Thrush: Can your diet make a difference?
It may not be a pleasant thought but your body, inside and out, is literally teeming with billions of microorganisms – some good, some not so good.
Some are bacteria and some are fungi. While they are in balance, there’s no issue, but when they get out of balance they can cause irritating conditions like thrush.
Thrush can occur in a number of places including your mouth and vagina – and when it’s down there it can be very irritating indeed.
Candida albicans is the fungus behind thrush. According to the Centers for Disease Control and Prevention there are various things that can cause an overgrowth of this yeast including:
- a compromised immune system
- a change in vaginal pH (which is why menopausal women may have it more often as decreased oestrogen can cause a change in the pH which allows for an overgrowth)
- having recently taken antibiotics (they can knock out the good bacteria and fungi that keep the others in balance)
- high levels of oestrogen (which is why pregnant women often get it)
- having poorly controlled diabetes.
So, how to prevent it or get rid of it? Unfortunately social media carries a myriad of suggestions on how to deal with things when they go wrong, many of which involve changes to your diet.
There’s even a specific diet called the Candida Diet that advocates cutting out sugar and carbs (including many fruits), yeast, refined carbohydrates, dairy, red meat and shellfish. Some diets they suggest adding probiotics could help.
Is there any evidence?
But is there any evidence to suggest these changes can help?
While it may be good advice generally to reduce refined sugars or excessive simple carbohydrates like white bread and pasta in your diet – and it may even be logical to think that eating sugar will feed candida overgrowth – but is it actually the case?
The problem is that this sugar isn’t making it to the vagina where the candida is sitting – so changing your diet to reduce or prevent infections is unlikely to work.
But, what about people with diabetes? They have difficulty with their blood sugar levels and are more prone to thrush infections – so surely the argument holds water?
Diabetes is a disease characterised by an abnormal increase in blood sugar (glucose). While yeast is not typically found in the bloodstream (with the exception of invasive candidiasis a compromised immune system), any rise in blood sugar can alter the glucose concentration in the mouth and vagina, helping yeast grow.
With that said, thrush in people with diabetes is driven by uncontrolled blood sugar levels due to insufficient production of insulin and/or insulin resistance. For those of us who aren’t diabetic this is not an issue.
The other thing these diets often suggest is cutting out beer or anything that contains yeast. Again the chances of these yeasts reaching your vagina are very slim and, the type of yeast used in beer and bread is not the same as the one that causes thrush.
Diet experts consistently say having a healthy diet with a wide range of food groups is essential to a healthy immune system, and cutting out whole food groups especially fruit and vegetables is not recommended. And there are studies that show that the incidence of oral thrush may be reduced by fructose intake (the sugar found in fruit).
There is very little evidence however to support the idea of cutting sugars in the diet to reduce the risk of thrush developing thrush.
The flip side of this is upping your intake of probiotics – orally or vaginally with a lactobacillus pessary.
Probiotics are great for gut health and play an important role in vaginal health but oral consumption has not been shown to improve vaginal levels as it passes through the gut and doesn’t get to the vaginal. Vaginal pessaries used in the short term have been shown to improve thrush symptoms when combined with conventional antifungal treatments. There is in general not great evidence to support their use to prevent recurrence beyond one month according to a Cochrane review, mainly due to the lack of good quality studies.
The take home message?
While it’s a good idea to limit refined sugars and have a low GI diet in general, cutting food groups is not recommended and shouldn’t be relied on to reduce your incidence of thrush or to cure it.
If you have repeated bouts of thrush see your doctor to rule out other causes and make sure you’re getting the best treatment for you.