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UTIs and Hypothyroidism

Can hypothyroidism cause UTIs or worsen symptoms? Read more to explore the potential relationship and how to reduce your risk of a UTI.
UTIs and Hypothyroidism
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Urinary tract infections, abbreviated as UTIs, are a prevalent medical issue affecting millions worldwide. Despite being quite common, a UTI can considerably impact the quality of life. So much so that the annual cost of managing and treating UTIs in the United States is estimated at $3 billion! In this article, we’ll explore UTIs, their symptoms and treatment, and the potential connection to hypothyroidism.

UTI risk factors

UTIs primarily involve the urinary system, which includes the kidneys, ureters, bladder, and urethra. UTIs are more common in females because the female urethra is shorter and closer to the rectum, which makes it easier for bacteria to enter the urinary tract. UTIs typically occur when bacteria, most commonly Escherichia coli (E. coli), enter the urinary tract and multiply, leading to an infection. The most common type of UTI is a bladder infection, also known as cystitis.

To understand UTIs, we must also recognize and learn their diverse causes. While bacterial invasion is the usual cause, several other factors increase the risk of getting a UTI. These include:

  • Medical history: having a history of previous UTI(s)
  • Menopause
  • Use of spermicides
  • Anatomical abnormalities in the urinary tract, such as kidney stones and enlarged prostate glands in men, are also trigger factors. Both kidney stones and an enlarged prostate can obstruct urine flow, creating the perfect breeding ground for bacteria to grow.
  • Conditions that compromise the immune system, such as diabetes or HIV/AIDS
  • Behavioral factors like inadequate hydration, poor hygiene practices, and sexual activity 

UTI symptoms

Some people, usually older adults or those with compromised immune systems, have atypical symptoms or even no symptoms at all, which can make diagnosis very challenging.  Symptoms of UTIs also vary depending on the affected part of the urinary tract and how long it has been prevalent before treatment. But in general, some of the most common signs and symptoms to look out for include:

  • Pain or burning sensation during urination: One of the most common symptoms of a UTI is a burning sensation or pain when urinating. This discomfort can range from mild to severe and can be accompanied by a frequent urge to urinate.
  • Frequent or urgent need to urinate: If you run to the bathroom more often than usual, it could be a sign of a UTI. This frequent urge to urinate may also be accompanied by only passing small amounts of urine.
  • Cloudy or strong-smelling urine: Urine that appears cloudy or has a strong, unpleasant odor can indicate a UTI. This change in urine color or smell is due to bacteria in the urinary tract. 
  • Blood in the urine: In some cases, a UTI may cause blood to appear in the urine. This can range from a pinkish tint to visible blood in the urine.
  • Pain in the lower abdomen or back: Some individuals with UTIs may experience pain or pressure in the lower abdomen or back. This discomfort can range from mild to severe and may be constant or come and go.
  • Fever or chills: In more severe cases, a UTI can cause fever, chills, and even fatigue. These symptoms may indicate that the infection has spread to the kidneys and requires immediate medical attention. 

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UTI diagnosis

A urinary tract infection (UTI) is a common condition that occurs when bacteria enter the urinary tract and cause infection. If you suspect a UTI, seeing a healthcare provider for proper diagnosis and treatment is essential.

There are several ways a healthcare provider can diagnose a UTI:

  • Symptoms assessment: The healthcare provider will ask about your symptoms, such as frequent urination, burning sensation during urination, cloudy or strong-smelling urine, and pelvic pain. Your provider may also ask about your medical history and any risk factors increasing your chances of developing a UTI.
  • Urine analysis: A urine analysis is one of the most common diagnostic tests for a UTI. This test involves collecting a urine sample and analyzing it for the presence of bacteria, white blood cells, and red blood cells. A positive urine analysis can confirm the presence of a UTI.
  • Urine culture: In some cases, a urine culture may be ordered to identify the specific bacteria causing the infection and determine the most effective treatment. This test involves growing bacteria from a urine sample in a lab to determine the type of bacteria present.
  • Imaging tests: In some cases, imaging tests such as an ultrasound or CT scan may be ordered to check for any abnormalities in the urinary tract that may be causing recurrent UTIs.
  • Cystoscopy: In rare cases, a cystoscopy may be performed to examine the inside of the bladder and urethra for any abnormalities or signs of infection. This procedure involves inserting a thin tube with a camera into the urinary tract.

