Melatonin And Acute And Chronic Detrusor Overactivity Models
In acute detrusor overactivity, melatonin does not significantly affect any of the urodynamic parameters. In urodynamic studies recorded in chronic detrusor overactivity, however, it is associated with an increase in inter-contraction interval, increased bladder capacity, and an increase in threshold pressure . These effects are due to melatonin’s antioxidative function and not through its receptors because administering agomelatine, an antidepressant with melatonergic activity, deteriorates bladder dysfunction. However, this may not be the only reason behind agomelatine’s action on the bladder. It may induce bladder overactivity by its 5HT2C receptor antagonism. Also, peripheral melatonin administration results in more antioxidative effects without involving the receptor .
Reduce Nighttime Urinary Frequency In Men
Multiple trips to the bathroom at night increase risk of falls and decrease quality sleep. In a recent human study, 64% of men using a nutrient combination experienced a reduction in nighttime overactive bladder.
Scientifically reviewed by: Dr. Heidi Yanoti, DC, on February 2020. Written By Stephen Harrington.
Waking up multiple times during the night to urinate is more than an inconvenience.
Its one of the most common lower urinary tract symptoms in older men.
The medical term for this is nocturia.
It disrupts sleep patterns, which can lead to a host of health problems, and its a frequent cause of falls and resulting fractures.1,2
Current medical therapies offer limited improvements.3
A recently conducted pilot trial evaluated the effect of four nutrient compounds plus melatonin on mild, lower urinary tract symptoms, especially nocturia in healthy, older men.4
The primary study outcome was a decrease in nighttime urination.4
By the end of the study, the number of people suffering from nocturia at all was reduced by 64%. And not a singleparticipant was left waking up more than one time a night.4
This finding can potentially help millions of men who suffer from an overactive bladder to improve their sleep health, while reducing risk for falls and injuries.
Health Issues Related To Nocturia
While nocturia often gets dismissed as a mere nuisance, it can significantly impact a persons quality of life when experienced regularly. For many, sleep deprivation caused by nocturia symptoms can lead to associated conditions like fatigue, reduced productivity, mood disorders and impaired cognitive performance.
Whats more, a need to void at night often puts people at risk of falling and injuring themselves, especially the elderly. Its estimated that the US healthcare system spends $1.5 billion a year on nocturia-related hip fractures alone !
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Health Issues That Come With The Nocturia
There are many Americans who dismiss the condition of Nocturia as a merenuisance it can significantly impact the quality of life when experiencedregularly. People who suffer from the condition often describe it as anightmare because it can lead to fatigue, mood disorders, sleep deprivation,and impaired cognitive performance.
What is more dangerous is that they need to void at night and putpeoples risk of falling down and injuring themselves, especially elders whofind it challenging to reach the bathroom in time.
Other Therapies For Urge Urinary Incontinence
Botulinum toxin. Botulinum toxin A , a powerful neurotoxin produced by the bacterium Clostridium botulinum, has been studied as therapy for idiopathic detrusor overactivity in a variety of patients, including those who did not respond to anti-cholinergic drugs. BTX-A prevents the release of acetylcholine at the neuromuscular junction. This effect, in turn, inhibits depolarization of the detrusor muscle, resulting in chemical denervation of the bladder. BTX-A is administered via a cystoscopic technique that is reported to be safe and well tolerated. The toxin is injected directly into the detrusor muscle. In clinical trials, the duration of response was typically 3 to 6 months. Intravesical injections of BTX-A in patients with OAB resulted in increased bladder capacity, increased bladder compliance, and improved quality of life.,
A study of onabotulinumtoxinA in patients with idiopathic UUI or OAB indicated that doses ranging from 100 U to 150 U were effective in managing the disorder. Adverse effects included UTIs and urinary retention.
Although clinical trials with BTX-A have not been robust, they suggest that this agent may offer potential benefits for patients with UUI. Further research is necessary to substantiate the usefulness of BTX-A in this population.
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Some Medications For Type 2 Diabetes
The newer medications for type 2 diabetes, a class called sodium-glucose cotransporter-2 inhibitors work by increasing the amount of glucose or blood sugar your kidneys excrete and pass through urine, which takes fluid with it, says Varin. Some good news: There was a concern that SGLT2 inhibitors would also increase the risk of urinary tract infection , but newer research has failed to find that connection, suggests the February 2020 issue of Clinical Kidney Journal.
Alternative Treatments For Nocturia
Many people turn to complementary and alternative medicine before seeking medical help. You may also be interested in alternative medications or treatments for nocturia, but there are few studies to support their use. These treatments may work for nocturia, but only if OAB is the cause.
For example, research has found that:
- herbal medications have a positive impact on symptoms of OAB and quality of life
- acupuncture provides short-term relief for OAB symptoms
- homeopathic remedies may have benefits, but need more studies
- alternative treatments have fewer side effects than medications
- saw palmetto berry extract has no benefit for nocturia
But more research is needed to confirm if CAM works for OAB.
