Andrew Weil's Blog: Dr. Weil's Healthy Living Blog, page 4

“The Corpse Pose may be the most difficult pose of yoga – not because of its physical requirements, but because of the mental focus you need to properly perform it.” – Andrew Weil, M.D.

Description & History
The Corpse Pose is considered by many practitioners to be the most important part of a yoga session. It is most often used as the final pose of a yoga sequence as a time for relaxation and recovery. The Sanskrit name of Corpse Pose, Savasana, comes from sava meaning corpse and asana meaning posture.

In Corpse Pose, the body rests in the supine position: lying with the back on the ground and face up. During the pose, focus is placed on breathing and the release of tension from the body.

How to Perform Corpse Pose

Begin in the supine position: lying on your back facing the sky. Spread your legs shoulder-width apart, exhale and rotate your legs outward by opening your hips. Place your arms out from your body about 45 degrees with your palms facing up.Consciously extend your spine by stretching and adding space between your head and feet. Close your eyes but stay focused on the moment.Focus on slowing your breath and heart rate with each breath. Feel as if all the stress and tension in your body is melting away. Imagine your arms and legs are heavy and that you cannot lift them no matter how hard you try.Hold the pose for several minutes (between two and 20 minutes depending on how much relaxation you feel you need).To come out of the pose, open your eyes and slowly lift your knees, bringing your feet toward your buttocks. Use your legs to push you to your side, then press your hands against the floor and lift your torso, followed by your head, which should always be last as you stand up.

Potential Health Benefits

Decreases heart rate, blood pressure and respirationReleases muscle tension and stressIncreases mental awareness and concentrationProvides relaxation after yoga session

That last benefit is referred to as “passive recovery” after a yoga session, as opposed to “active recovery” such as walking. One study that looked at recovery periods following short, high-intensity hatha yoga sessions found that active recovery was preferable for those who wanted to return to work quickly after their session. This was due to the more efficient restoration of the pre-yoga metabolic rate. The prolonged relaxation induced by the corpse pose in passive recovery may not lend itself to a quick return to work, but if your goal is rest and repose, and not a rush back to work, the Corpse Pose should help you stay relaxed.

Researchers have also examined the effects of certain yoga poses and breathing exercises as potential therapeutic options for patients suffering from schizophrenia. Because the Corpse Pose focuses on relaxation and breathing, it was incorporated into the study. Results of the 8-week program, which were published in The Journal of Alternative and Complementary Medicine, reported significant reductions in psychopathology and increased quality of life for those practicing the pose, compared to the control group.

Modifications & Variations
There are no modified or advanced variations of the Corpse Pose since it is a simple resting pose. To ease discomfort from lying on the ground, place a yoga mat or towel underneath your body for support. You can also roll up the yoga mat or towel and place it under your lower back for lumbar support. It is important to be comfortable while in the Corpse Pose as the purpose of the pose is the focus on releasing tension built up in the body. Any slight discomfort can distract you and make you lose concentration.

Precautions
If you have back pain or have difficulty lying on your back for an extended period of time, refrain from performing the Corpse Pose. Also, be cautious when standing after performing the Corpse Pose as a sudden drop in blood pressure could cause fainting. To counter this risk, stand up slowly by first rolling over, then sitting up, going to your knees, and then slowly rising to standing.

Related Poses

Child’s Pose(Balasana)

Sources
Lee KH, Ju HM, Yang WH. Metabolic Energy Contributions During High-Intensity Hatha Yoga and Physiological Comparisons Between Active and Passive (Savasana) Recovery. Front Physiol. 2021 Sep 24;12:743859. doi: 10.3389/fphys.2021.743859. PMID: 34630165; PMCID: PMC8497825. https://pubmed.ncbi.nlm.nih.gov/34630...

Visceglia, Elizabeth, and Stephen Lewis. “Yoga therapy as an adjunctive treatment for schizophrenia: a randomized, controlled pilot study.” The Journal of Alternative and Complementary Medicine 17, no. 7 (2011): 601-607.

Originally Posted August 2013. Updated July 2022

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By Andrew Weil, M.D.

I love everything about mushrooms — foraging for them in beautiful settings, identifying them to make sure that a species is edible (never guess about this!), learning the best ways to cook them, savoring their rich flavors and textures, discovering their medicinal properties and health benefits.

My enduring fascination with mushrooms was inspired by my mother’s fear of them. She worried that fresh button mushrooms — the only ones widely available when I was growing up — might be poisonous and even warned me not to touch the “toadstools” that occasionally popped up on our small front lawn. Neither she nor I knew at the time that very few mushrooms are deadly and those that are can’t harm you if all you do is handle them. I’ve since realized that my mother’s attitude was typical of the fear of mushrooms prevalent in the English-speaking world. Much later when she found out that I was collecting and eating wild mushrooms, she told me I was a reckless fool.

