Bladder Support: Supplements 101

[00:00:00] Leah: So Tina, I know you love herbs

[00:00:02] Tina: Yes, I do.

[00:00:02] Leah: and that's kind of what brought you to naturopathic medicine.

[00:00:06] Tina: Absolutely. Yep.

[00:00:07] Leah: Yeah, kind of me too, but I've kind of drifted away from that. I've mentioned that before. Um, so I have a question for you. When you talk to patients about herbs, do you use their common name or do you use their botanical name?

[00:00:20] Tina: Well, I would say when I'm talking to people, I'd probably use their common name as much as possible. And then when I'm actually using the herbs, you know, when we had 110 separate herbs on our shelf, I formulated them using the Latin names because you need to be more precise, so I would call it cramp bark.

I wouldn't call it viburnum opulus, that kind of thing.

[00:00:42] Leah: Okay.

[00:00:42] Tina: Cause it's a lot of Latin.

[00:00:44] Leah: It is a lot of Latin and I feel like I really have drifted away from using. the Latin names for herbs.

[00:00:51] Tina: Yeah. I mean, if you're not using them all the time. And you're not formulating. Yeah.

[00:00:55] Leah: Right. Cause I, I, I'm not formulating and I'm just talking with, patients about it. Yeah. What kind of brought it up was, um, when I was reviewing different, papers and stuff for this episode where we're talking about bladder support. I, yeah, I had to keep looking up what they meant. If it didn't say what the, what the common name was, I was just like, I don't know what that is.

I just feel like I'm, I'm so out of the loop.

[00:01:23] Tina: Well, and you know, there's not a whole lot of reason to have good rote memory. You could just look it up every time you need it. I mean, it's, it's not like it was 25 years ago or 30 years ago when you actually had to keep it all in your head or else it was laborious to look everything up that you needed to.

Right.

[00:01:37] Leah: Yeah. And I don't really have the need to know, you know, the, the Latin name for these herbs because yeah, I'm typically talking to patients one on one,

[00:01:48] Tina: Mm hmm.

[00:01:50] Leah: dazzle them with my. with my knowledge. Anyway, speaking of razzle dazzle, this is going to be a really interesting episode because my use of bladder support is kind of limited, because of the circumstances, you know, where I worked in, in hospitals.

And so you are the, especially when it comes to herbs, I mean, you've got a lot more, knowledge on this. And so I'm going to be learning a lot.

[00:02:14] Tina: Oh yeah. We shall see.

[00:02:15] Leah: We shall see if you learn anything. There's a quiz afterwards. There's a Scantron,

[00:02:21] Tina: a Scantron. Some of our listeners will not know what you're talking about when you say Scantron, but.

[00:02:26] Leah: There's a test.

[00:02:28] Tina: I don't want to get anyone's expectations too high. We will be talking about some plants here, but, um, hopefully, yes, everyone learns a little something, including me.

 I'm Dr Tina Kaczor and as Leah likes to say I'm the science-y one

[00:02:40] Leah: and I'm Dr Leah Sherman and on the cancer inside

[00:02:43] Tina: And we're two naturopathic doctors who practice integrative cancer care

[00:02:48] Leah: But we're not your doctors

[00:02:50] Tina: This is for education entertainment and informational purposes only

[00:02:54] Leah: do not apply any of this information without first speaking to your doctor

[00:02:58] Tina: The views and opinions expressed on this podcast by the hosts and their guests are solely their own

[00:03:05] Leah: Welcome to the cancer pod

[00:03:23] Tina: Hi, Leah.

[00:03:23] Leah: Hi, Tina.

[00:03:24] Tina: So, before we get into this episode on bladder health and what people can do for the bladder, I want to welcome a bunch of new followers we have and for whatever reason. The UK has found us. And so we've always had, you know, sporadic listeners around the globe, but there's been a bump in our listeners in the UK.

So welcome aboard. And I hope you continue to follow us and give us feedback on what you would like to hear. And, and that goes for all of our listeners out there. So around the world, most of them are in the United States, about 80%, but 20 percent are international. So I just want to say welcome, welcome aboard.

[00:03:58] Leah: Well, you know my theory about the bump in the UK

[00:04:01] Tina: Oh, cancer is maybe more of a topic of conversation.

[00:04:05] Leah: No, I just, I think it's the actual royal family. I think we've finally broke Well, we've actually broken through. I think the royal family is listening to us.

[00:04:13] Tina: We can all picture it because we've all watched The Crown.

[00:04:15] Leah: I have not.

[00:04:16] Tina: What?

[00:04:17] Leah: I know, and it has corgis and I have not watched it,

All right. All right. So let's get back on topic. Let's talk about, bladder health.

Okay, so we're going to talk about different supplements, lifestyle recommendations to support the bladder as somebody goes through cancer treatment and beyond, things that help to. soothe the bladder because there's a lot of irritation with chemotherapy and with radiation especially and then some things that are more antimicrobial, so it might be used in prevention of recurrent urinary tract infections.

