Hope for Overactive Bladder, by Terry Lemerond

Article by Arnie Gitomer

If you have an overactive bladder and need to go the bathroom several times a day or night, it gets tiring in more ways than one. Or, worse yet, if you deal with enuresis (bed-wetting) because of a weak and leaking bladder, you feel frustrated and embarrassed.
But you are not alone. About 17% of women and 16% of men over the age of 18 have overactive bladder issues. As we age, an overactive bladder becomes common -- affecting one in five adults over the age of 40.1
Urinary incontinence, whether due to chronic bladder irritation, bladder weakness, bacteria, or prostate enlargement, (technically known as Benign Prostatic Hyperplasia, or “BPH”), which causes urgency and urinary frequency, affects at least 25 million Americans. Most of the sufferers are women, but one-third of women and men 30 to 70 years old have experienced some symptoms of urinary incontinence.1
And while bed-wetting is often associated with children, there are some adults who, because of their overactive or weak bladders, have never experienced a dry night.
Conventional prescription approaches aren’t always effective, cause side-effects, and can be risky as well.
In fact, the class of drugs (anticholinergics like Ditropan®, Vesicare®, and Detrol®) used to treat overactive bladder have been found in a recent, rather alarming study to cause cognitive impairment after only 2 months of use. Worse yet, if a person is using a drug for overactive bladder or incontinence, and then also takes an over the counter drug like Benadryl (diphenhydramine, also an anticholinergic) for allergies, or Advil PM, Tylenol PM, etc., for sleep, the potential for dementia is magnified.2
Of course, in many cases, even natural approaches dealing with bladder health and incontinence are divided between men and women, so they can’t always suit everyone’s needs. However, clinically tested Angelica archangelica –can offer a true ray of hope for both.
An important thing to note is that Angelica archangelica grows in Iceland – it is not the same as Chinese angelica (Angelica sinensis), also known as dong quai.
This angelica extract is taken from the leaf of the plant, and has clinical research to back it up. In an 8-week, randomized, double-blind, placebo-controlled study, men suffering from nocturia – basically an overactive bladder at night – used Iceland’s Angelica archangelica or a placebo. The men in this study were age 45 and older, which is often when men begin noticing urinary frequency and the first symptoms of BPH.3  Not surprisingly, in Iceland, Angelica has become the number one herbal treatment to reduce urinary frequency in men, and has replaced saw palmetto berry as the treatment of choice.  
Many times, any urinary frequency issues for men are immediately considered a prostate problem. But that’s not always the case. In fact, overactive bladder is prevalent too, and requires a very different approach than we’d use for prostate health.
Of course, one of the biggest problems with nocturia isn’t just the fact of having to go to the bathroom; it’s the disruption of sleep, and the low energy and grogginess the next day.
During this study, three main parameters were measured: the increase in bladder volume, reduction in nocturnal voids, and the increase in the duration of the first sleep period. The results were excellent.
• In the subgroup with a bladder capacity of less than 260 ml, those taking angelica saw an increase of over 300% in bladder capacity.  
• In the subgroup with more than 3 voids during the standardized 8.7 hour night, angelica reduced voids by an average 14%.
• And, in the subgroup of men age 70 or older, angelica increased the first uninterrupted sleep period by 280% vs. the placebo group. This is impressive, because the prevalence of nocturia for men aged 70 and older can range from 50% to 80% or more. No wonder so many older individuals only get a few hours of sleep each night.
So why does it work?
The authors of the study note that Angelica archangelica contains a number of important compounds, including isoquercitrin and other flavonoids, polyphenols, and polysaccharides. It is these compounds that are considered to be responsible for the plant’s many amazing effects.3-7
Isoquercitrin influences the activity of leukotrienes (LTD4) that are derived from arachidonic acid in the smooth muscle cells of the bladder. They cause contractions in the bladder and urethra by stimulating receptors. When this happens, the result is an overactive and potentially leaky bladder and a feeling of “needing to go” throughout the day and night.
The isoquercitrin may inhibit the activity of these leukotrienes by either slowing their production or stopping them from binding on the receptor cells that trigger the bladder contractions. The result is less urinary urgency, an ability of the bladder to fill to greater capacity before needing to be emptied, and much more restful, undisturbed sleep.
What’s also interesting about this study is that the direct action of Arctic Angelica archangelica was not on the prostate, but on improving bladder strength, meaning it can benefit men or women.
Additionally, the Angelica extract was very well tolerated and showed no hormonal effects or unwanted side effects like increased blood pressure or heart rate, or reduced libido.
That’s a definite difference from many prescription drugs, and provides a very real hope for those with overactive bladder.
References:
1. “Urge Incontinence/Overactive Bladder”, from National Association for Continence. Available at: http://www.nafc.org/media/statistics/urge-incontinence-and-oab/. Accessed: March 25, 2013.
2. Cai X, Campbell N, Khan B, Callahan C, Boustani M. Long-term anticholinergic use and the aging brain. Alzheimers Dement. 2012 Nov 22. doi:pii: S1552-5260(12)00081-7. 10.1016/j.jalz.2012.02.005.
3. Sigurdsson S, Geirsson G, Gudmundsdottir H, Egilsdottir PB, Gudbjarnason S. A parallel, randomized, double-blind, placebo-controlled study to investigate the effect of a proprietary Angelica archangelica extract on nocturia in men. Scand J Urol. 2013 Feb;47(1):26-32.
4. Sigurdsson S, Gudbjarnason S. Inhibition of acetylcholinesterase by extracts and constituents from Angelica archangelica and Geranium sylvaticum. Z Naturforsch C. 2007 Sep-Oct;62(9-10):689-93.
5. Sigurdsson S, Ogmundsdottir HM, Gudbjarnason S. Antiproliferative effect of Angelica archangelica fruits. Z Naturforsch C. 2004 Jul-Aug;59(7-8):523-7.
6. Sigurdsson S, Ogmundsdottir HM, Gudbjarnason S. The cytotoxic effect of two chemotypes of essential oils from the fruits of Angelica archangelica L. Anticancer Res. 2005 May-Jun;25(3B):1877-80.
7. Sigurdsson S, Ogmundsdottir HM, Hallgrimsson J, Gudbjarnason S. Antitumour activity of Angelica archangelica leaf extract. In Vivo. 2005 Jan-Feb;19(1):191-4.