If you’ve felt it… you know that burn.

The dread washes over you…it’s back again.

You know what’s in store: the burning, of course…constantly feeling like you need to find a bathroom… another trip to the doctor for a urine sample…And probably another round of antibiotics. 

That’s life when you’re struggling with recurrent urinary tract infections (UTIs).

And based on the number of women I see with this issue…recurrent UTIs are a major issue that gets very little attention from mainstream medicine.

(In fact, your doctor might not even want to admit it’s happening.)

But if it is happening to you…I’m not being dramatic when I say it’s like a recurrent nightmare. 

Today I want to shine a big, bright light on this common issue: explaining not just WHY it happens, but steps you can take to treat existing UTIs and keep them from coming back. 

Why Did I Get The First UTI?

If not normal, UTIs are actually very common in women. It’s simply a matter of anatomy: women have shorter urethra, and with the proximity of various openings (you know what I mean), bacteria transfer is inevitable. 

Other factors that increase the risk of UTI include:

• Sex (especially with a new partner, who is introducing new bacteria)
• Exercise (especially in tight-fitting pants)
• Holding urine 
• Hormone fluctuations
• Pregnancy
• Menopause

Most UTIs are caused by naturally occurring E. coli bacteria that hangs out in the gut. If you have more of that bacteria in your gut, it’s also more likely some of it will migrate down to the urinary tract and cause issues. 

My main point here is that there shouldn’t be any shame around getting a UTI – it happens! But if they’re happening over and over again – you don’t have to live that way. So why does it happen?

What Causes Recurrent UTIs

First, I have to tell you an unfortunate truth: The more UTIs you have, the more likely you are to get another. 

I know – it’s not fair. But here’s why: the most common treatment for UTIs is antibiotics. Antibiotics wipe out good AND bad bacteria. They don’t discriminate. That can lead to an imbalance of bacteria, weakened immunity, and an easy way for any bacteria that escaped the antibiotic treatment to build back up very quickly. That leaves you at increased risk not just for more UTIs, but bacterial vaginosis and yeast infections, too. 

Candida overgrowth can also be a root cause of UTIs. (It’s sort of a chicken-or-the-egg situation, where it’s hard to say if candida came first, or candida was able to flourish because of repeat antibiotic use. Either way, candida has to be treated.)

Recurrent UTIs are also often associated with hormonal contraceptive (the Pill) and long term antibiotic use, such as for acne treatment. 

Hormone changes – such as premenstrual – as well as flares of gut conditions (IBS, SIBO, etc.) both also often set off UTIs in my patients. 

Recurrent UTIs can also be a sign of an autoimmune-type condition called Interstitial cystitis (IC) that causes chronic pelvic pain. 

Depending what the root cause of your recurrent UTIs is, treatment will need to be tailored – but it’s usually some combination of gut microbiome rehab and hormone balancing (more on that to come). 

Negative Test Nancy

Remember how I said some doctors don’t even want to admit recurrent UTis are an issue? Part of that has to do with a major testing issue.

The standard UTI test (urinalysis), which looks for white blood cells in the urine to confirm bacterial infection of the urinary tract or kidneys, is not 100% accurate – in fact research has suggested it may be accurate only as much as 30% of the time!

(Because it was designed to detect kidney infections, it uses a threshold for white blood cells that is much higher than many UTIs cause.)

Even worse – the next most commonly used test – a bacteria culture – is based on the now disproven idea that urine is sterile. We actually know urine is teeming with tons of bacteria that should be there…. So a positive bacterial culture doesn’t mean much, either.

And finally, we know that bacteria produce biofilms – I think of them like protective layers of goo on the outside of bacteria – that help them prevent shedding in urine and evade testing. 

If you have the symptoms of a UTI, know what it feels like because you’ve had it before, go to the trouble of getting tested, and then get a false negative? It’s incredibly frustrating. 

Even if your test is technically negative, you could be dealing with a UTI. There could be multiple causes. There could be multiple solutions. And working with an expert is the best way to suss all this info out. 

How To Treat Recurrent UTIs

As I mentioned before, treating recurrent UTIs depends on what the root cause is. 

Got crazy PMS that gives you a UTI every month like clockwork? Hormone balancing and healing may be your answer.

Have a wicked case of IBS that comes with a side of UTIs? Gut healing will be key for you. 

Been using antibiotics 4x/year for the last 5 years? We’ll need to come up with a customized plan to heal your microbiome and get it thriving again. 

Interstitial cystitis at play? I’ve seen patients make major improvements with diet and gut healing work. 

But no matter your root cause, if you’ve got a current UTI, we need to take care of it first. (No antibiotics required.)

My method involves:

• Supporting the vaginal microbiome (with both oral and vaginal probiotics)
• Using a biofilm breaker 
• Using herbs and supplements to address the infection (more effective and less likely to cause resistance compared to antibiotics, in my opinion)
• Following up with probiotics for preventing recurrent UTIs (this is backed by research)

Normally, I only share my tested UTI protocol with clients…but if you’ve made it this far, I want you to have it, too!

>>>> Download my day-by-day UTI protocol HERE <<<<

Think of it as a sneak-peek into what working with me as a practitioner is like. I hope it helps. 

• Brie

PS – If my UTI protocol helps you, leave a comment and let me know! And if you’d like some guidance on your unique situation, don’t forget you can schedule a no-obligation free consult anytime here. 

I will be expanding my practice, and am looking to hire a Certified Health Coach to help our clients know their role as an equal partner, and to be their ally in the process of change. I’ll be accepting applications until June 19th.

The certified health coach in clinical practice is the first point of contact in the patient experience, setting the tone for their journey. Our clinic’s focus is digestive and hormonal balance and is 100% telemedicine, therefore, this position is completely remote.

The Health Coach’s role of welcoming new patients, onboarding patients to technology platforms, and driving the first encounter to prepare patients for the functional medicine process and partnership; plus offering on-going coaching to provide accountability as patients move through their change process is a synergistic complement to the provider’s medical expertise.

The role maximizes the coach’s skill set to benefit the provider, patient, and practice. The three Ps are somewhat independent, running on their own track. The Health Coach also serves as the best professional to identify and correct any broken link in the patient’s interactions with both the front and back-office systems.

A seamless patient journey, that minimizes overwhelm and patients falling through the cracks will optimize clinical outcomes, increase word of mouth referrals, therefore, enhancing the practice’s bottom line.

Functional Medicine is a process and a partnership. The Health Coach is responsible for assisting the patient to know their role as an equal partner and to be the patient’s ally in the change process.

Time:

Estimated 6-20/hours a week. Hours will grow organically as more patients utilize ongoing coaching, beyond the clinical onboarding.

Health Coach uses Harvest Time Tracking -google extension, and submits invoice to practice bi-monthly. The clinical coordinator position is a 1099 independent contractor.

Requirements:

• Clinical Coordinators need to possess the following skills, knowledge, and attributes to be effective and succeed on the job.
• Proficient collecting and telling back the patient’s story, using Active Listening skills.
• Has excellent communication skills and the ability to address customer’s needs and concerns in an empathic and impactful way. You have patience, and the ability to intently listen. Experience in online customer support is not necessary, but would be a bonus.
• Understands our community. Maybe you, or someone you know, has dealt with health challenges. You have empathy for the sick and a passion for helping others.
• Must have strong computer skills to navigate, use, and integrate cloud-based software platforms. (Must be proficient in using or learning online tools such as Google Docs, Acuity, IntakeQ, and Zoom).
• Must have knowledge of Functional Medicine principles yet have the ability to take a high-level concept and distill it down into a way patients can understand and connect meaning to their unique and current circumstances.
• Must possess strong interpersonal communication skills and an encouraging attitude.
• Must possess strong organizational, system infrastructure skills.
• Must be passionate about working as part of a team.
• Must have a strong understanding of diets relative to digestive/food intolerance issues (such as low FODMAP, candida, histamine, Specific Carbohydrate Diet, etc).
• Is committed to ongoing learning.
• Lives in the United States.

Health Coaching Responsibilities:

• Front Line of Care Responsibilities + Charting
• 30-minute new patient Follow-up coaching session after the provider’s new patient appointment.
• Patient will pay and schedule ongoing coaching sessions, via the practice.
• Communicate with practitioners about ongoing patient progress and care at weekly clinical rounds.

Coach’s LLC Responsibilities:

• Provide proof of insurance.
• Coach and Provider case study reviews. Patients flagged for ongoing coaching.
• Responsible for communicating with patients and selling single coaching sessions to assist patients in the change process and keep them activated in the partnership.
• May have the option of contributing content related to supporting patients through the change-process, for use in newsletter and direct to the patient population, as a form of internal marketing.
• Flag patients who are excellent coaching candidates for provider. Independently, coach follows-up with patients who are good candidates for coaching, to offer ongoing coaching sessions.

>>>>>>CLICK HERE TO APPLY<<<<<<

Last week I had a consultation with a new patient who had the gut symptoms I see all the time: bloating, food intolerances, and bowel disturbances (yes, I’m talking constipation and diarrhea!).

