bladder pain

Atomic Imprint: A Legacy of Chronic Illness

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In a sense, my complicated health history began a decade before I was born. In 1951, on a chilly pre-dawn morning in Nevada, my father-to-be crouched in a trench with his Army comrades and shielded his eyes with his hands. Moments later, an atomic blast was detonated with a light so brilliant that he could see the bones in his hands through his eyelids, like an x-ray. The soldiers were marched to ground zero within an hour, exposing them to massive amounts of radiation. My father suffered many physical issues and died of chronic lymphocytic leukemia at 61 – a far younger age than usual with this disease.

Many of the soldiers exposed to atomic tests and military radiation cleanup efforts paid dearly with their health, and the legacy was passed on to their offspring in the form of miscarriages, stillbirths, deformities, retardation, childhood cancers, and chronic health issues. I never wanted children, in part because I was concerned that my own genes were affected by my father’s radiation exposure.

Early Markers of Ill Health

Physically, I didn’t feel right as a child. I had mononucleosis as a baby and needed a prednisone shot to get well. I was sick often and lacked stamina. I had mono again in high school and relapsed in college.

I fared well as a young adult, but then hit a wall in my mid-30s when I suddenly became chronically ill with digestive issues, insomnia, brain fog, and fatigue. A hair test revealed off-the-charts mercury poisoning, so I had ten fillings replaced and detoxed. All my hormone levels crashed, so I went on bioidentical hormone replacement therapy for a time. I recovered quickly but adrenal and thyroid hormone support were still necessary. I even fared poorly with the ACTH cortisol stimulation test to assess for adrenal insufficiency (“adrenal disease” beyond so-called “adrenal fatigue”).

In 2001, a DEXA scan revealed I had osteopenia at just 40 years old and I tested positive for elevated gliadin antibodies, a marker for celiac disease, the likely cause of the bone thinning. I went gluten-free and began lifting weights – thankfully, my bone density resolved. I shifted away from a vegetarian diet and gained muscle mass and energy.

Over the next several years, I had bouts of “gut infections,” resolving them with herbal antimicrobials. About a decade ago, the dysbiosis flares became more frequent and difficult to resolve. I tested positive again for mercury. This time I did the Cutler frequent-dose-chelation protocol and reduced my mercury burden to within normal levels according to hair tests.

A Labyrinth of Health Issues

My health issues were becoming more numerous, complex, and difficult to manage as I grew older. Besides the persistent sleep and digestion issues, I often had fatigue, pain, bladder pain, urinary frequency, restless legs, migraines, Raynaud’s, chilblains, and more. Managing all these symptoms was a real juggling act and rare was the day that I felt right.

As I searched for answers, I turned to genetic testing, starting with Amy Yasko’s DNA Nutrigenomic panel in 2012 and then 23andMe in 2013 to learn which “SNPs” (single nucleotide polymorphisms) I have. A Yasko-oriented practitioner helped me navigate the complexities of the nutrigenomics approach – that is, using nutrition with genetic issues.

I learned that genes drive enzymes that do all the myriad tasks to run our bodies (which don’t just function automatically), and that certain vitamins and minerals are required to assist the enzymes, as specific “cofactors.” Genetic SNPs require even more nutritional support than is normal to help enzymes function better. So my focus shifted toward using basic vitamins and minerals to support my genetic impairments. I now understood that I needed extra B12, folate, glutathione, and more. I began following Ben Lynch’s work in elucidating the MTHFR genetic issue, as I had MTHFR A1298C.

Also in 2013, given my struggle with diarrhea, I was diagnosed with microscopic colitis via a biopsy with colonoscopy. In 2014, I learned about small intestinal bacterial overgrowth (SIBO), which gave me a more specific understanding of my “gut infections,” and tested positive for methane SIBO. I worked with a SIBO-oriented practitioner on specific herbal treatments with some short-lived success.

At the end of 2014, I learned that I have Ehlers Danlos Syndrome (EDS, Hypermobile Type), confirmed by a specialist. I came to understand that my “bendiness” likely had implications in terms of chronic illness, and I saw my bunion and carpal tunnel surgeries in a new context, as part of this syndrome.

Even with these breakthroughs in understanding, I still relentlessly searched deeper for root causes.

Genetic Kinetics

In 2018, Ben Lynch published Dirty Genes, focusing on a number of common yet impactful SNPs.

