How metabolic testing takes the guesswork out of candida diagnosis

From a naturopath’s point of view, the digestive tract is considered the cause of many health issues, not just those related to digestion.

Aching muscles, fluid retention, weight gain, slowed metabolism, joint pains, concentration, headaches and skin problems as well as depression can have their source in the gut.

One of the principles of naturopathic medicine is to find the underlying cause of a problem in order to get the best result long term. You can’t do that if you don’t know what the cause is. This article will explain how we were able to accurately identify a common G.I. infection caused by a yeast called Candida albicans.

The gut’s connection to other health issues

I recently saw Helen, a patient who had been suffering from chronic fatigue for six years. She had gone through all the medical tests: hormonal, blood, etc. but no cause had been identified.

Although Helen was naturally a positive person, she was suffering from depression and postpartum. Her body often ached, especially her muscles, making exercise nearly impossible and as a result she had become overweight. It was clear that something was affecting Helen’s overall health – and it seemed Helen’s digestion was the root cause, as there was bloating and discomfort too. I wondered about allergies and whether there were any infections in her intestines causing her symptoms.

After a long struggle, Helen was keen to find the underlying cause. We did a blood test to look for food intolerances and a urine test called the Organic Acids Test (OAT).

The OAT test looks for yeast and fungal toxins as well as waste products of metabolism, giving a wider view of her internal functions.

When the results arrived, Helen had no food intolerances or allergies at all, which was unexpected. However, her urine test revealed the underlying issues: she was overwhelmed with toxins produced by yeast in her intestines. See her result here.

The usual Candida yeast sufferer has two or so of these toxins elevated. In Helen’s case: seven yeast toxins, several at extreme levels were causing her fatigue and mood disorders. Helen’s report was the worst I’ve seen and her ability to cope well regardless was owed to her positive spirit. If you look at the report 8 of the 9 yeast and fungal markers listed were elevated, some hundreds of times higher than normal.

It turned out Helen’s kitchen was very moldy, especially in the fan system in the kitchen. Some of the fungal toxins identified in her OAT test (listed as 2, 3 and 4 on the report) were probably signs of black mould, Aspergillus, which she had been breathing in while cooking.

The markers 6 (tartaric) and 7 (arabinose) are the ones that Candida produces.

So Helen had a yeast infection from household mould exposure, as well as Candida growing in her gut. All these fungal toxins were putting a tremendous load on her system.

Other findings from her Organic Acids Test showed her energy producing metabolism was messed up, with high levels of lactic acid, which were causing her muscle aches and low tolerance to exercise.

Other parts of her test identified abnormalities in her feelgood neurotransmitters like serotonin. Gut infections cause a drop in serotonin, causing secondary anxiety, and possibly depression.

Helen’s case gives a clear insight into how gut infections can have metabolic effects, manifesting as many other symptoms seemingly unrelated to the gut.

Metabolic testing takes out the guesswork

The Organic Acid Test was able to help us in getting an accurate diagnosis for Helen. It is a urine test that provides a snapshot of the metabolism based on the byproducts the body discards through the urine. These discarded organic acid molecules indicate disorders of metabolism including energy production, the presence of yeast (Candida) or bacterial overgrowth in the gut leading to toxicity and many other issues.

As Candida infections can be hard to identify—Helen had no outward signs of yeast infections at all—it is an accurate way to be certain of the issue, since the yeast has to be alive and active to produce the yeast toxins. In the case of Candida, tartaric and arabinose are key markers. The same test can also point us to bacterial infections in the gut, which were only mildly elevated in Helen’s case.

Abnormally high levels of these intestinal microorganisms can cause or worsen behaviour disorders, hyperactivity, depression, attention deficits, concentration issues, muscle pain, some movement disorders, fatigue and immune dysfunction.

Many people with chronic illnesses and neurological disorders often excrete several abnormal organic acids. The cause of these high levels could include: oral antibiotic use, high sugar diets, immune deficiencies, gluten intolerance, and genetic factors.

