• Nicole Cozean, PT, DPT, WCS

The Best Supplements for Interstitial Cystitis

Supplements can be an important part of holistically treating interstitial cystititis. They are less expensive than medications and often have fewer side effects. But which supplements are best for IC, and which supplements may irritate bladder symptoms and you should avoid?

You'll see recommendations for a wide variety of supplements for IC, and it's hard to know where to start: aloe vera, l-arginine, quercetin, magnesium, collagen, Prelief and Omega-3 fish oils all have their proponents in the IC community. And there are several combinations like Bladder Builder, Cystoprotek, and others purporting to help with IC symptoms.

Supplements to Take and Avoid for IC
Supplements for Interstitial Cystitis

We do a full review of all the most important supplements we recommend to our patients with IC symptoms, and the ones that can be irritate bladder symptoms in the IC: Roadmap to Healing online course ($87). but here is a great summary!

Supplements can be a great tool for IC and bladder pain, but generally aren't enough by themselves to provide lasting relief. Instead, they are best when combined with a holistic treatment approach and pelvic floor physical therapy to resolve the underlying "why' of your symptoms.

Supplements to Avoid with Interstitial Cystitis

We want to make sure anything we put in our bodies isn't flaring symptoms, and some supplements can be triggers for IC symptoms and should be avoided. As always, let your symptoms be your guide! In the course, we recommend creating a Symptom Log to track what is - and what isn't - affecting your symptoms.

Patients often report multi-vitamins irritate their bladder and pelvic pain symptoms. Vitamin C, which is found in almost all multi-vitamins, may be a trigger for many. We also want to avoid any supplements causing constipation, diarrhea or GI issues. These gut health issues can have a major effect on IC symptoms. Probiotics and high amounts of aloe vera can contributing to bowel issues as well.

Benefits of Supplements for IC

Supplements can have many benefits for IC - they are far less expensive than prescription medication, often have fewer side effects, and can be purchased online or over-the-counter at stores. In general, supplements are not rigorously proven in clinical trials, and the claims on the bottles are not evaluated by any regulatory agency (that's why you'll see the little *Statements not evaluated by the Food and Drug Administration* disclaimer on most bottles). We've included links below to some of the brands we typically recommend to our patients.

As with medication, there is no 'one size fits all' approach - everyone with IC is unique and responds differently. You may want to try several of the options below and see what works best for your body. Using a symptom log (you can download and print the PelvicSanity Symptom Log for IC) can help you evaluate if the supplement is showing a benefit for you. Finding the right supplement can have significant upside for you, and little downside. As we always say: if it works, keep it; if not, discard it!

Supplements for IC that Fight Inflammation

Inflammation, when trapped in a region, can increase pain and cause dysfunction (think of a knee swollen with arthritic pain, for example). With IC, inflammation tends to gather in the lower abdomen, just above the bladder, and on the inner thighs. You can test yourself by trying to (gently) lift the skin on your stomach or inner thighs up and away from the muscle underneath - if it feels tender or difficult to lift, it's likely that inflammation is playing a role in your condition.

L-Arginine - A common amino acid that is both made by the body and found in many foods, L-Arginine isn't generally included in many multivitamins or supplement blends because there is generally enough already present. It is a precursor to nitric oxide, a molecule that helps open up blood vessels and increase circulation.

L-Arginine Supplement for IC
Open Blood Vessels to Remove Inflammation with IC

The idea behind L-Arginine is that increasing blood flow and opening up blood vessels can help clear away some of the inflammation that builds up in the pelvic region with IC. It's one of the only supplements that has been truly evaluated in a published, scientific study specifically for interstitial cystitis. In a double-blind, randomized, controlled study of about fifty patients, 48% reported a significant overall improvement with their symptoms with 1,500 mg daily of L-Arginine. (As a comparison, two similar trials of the prescription drug Elmiron showed only 28% and 32% of patients showed a global benefit.) The group that received the placebo (sugar pill) only reported a 24% improvement. Improvements were noted in pain intensity, pain frequency, and urinary symptoms.

Omega-3 Fish Oil - Omega-3 is a type of oil found in (you guessed it!) fish that helps to fight inflammation. It's counterpart, Omega-6, is found in processed foods and increases inflammation - not surprisingly, most of us consume far more of the bad Omega-6 than the good Omega-3 oils. One study found that the American diet has more than twenty times as much of the 'bad' oils than the good Omega-3s.

Interstitial cystitis and pelvic pain both cause inflammation to build and linger around the bladder and pelvic floor, causing additional pain and dysfunction. Taking Omega-3 supplements (or trying to eat more fish!) can help balance out the bad oils in our daily diet and fight inflammation. When looking for a good Omega-3 supplement, try to find one with a 1.5:1 ratio of EPA:DHA, the two major components.

Quercetin - Quercetin is a bioflavonoid that may help IC symptoms and inflammation. It occurs naturally in apples broccoli, onions, blueberries and more! It reduces inflammation by scavenging free radicals within the body, stopping inflammation before it starts. Studies have shown Quercetin was effective in reducing pelvic pain in the closely related condition of chronic prostatitis, and may be beneficial for patients with IC. In supplements, it's often combined with Bromelain, which may have some analgesic or pain-reducing properties as well.

Antacids for Interstitial Cystitis

The majority (around 80%) of patients with IC have some level of food sensitivity. For many, this involves only a small handful of trigger foods - common triggers include citrus fruits and juices, caffeine, alcohol, tomatoes, artificial sweeteners, and spicy/exotic foods. Others are more diet-sensitive and have to be more careful about the foods they avoid.