![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
medical thoughts
Apr. 1st, 2021 07:37 amI got sick this week with a UTI. I get a lot of UTIs, maybe two times a year. Every year.
Most people know all the little tips about preventing UTIs: drink lots of water and go to the bathroom as soon as you have the urge, wipe front to back and pee before and after sex. But some people might not know that your personal biology might have something to do with it too; in fact, if you get a lot of UTIs like I do, and you're doing all of the right things listed above, then your biology is probably a big reason for recurrent UTIs:
"Additionally, some women have cells that are naturally more receptive to bacteria, meaning the bacteria are less likely to be flushed out by your natural body functions. In a 2009 study of more than 1,200 women who experience recurrent UTIs and kidney infections, researchers determined that a genetic variation in these cell receptors is associated with an increased risk of bladder and kidney infections." Uristat.com
At this point in my life, my immune system is getting sluggish enough that I don't pop a fever until pre' late in the infection game. I tend to realize that I have a UTI when I get pain on urination, but by that time I'm also fatigued (I always blame overworking, which is true) and have brain fog. With those two things going on, I'm slower to act -- this time about a day slower, which is a long time in the life of bacteria.
The evening I started my antibiotics, I got the chills so bad that I could barely walk. I had Mike cover me in two extra quilts and the chills calmed down and finally stopped after an hour or two. Still no fever though. Come on, immune system! Fever is important!
I know that if this UTI had gone on completely untreated, I would have gone into septic shock and died.
As I was lying there shivering, I was thinking that this was why I'd become a nurse in the first place: it was the very first part of The Plan. What was an option for UTI if there's no available antibiotics?
Ive been thinking about this for a couple of days now, and the obvious answer for my little clan will be cranberries. Lots of cranberries. Because the bacteria that cause UTI have these little cilia, hairs on the exterior of the cell, that allow them to cling to the walls of the bladder. Cranberry has a chemical called proanthocyanidin, or PAC, and it was thought that this PAC dissolves the cilia, allowing the bacteria to be flushed away in the urine. Studies are showing that something is going on with the cranberry, but they're not sure what:
"It can be speculated that the increased urinary antiadherence and lower incidence of UTIs are connected to other cranberry constituents apart from PACs, anthocyanins, phenolic acids, flavonoids and their microbial‐derived metabolites (de Llano et al., 2015). The pentacyclic triterpenoids, mainly ursolic acid, may play a complementary or synergistic role together with polyphenolic constituents in the antiadhesion activity of cranberry fruit (Vasileiou et al., 2013). For example, this compound caused differential gene expression in E. coli and inhibited biofilm formation in several bacterial species (Ren et al., 2005). Ursolic acid has been shown to affect P fimbriae and the curli fibre morphology of uropathogenic E. coli strains and their adhesion to uroepithelial cells (Wojnicz et al., 2013). Also, some metabolites are formed through the action of intestinal microflora, which is unique for each individual (Cardona et al., 2013). This might explain individual sensitivity to the effects of cranberry.
In summary, results of this study showed that intake of 500 mg of cranberry fruit powder containing 2.8 mg of PACs/day for 6 months was associated with a reduction in incidence of recurrent UTIs. The compliance with the study protocol was excellent and no adverse events were recorded. From the results, it is not possible to pinpoint which compound/compounds in CFP protected the epithelium of the urinary tract against the formation of bacterial biofilm. Our data nonetheless provide encouraging evidence for the protective effect of whole cranberry (peel, seeds, pulp) in women with a medical history of rUTIs. This effect is possibly due to the synergy of all cranberry components and/or its metabolites rather than just PACs. However, additional studies are needed to determine which cranberry secondary metabolites in addition to PACs are responsible for the effects found." Vostalova, J, et el. (2015) Are High Proanthocyanidins Key to Cranberry Efficacy in the Prevention of Recurrent Urinary Tract Infection? Phytotherapy Research, 29(10), 1559-1567.
So, lots of mushed cranberries. The concentrate I'm looking at has 250 grams of dried whole fruit in 50 grams of powder. That's about one cup of whole, fresh cranberries -- unless it was 250 grams after drying? Aarg! I need clarification! Also, I can make my own powder by freeze drying the berries and grinding them. hmmm.
