Urinary Tract Infections Naturopathic Protocol
Urinary Tract Infections Naturopathic Protocol
This Urinary Tract Infections Naturopathic Protocol is provided as information for patients of HealthMasters Naturopath Kevin Tresize ND as part of a treatment plan to assist patients with understanding of their treatment plan and should not be substituted for medical advice, diagnosis or treatment. It is important to note that this is a summary only and is intended to assist discussion between practitioner and patient as part of consultations. This Urinary Tract Infections Naturopathic Protocol may be changed to suit the individual requirements of the patient and should not be substituted for medical advice, diagnosis or treatment.
HealthMasters Naturopath Kevin Tresize ND
2. Aetiology and Risk Factors
3. Signs and Symptoms
4. Core Treatment
5. Alphabetical Reference of Nutritional Support
6. Diet and Lifestyle
7. Supportive Lifestyle Program
8. Point-of-care and Pathology Testing
9. Pharmaceutical Treatments
Urinary Tract Infections (UTI) are common and are mainly due to bacterial infection. The predominant organisms include Escherichia coli, Staphylococcus saprophyticus, Klebsiella spp. and Proteus spp.
Cystitis is a bladder infection. Symptoms of cystitis include frequent urgent burning or painful voiding of small volumes of urine. Nocturia, and often low back pain is common.
Urinary tract infections and cystitis occur predominantly in women. Isolated UTIs occur in 30% of all women; recurrent UTIs occur in 60% of cases, 95% of which are due to exogenous reinfection.
2. Aetiology (Cause) / Risk factors:
Major causative factors and risk factors that can contribute to the incidence of UTI/cystitis include:
- Poor hygiene
- Diabetes mellitus
- Changes in sexual activity: partner, frequency, intensity
- Use of irritant chemicals (detergents, spermicides)
- Use of irritant contraceptive devices (diaphragm)
- Use of oral contraceptives
- Heavy antibiotic use
- Urinary tract abnormality or obstruction (tumour, calculi, stricture, inability to empty bladder completely)
- Previous UTIs less than 6 months apart
- Urethral or bladder catheterisation
- Medications such as immunosuppressants, and corticosteroids
3. Signs and Symptoms:
Common signs and symptoms of UTI/cystitis include:
- Painful urination, with a burning sensation, frequency, and urgency
- Blood or pus in urine
- Pain or cramping in the lower abdomen
- Pain in the lower back region
- Chills, fever (fever may be the only symptom in infants and children)
- Strong-smelling urine
4. Core Treatment:All may be used in conjunction with antibiotic therapy if required
4.1 Reduce infection, pain and urinary frequency
4.1.1 Chinese Herbal Support for Urinary Disturbances - 5 tablets 4 times daily and gradually reduce to 3 tablets twice daily as symptoms reduce
4.1.2 Nutritional Support for the Kidney - 2 tablets three times daily
4.1.3 Meta Mag Magnesium Bisglycinate, Corydalis and California Poppy for Pain - 2 tsp twice daily
4.2 For bacterial or fungal/yeast infection
4.2.1 Small Intestinal Bacterial Control - 2 capsules twice daily with food
4.2.2 Detox Greens - 2 scoops twice daily
4.3 Stimulate immunity to fight infection and prevent chronic or recurrent infection
4.3.1 Cordyceps, Coriolus and Reishi for Immune Stimulation - Acute: 1 serve three times daily
4.3.2 Mushrooms and Astragalus for Immune System Support - 1 tablet twice daily
4.3.3 High Bioavailability Zinc with Vitamin C - 1-2 serves (½-1 tsp) 2-4 times daily
4.3.4 Lactobacillus plantarum HEAL9, Lactobacillus paracasei 8700:2 and Lactobacillus rhamnosus LGG® to Boost Immunity - 5 capsules 2-3 times daily in acute infections
