other words, the more carbohydrates a person consumes, the higher the abundance of C. albicans. On the other hand, a negative correlation was found between C. albicans abundance and diets rich in amino acids, proteins, and fatty acids, meaning that these diets could inhibit C. albicans growth.

This is why it's crucial to keep our digestive system healthy and maintain a balanced gut environment to safeguard overall health. Candida infections can have various causes, so let's delve into why some people may be more prone to them.

Causes of Candida overgrowth:

  • Weakened immune system
  • Diet high in sugar and carbohydrates
  • Bacterial and fungal dysbiosis
  • Use of antibiotics
  • Use of corticosteroids
  • Stress
  • Use of some birth control pills
  • Lifestyle factors
  • Poor hygiene
  • Hormonal changes
  • Genetic predisposition

What are the symptoms of oral Candida?

Oral candidiasis is a fungal infection characterized by the appearance of white patches or plaques on the oral mucosa that are slightly raised. Oral candidiasis is quite common in the population, especially in children, the elderly, and people with immune disorders.

Main symptoms of oral candidiasis:

  • White patches or plaques on the tongue, inner cheeks, gums, tonsils, or palate
  • Redness, pain, and/or irritation in the affected areas
  • Difficulty and/or pain in swallowing
  • Change or loss of taste
  • Redness at the corners of the mouth
  • Cotton-like sensation in the mouth
  • Bleeding from the affected areas

What are the symptoms of genital Candida?

Genital candidiasis, commonly known as thrush, is characterized by a white discharge accompanied by an itching or burning sensation in the vagina. In males, the symptoms may also present as an itchy rash. Genital candidiasis, like other forms of candidiasis, is caused by an imbalance in the normal microbiome. When treating genital candidiasis, it is important to remember that sexual partners must also be treated, as re-infection with the fungus is possible.

Main symptoms of genital candidiasis (thrush) include:

  • Burning and itching in the external genital area
  • In women, white, curd-like vaginal discharge
  • Swelling and redness of the vagina and vulva
  • In men, white, semen-like discharge from under the foreskin
  • Pain during sexual intercourse and urination

Probiotics for Candida – do they work?

Due to the high prevalence of candidiasis and its increase in resistance to treatment, alternative therapeutic approaches are being explored, including the development and use of probiotics. The beneficial role of probiotics as a therapeutic alternative to combat fungal infections is becoming increasingly evident. Some bacterial and fungal strains have been shown to reduce the abundance and prevalence of Candida. It has also been shown that in some cases, the use of certain probiotics with conventional anti-fungal drugs can reduce the duration of therapy.

The mechanisms by which probiotic bacteria fight Candida fungi may be different. The main benefit of probiotics is their ability to restore a naturally healthy microbiome, which can prevent excessive fungal growth. Probiotics can reach the lower parts of the gastrointestinal tract and prevent the growth of pathogenic fungi, including Candida.

Probiotics may inhibit pathogenic fungi by competing for food sources or by producing biologically active compounds that inhibit the growth of Candida and other harmful fungi. In addition, probiotics could modulate the host's immune system by enhancing the anti-inflammatory response.

Which are the best probiotic strains for Candida?

Several studies have been made exploring different bacterial and fungal strain influences on Candida and fungal dysbiosis overall. The main species used as probiotics against Candida belong to species and strains of bacteria groups such as Lactobacillus, Bifidobacterium, and Saccharomyces.

Lactobacillus rhamnosus

Lactobacillus rhamnosus is one of the best-studied bacteria used as probiotics. It is also used to help with diarrhea in children. It was demonstrated that L. rhamnosus produces different metabolically active metabolites, such as lactic acid, and different carbohydrate ferments. It has been successfully used to reduce colonization of C. albicans strains.

Lactobacillus plantarum

It was demonstrated that L. plantarum inhibited the growth of C. albicans by being able to attach to vaginal epithelial cells and significantly reduce the adhesion of C. albicans in vaginal thrush.

Bifidobacterium longum

Bifidobacterium longum is another beneficial bacterium commonly used as a probiotic for different kinds of health issues. Primarily, B. longum is known for its potential health benefits in the gastrointestinal tract and its ability to inhibit the growth of the opportunistic fungal pathogen C. albicans and produce anti-inflammatory metabolites.

Saccharomyces boulardii

Not only bacteria can be used as probiotics. For instance, Saccharomyces boulardii is a studied yeast that produces caprylic acid, a substance that may help reduce Candida overgrowth.

Probiotics are beneficial to the health of the host when administered in appropriate amounts, considering human health conditions. Although probiotics cannot stimulate Candida overgrowth further, some probiotic strains may be inappropriate for some people. Therefore, successful treatment of local and systemic candidiasis requires the use of specialized probiotics that contain high concentrations of vital cells with proven anti-fungal properties.

Possible side effects of probiotics for Candida

Although probiotics are generally considered to be safe, there are some aspects that need to be considered. People with compromised immune systems or certain health problems should speak to their healthcare provider before using probiotics as they may not be recommended. General side effects that are commonly experienced include:

  • Temporary indigestion
  • Bloating
  • Nausea
  • Gas

Should you use probiotics for Candida?

Candida is a yeast fungus that is part of the normal human microflora. However, dysbiosis of human microbiota can affect Candida and its prevalence may increase, which leads to candidiasis. Candida infections are typically seen as oral or genital candidiasis, and medication can be prescribed by your doctor.

New strategies to tackle candidiasis, like probiotic use, are emerging. Several studies indicate the positive impact of probiotics on various forms of candidiasis. However, it's important to acknowledge that further research is necessary to grasp the mechanisms of probiotics fully, explore different strains, and discern their role in specific health conditions.

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