Medicinal Mushrooms

I first learned about the medicinal benefits of mushrooms in the 1970s when I began reading about Chinese medicine and about research in China and Japan where traditional doctors esteem fungi as both food and medicine. I became a great believer in the immune-enhancing and cancer-protective properties of shiitake, oyster mushrooms, maitake, enoki, and other Asian species. Some of the most prized remedies in the Chinese herbal repertory are mushrooms that act as tonics — that is, they are believed to increase resistance to all kinds of stress as well as to extend longevity. Some tonic mushrooms, such as shiitake and maitake, are good to eat, while others like reishi are too woody or too bitter to be edible but can be made into medicinal teas or extracts. I take a dose of a liquid extract of seven different species every day.

I also learned that our most widely available mushrooms (white and brown buttons, cremini and portobello) are all the same species (Agaricus bisporus) and contain natural carcinogens. They do not offer the health benefits of species popular in east Asia.

I thought it odd that there was no interest in the West in the medicinal properties of mushrooms. In the late 1970s, I began giving talks on the subject at mushroom conferences and called for scientific studies. (It has taken a long time for researchers in North America and Europe to look into the health benefits of mushrooms, but I’m happy to say it’s finally happening.)

Magic Mushrooms

During this period, I also was exploring and writing about magic mushrooms, those with psychoactive properties. I first experienced their effects in Mexico in 1972. (See my story about this in my book, The Marriage of the Sun and Moon.) Soon after, I got to know the Liberty Cap mushroom (Psilocybe semilanceata) and related psychoactive species in Oregon. All of them owe their magic to the psychedelic compound, psilocybin. After I wrote a scientific article on the subject, “The Use of Psychoactive Mushrooms in the Pacific Northwest: An Ethnopharmacologic Report,” I began to receive even more invitations to speak at mushroom conferences.

In my travels throughout the world, I’ve come to know many mushrooms. That’s not something you can learn from books. Your best bet is to spend time with people who know mushrooms and can teach you how to recognize and find them. I first learned to collect edible wild mushrooms from experienced hunters in Oregon in the 1970s. I came to know and love chanterelles, hedgehogs, blewits, shaggy manes, and woodland russulas. The Arizona desert, where I live most of the year, is too dry a habitat for mushrooms (except in the forests on mountain tops after summer rains), but I try to collect in British Columbia and other good areas whenever I can.

Attitudes toward mushrooms in the U.S. appear to have changed in recent years. Fear of them has lessened somewhat, and formerly exotic species are now widely available. Still, nutritionists often say that mushrooms have little food value, despite the fact that they are respectable sources of good quality protein and micronutrients.

Culinary Mushrooms

I strongly advise against eating any mushrooms raw, whether they’re wild or cultivated. Cooking breaks down their cell walls, which are tough and resistant to digestion, and many species contain toxins that cooking destroys. Always cook mushrooms well by sautéing, broiling, or grilling.

When trying a mushroom I’ve never eaten before, I usually sauté it in a little olive or avocado oil with a sprinkle of salt to sample its flavor and texture. If I like it, I look for ways to prepare it that will enhance its qualities without violating principles of healthy eating. In general, Asian cooking methods work well, such as grilling whole or sliced mushrooms after brushing them with teriyaki sauce or adding them to soups or stir-fries. These preparations use little or no fat, in contrast to the cream- and butter-rich mushroom dishes often served in restaurants.

Andrew Weil, M.D.

(I’ll discuss the use of mushrooms for skincare as well as what we’ve learned about their power to enhance soil and forest health in “My Life With Mushrooms, Part Two.”)

More information:

All About Mushrooms

Originally Posted March 2018. Updated July 2022. 

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Roughly 5.8 million Americans have Alzheimer’s disease; that number is expected to grow to 14 million by 2060. Given its prevalence and consequences, it’s no wonder that many of us are afraid of developing the condition – one study of nearly 1,500 people in Germany reported that more than 70% felt at least a little fearful of dementia. Unfortunately, the results of clinical testing of drugs intended to slow or reverse the progression of dementia have been disappointing thus far, but there are two strategies that may help keep the devastating – and often fatal – deterioration of the brain that characterizes Alzheimer’s at bay.