After hearing her entire health history, I asked if she had ever been tested for SIBO (Small Intestine Bacterial Overgrowth).

“No, that’s not it” – she told me – “I had a stool test that was negative for SIBO.”

Major. Red. Flag. 

This is a HUGE misconception – but stool tests cannot diagnose OR rule out SIBO.

I don’t blame this woman or her doctor for being confused. Even great practitioners are often unsure what tests can and can’t diagnose SIBO.

This is really important because with the right testing… SIBO can be treated and resolved, most of the time.

That means you can say goodbye to the bloating and gas (for good) and get back to enjoying life. 

If you’ve got digestive complaints – even (and especially) if you’ve been told you don’t have SIBO before – this blog post is for you. Let’s clear up all the misconceptions about SIBO testing so you can get on the road to healing.

What Is SIBO?

Small Intestine Bacterial Overgrowth (SIBO) occurs when bacteria overgrow in the small intestine. Normally, there should be very few bacteria in the small intestine – instead, bacteria should live in the large intestine. 

When bacteria overgrow in the small intestine, those bacteria can feast on undigested food as it leaves the stomach and enters the small intestine. As the bacteria eat, they produce gas (hydrogen, methane, and hydrogen sulfide) and that gas causes symptoms like diarrhea, constipation, and bloating.

So why do they overgrow? There are tons of reasons – but some of the most common reasons I see are:

• Endometriosis (which can cause sticky scars, called adhesions, inside that prevent the normal flow of bacteria)
• Certain medications that slow down the digestive system (opioids are a common culprit)
• Past food poisoning (which can trigger an autoimmune reaction that impacts motility)

If you’ve never heard of SIBO, you might think it sounds really rare or unusual… but it is very common. About one billion people worldwide have “Irritable Bowel Syndrome” – and of those, 60% are believed to actually have SIBO as a result of post-infectious IBS – which puts the estimate at about 600 Million people with SIBO!

Why Having SIBO Can Be Good News 

The truth is I LOVE seeing a positive result on a SIBO breath test… not only does it explain why a patient has been dealing with symptoms (often for years)… but it is also a problem we can usually fix. 

Depending on the type and severity of SIBO, it can be resolved in as little as one treatment cycle. 

But successful treatment is wholly dependent on testing, since different types of SIBO require different treatments. 

That’s why SIBO really requires not just an accurate test – but a practitioner who can interpret the results and create a customized treatment plan based on them.

Why Stool Tests Can’t Diagnose SIBO

To put it simply, stool tests are looking at the wrong part of the body. Stool tests tell us mostly what is happening in the large intestine – not the small! 

So while it is possible that some of the organisms we see in stool testing are living in the small intestine, the results we get are more reflective of the large intestine.

Furthermore, while there can be some indicators that SIBO is likely from stool testing results, it’s impossible to differentiate small vs. large intestine.

Stool tests can be really useful for diagnosing many other conditions – parasites, enzyme deficiency, and more – but they are not able to determine if bacteria is overgrown in the small intestine. 

I love stool tests – and if you’re coming to me with gut issues, I almost always order a stool test  – but it won’t tell you if you have SIBO!

Urine Organic Acids Tests Don’t Work Either

The urine organic acids test is another popular and really useful test – unless you want to diagnose SIBO. 

The organic acids test can indicate if a bacterial overgrowth is present, but the problem is it can’t differentiate between the small and large intestine. 

(Yes, Large Intestine Bacterial Overgrowth (LIBO) is a thing too!)

If you don’t know where the overgrowth is, you don’t know which treatment to use. 

Again, this is a really useful test (and one I often use for other conditions) but it can’t diagnose SIBO. 

The Right Way To Test For SIBO

There are 2 ways to test for SIBO properly:

1. Endoscopy with culture (not commonly used anymore)
2. Breath test (the gold standard and what I use)

(There is also a blood test for post-infectious IBS (which is a form of autoimmune IBS caused by food poisoning) that can be used, since most people with post-infectious IBS have SIBO. I use this if a breath test was inconclusive.)

The breath test is far and away the most simple, accurate, and useful of these tests, and it’s what I alway use with my clients.

That being said… Even though the breath test is the best, it doesn’t mean it’s perfect.

The breath test works by measuring hydrogen and methane gas in your breath after a special 24-hour prep diet and consuming a sugar solution (aka the test substrate). There are two options: glucose or lactulose. 

The glucose test is only able to diagnose SIBO in the beginning of the small intestine (the small intestine can be over 20 feet long!). Because glucose is rapidly absorbed in the intestine, it isn’t good for finding SIBO that is farther down the small intestine.

The lactulose breath test can diagnose SIBO in any part of the small intestine, but it does have a higher rate of false positives.

Glucose is more likely to miss some cases of SIBO, but the ones it does identify are more likely to be true positive diagnoses.

Therefore, I sometimes run glucose and lactulose tests side by side to get a more complete picture. 

Why The Right Test Matters So Much

I’ve said it before, but it’s so important that I will repeat it now: in SIBO, testing guides the treatment. 

Depending on which gases are detected in your breath, and at what levels, treatment will differ. 

That’s why it’s also really key to have help interpreting a test from a skilled practitioner. SIBO breath test results aren’t a simple “positive” or “negative” – you’ll get a graph that shows different gas levels at different points in the test. 

If you’ve never seen them before, these graphs are confusing and overwhelming. But to someone who knows what they’re looking at, your breath tests results are like a map to healing your SIBO and resolving your symptoms.

Bottom line: if you suspect SIBO, get a breath test!

Get Help With SIBO

SIBO is a really complex condition (let’s not sugar coat it!). But it’s not incurable… and if you DO have it, resolving SIBO might be the answer to years of uncomfortable gut symptoms.

Every case of SIBO requires personalized treatment, but that’s part of why I love my job – helping you put the pieces of your health puzzle together and achieve your goals is my purpose in life!

I’ve helped hundreds of people diagnose and resolve SIBO… and I’d love to help you, too! There’s no need to make a commitment right now – book a free 15-minute consultation with my team to learn about how we could help you and what options you have here —> Book a Free 15-Minute Consult 

There’s only one topic on everyone’s minds and hearts right now: coronavirus. 

And as a health practitioner, I can’t ignore it! 

Unfortunately, there is so much bad information out there right now… and even worse, some of it is coming from the alternative health space.

I don’t want anyone to feel panicked, but we do need to take this very seriously. 

Today, I’m sharing exactly what we know about treating coronavirus (aka covid-19) so far. 

#1 Social Distancing Is The Best Tool We Have

Other than washing hands and covering your face when you sneeze or cough, (please do these things!) the best tool we have to slow the spread of coronavirus is social distancing.

Social distancing is like “herd immunity” in that it only works if people who are and aren’t sick (and are and aren’t at high risk) all participate.

Even if you are not personally worried about coronavirus, you help protect the health of those at risk by staying home as much as you can. Cancel appointments. Don’t have people over to your house. Don’t go to the gym. 

It’s OK to go on walks and spend time outside – just keep your distance from others as much as you can.

When you DO go out (like to stock up on essential groceries), wash your hands, change clothes, and wipe down anything you took out with you (yes, I’m talking about your dirtier-than-a-toilet phone!).  And if you are anyone in your household have symptoms that are vaguely viral, I would encourage you to use a service like Instantcart, and have someone shop for you for a very small fee and leave the groceries on your doorstep.

I recommend checking THIS website for accurate, up-to-date information on the virus. However, even medical professionals can’t get access to tests for covid-19 (because there are not enough tests!). You should assume the numbers in your community are MUCH higher than we see reported. 

#2 Antioxidants Have Potential To Help

Research has shown that certain antioxidants (lipoic acid, ferulic acid, and sulforaphane specifically) have potential for boosting the type 1 interferon response to RNA viruses (including influenza and coronavirus).

That’s a science-y way of saying, they help your body fight off viruses more effectively. 

Even better, there is some evidence that certain antioxidants could help fight off inflammation in the lungs caused by viral infections. This is important, because coronavirus primarily impacts the lungs, and, the part of the illness that can ultimately kill people is called ARDS (Acute Respiratory Distress Syndrome). ARDS occurs when an influx of inflammatory cells from your own immune system infiltrates the endothelial tissue in the lung, causing massive levels of oxidative stress in an attempt to fight the virus. 

Other nutrients to consider: 

Selenium: Selenium-deficient mice are more likely to get the flu, and selenium deficiency also promotes virus replication.  Selenium deficiency also increases the rate at which viruses can mutate, potentially creating more virulent strains that may be better at avoiding detection. Selenium deficiency is known to be wide spread across certain regions of China where the virus has more readily spread. 

Spirulina: Has been shown to decrease influenza mortality in mice.  (Yes, mice, but the mechanism by which it works functions the same way in humans)

High dose glucosamine: Dampens inflammatory reactions (and therefore may help protect the lungs in case of infection)

N-Acetylcysteine (NAC): promotes glutathione production, the “master antioxidant.” It’s also mucolytic, which means it can clear up mucus and help get rid of gunk in your chest and nose. This has shown to be particularly helpful in the elderly, perhaps because plasma cysteine levels and cellular glutathione levels tend to decline with advancing age.

