You’ve put in the work and have finally figured out that candida overgrowth is the cause of your bloating, brain fog, and digestive woes. You start an anti-candida protocol and feel like you’re on the path to feeling better. But after a few days, you start to feel even worse than when you started! You feel achy all over, flu-like, and forgetful, and your symptoms just keep getting worse. What’s going on?
What is Candida Die-Off?
When large numbers of bad bacteria or yeast/fungus are rapidly killed in the gut, metabolic by-products are released into the body, overwhelming your detox system. Technically this is known as a Herxheimer reaction. The flood of endotoxins causes unpleasant symptoms like nausea, feeling flu-like, bloating, or a flare-up of yeast symptoms. (see below for a full list).
When yeast cells die, they release all sorts of noxious substances, including at least 79 different toxins. (source) This list of toxic substances includes ethanol, uric acid, and acetaldehyde, which is a toxic by-product produced when you drink alcohol. Acetaldehyde is a doozy because it is very toxic and a known carcinogen. It destroys brain tissue and is in part responsible for the brain fog and overall crappy “hangover” feeling people experience when they have candida overgrowth.
When you have candida overgrowth, you’ll need to take anti-microbial herbs to kill the excess candida. The herbal treatments cause candida to die, releasing large amounts of the toxic by-products. (It should also be stated that candida overgrowth in general is responsible for similar toxins, which is why people feel bad when they have too much candida).
Your immune system responds to die-off by triggering an acute inflammatory response that leads to worsening symptoms and the development of new unpleasant symptoms. Not fun.
You can also experience diet-off when you suddenly change your diet during a detox or cleanse — or switch to a healthy eating plan.
Because your body is being flooded with toxins faster than it can clear them, you can experience these die-off symptoms that typically last 3-7 days. You are more likely to experience die-off if your detox pathways are compromised (e.g. you have an MTHFR mutation). (source) Most people notice the symptoms within days of starting a candida protocol or a cleanse. Symptoms include the following:
- Brain fog
- Headaches, dizziness
- Diarrhea and/or constipation
- Joint pain
- Flare-up of skin issues like acne, rashes
- Feeling flu-like and achy
- Recurring vaginal, prostate and sinus infections
Candida Die-off Prevention
Candida die-off is a toxic state. Not only does it cause inflammation and make you feel crappy, but the longer your body remains in this toxic state, the more likely you are to reabsorb the toxins being released by the dying microorganisms.
In my experience, the more candida you have in your gut, the more likely you are to experience die-off. If you have been battling recurrent candida that you just can’t seem to kick, or you’ve been struggling with candida overgrowth for a long time, you’ll want to take extra precaution to avoid die-off. I discuss this at length in my Candida MasterClass.
- Go slowly with your treatment. Many candida protocols have you jump right in and change your diet while taking high doses of anti-microbial herbs. This is a recipe for disaster. I recommend starting with your gut healing diet first, then once you’re feeling good (after 2 weeks or so, for example), start your candida protocol. Ease into it slowly, working up gradually. I always recommend starting with the diet first (and I emphasize this in my Candida MasterClass) because making dramatic diet changes can cause die-off symptoms too.
- Support your liver. A big cause of die-off is a detox system, primarily your liver, that’s overwhelmed. If you are prone to die-off or have high levels of candida, head into your candida-killing protocol with some liver and general detox support. I recommend a liver support tincture like this one, and practice daily detox habits (find here). The tincture contains liver protective herbs like milk thistle, oregon grape, and burdock.
- Stay well hydrated. Drinking plenty of water (at least half your bodyweight in ounces daily) is a great way to flush toxins that are released when candida dies. Bonus: staying hydrated helps you poop, and that is a critical vehicle for detox!
- Make sure you are pooping regularly! A daily poop is one of your body’s most powerful tools for detox. Toxins are bound up in the stool and released when you poop. When you’re not pooping daily, stool sits in your colon, and those toxins can be reabsorbed in your system, making you feel worse. My tips for addressing constipation are here.
- Get some movement daily. Nothing vigorous, but movement stimulates your lymphatic system. A healthy lymphatic system is crucial for healthy detox. A rebounder is great for lymph support.
How to Relieve Die-off Symptoms
- Activated charcoal works through adsorption rather than absorption. It contains negatively charged ions that attract positively charged elements such as the toxic byproducts released during die-off. These byproducts bind to the outside of the activated charcoal and get trapped in its tiny pores. Once trapped, the charcoal quickly escorts these harmful byproducts out of your body so they don’t get reabsorbed. Works great for bloating too because it also traps excess gas. CAVEAT: for taking charcoal: You MUST be pooping regularly for charcoal to work optimally! If you’re not, toxins get reabsorbed in your system. Take 1 charcoal in the morning and 1 at night with plenty of water. Do not take within 2 hours of prescription meds, as charcoal affects absorption of medications and other supplements. I also don’t recommend taking charcoal long term.
- Hydration: Water, water, water to help relieve inflammation and flush toxins. Herbal teas count, too.
- Ginger tea and hot water with lemon: freshly grated ginger tea is excellent for combatting nausea and bloating. Hot water with lemon first thing in the morning is very hydrating and cleansing; plus, it stimulates pooping. Great for skin and liver health.
- Sweat it out: sweat is another way toxins exit your body. A sauna is best because you don’t want to exert yourself when you’re not feeling well and your body is under stress. But not all of us have access to a sauna. A comparable method would be alternating hot and cold water in the shower. Great for lymphatic stimulation.
- Take a liver support supplement: if you’re not already, give your liver extra love with this tincture or this supplement. Add in liver detox foods like bitter greens (think dandelion greens, arugula, kale), beets, and detox teas.
- Supergreens and green juices: Green juice is a wonderful way to flood the body with nutrients. Many people with digestive issues cannot handle large amounts of fiber, so concentrated green vegetable juice is a great way to get minerals and boost detox. Lemon, parsley, celery, spinach, green apple, and ginger is a good one. If you can’t handle green juices, add a concentrated supergreens powder like this to your smoothies.
- Sleep & rest: The best way to heal your body is sleep. Get my sleep hygiene tips here.
Mary Vance is a Certified Nutrition Consultant and author specializing in digestive health. She combines a science-based approach with natural therapies to rebalance the body. In addition to her 1:1 coaching, she offers courses to help you heal your gut and improve your health. Mary lives in San Francisco and Lake Tahoe in Northern California. Read more about her coaching practice here and her background here.