Candida vs. SIBO vs. Dysbiosis: What’s the Difference?

Here’s a basic definition of candida vs. SIBO vs. dysbiosis:

Candida, SIBO and dysbiosis are three common gut “issues” that often get confused. While all three share similarities, they are totally different conditions.

Basic Definition: Candida, SIBO & Dysbiosis

• Candida: The overgrowth of natural candida yeast in the gut and/or throughout the body, typically in hollow spaces and cavities (lungs, mouth, nose, gonad organs, brain, etc.) and warm moist body areas (such as underarms).
• SIBO (Small intestinal bacterial overgrowth):An overgrowth of bacteria in the upper GI—small intestine—that should be fairly sterile and clear of lots of bacteria.
• Dysbiosis: An imbalanced biome, particularly in the large intestine. Sometimes this means too many of the same species…not enough healthy bacteria….or the overgrowth of “commensal” or more pathogenic type bacteria.

Let’s chat a little more in-depth about candida vs. SIBO vs. dysbiosis —key differences, how to know which one (if any) you have and how to tackle them.

Candida vs. SIBO vs. Dysbiosis: What’s the Difference?

Given that candida vs SIBO vs dysbiosis often share similar symptoms like bloating, gas, constipation, diarrhea, and systemic problems like skin breakouts, fatigue, hormone imbalances and brain fog, it can be difficult to distinguish between them.

However, each gut issue has its own unique characteristics that set it apart. 

Candida

Signs & Symptoms of Candida

In addition to digestive problems, here are some of the most common symptoms of candida:

• Multiple allergies (environmental, chemical food)
• Oral thrush (white coating in mouth and tongue)
• Redness inside your mouth or on your gums
• Cavities
• Recurring genital/vaginal infections and UTI’s
• Extensive of antibiotics
• Crave sugar/sweeteners and/or coffee
• Crave alcohol
• Rectal itching
• Persistent cold/flu/illness
• Recurrent bronchitis
• Sinus congestion and infections
• Shortness of breath/wheezing
• Athlete’s foot, ringworm, “jock itch” or other chronic fungi infections of the skin or nails
• Headaches
• Symptoms worse in damp, muggy or moldy places
• Psoriasis, skin rashes, itching or recurrent hives
• Dizziness
• Sore throat/hoarse voice
• Histamine intolerance
• Feel “hungover”, lethargic or tired (despite sleeping)
• Pain, stiffness and swelling in your joints (candida arthritis)
• Get sick easy (sore throats, cold, flu)
• Depression/anxiety 

Common Causes of Candida

Candida is a normal “resident” of a healthy microbiome. In fact, there are more than 20 species of Candida, the most common being Candida anabacis. The problem with candida happens when the yeast gets out of control.

Common triggers for candida overgrowth include:

1. Taking antibiotics
2. Eating a diet high in sugar, artificial sweeteners, industrial seed oils and starch
3. Frequent & high alcohol intake (more than 4 glasses per week)
4. Long-term low fiber diets (candida can feed on both ketones and carbs)
5. Oral contraceptives (ie birth control)
6. Chronic mold exposure
7. Poor immunity (from viral and bacterial infections like lyme and co-infections, to autoimmune disease, to dysbiosis of the gut biome)
8. Chronic stress 

Testing

Comprehensive stool testing is the most common way to detect candida, like the 3 day Doctor’s Data comprehensive stool analysis  + parasitology or 3 day GI Effects by Genova.

You can also run bloodwork with a healthcare practitioner to detect for systemic candida antibodies (IgG, IgA, and IgM levels).