I’ll also be sharing my own personal supplement regimen at the end of this post.

#3 Vitamin C Is Being Studied Right Now

At the time of this post, there are already 3 clinical trials underway in China right now where patients with coronavirus are being treated with high dose vitamin C. 

It’s obviously too early to make any conclusions but…. I like what I’m seeing!

Vitamin C helps in multiple ways. It can help prevent the onset of sepsis-related lung damage (a major concern for anyone who is hospitalized). It helps shorten the duration of the common cold and some studies have shown that low vitamin C levels are related to increased flu risk. And it is known to play a role in killing viruses and preventing their replication.

Just know: taking a vitamin C supplement every morning is not going to be the same as the high-dose IV treatments being studied in hospitals right now. If you are sick, taking vitamin C will not replace getting medical care! That being said, I’m still using vitamin C supplements right now., and if you do get sick, I recommend oral Vitamin C hourly, or administered via an IV by a licensed professional if you have access to one. 

#4 TCM Can Aid Western Medicine 

Most people don’t know that during the SARS epidemic, healthcare workers were treated with Traditional Chinese Medicine (TCM) to help prevent them from getting sick.

Today, the formula being used with coronavirus is adapted from Qing Fei Tang (clear the ling decoction). It is being used in combination with Western medicine to help people recover more quickly.

(FYI: This formulation isn’t for prevention – it’s for those who are already ill.)

In south Korea, public health officials are doing trials with Fah Talai Jone herb (Andrographis paniculata, also known as Chuan Xin Lian in Chinese Herbal Medicine) which contains Andrographolide (an extract from the herb). Tests in China indicated that Andrographalide could help prevent viruses in humans.

My hope is that anyone who is sick will be offered both Western and TCM treatments. The more we can do, the better!

→ Brie’s Supplement Regimen

I’ve amped up my supplement regimen in wake of the coronavirus. I don’t believe any of this will prevent me from getting sick… but I do know that it will help me recover should I become ill.

Even with supplementation, I’m still relying on washing my hands religiously and staying home as much as possible.

Luckily, I work with all my patients remotely, so it hasn’t had to impact the flow of our practice.

OK, here’s what I’m doing:

Multivitamin (this is the one I use)

Probiotics (Rotating Megaspore, Therbiotic Complete and floramyces)

Selenium 200 mcg

Zinc 20 mg

Host Defense Mushroom blend

Vitamin C 1000 mg 3 x day (it’s key to take vitamin C multiple times per day, as it is depleted and excreted very quickly)

Cold away by Health Concerns and/or Olivirex –1-2 times daily

Vitamin D 2000-5000 IUs 

Magnesium 400 mg

NAC 600 2 x day

Spirulina 15 g 

Jade Wind Screen (There are many brands with different names for this product. It is a chinese herbal formula called Yu Ping Feng San, and contains high dosages of astragalus in combination with other chinese herbs, and is intended to be used long term during cold and flu season to avoid illness. Do not use if you have known, active autoimmune disease.  Some of the brands I like are Health Concerns AstraC or Astra Essence and Kan Herbs Initial Defense).

I may add some sulforophane. I am certainly keeping andrographis stocked and on hand. I have some Biocidin throat spray around as a first layer of defense for when I’ve been out and about. 

I’m avoiding Elderberry because with PCOS, I’m on the autoimmune spectrum. Elderberry can flare existing autoimmune conditions, but it can also promote a “cytokine storm” – an overproduction of immune cells. If you’re prone to autoimmunity and you contract a virus, the resulting cytokine storm can trigger the development of autoimmune conditions. 

And I’m giving my baby Windbreaker by Kan herbs in low dose, with Vitamin D 400 daily and some Vitamin C.

What if you get sick? I would increase oral Vitamin C to hourly. High doses of vitamin C can cause loose stool, but this is less likely during times of sickness when your body has a higher demand of C. 

I keep on hand any brand of the Early stage “Wind attack” chinese medicine formulas, as variations on these are what is being used in China both for sick patients and preventatively for health care providers. Some of the formulas that can be used are:

Yin Qiao San

Gan Mao Ling

Cold Away

These are taken if you are exposed, and/or if you start to have symptoms like sore throat, or fever and are continued for as long as the symptoms stay in the throat, sinus, or upper lung.

Combining any of these, or similar, with Andrographis, one of the main chinese anti-viral herbs, (which I mentioned above is being used and studied for this virus). Some forms of this are Chuan Xin Lian, Antiphlogistic Formula, or Clear Heat)

There are other chinese herbal formulas being used for symptoms, but these should be prescribed and adapted by a chinese herbalist. I’m available for consultations should you or someone you love need support beyond the first stage of symptoms.

And equally importantly: don’t forget to consider your mental health and stress levels. Take a break from the news when you need to, and even with social distancing, stay connected via phone with the people you love.

I hope this information has given you some practical advice, as well as hope. 

Do you have questions about the coronavirus? I’d love to help clear up confusion where I can. Click here to contact my office.

More Information (And Works Cited In This Article)

https://www.domo.com/coronavirus-tracking

https://www.thaipbsworld.com/59-returnees-from-s-korea-isolated-as-two-new-covid-19-confirmed/

https://www.ncbi.nlm.nih.gov/pubmed/32061635

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295174/ 

https://news.cgtn.com/news/2020-02-25/TCM-used-to-treat-85-of-COVID-19-patients-OmQG7PIGWs/index.html?fbclid=IwAR0pcPYA_OwNCnF7bDLZ6zAGgMJUO7s6KPiD55PuPiSGkItN7FeIgoQ-vJY

https://clinicaltrials.gov/ct2/show/NCT04264533

http://orthomolecular.org/resources/omns/v16n12.shtml

Check out “Endometriosis 101 Part 1: What Is this Condition & Why Is it Happening to Me?” HERE

While functional medicine practitioners don’t know with certainty the root cause of endometriosis either (we’re still waiting on the science), we focus on what we do know about the condition by working to reduce inflammation and support the immune system.

Pain management and even surgery might be part of our treatment plan – but I would never see a woman in endometriosis pain and just throw the birth control pill at her! I am not interested in band-aids. I want real solutions for my patients.

Here’s how we address endometriosis (but remember that every treatment plan needs to be customized for your unique needs):

These steps can happen in any order or all at once, depending on your situation.

#1 Heal The Gut

Addressing gut health should always be high on your list for really any health concern, but especially for anything autoimmune. 

I often see bacterial infections like SIBO (Small Intestine Bacterial Overgrowth), parasites, viruses, mold and toxin exposure, and food sensitivities. In studies, 80% of women with endometriosis also had SIBO. 

These can all be signs and triggers for leaky gut, so addressing them and then working to heal the gut is key to recovery.

I like to start with a comprehensive stool test like the GI Map to find any gut health issues. Then we’ll work to clear any infections and implement dietary changes to support the gut (this could be an elimination diet, but that is not always the answer!). 

One dietary change I do recommend? Cutting dairy and soy. There is a lot of research to support the idea that dairy and endometriosis are not good together. Dairy is hormonal, it’s a really common allergen, and it’s also pro-inflammatory. (As is soy.)

Do you have to quit them both forever? Absolutely not. Once you have endometriosis under control, you can probably enjoy them again in moderation. And of course, quality and quantity matter a lot. Go for grass-fed and organic, minimally-processed dairy when you do have it. 

Another thing I look for on stool tests is high beta-glucuronidase. Beta-glucuronidase is an enzyme produced by gut bacteria and can be elevated by parasites and other gut infections. When beta-glucuronidase is high, it can lead to estrogen buildup. If you have high beta-glucuronidase, I’ll use calcium d-glucarate and Lactobacillus to help lower this and reduce the estrogen recirculation.

#2 Reduce Inflammation

Next, we’ll take a look at your lifestyle and see what could be leading to increased inflammation. It could be late nights at the office, too many meals out, drinking too much, or even “healthy” habits like over-exercise or a really restrictive diet. 

Overtraining isn’t an issue for all women – but you might be surprised how easy it is to become “overtrained” with even a moderate exercise regimen. Remember, overtraining isn’t necessarily about too much exercise… it’s about too much exercise relative to too little recovery. That’s why Olympic athletes can exercise so much without overtraining – they spend all the rest of their time recovering! But for women who have to work, commute, get dinner on the table, do laundry, etc. etc. etc. there is rarely enough recovery time!

Stress in any form is incredibly inflammatory, but it’s not the only inflammatory element to look out for. The modern world is pretty rife with chemicals… and no one wants to think about the cumulative effect of the pollution we breathe (drink and eat, too!), the chemicals in all the products we use (from cleaning to personal care), or the added ingredients in most of our food (including unwanted pesticides and other chemicals). But – it all adds up to a lot of potential inflammation.

But, you don’t have to start living like a monk and throw away everything plastic in your home. I’ll help you choose where you can make a few key changes to reduce overall inflammation. 

#3 Stabilize Blood Sugar

One big myth is that weight loss can help with endo symptoms. If you’re carrying a lot of excess weight, losing weight can potentially help with symptoms (since hormones are produced in fat cells) – but that doesn’t mean weight loss is a “cure.” 