First, the correlations between healthy eating and cognitive function continue to appear strong. In many studies, those who eat a plant-based diet rich in antioxidants, omega-3 fatty acids, and other staples of the anti-inflammatory Mediterranean diet had a lower risk of developing Alzheimer’s disease than those who eat more animal proteins, processed foods, and sugars.

In a study published in 2021 in the Journal of the American Geriatrics Society, researchers studied more than 1,000 people in a Mediterranean population, all over age 64, who did not have dementia. Over the course of three years the participants were monitored for cognitive changes, and the results were compared against their dietary intake. At the end of the follow-up period, 62 cases of dementia were observed. Those participants who had the best adherence to a Mediterranean diet were found to have a 72% lower risk of dementia when compared to those with the lowest adherence. The results were consistent with earlier studies of other populations that found reduced risk of dementia in those who followed a Mediterranean diet.

In addition, one U.S. based study reviewed the brain scans of 70 adults between the ages of 30 and 60, about half of whom followed a Mediterranean diet, over a three-year period. Although none of the 70 showed signs of cognitive dysfunction at the beginning of the study, those who did not follow a Mediterranean diet showed biomarkers associated with Alzheimer’s disease. The differences in brain images widened over the three years of the study, with the non-Mediterranean diet group showing increases in the biomarkers associated with dementia. That should be a wake-up call for all of us. The seeds of cognitive decline later in life are being sown in young adulthood and middle age, and preventive steps early on can help protect against dementia in older years.

To help reduce your risk of a wide variety of diseases, including not only Alzheimer’s but also heart disease, cancer, and diabetes, it is advisable to consume more omega-3 fatty acids and fewer omega-6 fatty acids. A good way to do this is to add wild-caught fatty fish such as Alaskan salmon to your diet, and reduce consumption of processed and fried foods, which tend to be saturated with omega-6-rich soybean oil. Rebalancing the ratios of these fats is an important component of an anti-inflammatory diet.

Second, you’ve probably heard that mentally stimulating activities and staying socially engaged and active can reduce the risk of Alzheimer’s disease. A review in the Journal of Alzheimer’s Disease looked at studies that included more than 2 million subjects and found that poor social engagement was associated with an increased risk of dementia. Risk factors included living alone, not participating in the community, and having poor social interactions. Depression magnified the risk of low social connections.

Even more notably, a new study from Rush University reported on 1,903 older individuals who were evaluated over several years for participation in cognitively stimulating activities. None had been diagnosed with dementia at the beginning of the study, but 457 of them showed signs of dementia after a mean of 6.8 years. Results showed that those who regularly engaged in activities that were mentally challenging developed dementia at older ages than those with lower levels of cognitive activity. Researchers concluded that staying mentally active – following the news, playing games, reading, going to the theater – could delay the onset of Alzheimer’s symptoms by as much as five years.

Although we still have much to learn, the current research is clear on this issue: challenging your mind on a regular basis helps to lower the risk of developing Alzheimer’s disease.

For more on better aging, visit   Dr. Weil on Healthy Aging , Your Online Guide to the Anti-Inflammatory Diet.

Sources
Charisis S, Ntanasi E, Yannakoulia M, Anastasiou CA, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. “Mediterranean diet and risk for dementia and cognitive decline in a Mediterranean population.” J Am Geriatr Soc. 2021 Jun;69(6):1548-1559. doi: 10.1111/jgs.17072. Epub 2021 Mar 16. PMID: 33724444. https://pubmed.ncbi.nlm.nih.gov/33724...

Berti V, Walters M, Sterling J, Quinn CG, Logue M, Andrews R, Matthews DC, Osorio RS, Pupi A, Vallabhajosula S, Isaacson RS, de Leon MJ, Mosconi L. “Mediterranean diet and 3-year Alzheimer brain biomarker changes in middle-aged adults.: Neurology. 2018 May 15;90(20):e1789-e1798. doi: 10.1212/WNL.0000000000005527. Epub 2018 Apr 13. PMID: 29653991; PMCID: PMC5957301.

Penninkilampi R, Casey AN, Singh MF, Brodaty H. The Association between Social Engagement, Loneliness, and Risk of Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2018;66(4):1619-1633. doi: 10.3233/JAD-180439. PMID: 30452410. https://pubmed.ncbi.nlm.nih.gov/30452...

Wilson RS, Wang T, Yu L, Grodstein F, Bennett DA, Boyle PA. Cognitive Activity and Onset Age of Incident Alzheimer Disease Dementia. Neurology. 2021 Aug 31;97(9):e922-e929. doi: 10.1212/WNL.0000000000012388. Epub 2021 Jul 14. PMID: 34261788; PMCID: PMC8408511. https://pubmed.ncbi.nlm.nih.gov/34261...

