Candida 101
Candida refers to a microbe that is commonly found in its beneficial yeast form, but can convert to its problematic, pathogenic fungal form. There are well over 200 different types of candida, but humans typically only harbor about 20 of these. The most well-known of these is Candida albicans.
In its beneficial yeast form, candida strains help to strengthen the body's immune system and also participates with some of the gut's beneficial bacteria in keeping the intestinal flora balanced and healthy.
In its problematic, pathogenic fungal form, candida is linked to over 125 different diseases and conditions and is the 4th most common cause of hospital-acquired bloodstream infections in the United States, something to keep in mind during your next hospital stay. If you happen contract a fungal candida infection in the hospital, your risks include longer hospital stays, poor outcomes, and higher mortality rates ranging from 30%-60%.
Candida in its yeast form and candida in its fungal form are not two separate organisms. They are the same one which undergoes changes from yeast to fungus and this determines how it will behave in the body. Although antibiotics are the main driver of this conversion from beneficial yeast to problematic fungus, there are also other factors such as the pH (acid-alkaline balance) of the surrounding fluids and tissues that also regulate this conversion process. If the surrounding tissue pH isn't cooperating with this change, then candida can contribute to the process.
pH
pH stands for "potential hydrogen" and reflects the degree of acid or base (alkaline) that is present, which is measured on a scale of 0-14. Most acids have high amounts of hydrogen. The measurement of 0 to 7 is the acid side of the scale. The measurement of 7-14 is the base or alkaline side of the scale. The 7 is considered to be a neutral pH where acid and base are balanced. Hydrochloric acid in the stomach is usually a 1-3 on the scale. Baking soda's pH is a 9. Our blood is in the tightly regulated range of being slightly alkaline, 7.35-7.45. The pH plays a crucial role in the function of the cells, tissues, fluids, and organs in the body. While many components of the body exist in an alkaline state, some components function best in an acid state. While much more can be said about pH, I'm going to stick to its effect with candida for this article.
Acid pH
Candida is an amazing microbe with many capabilities. It can exist in a pH range from 4-9. The pH helps to regulate which form of candida is present. The acidic range is one of the main regulators of candida. In this acidic 4-7 range, it exists in its beneficial yeast form. This is also true of many microbes in the gut and the reason why the majority of the small and large intestine are in a slightly acidic pH range. An acid pH plays a major role in keeping a healthy, balanced gut flora. It is why we find many types of acids in the gut, starting with hydrochloric acid, lactic acids, acetic acids, bile acids, short-chain fatty acids, and more.
Alkaline pH
In an alkaline pH, candida converts to its fungal (hyphal) form. This hyphal form has a great ability to invade and infect the body. After antibiotic use, this has been shown to happen as quickly as 4-52 hours later. Antibiotic use creates a shift in the intestines toward an alkaline pH, mainly through the elimination of the acid producing microbes which normally oppose and limit candida overgrowth.
If needed, candida also has the ability to shift the surrounding tissues and fluids to an alkaline pH through a process known as auto induction. To do this, it breaks down amino acids to generate ammonia, which alkalizes the surrounding pH causing candida to shift from yeast to fungus. The picture at the top of this blog post beautifully captures the auto induction process of candida secreting ammonia into its environment to alter the pH to an alkaline one.
The pH not only regulates the yeast-to-fungal switch, but it also plays a role in the activity and production of the some of the enzymes fungal candida produces to invade the body.
"The ability to switch between multiple morphologies, including a rounded yeast cell and an elongated hyphal cell, is a key virulence trait in this species, as this reversible switch is thought to promote dissemination and tissue invasion in the host. We report here that C. albicans can actively alter the pH of its environment and induce its switch to the hyphal form. The change in pH is caused by the release of ammonia from the cells produced during the breakdown of amino acids. This phenomenon is unprecedented in a human pathogen and may substantially impact host physiology by linking morphogenesis, pH adaptation, carbon metabolism, and interactions with host cells, all of which are critical for the ability of C. albicans to cause disease."
https://pmc.ncbi.nlm.nih.gov/articles/PMC3101780/
C. albicans is constantly exposed to fluctuations in pH ranging from acidic to slightly alkaline in different human body niches such as the digestive tract, vagina, oral cavity, blood, and tissues . pH sensing is mediated through Rim101, an important regulator of the yeast-to-hyphae morphological transition . Upon activation, the transcription factor Rim101 enters the nucleus and mediates pH-dependent responses . Remarkably, C. albicans is not only capable of sensing and adapting to environmental pH but can also modulate extracellular pH by alkalinizing its surrounding environment and auto-inducing hyphal formation . Furthermore, alkalinization has been shown to counter the macrophage acidification during engulfment, promoting its survival in the macrophage .
https://pmc.ncbi.nlm.nih.gov/articles/PMC8308684/#:~:text=Figure%201.&text=External%20hyphal%2Dinducing%20signals.,from%20endogenous%20and%20exogenous%20sources.
"In C. albicans, the ability to morphologically switch from yeast cells (blastospores) to filamentous forms (hyphae) is an important virulence factor which contributes to the dissemination of Candida in host tissues and which promotes infection and invasion."
https://pmc.ncbi.nlm.nih.gov/articles/PMC89204/
Confusion
As I said earlier, candida is an amazing organism. One can pursue their study of this microbe now more than ever with advances in our understanding of its cellular function, genetics, environmental responses, and more. For many decades, researchers never distinguished between the yeast and fungal forms of candida, referring to it only as a yeast. This lack of distinction creates a lot of confusion when discussing the effects of pH on candida.
Additionally, a few studies have shown an amazing ability for candida to survive acid pH while maintaining its fungal/hyphal form. A closer look shows that number of fungal candida cells able to do this in these studies was very limited and not anywhere near the ability of the fungal form's aggressiveness in an alkaline pH.
There is also a group of people who believe that everything acid is bad and only alkaline is good. This is counter to the human body's design when considering the many benefits where an acid pH is a healthier state for the stomach, intestines, skin, and vaginal tissues. It's concerning when people market themselves as experts and yet deny decades of science and research on this topic and others.
As I've repeatedly stated, "An expert is someone who knows more and more about less and less." I think it's better to continuously study more about everything, especially where the human body is concerned.
More Links
Dr. Jeffrey S. McCombs, DC, is founder of the McCombs Center for Health, the Candida Plan, the Candida Library, and author of Lifeforce, The Everything Candida Book, and The Everything Guide to Autoimmune Diets. Check out our podcast, Candida Diet Tips Recipes, and Insights on Apple Podcast, Spotify, Buzzsprout, Google Podcasts, Amazon Music and Alexa Flash Briefings. For advanced testing protocols, consider our Functional Genomic, Oxidative Stress, Microbiome panels and our ProDrome Scan and Bioscan testing - https://shop.candidaplan.com/meta-omics-advanced-testing-integration/Contact Us – (888) 236-7780, or support@candidaplan.com