If you’re already lean, the extra stress on the body of trying to lose more weight can make your symptoms worse. And even if weight loss is one part of your healing plan, it’s definitely not the whole story. 

Rather than emphasize weight loss, I like to focus on stabilizing blood sugar with a whole-foods based diet. 

This is really important because higher blood sugar levels lead to increased insulin, which stimulates the conversion of testosterone into estrogen. This is just another contributor to the high estrogen levels that are linked to endometriosis. 

#4 Balance Hormones

You can’t diagnose hormone imbalance based on symptoms, so I never start a hormone protocol without testing. I use the DUTCH Hormone Panel with my patients.

Once we’ve identified your imbalance, we’ll come up with a plan to correct it – everything from herbals and supplements to acupuncture, exercise, diet, and stress management can come into play.

Some of the herbs and supplements I use most often are:

Melatonin

Melatonin is an antioxidant that has been shown to be able to reduce pelvic pain associated with endometriosis. Now, I don’t want to give out a dose because it’s not the typical low dose that people use to help them sleep. It’s actually a pretty high dose. And it can definitely make people groggy. As a practitioner, I want to make sure it’s appropriate for you. But in the right dosage, melatonin can reduce endometriosis pain by as much as 40%. And it’s safer than the pharmaceutical options by far!

Before supplementing, you can also do things to naturally increase your own melatonin levels like have good sleep hygiene, avoid caffeine, avoid blue light after three in the afternoon, and sleep in a dark room.

Vaginal Probiotics

This is one of my favorite tools – and yes, it is what it sounds like: just take probiotics, and stick them up there! This is really safe and one of the easiest ways to shift the vaginal microbiome.

(If you have chronic yeast or bladder infections, or bacterial vaginosis, this can also help with those conditions in many cases!)

The brands I recommend are Jarrow’s Fem-Dophilus and FloraFemme. 

Pycnogenol

Pycnogenol is another really well-known antioxidant that’s very specific to lowering pain and lesions in endometriosis. It’s safe and effective for many women. 

Bioidentical Progesterone

This really depends on the woman and proper hormone testing. Please don’t go buy some natural progesterone cream and start self-supplementing! Getting the dose right and monitoring while you use it is so important. 

But this works because proper progesterone levels balance and oppose estrogen. Think of it like a teeter totter. But in women with endometriosis, there is evidence that they may have progesterone resistance and therefore need slightly higher progesterone levels than the average woman to achieve that balance. 

DIM

Diindolylmethane (DIM, in short) is a phytochemical found is cruciferous veggies (think broccoli, cauliflower, brussels sprouts etc.) and it’s one of my favorite tools for estrogen dominance. It helps balance levels of different types of estrogen and block androgen receptors. Get it from eating lots of veggies, or try a supplement.  

#5 Support Better Detox

Your body knows how to detox itself (thanks to your liver, kidneys & more) – and you don’t need a 10-day juice fast to “cleanse.” But that doesn’t mean we can’t support detox.

Your detox symptoms can easily become overburdened when you consider the amount of toxins you’re exposed to (pollution, chemicals in cosmetics, pesticides on food to name a few). Your liver can get “jammed” trying to detox as much as possible – which can then burn through your glutathione stores and leave you feeling totally burnt out. 

And remember – your liver also plays a major role in detoxing excess estrogen, so if it’s jammed up, you’re setting yourself up for estrogen dominance. 

I’ll have you take a look at where you’re being exposed to toxins as well as teach you some easy tricks for supporting the body’s detox processes. 

These are some of the supplements I love for supporting better detox: 

Calcium D-Glucarate

Calcium d-glucarate is one I mentioned before for gut health. It is a supplement that’s pretty safe to play with if you have endometriosis because you can assume that you have some level of estrogen dominance. But again, I like to use it based on stool testing so we can be certain that excess beta-glucuronidase enzyme is in fact a part of your issue. Because why take excessive supplements that are not doing for you what you need? That’s a waste of time and money.

N-Acetylcysteine

I always say this is the supplement I would take if I was trapped on a deserted island… it’s just awesome. It has many uses and it supports the production of or master antioxidant, glutathione (which we all need more of!)

In a double-blind study, 92 women with endometriosis were either given NAC or no treatment. And during the NAC treatment, they saw a distinct reduction in the number of cysts or tissue implants, as well as size. In the women using NAC, lesions stayed the same or actually shrunk. 

In the no treatment group, lesions tended to grow! The NAC was more effective than hormonal treatments.

And the crazy part is that 24 women in the NAC treatment group who had scheduled laparoscopy actually cancelled their surgery because they had such a great reduction in pain. One woman even got pregnant!

I can’t recommend NAC highly enough. But quality does matter – I usually use physicians-grade from brands like Pure Encapsulations, Thorne, or Designs for Health. I like to use 500 mg, 2-3 times daily.

One caveat: if you have acute gastritis (inflammation of the gut lining) NAC can thin the gut wall slightly, so it might not be right for you. 

Don’t Just Accept Endometriosis or Painful Periods

I would never lie and tell you that I have a magical cure for endometriosis. I don’t (and no one does).

What I do have is a holistic approach to healing that takes into account not just symptom management – but also addressing the root causes so that you can experience true relief.

Because there are multiple layers to healing endometriosis, I recommend you get support from an experienced practitioner. A practitioner can help you assess your gut health, hormones, and detox symptoms and strategize healing. Working with an experienced practitioner can turn and a long and frustrating process into a much shorter one. (The majority of my clients see major, lasting improvements in just 3-6 months.)

It’s very possible to be symptom-free, even with endometriosis. It’s very possible to see heavy bleeding, painful periods, and PMS go away. I’d love to help you.

You can book a free 15-minute consult with my team right now. During the call, we’ll listen to you and explore how we could guide your health forward (no obligation!).

Periods shouldn’t be painful or something to dread! I’d be honored to help you take back control and feel better.

P.S. Do you feel like you’re already eating well, managing stress, and STILL struggling with endometriosis? I’d love to learn more and see if we can’t get you feeling better. Book a free 15-minute consult today. 

You might have heard me say this before: Your period is not a curse.

The truth is that your period is actually a sign of amazing things happening inside your body (regardless of if you ever even want kids!).

But…for some women, your period can feel like a curse from hell – all due to a condition called endometriosis.

Listen up ladies: If your periods are painful, long, heavy, and something you downright dread, please read this article.

If your doctor has told you they suspect endometriosis, please read this article.

If you’ve been suffering for YEARS without relief, please read this article.

One in 10 women in the U.S. is estimated to have endometriosis. (And it takes an average of 8-12 years to be diagnosed).

I won’t pretend I have a magic cure for endo (I wish I did!). But what I can do is share what I know, and assure you: You aren’t crazy. It does hurt. But it doesn’t have to be this bad forever.

This is a big topic, so I’m going to be covering it in two posts. Today, in Part 1, we’ll learn what endometriosis is, its symptoms, and what we (think) causes it. Part 2 will be all about actionable solutions you can put into practice right away.

What Is Endometriosis?

Have you ever wondered what your period is actually made of? It’s not just the same blood you see when you cut your finger – it’s actually endometrial tissue. Over the course of the month, women grow endometrial tissue in the lining of the uterus. When you have your period, that tissue is shed. (If you get pregnant, that endometrial tissue is important for supporting the fetus).

Endometrial tissue is “hormonally responsive” which means it reacts to normal hormone changes that come with your monthly cycle. Blood flow is controlled by inflammatory compounds called prostaglandins.

A normal woman grows endometrial tissue in the uterus and then sheds it during her period. It’s all relatively painless.

But in a woman with endometriosis, the endometrial tissue grows outside the uterus. Most commonly it grows around the fallopian tubes and ovaries, but it can extend into the digestive system and really start growing anywhere in the body.

Endometrial tissue is hormonally responsive no matter where it is in the body – when hormone levels fluctuate (as they should to create your monthly cycle), all endometrial tissue (even that which has overgrown) will respond.

That means more inflammatory prostaglandins leading to pain, inflammation, and even scar tissue (adhesions) where endometrial tissue is located.

This can cause extreme pain during your period, from ovulation through your period, mid-cycle, and, for some women, all month long.

Pain can range from mild to excruciating, and frustratingly, the extent of the endometriosis does not correlate with how severe symptoms are. A little endometriosis can cause a LOT of pain.

Aside from pain, endometriosis regularly causes digestive issues and can impact fertility. It also increases PMS.

It’s estimated, however, that 20-25% of women with endometriosis have no symptoms. They may only be diagnosed when they have fertility issues.

If you do have extremely painful periods, heavy bleeding, and even symptoms like IBS that haven’t responded to treatment, please know that it is not normal and can be a sign of endometriosis. It takes the average woman 8-12 years to be diagnosed with endo. That’s 8-12 years of suffering you shouldn’t have to endure!

What Causes Endometriosis?

The sad truth is that we don’t know for sure what causes endometriosis. Both traditional and functional medicine practitioners agree on certain things – but there’s no one proven cause.

