Hi, Everyone,

The idea that an overgrowth of a yeast called Candida in the gut can cause a wide range of problems has been around for at least 30 years.

Alternative health practitioners have diagnosed patients with it (and patients have also diagnosed themselves). 

But is Candida overgrowth a legitimate, evidence-based condition? 

Well … yes and no.

I do think Candida is overdiagnosed—and often diagnosed without any real laboratory evidence. 

For example, there are questionnaires on the internet that you can fill out that claim to be able to tell you whether you have Candida

There are also a variety of similarly unscientific “tests” that are used to “diagnose” Candida, like spitting into a glass and assessing how “sticky” the spit is.

While we can’t rule out that patients diagnosed in this way don’t truly have an overgrowth of Candida in their gut, these are not reliable diagnostic methods. And in these cases, I’d be inclined to agree that Candida was not an evidence-based diagnosis.

On the other hand, the conventional medical claim that Candida overgrowth is a completely phony condition is also untrue. 

Over the past 10 years, new methods of sequencing microbial communities have shed light on the “mycobiome”—the diverse array of fungal organisms that inhabit the gut and other parts of the body.

This research has shown that fungal species, including Candida, play an important role in both health and disease. 

For instance, a 2017 study found that fungi may play a role in multiple sclerosis (MS). 

Other evidence has shown that fungi affect our immune response and can be a risk factor for many immune-mediated diseases. 

And several recent studies have investigated the role that fungi play in inflammatory bowel diseases like Crohn’s and ulcerative colitis. 

If you suspect that you might have fungal overgrowth, here’s what I’d suggest:

  • Get testing from a Functional Medicine practitioner, which might include DNA/PCR stool, serum, and urine organic acids.
  • Make sure you actually have a fungal problem before you treat with antifungals (natural or prescription). Fungi also play an important role in health, and disrupting the mycobiome with antifungals can cause problems, just as taking too many courses of antibiotics can.

In health,

P.S. A quick clarification re: my recent email about how conventional medicine has failed with diabetes. I was specifically referring to type 2 diabetes—which is primarily driven by diet, behavior, and lifestyle—not type 1 diabetes, which is an autoimmune disease that typically begins in childhood. That said, it’s worth pointing out that diet and lifestyle are also important factors in both the etiology and management of type 1 diabetes. The conventional approach of just giving insulin and not addressing diet or lifestyle also fails type 1 diabetes patients.