[It’s not a dietary prison sentence! Here are just some of the foods you can eat in Stage 1 of the diet. All recipes are on this blog. Clockwise from top: Kale Salad, Fully Loaded; Black Bean Fudge; Mixed Grains and Veggie Bowl; Grain-Free Coconut Flour Biscuits; Sweet Potato Rounds with Sweet Almond Sauce; and High Protein Snackin’ Orbs (two flavor variations).]
After starting to chronicle my personal struggle with Candida Related Complex (CRC, or just plain “candida”) in March, 2009 and living on some form of the diet since then, I put together this FAQ page to answer the dozens of questions from blog readers and others who have either been diagnosed with CRC themselves or believe they are also dealing with candida symptoms. If you’re not sure where to begin, start here.
Q What is Candida Related Complex (CRC)?
CRC is a condition that arises when someone has an overgrowth of yeast (usually candida albicans) in the body. Although candida usually coexists peacefully with other “good” bacteria in our digestive tracts and on our skin (it’s everywhere all the time) with no ill effects, when it has the opportunity to grow out of control, it can wreak havoc and cause a plethora of symptoms.
Q What is the anti-candida diet (ACD)?
The anti-candida diet (ACD) is a diet specifically designed to reduce the amount of candida yeast (or candida albicans) in the body. In general, the diet is designed to drastically reduce the amount of yeast by depriving it of foods upon which it feeds (mostly sugary foods or foods that break down into sugars; moldy foods; or yeasty foods); by killing the excess yeast directly (with supplements, creams, prescription medications or other treatments); and by detoxifying the body to clear away any excess candida or destroyed candida organism; and by strengthening the immune system as a safeguard against excess candida (more on the specific diet I follow below).
Q What causes Candida Related Complex (or CRC), an overgrowth of candida?
Candida is a type of fungus, and, like all fungi, it thrives in dark, moist, warm environments. It also loves to feed on sugars of all kinds. If, for some reason, your immune system has been compromised and your body is no longer able to keep a balance between candida and “friendly” bacteria; if you’ve taken several courses of antibiotics (which kill off those friendly bacteria and allow yeast to proliferate); if you have consumed large amounts of sugars (which feed the yeast) or refined carbohydrates (which convert to sugar very quickly) over the years; if you have allergies or poor digestion; if you get stressed a lot or easily; if you’ve been on birth control pills or other drugs for any length of time–then you are more susceptible to candida than an average, healthy person.
When the internal environment (or “terrain”) in the body favors candida, it will swoop in and grow out of control. Couple this with an external environment that encourages candida (such as hot, humid weather or sweaty skin), and candida is ready to throw a party. But it can be treated and put in its place once again!
Q What are the symptoms of candida?
The most common symptoms include recurrent vaginal yeast infections; oral yeast infections (thrush); overweaning fatigue; “foggy brain” (the inability to focus or concentrate–as if you are looking at the world through a “fog”); poor concentration or memory; sugar or carb cravings; anxiety; allergies; fuzzy thinking; headaches; skin rashes; sleep disturbances; sinus problems (especially sinus infections); weight gain; and more. Because many of the symptoms are vague or common to other disorders as well, it’s always best to be diagnosed by a health care provider (though most conventional doctors don’t believe in candida; I see both a naturopath and a holistically-minded MD).
Q How Can I Tell if I Have CRC?
Because everyone has candida albicans in and on their bodies all the time, it’s very difficult to tell if you “have” candida; there are various tests to determine whether you have a candida overgrowth, including a stool analysis, blood test, and what’s called lsls acids test (which looks at products of candida in the urine). However, none of these is 100% accurate. For that reason, most practitioners use what’s called a clinical diagnosis, looking at the symptoms and subjective experience of the person they’re testing. Many will use a questionnaire as well to examine symptoms, past health history, history of medications, and other factors. In our upcoming book, Living Candida-Free, Andrea Nakayama has devised an extensive questionnaire that can help you assess whether you have a candida overgrowth, and how serious it is.
Q Which diet did you follow?