I learned that I had NEARLY ALL of these SNPs – NEARLY ALL as “doubles” and even a “deletion.” (Deletions are worse than doubles; doubles are worse than singles.) Researching further, I had doubles in many related genes with added interactive impacts. Typically people might have just a few of these SNPs.

Understanding my “dirty gene” SNPs revealed that I could be deficient in methylation, detoxification, choline synthesis, nitric oxide synthesis, neurotransmitter processing, and histamine processing. Each of these SNPs could potentially impact sleep, digestion, and much more in numerous ways. Now I potentially had a myriad of root causes.

Lynch warns people to clean up their health act before supplementing the cofactors, whereas I’d cleaned mine up years prior. Sadly, I found only limited improvements in adding his nutritional protocol. Suffice it to say I felt rather overwhelmed and disheartened.

But at the same time, I gained vital and necessary insights. I now understood why I had mercury poisoning twice: detox impairments. I understood why I had Raynaud’s, chilblains, and poor circulation: nitric oxide impairments. My migraines could be histamine overload. I needed high levels of choline for the PEMT gene to prevent fatty liver disease and SAMe for the COMT gene. Much was yet still unexplained. So I relentlessly soldiered on, following every lead, clue, and a new piece of information.

Later in 2018, a friend who also has EDS encouraged me to learn about Mast Cell Activation Syndrome (MCAS), as many with EDS also have this condition. A few weeks later, I had a three-day flare of many issues, which prompted me to delve into the MCAS world, which was just as complex as the genetic approach. In working with an MCAS specialist, I honed in on three supplements, quercetin, palmitoylethanolamide, and luteolin, to help stabilize mast cells, which improved my bladder pain, bone pain, migraines, fatigue, and generalized pain. This was the culmination of months of research and work. All of this points to further genetic involvement, even though I lack specifics.

Downward Spiral

Twenty-nineteen brought further insights. I integrated circadian rhythm entrainment work. I tried a low-sulfur diet, suspecting hydrogen sulfide SIBO, which made me feel worse; and I began taking dietary oxalates somewhat more seriously after testing positive on a Great Plains OAT test. I did glyphosate and toxicity testing, which provided a picture of my toxic load. Testing also indicated high oxidative stress and mitochondrial issues (very interrelated). Hair Tissue Mineral Analysis (HTMA) testing, with the assistance of a specialist, helped me understand my mineral status and to begin rebalancing and repleting.

In 2020, I took a hiatus from all this effort, during which time I turned my attention towards personal matters, but 2021 has been a doozy in redoubling my health efforts. My digestion had worsened, so I focused on this area. I learned about sucrase-isomaltase deficiency, a lack of certain enzymes to digest sucrose and starch. I hadn’t tolerated sugar and starch for years, and I found I had a SNP for this condition. In January, a zero-carb trial diet helped me feel much better, so I continued. I tested positive for hydrogen sulfide SIBO, and I wrestled with this “whole-other-SIBO-beast” – in February trying again the low-sulfur diet and again feeling worse. Combining the zero-starch and low-sulfur diets left few options. Despite all my best efforts, I experienced a downward spiral with a loss of appetite, nausea, and vomiting every few days.

Discovering Thiamine

Around this time, I read an article about low thiamine (Vitamin B1) lowering intracellular potassium – I had been trying unsuccessfully to raise my potassium level in my HTMA work. I began following author Elliot Overton’s articles and videos on thiamine deficiency and oxalates. I was finally persuaded to take oxalates seriously. I then read the definitive book “Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition” by Drs. Derrick Lonsdale and Chandler Marrs. I learned how B1 was key in many processes involving energy, digestion, and much more. I found that I had multiple SNPs in the B1-dependent transketolase gene, which is pivotal in several pathways. I gained some understanding of how all this related to some of my other genetic impairments, and why I might need high dose thiamine to overcome some issues.

All this was quite a revelation for me. It fit perfectly with my emphasis on vitamins and minerals to assist genes…but why hadn’t I learned of B1’s significance sooner?

In early March, I began my thiamine odyssey with 100 mg of thiamine HCL, upping the dose every couple of days. At 300mg HCL, I added 50 mg of TTFD, a more potent and bioavailable form of B1, then continued to up the TTFD dose every few days.

Similar to my experience with other vitamins, I was able to proceed rather quickly in dose increases. Many other people are not so fortunate and must go much more slowly. I already had in place most of thiamine’s cofactors (such as glutathione, other B vitamins, and methylation support) – so perhaps this helped me proceed more readily. Without these cofactors, peoples’ thiamine efforts often fail.