Originally Posted April 2007. Updated July 2022.

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I am pleased to have an ongoing association with the Environmental Working Group (EWG), a nonprofit organization that advocates for policies that protect global and individual health. Specifically, I help EWG spread the word about one of its most valuable pieces of research – its Shopper’s Guide to Pesticides in Produce. The 2023 version is based on the results of ongoing pesticide tests performed on produce and collected by federal agencies.

Nearly all of the data used took into account how people typically wash and prepare produce – for example, apples were washed and bananas peeled before testing. The following “Dirty Dozen” had the highest pesticide load, making them the most important to buy organic versions – or to grow them organically yourself.

The Dirty Dozen (2023)StrawberriesSpinachKale, collard, mustard greensPeachesPearsNectarinesApplesGrapesBell and hot peppersCherriesBlueberriesGreen Beans+Potatoes

Why should you care about pesticides? The EWG points out that there is a growing consensus in the scientific community that small doses of pesticides and other chemicals can have adverse effects on health, especially during vulnerable periods such as fetal development and childhood. Here’s a video in which I address the importance of avoiding pesticides.

Also keep in mind that maintaining your family’s health is not the only reason to choose organic food. Pesticide and herbicide use contaminates groundwater, ruins soil structures and promotes erosion, and may be a contributor to “colony collapse disorder,” the sudden and mysterious die-off of pollinating honeybees that threatens the American food supply. Buying or growing organic food is good for the health of the planet.

At the opposite end of the contamination spectrum, check the list of Foods That You Don’t Have to Buy Organic, also known as the “Clean 15.”

Source:
ewg.org/foodnews/dirty-dozen.php

Reviewed by Benjamin S. Gonzalez, M.D., May, 2016. Updated April 2023

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If you’ve ever wanted to spend part of your afternoon with Dr. Weil, now you have the chance. On March 21, 2022, Dr. Weil opened his home to viewers around the world, who joined him — remotely — for a live self-care event. The opportunity was part of IMmersive, an ongoing series of free 30-minute healing sessions led by experts in integrative medicine and made available by the University of Arizona’s Andrew Weil Center for Integrative Medicine.

The session began with Dr. Weil welcoming viewers into his home and introducing his two Rhodesian Ridgebacks, Juno and Kengo. After explaining the importance of proper breathing for good health, he led everyone through one of his most recommended breathing exercises, The Relaxing Breath, also known as the 4-7-8 Breath. To experience the full benefits of The Relaxing Breath, he suggests practicing it at least twice a day.

Next up: a visit to Dr. Weil’s kitchen, where he prepared one of his favorite dishes, sauteed kale. Made with lacinto (black) kale, this quick, simple and healthy side can easily transform into a hearty main dish when mixed with pasta or grains. If viewers were wondering where Dr. Weil gets many of the vegetables he cooks, they soon received an answer, as he brought them along for a tour of his garden. Some of the plants on display included chard, baby Bok choy, radishes, carrots, beets, a Japanese variety of spinach, various herbs — and the lacinato kale he had just prepared.

The relaxed event concluded with Dr. Weil answering questions from viewers. His companion animals also made another appearance in the garden, where Juno enjoyed a few bites of kale.

If you missed the live event, you can still enjoy the recording, which is available here.

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“Practicing a regular, mindful breathing exercise can be calming and energizing and can even help with stress-related health problems ranging from panic attacks to digestive disorders.”
Andrew Weil, M.D.

Since breathing is something we can control and regulate, it is a useful tool for achieving a relaxed and clear state of mind. I recommend three breathing exercises and techniques to help relax and reduce stress: The Stimulating Breath, The 4-7-8 Breathing Exercise (also called the Relaxing Breath), and Breath Counting. Try each of these breathing exercises and techniques and see how they affect your stress and anxiety levels.

Breathing Exercise 1 : The Stimulating Breath (also called the Bellows Breath)

The Stimulating Breath is a yogic breathing techniques. Its aim is to raise vital energy and increase alertness.

Inhale and exhale rapidly through your nose, keeping your mouth closed but relaxed. Your breaths in and out should be equal in duration, but as short as possible. This is a noisy breathing exercise.Try for three in-and-out breath cycles per second. This produces a quick movement of the diaphragm, suggesting a bellows. Breathe normally after each cycle.Do not do for more than 15 seconds on your first try. Each time you practice the Stimulating Breath, you can increase your time by five seconds or so, until you reach a full minute.