While not currently classified as an autoimmune disease, endometriosis is known to have autoimmune features. It is also known to be related to hormone imbalance.

One other theory is about retrograde blood flow – basically when blood flow washes back up into the uterus and fallopian tubes. But, not all women who have some degree of retrograde blood flow develop endo – which means retrograde blood flow is just one of the mechanisms of endometriosis.

Because there isn’t a good understanding of what causes endometriosis in traditional medicine, most traditional solutions are focused on pain and symptom management…

Traditional Endometriosis Treatments (The Good, Bad & Ugly)

In traditional medicine, typical endometriosis treatments include:

• Oral contraceptives or the hormonal IUD (to block ovulation)
• Pain management (Ibuprofen, etc.)
• Surgery (ablation to remove endometriosis and even complete hysterectomy)

I will never shame a woman for using any of these treatments, and I think (at times) they have merit.

The biggest “red flag” is using oral contraceptives to block ovulation. Like with other conditions, oral contraceptives just work as a “band-aid” and do not address underlying causes. When you stop the pill, symptoms will resume. And because the artificial progestins in birth control can exacerbate estrogen dominance, long-term oral contraceptives can make endometriosis worse.

Not to mention that oral contraceptives can be just as damaging to the gut as antibiotics, and that can exacerbate leaky gut!

Are you using oral contraceptives to manage endometriosis? I’d love to explore what other treatment options are available to you. Book a free 15-minute consult with my team today.

Ablation surgery, on the other hand, can be transformative for women who have progressed endometriosis – and can even restore fertility in some cases! However, I think surgery should always be accompanied by other approaches to address underlying causes and inflammation.

I think a total hysterectomy is unfortunate…and I hope that most women with endometriosis don’t get to the point where such an extreme surgery seems like the only answer. In Chinese medicine, the uterus is considered the second heart, and a recent study showed women who had hysterectomies had higher rates of depression.

And while there is nothing wrong with pain management, functional practitioners like myself tend to focus more on suspected root causes of endo so that we can move beyond just pain management and toward resolution of symptoms.

Let’s talk about that now…

A Functional Perspective On What Causes Endometriosis

I often call endometriosis a disease of hormone imbalance. Specifically, endometriosis is associated with estrogen dominance due to low progesterone (where estrogen becomes high relative to low progesterone).

Low progesterone can have many causes. The most common I see are genetic, due to extended use of hormonal contraceptives (which tend to increase estrogen and decrease progesterone), and as a result of chronic stress. If you have adrenal dysfunction or HPA axis dysfunction, your body may downregulate progesterone to prevent conception during stress.

What you might not know is that estrogen dominance is a component of many autoimmune conditions. (And that may be why autoimmunity is more common in men than women). This might be because high estrogen levels are inflammatory.

Like I mentioned earlier, endometriosis isn’t considered an autoimmune disease (yet). But it definitely has the “hallmarks” of autoimmunity: inflammation and immune dysregulation.

With endometriosis specifically, there is both a localized, chronic inflammation and the presence of self-antibodies. What we don’t yet know is if this is a response to endometriosis or the actual cause of endometriosis.

But we do know that there is also an increased number cytokines, an inflammatory component, and lower levels of apoptosis, which means cells aren’t dying at a normal rate.

All of this points to autoimmune – as does the fact that endometriosis also frequently occurs alongside other autoimmune diseases like MS, Hashimoto’s, lupus, and Inflammatory Bowel Diseases like Crohn’s and Ulcerative Colitis.

Research at the University of Tennessee has also shown that 100% of women with endometriosis also have leaky gut. (This doesn’t mean 100% of women in the world have leaky gut if they endometriosis – just women in the study – but it is a compelling number!)

That makes sense, since functional practitioners have long seen a strong link between leaky gut and the development of all kinds of autoimmune conditions.

I Have Endometriosis…Now What?

I never want to see another woman with endometriosis given a prescription for the Pill and a suggestion for a heating pad as a “solution” ever again.

As a functional medicine practitioner, my mission is to help you address endometriosis holistically.

Make sure you check out part 2 of this article for more information on exactly how I support my patients with endometriosis.

P.S. Also be sure to listen to my guest podcast appearance where I spoke with Tawnee Gibson of Endurance Planet all about endometriosis! Listen here.

It’s hard to believe my baby girl is coming up on 5 months old already!

All the mamas out there know… the postpartum period is a whirlwind!

Not only are you adjusting to taking care of baby, but your body is undergoing massive changes (just as big as during pregnancy!)

And you’re sleeping less, nursing (literally nourishing an entire other human with YOUR body!), and might even be going back to work around the 3-month mark if you’re in the U.S.

It’s a lot! That’s why I think your postpartum recovery plan is just as important as what you do before and during pregnancy (if not more important!) 

Today I want to share my go-to supplements that I’ve used in my own postpartum recovery and first months of motherhood – I hope they help you as much as they have helped me over the past few months.

What I’m Taking For Postpartum Recovery & Surviving New Motherhood

Here’s a quick rundown of my daily supplement routine since giving birth. (Remember that this is what was appropriate for me, and may not be exactly right for you! Book a free consult with my team to learn more about customizing supplement plans for you). 

#1 A good prenatal multivitamin

There’s nothing that depletes your body of nutrients quite like growing another human and then nursing them! You need the extra nutrients in a good prenatal just as much after birth as you do before.

I like Designs For Health Prenatal Pro because it contains chromium and other important micronutrients. Because I have a family history and personal tendency toward diabetes (and dealt with gestational diabetes), I specifically chose a prenatal that contains chromium. Research suggests that chromium can help lower fasting blood sugar and insulin levels.

#2 Magnesium

Magnesium  – for everything! Magnesium has so many benefits…. But it’s especially good for mitochondrial energy, maintaining your calm, supporting healthy sleep, hormone support, and insulin signaling. I use Magnesium Buffered Chelate Glycinate by Designs for Health.

#3 Mushroom blend 

I use a mushroom blend with reishi, cordyceps, and lions mane called Host Defense Stamets 7.

Mushrooms have so many benefits! Lion’s mane helps with brain health, stress and anxiety, and diabetes prevention and management. 

Cordyceps can help protect mitochondria and therefore have anti-aging benefits. And with how little sleep I’m getting, I definitely feel like I need the help!

#4 Adaptogens

Adaptogenic herbs (like goji berry, maca root, ginseng, and more) support adrenal health and mitochondrial function. With all the stress of a new baby and the limited sleep, adaptogens can be really useful. I use “The One” from Quicksilver Scientific.

#5 Flax seed meal

I have PCOS (Polycystic Ovarian Syndrome) and as a result my hormones need extra support to stay in balance. I personally tend toward estrogen dominance (not all women with PCOS do – so be sure to get your hormone levels tested with a practitioner!)

Flax seed meal has a “bad reputation” as an estrogenic food but the truth is that flax seed meal can help with estrogen detox, keeping the body’s hormone levels in better balance if you’re estrogen dominant like I am. I eat a couple tablespoons of ground flax daily. 

#6 Probiotic & prebiotic

I rotate through 3 probiotics to keep my gut healthy: FloraMyces, Klaire Therbiotic, and MegaSporeBiotic.

I’m also taking a daily prebiotic. Prebiotics are indigestible fibers that act as food for the bacteria in the gut. I use MegaPreBiotic.

The probiotic and prebiotic are for my health – but also for baby girls’! Right now, my daughter’s microbiome is still “under construction”and is strongly influenced by who she has contact with – namely her dad and I. Moms transfer bacteria to baby through kissing, cuddling, and (most importantly) breastfeeding. That’s why gut health is even more of a priority right now than usual.

#7 Natural toothpaste & mouth rinse

Your oral microbiome seeds your gut microbiome, and with as much as my daughter open mouth kisses me and all the germs we pass back and forth, I’m doing everything I can to support a healthy microbiome body-wide. Research has shown that baby’s oral microbiome continues to develop up to 1 year.

I use PerioBiotic toothpaste from Designs for Health and Dentalicidin Mouth Rinse from BioBotanical Research.

Why I’m Passionate About Breastfeeding

I’m also taking supplements that have made breastfeeding easier and confer benefits to baby through breastmilk. I promise I’ll share all those with you – but first I want to cover why I’m so passionate about breastfeeding.

My intention is to breastfeed my daughter past one year – what’s called extended breastfeeding. That’s because there are so many benefits to breastfeeding:

• Breastfeeding prevents autoimmunity – research has shown being breastfed is associated with a lower incidence of diabetes, celiac disease, multiple sclerosis and asthma
• Breastfeeding builds a stronger immune system and may even help prevent development of disease later in life
• Breastfeeding boosts the brain – this study showed it improved cognitive development and this one showed those breastfed for 6+ months had better test results in school

And with my history of gestational diabetes and tendency toward high blood sugar, it was important to me that breastfeeding decreases the risk of diabetes in mom AND baby and especially helps prevent Type 2 diabetes for moms who had gestational diabetes. 

That doesn’t cover even a fraction of all the health benefits of breastfeeding for mom and baby… not to mention the emotional and mental benefits.