Always talk to your doctor before trying a supplement or alternative treatment. Certain CAM treatments can cause unintended side effects, especially if youre already taking medication.
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Reasons To Be Cautious About Melatonin
Your sleep-deprived friends may swear by it and you’ve probably read about it online or seen it on drugstore shelves. But is melatonin all it’s cracked up to be, or are you better off just counting sheep to get some ZZZs?
First, the basics: Melatonin is a naturally occurring hormone in the brain that your body uses to help regulate your circadian rhythm. That’s the 24-hour body clock that, among other vital functions, tells you when to sleep and when to wake up each day.
Your body gradually starts making melatonin about two hours before bedtime, bringing on that familiar drowsy feeling, and production continues throughout the night. In fact, melatonin is often called the “Dracula of hormones” because levels rise when it gets dark outside. As sunrise approaches, levels begin to drop, letting you know it’s time to rise for the day.
Given melatonin’s essential role in the body’s internal clockworks, many people assume the supplement is safe. This may be one reason why it has become the fourth most popular supplement among U.S. adults, according to a National Health Interview Survey. Its use doubled between 2007 and 2012, as more than three million adults reported taking the sleep aid.
And it is true: Melatonin is generally harmless – at least if you take it for a short period of time.
How To Talk To Your Doctor About Adult Bedwetting
Before a treatment can be prescribed, your physician will want to zero in on the cause of your nocturnal enuresis. A bedwetting diary is one of the most useful tools for a healthcare provider.
Take care to note when you void during the day and night:
-
When accidents occur
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Amount of urine voided
-
Drinking patterns
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What you drink
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Nature of the urinary stream
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Some Of It Is Part Of Aging
Its true that as we age, our bodies make less of the hormone that allows us to retain fluids. Because of this, our bladders fill more rapidly. Also, our bladders are unable to hold a lot of urine as we get older.
Between these two factors, adults beyond age 60 should expect to wake to use the bathroom at least once each night. But even so, these tips can help minimize the nightly excursions for people of any age.
Dangerous Interactions Could Occur
The supplement could also interfere with other important medications, including blood thinners, diabetes drugs, immune system-suppressing drugs, anti-seizure drugs and some contraceptives. If you’re taking any type of medication, it’s important to talk to your HCP before taking melatonin or any other dietary supplements.
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Taking Melatonin When Pregnant
Taking melatonin during pregnancy might help protect the babys brain against damage. However, there is not enough available evidence to confirm this benefit.
A 2016 review of studies did not find any evidence that taking melatonin during pregnancy has protective effects on a fetus.
When it comes to promoting sleep, melatonin may not be the best choice during pregnancy. It might interfere with the sleep cycles of the woman and the baby.
Although melatonin is safe overall, there is not enough research on its effects during pregnancy. Women who are pregnant or thinking about getting pregnant should talk to their doctor before taking this supplement.
Prostate Medications That Don’t Interfere Directly With Cold Medications
There are prostate medications which do not directly interfere with cold medications. These drugs, known as 5-alpha reductase inhibitors include:
- Proscar or Propecia
- Avodart
Keep in mind that these drugs will not interfere directly with cold medicines , but taking cold medications could still result in urinary retention.
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How Common Is Nocturia
Nocturia is quite common among both men and women. Studies and surveys have found that 69% of men and 76% of women over age 40 report getting up to go to the bathroom at least once per night. About one-third of adults over age 30 make two or more nightly bathroom trips.
Nocturia can affect younger people, but it becomes more common with age, especially in older men. It is estimated that nearly 50% of men in their seventies have to wake up at least twice per night to urinate. Overall, nocturia may affect up to 80% of elderly people.
Rates of nocturia have been found to be higher in people who are black and Hispanic than in white people even when controlling for gender and age. The reason for this disparity is not well understood.
Nocturia frequently occurs during pregnancy but usually goes away within three months after giving birth.
They Can Lead To Magnesium Toxicity
According to Wirtz, taking magnesium supplements can also cause magnesium toxicity, which in turn can “result in various side effects such as low blood pressure, vomiting, retention of urine, depression, and muscle weaknesses.”
However, Wirtz clarifies that this particular side effect is unusual and “generally associated with extreme amounts of supplementation and/or underlying impaired kidney function.”
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Bladder Anatomy And Physiology
The anatomy and physiology of the bladder are complex, but a basic understanding of these topics is essential in order to appreciate the various types of UI and their management., illustrates the basic anatomic structures and nervous system wiring involved in bladder function, including the detrusor muscle, the internal and external sphincters , and their neurological components.
Bladder anatomy and physiology.
Reduced activation of the sympathetic nervous system results in relaxation of the detrusor muscle, closure of the sphincter, and bladder filling. When the volume of urine in the bladder reaches 200 to 400 mL, the sensation of urge to void is relayed via the spinal cord to the brain centers. Voluntary voiding involves the parasympathetic nervous system and the voluntary somatic nervous system. Influences from these systems cause contractions of the detrusor muscle and corresponding somatic nervous activity, leading to sphincter relaxation.