Some of these herbs are diuretic. So, you know, there's some cautions around that, especially if someone's taking a diuretic.

[00:04:58] Tina: Yeah. Yeah. And I, I want to mention also that we've already interviewed a physical therapist, pelvic health oncology expert, Dr. Alex Hill. So we'll put a link to that in the notes. So we're not going to talk about the pelvic floor and the muscles that make up the pelvic floor per se. So when it comes to the musculature and the function of it from a mechanical perspective, from that mechanical perspective.

refer back to that episode. There's a lot of great information. We had a good time and learned a lot with that episode.

[00:05:26] Leah: And a lot of what I did when I was working in Arizona is to refer to physical therapy if I felt a patient needed it. And so I'll start off by saying, talk to your doctor if you feel physical therapy is for you.

So listen to the episode. If there's something that you're like, Oh yeah, that's me. Then talk with your doctor, get a referral.

Cause it is such an important part of the whole picture.

[00:05:52] Tina: Yeah. And we're going to talk about it in reference with treatments today because there are so many treatments that affect the bladder and, with aging, And natural loss of hormones and tissue laxity and all sorts of things that happen over the decades, chronic UTIs, urinary tract infections, and some of the issues we're going to be talking about today really are also, if someone has never had cancer, can be part of the aging process.

[00:06:16] Leah: Well, right. So, you know, with changes with menopause, which if somebody has had certain cancers that could happen overnight, you can suddenly overnight be menopausal. So, yeah, it's definitely relevant to anyone who has, experienced those, those hormone changes.

[00:06:34] Tina: hmm.

[00:06:34] Leah: So let's start off with what irritates the bladder.

[00:06:38] Tina: Okay, remember in our visuals that the bladder is precisely what the word describes. It's a holding tank. It's a bladder of urine. So it goes from the kidneys . through the ureters into the bladder and that holds the urine until you're ready to urinate. And I'm saying that because what you put in your mouth has a lot to do with what comes out in your urine.

And that means you have a lot of control of what sits in the bladder. You have some control of the pH, you have some control over the actual chemical compounds, whether they're from plants or they're artificial. So irritants to the bladder are exactly that. They literally. Irritate the walls of the bladder and can cause discomfort.

So the most common and the worst irritants are alcohol, coffee, cola drinks, cigarettes and tobacco, artificial sweeteners, chocolate, sorry, and tea. And they mean mostly black tea with that.

[00:07:34] Leah: Yeah. So it's like things with caffeine.

[00:07:36] Tina: Yeah, and those are the worst culprits. So those are the, absolute don't do those. And then there's another list of culprits, and then there's a tertiary list.

If the first list doesn't do it, go down to the second list, and if the second list doesn't do it, you go down to the ultimate.

[00:07:49] Leah: I would add things that are acidic. So maybe you're drinking a lot of lemonade during your treatment. You can taste it, but something that's really acidic like that or orange juice, be cautious with juices because of that acidity can also be irritating to the bladder.

[00:08:05] Tina: Very much so. So all fruits and their juices. So pretty much all fruit juices are going to be acidic. So that includes apples, peaches and pineapples. Of course, tomatoes. We all know they're fairly acidic. some grains can cause irritation, mostly rye and sourdough breads have been the culprits.

And I'm not making this

up.

[00:08:23] Leah: I can't figure out what it is about those that would be irritating to the bladder.

[00:08:28] Tina: I don't know, this is lists that have come with the Interstitial Cystitis Association and interstitial cystitis is basically a constant irritation of the bladder wall that feels like a urinary tract infection. It's very uncomfortable. And it's chronic with a lot of people, and so there's plenty of data out there to see from diet diaries and such what irritates people who have interstitial cystitis.

[00:08:56] Leah: And so we're taking this information as irritants for a specific condition and we just, we just are applying it, if you're undergoing treatment for cancer, if you're having irritation because of your cancer treatment, then.

Definitely look at your diet, see if there are patterns in what you're eating, what you're drinking. did you mention tobacco? Smoking is very, very irritating, you know, to the bladder. Which, which people are like, smoking? That's my bladder, not my lungs. But yes, it is, it is irritating,

[00:09:25] Tina: And to complete that list, vinegar, anything vinegar. That means dressings.

[00:09:30] Leah: it's acidic.

[00:09:31] Tina: Because it's acidic and spices and spicy food can be too. And I can tell you from experience, because we would, we would hand out to our patients who had bladder issues, we would have this handout with the foods called bladder irritants to avoid.

That's what we named it. And we did get the list from the same source We'll put a link to this list. I pulled this one from Brigham and Women's Hospital. In Massachusetts, they have a nice PDF online, we'll link to that, but basically it's the same list we're all pulling from Interstitial Cystitis Association. But it works, is my point. It doesn't matter what's causing the irritation to the bladder. This tends to work because you're removing the irritant. And so whatever's causing it,

[00:10:10] Leah: Well, you're, you're, no, you're, you're removing. And I'm going to say it's an aggravant because the irritant would be you're getting radiation. The irritant would be you're getting chemotherapy. And that's what's causing the main irritation that these other things, which normally if you're not undergoing treatment, you're like, well, I've never had that issue with coffee.