4.3.5 Strain Specific Probiotics for Gut Microbiota Restoration and Support - 1 capsule twice daily
4.3.6 Boulardii and Bi-07 for Management of Dysbiosis - 1 capsule twice daily
4.4 For chronic or recurrent infection
4.4.1 Specialised Pro-Resolving Mediators - 1 capsule twice daily
5. Alphabetical Reference of Nutritional Support:
Formula Catch Phrase
|Chinese Herbal Support for Urinary Disturbances||A Traditional Chinese Medicine herbal preparation for the treatment of urogential disturbances such as acute and chronic cystitis, and acute and chronic urinary tract infections in men and women. It has been shown to reduce swelling and pain and exert anti-inflammatory and antibiotic activity.|
|Cordyceps, Coriolus and Reishi for Immune Stimulation||These four medicinal mushroom extracts each have demonstrated potency to enhance immunity. Supports the resolution of chronic, latent and/or recurrent infectious conditions, including yeast and fungal infections.|
Herbal and nutritionally based ingredients to support gastrointestinal mucosal integrity, detoxification of heavy metals, balance acidity, enhance digestion and healthy probiotic balance, whilst enhancing kidney and lymphatic detoxification. spirulina is assisting removal of toxicity induced by: heavy metals: arsenic, mercury, chromium, cadmium, lead, fluoride, Insecticides. This formula also contains prebiotic compounds improving the microbiota.
|High Bioavailability Zinc with Vitamin C||Providing immune support via the inclusion of zinc and vitamin C may decrease the severity and duration of the infective episode. Zinc and vitamin C are also necessary for correct healing of the urinary tract tissues and prevention of scarring which leaves the body prone to recurring infections.|
|Lactobacillus plantarum HEAL9, Lactobacillus paracasei 8700:2 and Lactobacillus rhamnosus LGG® to Boost Immunity||Probiotics are shown to help stimulate and regulate immunity and promote T-regulatory cells, thereby promoting resistance to infection. Contains two strains specifically helpful in the management of infections.|
|Mushrooms and Astragalus for Immune System Support||Polysaccharides from both mushrooms and astragalus may enhance and regulate the immune system via interaction with the intestinal ecosystem and gut associated lymphoid tissue (GALT). Coriolus exerts prebiotic activity which modulates the gastrointestinal microbiota, and Reishi may protect against impaired intestinal permeability and dysbiosis. Astragalus also contains polysaccharides that may enhance macrophage, B-cell and T-cell activity, leading to increased surveillance and defence against pathogens. Astragalus also increases the number and activity of T-regulatory cells and modulates inflammatory pathways.|
|Meta Mag Magnesium Bisglycinate, Corydalis and California Poppy for Pain||Reducing muscle spasm of the bladder and bladder neck may reduce the severity of the symptoms and signs of UTI and cystitis. Glycine is anti-inflammatory and overall the combination of magnesium, taurine, B vitamins and supportive nutrients help balance blood sugars, improve energy production and reduce stress.|
|Nutritional Support for the Kidney||
Demulcent, antimicrobial and anti-inflammatory herbs and supportive nutrients provide preventative support to promote optimal kidney function to decrease the frequency and severity of UTI’s
|Specialised Pro-Resolving Mediators||
SPMs are lipid mediators that promote resolution, reduce pain, encourage clearance of pathogens and mitigate pathological inflammation, without immunosuppression. SPMs regulate macrophage polarisation; triggering the switch from M1 (proinflammatory) to the M2 (anti-inflammatory) phenotype, therefore promoting resolution.