I started the ACD for the second time in March, 2009. Back in 1999, I was on the diet for two years; at that time, I followed exactly what my naturopath prescribed, a specially tailored ACD just for me. This time round, I mostly followed a combination of diets: one that my naturopath recommended, with elements of diets I found in other books on candida and online. I also wrote more about my diet here . (I also discuss the general dietary principles I follow in this post.) As of January, 2015, you’ll be able to read the complete, detailed dietary protocol I followed and then fine-tuned with my colleague, Andrea Nakayama, in my book Living Candida-Free.
However, if you do any research about the ACD, you will find that there are almost as many diets as there are people with candida. Each individual is different, and you won’t know exactly what works for you until you start the diet and see how it affects your symptoms. For that reason, the diet we include in the book offers different variations so that people can adapt the diet to what suits them best.
Here’s what I did this last time round:
Stage One (the first 4-6 months): I followed a very strict no-sugar, no-fruit, veggie-full, most nuts and seeds (though never peanuts or pistachios), light on gluten-free grains and legumes, as prescribed by my naturopath, to a tee; no diversions. For me, following the diet exactly as prescribed and never cheating (I can’t stress that point enough!) was crucial to my success. It took almost 6 months for me to see any progress at all, but I knew from previous experience that cheating would only prolong the suffering.
Stage Two: (6-8 months): I moved to Stage 2 of the diet, again adapting to my own needs and body’s reactions, under the guidance of my naturopath. I brought in additional nuts (including the occasional cashews) as well as apple cider vinegar, not advocated by some ACDs, but considered helpful according to many others. I also ate tofu or tempeh on occasion (again, not all ACDs will recommend it). I allowed one non-sweet fruit a day and also brought some gluten free flours into my life (just the grain-based ones, not the starches).
Stage Three (12+ months): At this stage, I allowed myself the occasional low-glycemic sweetener (such as coconut sugar or agave nectar [but note that agave is now considered a bad choice for the ACD]) in baked goods. I also bake with the occasional starch (such as tapioca, arrowroot or potato starch) as well as regular gluten-free flours. And I’ve begun to use unsweetened chocolate in baking. I never (never, never, never) consume sugar, maple syrup, Sucanat or other high glycemic sweeteners, sweet dried fruits, tropical fruits, gluten, alcohol, fungus-laden foods such as mushrooms or peanuts, or yeasts of any kind.
I have added pineapple and papaya (both considered “safe” because they supply natural digestive enzymes that help you digest your meals). Although I wasn’t a huge drinker before the ACD, I find that I really do miss having the occasional glass of wine and my beloved Gin and Tonics in the summertime; I’m going to ask my naturopath when he thinks I might introduce a libation such as those back into the menu (if ever).
Maintenance: As I continue to live an anti-candida lifestyle, I know I’ll never again eat refined sugar or flour. On the rare occasion, however, (say, a birthday), I’ve allowed myself to eat something with maple syrup, or dates, or dried fruits. I seem to be okay having these very rarely. I also now allow balsamic vinegar in my diet, but again, only rarely (say, if we’re at a restaurant and I don’t want to ask for yet another special request!).
I also followed a naturopath-prescribed regimen to detox and get myself physically in better shape. This included daily sweating in an infrared sauna; oral chelation (heavy metal detox); supplements to cleanse both candida and parasites; and regular exercise. I have been attempting to bring back my former practice of daily meditation, but haven’t been quite successful at that so far. I’m working on a detox-related post and will link up to it as soon as it’s published.
Q What kind of reactions did you have to detoxing, if any?
I’ve done more than one detox, since I’ve been on the diet twice now (once starting in 1999, and once in 2009). The first time on the diet, I approached it entirely the wrong way–a sudden, massive change in diet paired with some very strong herbal supplements (prescribed by a naturopath). Naturally, I had a horrible detox reaction. The second time, in 2009, I eased into it, properly, and had virtually no “die-off” reaction. I describe my experiences in more detail in this post.
Q How long will it take to get better?
Every person is different, so it’s impossible to say how long it will take one individual versus another. It depends on the severity of your symptoms, how well you adhere to the diet, environmental factors, your body and metabolism, and probably another hundred or so factors about which I’m not knowledgeable.
