Good Health ALWAYS Starts with Good Diet and a Healthy Lifestyle
A good diet is the foundation for optimal health, and bladder health is no exception. One of the kidneys’ jobs is to reabsorb glucose from the blood stream to conserve it and help maintain blood glucose homeostasis. When there is excess glucose in the blood stream, the kidneys absorb more. The more glucose the kidneys are exposed to, as when blood glucose is chronically elevated, the higher the risk of damage to the kidneys and their filtering apparatuses (glomeruli), causing deteriorated function.3 The nerves that serve the bladder can also be damaged by chronically elevated blood glucose, which leads to further dysfunction.4 Staying off the blood sugar rollercoaster by eating a diet that is rich in vegetables, quality proteins and healthy fats and that minimizes or eliminates sugars, flours and processed grains protects kidney function.
Diet may also be important for people with interstitial cystitis (IC), since 87% report that certain foods make their symptoms worse.5 The foods most commonly reported to be problematic are citrus fruits, tomatoes, coffee, tea, carbonated beverages, alcoholic beverages, spicy foods, artificial sweeteners, and cranberry juice.6 While eliminating these foods is a good place to start, those with IC may find their own personal response to be different, so keeping a food diary can be helpful.
In addition to diet, bladder health can often be improved with techniques like bladder training, targeted physical therapy, and complementary medical approaches, such as acupuncture.
Because we still don’t fully understand why bladder issues happen in the first place, treating them can be especially difficult. As you improve your diet and test out new supplements and herbs, be patient while you find the ones that work best for you.
Bladder Issues and Prostate Problems
Men, if you’re suffering from a frequent need to urinate, urinary urgency, frequent nighttime urination, urinary incontinence, and especially dribbling at the end of urination or trouble starting urinating, you may need to get your prostate checked.35 When the prostate gland swells, a condition known as benign prostatic hyperplasia (BPH), the urethra can get squeezed, affecting the flow of urine. While men can certainly suffer from bladder issues not related to the prostate, you’ll find the best relief if you know exactly what you’re dealing with. For more information, check out the Customer Literature File Prostate—Urinary Incontinence.
Nutrients & Herbs to Support Bladder Function
Low vitamin D levels have been associated with incontinence and overactive bladder in women, older adults, and pregnant women.7 8 9 There are vitamin D receptors in the bladder and the muscles of the pelvic floor, and it is theorized that vitamin D may support bladder function not only through maintaining the efficiency of those muscles but also by exerting an anti-inflammatory effect.10 Studies have found that supplementing with vitamin D improves symptoms of urinary incontinence, especially in those who are vitamin D deficient to begin with.11 12
Pumpkin Seed Oil
Known to be rich in essential fatty acids and phytosterols, as well as carotenoids (such as lutein and zeaxanthin) and vitamin E.13 14 Pumpkin seed oil has long been recommended for prostate problems, but it may also support the urinary system more broadly. In one small study, 10 grams of pumpkin seed oil given to adults with overactive bladder daily for 12 weeks resulted in significant improvement in their overactive bladder symptom scores.15
Herbs to Support Bladder Health
Throughout history herbalists have relied on the healing power of herbs to treat bladder issues and many are still recommended today. Below are some of the herbs that support bladder function.
- To nourish the tissues and support normal functioning of the urinary tract system, cleavers (Galium aparine) and/or yarrow (Achillea millefolium) are often used as bladder tonics.
- For urinary frequency, herbs with soothing demulcent properties such as cornsilk (Zea mays) and marshmallow (Althaea officinalis) are often recommended by herbalists.
