I noticed that when you and Chris talk about doing approaches for fungal treatment, you don’t talk about a restricted candida type diet. Do you ever use restricted diets like this when treating fungal overgrowth? On the same topic, some other practitioners I know think that when yeast show up on the stool test even to a mild degree that there’s a likelihood it could be deeply entrenched yeasting candida that doesn’t slough off into this. Oh, let’s see, there’s a likelihood it could be deeply entrenched that doesn’t slough off into the stool and should be treated aggressively. What do you think about this?

Dr. Amy Nett:  Okay, so a couple things. Candida diet. So there is quite, candida diets I think became pretty popular and probably made some people a lot of money. I don’t know that there’s something to these candida diets that that sort of thing, because I’m seeking quite a few different variants on them and some of them are completely restricting sugars and most carbohydrates. So I’ve had some patients who have said, “Oh I’m following a candida diet.” And then they basically end up on a ketogenic diet, and I think Paul Jaminet Perfect Health Diet has said that in his opinion, ketones potentially can feed yeast. So in general I, would say fungal overgrowth can be difficult to treat. We normally use a standard Paleo diet. Of course when we’re recommending a Paleo diet, we’re pretty much recommending a low-sugar diet. So in that sense, maybe it’s kind of a candida diet, but I wouldn’t limit carbohydrates otherwise. And I would really worry about limiting prebiotics, limiting carbohydrate sources. So no, we really don’t do any sort of specific fungal overgrowth diet. We generally just go with a standard Paleo diet.

And then your question about whether or not the yeast is deeply entrenched, so this is a great question, and partly because there I think there are two ways to think about this. If you see some yeast on a stool test, remember, yeast is a completely normal part of our GI microbiome. So we should have some yeast. And then I think what you’re saying is, could we be getting to some extent maybe a false-negative test result? Again, we say oh, there’s just rare yeast on the stool test. Is it possible that, for whatever reason there is yeast within the colon we’re not seeing the degree of overgrowth or the degree to which the yeast is populating the colon? And so it really would be considered an overgrowth. We’re just not seen that on the test result. And should we therefore be treating things more aggressively?

So, and that’s a good question. I don’t have a good answer to that. I want to say in our practice, we probably have three or four patients with yeast infections, like chronic GI yeast that comes up almost every time on a stool test. On one of the patients, she also had SIBO, so we tried an elemental diet and she had white coating on her tongue within two days; she has toenail fungus that we can’t get rid of. So I think there are some people who really struggle with yeast overgrowth, and I’m not sure why that is. And maybe it is that there are some types of yeast that are deeply entrenched within the stool, or within the colon, I should say. So I think it’s a great question. I don’t have a good answer. But it is. It’s an interesting point and maybe it explains why sometimes yeast can be so difficult to treat or why our GI treatments may not be as effective. Maybe it’s because there’s more yeast there than we realize is potentially what you’re saying. So, great question. We’ll have to see what research comes out for that.