Candidiasis is an opportunistic infection caused by Candida, a fungus that naturally grows in the gastrointestinal tract, skin, and genitals. There are many forms of Candida species, and Candida albicans is the most common to cause infection. The significance of comprehensive and targeted lab testing cannot be understated for patients grappling with the challenge of recurrent yeast infections. This article delves into the top laboratory tests that stand as pillars of proactive care and help clinicians tailor interventions, monitor treatment progress, and foster a holistic approach to treating recurrent candidiasis.

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What Is a Reoccurring Yeast Infection (Candidiasis)?

Candidiasis, commonly called a yeast infection, is a fungal infection caused by Candida yeast species. Candida normally exists in small amounts in various parts of the body, such as the mouth, throat, digestive tract, and genital area. However, the yeast can overgrow under certain conditions and lead to an infection.

Candidiasis can occur in different forms and affect various parts of the body:

1. Oral Candidiasis (Thrush): This type of infection affects the mouth and throat, leading to white patches on the tongue, inner cheeks, and throat. It is common in infants, people with weakened immune systems, and those using inhaled corticosteroids. (14) 

2. Vulvovaginal Candidiasis (VVC): This is a common female reproductive infection that affects the tissues of the vagina and the vulva.

3. Cutaneous Candidiasis: This form affects the skin and can cause red, itchy, and sometimes painful rashes, particularly in warm and moist body areas, such as the armpits, groin, and under the breasts (13). 

4. Gastrointestinal Candidiasis: Candida normally resides in the gastrointestinal tract along with other microorganisms, but an imbalance in the gut microbiota can lead to the proliferation of Candida. When this occurs in the small intestine, it is often called small intestinal fungal overgrowth, or SIFO. 

5. Invasive Candidiasis: This is a more serious form of infection that occurs when Candida enters the bloodstream and spreads to internal organs. It primarily affects individuals with weakened immune systems, such as those undergoing chemotherapy or organ transplantation. (16) 

Risk factors for candidiasis include a diet high in refined sugars, excessive alcohol consumption, a weakened immune system, diabetes, hormonal fluctuations, prolonged use of antibiotics or corticosteroids, poor hygiene, and wearing tight-fitting, non-breathable clothing. (6, 11) 

Treatment for candidiasis varies depending on the type and severity of the infection. It often involves antifungal medications, which can be administered topically, orally, or intravenously, depending on the location and extent of the infection. In addition to medical treatment, maintaining good hygiene and avoiding factors that promote yeast overgrowth can help prevent candidiasis. (1, 2)

What Causes Reoccurring Yeast Infections (Candidiasis)?  

From a functional medicine perspective, recurrent Candida infections can be attributed to a combination of factors that create an environment conducive to Candida overgrowth. Some of these factors include:

Diet and Lifestyle

Recurrent candidiasis can be influenced by dietary and lifestyle choices that create an environment favorable for Candida overgrowth. Diets high in refined sugars, processed foods, and refined carbohydrates provide an abundant supply of nutrients that Candida thrives on, allowing it to multiply and cause infections. These dietary choices also disrupt the balance of the gut microbiota, reducing the presence of beneficial bacteria that help keep Candida in check. Chronic stress, inadequate sleep, and lack of physical activity can weaken the immune system's ability to control Candida overgrowth, making the body more susceptible to repeated infections. (11) 

Weakened Immune System

A weakened immune system elevates the vulnerability to Candida overgrowth by compromising the body's intrinsic defense mechanisms, thus permitting the opportunistic Candida yeast to propagate without restraint. The immune system is pivotal in upholding a balanced microbial equilibrium across various bodily domains, encompassing the gut, skin, and mucous membranes. Underlying health conditions, such as HIV/AIDS, autoimmune disorders, cancer, immunosuppressant medications, and exposure to environmental toxins dampen the immune system, fostering an environment conducive to Candida overgrowth. (16)

Antibiotic Use

Broad-spectrum antibiotics target harmful bacteria and disrupt the balance of beneficial bacteria in the gut. This imbalance can create an opportunity for Candida and other species of yeast to flourish in the body.