[00:10:34] Tina: I'm now undergoing radiation for prostate cancer. It's super, super irritated. Yes, you're getting radiation, but if you take out the coffee, if you take out the, orange juice, it can help to lessen that. So but they are called bladder

[00:10:49] Leah: right, right. But in, in the picture of cancer treatment, it's the treatment that's the, the main irritant.

I mean, granted, you may be having. bladder irritation and you're not getting radiation to the bladder and those are definitely things to remove from your diet But yeah, I'm just talking about in the picture of the cancer pod

[00:11:10] Tina: Mm hmm. still would call the, the foods.

[00:11:14] Leah: I mean, they're definitely irritants, but you know, they're they're they're irritating further It's not like if you are getting bladder Radiation and you take out, you know, one of these foods. It's not gonna make everything better Like change, like it's, it's multi level, right? It's like, it's, that's the lifestyle aspect of, you know, modifying your, your diet.

[00:11:36] Tina: I guess I think of the chemotherapy and the radiation as toxicity though.

[00:11:39] Leah:  I mean, it is toxicity, but it's, I mean, it's in my mind, it's like, that's your primary irritant and then everything else is just kind of aggravating. I guess it's, you know, it's, it's semantics.

[00:11:51] Tina: It may be semantics,

[00:11:52] Leah: Semantics.

[00:11:53] Tina: yeah, because I think of that as like damaging, toxicant, literally hitting the basal layer of your bladder cells with radiation and causing sometimes damage to the actual stem cells. So it's hard to create a new layer of cells because our, you know, like all tissues in our body, they renew.

And sometimes the fibrosis or the scarring of radiation can lead to a difficulty in having a good healthy bladder lining. And in our bladders, we should remember, urine naturally is slightly acidic. And so our bladders have a nice mucosal layer. And that mucosa, yes, it is mucus we're talking about. A nice mucosal layer is what protects us from our own urine.

So the bladder wall needs protection. And sometimes the production of that is difficult after treatment.

[00:12:41] Leah: Okay, so let's start with things that soothe the bladder. So, the different supplements that are soothing, and those tend to be known as demulcents, and those tend to be kind of a little viscous,

[00:12:54] Tina: Yep, they can look a little mucusy themselves.

[00:12:57] Leah: In terms of soothing the bladder, I think what I most often recommend to patients is corn silk tea. It's super mild. It's very effective. It doesn't interact, really, with anything,

[00:13:13] Tina: Which means they can do it during treatment with permission from their team.

[00:13:17] Leah: Yeah. You know, I've had patients who mix it with honey I don't think it has a bad flavor. I've actually never tried it.

[00:13:23] Tina: I had one patient who mixed it with honey and was just like, this is, this is awesome. You have to be careful with honey during radiation in the pelvis because it can in some people cause gas.

[00:13:34] Leah: So check what, if you are seeing a dietician, just make sure that it's okay to do honey.

[00:13:38] Tina: And as always, if you're not allowed to have raw fruits because you're doing a treatment that's so immune suppressive, then raw honey is off the list too. So just make sure that you get it pasteurized.

[00:13:47] Leah: Yeah, so, with corn silk, if it's corn season and you know corn that hasn't been sprayed, you can actually make your own tea and maybe we'll just write up a little recipe on our blog for people to check out.

[00:14:00] Tina: Yeah. Yeah. And when we say corn silk, it's that silky stuff around the husk when you go It's the hairs on the corn cob!

 right now when we're recording, it happens to be spring, early summer, corn comes in. If you know people are growing it and it's clean, Or you get it from the farmer's market or whatever. You can dry the corn silk yourself. What I would do, cause I would dry it and bring it to my office, cause It's difficult to find out there. You can find some corn silk tea bags, but it's not always easy to find. So when it was in season, I would take it and I would put it in little circles, like take the whole thing.

[00:14:32] Leah: Make a little bird's nest.

[00:14:34] Tina: make a little bird's nest, make, I could make probably four or five out of each, ear of corn. And then I would just let it dry in a nice clean, warm spot in my house. And then once it's super dry, kind of like you dry spaghetti. This is no different. Once it's dry, you can put it away. You

[00:14:48] Leah: For all you pasta makers out there.

[00:14:50] Tina: To our listeners in Italy. you can then put it in a mason jar, stack it all up, and that's how I would dispense it sometimes. Just, here, here's your corn silk, because it was so hard to come by. Um, I would just hoard it in the early summer when it was in season, But it, I would always run out every year.

I could never quite husk enough of that stuff.

[00:15:10] Leah: Husk a niff.

[00:15:11] Tina: But it is delicious. It tastes a little, it's, of course it tastes a little bit like corn.

but it's faint. if someone crossed corn with, um, hay,

[00:15:19] Leah: That does not sound good. I was, I was thinking you were going to say corn and chamomile. Um, but chamomile would be a good, chamomile, chamomile. that would be a good thing to mix it with anyways, because that's a very relaxing, soothing herb.