If done properly, you may feel invigorated, comparable to the heightened awareness you feel after a good workout. You should feel the effort at the back of the neck, the diaphragm, the chest and the abdomen. Try this diaphragmatic breathing exercise the next time you need an energy boost and feel yourself reaching for a cup of coffee.
Watch a video of Dr. Weil demonstrating the Stimulating Breath.

Breathing Exercise 2 :The 4-7-8 (or Relaxing Breath) Exercise

The 4-7-8 breathing exercise is utterly simple, takes almost no time, requires no equipment and can be done anywhere. Although you can do it in any position, sit with your back straight while learning the exercise. Place the tip of your tongue against the ridge of tissue just behind your upper front teeth, and keep it there through the entire exercise. You will be exhaling through your mouth around your tongue; try pursing your lips slightly if this seems awkward.

Exhale completely through your mouth, making a whoosh sound.Close your mouth and inhale quietly through your nose to a mental count of four.Hold your breath for a count of seven.Exhale completely through your mouth, making a whoosh sound to a count of eight.This is one breath cycle. Now inhale again and repeat the cycle three more times for a total of four cycles.

Note that with this breathing technique, you always inhale quietly through your nose and exhale audibly through your mouth. The tip of your tongue stays in position the whole time. Exhalation takes twice as long as inhalation. The absolute time you spend on each phase is not important; the ratio of 4:7:8 is important. If you have trouble holding your breath, speed the exercise up but keep to the ratio of 4:7:8 for the three phases. With practice you can slow it all down and get used to inhaling and exhaling more and more deeply.

This breathing exercise is a natural tranquilizer for the nervous system. Unlike tranquilizing drugs, which are often effective when you first take them but then lose their power over time, this exercise is subtle when you first try it, but gains in power with repetition and practice. Do it at least twice a day. You cannot do it too frequently. Do not do more than four breaths at one time for the first month of practice. Later, if you wish, you can extend it to eight breaths. If you feel a little lightheaded when you first breathe this way, do not be concerned; it will pass.

Once you develop this technique by practicing it every day, it will be a very useful tool that you will always have with you. Use it whenever anything upsetting happens – before you react. Use it whenever you are aware of internal tension or stress. Use it to help you fall asleep. This exercise cannot be recommended too highly. Everyone can benefit from it.

Watch a video of Dr. Weil demonstrating the 4-7-8 Breath.

Breathing Exercise 3 :
Breath Counting 

If you want to get a feel for this challenging work, try your hand at breath counting, a deceptively simple breathing technique much used in Zen practice.

Sit in a comfortable position with the spine straight and head inclined slightly forward. Gently close your eyes and take a few deep breaths. Then let the breath come naturally without trying to influence it. Ideally it will be quiet and slow, but depth and rhythm may vary.

To begin the exercise, count “one” to yourself as you exhale.The next time you exhale, count “two,” and so on up to “five.”Then begin a new cycle, counting “one” on the next exhalation.

Never count higher than “five,” and count only when you exhale. You will know your attention has wandered when you find yourself up to “eight,” “12,” even “19.”

Try to do 10 minutes of this form of meditation.

Watch a video of Dr. Weil demonstrating Breath Counting.

Reviewed by Benjamin S. Gonzalez, M.D., May, 2016.

Reviewed by Andrew Weil, M.D., February 2022.

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If anything positive has come from the ongoing COVID-19 pandemic, it’s that many of us are now more connected with our health care providers than ever before. According to a variety of surveys compiled by Becker’s Hospital Review, 64 percent of American households with broadband reported using a telehealth service in the past 12 months, while 43 percent of adults want to keep using telehealth services after the pandemic and 34 percent would prefer telehealth to an in-person office visit — largely due to convenience.

Virtual integrative health at your fingertips

Now, a new offering developed in partnership with Dr. Andrew Weil allows patients to access a wide selection of integrative medicine physicians and other health care providers from the comfort of their own homes. The platform — known as Andrew Weil M.D. Integrative Health — lets registered users search integrative practitioners in their geographic area and check availability for telehealth appointments. For example, a patient in New York can browse New York-based providers and can also filter to search by specialty. Visitors can currently choose from a diverse range of providers trained in integrative medicine, including those who specialize in:

Integrative cardiologyIntegrative health coachingIntegrative internal medicineIntegrative medicine (general)Integrative rheumatologyExercise fitnessNationally board-certified health and wellness coachingMen’s healthWomen’s healthSpeech-language pathologySwallowing disorders

The number of available practitioners and specialties on the platform will likely increase over time. Once a patient has selected a provider and search for availability, they can schedule a virtual appointment with them. The platform will first be available in New York State but the plan is to roll it out nationally, in accordance with varying state laws about telehealth.