Most people know all the little tips about preventing UTIs: drink lots of water and go to the bathroom as soon as you have the urge, wipe front to back and pee before and after sex. But some people might not know that your personal biology might have something to do with it too; in fact, if you get a lot of UTIs like I do, and you're doing all of the right things listed above, then your biology is probably a big reason for recurrent UTIs:
"Additionally, some women have cells that are naturally more receptive to bacteria, meaning the bacteria are less likely to be flushed out by your natural body functions. In a 2009 study of more than 1,200 women who experience recurrent UTIs and kidney infections, researchers determined that a genetic variation in these cell receptors is associated with an increased risk of bladder and kidney infections." Uristat.com
At this point in my life, my immune system is getting sluggish enough that I don't pop a fever until pre' late in the infection game. I tend to realize that I have a UTI when I get pain on urination, but by that time I'm also fatigued (I always blame overworking, which is true) and have brain fog. With those two things going on, I'm slower to act -- this time about a day slower, which is a long time in the life of bacteria.
The evening I started my antibiotics, I got the chills so bad that I could barely walk. I had Mike cover me in two extra quilts and the chills calmed down and finally stopped after an hour or two. Still no fever though. Come on, immune system! Fever is important!
I know that if this UTI had gone on completely untreated, I would have gone into septic shock and died.
As I was lying there shivering, I was thinking that this was why I'd become a nurse in the first place: it was the very first part of The Plan. What was an option for UTI if there's no available antibiotics?
Ive been thinking about this for a couple of days now, and the obvious answer for my little clan will be cranberries. Lots of cranberries. Because the bacteria that cause UTI have these little cilia, hairs on the exterior of the cell, that allow them to cling to the walls of the bladder. Cranberry has a chemical called proanthocyanidin, or PAC, and it was thought that this PAC dissolves the cilia, allowing the bacteria to be flushed away in the urine. Studies are showing that something is going on with the cranberry, but they're not sure what:
"It can be speculated that the increased urinary antiadherence and lower incidence of UTIs are connected to other cranberry constituents apart from PACs, anthocyanins, phenolic acids, flavonoids and their microbial‐derived metabolites (de Llano et al., 2015). The pentacyclic triterpenoids, mainly ursolic acid, may play a complementary or synergistic role together with polyphenolic constituents in the antiadhesion activity of cranberry fruit (Vasileiou et al., 2013). For example, this compound caused differential gene expression in E. coli and inhibited biofilm formation in several bacterial species (Ren et al., 2005). Ursolic acid has been shown to affect P fimbriae and the curli fibre morphology of uropathogenic E. coli strains and their adhesion to uroepithelial cells (Wojnicz et al., 2013). Also, some metabolites are formed through the action of intestinal microflora, which is unique for each individual (Cardona et al., 2013). This might explain individual sensitivity to the effects of cranberry.
In summary, results of this study showed that intake of 500 mg of cranberry fruit powder containing 2.8 mg of PACs/day for 6 months was associated with a reduction in incidence of recurrent UTIs. The compliance with the study protocol was excellent and no adverse events were recorded. From the results, it is not possible to pinpoint which compound/compounds in CFP protected the epithelium of the urinary tract against the formation of bacterial biofilm. Our data nonetheless provide encouraging evidence for the protective effect of whole cranberry (peel, seeds, pulp) in women with a medical history of rUTIs. This effect is possibly due to the synergy of all cranberry components and/or its metabolites rather than just PACs. However, additional studies are needed to determine which cranberry secondary metabolites in addition to PACs are responsible for the effects found." Vostalova, J, et el. (2015) Are High Proanthocyanidins Key to Cranberry Efficacy in the Prevention of Recurrent Urinary Tract Infection? Phytotherapy Research, 29(10), 1559-1567.
So, lots of mushed cranberries. The concentrate I'm looking at has 250 grams of dried whole fruit in 50 grams of powder. That's about one cup of whole, fresh cranberries -- unless it was 250 grams after drying? Aarg! I need clarification! Also, I can make my own powder by freeze drying the berries and grinding them. hmmm.