[00:15:32] Tina: it is, and it's anti inflammatory.

[00:15:34] Leah: Yeah.

[00:15:35] Tina: Yeah, so on the same note, the other demulcents that are used for the bladder, and so they're very soothing, marshmallow root, and marshmallow root Again, it's best gotten in bulk. This is an unusual one because you want to put marshmallow root into cold water. You want to do a cold water extraction of marshmallow root to really get the good stuff out of it.

And it will look a little mucilaginous,

[00:15:58] Leah: Mucus y. Yeah.

[00:15:58] Tina: Looks a little mucusy when you're done, but that's the good stuff. It's kind of like okra. You can either handle it or you can't, right? Those are the two that are top of mind,

[00:16:07] Leah: You can mix, a demulcent, you know, a soothing herb with another herb that is antispasmodic because when somebody is having bladder irritation, they can have bladder spasms. And so you can, you can blend these. So it's not like when somebody takes pharmaceuticals, you're taking this medication addresses this symptom and patient addresses this one.

Like you can do all of that if you have a safe formula, you know, blended.

[00:16:33] Tina: Yeah, so the most effective antispasmodic would probably be Kava kava also known as Piper Methisticum.

[00:16:41] Leah: So Kava Kava, which got a bad rap many moons ago, a couple decades ago, because there was a batch of Kava Kava on the market that had a whole different plant that happened to be toxic to the kidneys.

[00:16:52] Tina: there was liver toxicity as well from this. contaminant. It wasn't the cava cava that ended up being the problem

Um, it's making a comeback. I do prefer people do a tea because that's the traditional use of kava unless they source it from someone who is extremely responsible, like a professional grade company, because they're looking for contaminations and they're looking to make sure that they didn't extract it improperly.

and that's a whole nother episode we'll have someday on how people extract plants.

[00:17:18] Leah: Oh yeah. So, so it's not something that you would get off of Amazon because there is a lot that is coming out about the. lack of quality control on Amazon. So don't, yeah, this, and not that we're, you know, making recommendations, but if somebody wants to get any sort of herbs, just proceed with caution because even if it's a name brand, it may not be, who they say they are.

[00:17:38] Tina: Exactly.

[00:17:38] Leah: Um, the thing also with kava is when you drink it as a tea, it's got a little numbing effect. So, if you are going through chemotherapy and you drink this tea, it may have a little numbing effect on your, on your mouth. So, um, it's the tea. It could be the chemo, but yeah, just keep that in mind.

[00:18:00] Tina: Yeah. And the last antispasmodic that I would put in a formula probably pretty reliably is, um, cramp bark, Viburnum

There are a lot of viburnum species, but viburnum opulis is the one that's most commonly used as cramp bark. And it's, it is reliable for bladder spasms. It's also reliable for menstrual cramps, that's kind of its claim to fame. That's why they call it cramp bark.

[00:18:19] Leah: I think the last piece of this whole irritation to the bladder, regardless of the cause of it, um, bioflavonoids just in general. There is some reason to believe that bioflavonoids would be helpful to maintain the integrity of the bladder lining. So, making sure that you're getting plenty of bioflavonoids in your food is probably also a good

Examples being

[00:18:38] Tina: Blueberries, red cabbage, anything in the spectrum of blue to red in particular. Carotenoids count, so everything that's yellow and orange as well. But I think more towards the red to blue spectrum.

[00:18:51] Leah: And those have other properties as well those foods, the, the berries have properties that kind of delve into the more antimicrobial aspect.

[00:19:00] Tina: That's true. And they're a little, and it's a way of getting your fruits and vegetables without going too much towards the more acidic fruits too. Right. So we often advocate berries on the show, cause they're low glycemic. They're not highly acidic. Um, they have a good amount of

[00:19:14] Leah: We did a whole

[00:19:15] Tina: Yeah, we did. We had, we dedicated a whole episode. You're right.

[00:19:18] Leah: And we did the cranberry episode too.

[00:19:20] Tina: yeah. Yes. One of our short holiday episodes. We'll link to those in the notes.

[00:19:24] Leah: Oh, and just before we, we move on to, antimicrobials. . People probably are familiar with the over the counter medication Azo, Azo standard, and that is a medication that, back in the day that was a prescription and then it became over the counter.

 and that is it's a anesthetic and it turns your urine dark, like orange, like crazy orange.

[00:19:48] Tina: Oh, okay.

[00:19:50] Leah: Yeah, so that's just.

[00:19:52] Tina: That's kind of a pain reliever then. Yeah,

[00:19:56] Leah: I do remember when people first started buying it over the counter, they would take that if they felt a urinary tract infection coming on. And, it's not an antibiotic.

It's just numbing to the bladder. So, just be cautious. Just in general, that knowing that it's just numbing, it's just, yeah. And I don't know about using it during treatment. I just know that it's out there. And I think I have had patients that have used it separately from direct treatment, on their bladder, but always check with your doctor.

[00:20:26] Tina: Definitely. All right. So maybe we'll take a break now and then we'll talk a little bit about infections. All right.