Magnesium is one of the most important thiamine cofactors, and for me, the most challenging. My gut cannot handle it, so I must apply it transdermally two or more times a day. At times, I had what I interpreted as low magnesium symptoms: racing and skipping heart, but these resolved as I continued.

Additionally, one must be prepared for “paradoxical reactions.” Worse-before-better symptoms hit me the day after thiamine dose increases: gut pain, sour stomach, headache, fatigue, and soreness.

My symptoms improved as I increased the dosing. When I added 180 mg of benfotiamine early on, my bit of peripheral neuropathy immediately cleared. This form of B1 helps nerve issues. As I increased my thiamine dosing, the nausea abated, my appetite came roaring back, and gastritis disappeared. Diarrhea, fatigue, and restless legs improved. I was able to jog again. My digestion improved without trying to address the SIBO and inflammation directly; the strict keto and low oxalate diets may have also helped.

In June, I attained a whopping TTFD dose of 1500 mg but did not experience further resolution beyond 1200mg, so I dropped back down. At 1200mg for a month, a Genova NutrEval test revealed that I was not keeping pace with TTFD’s needed cofactors, especially glutathione and its substrates. Not too surprising, given my malabsorption issues and my already high need for these nutrients. I dropped the TTFD to 300 mg, but quickly experienced fatigue. I’m now at 750 mg, which is still a large dose, and clearly, there is more to my situation than thiamine can address. I still have diarrhea and insomnia, and continue working to address these.

The Next Chapter

With TTFD, its cofactors, and my new gains in place, I’ve turned my attention towards a duo of genetic deletions that I have in GPX1 (glutathione peroxidase 1, one of Lynch’s dirty genes) and CAT (catalase). Both of these enzymes break down hydrogen peroxide (H2O2), a byproduct of numerous bodily processes. This unfortunate double-whammy causes me a build-up of damaging H2O2 and lipid peroxides – in other words, oxidative stress, a major factor in mitochondrial impairment, many diseases, and aging. This might be one of my biggest and yet-unaddressed issues, and I am digging deep into the published medical literature. This new chapter is currently unfolding.

I believe these two deletions are related to my father’s radiation exposure, for reasons beyond the scope of this article. But what about all the other SNPs? Many questions remain unanswered.

All my gains have been so hard-won, involving much research, effort, and supplementation. Yet what other options do I have, besides playing whack-a-mole and spiraling downward? Looking back, my improvements have been substantial, given the multitude of issues I’ve had to deal with. Perhaps now at 60, my life can start to open again to more than just self-care.

I hate to think of where I would be now, had I never come across the thiamine deficiency issue. I believe a number of factors had driven my thiamine status dangerously low earlier this year, such as malabsorption, oxidative stress, and hydrogen sulfide SIBO. I’m forever grateful to Lonsdale, Marrs, and Overton for their invaluable thiamine work that helped guide me back from the brink, and to the numerous doctors and practitioners who have helped me get this far. Perhaps my story can help others struggling with chronic health issues.

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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This article was published originally on September 23, 2021.

My Life with Interstitial Cystitis

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This silent disease can not only take over someone’s body, but can also crumble their world. Interstitial cystitis (IC) is mainly a women’s disease, but there are some men who do get this as well. I am one of them, and this is my story.

Let me tell you who I am.  I am a military vet of 8 years in service, and I have also served my home county, the Winston County, Alabama Sheriff’s office, and the property appraisal office.  I played many sports in high school and went to 2 years of college.  So I have always been busy and active.  When I was in the Army I was diagnosed with depression, bipolar disorder, anxiety, personality disorder, and also PTSD. I had already had too many issues to work on before even getting IC.

I was diagnosed with interstitial cystitis in November of 2015. At that time, I had no idea what I was in for. When I first started getting bladder pain, the doctors thought I was getting urinary tract infections, so I was given several rounds of antibiotics. Those did not work and I continued to have pain. I finally had a cystoscopy, and four tumors were found in addition to the interstitial cystitis.  I had surgery for the tumors, which ended up being non-cancerous. After the surgery I was just given Tamsulosin (Flo-max) and Tramadol for pain and sent on my way. I also started the IC diet.