For most people, a total of 2-3 months, moving from the most strict to a more relaxed stage of the diet, is usually sufficient to clear up the symptoms and return them to their normally healthy state. I do know that my case is highly atypical (lucky me!). It’s almost unheard of for someone to follow the strict diet for two years. At this point, however, I have brought back quite a few foods that were forbidden in early stages of the diet, and I’m quite used to eating this way.
Even after five years on the diet, I would not say I am “cured.” If I eat too many carbs in a day or too many “special” foods (such as dried fruit, or sweets with coconut sugar), symptoms flare by the next morning. I also continue to struggle with intermittent cravings and weight fluctuations (which I wrote about here). According to my holistic doc, if you’ve had candida once, you are more prone to relapses; and every time it returns, it returns more forcefully, and is more difficult to get back under control. Given my experience ten years ago and my experience since 2009, I would say this is true for me.
Q. Which sweeteners can I have?
Depending which stage of the diet you’re on, there are different types of sweeteners you can use. When you first start, all sweeteners except stevia (a zero calorie, zero glycemic index herbal sweetener) are usually forbidden. This would mean no sugar, no syrups, no evaporated cane juice, no palm sugar, no molasses, no dried fruits (the sugars are concentrated), no fresh fruits except lemon, lime and avocado, no juices except veggie juice (and even then, no carrot juice, which contains concentrated sugars), and absolutely, positively, DEFINITELY no artificial sweeteners! You can read my take on stevia here.
At later stages in the diet, you may bring in some low glycemic fruits (apples, pears, berries, peaches, apricots, etc.) and even later, low glycemic sweeteners (yacon syrup, coconut sugar or palm sugar, coconut nectar, vegetable glycerin—be sure it is food grade, though). Please note that, when I started this diet in 2009, agave nectar was considered a good low-glycemic sweetener for those on the ACD. Since then, we’ve discovered that agave contains a fairly high level of fructose, which can be hard on the liver. As a result, I’ve changed my mind on agave in the early stages (your liver has enough to contend with at that time!!). So, I do now have agave very infrequently (maybe 4x/year or less), but wouldn’t use it regularly.
I try to keep my sweetener use to a minimum; if I do use coconut sugar, for instance, I always combine it with stevia so I can keep the coconut sugar amount very low (no more than 1/4 cup in most recipes). I find the combination allows me to benefit from the flavor and binding qualities of the sugar while avoiding the consequences of eating too much sweetener. I’ve also recently discovered xylitol and have come to love it as a dry sweetener (but if you’re new to xylitol, go very slowly and start with very little; it can cause bloating and gas if you’re not accustomed to it).
I also wrote a post that provides a bit more information about some of my favorite ACD-friendly sweeteners, when you can eat them, and how to use them, here.
Q Can I Follow a Vegan Diet and Still Do the ACD?
As someone who is doing just that, I would, of course, answer “yes” to this question. However, since candida feeds on carbohydrates (a staple food among vegans), it may mean that your progress moves at a slower pace on a vegan diet (but you can still get better!). Since I was determined that vegans could follow a plant-based anti-candida diet and succeed, I made sure that the complete diet protocol in Living Candida-Free was offered in a vegan variation (as well as the omnivorous options that were designed by Andrea).
Other versions of the diet don’t provide vegan options. Most will suggest that you cannot follow a vegetarian diet and effectively fight off candida yeast; they recommend animal sources of protein along with a careful recommendation to delve into the sources of your protein so that the animals were humanely raised and slaughtered. Others are more accommodating and offer a vegetarian plan along with the “regular” plan.
All of the recipes on this blog after March, 2009 are ACD-friendly; many before that are, too. The Recipe Index is a good place to start, as are the Anti-Candida Breakfasts: What Do You Eat? and the Anti-Candida Desserts: What Do You Eat? posts.
Q. What about eating at the holidays–how can I stay on the diet when everyone around me is feasting on foods I can’t eat? Can’t I cheat, just a little?
