Interstitial Cystitis (IC)

Interstitial cystitis (IC) is a condition characterized by increased urinary urgency, bladder and pelvic pain due to injury to the uroepithelium, a layer between the urinary space and underlying tissues. It is also frequently accompanied by symptoms such as chills, night time sweating and low grade fevers.


IC is associated with autoimmune connective tissue diseases and could be caused by viral infections such as CMV, EBV and other enveloped viruses. It can also be a result of low levels of glucosamine (Glycosaminoglycans deficiency), chondroitin, and MSM that are the nutrients required for maintaining of a protective bladder glycosaminoglycan (GAG) layer.


Since the IC induces a significant stress at a systemic level, transitional increase in cortisol levels attenuates an immune system function often leading to reactivation of dormant infections such as herpes family viruses, yeasts, h.pylori, etc.

Individuals with interstitial cystitis eventually develop thinning of the glycosaminoglycan (GAG) layer, the first line of defense at the bladder’s luminal surface. When this layer is damaged, metabolites such as potassium pass through the bladder lining into the submucosal layer. Leaking through the uroepithelium lining these metabolites cause depolarization of smooth muscles of pelvis and bladder while activating the sensory nerves. This process causes an inflammatory reaction via activation of sub-mucosal mast cells which release histamine, further stimulating sensory nerves, invoking tissue damage and causing vascular constriction.

Over time, if IC is persistent and not treated, the bladder will be reduced in size due to fibrotic changes and its functional capacity will be significantly decreased. Further implications of capsacin-sensitive nerve fibers activation by chronic mast cell degranulation may involve a neural up-regulation and changes within the spinal cord. Once this complication has occurred, individuals may be affected by a long standing pelvic pain.


To halt the progression of the degenerative effects of IC, the treatment of interstitial cystitis has two address both glycosaminoglycan (GAG) layer restoration and reduction of mast cells activities.

  1. The GAG layer of the bladder is primarily made up of glycosaminoglycans like chondroitin and glucosamine, therefore nutritional supplementation of these compounds is essential.
  2. Damaging mast cell degranulation can be addressed via avoidance of dietary, substance and environmental irritants and utilization of medications and supplements that target both reduction in mast cell activity and potential viral pathogens that may trigger mast cell degranulation.
    • Triggers
      • Over-cooling, especially the area around bladder and feet. In cold seasons, always wear 3-4 layers of clothing and socks and 2 layers in warm seasons
      • Foods that can irritate the exposed bladder wall such as coffee and tea, alcohol, citrus fruits, tomatoes that are ripen with gas, concentrated juices, cranberries, chocolate, msg, sugar, spices, synthetic sweeteners, bananas and other potassium rich foods that can trigger reactivation of a viral cause due to increase of intracellular calcium
      • Wearing tight clothing around the waist area
      • Straining, lifting heavy items
      • Psychological stress as it promotes inflammation via neurotransmitter and hormone changes
      • Severe dehydration
    • Maintenance
      • Exercise regularly (20-30 minutes of gentle cardio, daily). Mild cardio exercise in a warm pool can be very helpful.
      • Kegel exercises are of utmost importance for healthy pelvic floor muscles. The consequences of weakened pelvic floor muscles may include urinary or bowel incontinence.
      • Keep your urine pH between 6.5 and 7 with potassium rich foods and potassium citrate 100mg supplements taken right before meals
      • Use infrared heating pads on the bladder area a few times a day for 10 minutes until pain subsides
      • Take hot baths then put on multiple layers of clothing to keep warm, do not cool down
      • Place knees against the chest to relax the pelvic muscles
      • Before being intimate, take an antispasmodic
      • Drink more water in morning and afternoon to dilute urine metabolites, but not late in evening to avoid urinary urgency at night
    Only one of the below solutions needs to be used. The process of building up the layer to start protecting the bladder tissues from toxins may take 4-8 weeks. The symptoms at that point may improve or completely resolve.
    • Low level infrared/laser 10-minute treatment over the bladder area for the first few days of flare up
    • Glucosamine 500mg/Chondroitin 500mg/Msm 500mg – can be taken as one supplement/combo 3 times each day. Start once a day with meals and gradually build up to three times times a day over a few weeks period. Important! If you have herpes family viruses, glucosamine from shellfish such as crab and shrimp may trigger outbreaks, in which case, the bone broth is a great alternative.
    • Bone broth alone can be very effective replenishing glucosamine and chondroitin. However, caution must be taken not to overconsume as it may cause hypercalcemia and reactivate the herpes virus family.
    • Pentosan polysulfate sodium (PPS) – by prescription only. Artificially coats the bladder wall. Required long term usage. Refer to your doctor for dosage. The best choice remains naturally restoring the GAG layer with collagen supplements and bone broth.
  • FLARE UP TREATMENT (Addresses viral replication and decreases mast cell histamine release)
    The antiviral part of this treatment can be used occasionally for maintenance to prevent flare ups.
    Histamine rich foods should be avoided during a flare up.
    • Morning, 30-60 minutes before breakfast
      • St. John’s Wort (standardized) 600mg (decrease nerve sensitivity). Avoid prolonged UV exposure when using.
      • Histamine release control (reduce mast cell activity)
        • Methionine 500mg
        • Quercetin 300-500mg / Bromelain complex with bioflavonoids [srs]
        • Potassium 100-200mg to reduce urine acidity
      • Antivirals
        • Colloidal silver 30ppm (antiviral)
        • Vitamin C (buffered only, sustained release) 1000-2000mg (antiviral)
        • Garlic extract 1000mg (antiviral)
    • Evening, 60 minutes before or after a meal
      • Histamine release control (reduce mast cell activity)
        • Methionine 500mg
        • Quercetin / Bromelain complex with bioflavonoids [srs]
        • Chelated Molybdenum: 150mcg (Flare ups only. Can chelate copper)
        • Alternatively H2 blockers are ok short term between meals [srs].
      • Chromium GTF 200mcg (stabilize insulin response as implicated in hypoglycemia which may trigger mast cell degranulation)

You can also refer to histamine toxicity to obtain more relief with bladder wall inflammation.

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