- Horsetail (Equisteum arvense) has been historically used for involuntary discharge of urine, and Ayurveda recommends it for urinary incontinence.16
- Butterbur (Petasites hybridus) contains the sesquiterpenes petasin and isopetasin, which are believed to be responsible for its antispasmodic and anti-inflammatory activity.17 It can be used in cases of irritable bladder and urinary tract spasms and may reduce urinary frequency.18 19
- The adaptogenic herb Schisandra (Schisandra chinensis) is used in Traditional Chinese Medicine for urinary frequency and incontinence. It might be especially useful for people who are also experiencing a lot of stress due to or in addition to their urinary symptoms.20
Nutrients Specific to Interstitial Cystitis
While people with interstitial cystitis (IC) often experience urinary urgency and frequency and frequent nighttime urination, IC is characterized also by discomfort, pressure, or pain in the bladder, lower abdomen, and pelvic area. IC is sometimes called Bladder Pain Syndrome. While supporting overall urinary function with some of the above recommendations is a good place to start, people suffering from IC may benefit from a slightly different approach that includes some of the following nutrients and herbs.
There is a notable difference in the urinary microbiomes of people with IC compared to those without.21 22 This difference may contribute to the symptoms of IC through cross-talk with the pelvic organs or directly through the gut-brain axis.23 Especially if there is a history of antibiotic use, supporting a healthy gut microbiome through the use of supplemental probiotics is a good place to start to modulate inflammation and support overall health.
Hyaluronic acid, chondroitin sulfate, and glucosamine or N-acetyl-glucosamine
One theory of what is happening in the bladders of people with IC posits that the mucosal layer of the bladder is disrupted. Normally, the mucosal layer is rich in glycosaminoglycans (GAGs) which help protect the bladder from harmful irritants in the urine. When this layer is damaged or otherwise disrupted, toxins in the urine can set off an inflammatory chain reaction that produces pain.24 GAGs are sometimes injected directly into the bladder of IC patients. There is also evidence to suggest benefit can be achieved by oral supplementation with the GAGs hyaluronic acid, chondroitin sulfate, and/or glucosamine or N-acetyl-glucosamine.25 26 27 28
This amino acid is a precursor for nitric oxide (NO), a signaling molecule produced by the body. NO is believed to positively influence bladder function by promoting the relaxation of smooth muscles (like those of the bladder), by inhibiting inflammation, and by modulating pain.29 30 In studies, IC patients taking 1.5 g to 2.4 grams of l-arginine a day for one month or more saw modest but significant improvements in their symptoms.31 32
Herbs for IC
In addition to the bladder tonics mentioned above, herbalists often recommend the following herbs.
- Mucilaginous or demulcent herbs to support the mucosal layer of the bladder such as marshmallow (Althaea officinalis), corn silk (Zea mays), and slippery elm (Ulmus rubra).
- Kava kava (Piper methysticum), known for its antispasmodic activity, may also soothe irritated urinary structures and promote muscle relaxation.33 34
- Licorice (Glycyrrhiza glabra) has anti-inflammatory and immunomodulatory actions that may benefit those with IC.35 (Caution: If you have high blood pressure, licorice should be avoided unless it is deglycyrrhizinated.)
- Coyne, K.S., Sexton, C.C., Bell, J.A., Thompson, C.L., Dmochowski, R., Bavendam, T., Chen, C-I., Clemens, J.Q. (2013). The prevalence of lower urinary tract symptoms (LUTS) and overactive bladder (OAB) by racial/ethnic group and age: results from OAB-POLL. Neurourol, 32, 230-237. https://doi.org/10.1002/nau.22295
- U.S. Department of Health and Human Services. (2017, July). Definition & Facts of interstitial cystitis. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved November 10, 2021, from https://www.niddk.nih.gov/health-information/urologic-diseases/interstitial-cystitis-painful-bladder-syndrome/definition-facts.