While I understand that breastfeeding isn’t possible for all new moms, I highly recommend it… and if you’re struggling with low supply, keep reading for some of the solutions that made breastfeeding work for me.

Breastmilk Boosters

I struggled with low supply from day 1 (largely as a result of hormone disruption caused by my PCOS) – but luckily I found a few solutions that helped get my supply up to normal. If you’re a fellow PCOS sister, I hope you’ll consider these ideas. 

#1 Myo-Inositol 

Myo-inositol is a natural substance, found in plants and animals, which helps to regulate insulin in a similar way to metformin and may be useful for mothers with PCOS who are dealing with low supply.

It’s a major ingredient in breast milk and taking it supplementally can help boost breast milk production and increase baby’s brain health.

#2 Metformin

Metformin is a prescription drug that can help lower blood sugar to boost supply. It doesn’t work for all women – but if it helps you, it’s a powerful tool that’s safe for baby. Metformin is considered low-risk for baby. 

The dosage starts at 500 mg, but talk to your doctor (you’ll need a prescription) to find what’s right for you. 

For anyone nervous about using metformin: you should know this what what finally increased my supply to nearly normal levels!

I also take therapeutic levels of Fenugreek, Goat’s Rue, Moringa, and Shatavari— all proven to improve milk production and flow safely. While different women will have different degrees of response to these herbs, they are generally safe to try. It can take up to 2 full weeks to notice a shift in supply or flow. 

What I’m Taking For Baby’s Benefit 

Nursing mamas aren’t just a milk machine… But everything you take in is transferred to your breast milk. And when that milk is baby’s only source of nutrition for 6 months, you want it to be as good as possible!

A healthy and diverse diet with more-than-enough calories is step one to make the best milk, but I also am using these supplements for “milk enhancement.”

#1 Lugol’s iodine

Pregnancy requires higher levels of iodine, and research has shown women who are iodine deficient in pregnancy and postpartum are more likely to have children with neurological and psychological deficits like attention deficit disorders and lower IQ.

Since I don’t eat iodized salt or iodine-rich foods regularly, I use 2 drops of 2% Lugol’s iodine solution daily.

#2 Calcium

Here’s a wild breastfeeding fact: if you’re not taking in sufficient dietary calcium while breastfeeding, your body will leech calcium from your bones to supply calcium in your breastmilk!

I don’t want to feed my baby my own bones – so I supplement with calcium to make sure I have adequate supply for both of us. 

#3 DHA 

The omega-3 fatty acid DHA is one of the most important nutrients for a healthy baby. It’s critical for healthy brain development plus vision and memory.

Lots of research has shown that supplementing with DHA can increase DHA levels in breastmilk and lead to better health outcomes for baby, so I use Nordic Natural Prenatal DHA.

#4 Coconut oil

Coconut oil is one of my favorite sources of healthy fat – and eating it regularly can increase lauric and caprylic acid content in breastmilk. Lauric and caprylic acid are powerful antimicrobials that can help strengthen your baby’s immune system and keep them healthy.

Studies have shown eating 3 tablespoons at a meal can significantly increase levels, so I aim for 3 tablespoons in my daily smoothie.

#5 Liver and organ powder

Liver and other organ meats are on the best sources of important nutrients like choline… but most of us are deficient! Choline is particularly important for healthy brain and memory development, so it’s important for breastfeeding moms to get enough.

I use a powdered form of organ meats made by Ancestral Supplements and try to eat 2 pasture-raised eggs (the yolks are a great source of choline!). Use code BRIEW10 at checkout for a 10% discount!

What To Give Baby 

Right now, all baby girl gets is milk, milk, and more milk!

That’s all infants less than 6 months of age need – it’s the perfect food. 

The only supplement I give to her is  Klaire Therbiotic Infant 4 times a week to support her healthy microbiome development. I give this to her either on my nipple by dampening the skin with a little milk and then dabbing the powder on there, or, by mixing it in a bottle of milk, when she takes a bottle. 

She’s getting her Vitamin D through my milk; you must take 5000 IU or more daily to accomplish this–test first to make sure that dose is safe for you. 

That’s it!

Your Postpartum Recovery Strategy

As a hormone specialist, I’ve always loved working with moms in the postpartum period – but as a mom myself now, I have a profound respect for all my mom clients!

If you’re pregnant now, hope to be soon, or are in the postpartum period now, I’d love to support you in finding your own postpartum recovery strategy, tailored to your unique needs.

Book a free 15 minute consult with my team by clicking here. During the consult, we’ll talk about your experiences and needs and start on a strategy for long-term wellness, together. 

To your health,

Brie

P.S. Are you interested in hearing more about my motherhood journey? Be sure to check out my Instagram where I share candid pics and commentary!

In Part 1 of this series, I covered what Candida is (and isn’t) and how it could be present in your body. In Part 2, I covered the symptoms and root causes. Today, we’re going to talk testing for and treatment of Candida. 

So, you’ve read Parts 1 and 2 of this series. You understand what Candida overgrowth is, and (I hope!) you even understand HOW it can cause so many systemic symptoms.

And if you’ve made it here to Part 3, you probably suspect that chronic Candida overgrowth is something you could be dealing with.

Today, I want to share how I work with patients in my clinic who present with Candida symptoms. I hope this is helpful to you – and please don’t forget that I’m here for you! My passion in life is supporting women through health challenges like Candida overgrowth so they can overcome them and get on with the stuff that really matters in life!

If you want to learn more, book a free 15 minute consult with my team by clicking here. 

Testing For Candida Overgrowth

“Don’t guess, test” is one of my mantras for life.

There are some instances where guessing is perfectly fine  – but when it comes to something as vital as your health, why mess around??

Testing is more accurate and affordable than ever before. It ensures we know exactly what we’re dealing with – and aren’t wasting time, money, and energy on the wrong treatments.

With a condition as diverse as Candida overgrowth, testing is especially important. The same symptoms could be caused by hormone imbalances, gut dysbiosis, HPA axis issue, SIBO and more… so bottom line: don’t guess, test!

In my clinic I use a few different tests (depending on the patient).

1. 1. Stool Tests – not all stool tests can pick up Candida, but advanced ones like the GI-Maps and Genova GI-Effects can. I like to order a comprehensive stool test on all my patients because it can reveal a ton about your overall health – not just candida!
   2. Organic Acids Panel – This test (I like the Organix test from Genova) looks for D-arabinitol, a specific marker for  invasive candidiasis. Some other organic acids panels look for arabinose as a marker instead, but I don’t like those, as they can easily give false positives based on what you’re eating. Organic acids tests are another of my favorite tests because of the breadth of information they can provide (and they’re totally non-invasive!)
   3. Blood testing – antibodies in your blood can show past or current level of candida overgrowth… but can’t tell you which. (I rarely use blood testing).
   4. Culture sample – you can take scrapings from the vaginal mucosa, vulva, oral cavity, etc and culture it to identify candida. (Again, I don’t usually use this testing myself). 

And this is important – be sure you test BEFORE you complete any treatment for candida. If you’ve recently treated candida, your test will probably come back negative – but that doesn’t mean you don’t have any remaining yeast – especially if it is invasive. 

Before You Go Any Further…

When you have Candida overgrowth, your white blood cells produce antibodies to fight the candida called IgE immunoglobulins, which also cause allergic reactions.

More IgE is made every time you have another yeast infection flare. When the IgE reacts against the Candida, it causes the release of histamine. Histamine makes your blood vessels dilate and can cause swelling, redness, itching, and burning (in super fun places like the vagina, sinus, and gut).

When you treat the candida, killing it causes the yeast to release antigens, causing an increase in IgE…  which means more histamine symptoms (itching, burning, redness). 

Basically – all of this was to say: you’re very likely to experience die-off symptoms when you treat candida! 

The bummer is that this WHOLE process weakens your immunity. The increased levels of histamine suppress your white blood cell mediated immunity and inhibit the production of T cells. 

This means that supporting your immune system during Candida treatment is absolutely necessary! You must protect and support immunity ON TOP of changing your diet, using antifungals, and doing leaky gut repair. 

Don’t forget your immune system in this process!

How I Treat Candida Overgrowth

Step #1: Clean Up Your Microbiome

Before you treat Candida, you need to clean up other gut infections. A stool test can identify which bacteria overgrowths or parasites you’re dealing with. If you don’t get a handle on this first, your Candida treatment won’t be effective!

Probiotics and prebiotics can also help. Lactobacilli bacteria can inhibit the growth of candida albicans (I like the Femecology formula by Vitanica). Both oral supplementation and vaginal use can help. 

 Step #2: Adapt Your Diet

Most people don’t need to go on a super-restrictive, very low-sugar diet – but most people do need to make SOME changes.

A yeast-free, carbohydrate restricted diet alone won’t cure candida overgrowth. In a study of those with chronic candida, diet and anti-fungals was shown to be the most effective treatment (compared to diet and antibiotics, or diet alone). In fact, antibiotics and diet combined had the WORST outcomes!

