Candida, BV and UTIs

2 Feb

I have been thinking about this for a while and have decided to start sharing some of the patterns I see every day in clinic. These notes will focus on common conditions, how we test for them, and what tends to work well in practice and what often does not.

Candida

Candida is more than just thrush. It is a type of fungus that naturally lives in the digestive system. Problems arise when it overgrows due to an imbalance in the gut microbiome. This can affect both men and women and may appear in different parts of the body, including the digestive tract, mouth, skin and vaginal area.

Candida behaves like an opportunist. It often appears after periods of high stress, injury, illness or antibiotic use. It is also more common in people with thyroid conditions, diabetes, or those taking long term medications such as hormonal contraceptives.

Candida thrives when the balance of the microbiome is disrupted. It feeds on simple sugars and grows more easily when beneficial bacteria are depleted.

Over the counter antifungal medications can be helpful and often work well for common strains. However, some strains are less typical or more resistant to medication. In those situations, nutrition and targeted herbal formulas can be very effective in restoring balance.

One important point is that you do not need to starve Candida. You need to feed your beneficial bacteria.

A very common approach people try is an extremely restrictive “anti Candida” diet. This often removes sugar, dairy, gluten, fruit, vegetables, grains, nuts and seeds. The result is a diet that is very low in fibre and difficult to sustain. While this may temporarily slow Candida growth, it does not address the underlying imbalance. When someone is tired, undernourished and eventually reintroduces carbohydrates or fruit, symptoms often return quickly.

Instead of severe restriction, the approach I usually take focuses on:

Supporting beneficial gut bacteria
Protecting the gut lining
Temporarily avoiding yeast sources
Using targeted herbal antifungals where appropriate

To understand which strain may be present and which herbs may work best, testing can be helpful. A simple stool test and oral swab can often identify Candida strains and costs less than €100.

BV - Bacterial vaginosis

Bacterial vaginosis (BV) and anaerobic vaginosis (AV) are very common. In some cases they are linked to organisms such as ureaplasma or other bacteria that are often classified as sexually transmitted infections. In other cases they arise from shifts in the vaginal microbiome involving different bacterial strains.

As with Candida, identifying which organisms are present is important before deciding on treatment.

Detection is usually done through a vaginal swab, urinalysis, or sometimes both. These tests can be done privately or through a GP or sexual health clinic. Many public health services do not routinely test for ureaplasma, which can make diagnosis more difficult.

Treatment usually focuses on restoring balance in the vaginal microbiome. This may involve:

Vaginal microbiome support such as pessaries
Oral probiotics for longer term balance
Microbiome supportive foods rich in antioxidants, amino acids and prebiotic fibres

In many cases it is also necessary to address biofilms. Some bacteria build protective layers that make them harder to treat. Nutrients such as N-acetyl cysteine (NAC) and other biofilm support formulas can help break these layers down so that treatments are more effective.

UTIs

Urinary tract infections can be extremely disruptive. Anyone who has experienced one will know how painful they can be and how difficult it is to focus on anything else.

One challenge is that many healthcare systems primarily test for E. coli infections. However, UTIs can also be caused by other bacteria, mixed infections, or organisms that form embedded or persistent infections. These may not always be detected on standard testing.

Common contributors to UTIs include:

Chronic stress
Vaginal dryness
Low oestrogen levels
Imbalances in Lactobacillus strains
Low levels of protective vaginal bacteria

Functional testing can help identify the organisms involved. Vaginal swabs and detailed urinalysis allow us to identify specific strains. Sometimes a short course of biofilm support nutrients is used before testing to improve detection.

Once the results are available, they can be shared with a GP or consultant to guide appropriate medical treatment. Alongside this, nutritional and microbiome support can help restore bladder health, rebalance the vaginal microbiome and improve protective lactic acid producing bacteria.

We also look at the wider picture. Understanding why the infection developed in the first place is essential if we want to reduce the risk of recurrence and support long term urinary and vaginal health.