UTI treatment

UTIs can be painful and uncomfortable, but they are generally easy to treat with the right medications and care. The most common treatment for a UTI is a course of antibiotics. Your doctor will prescribe antibiotics based on the type of bacteria causing the infection and the severity of the UTI. The most common antibiotics prescribed to treat urinary tract infections (UTIs) are nitrofurantoin, trimethoprim/sulfamethoxazole (Bactrim), ciprofloxacin (Cipro), and levofloxacin (Levaquin). These antibiotics are effective in treating the bacteria that cause UTIs, which are usually E. coli. It is crucial to take the entire course of antibiotics as a healthcare provider prescribes to ensure the infection is fully treated and does not return. Sometimes, a healthcare provider may need to switch to a different antibiotic if the initial one is ineffective or if the bacteria causing the infection is resistant.

After completing a course of antibiotics, your doctor may recommend a follow-up appointment to ensure the infection has cleared up completely. If symptoms persist or worsen, further testing may be necessary to determine if a different course of treatment is needed.

UTIs can also cause pain and discomfort, especially when urinating. Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate these symptoms. Your doctor may also prescribe a medication specifically for managing UTI pain, such as urinary analgesics. These medications help numb the bladder and urethra, relieving pain and discomfort while urinating. In some cases, your doctor may recommend a urinary tract antiseptic to help prevent the growth of bacteria in the urinary tract and reduce the risk of recurring UTIs.

Lifestyle modifications play a crucial role in reducing the burden of UTIs. These may include staying hydrated by drinking plenty of water, practicing good hygiene habits, such as wiping from front to back after using the bathroom, taking showers instead of baths, changing out of wet clothes and undergarments, and avoiding potentially irritating substances like douches, sprays, powders or strong perfumes in the genital area.

Some foods and beverages, such as caffeine, alcohol, and spicy foods, may irritate the urinary tract and contribute to UTI risk. Coffee, for example, can increase the rate of urination, which could lead to increased dehydration. If treating an existing UTI, avoid eating acidic and spicy foods because they can cause bladder irritation and heighten any existing symptoms. Instead, eat other foods rich in vitamin C, such as strawberries, kiwi, and leafy green vegetables, to help lower the pH level in the urine.

Finally, cranberry juice, while an old-age alternative, does help lower the recurrence of UTIs in women. A study showed that cranberry juice helps to reduce developing UTIs by 26% due to a compound called A-type proanthocyanidin (PAC) that reduces the ability of e-coli bacteria to stick to the urinary tract walls and helps flush the bacteria out of your system.

It’s important to seek medical attention if you suspect you have a UTI. If left untreated, a UTI can spread to the kidneys and cause a kidney infection, which can result in permanent damage to the kidneys or even sepsis if not treated promptly. UTIs can also cause discomfort and pain, and if left untreated, these symptoms can worsen over time. In some cases, untreated UTIs can lead to recurrent infections, which can become chronic and require more aggressive treatment. Early medical attention and treatment for UTIs can prevent these complications and ensure overall health and well-being.

The link between UTIs and hypothyroidism

In recent years, researchers have begun to explore the potential connections between urinary tract infections and hypothyroidism. While the relationship between these two very different conditions is not yet fully understood, emerging evidence suggests a possible connection worth understanding and learning more about.

Several studies have shed light on the potential association between UTIs and hypothyroidism.

A study of 725 women, of which 258 had hypothyroidism, found that more than one-third of the women had both chronic LUTS (lower urinary tract symptoms) and hypothyroidism. Urodynamic studies, which help diagnose lower urinary tract problems, have found that for those with thyroid dysfunction, there are significant issues involving the urinary tract system. These include diminished flow rate, increased post-void residue (amount of urine held in the bladder after urinating), increased pelvic floor activity during urination, early first sensation to urinate, and an overactive bladder.

While the exact mechanism that links UTIs and hypothyroidism remains unclear, there are several potential pathways.

Immune system function

Thyroid hormones play a vital role in modulating immune function, including producing immune cells and cytokines involved in the body’s defense against infections. In hypothyroidism, immune function may be weakened, increasing susceptibility to infections such as UTIs. Additionally, thyroid hormones regulate the body’s metabolism and immune response, so when levels are off, they can affect the body’s ability to fight off infections.

Hormonal imbalances

Thyroid hormones influence various hormonal pathways, including those in urinary tract health. Disruptions in hormonal balance due to hypothyroidism could potentially affect the urinary tract’s ability to resist bacterial colonization and infection.