- Triplitt, C.L. (April , 2012). Understanding the kidneys’ role in blood glucose regulation. The American Journal of Managed Care, 18 (1 suppl). Retrieved from: https://www.ajmc.com/view/ace005_12jan_triplitt_s11
- Golbidi, S., Laher, I. (2010). Bladder dysfunction in diabetes mellitus. Front Pharmacol, https://doi.org/10.3389/fphar.2010.00136
- Pang, R. Ali, A. (2015, Dec). The Chinese approach to complementary and alternative medicine treatment for interstitial cystitis/bladder pain syndrome. Translational Andrology and Urology, 4(6), 653-661. doi: 10.3978/j.issn.2223-4683.2015.08.10
- Shorter, B., Lesser, M., Moldwin, R. M., & Kushner, L. (2007). Effect of comestibles on symptoms of interstitial cystitis. The Journal of urology, 178(1), 145–152. https://doi.org/10.1016/j.juro.2007.03.020
- Sharma, J.B., Kakkad, V., Kumar, S., Roy, K.K. (2019). Cross-sectional study on vitamin D levels in stress urinary incontinence in women in tertiary referral center in India. Indian J Endocrinol Metab, 23(6), 623-627. doi: 10.4103/ijem.IJEM_531_19
- Abdul-Razzak, K.K., Alshogran, O.Y., Altawalbeh, S.M., Al-Ghalayini, I.F., Al-Ghazo, M.A., Alazab, R.S., Halalsheh, O.M., Sahawneh, F.E. (2019). Overactive bladder and associated psychological symptoms: a possible link to vitamin D and calcium. Neurourology and Urodynamics, 38, 1160-1167. https://doi.org/10.1002/nau.23975
- Stafne, S.N., Mørkved, S., Gustafsson, M.K., Syversen, U., Stunes, A.K., Salvesen, K.A., Johannessen, H.H. (2020). Vitamin D and stress urinary incontinence in pregnancy: a cross-sectional study. BJOG, 127: 17041711. https://doi.org/10.1111/1471-0528.16340
- Vaughan, C.P., Tangpricha, V., Motahar-Ford, N., Goode, P.S., Burgio, K.L., Allman, R.M., Daigle, S.G., Redden, D.T., Markland, A.D. (2016). Vitamin D incident urinary incontinence in older adults. Eur J Clin Nutr, 70(9), 987-989. doi: 10.1038/ejcn.2016.20
- Oberg, J., Verelst, M., Jorde, R., Cashman, K., Grimnes, G. (2017, Oct). High dose vitamin D may improve lower urinary tract symptoms in postmenopausal women. J Steroid Biochem and Molec Bio. 173, 28-32. https://doi.org/10.1016/j.jsbmb.2017.03.013
- Markland, A.D., Tangpricha, V., Beasley, T.M., Vaughan, C.P., Richter, H.E., Burgio, K.L., Goode, P.S. (2019). Comparing vitamin D supplementation versus placebo for urgency urinary incontinence: a pilot study. J Am Geriatr Soc, 67, 570-575. https://doi.org/10.1111/jgs.15711
- Montesano, D., Blasi, F., Simonetti, M. S., Santini, A., & Cossignani, L. (2018). Chemical and Nutritional Characterization of Seed Oil from Cucurbita maxima L. (var. Berrettina) Pumpkin. Foods (Basel, Switzerland), 7(3), 30. https://doi.org/10.3390/foods7030030
- Procida, G., Stancher, B., Cateni, F., & Zacchigna, M. (2013). Chemical composition and functional characterisation of commercial pumpkin seed oil. Journal of the science of food and agriculture, 93(5), 1035–1041. https://doi.org/10.1002/jsfa.5843
- Nishimura, M., Ohkawara, T., Sato, H., Takeda, H., Nishihira, J. (2014). Pumpkin seed oil extracted from Cucurbita maxima improves urinary disorder in human overactive bladder. J Tradit Complement Med, 4(1), 72-74. doi: 10.4103/2225-4110.124355
- American Botanical Council. (2014, September 15). HORSETAIL. Retrieved October 26, 2021, from https://www.herbalgram.org/resources/herbclip/herbclip-news/2014/horsetail/
- Tys, J., Szopa, A., Lalak, J., Chmielewska, M., Serefko, A., Poleszak, W. (2015). Current issues in pharmacy and medical sciences. Curr Issues Pharm Med Sci, 28(2), 151-154. DOI:10.1515/cipms-2015-0062
