Background
Maria was referred to me by her urologist over four years ago. She had just been diagnosed with interstitial cystitis (IC), a chronic bladder disease caused by inflammation in the bladder walls that causes urinary frequency, burning, pelvic heaviness or pain and in some cases can be so severe that the urge to urinate occurs every 30-60 minutes. That’s how severe Maria’s symptoms were when she first came to see me. She was 45 at the time, which put her into the age group when many women start to experience hormonal changes. In addition to the bladder problem she was experiencing fatigue, food allergies, night sweats, sinus problems, mood swings, and depression. She had been on Prozac for her depression and was in tears during our meeting wondering how she was going to cope with this new illness.
Treatment
Since I have worked with many IC patients over the years, I was able to give Maria reassurance that by changing her diet and adding some key anti-inflammatory supplements, she would feel better soon. As an Italian, Maria consumed a lot of red sauces and tomatoes, two of the worst foods for IC, due to high acid content. I also recommended that she remove other acidic foods like coffee, alcohol, vinegar and citrus fruits, and other foods that are irritants like cheese, dried fruit, avocado, nuts, and chocolate from her diet. I explained to Maria that these foods needed to be eliminated for a short time (usually one-three months) to allow the inflammation in her bladder to be repaired. When she was feeling better, foods could be added back in moderation without any problem.
It was also important for Maria to improve her sleep so she could better handle her anxiety and stress, which were exacerbating the IC symptoms. I recommended acupuncture treatments and relaxation exercises as an adjunct to the nutritional program.
The supplements that were recommended for Maria were a multi-vitamin/mineral complex for overall balance, a non-acidic vitamin C for her sinus problems, vitamin E for night sweats and allergies, fish oil for inflammation and depression, calcium/magnesium for anxiety and relaxing the bladder muscles, and a probiotic supplement to make sure there wasn’t extra bacteria or yeast that were making her symptoms worse. I recommended the following tests for Maria: a food sensitivity panel, since many people with IC have food intolerances; a hormone saliva profile since I suspected that her hormones were playing a major role in the anxiety/depression; and blood work to rule out anemia and thyroid problems.
Results
On her follow-up visit, Maria reported that she thought the diet would be much harder than it was. She was feeling a lot better with more energy, longer sleep without night sweats, and less frequency and burning when she urinated. The blood work showed slight anemia and no thyroid problems. The food sensitivity test showed problems with cow’s milk, aspartame, wheat, garlic, banana, lentils, cashews, and certain vegetables. Her hormone test revealed estrogen at the low end of normal with no mid-cycle surge, an elevated progesterone level, and normal testosterone levels.
The next phase of Maria’s program was to customize her diet based on the food test for a period of 90 days so that the sensitive foods could be removed from her system, allowing her body to heal. Because of the low iron levels, I recommended that Maria add more meat, fish and poultry to her meal plan since these are the best sources of natural iron. For her low estrogen levels, I suggested she add more plant estrogens to her diet like soy and flax and try using chasteberry extract, an adaptive herb* that helps with hormone balance.
Summary
Over a period of several years I have seen Maria on and off. For the most part she is managing her IC and emotional symptoms well. She occasionally calls for a visit when she goes off of her diet and supplements and starts experiencing a flare-up of symptoms. This is common for patients with IC. When they closely follow the diet and take their supplements regularly most of them feel normal again in a matter of a few months. Many are then able to tolerate a little citrus fruit or a glass of wine without consequence. It is having the motivation to make the change in the first place that is the most difficult. As Maria is nearing 50 she has had few menopausal symptoms other than some anxiety and depression once in awhile which she feels she can tolerate. Overall, her diet, supplements and life style changes have served her well and she is maintaining good health and balance. When we last spoke, Maria had gone back to work full-time and was energetic and able to handle her daily stress better. She is currently working with her doctor to wean herself off of Prozac.
Maria’s Makeover: Before
Problem: Interstitial cystitis (IC), fatigue, food allergies, perimenopause symptoms. Maria had pain and urinary frequency. She was anxious, with night sweats, sinus problems, fatigue, mood swings and some depression. She was also sleep deprived and not sure what foods were safe for her newly diagnosed medical condition.
Diet: She consumed a lot of red sauces and tomatoes, highly acidic foods which were inflaming her bladder condition. She also drank a lot of coffee and consumed a fair amount of sugar and refined grains.
Supplements: Centrum multi and vitamin C.
Exercise: Was not able to exercise after her IC diagnosis.
Stress Mgt. & Self-Care: Had a great deal of stress dealing with this new illness as well as some personal stuff going on with her extended family. She had a lot of support from her husband but no formal program for stress management.
Maria’s Makeover: After
Problem: IC, perimenopause symptoms, food sensitivities & fatigue Maria found that the IC diet was easier to follow than she anticipated so much of her anxiety improved. She was sleeping through the nights with minimal night sweats and only getting up once to urinate. Her energy and overall vitality improved substantially.
Diet: Recommended a balanced plan with three meals and two snacks. Per her food challenge test, Maria removed the foods that she was sensitive to as well as acidic and other foods that cause a problem for IC.
Supplements: Switched her multi to an all natural one with no artificial colors or preservatives. Added vitamin E, non-acidic vitamin C, EPA/DHA, GLA, and B- complex to help with Maria’s ongoing stress and anxiety.
Exercise: Maria began running three times a week and walking on the week-ends.
Stress Mgt. & Self-Care: Maria started acupuncture, which relaxed her and helped with the IC symptoms. She also prayed and spent quality time with her husband and children.
