Urinary Markers of Yeast Overgrowth

Summary

This paper presents a review of scientific reports of some urinary markers of yeast overgrowth. Richard S. Lord, PhD, Cheryl Burdette, ND, J. Alexander Bralley, PhD, CCN

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Lord RS, Burdette C, and Bralley JA, “Urinary Markers of Yeast Overgrowth.” Integrative Medicine. 2004. 3(5): p. 24-29.

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An elevated level of serum or urinary D-arabinitol is evidence of yeast overgrowth. Many analytical investigations have established the validity of laboratory methods for D-arabinitol measurement, and clinical studies have shown the association of elevated levels with abnormal yeast growth. With the exception of invasive candidiasis in immunocompromised patients, the clinical relevance of elevated D-arabinitol, like any other method that reveals abnormal growth of either intestinal or mucocutaneous yeast, is controversial. In contrast to D-arabinitol, arabinose is a common component of carbohydrate-rich foods. It is metabolized by intestinal microbial populations and by human hepatocytes. Arabinose has never been reported to be a metabolic by-product of any strain of yeast or fungus. Similarly, tartaric acid is a common food component that is excreted in highly variable amounts, depending on intake of commonly consumed foods. Tartarate is metabolized by a variety of microbes, and there is no evidence of significant production in the human gut under any conditions. Neither tartarate nor citramalate shows correlation with D-arabinitol, based on data from their simultaneous measurement in a large human patient population. We conclude that yeast growth in humans does not produce significant amounts of arabinose, tartaric, or citramalic acids, and that, when these compounds are found in human urine specimens, they do not constitute evidence of yeast overgrowth.