SIBO

Signs & Symptoms of SIBO

Symptoms traditionally linked to SIBO include bloating, diarrhea, and abdominal pain/discomfort, and SIBO shares many of the same symptoms as candida; however key differentiators are bolded below:

• Significant bloating or gas
• Abdominal pain/cramping
• Constipation (despite drinking water)
• Most all foods make you bloat/feel poorly
• Eating higher FODMAP foods often exacerbates symptoms
• Gas may smell like rotten eggs
• History of heartburn, acid reflux and/or PPI use
• History of long-term restrictive dieting
• Fat malabsorption (signified by pale, bulky, and malodorous stools)
• Rosacea and other skin rashes
• Cravings for foods that make you feel poorly
• Loss of appetite
• B vitamin deficiencies and other nutrient deficiencies (iron, Vitamin D, etc.)
• Diagnosis of IBS (85% of IBS patients have SIBO)
• Hormone imbalances (bad PMS, man boobs/low T, hypothyroidism, PCOS)
• Halitosis (bad breath)
• Require laxatives or prokinetics to poo
• Anxiety and panic attacks
• Acne
• Probiotics and fermented foods make you feel worse
• Can’t tolerate many supplements 

Common Causes of SIBO

SIBO is often a result of several things:

1. Decreased stomach acid, digestive enzymes and bile acid production in the gallbladder—this is particularly common for patients who have been on PPI acid suppressing drugs
2. Carbohydrate malabsorption—often from low stomach acid and enzymes, low saliva formation and chewing, or diets high in refined foods
3. Problems with the migrating motor complex—the peristalsis ability of your gut to sweep food through the gut onwards to the colon
4. Hormone disruption—especially in the estrobolome—the bacteria that metabolizes estrogen—this is common from oral birth control and environmental triggers that disrupt estrogens
5. Mold exposure—living or working in a moldy environment, breathing in mold spores regularly

These 5 malfunctions lead to the fermentation of food in the upper gut and an increase in bacteria that produce excess hydrogen and/or methane gas. 

Testing

SIBO breath testing is the gold standard when it comes to SIBO testing. It is the most accurate and it determines if the SIBO is hydrogen or methane dominant, and to rule out the possibility of hydrogen sulfide SIBO.

Inflammatory markers on stool testing, like fecal calprotectin, and D-Lactate on organic acids can help point to SIBO, as well as nutritional deficiencies on bloodwork (especially elevated folate, anemia, vitamin B-12 deficiency, or other nutritional deficiencies).

Organic acids testing analyses the urine for by-products of yeast or bacteria in the small intestine. If your small intestine is housing a yeast or bacterial overgrowth, byproducts will appear in your urine, indicating their presence. 

DYSBIOSIS

Signs & Symptoms of Dysbiosis

SIBO share many of the same symptoms as candida; however key differentiators are bolded below:

• Bloating and gas
• Constipation
• FODMAP and fiber sensitivities (because you have a low growth of healthy gut bugs to digest)
• Cravings for sugar, fruits or artificial sweeteners
• Disordered/restrictive eating or processed food diet or high fat or high protein diet (low fiber)
• Obesity/difficulty losing weight
• Eczema and skin issues
• Brain-gut imbalances (Autism, ADHD, anxiety, depression)
• Autoimmune conditions and other chronic diseases (diabetes, cancer, asthma, heart disease, hypothyroidism, etc.)
• High incidence of SIBO
• Allergies
• Decreased concentration 

Common Causes of Dysbiosis

Dysbiosis—gut bacteria imbalances—is caused by a variety of factors and is often simultaneously present with candida, SIBO or both.

Common causes of dysbiosis include:

1. History of antibiotic exposur Perhaps one of the #1 causes of dysbiosis is the disruption caused by antibiotics in the gut.
2. History as a C-section, formula-fed or processed food kid. Your gut was not “seeded” with healthy gut bugs during the most integral time in your life—shaping your gut potentially for a life time.
3. Dietary triggers. What we eat alters our gut bacteria for the better or worse. The top dietary triggers for gut dybsiosiso include: restrictive eating, binging/purging, long term animal-based diets, high fat low fiber diets, diets high in refined carbohydrates and processed foods AND eating the same foods every day.
4. Chronic stress—overtraining, under-sleeping, circadian rhythm disruption

Dysbiosis is primarily about imbalance, not gut infections or “bad bacteria;” hence, imbalances in our daily lifestyles ultimately can lead to imbalances in our gut. 