At a follow up three months later, when I told the doctors that I was still in pain and still going to the bathroom all the time, they said that was normal for IC , and told me to stick to the diet. It seems like some doctors don’t have a lot of knowledge about this disease. Since then I still hurt and I have even gotten worse. Cutting grass used to be my favorite thing to do, while listening to music and unwinding. Now I can’t even do that.  Even walking is a chore–it starts off as a small pain, and then it escalates into a pain that just shuts me down.  Barbecuing is another former pleasure that has vanished from my life. For one thing, BBQ sauce is a big no-no on the IC diet.  But also standing up for a long period of time causes a sharp pain and a burning sensation that feels like my whole gut is on fire.

My love life is now also gone because the pain of arousal and actual intercourse is so painful it makes my eyes tear up.  I have three boys ages 2, 3 and 10 years old, who love to wrestle and run. Now I can’t play with them—I can only watch from the sidelines. I get very little to no sleep because of the pain and the frequency of getting up all night to go to the bathroom. This disease has zapped me of all my dignity. My self-respect and self-esteem have suffered greatly. Not only is there a huge physical toll, but it has a major toll on you mentally as well.

This disease can affect anyone—it doesn’t matter what gender or race you are, or how young or old you are. It has a huge impact on a person’s world, and on their family and friends. For example, when we travel I always have to know where all the bathroom stops are en route, and we sometimes have to cancel family get-togethers. When I informed my family about what I had, they didn’t know what it was, and they didn’t understand it. They responded with comments like “oh, just walk it off,” or “you will be okay, just keep working at it.” It’s hard to face your family and friends, and pretend that you are okay, when you are not. I was in despair beyond belief, but then I found a support group on Facebook to help me along, and I am very thankful for that.

The only way we can beat this is to accept our situation, support one another, and pick each other up. We also need to communicate how we feel (especially men, who are more prone to hold everything inside) and help others understand what we are going through. All we can do is put one foot in front of the other, and walk hand in hand with each other. I hope that we will one day find a cure for interstitial cystitis.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

This article was published originally on Hormones Matter on April 11, 2016. 

The Trials of Living with Interstitial Cystitis

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Living with interstitial cystitis (IC) is hell.

I started noticing symptoms when I was 13 years old. I kept going to the restroom feeling like my bladder was full, but there would be no urine. This was 1998, and much less was known then about interstitial cystitis than is now. My family doctor had no idea what was going on and referred me to an urologist. That doctor initially thought I had pelvic bones pressing on nerves and suggested chiropractic therapy. That gave me some relief, but symptoms got worse so I returned to the urologist two years later. This time she suspected IC and wanted to perform a cystoscopy. Back then it involved being in an operating room and put under anesthesia. Today they are usually performed in the clinic. The cystoscopy revealed bleeding in my bladder walls, and I was officially diagnosed with interstitial cystitis.

Trying Various Treatments

The first treatment I tried was the oral pill Elmiron, which is specifically supposed to treat IC. I took that for a year with no relief. I then had an Interstim implanted in 2002. This is similar to a pacemaker but is implanted in my low back and hooked up to nerves related to my bladder. It sends electrical pulses to try to override the constant feeling of a full bladder – basically it’s supposed to tell my bladder to shut up. This took the edge off my symptoms for ten years, but it no longer helps and my symptoms have worsened. I have had seven surgeries related to the Interstim, including a battery replacement and wire revisions. I switched to an urogynocologist in 2014 and he performed the last two wire revisions.

I have also tried using Botox to mange my symptoms. A catheter is inserted and Botox is injected with a needle several times directly into the bladder wall. I was given a valium prior to the procedure, but it was still painful and I was in pain for about five hours afterwards. Botox ended up not helping my IC either. My urogyn wanted to try another injection with a higher dose of Botox, but I did not want to go through that pain again and I could not afford it. I have group health insurance with a $3500 out of pocket. Botox injections cost all of that.

I tried acupuncture a few times, but that seemed to make my bladder worse. I went back to trying oral medications. Today I take six medications daily – prescription gabapentin for pain relief, Myrbetriq to decrease the urinary frequency, and hydroxyzine, an antihistamine that can help with bladder pain. I also take over the counter marshmallow root, d-mannose, and Azo bladder control pills. I also have prescription hyophen (a smooth muscle relaxer) for flares. I take a lot of OTC Azo UTI pain relief pills, but not daily. I have taken OTC Kratom pills (a herb), too, that help the pain a bit.

What Interstitial Cystitis Feels Like

I read a meme relating to chronic disease that said “my life consists of tolerable pain and intolerable pain.” I’ve never seen anything more truthful. I have good days and bad days with IC.  On good days, symptoms are always there but they are tolerable.  I have constant urinary urgency that varies in intensity. I have pressure and pain in my urethra and pelvic region. I do not have the option to “be sick” and stay in bed every time I do not feel well, otherwise I would spend 90% of my life in bed. I have to go about normal functions in life while enduring pain that would make most people unable to move. And those are my good days.