A Common Aging Problem
The male urinary tract is prone to problems that worsen with age.
Lower urinary tract symptoms are a broad spectrum of clinical manifestations related to the bladder,urethra, and prostate gland. LUTS affect as many as 70% of men over 80 years of age.5
Besides nocturia, these symptoms can include increased urinary frequency, urgency, incontinence, incomplete bladder emptying, hesitancy, prolonged micturition, dribbling and a weak urine stream.6
The worsening of LUTS as men get older is due to various factors that cause dysfunction of the urinary system.7 An overactive bladder, enlargement of the prostate gland, and damage to the urethra can all contribute to urinary symptoms.
Compounds that incite chronic inflammation in the urinarytract can contribute to the development of LUTS and prostate enlargement.8,9 Men with LUTS have increased levels of plasma pro-inflammatory biomarkers.8
The aging process increases the risk for all of these problems. Obesity, diabetes, high blood pressure, smoking, some medications, nervous system disorders, and others can also contribute to LUTS.10
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Taking Control Of Excessive Urination At Night
Nocturia deserves more public attention and open conversation especially because, in many cases, it can be significantly remedied through a variety of therapies.
One of those therapies might include the combination of omega-3s and melatonin in the form of Omega Restore. Though clinical research is still in its early stages, we believe well be hearing more stories like Harriets in the future!
Limited Fluid Intake Due To Renal Disease
Some patients have kidney damage that forces them to limit their fluid intake to prevent fluid overload. If you have this problem, you should avoid nonprescription products that must be taken with a lot of fluid so you can get them down. This includes bowel regulation products containing psyllium and methylcellulose.
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Nonpharmacological Management: Conservative Measures And Exercises
The management of UI should include an evaluation of potential reversible contributors and trials of nonpharmacological interventions, which depend on the type of UI identified. Clinical studies support proper nutrition, the avoidance of constipation, weight loss, and physical activity as beneficial in improving symptoms. A study of weight loss in overweight women reported a clinically relevant reduction in the frequency of both stress and urge incontinence episodes. Women who are able to engage in regular daily exercise of moderate intensity are reported to have a lower incidence of UI than sedentary women, although the ability to exercise may be limited by physical disabilities in elderly women.
Other non-drug interventions for UI include prompted or timed voiding, habit retraining, and praises for appropriate toileting. Success with these interventions requires the patients awareness of the need to void and the ability to delay voiding if necessary. These interventions, along with exercise, are associated with modest and short-term improvements in daytime UI. Absorbent products or pads may also be helpful to some patients the use of these products should be based on the needs of the patient rather than on the convenience of the caregiver or facility staff. The drugs listed in are often problematic in these patients and may contribute to or exacerbate UI thus, evaluation may be necessary.
Role Of Anticholinergic Therapy
Anticholinergic drugs have a role in the management of UUI, but nonpharmacological interventions should generally be considered first. Although none of the six currently available anticholinergic agents appears to have a clear advantage in terms of efficacy, dosing convenience and drug tolerability may influence the choice of therapy. ER formulations offer daily dosing, improved compliance, and improved tolerability profiles, especially when compared with dose escalation of IR products. Trospium chloride, with its quaternary amine structure and reduced penetration of the bloodbrain barrier, may be an option for patients who experience excessive CNS side effects from other drugs in the class.
Topical formulations, such as the oxybutynin transdermal patch and topical gels, may offer more tolerable and convenient dosing for some patients with UUI. Pharmacokinetic differences among the various agents may be relevant in patients with renal or hepatic impairment or when drug interactions are a concern. Pharmacogenomic metabolic profiles may also play a role in drug selection in some patients, based on their CYP450 metabolism genotype.
The initial dosage of anticholinergics should be low, especially in older adults. The dose may be titrated, if necessary, with careful monitoring for adverse effects and drug interactions. An adequate trial of 1 to 2 months is recommended before clinicians consider alternative agents or therapies.
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Urinary Incontinence In Middle Tennessee
If you are suffering from urinary incontinence, overactive bladder syndrome, or enlarged prostate, it may be worth it to try natural supplements. Of course, you need to consult your physician before starting vitamins or supplements, to ensure they will not react with your medications or have any adverse effects. If you live around Nashville, Tennessee our team of expert physicians would love to help. Contact our discreet, dedicated Medical Concierge by phone or private message today.
What Help Is Available
If you are concerned about your problem and it is starting to affect your day-to-day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems.
It would be a good idea to keep a record of your bladder activity for a few days before your appointment with your doctor or nurse. You would need to keep a record for at least 3 days and filling in a bladder diary is a simple way of doing this. Please visit our Bladder Diary/Retraining page for more information.
A urine dipstick test may be done to rule out a urinary tract infection. The doctor may also arrange for you to go to a hospital for special tests on your bladder, these tests are called Urodynamics.
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