 All right, Leah. So before we get into the infectious causes of irritating the bladder and what can be done for that, we really should talk about non infectious reasons for bladder inflammation, Cystitis is bladder inflammation. Did we ever define that? We haven't said that, have we?

[00:20:54] Leah: No, we kind of jumped right

[00:20:56] Tina: Okay. All right.

One of the most horrifying

[00:21:00] Leah: possible side effects that I remember being told would happen when I underwent treatment for breast cancer was, you know, there's that risk when you're receiving cyclophosphamide and other, other chemotherapies as well, like ifosfamide, which is often, a chemo that patients with sarcomas receive, you hear the words hemorrhagic cystitis. Which just sounds terrifying. Absolutely terrifying. And then if you're getting the Adriamycin and the Cytoxan, Cyclophosphamide, you're going to have red urine anyways, because that red devil comes out red.

[00:21:36] Tina: That's the Adriamycin.

[00:21:37] Leah: Yeah. So you are warned about this hemorrhagic cystitis. You go to the bathroom, you're peeing red and you're like, it happens that fast?

No, that's the red devil. But yeah, I mean, it's a really like, it's not one of those side effects you expect to hear about.

[00:21:55] Tina: And I don't think you need to know much about medicine to know something that is prefaced with hemorrhagic is probably not good. Right. Yeah.

[00:22:02] Leah: It's, it's no bueno, but I think really one of the most foundational things that we can talk about for bladder support. And a lot of this obviously has to do with kidney function. If somebody has any sort of kidney dysfunction and is told limit Or increase your hydration. I mean, it's, that's outside of what we're talking about.

Uh, we're just talking about regular standard protocols for bladder support during chemotherapy, is hydration, just drinking fluids, water.

[00:22:34] Tina: Yeah. And the simplest way to remember this is that when you're drinking fluids and yes, you will pee more, but that is the point you're diluting the holding tank, your bladder, right? So if it's more dilute, then it's going to be less toxic to the lining of the bladder.

[00:22:49] Leah: And while you're getting chemo, you know, you often have nurses encouraging you to drink because it helps to flush out all of those Toxins, irritants and whatnot that you are receiving as part of your treatment. So, um, again, I have to add in the, if you have kidney disease in any way, the amount of water you drink is between you and your medical providers,

[00:23:14] Tina: You and your

[00:23:14] Leah: you and your nephrologist.

Yeah. No, I didn't. I'm sorry. I always talk to the dietitians about this, how I am really like. so cautious around anybody with, with kidney disease. It's just, there's that, there, there's that balance. And so I just want to put that out there. but yeah, so water is the foundation. You can take all the herbs you want, if you're not drinking water.

[00:23:37] Tina: And it might be the other reason I lean towards teas in general with any bladder issues, because if you want to deliver the plants to where they need to go, well, peeing more will help. And so I do lean more towards teas. I don't think corn silk tincture works all that well in my experience with patients.

It's more convenient. You can throw it in your purse or your backpack or whatever you're carrying and But it just doesn't seem to do the trick as well as the tea does. And there are, like I said, there are some pre made tea bags out there, so you don't have to go, finding corn in the next three months,

[00:24:08] Leah: Yeah. And, and in the, in the winter time, it's, it's kind of hard to find that. But, um, also there used to be a company that made corn silk capsules and I would Patients open those and put those in water and make a tea out of that. Sometimes that's a little easier than carrying around a bird's nest.

[00:24:25] Tina: Yes. Although it is a good experience. I mean, if you can do plants whole like that, you just, it's just such a nice, I know it's crazy, but

[00:24:33] Leah: no, I think it's the coolest thing. And I'm going to be growing corn. If I get corn, I'm going to be making birds nest

[00:24:38] Tina: did we talk about radiation?

[00:24:39] Leah: radiation.

[00:24:40] Tina: We ha we do have to mention that. If the bladder is anywhere within the zone that somebody gets radiation, it's going to be damaged somewhat. Hopefully, it won't be so severe that it leads to a chronic cystitis afterwards. Radiation induced fibrosis is not uncommon when someone is going, especially for a curative treatment.

And in that case, I think of things like cervical cancer, rectal cancer. I have had many patients with prostate cancer who have had radiation as part of their treatment who went on to have issues with their bladder. Because, of course, the bladder is in the radiation zone. And, and it. It's getting a pretty good dose because it's so close.

So I do want to put radiation, cystitis on the list of non infectious causes.

[00:25:28] Leah: Absolutely. And radiation is getting more and more precise. So I've I have noticed that in more recent years, I have seen less of that irritation, but it's still happening, especially with something like radiation for prostate cancer.and that was most of my helping to manage those, those side effects.

And then also surgery for prostate cancer. Also, there are patients who experienced bladder issues after that as well.

[00:25:55] Tina: The nerve that runs through and controls the bladder sometimes, depending where the cancer is located in the prostate, it can be difficult for the surgeon. to completely spare the nerve. And so, um, that nerve runs on both sides right along, and it's so close. If the, if the growth of the tumor is close to it, then of course they're going to make sure they have curative surgery.

