I developed moderate to severe Interstitial Cystitis (IC) symptoms during the worst of my flares and symptoms overall. IC is a condition that can mimic a bladder infection, but it’s not caused by bacteria (this is called a “sterile cystitis”). As usual, this occurred when I was “hyper” overall, or had an increased T3:T4 ratio (ie, Hashitoxicosis state), or iodine was increased too much or too rapidly. Symptoms of small, frequent urinations and urgency, constant feeling of “needing to go”, painful and burning urethritis and bladder pain, along with a painful feeling right above my pubic bone would occur. Urinalysis (UA) would show a sterile cystitis (ie, non-bacterial in origin), along with occult hematuria (RBC’s seen microscopically, but no obvious hint of blood in gross urine sample), trace blood on dipstick, and during major flares, mild ketonuria. This all cleared up when I was on an appropriate dose of TH meds. The thyroid panel I was monitoring for myself happened to include a UA, so I ended up running UA’s every two to four weeks once I started on TH. I literally watched these UA lab parameters dissipate and clear up, along with my symptoms, over the subsequent several months as my TH values normalized.
Once I was on a suppressive dose of TH, I didn’t have to worry about flares anymore, but I could always tell when I was getting a little too high with either T4 or T3 as I became quite sensitive to the slightest increase in these symptoms, and I would adjust accordingly. I also had to put up with the annoying “dosage cycles” of these, ie, very very slight symptoms would occur right after I took the meds for an hour or so, but then clear up after. In Year 4, when I was OFF TH meds and now understood how endogenous TH and iodine were affecting me, I had to control iodine intake and other dietary considerations to prevent flares from occurring or the T3:T4 ratio from getting too large. A couple of trials of Armour/Naturethroid were disastrous in several ways for me because of the high T3:T4 ratio, and these IC symptoms were part of that for me. IC is another one of those conditions that doesn’t kill you but can make your life absolutely miserable and not worth living. It also occurs quite commonly with Hashi’s and other autoimmune disorders. I think I probably only experienced moderate to moderate-high symptoms, but it was enough, and I suffered greatly from this when I had no idea of how to control it. Until I understood what was causing these symptoms, I lived in fear of them, and once I became aware of the causes, learned to fine-tune adjust at the slightest hint of them.
It would not surprise me if low overall iodine status is one potential cause of frequent bladder infections. Iodine from TH metabolism is normally recycled or excreted as needed, so this is one source of urinary iodine. Excess ingested iodine is also another source. If my iodine intake was low, my body was going to recycle more and more of the iodine from TH, which meant there was less urinary excretion, and less protection for bladder health. For much of my life I was on a rather high iodine diet, and never suffered from bladder infections during that time. It may be that one of the functions of urinary iodine is as an anti-bacterial within the bladder. Based on my IC experiences, and pelvic pain that accompanies IC, it wouldn’t surprise me if iodine is necessary for bladder cells or bladder health in some other capacity, in addition to as an anti-bacterial, as well.