Dean Mitchell, M.D., is a board-certified immunologist and a pioneer in holistic immunology. As a founder of the Mitchell Medical Group with his wife, Dr. Ricki Mitchell, in New York City, he specializes in diagnosing and treating candida overgrowth, mast cell activation syndrome and toxic mold exposure. With more than 30 years of practical experience, he combines conventional and integrative care to address the root causes of disease and educate patients on sustainable wellness solutions.

Mitchell, an adjunct assistant professor at Touro College of Osteopathic Medicine, is also a published author of several books and host of a popular podcast, The Smartest Doctor in the Room, where he interviews renowned medical specialists. His latest book is Conquering Candida: The New 30-Day Protocol for Restoring Your Microbiome and Health, co-authored with his daughter-in-law, Joelle Mitchell, a registered dietitian.

Candida is a type of yeast that can live on the skin and in the body without causing problems, but an overgrowth can lead to an infection called candidiasis, also known as a yeast infection, which can range from mild to severe and affect various parts of the body.

 

Why did you write this book?

Over the past three decades, I have noticed a rise in patients with chronic fatigue and brain fog, and I have identified microbiome imbalance, particularly candida, as a key contributing factor. These patients, including those with chronic vaginitis, chronic sinusitis and fatigue, have benefited from a low-carb, sugar-free diet combined with our protocol of vitamin therapy, antifungal medications and sublingual immunotherapy drops.

It has been 50 years since Dr. William Crook published his seminal work, The Yeast Connection. Through my podcast, I have had the privilege to interview top microbiome experts, and I wanted to present the latest science and my experience in a comprehensive book. Most important, I wanted to validate the patients who, unfortunately, were told by their general doctor, “Candida doesn’t exist. It’s a made-up diagnosis.”

 

What is a candida overgrowth?

A healthy microbiome is diverse, with all kinds of different bacteria, viruses and yeast, whereas an unhealthy microbiome is distorted because the good bacteria have been wiped out, leaving candida, a highly resistant organism, as the dominant species. A candida overgrowth occurs when candida yeast microorganisms predominate, affecting the microbiome and resulting in a range of unpleasant symptoms.

 

What are the most prevalent symptoms of a candida overgrowth?

After treating thousands of patients, I have categorized symptoms into four distinct levels. The initial stage manifests as gastrointestinal symptoms such as bloating, constipation or diarrhea.

The next stage involves leaky gut syndrome, where the yeast moves out of the intestine. This phenomenon is particularly prevalent in women who develop chronic vaginal yeast infections. Their gynecologists may prescribe three antifungal pills, but that’s just not enough, and dietary modification and immune-strengthening measures are often overlooked. In our practice, we see women who have been suffering for years, and they just don’t get better until they go through our protocol.

The third stage of candida overgrowth occurs when the candida penetrates deeper into the body, leading to symptoms like brain fog. This occurs because excessive yeast production generates acetaldehyde, a substance that can cause cognitive impairment. I have a lot of young patients experiencing this stage that say, “I have to quit my job; I just can’t keep up.” We treat them, and they get better.

The fourth stage is when the candida becomes deeply ingrained, resulting in chronic fatigue, fibromyalgia and widespread muscle pain. This stage can also be effectively treated.

 

What causes an overgrowth of candida?

Long-term use of antibiotics, proton pump inhibitors or acid blockers, birth control pills and even steroids—including the ones you inhale or take orally—can disrupt the natural balance of the gut microbiome, leading to candida overgrowth. The other big culprit is excessive glucose intake. One of the first things you want to do with a candida overgrowth is to cut out simple, processed sugars because they’re feeding the candida.

Disruptions in the endocrine system can also lead to candida problems. That includes people with diabetes, metabolic syndrome or polycystic ovarian syndrome who tend to have high insulin and high blood sugar levels. And when you’re under a lot of stress, your cortisol levels go up as a defense reaction, which can also increase blood sugar levels and precipitate a candida imbalance.

 
Why has this condition been overlooked or discounted by many conventional doctors?

For one thing, there is no perfect test to diagnose candida. I have a questionnaire in the book that you can take, but a proper diagnosis depends on the clinician’s experience of taking a thorough history and being a good detective. For example, because candida affects the intestinal microbiome, I find that patients have deficiencies in vitamin B12, iron and other nutrients, which tips me off that their gut is not absorbing things as well as it could be.

