You are here: IC Network > Patient Handbook > Vitamins & Minerals

Vitamins & Minerals

Vitamins and minerals are essential nutrients found in foods that are normally consumed. They are also referred to as micronutrients because our bodies only require a small amount of vitamins and minerals compared to the other four basic nutrients: water, carbohydrates, proteins, and fats. The recommended daily allowances (RDA) set by the U.S. Food and Drug Administration are averages for adequate health of the population as a whole. Depending on their situation, individuals can vary slightly in their need for these nutrients.

Due to food sensitivities and known bladder triggers of IC patients, many limit their diets to avoid bladder symptoms. If maintaining a healthful and balanced diet is difficult for the average person, how much harder is it for an IC patient with numerous food triggers? It is not surprising that some IC patients worry they may not be receiving an adequate amount of vitamins and minerals in their daily diets. IC patients often find themselves searching for alternative sources which will help maintain the proper recommended daily allowances that are so vital for optimal health.

The one question commonly asked by IC patients is "What vitamins and minerals are safe to take without causing a bladder flare?" Actually, vitamins and minerals are contained in a lot of the foods that are known to be IC friendly. By consuming IC friendly foods from the six basic food groups, you can actually receive the proper amount of vitamins and minerals in your daily diet. The six basic food groups are:

• Grain Group - bread, rice, cereal, and pasta, etc.


• Vegetable Group - squash, lettuce, green beans, potatoes, etc.


• Fruit Group - pears, blueberries, etc.


• Meat, Fish, Dry Beans, Eggs and Nuts Group - chicken, salmon, lentils, almonds, etc.


• Dairy Group - milk, mozzarella cheese, cottage cheese, etc.


• Fats, Oils, and Sweets - butter, olive oil, candy, etc.

According to Dr. Robert Moldwin, Director of the Interstitial Cystitis Center in Long Island, NY, and author of the book The Interstitial Cystitis Survival Guide, certain vitamins and minerals may be more important to IC patients than others because of the jobs they do in the body. He speculates that the vitamins most beneficial to the overall health of the IC patient might include Vitamin C, Vitamin B-6, Vitamin A, and Vitamin E. The also believes the minerals Zinc, Calcium, and Manganese may be important. However, in his book he does point out that, "There is no scientific evidence to support improvement in the symptoms of IC using any specific vitamin/mineral regime."

Fair warning. It's very normal for IC patients to flare if they take a commercial multivitamin supplement. Why? In addition to being acidic (such as many vitamin C preparations), patients may also react strongly to the artificial ingredients, fillers and preservatives. This is yet another reason to have a well balanced diet that includes many of the foods listed in the table below.

Vitamins

Vitamin C
Vitamin B-6
Vitamin A
Vitamin E
Other Vitamins (table)

Zinc
Calcium
Manganese
Potassium
Other Minerals (table)

Vitamins

Essential vitamins are broken up into two groups: water soluble vitamins and oil/fat-soluble vitamins. Water soluble vitamins must be taken into the body daily because they cannot be stored and are flushed from the body within one to four days. They include vitamin C, folic acid, biotin and the B vitamins. Oil/fat soluble vitamins can be stored in the body for longer periods of time; they include vitamin A, vitamin D, vitamin E and vitamin K. Because excesses are not rapidly flushed from the body, it's important not to take too much of the oil/fat soluble vitamins in supplement form. They can build up over time to toxic levels. One of the benefits of getting these vitamins from food as opposed to supplement pills, is that it's extremely difficult to get too much.

Vitamin C is an antioxidant, and it is essential for tissue growth and wound healing. It is involved in the formation of collagen. Collagen is a connective tissue that is significant in holding together muscles, bones, and other tissues. Vitamin C also helps the body absorb iron from plant sources.

One problem that exists with vitamins is the acidic form of vitamin preparations. Vitamin C for instance, is usually sold in the form of ascorbic acid, which is not well tolerated by IC patients. Even though vitamin C can be purchased in buffered form, many ICer's find that this is also a bladder trigger. So how does an IC patient get the daily requirements of vitamin C? As with many vitamins, it can be obtained by consuming bladder-friendly foods, such as: green leafy vegetables, broccoli, cabbage, brussels sprouts, potatoes, and others. Half a cup of chopped red bell peppers for example, have 75% more vitamin C than a medium-sized orange, and half a cup of cooked broccoli has just as much vitamin C as that orange.

Return to Top

Vitamin B-6 is required by the nervous system and is needed for normal brain function and for synthesis of nucleic acids RNA and DNA, which contain the genetic instructions for the reproduction of all cells and normal cellular growth. It activates many enzymes and aids in the absorption of vitamin B-12. It helps the body produce insulin and antibodies to fight infection.

Vitamin B-6 is also known as pyridoxine, and is another problematic vitamin supplement for IC patients. Pyridoxine is notorious among IC suffers for causing bladder symptom flares. However, we can easily get the amounts we need from bladder-friendly foods. Vitamin B-6 is commonly found in many foods but the best source is chicken or pork.