And some people can have incontinence,afterwards or issues like that.

[00:26:23] Leah: So it's really important that before addressing this irritation yourself, you find out, make sure, rule out, this is not a bacterial infection.

[00:26:33] Tina: Absolutely.

[00:26:34] Leah: And you can have irritation from your cancer treatment and a simultaneous bacterial infection, so always get that checked out.

[00:26:43] Tina: Ultimately, the only way and the best way to check it out is your doctor will get. a urinary sample and have it cultured and see what grows, if anything.

[00:26:52] Leah: And what is the most common bacteria found in cultures in samples taken from people with suspected urinary tract infections?

[00:27:01] Tina: Uh, that would be E. coli, Bob.

[00:27:04] Leah: Yeah. And so that's what the target, as we've mentioned in our cranberry episode, I mean, that's kind of what the cranberry is targeting. It's keeping those little pilli I'm doing my fingers, y'all can't see.

that surround the, the bacteria and it keeps it from sticking to the, to the bladder walls.

[00:27:24] Tina: Yes. It's like the bladder walls are like a slippery slide.

[00:27:28] Leah: Yeah, they're grasping with all their like multiple little pill eye. They're grasping, trying to hold on.

[00:27:33] Tina: Did you ever do a slippery slide when you were a little kid?

[00:27:34] Leah: Like a slip and slide?

[00:27:36] Tina: Yeah. Then we take a running start and you go flying for like 40 feet.

[00:27:40] Leah: No, I think I was afraid of those. I'm just very accident prone.

[00:27:44] Tina: Anyways, if anyone had, has done that in their childhood, that's what your urethra becomes. So remember that having a healthy microbiota . in the genital area actually is the first measure of preventing infections. So I just want to put that out there first because if you don't have a healthy microbiota, then you're more prone to infections.

And that's why we talk about a slippery slide or impossibility of E. coli to grab the sides and make its way up. So the other thing that does that is D mannose powder. which is sweet, very easy to take, it works like a charm, if it is used at the first signs, or symptoms of a bladder infection, but it has to be used really early, before that E.

coli makes its way all the way up, so, you know, people who have repeat UTIs, urinary tract infections, they know when one is coming, there's a, there's a sensation, and they get familiar with it, and they're like, uh oh, here comes another one, and a lot of these folks will unfortunately end up taking repeats, rounds of antibiotics.

but a good dose of D mannose early on, along with some other plants, I would say 80 percent of the time works because it's E. coli. Now, if it's not E. coli, D mannose doesn't work. That's the thing that people have to remember is that if D mannose doesn't work and you did it very early and you did it in an adequate dose,

[00:29:02] Leah: Oh, and a repeated dose. And I think that's always been my caution with, taking herbal medicine as an antimicrobial is that it's not like an antibiotic where it's one and done or three days and done. This is something that is often needing to be repeated for at least a couple of weeks.

 I don't know.

I just get a little, like, weirded out when people just want to do herbal medicine. And I'm like, you have to understand, it's not going to knock it out in like, if you take

it once,

[00:29:33] Tina: Right, And I think if people know the consequence of not knocking it out completely, they tend to comply better. So what we're preventing, and the reason they give an antibiotic for a bladder infection isn't just to treat the symptoms, it's to make sure it doesn't keep ascending and make its way to the kidney.

Because an infection in the kidney can very easily become an infection in your bloodstream. And so you're right. You have to be cautious and. Diligent to make sure that there's not an ascending infection because if it goes to the kidneys, it's a hop, skip and a jump to the bloodstream. And that's sepsis.

And that can be very, very serious. can be fatal. And so,

yeah, we're very careful as clinicians.

[00:30:13] Leah: Yeah, so the D mannose amount is in grams, not milligrams. And so I would give two to three grams. Usually it starts on the jar for urinary tract infections at 1. 5 grams, but I would have people dose it high and deliberately. consistently throughout the day. So we're dosing it in like, you know, half a teaspoon.

[00:30:36] Tina: There could be a scooper in the powder, but you're not taking a bunch of capsules. You're actually putting the powder in water. It tastes a little bit sweet. so it's very easy to take or I would have them put it in their tea. So it might be doing, a tea that has an antimicrobial, something like Oregon grape.

In my neck of the woods, we use a lot of Oregon grape. Uh, here in Oregon, but if you're somewhere in the southeast of the States, you might use Goldenseal or Barberry or anything else that contains berberine. You don't need to go out and get large capsules of berberine. You kind of just want to do something gentle.

What berberine does, it's not only antimicrobial, but it also helps your body make some of the antibodies that line the bladder. So that's IgA type of antibodies and those are the ones that help to protect you. And so berberine kind of has a dual use in this scenario. So I would say that's high on my list.

And then I may do some vitamin A with folks.

[00:31:31] Leah: Oh, I want to go back to D mannose.

[00:31:33] Tina: Oh, okay. Let's go back.

