All you need to know about candida and what to do if you have it

Candida albicans is a complex parasitic yeast-like fungus that inhabits the intestines, genital tract, mouth, oesophagus and throat. Normally this fungus lives in healthy balance along with a host of other organisms and does not cause problems. Certain conditions can allow the candida to multiply and cause a condition known as candidiasis. When this happens, the candida enters the bloodstream and spreads to different organ systems. This is when the condition is called “systemic” and is no longer a simple local infection.

Along with hundreds of other microscopic organisms, Candida albicans makes up part of the human digestive flora more recently known as the gut microbiome or microbiota. We have a lot more of these micro-organisms living in our digestive systems than you may suspect. In fact, put together they would account for up to two kilos of your total weight. These micro-organisms help digest your food, create a healthy immune system and even make certain vitamins. When the digestive flora are out of balance, candida organisms are able to overwhelm the “good” digestive flora and cause candidiasis.

Why is candidiasis a problem?

The metabolic processes of candida, whether in the yeast or fungal form, cause candida to release a host of by-products that are responsible for candida’s nasty side-effects. Of these by-products, acetaldehyde, ammonia and uric acid are the most notorious and are responsible for symptoms ranging through brain fog, fatigue, weight gain and digestive problems.

It’s not true that “we all have candida in our guts”. Although, alarmingly, a German study in 2004 found that 70 per cent of people studied had candida present in their digestive systems. This does not mean that 70 per cent of the population is sick. If candida remains in small numbers alongside a host of other microbes making up a diverse but healthy digestive flora, there is no problem. The problem exists when candida increases in numbers and gets out of control.

Modern medicine is learning more and more about the significance of bowel flora and its impact on health. We now understand that an imbalance in healthy gut flora can impact not only on digestion but also mental health, immunity and even our susceptibility to allergies. Despite this, systemic candidiasis in “healthy” people is not (yet) recognised by mainstream medicine.

Candida albicans, however, is well known in mainstream medicine as it can be life-threatening for those with a compromised immune system. It is of particular concern, for example, in those with cancer or AIDS or those undergoing organ transplant procedures. Candida has become the fourth largest cause of hospital-acquired infection in the US.

Candida manages to grow and spread throughout the body via its fungal form. This involves the single-celled yeast developing long arms or hyphae. These hyphae enable the candida to multiply along the gastrointestinal tract, mouth and vagina. Unfortunately, human body temperature is a perfect environment for candida, which is very comfortable at 37°C.

=Q=

Candida also prefers a neutral or slightly alkaline pH. Given half a chance, candida will work very hard to create its perfect pH. Candida actively works to reduce the acidity in your gut by producing the alkaline gas ammonia. This changes the pH in the intestines from acidic to neutral or slightly alkaline. This alteration in pH allows candida to change from its single-celled yeast form to its pathogenic fungal form.

Candidiasis can appear as superficial complaints such as oral thrush, vaginal thrush or even fungal toes. These outbreaks are often treated topically with creams, only to return. If the origin of the external fungal infection is the gut, the recurrence is easily explained. The ease with which the fungal form of candida can travel from your gut to other tissues of the body means the infection needs to be treated holistically and not just topically.

Leaky gut and candidiasis are often linked, with candidiasis being one of the most common causes. When candida turns pathogenic and grows its arm-like hyphae, these branches attach themselves to the cells lining the digestive tract and literally break through it. This allows large food molecules to easily move into the bloodstream where the immune system has to clean up the mess so to speak. This can lead to immune dysregulation and even digestive inflammation and the appearance of symptoms that are often associated with food allergies.

There is also some thought that this burdening of the immune system due to leaky gut can cause the immune system to inappropriately attack our own bodies, resulting in autoimmune disease. Some autoimmune diseases that are associated with candida include fibromyalgia, Crohn’s disease, chronic fatigue, multiple sclerosis, ulcerative colitis and rheumatoid arthritis.

What causes candidiasis?

A fungal infection with candida, or candidiasis, is usually caused by some sort of disruption of the gut flora. In a healthy digestive system, the populations of “good” gut flora are so high that there is very little space or food left for candida to establish itself.

When the delicate balance of the “good” gut flora is upset, however, the “bad” bacteria are suddenly given an opportunity to multiply. Gut flora can be upset by myriad factors, including antibiotic use, a high-sugar diet, high stress, constipation, a depressed immune system, hormonal imbalance and even diabetes.