Improving access for patients

The goal of Andrew Weil M.D. Integrative Health is in line with what has long been Dr. Weil’s vision for the field: to increase access to providers trained in integrative medicine, particularly for patients who may have difficulty finding a practitioner in their area, cannot travel for appointments, or simply want the convenience of a virtual visit. “I believe telehealth to be the way of the future and a way to bring integrative medicine to many more people,” says Dr. Weil.

To learn more about Andrew Weil M.D. Integrative Health, visit awihealth.com.

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What is cystitis?
Cystitis is an inflammation of the bladder that can be due to a bacterial urinary tract infection (UTI) or due to noninfectious causes (like interstitial cystitis). Most UTIs are caused by Escherichia coli (E. coli). However, Staphylococcus saprophyticus accounts for five to 15 percent of UTIs, mostly in younger women. Klebsiella, Enterococci bacteria, and Proteus mirabilis are responsible for most of the other cases, generally those that occur in older women.

Most women develop a UTI at some point in their lives. Reportedly, these infections are the third most common medical complaint (after colds and flu) among women of reproductive age, although they are also common among postmenopausal women. Between three and five percent of women develop recurrent, ongoing UTIs. In some cases, these infections can spread to the kidneys, called pyelonephritis.

Men become more susceptible to UTIs after age 50, when they begin to develop prostate enlargement. Recurrent UTIs in men are associated with bacterial prostate gland infections (prostatitis) and tend to be more serious than UTIs that occur in women.

What are the symptoms of cystitis?
The symptoms of cystitis usually include a strong, persistent urge to urinate often yielding only small amounts of urine, burning while urinating and cloudy or strong-smelling urine. Sometimes cystitis can cause pelvic area discomfort, pressure in the lower abdomen, and a low grade fever. Rarely, UTIs can cause blood in the urine.

In young children, new episodes of accidental daytime wetting also may be a sign of a urinary tract infection (UTI), but nighttime bed-wetting usually isn’t linked to a UTI.

What are the causes of cystitis?
Bacterial bladder infections often occur in women as a result of bacteria getting transferred from the area around the woman’s anus towards her urethra during sexual intercourse.This is known as “honeymoon cystitis” or “post-coital cystitis”. But even sexually inactive girls and women are susceptible to these infections because the anatomy of the female genital tract is such that the anus and the urethra are located very closely together. This proximity makes the bacteria that are naturally located near the anus easily accessible to the urinary tract.

Perimenopausal and postmenopausal women have lower estrogen levels, causing a natural thinning of the tissue around the urethra. This makes this area more likely to become irritated, injured, and/or infected.

Caffeine and alcohol are known bladder irritants and cause most people to urinate more frequently.

Sometimes, cystitis occurs as a complication of certain disorders such as gynecologic cancers, pelvic inflammatory disorders, endometriosis, Crohn’s disease, diverticulitis, lupus or tuberculosis. Less often, the inflammation can develop in reaction to certain drugs, including the chemotherapy drugs cyclophosphamide and ifosfamide, in response to radiation therapy or as a reaction to potentially irritating chemicals in feminine hygiene sprays, bubble baths and spermicidal jellies or long-term use of a urinary catheter.

Women who use diaphragms for birth control are at increased risk for UTIs, as are pregnant women as a result of the hormonal changes that occur during pregnancy.

In addition, immune system changes that can occur with diabetes, HIV infection and cancer treatment can increase the risk of bladder infections.

How is cystitis diagnosed?
Cystitis can sometimes be diagnosed on the basis of symptoms alone, often over the phone, in low-risk women who have no additional symptoms suggesting other problems. In other cases, an analysis of a urine sample may be recommended to look for bacteria, blood or pus. For those with history of recurrent, frequent, or chronic UTIs it is recommended to submit a urine sample for culture and sensitivities, as there are now many bacteria with resistance to commonly used antibiotics. Rarely an examination of the bladder with a cystoscope may be needed to investigate the potential cause of cystitis (as in the case of bladder cancer or interstitial cystitis). The cystoscope is a thin tube with a small light and camera attached. It can be used, if necessary, to take a tissue sample for a biopsy. Imaging tests such as ultrasound or x-rays usually aren’t needed to diagnose cystitis but may be used to help rule out a structural abnormality or tumor if no infection is found to be causing the symptoms.

What is the conventional treatment of cystitis?
Cystitis caused by bacterial infection is treated with antibiotics (common ones include Bactrim, Ciprofloxacin, and Macrodantin), taken for three days to a week. Longer courses of antibiotics may be recommended for recurrent infections. Women who are prone to post-coital or “honeymoon cystitis” are sometimes given “prophylactic antibiotics” to be taken after intercourse to help prevent a UTI. Postmenopausal women may also be treated with vaginal estrogen cream in order to strengthen the tissue around the urethra.

