Sunday 17 December 2017

Dear Dr Nina: Can thrush really take over your whole system?

At least 75pc of woman have experienced at least one candida infection in their lives
At least 75pc of woman have experienced at least one candida infection in their lives

Nina Byrnes

Dr Nina Byrnes answers your medical queries in her weekly column.

I'm a 45-year-old woman and I've been feeling tired a lot lately. I had bloods done to see if I was premenopausal, but I'm not. I also had a bout of what I thought was thrush - I wasn't diagnosed, I just treated myself with an over the counter treatment and it seems to have worked.

A friend mentioned to me that I may be riddled with candida. She is into a lot of alternative therapies that I wouldn't give credence to, but I was wondering if she may have a point. She suggested I try the candida diet that removes food believed to promote candida overgrowth. However, I would like to know the science, if any, behind this theory first. Can candida take over your system?

Dr Nina replies: Thrush is the term commonly used to describe yeast infections of the genital area. The medical term is vulvovaginal candidiasis. Candida infections are very common and it is thought that 75pc of adult women have experienced at least one infection in their lives. Candida can also cause thrush infections of the mouth, throat and skin though these are less common. The infection can occur in anyone. In the majority of people they cause discomfort but no serious illness. However in those who are severely immunosuppressed such as those with HIV or undergoing cancer treatments,  candida infection can be serious or even life threatening.

Candida is normally found in the vaginal area and makes up part of the normal bacterial flora. Symptoms and discomfort occur when an alteration of the normal bacterial environment leads to an overgrowth of this yeast.

In women, menstrual flow, the use of tampons and pads, sexual intercourse, pregnancy and the use some contraceptive pills can increase the risk of thrush developing. Antibiotics can disrupt the normal bacterial balance on skin and increase the risk in everyone. The use of perfumed body washes and bubble baths also disrupt normal skin flora and should be avoided. A diet high in refined sugars can increase the risk in some people and as high sugar levels increase the risk recurrent thrush may be a sign of the development of diabetes. Yeast thrives in a warm moist environment so wearing tight or synthetic clothing may also increase the chance of attacks of thrush. Lastly emotional stress and anxiety can be a trigger for some people.

Thrush causes genital discomfort, itch and irritation and whitish cottage cheese-like discharge may be obvious. In men it may cause some penile irritation.

Oropharyngeal thrush can cause soreness of the mouth and throat or a sensation of difficulty swallowing. There may also be some cracking of the skin at the corners of the mouth. Candidiasis of the skin can cause patches of redness or flaking skin.

Over the counter creams or oral gel may provide relief. For vaginal symptoms pessaries are also available. If these remedies haven't helped and your doctor believes candida is the cause, prescription antifungal medicine may be required. Thrush can transfer between sexual partners so treating your partner is advised. If symptoms are frequent or reoccurring it may be necessary to have swabs to rule out other vaginal infection. If you are feeling tired it is unlikely to be due to candidiasis but having bloods to rule out the possibility of diabetes or a suppressed immune system is worthwhile.

Systemic candidiasis is often spoken about in alternative medicine but this is actually a rare and potentially serious illness that pretty much only occurs in those who are immunosuppressed. There is little medical evidence that cutting out yeast from your diet makes any difference to how you feel.

If you have a tendency towards candida be aware of common triggers. Consider taking probiotics with antibiotics and keep stress to a minimum.

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