While I’d never presume to tell anyone else what to do, it’s important to realize that if you do “cheat,” the next day will revert to Day One on the diet. In other words, according to anti-candida experts, eating anything with one of the “forbidden” foods will undo all of the progress up to that point. My personal feeling (and please note, I am not a scientist or medical professional–this is simply my own personal experience) is that, once you reach maintenance, it’s okay to have the occasional “treat”–as long as you wait until you’ve been stable for at least three or four months, AND you limit your “treat” to just one, small, portion. From my own personal experience, I’ve found that nearly impossible to accomplish (one treat leads to another, and another. . . before you know it, you’re back at Stage One of the diet), so I prefer to simply stay within the bounds of the diet all the time.
Q. I notice you use chocolate sometimes in your recipes. I thought it wasn’t acceptable on an anti-candida diet. Is it?
I myself adore chocolate and can’t imagine life without it! But I’ve had to alter my chocolate-eating habits considerably so that they are in line with what works for me on the ACD. Here’s what I’ve learned:
Most anti-candida diets prohibit chocolate, for a few of reasons. First, it usually contains sugar. Obviously, you don’t want to ingest that! It also contains caffeine, which might be a problem for some people. Finally, chocolate is known to raise serotonin (also known as a “feel-good chemical”) in our bodies, and can therefore quickly trigger cravings.
Consequently, if you are going to include chocolate in your diet (and you may need to experiment with whether or not you can tolerate it), most diets suggest reserving it until at least the second stage of the diet. I use only organic, unsweetened chocolate (I like Cocoa Camino brand, but I’ve heard that Ghirardelli and Scharffenberger are both good, too) and I sweeten it myself with stevia, yacon syrup or coconut sugar. Because chocolate is so bitter, I find adding a bit of carob powder along with the chocolate allows me to use less sweetener and avoid the unpleasant bitterness that results when you combine too much stevia with unsweetened chocolate. I also use unsweetened cocoa powder this way.
I’ve recently discovered raw chocolate. I use raw caco nibs (I grind them slightly and add to cookies or bars as I would chocolate chips; or I add them to smoothies) and raw cacao powder as I would cocoa. I find that the raw cacao is less bitter than regular unsweetened chocolate or cocoa, and has a very slight, very subtle fruitiness that I don’t taste with regular chocolate. I loved making my own raw “chocolate” with coconut oil and cacao powder.
The bottom line seems to be that it’s okay if you can tolerate it, if you can keep consumption moderate, and if you use organic, unsweetened chocolate or cacao.
[Update, August 2011: Thanks to Kris for asking about how I make my chocolate (see question in the comments, below).]
Here’s a recap of my answer: In the beginning, I used a mixture of unsweetened chocolate and carob powder to cut the bitterness a bit. I’m someone who loved milk chocolate, so getting used to the bittersweet taste (I never make it any sweeter than a 70% cacao bar) was a bit of an adjustment, but now I love my chocolate! I also think that the taste totally depends on two things: 1) the stevia you use; and 2) the amount of stevia you use. For chocolate, I only use NuNaturals because I find it has no bitter aftertaste. Because stevia tends to bring out the natural bitterness in chocolate, I also always err on the side of too little stevia vs. too much (which, strangely, makes the chocolate taste more bitter to me). Try the chocolate in this recipe for a stevia-only version, or the coating in this recipe (reduce the coconut oil so it won’t melt at room temperature) and see what you think.
Q. I would love to hear what you know about soy. I’m a little confused about it. Are fermented soy products okay? Or is it better to avoid soy altogether?
There’s a lot of controversy over soy these days. I actually am fine with unfermented soy as well (ie, tofu). I realize that it is processed and that it contains phytates, which are difficult to digest. I also realize that tofu is considered a goitrogen, which means it can interfere with or suppress thyroid functioning, particularly in those with already-low thyroid function.
However, for someone without those problems, and for someone who cooks their tofu (as I do 90% of the time–unless I use it in ice cream or a salad dressing), I don’t see a problem with tofu in moderation. When you’re on a vegan diet, sources of complete protein are limited, and tofu fits that bill. People in many Asian cultures have eaten tofu for centuries and seem to be doing just fine. The difference is that in North America, as with so many things, we go overboard: soymilk for breakfast, tofu scramble for lunch, soy burger for dinner. A classic Japanese dish uses tofu more as a garnish than a main course; if we followed suit (instead of eating as much tofu per meal as we would eat meat), I’m sure we’d have many fewer problems with it.
