Negative with Candida

[cagey19]

Hi Doctor,

I already know about your stance on hiv and thrush but wish to get your opinion please. I have confirmed candida now for about  2 months. It is in my mouth, throat and moving with bowels. It is ruling my life at the moment with discomfort and stress. 13 weeks ago I had what started off as protected sex with the condom coming off me during/until finish. My penis was chafed as well. My last hiv test was negative at 13 weeks.
My questions are:

If candida is a sign of a weak immune system, wouldn't it take longer for antibodies to produce? Longer than say someone who is infected with no symptoms?

Also, I was consuming coconut oil daily to try and boost my immune system. There seems to be some info out there that it also suppress the virus. Could this have delayed antibodies as well?

I am at the point where I am spending lots of money with Dr's, meds, etc. Is your professional opinion that my last test is conclusive? I can't help but feel that my ailment is due to exposure.

Thank You

[H. Hunter Handsfield, M.D.]

Thanks for the follow-up. The additional information does not change my original opinion or advice, i.e. for sure you don't have HIV.

And I am equally convinced you have no other infection acquired during the sexual exposure you are concerned about.  Epstein Barr virus is also not a plausible explanation.  And yes, your symptoms certainly are very consistent with the physical manifestations of anxiety or other mental stress.

But that's as far as this forum can go.  Good luck with it.

[cagey19]

Hi Dr Handsfield,

You asked for a follow up and I'm happy yet still frustrated with my situation. My Gastroenterologist had me in for an endoscopy and colonoscopy with results of patent pylorus and mild diverticulosis. He otherwise said" you're fine" after the procedure. He was quite "annoyed" that I or my ent/dr suggested I had oral thrush, though he never actually said "you don't". So, I am still left with the following: White "growth" on tongue and tonsils 3 months. Sore throat on/off for 3 months. Pain in ear canals 3 months ( ent says they cannot locate infection ) coughing and phlegm 3 months. I will lead you off with my thought/question, of a lot of this being stress related. I know my mental and physical health has been compromised. Poor sleep, fatigue etc. Had bronchitis for two weeks post exposure, which kind of started the whole mess. I was totally convinced that I was exposed and unfortunately still have my concerns because of my ongoing situation. My only other thought is to be tested for epstein barr at this point.

Thanks Again

[H. Hunter Handsfield, M.D.]

Although of course I cannot make a definitive diagnosis from this distance, in my opinion it is very unlikely that the problem is candida or any other yeast/fungus infection.  Perhaps you had oral candida which triggered some concern by your doctors, but it is not a logical explanation for your current symptoms; and real candida almost certainly would have improved on fluconazole (Diflucan) and/or nystatin.  Mucus in stools is not indicative of candida or any other yeast or fungus. I doubt your dietary changes or herbal supplement are going to make any difference.

None of this suggests HIV or any sexually acquired infection, and probably your illness is unrelated to your sexual exposure 3 months ago. However, it sounds significant, probably an infection of some kind, and potentially serious if not properly managed.  I think you are right to be thinking about a specialty consultation.  An infectious diseases specialist might be best; or perhaps a gastroenterologist.

I'll be interested how this turns out; please return with a follow-up when more is known.  But please don't worry about HIV; that has been reliably ruled out as a possibility.

[cagey19]

I was diagnosed by my md and ent. Although I will admit that neither one was over concerned. However it is painful and not going away. I have been on dyflucan and nystatin. neither has worked. As far as my stomach, The discomfort started a week or so after the oral thrush. I started cutting out carbs, sugars and taking an oral herbal supplement. The "die off's", if you will, have had me on the toilet multiple times passing mucus, blood and what seems to be, in my amature but honest opinion, yeast. I'm bringing a sample to a specialist. There seems to be an entire community out there who are suffering from the same thing as me.

Thanks for your advice and opinion Dr Hansfield

[H. Hunter Handsfield, M.D.]

And by the way, it seems you are skeptical about our previous comments about thrush ("I already know about your stance..." and, from the community forum, "Dr's don't seem to take...thrush too seriously").  Be assured that such our advice is based purely on scientific data.  There is no debate among legitimate scientists about this forum's perspectives on candida and HIV, or about "systemic candidiasis".

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Before I address your concerns about HIV infection per se, let's sort out some of the related issues raised by your question.

"Thrush" is a superficial yeast (Candida) infection of the skin or a mucous membrane, usually the mouth or genital area.  Most cases respond quickly to simple treatment with anti-yeast drugs, either topically (e.g. vaginal creams or suppositories) or pills.  Candidasis/thrush does not cause bowel problems or other systemic problems, and (looking at your follow-up comment below) doesn't cause cough, phlegm, or abdominal pain.  The notion of "systemic candidiasis" is an urban myth.  So please clarify the diagnosis, whether it was professionally made, and what treatments have been tried.

Now let's assume you indeed have thrush.  You have apparently read that thrush is more common in people with HIV.  That is true.  However, the vast majority of people with thrush (or other forms of candidiasis) do not have HIV and their immune systems are entirely normal.  I once had oral candidiasis myself.  Having thrush is not, in itself, a strong indicator of HIV infeciton.

Perhaps most important, HIV test results overrule all other considerations in deciding whether or not someone is infected, as long as testing is done sufficiently long after the last possible exposure.  For the HIV antibody tests, that interval is 6-8 weeks (even though many health agencies recommend testing at 3 months after the last exposure).  There are no medical conditions that make the test result unreliable; although life threatening illnesses (e.g. terminal cancer) might do it, even this is theoretical with no proved cases it actually happened.

So the bottom line is that your negative HIV test result 13 weeks after a possible exposure is absolute proof you didn't catch HIV.  You can stop worrying about that possibility.  Continue to work with your doctor or clinic about the actual cause of your symptoms and treatment.

Good luck with it.  I hope this has helped.

Regards--  HHH, MD

[cagey19]

Sorry Doctor,

My condition is a few weeks short of three months, not two. I may add that it was accompanied by other symptoms that still persist. Cough, phlegm, abdominal pain. I've had ct scans and x-rays which seem normal.

Thanks again