I would like to ask about chronic vaginal yeast infections. Client is 25 years old, has chronic vaginal yeast infections for the past three years since moving to Vancouver Island from Alberta. She says she gets about one per month, but they don’t correlate with her cycle. She eats bread daily or nearly daily. She also drinks beer on the weekends. She’s a pescatarian. She has started taking probiotics, but they’ve had no effect. I suggested she cut bread and limit beer. I’m wondering if doing a gut workup is called for here, although I’m pretty sure she doesn’t have the funds to pay for all the testing. Do chronic vaginal yeast infections point to yeast overgrowth in the gut or elsewhere in the body? Please give me any info you can on treatment of chronic yeast infections.

Chris Kresser: Yeah, absolutely. This fits in with what I was just saying about the connection between the oral microbiome and the gut microbiome. We know that there’s a nasal microbiome, there’s a skin microbiome, there’s most certainly a vaginal microbiome, and they’re all connected. When we see disruption in one area, we often see disruption in another area.

Just a few interesting examples: In the chronic inflammatory response syndrome methodology or model for looking at biotoxin and mold-related illness, lately there’s been a lot of discussion about how multiple antibiotic-resistant coagulase-negative staph, or MARCoNS, that we typically measure for in the nasal cavity, can also occur in the mouth when there is a cavitation. And in patients who either don’t respond to the treatment for nasal MARCoNS or do respond but then have a recurrence of MARCoNS, Shoemaker and others have suggested looking for a dental source of MARCoNS that could be a reservoir for MARCoNS in the body. That’s an example of how the nasal and oral microbiome can be connected.

Then I definitely have many cases of women who have recurrent vaginal yeast infections or disrupted vaginal microbiome, and then we test their gut, and sure enough, they have fungal overgrowth and other disruptions in their gut microbiome. And the same oral antimicrobial protocol that works for fungal overgrowth and dysbiosis in the gut often tends to work for dysbiosis in the vaginal microbiome.

Having said that, there are some specific probiotics that have shown to be beneficial for the vaginal microbiome, and then there are delivery mechanisms like doing probiotic douches and more directly implanting the probiotics into the vagina and addressing it that way rather than just … not rather than, but in addition to taking oral antimicrobials and probiotics. Hopefully that gets you started on the right track. Definitely given her diet, I think it’s entirely likely that that’s what’s happening. So in addition to her changing her diet, doing some of the testing if you can swing it and the antimicrobial protocol would be good.

Dr. Danenberg points out that the connection in all of these cases is bidirectional. The gut microbiome can change the homeostatic balance of bacteria, he says, in dental plaque, creating a vicious cycle. There are some great peer-reviewed papers on this in PubMed, which I’m sure Dr. Danenberg would be willing to post to the Facebook group, and he has done some very interesting research within his own clinic in this area, so he’s a great source for anyone who’s interested in this.

I think it is a relatively unexplored aspect of health, and I was just mentioning the dental and nasal MARCoNS. There’s already a ton of research connecting periodontal infections with cardiovascular disease and other systemic health problems, and I think in some cases of chronic illness, what we’re going to find is that dental infections are the source in some of these cases, and that’s why these patients are going for years and years and not getting well. We always have to remember that the connection here is bidirectional. The mouth can affect the gut; the gut can affect the mouth. The gut can affect the brain; the brain can affect the gut. It’s really what most traditional systems of medicine have understood for hundreds or thousands of years, and it’s only recently that conventional Western allopathic medicine is coming around to that fundamental paradigm shift.