As vitamin D is a strong immuno-regulatory hormone(1) and has been proven effective for treating conditions, like musculoskeletal pain, there is reason to believe low D-levels, even if not causative, may exacerbate CP/CPPS. The findings above do also suggest why prostaglandin inhibitors are effective in treating CPPS, and why symptoms go in remission during summer.
This also lends support to the hypothesis that CP/CPPS has a neuromuscular/myofascial component. Cold and freezing may cause muscular tension. D-vitamin deficiency is implicated in myopathies, as are calcium and magnesium deficiencies, and depression (SAD).(2)
As Melatonin enhances cellular immunity and cold has an effect on at least some of the components involved in immunity this may also be a cause of winter-time flares, especially when bodily levels of D3 are low.
Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, värme, sommar, D-vitamin, inkontinens.
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(1) Hewison M. Vitamin D and the intracrinology of innate immunity. Mol Cell Endocrinol 321(2):103-11, 2010.
(2) Verstuyf A, Carmeliet G, Bouillon R, Mathieu C. Vitamin D: a pleiotropic hormone. Kidney Int. 2010 Feb 24. Epub ahead of print
Showing posts with label vitamin D. Show all posts
Showing posts with label vitamin D. Show all posts
Sunday, May 23, 2010
Friday, April 9, 2010
Bladder overactivity and vitamin D
Few studies about vitamin D and its relation to bladder overactivity and incontinence have been done despite the association between vitamin D and muscle weakness and coordination. The only two I have found show a correlation with decreasing vitamin D levels and female pelvic floor disorders incl. urinary incontinence(1) and risk of onset of overactive bladder.(2) Especially with age. The studies have been made on women only, but there is no reason to believe men should differ in this respect.
Another study has also shown that bladder cells (“bladder epithelium and stromal cells along with vascular endothelial cells”) contain vitamin D receptoirs (as most of the other cells of the body also do) and that treatment with vitamin D analogues “inhibits basal and androgen-stimulated human bladder cell growth and enhances their apoptosis” and “prevent[s] starvation-induced cell phenotype modification”.(3) All factors thought to cause overactive bladder.
Thus different lines of evidence point at low vitamin D levels being a possible causative agent. As CPPS show distinct seasonality with summertime improvement, the studies are interesting and one can hope vitamin D levels will be studied in CPPS sufferers.
On a personal note I have been treating myself with vitamin D since 2008 (after noting the distinct seasonality of my symptoms) and have noted a distinct remission of all CPPS problems
Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, värme, sommar, D-vitamin, inkontinens.
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(1) Badalian SS, Rosenbaum PF. Vitamin D and pelvic floor disorders in women. Obstet gynecol 115(4):795-803, 2010.
(2) Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM. Leicestershire MRC incontinence study group. Nutrient composition of the diet and the development of overactive bladder: a longitudinal study in women. Neururol urodyn 23:204-210, 2004.
(3) Crescioli C et al. Human Bladder as a Novel Target for Vitamin D Receptor Ligands. J Clin Endocrin Metabol 90(2):962-972, 2005.
Another study has also shown that bladder cells (“bladder epithelium and stromal cells along with vascular endothelial cells”) contain vitamin D receptoirs (as most of the other cells of the body also do) and that treatment with vitamin D analogues “inhibits basal and androgen-stimulated human bladder cell growth and enhances their apoptosis” and “prevent[s] starvation-induced cell phenotype modification”.(3) All factors thought to cause overactive bladder.
Thus different lines of evidence point at low vitamin D levels being a possible causative agent. As CPPS show distinct seasonality with summertime improvement, the studies are interesting and one can hope vitamin D levels will be studied in CPPS sufferers.
On a personal note I have been treating myself with vitamin D since 2008 (after noting the distinct seasonality of my symptoms) and have noted a distinct remission of all CPPS problems
Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, värme, sommar, D-vitamin, inkontinens.
____________
(1) Badalian SS, Rosenbaum PF. Vitamin D and pelvic floor disorders in women. Obstet gynecol 115(4):795-803, 2010.
(2) Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM. Leicestershire MRC incontinence study group. Nutrient composition of the diet and the development of overactive bladder: a longitudinal study in women. Neururol urodyn 23:204-210, 2004.
(3) Crescioli C et al. Human Bladder as a Novel Target for Vitamin D Receptor Ligands. J Clin Endocrin Metabol 90(2):962-972, 2005.
Saturday, March 13, 2010
Cold-induced diuresis (CID)
As CPPS micturition problems worsen in winter and cold it may be of interest to know that diuresis can be induced by cold weather (<10-15 C) or cold water (<18-23 C). CPPS sufferers seem to have a more easily induced CID. This may be indicative of low AVP levels, as the reflex can be blocked by administration of AVP or a synthetic analogue (e.g. desmopressin). Murine experiments have also shown that “genetic AVP deficiency abolishes cold-induced diuresis but does not attenuate cold-induced hypertension” and that acute CID is due to AVP reduction, while chronic CID is due to suppression of renal V2 receptors and the associated AQP-2 water channels, rather than inhibition of AVP release.(1)
Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, köld, värme, vinter, sommar, D-vitamin.
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(1) Sun Z. Genetic AVP deficiency abolishes cold-induced diuresis but does not attenuate cold-induced hypertension. Am J Physiol Renal Physiol.290(6):F1472-7, 2006.
Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, köld, värme, vinter, sommar, D-vitamin.
______________
(1) Sun Z. Genetic AVP deficiency abolishes cold-induced diuresis but does not attenuate cold-induced hypertension. Am J Physiol Renal Physiol.290(6):F1472-7, 2006.
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.
___________
(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.
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.
___________
(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.
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