|Strain Specific Probiotics for Gut Microbiota Restoration and Support||Highly researched probiotic strains, Lactobacillus rhamnosus (LGG®), Saccharomyces cerevisiae (boulardii), Bifidobacterium animalis ssp lactis (BB-12®) have demonstrated the ability to disrupt pathogenic bacteria, protect commensal groups and encourage restoration in the event of disruption, enhance gastrointestinal mucosal integrity, and have a beneficial impact on gastrointestinal function.|
|S Boulardii and Bi-07 for Management of Dysbiosis||Sacchromyces boulardii helps to clear yeast and fungal infections from the digestive tract. The gut represents a major reservoir of infection for the genito-urinary tract.|
|Small Intestinal Bacterial Control||A combination of phellodendron with potent essential oils to target resistant microbial infections, such as overgrowth of flora in the small intestines, as well as systemic, recurrent or unidentified infections.|
6. Diet and Lifestyle:
To assist in the management of UTI/cystitis:
- As with many recurrent infections, the reactive antigens that trigger immune dysfunction must be minimised through correcting intestinal flora imbalances, eliminating reactive foods and chemicals, and repairing damaged mucosal barriers and defective liver detoxification enzyme systems.
- Drink unsweetened cranberry juice, or consume a cranberry tableted extract.
- Avoid sexual activity until the acute stage of the infection is resolved.
- Drink plenty of fluids, such as water and herbal teas.
- Avoid sweetened fruit juices and other sweetened drinks.
- Reduce pro-inflammatory foods in the diet including refined foods, and sugar.
- Emphasise foods high in essential fatty acids such as oily fish and nuts / seeds.
- Eat a minimally processed diet rich in antioxidants, phytonutrients and bioflavonoids.
- Stress management techniques should be implemented.
7. Supportive Lifestyle Programs:
|Supportive Lifestyle Program||Description|
|Wellness and Healthy Ageing Program||
This program recommends a low glycaemic load diet with lifestyle recommendations for exercise, relaxation, intellectual stimulation and effective stress management – all factors associated with creating a low antigenic and anti-inflammatory environment – a healthy terrain for efficient immunity.
|Metagenics Clinical Detoxification Program||Re-current infections tend to flare with gut inflammation, weakened digestion and exposure to environmental stressors and toxins. Therefore a comprehensive screening questionnaire to help assess the requirement for detoxification, and the most highly indicated Detoxification program for the patient is recommended to use before embarking on detoxification, and again upon completion and for ongoing screening of detoxification capability.|
8. Poin-of-care and Pathology Testing:
|Pathology Test||Interpretation Guidlines|
|Urinalysis||An array of tests performed on urine to assist in determining what might be causing the infection. The sample is ideally mid-stream.
Albumin: levels >300mg/L is suggestive of urinary tract infection or glomerulonephritis.
Blood: presence of blood in the urine can be indicative of glomerulonephritis, infection, inflammation, trauma, tumour.
Pyuria: the presence of white blood cells in the urine occurs with infection.
|Bacterial culture||A bacterial culture is used to determine what bacterium is causing the infection. The sample is inoculated on to a sterile petri dish, which is then incubated. If, after 72 hours, there is no growth on the petri dish, there are no bacteria present able grow under the conditions provided by that media. If bacteria are present, colony morphology, staining and microscopy, or nucleic acid detection following amplification are used to enable identification.|
|Omega-3 Index Test||A validated test that measures red-blood cell (RBC) EPA and DHA status to personalise supplemental and diet prescriptions, as well as identifying those at risk of health conditions associated with omega-3 deficiency. An Omega-3 Index in the desirable range of 8%-12% is an indicator of better overall health.|
9. Pharmaceutical Treatments:
- Antibiotics: this class of substances kill bacteria or inhibit their growth. Examples include co-trimoxazole, amoxicillin/clavulanate and fluoroquinolones. Depending on the severity of the infection, antibiotics may be given by mouth or by intravenous injection. They are often prescribed prophylactically but can have numerous side effects.
- NSAID’s: non-steroidal anti-inflammatory drugs are often recommended for their antipyretic and analgesic effects.
- Alkalinising agents: e.g., Citravescent, is often prescribed for symptomatic relief during a UTI.
 Ensuring patients maintain an omega 3 index above 8% is essential to SPM production. Omega-3 status can be evaluated/monitored using the Omega-3 Index Test (refer to pathology testing section). In the instance of deficiency, consider co-prescribing an omega-3 essential fatty acid supplement.