NIH Clinical Center - Facts About Dietary Supplements-

Return to Top

Vitamin A is needed for the maintenance and repair of epithelial tissue, of which the mucous membrane in the intestinal and urinary tract is composed. In this way, vitamin A helps protect against infections.

Vitamin A can be made from beta-carotene, a constituent of many red- and yellow-colored vegetables. It acts as an antioxidant, helping to protect the cells against disease and is necessary for new cell growth. It helps your eyes see normally in the dark.

NIH Clinical Center - Facts About Dietary Supplements

Return to Top

Vitamin E is an antioxidant, and as such protects essential fatty acids from oxidation. It also helps increase the body's stores of another antioxidant, vitamin A, as well as the maintenance of red blood cells. Works in with vitamin C and selenium to prevent cell damage.

NIH Clinical Center - Facts About Dietary Supplements

Return to Top

Vitamins
Vitamin	RDA	Function	IC Friendly Food Sources
A	F: 2330 IU M: 3000 IU	Vitamin A	liver, fish, eggs, sweet potato, carrot, kale, spinach, red bell pepper, milk, butter, broccoli, dark green vegetables, orange vegetables
B-1(thiamine)	F: 1 - 1.1 mg M: 1.2 - 1.5 mg	produces energy from carbohydrates, strengthens muscles; during periods of stress the need for this vitamin is increased	beef liver, lean pork, enriched rice, dried peas and beans, nuts, whole wheat products
B-2 (riboflavin)	F: 1.2 - 1.3 mg M: 1.4 - 1.7 mg	metabolizes amino acids; helps produce energy from carbohydrates	beef liver, milk, egg, cheese, enriched bread, whole grain products
B-6 (pyroxidine)	F: 1.3 - 1.5 mg M: 1.3 - 1.7 mg	Vitamin B-6	chicken, pork, black beans, almonds, enriched white bread, whole wheat products, lentils, dried peas, fish
B-7 (Biotin)	F: 30 - 100 mcg M: 30 - 100 mcg	aids in cell growth, essential to metabolize carbohydrates, proteins and fats, helps promote healthy nerve tissue and bone marrow	cauliflower, nuts, egg yolks, meat, milk, poultry, whole grains
B-9 (folic acid)	F: 400 mcg M: 400 mcg	cell division and reproduction, and in the manufacture of hemoglobin	green leafy vegetables, pears, blueberries, brown rice, chicken, salmon, whole grains
B-12 (cobalamin)	F: 2.4 mcg M: 2.4 mcg	necessary for production of red blood cells, absorption of food, healthy nerves	fish, eggs, liver, milk, poultry
C	F: 60 mg M: 60 mg	Vitamin C	green leafy vegetables, broccoli, cabbage, bell peppers, brussels sprouts, potatoes, beets, collard greens, mustard greens, turnips, fennel, parsley
D	F: 5 - 15 mcg M: 5 - 15 mcg	essential for strong teeth and bones, required for calcium and phosphorus absorption	egg, milk fortified with vitamin D, cream, salmon, herring
E	F: 22 IU M: 22 IU	Vitamin E	vegetable oils, margarine, almonds, cashews, sesame seeds and oil, sunflower seeds, wheat germ, whole wheat products, green leafy vegetables
K	F: 60 -65 mcg M: 70 to 80 mcg	needed for blood clotting, bone formation and repair	green leafy vegetables, broccoli, egg, wheat, milk; also produced by bacteria in the intestines (prolonged use of antibiotics may reduce levels of such bacteria)

RDA = Recommended Daily Allowance
IU = international units; mcg = micrograms; mg = milligrams
F=Female: M=Male

Minerals

Essential minerals belong to two groups, bulk minerals and trace minerals, which are stored in the body's bone and muscle tissues. Bulk minerals include calcium, magnesium, potassium, sodium and phosphorus. Bulk minerals are the core elements that make up the bodies tissues and fluids. Trace minerals include zinc, copper, chromium, iodine, iron, manganese, molybdenum, selenium, silicon, sulfur, vanadium, germanium and boron.

Zinc has antioxidant properties, is a component of many enzymes involved in energy metabolism, is needed for normal skin and hair, and is involved in wound healing. One important function is the promotion of glandular reproductive health and proper functioning of the immune system.

NIH Clinical Center - Facts About Dietary Supplements

Return to Top

Calcium is necessary for maintaining bones and teeth, the transmission of nerve impulses, blood clotting, muscular growth and contraction, maintains proper cell membrane permeability and aids in neuromuscular activity.

Return to Top

Manganese is needed in minute quantities, is required for reproduction and bone growth, growth of connective tissues and cartilage, energy production, healthy nerves and the overall immune system.

Return to Top

Potassium helps transmit nerve impulses, helps muscles contract, and is crucial for maintaining a healthy nervous system. It plays an important role in maintaining normal blood pressure, and works in combination with sodium to control the body's water balance.

Potassium, in balance with calcium and magnesium, is essential to the maintenance of excitability of muscle tissue, especially the cardiac muscle. Adequate intake of potassium is especially important for people taking medication for high blood pressure.

A potassium deficiency can result in excess thirst, weakness of muscles, changes in the electrocardiogram, and mental confusion. The herbal product Licorice, when taken for long periods of time with certain other drugs, can cause depletion in the body's potassium supply.