This one simple urine test can reveal:

• High levels of intestinal yeast (Candida) overgrowth
• High levels of bacteria and other toxins in the gut
• Evaluation of the integrity of intestinal wall for leaky gut
• Assessment of neurotransmitter levels relevant to anxiety, addiction or depression
• Assessment of central nervous system function for inflammation
• Evaluation of energy production by the mitochondria
• Detection of nutritional and antioxidant deficiencies
• Determining problems in fatty acid metabolism

On the first page of the sample report you will see “Yeast and Fungal Markers” and “Malabsorption and Bacterial Markers”.

The sample report shows a yeast clearly, due to elevated levels of tartaric and arabinose. Tartaric will cause fatigue and muscle weakness or pain, while arabinose causes attention and concentration issues, interfering with normal brain chemistry and affecting moods.

A patient with a report like this could be classified as suffering  from “Gut and Psychology Syndrome” or GAPS for short. 

Who is the OAT useful for?

I recommend the OAT as an initial screening test, especially for the following:

• ADD/ADHD
• Fatigue
• Anxiety
• Asperger’s Syndrome
• Autism
• Chronic Fatigue
• Colitis and Crohn’s Disease
• Depression
• Fibromyalgia
• Gastrointestinal disorders, Irritable Bowel Syndrome, diarrhoea or constipation
• Learning disabilities
• Movement disorders – including muscle pain and muscle fatigue
• Multiple Sclerosis
• Obsessive Compulsive Disorder
• Recurrent infections such as cystitis or sinusitis
• Tic disorders and Tourette’s Syndrome
• Common symptoms indicating gut infections which include: gas, bloating, abdominal discomfort, diarrhoea or constipation, anal fistula, steatorrhea or floating smelly stools, weight loss
• Micronutrient deficiencies – especially vitamin B12 and folate 

Organic Acid Test – A Few Markers Explained

Arabinose
A yeast metabolite that causes functional Vitamin B deficiencies, affecting the brain, nerves (neurotransmitters) and energy production. Depletes the cellular defence systems (enzymes such as glutathione and SOD) causing increased and multiple chemical sensitivities. Interferes with normal sugar metabolism.

4-Cresol
Indicates a possible overgrowth of bad gut bacteria that are p-cresol producers, like Clostridia. 4-Cresol levels are higher in children with autism. High-potency multi-strain probiotics may help rebalance GI flora.

DHPPA
Harmless or beneficial bacteria mediate the breakdown of chlorogenic acid to 3,4-dihydroxyphenylpropionic acid (DHPPA). High values of DHPPA are associated with increased amounts of good bacteria in the gastrointestinal tract.

5-Hydroxyindoleacetic (5-HIAA)
Gives indication of serotonin levels in the body

Quinolinic Acid
This acid derived from the amino acid tryptophan and can be neurotoxic at high levels. Quinolinic acid can over stimulate nerve cells, causing the cells to die. Brain toxicity due to this acid has been implicated in Alzheimer’s disease, autism, Huntington’s disease, stroke, dementia, depression, HIV-associated dementia, and schizophrenia.

Quinolinic Acid/5-HIAA Ratio
A high ratio of quinolinic acid to the metabolite 5-hydoxyindole-acetic acid indicates excessive inflammation, which will age and damage the brain. High levels of these markers could be due to recurrent infections, including persistent infections in the gut, immune overstimulation, excessive tryptophan intake, excessive adrenal production of cortisol (stress), sleep deprivation, and frequent exposure to phthalates (chemical used in plastics and many household items).

Malic Acid
When malic acid is elevated simultaneously with citric, fumaric, and alpha-ketoglutaric acids, it may cause Cytochrome C Oxidase deficiency, a metabolic disorder disrupting mitochondrial function and energy production.

Tartaric acid
Tartaric acid and other yeast byproducts are elevated in urine samples of adults with fibromyalgia, a debilitating disease associated with muscle and joint pain, depression, foggy thinking, and chronic fatigue. The tartaric acid made by Candida has the ability to cause sugar cravings and low blood sugar levels by blocking the Krebbs Cycle for energy production in our cells.

Uracil

Indicates folate deficiency.

Methylmalonic

Indicates Vitamin B12 deficiency.

Could the OAT test reveal what the root of your symptoms are?

Living with daily symptoms like fatigue shouldn’t be your normal. Our naturopaths can assess your symptoms and point you towards the right test to pinpoint the root cause of your health concerns.