For my patients, I recommend:

• 80 grams or less of carbohydrates daily (avoiding refined and processed carbs entirely)
• Avoid dairy (except ghee, butter, and some cheeses)
• Avoid yeast in foods (like kombucha, alcohol, and apple cider vinegar)
• Avoid all refined sugar
• Avoid alcohol

Step #3: Antifungals

To get rid of Candida overgrowth, you must use an antifungal that can kill the yeast overgrowth. 

In certain cases, I have seen clients gain greater success by combining natural antifungals with prescription antifungals like Nystatin or Difllucan, for limited periods through the extended herbal treatment period. Nystatin is not absorbed outside of the gut (it is local, not systemic), so it’s a good choice. Most systemic antifungals (like Diflucan) can cause elevations in liver enzymes. If you’re using a systemic antifungal, you need to have liver testing before starting and every 2 weeks of treatment.

But there’s also plenty of evidence that Candida is becoming resistant to antifungal drugs – just like bacteria are becoming resistant to antibiotics. Yikes!

That’s why, I always use a well rounded botanical protocol alongside prescription antifungals to help prevent resistance. 

The 2 keys to remember when using natural products like garlic, caprylic acid, undecylenic acid, lauric acid from coconut, lactoferrin, propolis, specific enzymes, and essential oils like oregano and cinnamon:

• Treat long enough! 7-10 days of treatment is not enough. It might clear some symptoms – but you need at least 8 weeks of treatment (sometimes more) to truly clear Candida overgrowth.

• Use the right dosage! If you take natural products in the wrong amounts, you won’t only not get better – but you risk damaging your microbiome. Don’t mistakenly believe they are safe at any dose because they are natural–I’m looking at you, oregano! I highly recommend working with a professional (like me) to get the right doses.

Step #4: Hyphae Interrupters

Remember the “roots” Candida can grow called hyphae? A good Candida protocol should also include something to help hyphae release from the gut wall.

In my practice, I like to use undecylenic acid. It’s a fatty acid obtained from castor bean, and it helps disembed hyphae from the intestinal wall. 

Treating Tough Cases

Truthfully, I think every case of Candida is a “tough case.” Most of my patients need the specialized support I can provide after working with Candida overgrowth for years to get better. 

For those with repeat vaginal Candida, monthly mid-cycle treatment can help (alongside systemic treatment). We use vaginal treatments for 3 days, and often for 3 more days prior to the start of your period, for 3-9 months to help stop the yeast cycle.

And for those with a history of Candida, we take preventative measures if they have to use antibiotics, corticosteroids, PPIs, or are following an elemental diet (as a treatment for SIBO). Preventative antifungals can help keep Candida at bay!

Need Help With Candida?

We’ve covered a LOT in these 3 articles (make sure you read parts 1 and 2 as well!) and I know you might be feeling overwhelmed.

Are you uncertain if Candida overgrowth could be an issue for you? Not sure what the next step should be? I get it! 

My job as a clinician is to take all this complicated stuff and make it easy for you to get better. No more confusion, just results.

I’d love to work with you. Don’t be shy – book a free 15-minute consult with my team. It’s a no-obligation way to see if we can help you. I hope to chat with you soon!

In Part 1 of this series, I covered what Candida is (and isn’t) and how it could be present in your body. In Part 2, we’re going to cover the symptoms and root causes. Be sure to look for Part 3 (all about how I treat Candida in my practice!). 

Sugar cravings, brain fog, joint pain, fatigue… these are just some of the nonspecific symptoms often attributed to chronic Candida overgrowth. 

But the problem is these same, ambiguous symptoms can be caused by multiple conditions! So how do you know if a Candida diagnosis is really something you should pursue?

Today, I’m going to dig into the symptoms that send up red flags for Candida in my practice – and I promise, it’s a lot more than “exhausted mom craves dark chocolate before bed!”

I’m also going to talk about the risk factors and root causes that make a Candida overgrowth more likely.

Here, There, Everywhere: Candida Symptoms

The most striking characteristic of Candida is its complexity. While no two people with chronic Candida may have the *exact same* symptoms, they will all have a variety of seemingly unrelated symptoms – ranging from “annoying” to “life-altering.”

Here are just some of the places you might have Candida-related symptoms:

• Central nervous system,
• Gastrointestinal tract (digestive)
• Genitourinary tract
• Endocrine glands
• Skin
• Muscles and joints
• Respiratory system

How could one condition cause so many different symptoms?

How Candida Can Mess With Your Whole Body

This gets kind of complicated, so I’m going to try and make it as simple as possible to understand. 

Candida can produce acetaldehyde and ethanol (AKA the same compound we drink in alcohol!) when the yeast in the gut ferment sugar and carbs. In fact, Candida can produce so much ethanol, it can cause your blood alcohol level to rise and make you drunk. (This phenomenon is called Auto-Brewery Syndrome).

Then, when the ethanol or acetaldehyde is oxidized, it requires that Nicotinamide adenine dinucleotide (NAD) be changed from its oxidized form (NAD+) to its reduced form (NADH). It’s basically like drinking a 6-pack daily – but without the fun part! 

(You may have heard about NAD as an anti-aging supplement. NAD is a really important cofactor and levels reduce over time, as we age. Some promising research suggests that raising NAD levels can reverse mitochondrial damage – aka the effects of aging!)

OK, here’s what all this means: chronic Candida causes the production of a bunch of alcohol inside your body. To get rid of the alcohol, NAD+ is converted to NADH. Over time, this leads to lower levels of NAD+ in the body – and that can lead to a cascade of symptoms.

Low NAD+ levels are linked to chronic illnesses like diabetes, heart disease, Alzheimer’s vision loss, and premature aging. Higher levels of NADH can lead to less mitochondrial energy production, lower levels of serotonin, and problems metabolizing proteins, fats, and carbs. 

But that’s not all…

Acetaldehyde produced by Candida can also impact the membranes inside your body. Membranes are the outer layers of cells and act as “gatekeepers” of your cells – keeping bad stuff out, letting good stuff in, and transmitting messages. 

When this happens to the cells in your gut, you develop “leaky gut” – aka increased intestinal permeability. Leaky gut causes by Candida can further complicate the symptoms caused by Candida.

If You Have Candida, You Might Also Have…

Here are some of the most common symptoms of Candida I see in my clinic:

• Sugar cravings – yes, this one is “overplayed” but real! Candida will send signals along the gut-brain axis to make you crave more sugar. 

• Allergies – Candida releases chemical mediators like histamine, leukotrienes, and prostaglandins that all lower your body’s white blood cells’ effectiveness. You might have rhinitis, chronic hives (urticaria), or asthma. Candida can also cause chronic stuffiness. 

• Inflammatory Bowel Disease – individuals with high Candida burdens appear to be more prone to intestinal inflammatory diseases.
• Carpal Tunnel Syndrome – this occurs as an effect of acetaldehyde.

• Formaldehyde Sensitivity – formaldehyde is processed through the same detox pathways as acetaldehyde, and with that system overburdened, you may have trouble detoxing formaldehyde. 

• Histamine sensitivity and intolerance – again, histamines are processed through same detox pathways as acetaldehyde. This can lead to food intolerances, rashes, and hives. 

• Central Nervous System Symptoms – especially common is trouble with short-term memory, a result of acetaldehyde lowering the availability of acetylcholine (an important neurotransmitter)

• Rashes – dermatitis, psoriasis, eczema, hives, jock itch, diaper rash are all common symptoms. Especially on nails, in skin folds, and in the area of the groin or genitals. 

Root Causes & Risk Factors for Candida

There’s no way I could cover every potential symptom of Candida, but if you read anything on the above list that was a little too familiar, keep on reading.

Now it’s time to talk about the most common risk factors and underlying causes for Candida overgrowth.

This is a BIG list, but I’m taking the time to write them all out because most people have multiple predisposing factors – and for each one you have, the likelihood of Candida becoming a problem for you increases. 

Risk factors are cumulative. That means, the more times you take antibiotics (for example), the more the ratio between opportunistic yeast and good bacteria shifts. Eventually, Candida levels will rise above a threshold and symptoms develop. 

#1: Antibiotics or Steroid Use

The number one cause of Candida overgrowth is prolonged use of antibiotics (especially broad spectrum). The worst offenders are penicillin, clindamycin, vancomycin, metronidazole, Cipro, keflex, zithromax, augmentin, bactrim and erythromycin. 

These drugs kill both aerobic bacteria and anaerobic bacteria. Anaerobes help prevent yeast colonization by inhibiting the ability of Candida to adhere to the gut wall. They can also lead to decreased digestive secretions and altered pH.  

Corticosteroids work by suppressing the immune system, so it’s understandable why can predispose to yeast! 

#2: Hormone Changes

Any change in hormone levels put you an increased risk for Candida overgrowth:

• • Oral contraceptive use has been shown to increase Candida in the oral microbiome , which leads to the gut (in fact, studies show that just brushing teeth 3 x daily reduced levels of Candida in the stool!)
  • Estrogen replacement therapy (for any reason)
  • Pregnancy not only causes increased levels of estrogen – but also causes natural immunosuppression and increased cortisol levels to keep the mother’s immune system from attacking the fetus. This creates an ideal environment for Candida to take hold!

