By Dr. Loretta Lanphier, ND, CN, HHP, CH

Thrush is a condition that is normally associated with newborns and infants. Ask any mother, and the chances are at least one of her children had thrush. It is no big deal for most kids, and usually clears up on its own. However, when thrush appears in adults, it can be harder to get rid of, and may often be an indicator of a more serious problem such as immune system dysfunction due to an underlying illness or certain medical treatments.

What is Thrush?

Thrush, also known as candidiasis, is an infection caused a yeast-like fungus called Candida albicans or Candida for short. This organism can and does cause infections in other parts of the body, but when infection is found in the mouth, it is called thrush. It is the same agent that causes vaginal yeast infections in women, and diaper rash in babies. Candida albicans is found in and on the bodies of almost everyone, and small amounts of it are normal.It is typically found in the digestive tract and on the skin, as well as in the mouth. Thrush occurs when Candida grows out of control and is not held in check by other bacteria and microorganisms that normally provide a balance.

Oral thrush is characterized by creamy, white lesions that are most often found on the tongue or inner cheeks. However, it is known to spread to other areas such as the tonsils, gums, back of the throat, roof of the mouth, or even the esophagus, which can particularly lead to a more serious and critical situation. The lesions are quite unique, and can usually easily be identified as thrush. It is most commonly found in babies and toddlers, and in senior citizens, however it can occur in anyone of any age, especially if they have a compromised immune system. In recent decades, many HIV/AIDS patients have been exhibiting chronic thrush infections, especially in the advanced stages of the illness.

What Are the Symptoms of Thrush?

The lesions associated with thrush are whitish, velvety plaques that often have a red tint due to bleeding of the tissues underneath. They are sometimes described as “cottage cheese-like” in appearance, and may be painful if scraped or aggravated while brushing your teeth, for example. They can show up suddenly, and may slowly increase in number and size. When a thrush infection manifests itself in an infant, it can usually be left to run its course without treatment. Most infections will disappear within about two weeks. The lesions are very identifiable, but in addition to them the baby may have a hard time feeding and be unusually irritable.

It is not unusual for mothers who are breastfeeding to get thrush from their baby if he or she has an infection. Women with thrush infections in their breasts may experience the following signs:

  • Very red, sore, and supersensitive nipples.
  • Uncharacteristic pain while nursing.
  • Tight, shiny areolas.
  • Sharp, piercing pains within the breast.

If an individual has a severe case of thrush, or his immune system is weakened, the infection can spread throughout the mouth and throat, and in some instances into the esophagus. Thrush that has spread into the esophagus (esophagitis) can produce a much more serious situation that can result in such signs as:

  • Difficulty swallowing
  • Painful swallowing
  • Fever
  • An uncomfortable sensation of food sticking in the throat or chest.

On rare occasions, usually with immune compromised individuals, Candida infections can spread throughout the body and sometimes create life-threatening situations. Potential complications include infections of the:

  • Eyes (endophthalmitis)
  • Brain (meningitis)
  • Heart (endocarditis)
  • Joints (a form of arthritis)

What Are the Causes of Oral Thrush?

There are many different viruses, bacteria, and fungi that exist in our bodies. When in right relationship with each other, they are very beneficial. In exchange for using our bodies as a place to live and breed, these microorganisms protect us against harmful invaders, help to stimulate our immune system when needed, and even aid in the synthesis of essential vitamins and other nutrients.

But there are gangs of other organisms prowling around in the environment that are not so friendly and helpful. In fact, some microbes such as those that cause malaria or certain types of meningitis can be downright deadly. When the balance of “good” and “bad” organisms is in the right proportions, and the immune system is working up to par, the bad guys are usually outnumbered and defeated. But when things are out of whack, unwanted infections can spread like wildfire, and thrush is a good example of that.

