Lemon Juice for UTI’s
As many people know, many of my clients have IC with chronic urinary tract infections with gram negative bacteria such as E. coli. What we often are finding is that lemon juice can actually help many of them with bladder pain and infections (Wittwer, 2018). It seems counterintuitive, as we often think of lemons as being acidic because of the pH of the food before it is digested. Instead, it depends on whether acidic or alkaline by-products are created once it is digested and processed by your body. Scientists use a method called the potential renal acid load (PRAL) to determine if a food can be classified as alkaline or acidic. The PRAL of a particular food is the amount of acid that is expected to reach the kidneys after the body metabolizes that food (Authority Nutrition, n.d). Interestingly, fruits and vegetables are high in alkaline nutrients such as potassium, calcium and magnesium. These ultimately reduce the amount of acid that the kidneys will need to filter out, and are thus given a negative PRAL score. Lemon juice produces alkaline byproducts once it has been metabolized. Therefore, it has a negative PRAL score. This is why some people consider lemon juice to be alkaline despite the fact that it has an acidic pH before it is digested.
What needs to be clarified is that lemon juice can effective alkalinize the pH of the urine, but does not have the same effect on the pH of your blood. The reason foods have such limited effects on the pH of your blood is because your body needs to maintain pH levels between 7.35–7.45 for your cells to function properly. If your blood pH values fall outside this normal range, you’re in a condition called metabolic acidosis or metabolic alkalosis, which can be dangerous or even fatal if left untreated. However, this rarely occurs because your body is very good at preventing blood pH values from falling outside the normal range
Lemon juice has many health benefits. For one, it a high source of vitamin C which is a strong antioxidant that supports the immune system. Regular consumption can also prevent kidney stones. What I found most interesting is the alkalinizing effect of the urine can also prevent urinary tract infections with gram negative bacteria such as E. coli. Henderson said that conventional wisdom in medicine favors the idea that acidic urine is better for restricting bacterial growth. But their results were surprising because samples that were less acidic, closer to the neutral pH of pure water, showed higher activity of the protein siderocalin (SCN) and were better at restricting bacterial growth than the more acidic samples. Importantly, the researchers also showed that they could encourage or discourage bacterial growth in urine simply by adjusting the pH, a finding that could have implications for how patients with UTIs are treated.
Here is how it works. During UTIs, cells in the urinary tract secrete SCN to inhibit bacterial proliferation by interfering with uptake of iron that the bacteria need to grow (Bardossi, 2015). SCN activity varies widely from person to person, but found that elevated pH also has small molecules called aryl sulfates, produced when gut microbes metabolize food, could enhance SCN’s antibacterial activity. Here, we see yet another link to the health of the gut affecting another system in the body, in this case the bladder! After analyzing thousands of compounds in the samples, the researchers determined that the presence of small metabolites called aromatics, which vary depending on a person’s diet, also contributed to variations in bacterial growth. Samples that restricted bacterial growth had more aromatic compounds, and urine that permitted bacterial growth had fewer of them. Henderson and his colleagues suspect that at least some of these aromatics are good iron binders, helping deprive the bacteria of iron. And perhaps surprisingly, these molecules are not produced by human cells, but by a person’s gut microbes as they process food in the diet.
In a study by Thorton et al, findings were that lower urinary tract infections were higher in acidic urine than in alkaline urine pH (Thornton et al., 2018). Interestingly, alkaline pH of 7 showed the highest growth. In addition, E. coli also grew better in dilute urine than in concentrated urine. Urine contains relatively high concentrations of urea, creatinine, amino acids, organic acids, inorganic ions (eg, ammonia, sodium, potassium), purines, and pyrimidines, which could affect E. coli growth. “Our study suggests that the body’s immune system harnesses dietary plant compounds to prevent bacterial growth,” Henderson said. “We identified a list of compounds of interest, and many of these are associated with specific dietary components and with gut microbes.”
So what are some tips for someone suffering from chronic E. coli UTI’s? According to Wittwer (2018), few glasses of lemon juice with a pinch of baking soda should create an unfavorable condition for the E. coli to thrive. Try not to dilute your urine, and don’t drink much water when eating your meals, particularly those with protein. Work on healing the gut and optimizing the microbiome. And if your gastric acid is low, working on restoring that to prevent the bacteria from getting through the intense acidity of stomach in the first place!
Also it should be mentioned that this strategy is only good for gram negative bacteria such as E. coli, Klebsiella and Proteus (Wittwer, 2018). If you are suffering from gram positive bacteria such as strains of Streptoccocus, Enterococcus, and Staphylococcus, this strategy will not be right for you. You should be keeping your urine acidic, but that is going to be saved for a future blog!
Authority Nutrition. Lemon Juice: Acidic or Alkaline , and Does it Matter? Retrieved (2018, March 31) from https://www.healthline.com/nutrition/lemon-juice-acidic-or-alkaline
Bardossi, Karen. (2015, July 6). Diet, urine pH may affect urinary tract bacterial growth. Retrieved (2018, March 31) from http://urologytimes.modernmedicine.com/urology-times/news/diet-urine-ph-may-affect-urinary-tract-bacterial-growth
Strait, Julia. (2015, June 25). Diet Acidity of Urine May Affect Susceptibility to UTI. Retrieved (2018, March 31) from https://source.wustl.edu/2015/06/a-persons-diet-acidity-of-urine-may-affect-susceptibility-to-utis/
Thornton, L. A., Burchell, R. K., Burton, S. E., Lopez-Villalobos, N., Pereira, D., MacEwan, I., . . . Gal, A. (2018). The Effect of Urine Concentration and pH on the Growth of Escherichia Coli in Canine Urine In Vitro. J Vet Intern Med, 32(2), 752-756. doi:10.1111/jvim.15045
Wittwer, R. (2018, March 31). [Facebook Messenger [Wittwer].