[00:31:35] Leah: Okay, so my caveat, I'm the Debbie Downer. My caveat with D mannose is, in some people, because it is a sugar, it can cause bloating. and gas,

And so again, if you're at the end of treatment, if you were receiving pelvic radiation, you know, like, and you don't mind the bloating and the gas, go for it. But if you're in the middle of radiation to your pelvis. Do not take this because it will cause bloating and gas in some people.

You know, one herb that we didn't mention is uva ursi.

[00:32:11] Tina: That's a big one.

[00:32:12] Leah: I do, you put Uva Ursae, it's in my combination formulas, when I would make for people. Uva Ursae, also known as Kinickkinick, it's a anti infective for the bladder specifically. And so there's something fun with plants plants have affinities for different organs.

[00:32:29] Tina: And that means that. We really use this for bladder infections specifically. We don't use it for infections and other parts of the body. We don't use it as a tonic for any other part of the body. It's really a tonic and an anti infective for the bladder specifically. And it's in most combination herbal formulas that you will see for bladder support out there because it's so reliable, Uva

[00:32:51] Leah: it's kind of a classic.

[00:32:52] Tina: Mm hmm.

[00:32:53] Leah: Something else that is really supportive to bladder health in general would be probiotics. And we have talked in other episodes about, taking probiotics, especially long term with certain treatments, maybe it's not the ideal time to take them, but even including foods with probiotics.

So, you know, I think lactobacillus rhamnosus is the one that is most talked about. Oh, not most talked about, it's talked about a lot in terms of bladder health. Um, and that is found in fermented foods, yogurt, kefir. So, if you tolerate those foods, that's something else you might include in your diet regularly to just keep, like you were talking about, that whole, microbiome internally, externally, just kind of keeping it all in check by including, probiotic rich foods.

[00:33:43] Tina: Yeah. Yeah. And what happens is, you know, it's a, it's a community of organisms. So the good guys can crowd out the bad guys. And so that's why we constantly are, advocating for prebiotics and polyphenols, which are those bioflavonoids, how, whatever word you are familiar with, but basically the colorful parts of the plant.

I didn't mention this. But on that same note of organisms, bacteria and other organisms form biofilms and a biofilm is basically exactly what it sounds like. It's like a film. Think of like a saran wrap that holds protective layer over bacteria, like a colony along the sides of the walls of the bladder.

Well, you want to break the biofilm and biofilm breakers are often from our foods. They're often things that we eat, things like those bioflavonoids. polyphenols. And so breaking the biofilm is essential no matter what your antimicrobial agent is, whether it's an herb or a drug, you want to get through.

And the last bit that I just want to mention, and then we can circle back to the microbiome, is I would often give people a very specific, uh, Nano formulated type of silver, and over the counter it was called Sovereign Silver, if it's a naturopath getting it. It's the same company, different label, it's called Argentyn 23.

Um, it's very specific, it's not just any colloidal silver, and it works really well to complement an antibiotic or I would use it alongside iodine at times. And so iodine is naturally antimicrobial and it will come out in the urine. And a little bit of iodine along the bladder walls is a good thing. I wouldn't mega dose it.

You don't need to mega dose it. It's good for all mucosal tissue and it's directly anti infective. And so I lean towards lower doses of iodine. I don't do those gigantic doses that I think can be dangerous for people's thyroid function. I would even sometimes just have people integrate. seaweed into their diet to make sure they're getting a constant flow of iodine, um, especially if they use natural salts.

Some of the natural salts that are in the stores don't have any iodine, so look carefully on the label.

[00:35:46] Leah: and, and again, I keep saying the caveat, but yeah, don't start willy nilly taking iodine, willy nilly taking just over the counter silver. These are things that, you need to be working with someone who knows what they're doing.

[00:36:01] Tina: I agree. Yes.

[00:36:03] Leah: These are things that you use with your patients.

You're not telling people, this is what you should go out and order on Amazon and start taking or buy at Whole Foods. Yeah. I mean, these are things that, that you work with your patients. Cause yeah, I don't use either of those and I haven't used either of those with, with my patients. And that's just cause we practice differently.

Um, yeah.

[00:36:23] Tina: And I'm just reporting what I have seen as a clinician work well in patients, too. And so the last bit of clinical pearl type information besides everything I keep spewing off is I actually had a patient with hemorrhagic cystitis, and we deduced that what was irritating him and causing actual hemorrhaging.

Uh, he was post radiation to the pelvis due to prostate cancer. And then he went on to get another cancer and had a chemo that was irritating to the bladder. I believe it was ifosfamide, but I can't remember well. In any case, he had hemorrhagic cystitis that wouldn't quit. And he took a lot of supplements.

This was someone who often would come to me with, you know, how about this one? How about this one? Right. Like to take a lot of supplements. We lined them all up on the counter and in many supplements, when you put it into a capsule, you need what is called a flow agent in the equipment to allow the powders to not clump as they go through and flow through the equipment and encapsulate some combination.

