Interstitial Cystitis Advice

Hi Katherine,

First off, a warm welcome to ICadvice.com!

I'm so sorry to hear that your supplements/vitamins are upsetting your bladder. Of the three that you listed, the closest I come to taking any of them is flax seed oil (which is much akin to fish oil), and I've never encountered a problem with it and my bladder. A lot of ICers have issues with multivitamins though (personally I've not tried taking one while I've had IC, though at times I've taken one specific vitamin, such as vitamin D; I know from trying different brands of vitamin D which contained added vitamin C, it's a problem for me), probably the most common reason would be that a lot of multivitamins contain vitamin C, the source of which often comes from acidic ingredients. When it comes to vitamin C there are some brands out there that make buffered, low acid brands (buffered vitamin C can be found in powdered form and mixed with water, instead of swallowing a pill, if you prefer).

Another component found in multivitamins that's been recognized as a source of trouble for some ICers is vitamin B6. One reason which has been put forth for this is this vitamin is often sourced from a substance called pyridoxine hydrochloride, and large quantities of this have been linked nerve problems (and as the nerves in our bladders are highly sensitive, it does stand to reason that pyridoxine hydrochloride could upset some peoples' IC).

While it is strictly a theory that I came to myself (I have not found it mentioned in any IC literature so far), I can't help but wonder if another reason why vitamin B6 bothers some ICers is that it is a known diuretic (a substance that increases urine output) - sometimes it's even prescribed to help with PMS/pre-period related water retension. I know that my bladder is highly sensitive to diuretic foods (even when they're low in acid) such as asparagus and celery and I always flare if I eat more than a tiny portion of considerably diuretic foods at one time. Not a lot has been written about how diuretics affect ICers, it makes perfect sense to me that if a food causes a person with a healthy (non-IC) bladder to have to void more often, why wouldn't it throw our already super hypersensitive bladders into a flare inducing frenzy! (I realize that urine output is generated/created by the kidneys and stored in the bladder, but the more it has to store, the more often you need to void and the more chance there is for increased frequency to set off your other IC symptoms such as urgency, spasms and pain.)

You didn't say what sort of antioxidants you're taking, but sometimes these are sourced from acidic products too (on something of a related side note, pomegranates which are famous for their antioxidant properties are both highly acidic and high in tannins, another substance which is known to upset IC bladders). Antioxidant pills have come under fire in both the medical and media worlds (for example, in this Washington Post article, Antioxidant Pills Questioned, Again and this ABC Australia piece, Antioxidant Pills Can Kill, Study Says, amongst others). I would approach antioxidant supplements with a very cautious outlook and try to get antioxidants from natural food sources wherever possible. (Blueberries, one of the most widely (by ICers) tolerated fruits are a fantastic source of antioxidants.)

On the whole when it comes to vitamins and supplements (and your daily nutrient needs in general), here a few helpful ideas are:

-Determine if you really need to be taking a multivitamin or other type of supplement. Dietary changes (even when following an IC friendly diet) can sometimes be enough to ensure that you're meeting your daily essential vitamin and mineral needs (for example, a lot of people think of citrus and tropical fruit as great sources of vitamin C, which they are, but bell peppers, broccoli, kale and spinach - amongst others - are all loaded with this healthy vitamin and are a whole lot easier on our bladders).

-If you do need to take certain supplements (whether for medical reasons or by choice), read the labels with a fine tooth comb. Look for any ingredients that you (already) know bother your bladder. Watch out for words like "citric (acid)", as well as things like stimulants (caffeine, etc) and artificial sweeteners, as these things are often bladder burners. Dyes can be another culprit.

-Generally, unless it's a multivitamin, the less ingredients on the label, the better. Try to buy brands with as few preservatives, fillers, dyes and artificial ingredients as possible. (If you have any food allergies, be certain that the brand you're buying is free of the problem ingredient or ingredients.)

-Pay attention to the dosage, taking more than the recommended amount (unless prescribed to do so by a doctor), could potentially cause a flare, as some component of the supplement might be tolerated by your bladder in small doses but cause a nasty flare when you up the dosage.

-Some ICers have found that the gelatin coating on some brands of supplements (as well as prescription drugs) irritates them. If you suspect this is the case, things to try include looking for a brand which is not coated with gelatin, removing the powder from the capsules and either putting it into non-animal based gelatin caps, or looking for powdered forms of the vitamin or supplement in question.

-If you smoke, try to quite. Not only is this good for your bladder overall, but studies have shown that smokers often require higher doses of certain vitamins to meet their daily needs.

-Don't blame everyone :-) If you're taking more than one type of supplement or vitamin, try a mini-elimination diet and (unless you have been prescribed the vitamin/supplement for medical reasons, in which case do not try this without first getting your doctor's consent) take just one type of supplement a day for at least two days. If after 48-72 hours you have not experienced a flare, it's somewhat safe to assume that another supplement may be the culprit (or, and this is always the case with IC, it seems, the flare could be coming from another source such as something in your diet, or the pairing of two or more pills together, which one their own, may not bother you). Try introducing another of your regular supplements back into the mix and see if it causes you to flare. (It would be wise to consult a doctor or pharmacist before trying this type of small scale elimination diet, just to make sure that doing so posses no risk to your health.)

Katherine, I hope that this helps you a bit...please, feel free to ask more questions, I'm not a doctor, but I do like to offer my firsthand impute when I can (trust me, my bladder has flared from a myriad of different pills, from supplements to OTC painkillers to prescription drugs, so I totally get where you're coming from).

Wishing you a super speedy end to your flare-up, *hugs*,
Jessica

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Jessica Cangiano: ICadvice.com creator and administrator

I have IC, but IC doesn't have me!