Poor diet
The typical Western diet is high in refined sugars. Foods such as lollies, chocolates, sweet biscuits and soft drink are obvious culprits, but even highly processed carbohydrates such as white bread, white pasta and white rice can contribute to the sugar load in the bloodstream. Candida loves sugar. Eating a diet high in sugar provides candida with plenty of the food it needs to multiply and develop as well as transform into its more virulent fungal form.

This is why an anti-candida diet’s primary focus is cutting out all sugar. This, of course, means cutting out all the obvious sugars but also sugars you may have thought were good for you, including fruit sugars. Starving candida of sugars has been proven to impair its ability to grow and multiply and reduce the chance of transformation into the fungal form.

Giving up sugar is easier said than done. In fact, a study in 2008 discovered that sugar consumption can trigger the same biochemical changes in the brain as cocaine, morphine and nicotine. So if you feel like you are addicted to sugar, it may be that you are. As with giving up any addiction, giving up sugar can be very hard initially. Having a good understanding of why it is so important to change your diet will help improve your motivation. A small amount of pain now can create a bigger pay-off for your future health.

Antibiotics
We get the beginnings of our digestive flora from our mothers during birth and the remainder from the environment and the food we eat. A healthy adult should have around 500 individual strains and up to 100 trillion bacteria. After taking antibiotics it can take years for this healthy gut flora to recover. Fortunately, doctors are much less inclined to prescribe antibiotics now than in the past.

However, if you have taken antibiotics in the past six months, you are much more likely to be suffering from candida overgrowth. This is even more likely if you took broad-spectrum antibiotics. Part of the reason for this is that antibiotics will not only kill off the bacteria that are potentially causing you harm but also some of your good gut bacteria. The loss of your good flora also weakens your immune system, which is responsible for cleaning up any candida found in the bloodstream, further enabling the spread of candida.

Of course, there are times when taking antibiotics is absolutely necessary. In these cases there are probiotics that are appropriate to take while on antibiotics. Once you have finished the course of antibiotics, it’s a good idea to swap to a high-strength probiotic with multiple beneficial strains. These come in both capsules and powders and generally need to be refrigerated and taken on an empty stomach.

Stress
An elevated level of mental stress is associated with increased vaginal yeast infections of which Candida albicans is the main culprit. Long-term emotional stress can create changes to the body’s chemistry and cause an increased level of cortisol. Cortisol triggers your fight-or-flight response and causes your muscles to break down glycogen into sugar and release it into the bloodstream. Cortisol also restricts the production of insulin, which means sugars float around in the bloodstream for longer. Of course, candida loves this increase in blood sugar. Higher levels of sugar in the blood also reduce the uptake of sugar from the intestines, thereby leaving more sugar in the gut for candida.

=Q2=

High cortisol also inhibits the activity of part of the immune system, namely white blood cells called lymphocytes. Some of these lymphocytes are vital for keeping candida in the gut in check. This weakening of the immune system leaves the body more vulnerable to opportunistic candida infection.

Stress can be a very difficult thing to avoid with our modern, hectic lifestyle. Stress management needs to be prioritised and actively sought if your stress levels are high. Different personalities release stress in different ways. Some people reduce stress best with hard physical exercise and others with peaceful meditation. Creative people really need to maintain a creative outlet, especially if their work is not creative. These personalities may reduce stress best with art or dance classes.

Everybody should prioritise sleep. Getting eight hours sleep per night helps increase health and resilience. Achieving more sleep is sometimes as easy as going to bed earlier. For individuals with sleep issues, seeking help from a health professional is recommended. We also know it is very important to have a healthy social circle. This helps you reduce stress, disconnect from work and connect with other people’s lives. If you feel too busy to catch up with friends, this is often a sign that stress levels are far too high and re-evaluation is needed.

The oral contraceptive pill
A study published in 2007 in the Journal of Medical Microbiology found a strong correlation between contraceptive use and vaginal candida. This link was the highest for the oral contraceptive pill (OCP) but also present for injectable contraception and IUD use.

If the OCP is mixed with antibiotics, then candida overgrowth is even more likely. Oestrogen in the OCP stimulates the production of glycogen in the vagina. Glycogen is a complex sugar and is an ideal food for candida. In a healthy person, this excess glycogen is metabolised by the “good” bacteria in the vagina and recycled into lactic acid. If these bacteria are destroyed or altered by antibiotic use, the glycogen becomes very available for candida.