Tofu is considered acceptable on some anti-candida diets and not on others. The one I first followed, The Complete Candida Yeast Guidebook by Rona and Martin (not to be confused with Rowan and Martin!), allows tofu in moderation. Most other diets are not as accepting of soy and tofu, because it can be an allergen as well. My personal feeling is that if you don’t have an allergy to soy, and once your digestive system is working better, tofu is okay in moderation–at least, this worked for me. I re-introduced the occasional tofu (never more than once per week) into my diet in Stage 2 of the diet.
Tempeh and other naturally fermented soy products are a little different. Tempeh is fermented with molds and some people react badly to it; yet it is a naturally fermented food, like sauerkraut or yogurt with live bacteria, so there are some potential benefits. Like tofu, tempeh was okay for me after a few months on the diet. It’s an excellent source of protein as well.
Miso is more widely accepted on different candida diets because of the natural fermentation process that produces “good” bacteria (probiotic bacteria) that can help with digestion. It’s also high in a variety of amino acids. Again, I decided to try miso after the first stage of the diet and I’ve never had any problems with it. According to some other anti-candida diets, however, fermented products can trigger yeast reactions because of their chemical similarity to yeasts. On the other hand, the Body Ecology diet recommends eating lots of fermented foods. So once again, it comes down to the individual and what works for your own body. You should work with your holistic healthcare professional or doctor (if you’re lucky enough to have a doctor who believes in candida) to see what is best for you.
Edamame (raw soybeans) should be okay for almost anyone as long as they’re not allergic to soy–there is no fermentation going on and I think of them as being like any other legume. Boiled and salted, they are a perfect snack or first course!
In the end, I think it would be worth doing an experiment with soy products (as long as they’re not highly processed fake soy “meat” or “bacon,” etc., which contain far too many chemicals and additives), and just try a little bit once you feel that your body is on the right track (provided you don’t have allergies or other health reasons not to eat it). For those who don’t react, you can decide whether or not to include it in your diet in moderate amounts. For me, this means the occasional meal with tofu or tempeh in it, and using miso as a flavor enhancer in some recipes (especially since I don’t use nutritional yeast–I find miso replaces some of that umami in a recipe).
Q. What’s the scoop on nutritional yeast or brewer’s yeast? Can we eat them on the ACD?
First, it’s important to note that the two types of yeast are not the same. Brewer’s yeast is a by-product of brewing beer. It is “dried, pulverized cells of Saccharomyces cerevisiae, a type of fungus” and contains both chromium and vitamin B12, essential for vegans.
Nutritional yeast, while based on the same strain of fungus, S. Cerevisiae, is an inactive form of yeast grown on sugar cane or molasses. Unlike brewer’s yeast, it doesn’t contain chromium, but is a good source of vitamin B12. It’s important to note, as well, that S. Cerevisiae is naturally present on most foods and even in the air (just as candida albicans, the most common source of CRC, is always present in and on our bodies).
For some reason, people with candida seem to have more of a reaction to brewer’s yeast than nutritional yeast, though they can react to the nutritional yeast, too. Since it’s a type of fungus, it may cause a reaction in people with candida simply because its structure resembles that of candida albicans, which the body is fighting against. Like an allergen, the yeast may cause an immune response in someone with CRC. One source notes, “The problem with eating yeast of any kind is that when we have candida infestation, because we have been *overesposed* to it, our bodies have developed a real dislike for and sometimes even, allergy to , anything that resembles yeast (mould, fermented products).” Similarly, Donna Gates of the Body Ecology Diet website, advocates against both brewer’s yeast and nutritional yeast.
I personally would not eat nutritional yeast in the early stages of the diet. However, at later stages and after I’ve been stable for some time, I am planning to cautiously try a little and see whether or not I have a reaction. If I don’t see any effects at all, then I might consider it safe to use sparingly, on occasion.