Testing

Dysbiosis is primarily a clinical “diagnosis” based on symptoms a patient currently experiences in combo with your medical and diet history, such as a history of antibiotics, high stress levels, dietary risk factors or comorbidities (suffer from one ore more chronic conditions).

As for formal lab testing, a comprehensive stool testing is the most common way to detect dysbiosis patterns, like the 3 day Doctor’s Data comprehensive stool analysis  + parasitology or 3 day GI Effects by Genova.

What to Do About It?

Although SIBO, candida and dysbiosis are different, there are similar diet, supplement and lifestyle strategies that can help send them into remission.

I generally recommend a core “gut reset” protocol, along with a BIG emphasis on restoring and optimizing the gut microbiome (probiotics, short chain fatty acids, fiber, etc.).

Along the way, we work closely to customize specific  supports for your individual needs. 

Diet Strategy

There are tons of “anti candida” diets and cleanses out there on the internet.

However, while some of these can be helpful to alleviate symptoms in the short term, many of them can be more detrimental in the long term—making your gut more dysbiotic in the long run if you deprive it of balanced meals and setting you up for increased food sensitivities.

Remember: imbalances in our lifestyles and nutrition cause imbalances in our gut biome. 

Thus, balance is ultimately the name of the game to restore the biome.

Here are some basic principles of a gut reset:

• Avoid added sugars and artificial sweeteners
• Avoid alcohol for at least 30 days
• Stick to 1 cup of quality organic coffee or less per day
• Stick to 1-2 servings of starch and 1-2 servings of fruit or less per day
• Avoid high lectin foods (grains, beans, gluten, peanuts, soy, seeds), conventional dairy, processed foods and industrial seed oils (canola, vegetable, grapeseed, etc.)
• Consume (at least) 1-2 cups of bone broth per day
• Eat 1-2 condiment sized servings of fermented foods daily, such as: sauerkraut, kimchi, water kefir, pickled/cultured vegetables (only if tolerated; not often advised in SIBO)
• Consume 5-9 servings of colorful veggies per day
• Cook, sauté, stew, steam and puree foods for better digestion/absorption
• Swig 1-2 tbsp of apple cider vinegar in water with meals as needed (for bloating) 

Helpful Supplements

When used appropriately, supplements can be powerful weapons to reset the biome.

I typically work in stages with a patient, helping them navigate a protocol for cleansing the gut naturally.

Stage 1: Prep the Body to Cleanse

• Mineral drops
• Drainage support (to aid in natural cleansing)
• Intestinal support formula
• Short chain fatty acids

Stage 2

• Broad spectrum anti-fungal and antimicrobial using herbs and homeopathic remedies (especially oregano oil)
• Lauricidin
• Biofilm disruptor (like NAC or bismuth and ALA)
• Triple probiotic therapy: saccharomyces boulardii, spore based probiotics and a synbiotic
• Short chain fatty acids

Stage 3

• Fermented foods and soluble fiber
• High dose probiotics
• Pre-biotics (rotating)
• Short chain fatty acids

Additionally, through each stage, I will give the option of using helpful digestive support aids if bloating or constipation are experienced, including:

• Digestive enzymes
• Prokinetics to help you go #2 (Like Iberogast, PooDoc and Ageless HydroC) 

The Bottom Line

Candida, SIBO and dysbiosis are some of the most common “root causes” behind gut-related symptoms.

Although they are each different, all three gut pathologies share the same strategy for remission and optimization: restore balance.

The good news? When given the right tools, the body (and gut) innately want to heal themselves.

Reach out to our functional medicine clinic today to find out how to feel good again (made simple).