A study published in 2008 in the Journal of Contraception showed candida can actually attach to the IUD itself, which encourages repeat vaginal thrush. Researchers found that candida could attach to every part of the IUD, whether it was plastic or copper. Diaphragms can also become a breeding ground for candida. For those looking for a candida-friendly alternative, condoms combined with a spermicidal cream have a 90 per cent effectiveness rate and do not involve anything being left in the vagina long term.

Diabetes
Unfortunately, sufferers of diabetes can be more prone to candida due to high blood-sugar levels. High blood-sugar levels can also weaken the immune system, which gives the candida a further toe-hold. A study in 2002 in the BCM Infectious Diseases journal found that type 1 diabetics were three times more likely to be colonised with candida than those with type 2 diabetes. The article concluded that improving blood-sugar level control in diabetics may reduce the incidence of candida. If you have had a high blood-sugar level result in the past and your doctor has mentioned you may be pre-diabetic, you may also have a higher risk of candida colonisation.

Chemicals in your drinking water
Traces of chlorine can be found in most domestic tap water. It’s used as a disinfectant to kill potentially harmful organisms. Unfortunately, chlorine is also capable of upsetting your delicate gut flora. Public health officials consider that the benefits of the reduction of water-borne disease through the use of chlorine are more important than any knock-on health effects. Water filters and even shower-head filters that remove chlorine can overcome this problem.

Causes of candida

Poor diet
Antibiotic use
Stress
Oral contraceptive pill
Diabetes
Exposure to chemicals or heavy metals
Hormonal imbalance

Symptoms of candidiasis

Recurrent vaginal thrush
Jock itch
Tinea
Itchy ears
Bloating and flatulence
“Foggy head”/poor memory/indecision
Fatigue/depression/anxiety
Oral thrush
Penile yeast infections
Fungal nail infections
Itchy anus
Low libido
Inability to concentrate
Allergies
Low immune function
Weight gain

Treating candida

Candida albicans is a slippery customer to treat because it can exist in different forms. Candida can exist as a single-celled yeast form or as a larger fungal organism. The ability to exist in different forms enables candida to live at different temperatures and at different pH levels. While both forms release the same myriad by-products that interfere with wellbeing, the invasive fungal form is of more concern.

It is the fungal form that can penetrate through the mucous membranes and enter the bloodstream. This then allows the by-products that candida creates to enter the bloodstream and potentially affect other organs. It should also be noted that Candida albicans is not the only strain of candida but it is the most prevalent when it comes to human fungal infection.

The main treatment for candida overgrowth is dietary change. The primary aim of the candida diet is to reduce sugar in all its forms in an effort to starve the candida out. Please be aware that the more you research anti-candida diets, the more confused you may become. There are many areas of contention. Keep in mind the elements that are the most hotly contested are often the least crucial. Remember that the most important goal of an anti-candida diet is starving the candida by reducing sugar. Other dietary recommendations are of secondary importance to this.

Foods you need to avoid on the candida diet

Sugar in all its forms, including honey, agave nectar, rice syrup, fructose and artificial sweeteners.
Fruit, as fruit contains fruit sugars. This includes dried fruit, fruit in natural fruit juice, fruit juices and fresh fruit.
Mushrooms and starchy vegetables, including potatoes, corn, sweet potato and pumpkin.
Processed meats are to be avoided, such as ham and salami, sausages and smoked or cured meats.
Gluten-containing grains such as wheat, rye, spelt and kamut.
Cow’s milk dairy products, as the high lactose content promotes the overgrowth of candida. These products include milk, cream, cheese, sour cream, ice-cream and sweetened yoghurt.
Sweetened milk substitutes, including sweetened soy milk, rice milk, oat milk and almond milk.
Alcohol, including beer, wine, spirits etc.
Peanuts — which are not nuts but legumes and grown under the ground. They can carry a mould that is harmful to your digestion.
Pistachios, as they can also carry a mould that is bad for digestion.
Margarine, prepared salad dressings, sauces and mayonnaise.
Soft drinks and coffee.