Dysbiosis

Every organ system in the human body hosts its own unique microbiome, consisting of bacteria, viruses, fungi, and other microbes. Dysbiosis, an imbalance in the normal microbial communities found throughout the body, heightens the risk of candidiasis by disturbing the inherent checks and balances that control the proliferation of Candida and other microorganisms. It compromises the competition between diverse beneficial bacteria and potential pathogens, such as Candida. Consequently, Candida may multiply with less restraint. 

A balanced microbiota modulates the immune system, ensuring it remains responsive and capable of countering potential threats like Candida. Dysbiosis, however, can disrupt immune function, leading to dysfunction or under-stimulation, hindering the body's ability to control Candida. Additionally, dysbiosis can induce alterations in local pH and environmental conditions, favoring Candida growth. 

Reoccurring Yeast Infection (Candidiasis) Symptoms

Candidiasis can cause different symptoms depending on the site of infection. Common symptoms indicative of yeast infections include (10): 

• Gastrointestinal: bloating, gas, belching, indigestion, abdominal discomfort, nausea, diarrhea, and constipation (5) 
• Skin: rash, itching, redness, white patches in the mouth, and thickened and discolored nails
• Genitourinary: recurrent UTIs, vaginal discharge, and vaginal irritation and itching
• General: fatigue and joint pain

What Are the Benefits of Regular Lab Testing for Patients With Reoccurring Yeast Infections (Candidiasis)?

Regular lab testing for individuals with recurrent yeast infections provides valuable advantages for diagnosis, treatment, and overall care. These tests accurately determine the specific Candida species causing the infection, aiding tailored treatment plans as different species respond variably to antifungal medications. Over time, frequent or improper use of antifungal medications can lead to drug-resistant Candida strains; lab testing helps ensure the most effective treatment is prescribed, reducing the risk of developing drug-resistant infections.

Furthermore, lab tests identify underlying contributors, including diabetes or immune disorders, guiding comprehensive management. Ongoing lab assessments enable treatment efficacy monitoring, prompting timely adjustments if needed. This insight directs lifestyle adjustments fostering well-being and reducing future infections. Regular lab testing underpins accurate diagnosis, treatment effectiveness, and holistic management for those facing recurring yeast infections, facilitating informed decisions and proactive health measures.

Top Labs to Run Bi-Annually on Patients With Reoccurring Yeast Infections (Candidiasis)

These are some of the popular testing options that functional medicine providers routinely order for their patients struggling with recurrent yeast infections. 

Complete Blood Count

A complete blood count (CBC) is often utilized in preventive health settings as a general screening for hematologic disorders. A CBC includes the number and types of white blood cells (WBCs) in a blood sample. Elevations in WBC counts can indicate acute infection. In contrast, sustained depletions can indicate a more chronic underlying health condition predisposing to recurrent yeast overgrowth and the need for additional testing to rule out diabetes, autoimmune diseases, and chronic infections.

Comprehensive Stool Analysis

A comprehensive stool test that assesses the gut microbiome can identify the species of Candida overgrowing in the intestines and general patterns of dysbiosis or other intestinal infections that may allow the Candida to overgrow. Additionally, for any infections identified, the lab will perform sensitivity testing on prescriptive and natural agents, which helps providers choose targeted and effective treatment recommendations. 

Vaginal Microbiome Assessment

Like a comprehensive stool analysis, a vaginal culture can assess the vaginal microbiome to identify infection and dysbiotic patterns in patients with recurrent vaginal symptoms. 

Candida Antibodies

A serum antibody panel that measures IgA, IgG, and IgM proteins evaluates immune activity against Candida albicans. While the results of this test do not indicate the site of Candida overgrowth, the level of measurable antibodies can help quantify the severity and chronicity of infection and can be used to track treatment progress.

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Summary

Candida is a naturally occurring yeast within the human microbiome that can overgrow under certain conditions, leading to a yeast infection. Recurrent yeast infections are a sign of an underlying imbalance; but the conventional medical paradigm rarely investigates and instead approaches the problem with a symptom-based approach of repeat courses of antifungal medications. From a functional medicine perspective, correcting the root cause(s) that make a person susceptible to overgrowth can prevent future recurrence of fungal overgrowth. Functional medicine labs are essential for successfully evaluating, monitoring, and treating recurrent candidiasis.