The other reason that candida has been discounted is that doctors and patients don’t want to believe that antibiotics or acid blockers aren’t good for us. In fact, when these drugs are taken chronically, they can induce a lot of harm, dramatically changing the intestinal microbiome.

For people experiencing candida symptoms, I’m frequently the tenth doctor they’ve consulted. They’ve sought advice from neurologists, rheumatologists, dermatologists and gastroenterologists, but each professional dismisses their concerns, saying, “There’s nothing wrong with you.” Yet they’re very symptomatic. That’s when they should start thinking that maybe this has something to do with their microbiome, and specifically candida.

 

In your 30-day candida protocol, what dietary changes do you recommend?

I tell patients right off the top that while the process may seem challenging, our goal is to help you feel better. Initially, there will be restrictions as certain foods can worsen your condition. The goal is to make smart substitutions and adapt, leading to a meaningful lifestyle change. Initially, avoid processed sugar, dairy (including cheese and yogurt), grains (especially wheat-based), fermented foods and alcohol.

You can consume fiber-rich foods, which benefit your microbiome. Apples and berries are good, but avoid very sweet fruits like watermelon, cantaloupe or pineapple. Include a variety of vegetables, especially cruciferous ones and greens, but avoid corn (too sugary) and mushrooms (too yeasty). Skip potatoes and rice, which spike your sugar. Quinoa is a better alternative. Ensure you have quality protein sources like chicken, fish, turkey and meats. Drink water and teas, but avoid soda or diet soda. When people adhere to this plan, along with my other treatments, they start to see big changes pretty quickly.

Gradually, we reintroduce certain foods. I follow the 80-20 rule: be good 80 percent of the time and allow yourself to indulge 20 percent of the time. It’s tough at first; I find people are surprisingly disciplined. I don’t want people to become overly restrictive or antisocial. The good news is restaurants offer many healthy choices.

My daughter-in-law, Joelle Mitchell, is an excellent dietician nutritionist. She has developed meal plans with plenty of choices and substitutions such as using stevia instead of sugar and gluten-free flours like coconut, almond, buckwheat, flax seed, cassava or sourdough.

 

What about the next prong of your treatment—the antifungal medications?

There is a big misunderstanding about the dangers of antifungals, even among some doctors. From my experience, they tend to be very safe medications. Several FDA-approved options work very well. Patients typically require a minimum of three to four weeks of treatment, with some needing more, potentially extending to several months, to eradicate candida when it has deeply infiltrated the tissue. If you give them only three or four days of treatment, you’re merely eliminating the superficial candida while leaving the more resistant strains intact.

 

What type of supplementation do you recommend?

I have patients come in, especially when I’m prescribing the antifungals, for intravenous vitamin therapy known as the Myers’ cocktail, comprised of B-complex vitamins, magnesium, vitamins C and D3, plus the antioxidant glutathione.

Studies show that oral vitamins are minimally absorbed. People who are having medical issues like candida need extra support. Intravenous vitamins also mitigate the Herxheimer reaction, a flu-like response that occurs when candida begins to die off and releases toxins, triggering an immune response.

 

Could you explain the sublingual immunotherapy drops included in your protocol?

Following my treatment with strong antifungals, the idea is to administer a little bit of candida in the form of sublingual drops to stimulate the body’s own immunity and build up a tolerance. This approach aims to empower the body to effectively manage candida without the reliance on future antifungal interventions. Essentially, it involves stimulating protective antibodies to keep the candida in check. The only other thing I would add is, if you have to go on a course of antibiotics, make sure to take a mild antifungal at the same time.

 

What kind of doctor should people look for to get help with candida?

A really good functional medicine practitioner that is a medical doctor or doctor of osteopathic medicine—somebody that can do blood testing, write a prescription and administer vitamin therapy. One of the purposes of writing this book was for a patient to be able to go to their doctor and say, “I have these symptoms, and can we work together on this?” That cooperation between doctor and patient is what you want for the best outcome.

 

Sandra Yeyati is national editor of Natural Awakenings.

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