A bad day is when my IC flares. Flares are when symptoms go from a 5 to a 10 and pain hits me like a brick. They happen at any time. They vary from lasting a week to two months. They feel like a sharp burning pain as though my bladder and/or urethra is touching an electric fence. Sometimes it feels like my bladder walls have turned to stone or are swollen and putting pressure on my whole pelvic area. Sometimes it feels like my urethra is pinching against itself as tightly as it can. I have things that help calm the flare a bit (bladder instillations where medication is inserted directly into the bladder through a catheter, steroids, baking soda in water, ice packs), but for the most part I just have to ride it out until the pain subsides to a tolerable level. For some reason, the doctors I go to will not prescribe pain medicine for flares. I have considered pretending I hurt my back so that I could get pain meds, because I know I will not get them if I say I have bladder pain due to IC. It pisses me off that people can fake pain and get pain meds, and I have actual pain and I cannot get any pain meds.

Those are my physical symptoms. There are also a lot of mental aspects that come with this disease. IC is very hard to live with because I do not look sick. There are no obvious signs on the outside of my body that anything is wrong (aside from surgical scars). I smile and laugh and have fun, all while inside my bladder is fighting me.  Treating IC is frustrating because symptoms vary widely from patient to patient, so treatment options vary widely as well. I wish it was like a headache where I could take an aspirin and get relief.

On really bad days during a flare when the pain has been unending and I am exhausted and have been crying from pain, thoughts of suicide come to mind. I think that’s a natural reaction. I would never act on those thoughts, but they come because it seems like the only way to get relief from the pain.

Living With Interstitial Cystitis

IC has made me unsympathetic towards people with minor pain. If I see someone with a broken foot who is crying, I do not feel bad for them. A friend had her tonsils removed and was complaining about the severe pain. I did not feel bad for her. I would give anything to have that kind of temporary pain rather than the pain I have to live with on a daily basis.  IC has made me jealous of mothers, because I do not know if I will be able to have children. I do not know how I can raise a child when I do not feel good the majority of the time. I am jealous of women who have vaginal deliveries. That will not be an option for me if I can have children.

My food and drink have limitations. I gave up pop several years ago, but I still struggle giving up coffee. I do not drink it daily but it’s been hard to eliminate, even though I know when I drink it will have to pay for it with increased burning with urination. I avoid tomato products and other spicy foods as much as I can. I recently started cutting out anything that has citric acid in it, and that seems to help a bit.

You lose a sense of privacy when you have IC.  A friend commented how she got over being nervous about pelvic exams after giving birth to her first child. I thought, I’ve been putting my feet in stirrups since I was 14 years old. I got over that a long time ago. I’ve gotten so used to not being able to wear pants during clinic visits that one time after a bladder instillation, I hopped off the table and started getting dressed before the nurse was even out of the room.

When I feel down and think about all that IC has taken from me, I remind myself what this disease has given me. I have more strength than the average person. I am capable of pulling myself up after being repeatedly knocked down. I feel a bond with other people who have chronic illnesses because we know what it is like to grieve over the healthy person we used to be, and grieve over the person we will never get to become. It has made my faith in God deeper because I trust in Him no matter what.

I also feel empowered. I have had IC for most of my life and have tried several different treatment options. I do not know everything about this disease, but I learn more about it with each treatment I try and each year that I live with it. I love being able to give advice to other people suffering from IC and tell them what my experiences have been. At the last appointment with my urogyn a few months ago, he asked if I could do him a favor. There was a 17 year old girl in the next room, crying and in despair because she was in pain and no one understood what she was going through. He asked if I could talk to her. I walked into the room and saw this young girl with red, puffy eyes holding Kleenexes in her hands. She reminded me of myself when I was a teenager and first diagnosed. I wrapped my arms around her and said, “I know exactly how you feel.”

IC can be a very lonely disease. I have a wonderful family who are extremely supportive, especially during flares.  But I have found one of the best things to help is when I can reach out to others who are going through the same struggles I am, whether I am the one giving support or being supported. I am beyond grateful for the Facebook IC support group I am in. It is wonderful to be able to ask questions about treatments or diet, or even just vent when in pain.

Living with IC is not easy. I have accepted that this is the battle God knew I would be strong enough to fight. And I am fighting. And I am living.