The main way that this imbalance occurs is when the body is weakened by other diseases or by the use of certain medications. The following conditions are common ones that can encourage the growth of oral thrush infections:

  • Cancer:  All types of cancer are very hard on the body’s immune system. Attempting to fight the illness can take a real toll on your ability to fight off other infections as well, and oral thrush is no exception. To complicate matters, cancer treatments like chemotherapy and radiation therapy can further drain the immune system. Candida infections throughout the body can occur alongside many cancers.
  • Diabetes is also an illness that is associated with immune system dysfunction. One of side effects of diabetes is that your saliva may have abnormally high amounts of sugar in it. This can easily stimulate outbreaks of oral thrush.
  • HIV/AIDS:  Oral thrush is only one of several fungal infections that can afflict HIV patients, and it is not the worst scenario. However, the presence of chronic thrush infections can often be an indicator that the condition of the AIDS patient is deteriorating. If an HIV positive person develops chronic thrush, it is not a good sign. It points to the development of full-blown aids. Most folks in this situation will not experience oral thrush until their T-cell count has fallen below 350. T-cells are critical components of the immune system. For HIV positive persons, if the thrush spreads to the esophagus, it is usually considered an “AIDS-defining illness.” Oral thrush (or the lack thereof) is often considered to be a barometer of health for HIV/AIDS patients.
  • Vaginal yeast infections:  These common infections are caused by the same fungus as oral thrush, and the presence of vaginal yeast infections also increases ones chances of getting oral thrush. Vaginal Candida infections are very common, and the way that most newborns get oral thrush is by being infected by their mother during the birthing process.
  • Xerostomia:  This is the official name for “dry mouth,” or a condition that occurs when the levels of saliva in the mouth are below normal. Saliva is an amazing substance that has many functions, including cleansing the mouth and helping to provide a balanced environment that keeps microorganisms in check. When saliva is lacking, the risk for oral thrush increases. There are many factors that can cause xerostomia, including many illnesses, nutritional deficiencies, and literally hundreds of medications. Even high levels of stress or anxiety can result in chronic dry mouth.
  • Chronic mucocutaneous candidiasis:  This is a rare family of disorders that most typically affect kids under the age of three. It is characterized by Candida infections of the mouth, fingernails, and skin on the scalp, hands and feet. It often produces scaly lumps called  “granulomas” that appear in the mouth or on the fingernails and skin. Sometimes an adult will develop a tumor of the thymus gland and develop this disorder as well, but that is even more rare than the occurrence in children.
  • Certain medications, such as birth control pills, antibiotics, and corticosteroids also increase a person’s risk for oral thrush. The reasons for this are thought to be related to hormonal changes and the negative effects such drugs have on the immune system and/or the balance of flora in the body.

What Treatments Are Available for Thrush and Other Candida Infections?

In otherwise healthy individuals, thrush is not generally a serious condition. It will usually clear up on its own. However, if you suffer from recurring, chronic bouts with thrush, or if you have a compromised immune system, these infections can put you at a greater risk of further complications. In special cases such as these, there are antiviral medications that are available. The problem is that some of them have some very significant side effects, and should probably not be used if you are not in a high-risk group. I would certainly recommend staying away from them if you have any liver problems. Some of them are known to potentially cause liver damage, and patients on these drugs must be regularly monitored for liver function. The use of these medications may be appropriate in the case of someone with a life-threatening immune disorder such as AIDS. Opportunistic infections such as thrush can be very dangerous under such circumstances.

For otherwise healthy people who have thrush, there are some much more “user-friendly” options that are safe and very effective:

  • Try eating some organic yogurt that has live cultures. This is a great way to help restore the balance of flora in the body. It works great for adults and even babies who have thrush.
  • The use of a quality probiotic product can also help to build up the levels of the good and necessary microorganisms that are typically diminished in folks who have such infections as oral thrush.

Other preventative tips include:

  • Don’t smoke. Smoking changes the atmosphere of your mouth and makes it friendlier to infections such as thrush.
  • Good oral hygiene:  If you allow bacteria from food particles to accumulate in your mouth, it also increases risk for thrush. Be careful about cleanliness if you wear dentures too.
  • Limit high-yeast foods such as beer, wine, and bread.

Thrush infections are certainly not the worst health problem a person could have, but they can be quite troublesome for folks in some circumstances. It is a good idea to nip them in the bud if they surface, because it is much more difficult to become free of chronic Candida infections. Thrush is just another way your body talks to you about something that is not quite right. I suggest we get in the habit of listening.

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