Q. I’m a little concerned. . . that this diet is a bit too much like the Atkins diet. . . . What are your thoughts on including more grains from the first two types of grain groups during Stage One of the diet? [Thanks to Nicole for asking this question in the comments.]
Since I’m not a medical professional, I am really not equipped to advise you on whether or not you should or should not eat more of those grains; I would highly recommend seeing a naturopath or holistically-minded MD who would be able to recommend the best course of action.
As I said, in my own case, I didn’t venture beyond the dictates of the original diet, and I had no problems–the first stage is often meant to be a short-term stage in which you starve the yeast as much as possible before going on to other measures. For most people, eating this way for a month or even two wouldn’t cause deficiencies. And while I guess I see some similarities to Atkins (low glycemic, low starch), the ACD isn’t actually completely low-carb; all vegetables contain complex carbohydrates, and you’re even permitted some root veggies in that stage (ie, sweet potato, beets, etc), plus some legumes and beans–all are good sources of carbs. I would be surprised if Atkins permitted those.
Having said all that, as I’ve learned over the past 2-1/2 years, each person is unique. It may be possible that a few more grains are good for you, while fewer were necessary for me. In my case, if I were to eat more of the grains, for instance, I’d be sure not to include a starchy vegetable or legumes that day.
Even on a less strict diet, most people eventually improve–it just takes longer. (In a way, it’s like losing weight very slowly rather than aiming for a big loss in the first two weeks before tapering off; eating a broader range of foods will not starve the yeast as quickly, but if you feed them less and less of what they need, they will eventually decrease in numbers.) Knowing how bad my own symptoms were, I wanted the healing to happen for me as quickly as possible, which meant fewer starchy foods and a stricter adherence to the first stage of the diet.
Q. Just wondering about black tea – I decaffinate mine (by pouring out the 1st cup of water and re-using the tea bag) and I really love it and can’t find any info on why it’s not healthy! Do I really need to give it up?
From what I’ve read, there are conflicting ideas about black tea. Caffeine can be a problem (and I would guess that you are drinking less caffeine, but still some–diluting it won’t make it disappear), but perhaps a larger problem is the fact that it’s fermented. Any fermentation involves sugars, and fermented foods in general tend to trigger candida symptoms. Apparently, the process can also generate molds, and even though they are not candida molds per se, they can trigger the same reaction. So to keep your digestive and immune systems from sending out alarms, it’s best to avoid the black tea.
On the other hand (and there is always another hand!), I’ve read that polyphenols in the black tea are anti-fungal. So, as with almost everything else that isn’t straight sugar or mold, it comes down to what works for you. I wouldn’t have even tried black tea at the beginning, but now that I’ve been more or less stable for a year or so, I might be willing to try a cup of black tea and see if I have any reaction. It’s not really an issue for me, though, as I adore my green tea!
Hope that helps!
For more candida information, you can also check the series of “Candida Q & A” posts that answer your more specific questions.
Have you got specific questions for me about the diet, what I did, ingredients I use, or how I cook and bake on this diet? Please leave your question as a comment on this page, or send them to me at firstname.lastname@example.org and I will respond to as many as I can right on this page.
Do you have suggestions for what will help you most to deal with–and conquer–candida? I’d love to know–and will use your suggestions to shape the Candida Kick-Start course. Answer the ONE QUESTION SURVEY by clicking here.
Please note, however, that I am neither a medical doctor nor qualified to prescribe, diagnose, or provide advice about what you should do for candida. I cannot answer specific questions about what you should or should not eat on the diet, and I cannot diagnose whether or not you have candida. This page is for general questions that would apply to anyone on the ACD. In other words, everything I share here is based on my own personal experience. Please do not assume that your situation will be identical to mine. Having said that, I am happy to share what has worked (and not worked) for me.
Before embarking on any kind of treatment or program for candida or anything else, please be sure to check with your doctor or health care provider.
Still have more questions, or looking for individual support? One-on-one candida coaching might be for you. Check out my personalized packages right here, or email me for more information at email@example.com (use the subject line, “Coaching Question.”
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