UTIs that develop in hospital patients can be difficult to treat because the bacteria found in hospitals can be resistant to the antibiotics used to treat infections that occur elsewhere.

Green tea has been shown to have antibacterial properties that make it potentially effective against urinary tract infections (UTIs). In fact, one study looked at 80 samples of E. coli that had caused a urinary tract infection, 63 of which were resistant to at least one common antibiotic. The study tested what concentrations of EGC from green tea would have a positive effect against the bacteria. All of the bacterial strains tested were vulnerable to EGC’s antimicrobial effects even at low concentrations, suggesting that consumption of green tea could be helpful against a UTI caused by E. coli.

Cranberry juice or tablets containing phytonutrients called proanthocyanidins may help reduce the risk of recurrent bladder infections. Conflicting research results make it difficult to know for sure whether cranberry juice really helps or whether there’s a placebo effect. It is possible that there are some individuals who benefit from the use of cranberry juice and others who do not. Be cautious of added sugar in some cranberry juice brands. It is prudent to ingest unsweetened cranberry juice or tablets. Be cautious when adding cranberry juice if you’re taking the blood-thinning medication warfarin (Coumadin) because cranberry juice can increase the effectiveness of warfarin, potentially leading to increased risk of bleeding. It would be prudent to inform your doctor or the Coumadin Clinic of your desire to add cranberry juice or tablets to your diet so that your Coumadin dose can be appropriately adjusted and your INR can be monitored more closely.

What therapies does Dr. Weil recommend for cystitis?
In cases due to bacterial infection, Dr. Weil recommends treatment with antibiotics and suggests use of vaginal estrogen cream for post-menopausal women, who have lower levels of estrogen. Some research suggests that estrogen may help increase the number of beneficial bacteria that help fight urinary and vaginal infections.

While some scientific studies have clearly shown that drinking cranberry juice lowers the risk of UTIs, research published in the Journal of the American Medical Association in 1994, found that women who drank cranberry juice were 58 percent less likely to develop a urinary tract infection than those who drank a placebo (another reddish drink containing vitamin C). Subsequent studies have indicated that cranberry juice helps because the fruit contains compounds that prevent bacteria from adhering to the bladder wall.

However, the latest study of the effect of cranberry juice on the incidence of UTIs appears to challenge earlier findings. Conducted at the University of Michigan, the study included 319 otherwise healthy college women who were diagnosed with UTIs at the university’s health center between August 2005 and October 2007. The women were randomly assigned to drink eight ounces of 27 percent low-calorie cranberry juice cocktail or the same amount of a placebo twice a day for six months. The findings, published in the January 2011 issue of Clinical Infectious Diseases, showed that those who drank the cranberry juice had a recurrence rate of 20 percent, compared to a 14 percent recurrence rate in those who drank the placebo.

Dr. Weil has said he doubts that the 2011 study will be the last word on this subject and continues to recommend drinking unsweetened cranberry juice concentrate diluted with water or taking powdered cranberry extract in capsules for treatment of UTIs.

There is less experimental evidence available to assess the efficacy for supplementing with D-mannose or probiotics to treat or prevent UTIs. A 2014 study published in the Clinical Journal of Gastroenterology gave a supplement containing a cranberry dry extract, D-mannose, and probiotics containing 2 microorganisms Lactobacillus plantarum LP01 (LMG P-21021) and Lactobacillus paracasei LPC09 (DSM 24243) to 33 premenopausal women with active uncomplicated UTI for a total of 60 days. Results suggest that taking this supplement for 60 days significantly reduced the symptoms commonly associated with UTI.

Drinking green tea may be helpful in addressing UTI, especially when it is just starting. If you consider using green tea, look for products that were decaffeinated through effervescence,  a process that helps retain its protective polyphenols.

In addition, Dr. Weil recommends the following measures to prevent cystitis.

Avoid tight-fitting pants. Also, wear cotton-crotch underwear and pantyhose. Use mild detergents when washing underwear.Don’t hold your urine. Be sure to urinate frequently and promptly when you have the urge.Increase your intake of fluids so that you urinate more frequently. Plain water is best. It is also important to avoid alcohol (if you are sensitive to this) and caffeinated beverages, which can irritate your bladder and worsen symptoms.Practice good hygiene before and after sex. Keep the genital and anal areas clean, and urinate before and after intercourse to cleanse the urethra of bacteria. Always wipe front to back after a bowel movement.