#3: Diet

Candida thrives on a diet rich in glucose – the simple sugar found in foods like bread, pasta, and refined sugar. Dietary glucose is necessary to start the process of candida invading tissues.

But please know: this doesn’t mean the answer to Candida is simply a zero-sugar diet! More on this in Part 3!

Diabetes and high blood sugar also put you at increased risk for Candida overgrowth.

Finally, alcoholism – or even just frequent alcohol use – increases risk of Candida. Beer, wine, and other fermented alcohols promote Candida colonization, and all alcohol inflames the gut lining, making you more prone to inflammation, dysbiosis, and leaky gut.

In those already genetically prone to alcoholism, research has suggested that Candida overgrowth (and the Auto-Brewery syndrome it can cause) can even lead to a Candida-perpetuated form of alcoholism.  (Other research has also established the connection between intestinal fungal overgrowth and alcoholic liver disease.)

#4: Nutrient Deficiency

Nutrient deficiency goes hand-in-hand with some of the other risk factors listed here. Low stomach acid (which can be caused by antibiotic use, stress, antacids, or PPI drugs) can cause incomplete digestion of the food you eat. 

Poor diet (like too much sugar or refined carbs, and not enough fruits and veggies) can lead to nutrient deficiency, too. 

Iron, zinc, and biotin deficiency are all risk factors. Both too much and too little iron (anemia) can predispose you to Candida. Iron stimulates yeast overgrowth, but low iron can interfere with the white blood cell’s ability to function and fight infection.

#5: Environmental Factors

Pesticides like glyphosate have been shown to disrupt the microbiome, reducing beneficial bacteria that help to protect you from Candida overgrowth. 

High levels of stress dysregulate the HPA Axis, and can cause abnormally low or high cortisol levels. We know stress is associated with an increased risk of vaginal Candida – and I suspect if we studied it, we’d find it also tracks with gut Candida.

#6: Gut Health

If you already have altered bowel flora – aka dysbiosis – you’re at increased risk for Candida. 

Overgrowths of H. pylori and Streptococcus facilitate Candida overgrowth. 

This is why it’s so important to treat those other bacterial overgrowths and gut dysbiosis alongside Candida. If you’re trying to clear Candida without addressing overall gut health, it’s like chasing your own tail! (More to come on this topic in Part 3). 

#7: Impaired Immunity or Underlying Disease States

If you have Candida, overgrowth, it’s a major sign your immunity is decreased. Likewise, if you have known decreased immunity, you’re at increased risk of Candida. 

Conditions like thyroid dysfunction and diabetes can also predispose you to Candida overgrowth. 

Start Counting…

Most people have multiple risk factors and symptoms for Candida overgrowth. If you count up all your symptoms and potential risk factors, what number do you come up with?

If you have more than one or two, be sure you read Part 3 of this series, where we’re going to discuss how you can find out if you actually have Candida overgrowth – and if you do, what to do about it!

I’ll share the tests and protocols I use with patients in my own practice – so don’t miss Part 3!

Depending on who you ask, Candida overgrowth is either entirely made up or the root of all disease. 

Some experts claim as much as 90% of people have chronic candida overgrowth and it causes a gamut of health issues from weight gain to cancer. Others say it’s only an issue in acute cases like oral thrush or vaginal yeast infections (which can be easily treated and eradicated). 

So what’s the truth?

As with most things, the truth is somewhere in the middle. Chronic candida is a research-backed condition, but that doesn’t mean everything you’ve heard about it is true. 

As a functional medicine practitioner, I’m interested equally in what the research has shown and what my patients are experiencing. In this series, I’m going to share everything I know—both from research and anecdotal experience—about candida overgrowth with you. 

This will be a multi-part blog post. Today, we’re going to focus on what Candida is (and isn’t) and how it presents.

Part 1: What The Heck Is Candida?

First of all, you need to know that 99% percent of the time, when you hear “Candida,” it refers to Candida albicans. 

Other species do exist (C. glabrata, C. krusei, C. tropicalis and C. parapsilosis for example) but C. albicans is the most common. For the rest of this post, know that I’m talking about C. albicans when I say “Candida.”

OK—moving on.

Candida is normally a commensal fungus that lives in your oral, gastrointestinal, and genital tracts and is part of the “world of microorganisms” that live inside your body and make up the microbiome. 

“Commensal” means that Candida gets nutrients from you without causing any harm. Your body recognizes the Candida as a “friendly” fungus and doesn’t mount an immune response against it. 

As a commensal fungus, Candida is very common: approximately 80% of healthy people have commensal Candida living in their mouths, guts, and vaginas. In fact, it’s completely normal for Candida colonization of the vagina to increase in puberty as hormonal shifts make the vagina even more hospitable to fungal growth.

The main point is: Candida isn’t all bad! For most people, it’s just part of a healthy microbiome.

But that can change when Candida shifts from “commensal” to “pathogenic.” 

Here’s What Happens When Candida Breaks Bad

Under specific conditions, Candida can shift from it’s normal commensal state to a pathogenic state, overgrow, and cause symptoms. 

This happens in two ways:

#1 Candida Changes Form

Under certain circumstances (like a change in temperature or acidity) Candida can go through a process called “morphogenesis” and change form from one your body recognizes as friendly to one it sees as an enemy. The result is an immune response from your body toward the new form of candida. This is also when candida can grow “roots” – aka hyphae – and start burrowing into intracellular space. 

#2 Your Body Starts Reacting To Candida

The Candida doesn’t always have to change form for a response to happen. In vulvovaginal candidiasis (vaginal yeast infection), the Candida that’s normally present in the vagina doesn’t necessarily change form (although that can also happen) – but the tissue of the vagina creates an immune response against the Candida. 

This means that the symptoms are caused both by Candida changing form AND your body changing how it reacts to the Candida. 

Acute vs. Chronic Candida Overgrowth

Acute Candida overgrowth is called candidiasis. This is the typical vaginal yeast infection or oral thrush, but can also cause infections in the esophagus and intestines. 

The acute form results in an overgrowth of yeast on mucosal surfaces (like your mouth and vagina), but that’s not all. During active infection, Candida can grow hyphae, which are like roots that can burrow into intracellular spaces. With hyphae, Candida can invade deeper tissues and grow inside the epithelial cells. There, they release products of fermentation and enzymes that kill the tissue cells. The result are the white patches that characterize candidiasis (the white is actually dead cells, not clumps of Candida colonies!).

Acute candidiasis is often treated with a short course of antifungal drugs or herbals. But if the treatment is incomplete, the yeast in the epithelial cells won’t be totally eradicated… leading to chronic Candida overgrowth symptoms. 

In the chronic form, the Candida is inside the epithelial cells, instead of just on the surface of the cells. The yeast is “dormant” but still releasing antigens that trigger inflammation, and can result in red and inflamed tissues. 

The low-grade inflammation caused by chronic Candida can cause pain, tenderness, burning, and more. This is especially common with vaginal yeast infections.

A Closer Look At Vaginal Yeast Infections

About 75% of women will be diagnosed with a vaginal yeast infection at least once in their lives, and Candida is the cause of about 40% of all vaginitis cases. A vaginal yeast infection is probably the most common type of acute Candida overgrowth or candidiasis. 

They’re most common in women of reproductive age because they have higher estrogen levels – and estrogen promotes yeast in the vaginal tissues. (Side note: this is also why oral contraceptives increase your risk of yeast infections—they contain synthetic estrogen. More on this to come!)

The symptoms are all too familiar to most women: Itching, redness, burning, white discharge, painful intercourse, yeasty odor, and painful intercourse from tissue irritation. It can also lead to vaginitis and urinary tract infections (UTIs). 

The worst part, however, is that yeast infections can become a vicious cycle for women, as the antibiotics used to treat UTIs and vaginitis make women MORE susceptible to yeast infections recurring. 

We know that repeat infections can lead to vulvodynia (vaginal pain and tissue irritation) that makes sex painful and everyday activities (like wearing yoga pants and using tampons) uncomfortable. The vulvodynia may very well be caused by the low-grade inflammation of chronic Candida leading to irritated vaginal tissue cells. 

But complications from vaginal yeast infections are just one way candida overgrowth can impact your life. 

In Part 2 of this series, I’m going to dig into the symptoms chronic candida can cause—and I’m going wayyy beyond just “sugar cravings!” You’ll also learn what the risk factors and predisposing conditions for Candida are. 

Recap: Candida Overgrowth

Because this is  an intense topic, I want to give a really quick recap before we wrap up this first part of the series.

Here are the main points:

• “Candida” usually refers to Candida albicans
• Candida is a normal, healthy yeast (type of fungus) that lives in about 80% of peoples’ microbiomes
• In certain circumstances, candida can overgrow and change form, causing two types of Candida overgrowth problems:
  • #1 Acute Candida Infections – like vaginal yeast infections and oral thrush 
  • #2 Chronic Candida Overgrowth – low-level, long-lasting candida overgrowth, often a result of incomplete treatment of an acute infection

OK—that’s all for now! I’ll see you back here for Part 2, where we’ll go over the symptoms and root causes of Candida overgrowth in-depth!