If you know someone that suffers from lower urinary tract symptoms, suggest they get their Vitamin D status checked. An article in The Journal of Urology suggests that if you have sufficient Vitamin D, you should not suffer from as much lower urinary tract symptoms. Can be an easy fix. ~ Dr. Broussard
December 07, 2020
The Journal of Urology
TAKE-HOME MESSAGE
- This systematic review and meta-analysis used data from 23 studies (86,332 participants) meeting inclusion criteria to evaluate the relationship between vitamin D and lower urinary tract symptoms. The odds of lower urinary tract symptoms was two to three times higher in individuals with vitamin D deficiency in case–control and cohort studies and 11% to 37% higher in cross-sectional studies. Individuals with lower urinary tract symptoms had lower vitamin D levels. Vitamin D supplementation was associated with a pooled decrease in odds of lower urinary tract symptoms of 0.89 (95% CI, 0.80–0.98) in five cohort studies and significant reductions in urinary incontinence episodes in four randomized controlled trials.
- These analyses demonstrated a significant relationship between vitamin D status and lower urinary tract symptoms across multiple study designs. Subgroup analysis suggested that certain populations may be more likely to be impacted by the relationship between vitamin D deficiency and symptoms, both with respect to deficiency and the potential benefits of supplementation.
– Joshua A. Cohn, MD
Vitamin D and Lower Urinary Tract Symptoms
We often don’t think of vitamin D as having an influence on lower urinary tract symptoms (LUTS). This meta-analysis may help us improve these symptoms with a safe and inexpensive treatment.
Vitamin D is more a hormone than a vitamin, with receptors found throughout the body, particularly the bladder, urethra, prostate, and pelvic floor musculature. The authors cite studies showing that vitamin D levels are inversely associated with prostate size and prostate cell growth. This may explain why there is a higher risk of prostate cancer in African American men or anyone with more pigment in the skin because melanin impairs vitamin D absorption.
The authors looked at LUTS in both men and women and found that vitamin D has a greater effect on LUTS in women than in men. This is encouraging therapeutically as many of the medications we use to treat LUTS in women have a high anticholinergic side effect profile that can result in impaired cognitive function.
The meta-analysis included 26 studies with 86,332 people evaluating different effects of vitamin D on LUTS. The authors concluded that:
The Nurses’ Health Study found that supplementing with vitamin D at 1000 IU/d was associated with a 30% lower risk of developing urinary incontinence versus supplementing with 200 IU/d.
Clinical Take-Home
In men or women with LUTS, check a 25-hydroxy vitamin D level and replenish if low. Below is a short summary of what I tell my patients to do to raise their vitamin D levels.
Vitamin D
You can raise vitamin D levels in a number of ways. The simplest is to spend time outdoors receiving non-burning sun exposure. The more pigment you have in your skin, the more time is needed. You can also get vitamin D through foods, including nuts (consider a handful daily), fish, and mushrooms. You can actually increase the vitamin D content of a mushroom if you let a mushroom (like a portabella) bake in the midday sun and then lightly sauté in a pan with olive oil. Mushrooms convert sunlight to vitamin D just like your skin does. This will provide about 800 IU of D.
It is also harder to get the converted vitamin D in the skin to your blood supply if one is overweight. Working towards an ideal weight will also raise vitamin D levels more from sunlight if there is not a thick layer of fat between the skin and your blood.
Supplementing with 1000 IU of vitamin D3 daily will raise your vitamin D level about 8 to 10 points. For example, if your vitamin D level is low at 15 and we want to get you up to a mid-normal level of 45, you would need to supplement with 3000 IU of D3 daily. To do the math, 45−15 = 30. To raise your level 30 points, you would need 3000 IU of vitamin D3 daily. (1000 = an increase of about 10).
Abstract
This abstract is available on the publisher’s site.
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PURPOSE
Cumulative studies have shown that vitamin D may be associated with lower urinary tract symptoms, but the findings have been inconsistent. The aim of this study was to systematically evaluate the relationship between vitamin D and lower urinary tract symptoms.
MATERIALS AND METHODS
The PubMed, Scopus and Embase databases were searched for articles up to June 2020. A meta-analysis was conducted to evaluate the effects of vitamin D insufficiency or intake on lower urinary tract symptoms. A qualitative description summarized vitamin D intervention for treating lower urinary tract symptoms. Sensitivity analysis was conducted to examine heterogeneity and the robustness of the results.
RESULTS
A total of 23 studies including 86332 participants were analyzed in our study. Vitamin D insufficiency was associated with a 1.37- to 2.06-fold increased likelihood of having lower urinary tract symptoms, and patients with lower urinary tract symptoms had significantly lower levels of vitamin D. Furthermore, vitamin D intake was significantly associated with an 11% reduction in the risk of lower urinary tract symptoms. In the subgroup analysis, the effects of vitamin D insufficiency on the risk of lower urinary tract symptoms were notably observed in nonAsians, females, and patients with urinary incontinence.
CONCLUSIONS
Consistent results indicated that vitamin D insufficiency was a crucial risk factor for lower urinary tract symptoms and that vitamin D supplementation showed promising effects on these symptoms. It would be of great guiding significance to consider vitamin D status when treating lower urinary tract symptoms.
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