- n.a. (2001). Monograph: Petasites hybridus (Butterbur). Alt Med Rev, 6(2), 207-209. Retrieved from https://altmedrev.com/wp-content/uploads/2019/02/v6-2-207.pdf
- Tierra, M. Butterbur. East West School of Planetary Herbology website. Retrieved from https://planetherbs.com/research-center/specific-herbs-articles/butterbur/
- Engels, G., Brinckmann, J. (Summer 2015). Schisandra. HerbalGram, 106, 1-7. Retrieved from: http://herbalgram.org/resources/herbalgram/issues/106/table-of-contents/hg106-herbpro-schisandra/
- Siddiqui, H., Lagesen, K., Nederbragt, A. J., Jeansson, S. L., & Jakobsen, K. S. (2012). Alterations of microbiota in urine from women with interstitial cystitis. BMC microbiology, 12, 205. https://doi.org/10.1186/1471-2180-12-205
- Hiergeist, A., & Gessner, A. (2017). Clinical implications of the microbiome in urinary tract diseases. Current opinion in urology, 27(2), 93–98. https://doi.org/10.1097/MOU.0000000000000367
- Braundmeier-Fleming, A., Russell, N. T., Yang, W., Nas, M. Y., Yaggie, R. E., Berry, M., Bachrach, L., Flury, S. C., Marko, D. S., Bushell, C. B., Welge, M. E., White, B. A., Schaeffer, A. J., & Klumpp, D. J. (2016). Stool-based biomarkers of interstitial cystitis/bladder pain syndrome. Scientific reports, 6, 26083. https://doi.org/10.1038/srep26083
- Cervigni, M. (2015). Interstitial cystitis/bladder pain syndrome and glycosaminoglycans replacement therapy. Transl Androl Urol, 4(6), 638-642. doi: 10.3978/j.issn.2223-4683.2015.11.04
- Rooney, P., Srivastava, A., Watson, L., Quinlan, L. R., & Pandit, A. (2015). Hyaluronic acid decreases IL-6 and IL-8 secretion and permeability in an inflammatory model of interstitial cystitis. Acta biomaterialia, 19, 66–75. https://doi.org/10.1016/j.actbio.2015.02.030
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- Theoharides, T. C., Kempuraj, D., Vakali, S., & Sant, G. R. (2008). Treatment of refractory interstitial cystitis/painful bladder syndrome with CystoProtek--an oral multi-agent natural supplement. The Canadian journal of urology, 15(6), 4410–4414.
- Panchaphanpong, J., Asawakarn, T., & Pusoonthornthum, R. (2011). Effects of oral administration of N-acetyl-d-glucosamine on plasma and urine concentrations of glycosaminoglycans in cats with idiopathic cystitis. American journal of veterinary research, 72(6), 843–850. https://doi.org/10.2460/ajvr.72.6.843
- Cartledge, J. J., Davies, A. M., & Eardley, I. (2000). A randomized double-blind placebo-controlled crossover trial of the efficacy of L-arginine in the treatment of interstitial cystitis. BJU international, 85(4), 421–426. https://doi.org/10.1046/j.1464-410x.2000.00490.x
- Yu, Y., de Groat, W.C. (2013). Nitric oxide modulates bladder afferent nerve activity in the in vitro urinary bladder-pelvic nerve preparation from rats with cyclophosphamide induced cystitis. Brain Res, 1490, 83-94. doi: 10.1016/j.brainres.2012.10.007
- Korting, G. E., Smith, S. D., Wheeler, M. A., Weiss, R. M., & Foster, H. E., Jr (1999). A randomized double-blind trial of oral L-arginine for treatment of interstitial cystitis. The Journal of urology, 161(2), 558–565.
- Yongbei, Y, de Groat, W.C. (2013). Nitric oxide modulates bladder afferent nerve activity in the in vitro urinary bladder-pelive nerve preparation from rats with cyclophosphamide induced cystitis. Brain Research, 1490, 83-94. https://doi.org/10.1016/j.brainres.2012.10.007
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- U.S. Department of Health and Human Services. (2014, September). Prostate enlargement (benign prostatic hyperplasia). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved November 10, 2021, from https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia#symptoms.