Chronic thrush: about bug and terrain

Dealing with recurrent thrush can be overwhelming, especially when conventional treatments provide only temporary relief. Functional medicine offers a personalised approach by identifying the underlying factors that allow Candida to thrive and tailoring a plan to restore balance. Since everyone’s body is different, seeking guidance from a functional medicine practitioner can help create a custom plan that addresses your unique health needs.

The Candida Connection – Why Does It Thrive?

Candida albicans is a yeast that naturally exists in the body. However, under certain conditions, it can overgrow and lead to symptoms such as itching, discharge, and discomfort. Some key factors that contribute to Candida overgrowth include:

• Hormonal changes – High oestrogen states, such as ovulation, pregnancy, oral contraceptive use, and hormone replacement therapy (HRT), can increase glycogen availability in the vaginal lining, providing fuel for Candida.

• Blood sugar imbalances – Conditions like diabetes and insulin resistance can create an environment where Candida thrives.

• Iron deficiency anaemia – This can compromise immune function, making it harder for the body to keep Candida in check.

• Immune dysfunction – A weakened immune system can lead to persistent or recurrent infections.

• Microbiome imbalances – A lack of beneficial bacteria, such as Lactobacilli, can lead to an overgrowth of Candida.

• Chronic stress – Stress impacts the immune system and gut health, contributing to dysbiosis and increased susceptibility to infections.

Testing for Candida – A Functional Medicine Perspective

Rather than relying solely on symptoms, functional medicine practitioners use advanced testing to identify Candida overgrowth and contributing factors. I may recommend some of these tests:

• Comprehensive Stool Analysis – Evaluates levels of Candida and beneficial gut bacteria, along with markers of digestion and inflammation. I use the GI MAP.

• Organic Acids Test (OAT) / NutrEval – Detects byproducts of Candida metabolism, providing insights into yeast overgrowth and insights into nutritional and mitochondrial deficits.

• Salivary or Urinary Hormone Testing – Identifies hormonal imbalances that may contribute to recurrent thrush.

• Blood Tests – Measures blood sugar levels, iron status, immune markers, and systemic inflammation.

• Vaginal Microbiome Testing – Assesses microbial balance and presence of Candida or other pathogens in the vaginal environment.

The Functional Medicine Approach to Treating Thrush

Functional medicine addresses both the terrain (the whole ecosystem, including the immune system and vaginal microbiome) and the bug (Candida itself). A comprehensive approach includes:

1. Supporting the Terrain (Whole-Body Balance)

• Balancing the Vaginal Microbiome

  • Take high-quality probiotics with Lactobacillus species to support a healthy vaginal microbiome. Lactobacillus crispatus is queen.

• Supporting the Immune System

  • Ensure adequate nutrient intake, including vitamin D, zinc, omega-3 and iron.

  • Address chronic stress with breathing exercises, meditation, or gentle movement practices.

  • Get sufficient sleep and rest to allow the body to recover and fight infections.

• Hormonal and Blood Sugar Balance

  • Support blood sugar regulation by eating protein, healthy fats, and fibre with meals.

  • Address hormonal imbalances that contribute to thrush recurrence.

2. Targeting the Bug (Candida Itself)

• Dietary Adjustments to Reduce Candida Growth

  • Follow an anti-Candida diet for 2-3 weeks, reducing sugar, refined carbohydrates, and processed foods.

  • Focus on nutrient-dense vegetables, healthy fats, and high-quality proteins.

  • Avoid high-mould foods such as peanuts, cashews, and processed cheese.

  • Stay hydrated with filtered water and herbal teas.

• Antifungal Nutraceuticals and Supplements

  • Use natural antifungals like oregano oil, caprylic acid, berberine, and garlic under practitioner guidance.

  • Support liver detoxification with milk thistle and N-acetylcysteine (NAC) to help the body process Candida die-off.

Long-Term Prevention and Vaginal Health

Once symptoms are resolved, maintaining vaginal health is essential to prevent recurrence. Key strategies include:

• Use breathable cotton underwear and avoid tight clothing that traps moisture.

• Avoid harsh soaps, scented products, and douching, which can disrupt the vaginal microbiome.

• Wipe front to back after toileting and change tampons or menstrual cups promptly.

• Limit antibiotic use where possible and take probiotics after any course of antibiotics.

• Manage stress levels, as chronic stress can weaken immune defences and disrupt the microbiome.

Final Thoughts

Thrush is not just a local issue – it reflects an imbalance in the body's overall health. Functional medicine provides a holistic approach that not only targets Candida but also restores balance to the gut, immune system, and hormones. If you are struggling with recurrent thrush, working with a functional medicine practitioner can help identify the root cause and create a personalised plan for lasting relief.