Is your immune system weakened or are you on antibiotic treatment? You might be prone to fungal infections.
According to this study conducted in 2019 on Candida albicans activity, fungal infections are often associated with a dysbiotic state. This means an alteration in the composition or abundance of the host microbiota at the infected site.
This environment becomes permissive to the survival of the pathogenic fungus, contributing to its proliferation.
Probiotics are defined by the WHO as “live microorganisms which, when consumed in adequate amounts in food, confer a health benefit on the host”.
Their use helps the host microbiota return to a state of balance. They can act orally as well as locally.
Research has provided evidence confirming their positive role in intestinal, oral, and vaginal health. But the studies conducted remain mixed. What about it?
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If you suffer from vaginal yeast infection
Prefer the strain Lactobacillus rhamnosus
The lactobacilli make up more than 90% of the vaginal flora. Therefore, certain lactobacilli are used as probiotics to restore the vaginal microbiota and prevent recurrent infections.
Main studies on probiotics generally focused on bacterial vaginosis. And considered them as a supportive treatment.
In case of antibiotic treatment
This prospective study from 2016 conducted on 250 women in Rome, showed that the vaginal flora of women treated with antibiotics and probiotics significantly improved compared to those treated with antibiotics alone.
Therefore, probiotic supplementation with vaginal Lactobacillus rhamnosus was useful in hindering bacterial growth. Particularly after antibiotic treatment.
A reduction in symptoms
However, only a few studies have investigated the role of probiotics in the treatment of vaginal yeast infections. This recent trial double-blind, randomized, and placebo-controlled, was conducted among 76 women with vulvovaginal candidiasis.
The results after 35 days of treatment indicated that administering probiotics alongside fluconazole was more effective than the placebo group. There was a significant reduction in candidiasis symptoms of 68% for the first group compared to 47% for the second.
The role of lactic acid
This probiotic effect of Lactobacillus strains is probably due, according to this study, to the accumulation of lactic acid. Higher local concentrations of lactic acid might prevent their proliferation in the immediate vicinity of Lactobacillus.
Moreover, the organic acids produced by Lactobacillus positively influence the effectiveness of antifungal agents. They help increase the permeability of the fungal plasma membrane structure, which facilitates the absorption of azoles.
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If you suffer from digestive yeast infection
Rebalance the flora
Digestive yeast infections arise when there is a disturbance of the intestinal and/or oral flora. Candidiasis is the most common digestive fungal infection.
When the intestinal microbiota is imbalanced, Candida albicans can excessively proliferate in the digestive tract and release toxins.
Particularly painful, the lesions caused by this fungal infection can prevent you from eating or swallowing. It can even lead to dysphagia or malnutrition.
The treatment of oral fungal infections requires the eradication of risk factors and the administration of antifungals. But it is also essential to rebalance this flora to prevent the occurrence or recurrence of the condition.
Probiotics effective in prevention
According to this meta-analysis from 2019 combining 5 studies with 435 patients, probiotics can reduce the incidence and mitigate the severity of oral fungal infections induced by cancer treatment.
These probiotic treatments, however, seem to be more effective in preventing oropharyngeal candidiasis and reducing their recurrence than in treating them as such.
I think that given the small number of clinical trials conducted, further randomized trials, multicentric, double-blind on a larger population could enlighten us further.
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My advice for taking probiotics in case of a yeast infection
For oral intake, I recommend taking the probiotic on an empty stomach. Count 30 minutes before the meal, or 2 hours afterward, so that it arrives intact in the digestive system.
Vaginally, I suggest taking it twice a day, morning and evening, whether it’s capsules, tablets, or suppositories to be inserted into the vagina. I recommend prioritizing the local route for vaginal yeast infections for a more targeted action.
Furthermore, if you are taking antifungal treatments at the same time, I advise taking probiotics away from them.
In the case of a cure, prefer the following lactobacilli strains: L. rhamnosus, L. reuteri, L. acidophilus, L. bulgaricus, L. crispatus
Finally, I invite you to observe the precautions for use. Taking probiotics in case of yeast infection can have multiple benefits but does not replace conventional antifungals. So, do not try to substitute the treatment your doctor prescribed with probiotics.
According to this study conducted in 2015, probiotics are generally considered safe. However, your doctor’s opinion remains essential in cases of immunodeficiency, weakened intestinal wall, as well as for pregnant or breastfeeding women.
Sources and scientific studies
Bertolini M, Ranjan A, Thompson A, Diaz PI, Sobue T, Maas K, 2019. Candida albicans induces mucosal bacterial dysbiosis that promotes invasive infection. PLOS Pathog.
Food Agricultural Organization/World Health Organization, Cordoba, Argentina: 2001. Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria.
Zekai Shu, Peijing Li, Bingqi Yu, Shuang Huang, Yuanyuan Chen, 2019. The effectiveness of probiotics in prevention and treatment of cancer therapy-induced oral mucositis: A systematic review and meta-analysis.
Nadia Recine, Ettore Palma, Lavinia Domenici, Margherita Giorgini, Ludovica Imperiale, Carolina Sassu, Angela Musella, Claudia Marchetti, Ludovico Muzii, Pierluigi Benedetti Panici, 2015. Restoring vaginal microbiota: biological control of bacterial vaginosis. A prospective case–control study using Lactobacillus rhamnosus BMX 54 as adjuvant treatment against bacterial vaginosis.
De Gregorio P. R., Parolin C., Abruzzo A., Luppi B., Protti M., Mercolini L., 2020. Biosurfactant from vaginal Lactobacillus crispatus BC1 as a promising agent to interfere with Candida adhesion. Microb. Cell Fact.
Zahra Vahedpoor, Mahdi Abastabar, Mojtaba Sehat, Parisa Talebian, Tayebeh Felfelian Fini, Zahra Dastanpour, Iman Haghani, Ramtin Chelongarian, Mehdi Nazeri, 2021. Vaginal and oral use of probiotics as adjunctive therapy to fluconazole in patients with vulvovaginal candidiasis: A clinical trial on Iranian women.
Isabella Zangl, Ildiko-Julia Pap, Christoph Aspöck, Christoph Schüller, 2019. The role of Lactobacillus species in the control of Candida via biotrophic interactions.
Shira Doron, David R Snydman, 2015. Risk and safety of probiotics.
