1. Eliminate all over the counter supplements.  THIS IS VERY IMPORTANT, that’s why I made it Number 1.  Many people with IC can’t tolerate vitamins AT ALL.  I have a really hard time with vitamins and some amino acids, so I don’t take them.  Period.  When your body doesn’t absorb a vitamin, it goes straight to your kidneys and out your bladder.  That bright, Kawasaki green pee you get after you take a multi-vitamin is killing your bladder lining.  Be nice to your bladder, stop taking vitamins and supplements except for the ones I’m going to tell you to take.  This means: Vitamins, Minerals, Fish Oil, Amino Acids, Protein Powder, “Energy Bars” with Vitamins in them, Cereals with vitamins in them, etc.  Anything you buy in a bottle from a health food store.  Please take this seriously, some of the worst bladder irritants come from this group of substances.   I’m going to make the same disclaimer that Amrit Willis makes in her book: 

If you can’t do this, I cannot promise that you will get well. 

2. Follow The ICA Diet Food List.  (you can find it here: http://www.ichelp.org/Portals/0/pdf/ICDietFoodList.pdf ) Follow it implicitly.  Do not eat anything on the “Try It” column until you are feeling better.  My only change to their diet is that you not eat any fruit while you are symptomatic.  You need to figure out what bothers you, and some people just can’t tolerate any fruit while they are getting better.  For example, they have apples listed as OK, they are definitely not OK when your bladder is hurting.   Just to make you feel better, you will DEFINITELY be able to add a lot of forbidden things back to your diet when you are better, but it is a matter of trial and error.  While you are in pain you really need to follow the diet strictly, or you will not get well.  Follow the instructions on the diet pages.  Easy recommendations:  Spicy food – Bad.  Sour food – Bad.  Acidic food – Bad.  Anything with Citric Acid in the ingredients list:  REALLY BAD.

3. Drink lots of water, preferably some with a high pH.  If you can find a water testing kit, do it.  DO NOT DRINK TAP WATER.  It contains tons of chlorine and other crap.  I don’t know if Brita water is OK.  I really don’t.  Buy bottled water, preferably in the clear plastic bottles.  I live on the west coast, and one of the best tested and cheapest waters here is Crystal Geyser.  Buy it by the gallon or whatever size you like. 

4. Try to get more vegetables into your diet.  Follow the IC Diet recommendations for the vegetables you can eat.  But be careful.  I can eat carrots, but if I eat too many or drink carrot juice, my bladder will be unhappy.  But I can usually eat half a bag of baby carrots without it bothering me. Try not to OD on one kind of vegetable at a time. 

5. Eliminate any face creams or body products that contain Alpha Hydroxy Acids. Trust me on this, I’m not crazy.  I once had a flare go on for weeks that I couldn’t figure out.  I was eating perfectly and this was when I was getting DMSO, so I knew should have been getting better.  I knew it had to be something I was ingesting, but I just couldn’t figure out what.  I knew that it would really start hurting around 11 am, and would taper off later in the day.  One morning after putting on my new, expensive face cream at 8 am, I noticed that it made my skin burn.  I immediately washed it off, and my bladder cleared up within 24 hours. 

6. Stop exercising until you are better.  I don’t mean don’t take a 15 minute walk, but if you are doing any exercise that creates lactic acid (aerobic exercise, weight training) stop it.  Your body eliminates that acid through the kidneys and out the bladder (are you seeing a pattern yet?).  I still can’t do more than 15 minutes of weight training at a stretch.  My general exercise program consists of walking, yoga, mild weight training.  I can no longer do 50 mile bike rides, my bladder just can’t take it.  You will have to try and see what you can handle once your symptoms are under control. 

7. Take your Urinary pH on the second urination of the morning.  The first one will always be acidic, no matter what you do.  The best time to check is the second pee after you wake up, but it should be before you eat breakfast.  But feel free to take your pH all day if you want.  I can promise you that if you are symptomatic, your urine will be acidic.  The first time I tested my urine it didn’t even register.  Most strips start with 5.0 or so.  I would pee on the strip, see nothing, drop it in the toilet and it would turn dark green because the toilet water was more alkaline than my urine.  Your goal is to get your urine above 6.8 all day long.  The next step is how. 

8. Take a Calcium capsule 2-3 times a day.  To get your pH up, you’ll need to take one calcium capsule 3 times a day to start, unless you have trouble tolerating it.  It shouldn’t take long to get it higher, but if it’s very low, it could take a week or two.  Don’t get discouraged.  You probably won’t register anything at first and it will take several days for your urine to show the effects of the calcium, please be patient.  The worse off you are, the longer it will take.  I recommend taking it after breakfast, lunch and dinner. 

9. Take Magnesium before bedtime.  This will be dependent on how much you can tolerate.  If you don’t take Magnesium while taking so much calcium, you will get constipated.  You can take the magnesium during the day too, but it does a better job of keeping you regular if you take it at bedtime.  It will also contribute to raising your urinary pH and it also allows your body to absorb the calcium better.  Start with two capsules, and if that makes your stools too loose, back off to one.   If you still have problems “going”, up the capsules to three. 

 Next:  What to Expect.

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