Foods you are allowed

Eat lots of non-starchy vegetables such as leafy greens, cucumber, broccoli, cauliflower, onions, garlic, avocado, celery, snow peas, zucchini, sprouts, asparagus and olives.
Eat unprocessed protein, including beef, lamb, kangaroo, chicken, turkey, eggs and fish (not tuna, swordfish or shark, which can be high in heavy metals).
Eat small amounts of gluten-free grains, including amaranth, quinoa, millet, buckwheat and brown rice.
Eat small amounts of natural cow, sheep or goat’s yoghurt (no sugar added) or kefir.
Coconut milk and small amounts of unsweetened soy milk.
Unflavoured tofu or tempeh.
Legumes, including kidney beans, black-eye peas and cannellini beans.
Nuts and seeds, including almonds, hazelnuts, pumpkin seeds, sunflower seeds and walnuts.
Fresh or dried herbs and spices.
Cold-pressed oils, including olive oil, flaxseed oil and sesame oil.
Herbal teas, including dandelion, peppermint, chamomile, rosehip and chicory-root coffee substitute.
If you are suffering from strong sugar cravings, a small amount of stevia or xylitol can be used. Make sure there are no other ingredients added when you choose one of the various brands of these sweeteners. Using xylitol as a sweetener is allowed because it actually inhibits candida and has also been shown to reduce tooth decay. No other sweeteners are allowed.
The only fruit allowed are lemons, limes, avocados and olives.
Butter or substitute with avocado or tahini.
Hummus.
Drink lots of water.

Some naturally antifungal foods you should include in your diet

Garlic. There have been many studies detailing the benefits of garlic, with one finding a garlic solution to markedly inhibit the growth of Candida albicans.
Coconut oil and coconut flour. Coconut oil is stable at high temperatures, making it an ideal oil to cook with. It contains three active constituents that have been found to be antifungal.
Onions. Several active constituents in onions have been found to be antifungal, although not as strongly as garlic, which is also in the onion plant family.
Olive oil. Contains the constituent oleuropein. A study in the Journal of Food Safety found it to be effective against 18 out of 30 fungi that were tested.

Meal suggestions

Breakfast ideas: Omelette with eggs and vegies; poached eggs with grilled tomato; leftover vegies mashed and made into patties then lightly fried in coconut oil; avocado on brown rice toast; miso soup with brown rice.
Lunch ideas: Salad with chicken and olive oil/lemon juice dressing; homemade chicken and vegetable soup; stirfried vegies with protein; boiled egg with chopped vegies.
Dinner ideas: Vegetable soup with split peas; kangaroo and vegies; fish and salad; stirfried vegies and beef; coconut milk curry with dried chilli and spices.
Snack ideas: Handful of raw nuts; cut-up vegetables with hummus; natural yoghurt; avocado on corn thins with seeds sprinkled on top; tinned salmon; herbal tea; boiled egg.

You may wonder why no reference has been made to eating an “alkaline diet”. The simple yeast form of candida actually prefers an acidic environment, which is why it happily exists in your slightly acidic intestines. For candida to switch to its invasive fungal form it needs a slightly alkaline or neutral environment. It actually creates this itself by using nutrients in your digestive system to make ammonia, which alkalises the pH in its immediate surroundings.

When you are trying to treat a bug like candida that can create its own pH level, eating an “alkaline diet” is not a high priority. The high priority is stopping the yeast form from morphing into the invasive fungal form. To do this, the best dietary approach is removing its food source, namely sugar in all its forms.

Probiotics

Probiotics are an essential part of any candida treatment program. When you are fighting an overgrowth of candida you are essentially trying to reduce the “bad” gut flora and naturally the next step is to increase the “good” gut flora. The natural flora in the intestines include over 500 species of bacteria. The vast majority of these bacteria are anaerobic. Your gut flora changes throughout your life. Factors such as diet, age, immune system functioning and regularity of bowel movements all influence this balance.

Optimising the balance of these organisms is of crucial importance to health for several reasons. Some micro-flora help digest foods that our digestive system would otherwise struggle to break down. Having an abundant population of good bacteria competing for food and space in the gut helps to limit the growth of harmful bacteria. There are several gut bacteria that help to regulate acidity in the intestines. The most common one is Lactobacillus acidophilus. Its name, acidophilus, gives a hint at its nature. This helpful micro-organism releases lactic acid and, when there are enough present, assists in keeping the gut at the correct pH level. Finally, good digestive micro-flora help to modify the immune system and suppress inflammation.