A lot of the times what is used is silica. Silica as a flow agent can add up if you're taking 20 different supplements and 10 of them have silica as your flow agent, that's going to be a lot of silica going through. And what happens to the silica is it can irritate the kidney a little bit, but it'll definitely irritate the bladder at that kind of dose.

So we removed all of the silica containing ones. We swapped it out for non silica and that helped tremendously. He actually stopped bleeding. It was just short of a miracle.

[00:37:48] Leah: Wow.

[00:37:49] Tina: Yeah. So silica is. In minute quantities in these capsules, but he's taken so many, it was adding up. That's my last clinical, pearl for the day.

[00:38:00] Leah: Well, I wanted to talk about a food that, in one form is a diuretic that would be celery, but celery seed traditionally has been used for incontinence.

[00:38:12] Tina: Hmm.

[00:38:13] Leah: So I thought that was interesting

[00:38:16] Tina: Yeah, it's apium graveolens. Anyways, celery seed. The only time I would put it in formulas that I can recall was, when people had high uric acid, or gout.

[00:38:32] Leah: the only thing I know for celery seed is, it's what's sprinkled in Bloody Mary. We might take that out. Um, so, no, so that's the other kind of thing, like, like dandelion as well, right? Dandelion root has a different action from dandelion leaf. Different affinities for different organs.

 I think that's a really cool thing about plant medicine.

[00:38:54] Tina: Yeah, that's why practicing herbal medicine is so rewarding, because it is incredibly effective if it is practiced well, but it is as much art as it is science. People who are steeped in science are going to say it's no, I actually know a couple. It's not science at all, but actually it is if you look. there is good data on a lot of it. It's interesting because the bar for standard of care is made by pharmaceutical companies. I put things through a very different criteria and that is, what is the downside risk of this particular item? Should we go ahead and use the celery seed for your gout?

along with dietary changes, for example. I don't need the level of evidence I would need if this were a drug with toxic side effects for the liver or kidneys or whatever, right? It's a different bar. But, that said, herbal medicine is put through the same screening and thought to have not enough evidence because it doesn't meet the pharmaceutical level of evidence or threshold of evidence to be adopted by

doctors, but the downside risk is not the same as a singular compound. That is, you know, a measured dose of a toxicant also known as a drug.

[00:40:00] Leah: Speaking of drugs, if someone is having issues with their bladder and it can't be pinpointed to, you know, any particular treatment, foods have been eliminated, One area to look is at the medications that people are taking. And the one that comes to mind is Sudafed. I mean, people take Sudafed for, you know, for allergies.

I take it before I fly just to kind of keep my ears from clogging. so it's a really common over the counter medication. It can cause urinary retention. So that is just, you know, one of many drugs that could possibly cause. side effects, that affect the bladder. So that's one thing to definitely keep in mind, to look at the medications, prescription and over the counter and see if there is something that, you know, talk to a pharmacist and have them look at them and see if there is anything that you are taking, if it is possibly affecting your bladder

[00:40:56] Tina: Yeah, I think that's a really good point because. The best thing you can possibly do is to remove the cause, right? So we're talking about, like, all these irritants and avoid these foods if they irritate your bladder, but yeah, if there is a way that you can remove something that's causing it, then that's even better because if you can switch out that med for a different one or get off of it or whatever, then you don't have to work so hard to keep the bladder healthy.

That's a good point.

[00:41:18] Leah: So in this episode, we covered, things that are soothing to the bladder. Things that can act as antimicrobials, touched a little on diuretics. if a cancer patient is taking a diuretic for a specific reason, I think that's probably you. Speaking of drugs, I think that is the, um, the priority and just be cautious with taking herbs.

 I've had to stop patients from taking herbal diuretics because they were already taking something that they didn't realize was a diuretic. so we kind of covered a lot. I think the handout will be helpful for a lot of people as well.

[00:41:59] Tina: The irritants? Yes. Mm hmm. Yeah, and we'll give some links to reliable places to get herbs.

[00:42:07] Leah: But again, be cautious with just starting these up on your own. If you don't know what's going on, don't start Dr. Googling yourself and, self prescribing. Okay. Like Tina mentioned, herbal medicine is an art and a science.

So remember to subscribe, rate, review. Tell all your friends about this podcast. Ellipses,

[00:42:34] Tina: that have an actual name somewhere under there, you can share

[00:42:37] Leah: ellipses, under the ellipses.

[00:42:38] Tina: Yeah. that one. Yeah. it's not, or on some apps, it looks more like a little hamburger. The lines, three

lines.

[00:42:44] Leah: And on that note, , I'm Dr. Leah Sherman,

[00:42:46] Tina: And I'm Dr. Tina Kaczor.

[00:42:48] Leah: and this is the Cancer Pod.

[00:42:49] Tina: Until next time.

Thanks for listening to the cancer pod. Remember to subscribe, review and rate us wherever you get your podcasts. Follow us on social media for updates, and as always, this is not medical advice. These are our opinions. Talk to your doctor before changing anything related to your treatment plan. The cancer pod is hosted by me, Dr.

Lea Sherman. And by Dr. Tina Caer music is by Kevin McLeod. See you next time.