Sources:
C. Barbosa-Cesnik, M.B. Brown, M. Buxton et al. “Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial.” Clinical Infectious Diseases. January 1, 2011; 52: 23–30. doi: 10.1093/cid/ciq073.

Thomas Hannan et al, “Estrogen and Recurrent UTI: What Are the Facts?” Science Transitional Medicine, June 19, 2013, DOI: 10.1126/scitranslmed.3006423

J Clin Gastroenterol. 2014 Nov-Dec;48 Suppl 1:S96-101.

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What is polycystic ovarian syndrome?
Also known as polycystic ovary disease, polycystic ovarian syndrome (PCOS) is a condition in which small, benign (non-cancerous) cysts develop in one or both of a woman’s ovaries. The condition is characterized by irregular menstrual periods, infertility, and other hormonal difficulties.

What are the symptoms?
PCOS usually causes more than one symptom. These may include:

Irregular or absent menstrual periodsDevelopment of some male sex characteristics, most commonly excess hair on the face and body, deepened voice, and male-pattern baldnessAcneWeight gain or obesityInfertility (PCOS is the most common cause of female infertility)Insulin resistanceDecreased breast size

Women with PCOS are also at higher risk for the following conditions:

HypertensionHigh cholesterolFatty liver diseaseSleep apneaEndometrial cancer

What are the causes?
In this condition, the pituitary gland produces an excess of luteinizing hormone (LH) and gonadotropin-releasing hormone (GnRH), without an increase in follicular-stimulating hormone (FSH). This imbalance triggers the ovaries to produce higher-than-normal levels of hormones known as androgens, which can influence the development of male characteristics This hormonal disruption prevents the ovaries from releasing an egg, which instead remains in an ovary and develops into multiple small noncancerous cysts.

Who is likely to develop polycystic ovarian syndrome?
PCOS affects between 5 and 10 percent of females. Symptoms often begin at puberty, but women are most likely to be diagnosed with PCOS in their twenties or thirties. Those who have a  mother or sister with PCOS have a higher risk of developing the condition.

How is polycystic ovarian syndrome diagnosed?
Physicians typically recognize PCOS by its symptoms alone, and can sometimes feel enlarged ovaries or large ovarian cysts during a pelvic examination. Other tests can be used to confirm a diagnosis of PCOS, including:

Abdominal or vaginal ultrasound, which use sound waves to create images of the pelvic organs on a screen.Blood tests, to check hormone levels.

What is the conventional treatment?
Conventional treatment of PCOS is aimed at addressing symptoms, especially those that contribute to increased risks of cardiovascular disease, such as hypertension, diabetes, and obesity. Treatments include:

Medications to regulate a woman’s menstrual cycle, such as oral contraceptives (birth control pills) and progesterone.Medications that block excessive androgen, such as the drug spironolactone (Aldactone).Fertility drugs (if pregnancy is desired) that trigger ovulation, such as Clomid.The drug Metformin (glucophage), which treats insulin resistance and shows promise for treating PCOS in particular.

For some women with PCOS who have difficulty getting pregnant, a type of surgery called laparoscopic ovarian drilling may be recommended to stimulate ovulation. This procedure involves using a laser fiber or electrosurgical needle to puncture the ovary up to 10 times, resulting in lowered production of androgens and a corresponding increase in fertility.

Women are also encouraged to achieve and attain a healthy weight by following a healthy diet and getting regular exercise.

What therapies does Dr. Weil recommend for polycystic ovarian syndrome?
In addition to maintaining a healthy weight through diet and exercise, Dr. Weil recommends the following approaches to PCOS:

Dietary changes:

Follow an anti-inflammatory dietAvoid conventionally raised beef and dairy products, which may contain residues of estrogenic hormones used as growth promotersIncrease intake of whole soy foods, which contain isoflavones, substances that may help regulate hormone imbalances

Exercise: Tieraona Low Dog, M.D., an internationally recognized expert in the fields of integrative medicine, dietary supplements and women’s health, says that PCOS is principally a metabolic problem and that many treatment approaches are similar to those for insulin resistance. For example, she says that exercise is “an absolute must – no exceptions!” This means exercising for at least 30 minutes every day.

Traditional Chinese medicine: Consider working with a practitioner of TCM, who may recommend peony and licorice, two herbs that have been studied for PCOS. He or she may also recommend acupuncture.

Supplements: Dr. Low Dog notes that a small study published in the July, 2007, issue of Fertility and Sterility showed that one-quarter to one-half teaspoon of cinnamon powder reduced insulin resistance in women with PCOS.

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