As a dietitian, patients come to me for a variety of reasons. Many have tried and failed to lose weight. Others hope to stave off hereditary chronic diseases. Some are simply looking for a healthier lifestyle.
More often, there seems to be a common thread: unexplained symptoms such as fatigue, mood swings and headaches. Other common worries include gastrointestinal issues, perceived food allergies or an inability to lose meaningful weight.
Many patients who follow social media or integrative medicine assume these symptoms are signs of gastrointestinal conditions like candida or "leaky gut." Although many wellness practitioners will say the two conditions are real, there isn’t much scientific literature on them and even fewer tested treatment paths.
This is the important information to know about leaky gut and candida.
What is leaky gut?
The gastrointestinal system can be compared to bathroom pipes. When the pipes are flowing and keeping their contents contained, there’s no problem. One crack, though, can lead to a leak. If the leak gets worse, it can turn into a major plumbing problem.
The gut is an intricate maze of pipes — the gastrointestinal tract — that keep food and its byproducts from getting out and into the rest of the body. When the strong barrier of the GI system becomes compromised, microorganisms, water and electrolytes leak out into the bloodstream. While increased intestinal permeability is real and well documented in both humans and animals, many physicians won’t refer to it as “leaky gut,” which isn’t a recognized medical diagnosis.
Doctors can identify and treat some of the symptoms, which are similar to other GI-related problems, include bloating, gas, joint pain and fatigue.
Does leaky gut cause disease or the other way around?
Once the gut environment, or microbiome, is altered and inflammation begins, many diseases can develop. The question is, which comes first?
Changes in the microbiome and low level inflammation, caused by obesity, chronic stress and a Western-style diet — characterized by a high intake of fat, sugar, refined carbohydrates and refined grains and a low intake of fruits, vegetables and fiber — may play a role, according to some studies. The closest correlations to leaky gut are GI disorders like irritable bowel disease, especially Crohn’s disease, celiac disease and type 1 diabetes.
But, the actual causes and effects of leaky gut aren’t fully known and need further research, scientists say.
What are the treatments for leaky gut?
There are several mechanisms to check for the possible condition. A common method is a urine test that looks for the presence of two sugars considered to be byproducts of leaky gut. Blood and saliva tests can assess antibodies or proteins that play a factor in hyperpermeability and there are food sensitivity tests, stool tests and nutrient deficiency tests.
Treatment options for leaky gut are not well defined in medical literature and any course will most likely depend on the practitioner. Supplements like L-glutamine, dietary changes and probiotics may all be part of the regimen. A large component of leaky gut treatment is geared towards improving overall gut health.
What is candida?
Another very common self-diagnosis for gastrointestinal problems is what people refer to as candida. Also sometimes called candidiasis, candida albicans, yeast syndrome or thrush, candida occurs where there is an overgrowth of yeast in the microbiome. While every human has yeast in various amounts, it becomes a problem when there’s an overgrowth. This can happen with a weakened immune system, antibiotic use, hormonal changes or certain chronic conditions, such as diabetes.
Wellness advocates cite that symptoms of candida can include fatigue, inability to lose weight, joint pain, mood swings and bloating and may often diagnose the condition based on results from either blood or stool tests or patient history that may involve recent or excess use of antibiotic use or a lousy diet. The medical research, however, is not definitive as to whether yeast is to blame for the symptoms that are often associated with the condition.
The theory that yeast in the diet creates yeast overgrowth in the body not has not been proven through scientific study.
What is the treatment for candida?
A common form of candida is a vaginal yeast infection. Studies show that about 75 out of 100 women will experienced a yeast infection at some point in their lives. A vaginal yeast infection is an accepted medical diagnosis, which is often treated with anti-fungal medications.
What’s often called “chronic candida” by wellness advocates is a condition in which they say “byproducts” of the breakdown of the yeast can enter the bloodstream and cause mood changes, food cravings and inflammation. This is a condition that may be diagnosed in integrative settings, but not by physicians, and the usual suggestion involves a strict low-carb diet that includes elimination of added sugars, alcohol, and sometimes gluten and dairy. Yeast products become enemy number one. Some wellness professionals may also compliment treatment with an anti-fungal agent, herbal treatments or probiotic supplements. The concept of the dietary restrictions is based on the theory that candida is perpetuated by the yeasts desire to “eat up” and thrive on sugar obtained from carbohydrates and that starving the yeast ultimately eliminates it. Further, the recommendations can be restrictive, and depending on the case, involve cutting out all grains and fruit. However, this diet is not supported by data or studies that show it works to stop yeast overgrowth.
There are benefits of the diet, of course. It can provide motivation, after all, to restrict simple sugar, refined grains and processed foods — all changes that can lead to better health and a longer life. However, many patients can find it difficult to cut out all carbohydrates and, in the end, may go back to bad habits.
Another theory often cited is that when candida overtakes the good bacteria in the gut, then it can lead to leaky gut. Anyone with symptoms that seem to be related to candida or leaky gut should seek a medical diagnois first to rule out other underlying conditions and assess treatment options before proceeding with self-treatment or integrative therapy.
In any case, a diet that is high in fruits, vegetables, whole grains, healthy fats and lean proteins — and lighter on sugar and processed foods — can benefit the microbiome, and thus, overall health.