Not a UTI

[Pusph]

Thinking I had picked up a UTI (strange feeling in bladder area and frequent feeling of needing to urinate) I requested a urine test, which was done. The triage nurse at my surgery informed me that although it showed no infection there were in fact microscopic traces of blood in there, (which would be expected with an infection but not expected without one) and would need investigation. I was put on a 2 week pathway to the hospital and must undergo a cystoscopy tomorrow. My question is - Is there any PMR/Prednisolone reason that could be causing or contributing to this please? Thanks.

[diana1998]

I had a cystoscopy and all was fine. The consultant put my UTIs down to steroid use as she was stumped. Once I got down to lower doses, they disappeared.

[Pusph in reply to diana1998]

Thank you, hoping they'll find nothing nasty!

[Pusph in reply to diana1998]

Can I ask - did you have the traces of blood in your urine too? Or just ?! frequency symptoms. Thanks.

[PMRpro Ambassador]

Pred can cause irritable bladder and occasionally it can result in microscopic traces of blood. If you are on calcium supplements they can also cause bladder irritation and similar symptoms including cystitis symptoms of pain and frequency. Grit forms in the urine and the bladder tries to get rid of the irritation.

[OldPenny in reply to PMRpro]

Hi, Pro. I've seen you mention this issue before where you state that calcium supplements can cause some bladder problems. Is this your experience or is it a known medical fact? I'm interested as I seem to be developing some unwanted symptoms myself. Thanks OP

[Rugger in reply to OldPenny]

See my reply to Pusph below. It is my experience with calcium supplements.

[PMRpro Ambassador in reply to OldPenny]

It is my personal experience but I am far from alone on the forum. Some others found they formed considerable amounts of calcium grit - not just in kidneys but also in the gall bladder and later formed stones.

There is even study evidence for it:

pubmed.ncbi.nlm.nih.gov/220...

"It was also found that if the diet was supplemented with calcium there was an increase in the excretion of calcium in the urine and a corresponding increase in bacterial adherence when bacteria and uroepithelial cells were incubated in this urine. It is suggested that an excretion of excess calcium in the urine may lead to an increased bacterial adherence in vivo and an increased potential for urinary tract infections."

[OldPenny in reply to PMRpro]

Many thanks, as always. I'll see what my GP reckons. Also, after a visit to my dentist recently, I've stopped taking AA.

I think a confrontation is required.

[PMRpro Ambassador in reply to OldPenny]

Did you NEED the AA? Had you had a dexascan?

[OldPenny in reply to PMRpro]

No. Never been offered one....

[Rugger]

I had cloudy urine with traces of blood and was fast-tracked for a cystoscopy, which was all clear. I stopped the calcium supplements and things returned to normal! Now I take vitamin D and plenty of dietary calcium, but not as supplements.

All the best to you.

[OldPenny in reply to Rugger]

Thanks, Rugger. Did you take any medical advice before stopping calcium supplements?

[Rugger in reply to OldPenny]

I suppose the answer is "yes", as my GP was involved, fast-tracking me into the bladder cancer pathway when I kept showing microscopic blood in my urine. I also did my own experimentation, by noticing the cloudy (milky!) urine when I took the calcium supplements and seeing it clear when I omitted it. I reported all this to the GP, so he stopped the prescription for calcium with vitamin D and changed it to vitamin D alone. I use a litre of milk a day for drinks and porridge / muesli and I eat cheese and yoghurt, so I have plenty of calcium in my diet.

I also have a Rheumatologist, so she is aware too. I have osteoporosis, so wouldn't do anything to make matters worse without her and my GP's knowledge.

I hope you can get some relief from your symptoms.

[OldPenny in reply to Rugger]

Thanks for your reply, Rugger. I also have a reasonable amount of calcium in my diet and feel that I could ditch the AdCal for D3 only, but I don't really have any evidence yet that it's affecting my urinary system. When you're an ageing man, there are a lot of other things that need to be considered! 😬 OP

[PMRCanada in reply to OldPenny]

My last bone scan revealed I am now borderline osteopeniac so my GP and I discussed a path forward. He suggested that I limit adding any more calcium supplements and instead add more calcium rich foods in my diet (and increase weight bearing exercise).

[OldPenny in reply to PMRCanada]

👍 Good luck with that

[Rugger in reply to OldPenny]

You could try to put an approximate figure on your "reasonable amount of calcium" in your diet. The Osteoporosis Society has a handy guide to the calcium content of various foods (theros.org.uk). If you are getting as much as 1000mg from your diet, you could discuss with your GP to have a prescription for vitamin D alone. The cost of AdCal is about 3 times the cost of a vitamin D tablet, so it would save the NHS some money too!

I see you are taking AA - have you had a DEXA scan to diagnose osteoporosis? If not, with your previous activity level from walking and gardening etc, it could be that you don't need the AA - and save the NHS even more money! 😂

Good luck.

[OldPenny in reply to Rugger]

Thanks, that's very useful.I've just stopped taking AA without discussing it with my GP. I've never been offered a Dexascan. Just given the usual pred, AA, omeprazole and VitDCalc tabs in Sept 2021. So far, I've ditched the omeprazole and AAcid....

[SheffieldJane]

I have been down this particular rabbit hole. I know that Adcal was making it much, much worse ( Calcium). I also know that this is one of the curses of getting older. One must be careful to empty the bladder completely, after a little pause sometimes. Keep the fluids up and take Mannose-D at the first sign of trouble. Addressing these issues has kept me symptom free for the most part.