Science’s growing understanding of probiotics means we can use particular strains to achieve very targeted outcomes in the body. For candida, the particular strains that are helpful are lactic acid-producing bacteria, including Bifidobacteria longum, B. bifidum, B. infantis, B. breve as well as Lactobacillus rhamnosus and L. acidophilus. Lactobacillus acidophilus has actually been shown in studies to prevent candida from attaching itself to human cells, as can other strains of lactobocillus bacteria.

Not only does taking a probiotic supplement “crowd out” the candida, but these probiotics also produce small amounts of acidic metabolites as part of their metabolic processes. This is particularly desirable in the intestines as it helps to establish a pH that prevents candida converting to the fungal form.

It’s also possible to make your own probiotics at home. Most traditional cultures have some form of cultured food as a staple in their diet. In Korea it is kim chee (chilli cabbage), in China it is kombucha (fermented tea), in Japan it is miso (fermented soybean paste). These have all been revered in their respective cultures as health-giving foods, even if the bio-mechanics were not understood as they are today.

In modern Western homes, some of the easier fermented foods you could begin to incorporate into everyday life are kefir (fermented milk) and fermented vegetables such as unpasteurised sauerkraut. Making kefir is very simple once you have sourced the kefir starter. This can be easily found on the internet and detailed instructions on how to make it abound. Sally Fallon has written a terrific book called Nourishing Traditions that gives many recipes for fermented vegetables as well as kefir.

Antifungal treatment

Using probiotics in the fight against candida is unfortunately not sufficient for most cases, except perhaps for very minor ones. Most cases will require some form of antifungal treatment as well.

Most antifungal agents attack or at least inhibit the growth of the fungal cell walls. Candida is particularly difficult to treat because it is capable of forming a “bio-film” around itself, which effectively protects it from your own immune system as well as antifungals. This is why candida is so difficult to eradicate and also why the three-pronged approach is needed: diet, probiotics and antifungals.

The most commonly prescribed antifungal is Nystatin (also known as Mycostatin, Nilstat or Nystex). It’s only available through your GP and can be associated with a number of side-effects, including diarrhoea, headaches, nausea, upset stomach and vomiting. Some prescription antibiotics are effective in the laboratory but once used in the human body really only manage to slow down the fungal growth. This phenomenon is known as “fungistatic”. The doses of prescription antifungals often can’t be increased to a higher dose due to issues with increased side-effects. So it’s worthwhile chatting with your GP about the efficacy of prescribed antifungals before starting a course.

There are many natural compounds that are antifungal in nature. Many of these are associated with minimal side-effects and are considered safe for longer-term use. Due to the tenacity of candida, even natural antifungals are usually recommended in combination in order to improve the effectiveness. It’s also quite safe to take natural antifungals along with probiotics. It is, however, advisable to take natural antifungals at least an hour apart from your probiotics because some antifungals may also display mild antibacterial effects.

Caprylic acid is one of three fatty acids found in coconut oil that are effective against candida. Of these, caprylic acid has the strongest effect. A study performed at Japan’s Niigata University found the antifungal properties of caprylic acid to be “exceedingly powerful”. Caprylic acid works to disrupt the growth of the fungal cell wall. Because it is an acid, it also works to correct the pH in the gut. As caprylic acid is readily absorbed in the intestines, it is best to take an enteric-coated caprylic acid that will allow for gradual release throughout the intestinal tract.

Oregano oil. A terrific antifungal to add to your candida protocol as it works slightly differently from other antifungals. Instead of destroying the candida cell walls it dehydrates them. One of the active constituents found to contribute to this effect is carvacrol. Ensure that any oregano oil product you choose contains at least 50 per cent carvacrol.

Grapefruit seed extract. An article in the Journal of Alternative and Complementary Medicine reported that grapefruit seed extract is effective against “800 bacterial and viral strains, 100 strains of fungus and a large number of single and multi-celled parasites”. This comes in liquid or tablet form. Do not confuse it with grape seed extract which is a different product altogether.

Pau d’arco. The bark from the lapacho tree has been used for centuries in traditional South American herbal medicine. Not only is it considered to be antifungal, it is also antibacterial, anti-inflammatory and immune stimulating. The naphthoquinones in pau d’arco have significant antifungal activity against candida and it’s considered especially useful in chronic candidiasis. This is very effectively used in a liquid herbal formula in combination with other anti-candida herbs.

