Cold and CPPS

Two interesting facts have been reported by a Finnish study(1). The authors found that prevalence of prostatitis was higher in married men, which could mean that a causal agent could be found in female pathogens. But, they also found that symptoms were worst from November through March (63% of the men, self-reported) and in northern Finland 14% of the men were diagnosed compared to 5-9% in central and southern Europe.

A Swedish study corroborates this data: “Nearly every other man stated that the disease had started in association with a specific event, which for 15 men (31%) included exposure to cold. Forty men (83%) reported that cold caused symptom aggravation and/or induced a relapse. Thirty men (63%) stated that taking a hot bath and 22 (46%) reported that spending time in a hot climate decreased the symptoms.”(2)

This is very interesting as it indicates a cold related factor (as the authors also suggest) or a sun-related problem (like D-vitamin deficiency) or both. The latter is also indicated by a Korean study(3). that found that increased exposure to sunlight decreased CPPS symptoms. The Koreans did not find any correlation with temperature.

Why may cold aggravate symptoms? One obvious cause is muscular tension, another less obvious may be that cold seems to slightly stimulate the immune system. The acute effect of (severe) chilling is a suppression of parts of the cellular and humoral immune response and the induction of heat shock proteins(4). But afterwards levels of proinflammatory cytokines (especially IL-6), natural killer cells, leukocytes, catecholamines and stress hormones are raised. Possibly due to the increased metabolic rate and effort to keep the core body temperature stable (peripheral vasoconstriction, shivering etc).(5-7)

But there is also the possibility of a correlation with blood viscosity and clotting propensity. Cold increases blood viscosity (makes it "thicker" and "less runny"). Viscosity is also higher in the morning, which anecdotally sees worse CPPS problems. Inflammation / infection is also correlated with increased viscosity and clotting propensity.(8) Curiously many treatments (I will discuss those later this year) decreases viscosity and clotting.

Another point of interest is that vitamin D levels are at their lowest in march. And accumulating evidence indicates that infection risk and immune dysregulation increases with lower D levels. Of wich I'll talk in my next installment.

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, köld, värme, vinter, sommar, D-vitamin.

20100314 edited the vitamin D - Korea paras and clarified the viscosity note.
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(1) Mehik A, Hellstrom P, Lukkarinen O, Sarpola A, Jarvelin M. Epidemiology of prostatitis in finnish men: a population based cross-sectional study. BJU Int 86(4):443-448, 2000.
(2) Hedelin H, Jonsson K. Chronic prostatitis/chronic pelvic pain syndrome: Symptoms are aggravated by cold and become less distressing with age and time. Scand J Urol Nephrol. 2007 Jun 21;:1-5 [Epub ahead of print]
(3) Ku JH, Kim ME, Lee NK, Park YH. Influence of environmental factors on chronic prostatitis-like symptoms in young men: results of a community based survey. Urology, 58(6):853-858, 2001.
(4) Shephard RJ, Shek PN. Cold exposure and immune function. Can J Physiol Pharmacol. 76(9):828-836, 1998.
(5) Janskyl L, Pospiilova D, Honzova S, Uliny B, Ramek P, Zeman V, Kamnikova J. Immune system of cold exposed and cold adapted humans. European Journal of Applied Physiology. 72(5-6):445-450, 1996.
(6) Walsh NP, Whitham M. Exercising in environmental extremes: a greater threat to immune function? Sports Medicine 36(11):941-976, 2006.
(7) Brenner IKM, Castellani JW, Gabaree C, Young AJ, Zamecnik J, Shepard RJ, Shek PN. Immune changes in humans during cold exposure: effects of prior heating and exercise. J Appl Physiol 87:699-710, 1999.
(8) Pop GAM, Duncker DJ, Gardien M, Vranckx P, Versluis S, Hasan D, Slager CJ. The clinical significance of whole blood viscosity in (cardio)vascular medicine. Neth Heart J. 10(12):512–516, 2002.