The thyroid’s impact on urinary tract health

Thyroid hormones have been shown to affect renal function and urinary tract physiology. Low thyroid hormone levels can impact muscle tone, making it more difficult to pass urine. Alterations in thyroid function may lead to changes in urinary tract dynamics, making individuals more prone to UTIs. Thyroid hormones are needed for kidney growth and development. When there is thyroid deficiency, it can result in decreased renal plasma flow (the volume of blood plasma passing through the kidneys per minute) and glomerular filtration rate (which measures how well the kidneys are filtering).

According to research, hypothyroidism, which is more common in middle-aged women, can lead to urinary retention and reduced bladder function. This can increase the risk of UTIs.  Another study found that people with hypothyroidism may develop symptoms like urinary frequency, urgency, incontinence, and incomplete emptying, which can increase the risk of developing a UTI.

Chronic lower urinary tract symptoms have also been reported in research to be more prevalent in adults with hypothyroidism.

While there appears to be a potential link between UTIs and hypothyroidism, it does not necessarily mean that one causes another. Other factors such as age, sex, comorbidities, and lifestyle factors can also contribute to the likelihood of someone developing or having both conditions. Also, one condition could exacerbate or worsen the other condition. For example, having frequent UTIs could trigger inflammatory responses that would also impact thyroid function, and hypothyroidism can increase the susceptibility to developing UTIs.

Managing UTIs in hypothyroidism patients

Managing urinary tract infections in those with hypothyroidism requires a comprehensive approach that addresses both the underlying thyroid condition and the acute illness. Given the potential relationship between hypothyroidism and UTIs, healthcare providers must provide treatment strategies that effectively manage both conditions and reduce the risk of recurrent infections.

Thyroid hormone replacement therapy is the cornerstone of hypothyroidism treatment and plays a crucial role in restoring thyroid hormone levels to normal. When the thyroid function is optimized, it can help strengthen the immune system and improve overall health, potentially reducing the risk of UTIs. Doctors and healthcare providers should also assess and manage any underlying risk factors that may predispose hypothyroid patients to UTIs, such as anatomical abnormalities in the urinary tract or comorbid conditions like diabetes.

Some antibiotics, including ciprofloxacin, have been known to interfere with the absorption of thyroid hormone replacement medication. This can lead to decreased levels of thyroid hormones in the body, resulting in symptoms such as fatigue, weight gain, and muscle weakness. In severe cases, it can even lead to thyroid hormone imbalance. If you are taking thyroid hormone replacement medication and are prescribed antibiotics, it is crucial to speak with your healthcare provider. They may need to monitor your thyroid hormone levels more closely and adjust your medication dosage accordingly.

Effective management of UTIs in hypothyroid patients often requires collaboration between healthcare providers, including primary care physicians, endocrinologists, and urologists. A primary care physician or endocrinologist will oversee thyroid hormone replacement therapy and monitor thyroid function. At the same time, urologists may provide specialized care for urinary tract issues, such as recurrent UTIs or anatomical abnormalities. Open communication and coordinated care among healthcare providers is essential for optimizing treatment outcomes and improving the patient’s well-being.

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A note from Paloma

While the potential link between urinary tract infections and hypothyroidism is still being explored, it is good to stay on top of any possible risks that might impact overall health, especially that of the thyroid. Managing UTIs in hypothyroid patients requires a comprehensive approach, and having optimal management protocols in place helps to minimize the risk of infections. By implementing tailored treatment strategies, focusing on prevention, and fostering interdisciplinary collaboration, it is possible to improve outcomes and enhance the quality of life for individuals with hypothyroidism and UTIs. Reach out to us at Paloma Health and set up a session with one of our knowledgeable doctors to get you on the right track toward achieving your best health!


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Dietary Tips for UTIs: What to Eat and Avoid.

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Neeyaz Zolfaghari

Holistic Nutritionist and Nourishment Coach

Neeyaz Zolfaghari is the founder of Unspoken Nutrition, a nutrition and lifestyle brand dedicated to helping others find and create harmony with their daily habits to support their wellbeing and ‘health’. Her journey began over a decade ago, when she was diagnosed with two autoimmune diseases. Knowing what she learned from her upbringing, Neeyaz turned to nutrition as the first pillar of her healing. As her body began to heal on a physical level, she began to learn how our minds, bodies and souls are all innately connected.  

Now as an Integrative Nutritionist and Patient Advocate, Neeyaz offers the people she works with the support, guidance, and tools they need in order to live a fulfilled life. While Neeyaz initially endeavored to make a difference at the individual level, her vision grew to embrace broader community impacts. She is currently pursuing her Masters in Public Health, serving as a testament to her unwavering commitment to instigate change on a grander scale.

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