Echinacea purpurea. Echinacea is widely known as an immune stimulant. This alone makes echinacea a useful herb in the holistic treatment of candida. Additionally, alkamides found in echinacea have been found to be antifungal as well as antibacterial. Native to North America, echinacea has become one of the world’s most important herbs. Echinacea can be used as part of a liquid herbal formula.

Garlic (Allium sativum). Garlic originated from central Asia but is now grown worldwide. It is a powerful treatment for a host of health problems but excels at treating infection. Its inhibition of Candida albicans in both animal and test-tube studies has shown it to be more powerful than nystatin, gentian violet and six other reputable antifungal agents. It is a powerful antibiotic but also has antifungal properties. It’s less well known for its ability to assist in expelling parasites and lowering cholesterol.

Calendula officinalis. Calendula, also known as marigold, is a very striking plant with dark-green foliage and vivid orange flowers. It is an antiseptic herbal remedy and contains resins that are antifungal. Calendula helps settle digestive inflammation (leaky gut) and is detoxifying, considered cleansing for the liver and gallbladder. Used topically, Calendula helps fungal conditions including ringworm, athlete’s foot, nappy rash and thrush. It can also be used in a mixed herbal liquid for treating candida.

Tea-tree (Melaleuca alternifolia). Tea-tree is one of the most important natural antiseptics. It was first researched in 1923 in Australia and since the 1960s it has been intensively investigated. Its antiseptic properties have been well established and it has been shown to be effective at treating a wide range of infectious conditions, especially fungal as well as vaginal thrush.

Thyme (Thymus vulgaris). Thyme is possibly best known as a tonic and antiseptic for the respiratory system. What is less well known is that the antiseptic and tonic properties of thyme make it a useful tonic for the immune system in chronic infections including fungal infections. Thyme is also useful for expelling intestinal worms. Used topically, it also helps with ringworm, athlete’s foot, thrush and other fungal infections.

Neem (Azadirachta indica). Neem is a well-known herb originating in India. It has traditionally been used for gastrointestinal upsets, skin ulcers, infections and malaria. In the West it is primarily used for its antibacterial and antifungal properties. Neem oil can be used topically on fungal conditions such as fungal toenails alongside holistic treatment for faster symptomatic relief.

Coptis chinensis. Coptis is a herb widely used in traditional Chinese medicine. It’s very high in a plant alkaloid known as berberine. Berberine is a potent antibacterial, antiviral and antifungal agent. It also helps expel parasites. In Chinese medicine, coptis is considered to be a very cold herb and would not be used in cases where the digestion was thought to be “cool”.

Digestive enzymes can also often be helpful in the fight against candida by optimising digestion. When digestion is optimal, hydrochloric acid in the stomach is such that candida should be destroyed before it reaches the small intestine. Digestive enzymes can be sourced in tablet form and taken with meals.

Apple cider vinegar. Often touted as a candida cure, raw apple cider vinegar has enzymes, vitamins and minerals as well as acetic acid and malic acid. The acids are particularly of interest as they help to acidify the colon, which creates an environment much less conducive to the proliferation of candida. Unpasteurised apple cider vinegar is best used as a short-term adjunct to a holistic approach to candida management. Long-term use can potentially damage tooth enamel and could cause low potassium. It’s best taken orally, diluted with water.

Olive leaf extract. Olive leaves have been widely used as a traditional remedy in Mediterranean countries and modern research has found olive leaf extract to be anti-inflammatory, to lower high blood sugar levels and act as a cardiovascular tonic. At low concentrations, olive leaf extract has shown unusual combined antibacterial and antifungal action to numerous organisms, including candida albicans. Olive leaf extract can be used as a herbal extract alongside other complementary antifungal herbal remedies as part of a multi-pronged anti-candida program.

Finally, a tip before you launch into the wide world of treating candida. If you are having unprotected intercourse with your partner it’s very likely that both of you may have candida. Candida is something you can pass to your partner, even though it’s not considered an STD. While women may battle with thrush, men may display no symptoms of candida at all and still be carrying the infection. Alternatively, your partner may have jock itch or a fungal toe infection and has never connected it with your battle with thrush or other candida symptoms.

It’s highly advised that before starting candida treatment you consider switching to a barrier method of contraception (condoms) and allow no unprotected contact to occur until both partners have completed candida treatment and are free of infection.