Dr. Lowell Parsons, a reknown IC researcher at the University of San Diego, has noticed that several foods IC patients regularly avoid (ie., oranges and tomatoes) contain fairly large amounts of potassium. Because some patients' bladders are known to react when potassium salts are instilled in the bladder, Dr. Parsons has suggested that for those patients, high-potassium foods may be a problem. Excess potassium is washed out of the body via the urine, so Dr. Parsons believes that the potassium ions in the urine could possibly "leak" across a faulty bladder lining into the underlying bladder muscle tissue where it would trigger spasms and pain. This may be true for some patients, it may not be true for others, and it most likely isn't the whole story when it comes to our problems with food. When ingesting potassium with food, it doesn't affect our bladders in the same way as instilling it directly into the bladder. Most IC patients can comfortably eat turkey and milk and many can eat bananas without suffering a flare. Yet a serving of roasted turkey meat has more potassium than a whole orange; a banana has almost twice as much potassium as an orange; and a cup of milk has 50% more potassium than an orange.

Return to Top

Minerals
Mineral	RDA	Function	IC Friendly Food Sources
Calcium	F: 1000 to 1200 mg M: 1000 to 1200 mg	Calcium	milk, cream cheese, cottage cheese, ricotta, kale, green leafy vegetables, broccoli, fish and cereal products (i.e., corn, wheat, rice, oat and barley)
Chromium	F: 20 to 25 mcg M: 30 to 35 mcg	stabilizes nucleic acids, activates enzymes, is a component of glucose tolerance factor which enhances the effect of insulin	beef, eggs, whole grains, brown rice, chicken, potatoes
Copper	F: 900 mcg M: 900 mcg	aids in bone, hemoglobin and red blood cell formation, is required for healthy joints and nerves, is involved in the process of healing, energy production and taste sensitivity	seafood, nuts (almonds and cashews), broccoli, garlic, green leafy vegetables, whole grain cereal products, lentils
Iodine	F: 150 mcg M: 150 mcg	required for proper thyroid function, helps in the metabolism of excess fat and is important for mental & physical development	iodized table salt, kelp, seafood, squash, garlic
Iron	F: 8 to 18 mg** M: 8 mg**	required for healthy immune system, energy production, formation of hemoglobin and oxygenation of red blood cells	eggs, oysters, clams, lentils, green leafy vegetable, rice, pork, beef, whole grain cereals, almonds
Magnesium	F: 310 to 320 mg M: 400 to 420 mg	essential part of bone and teeth, helps with nerve and muscle impulses, helps prevent depression and aids in maintaining the body's proper pH balance	dairy products, nuts (cashews, almonds), fish, shell fish, whole grain cereals, brown rice, garlic
Manganese	F: 2.3 mg M: 1.8 mg	Manganese	green leafy vegetables, nuts, beans, blueberries, egg yolks and whole grain cereals
Molybdenum	F: 45 mcg M: 45 mcg	component of tooth enamel and enzymes that metabolize fats and proteins	leafy vegetables, legumes (lentils), whole grains
Phosphorus	F: 700 mg M: 700 mg	forms and maintains bone and teeth, builds muscle, adds in cell growth and kidney function, involved in many metabolic functions, energy production and maintaining acid base balance	cream cheese, whipped cream, cottage cheese, ricotta, beef, lamb, poultry, fish, nuts, whole grains
Potassium	F: 500 to 2000 mg* M: 500 to 2000 mg*	Potassium	cereals, honeydew, blueberries, raisins, fish, legumes, potatoes, brown rice, cereals, nuts, chicken, fresh vegetables and most fresh foods
Selenium	F: 55 mcg M: 70 mcg	antioxidant, inhibits the oxidation of fats, protects the immune system, needed to form the enzyme glutathione	meat, fish, eggs, lobster, clams and other shell fish, broccoli, brown rice, vegetables, whole grains
Sodium	F: 500 mg* M: 500 mg*	maintains proper water balance and blood pH, components of bile and pancreatic juices, needed for nerve and muscle function	salt, snack food, beef, pork, cornbread and most foods
Zinc	F: 11 mg** M: 8 mg**	Zinc	vegetables, egg yolks, fish, lamb, poultry, meat, sunflower and pumpkin seeds

RDA = Recommended Daily Allowance
IU = international units; mcg = micrograms; mg = milligrams
F = Female; M = Male

* = For potassium and sodium there is no recommended daily allowance, but most experts consider these amounts to be the minimum safe and adequate intake for healthy adults.

** = vegetarians should consume twice the amount shown for these minerals. Iron consumed from non-heme (plant) sources is less well-absorbed than iron from heme (animal) sources. Zinc also is not well absorbed from plant sources.

Nutrition Data From:

• Dietary Supplement Fact Sheets, 2002, Clinical Nutrition Service, National Institutes of Health
• Dietary Reference Intakes (DRI's), Recommended Levels for Individual Intake, 1997-98, Food and Nutrition Board, National Academy of Science--Institute of Medicine.
• The American Dietetic Assn's Complete Food and Nutrition Guide, 1998, Chronimed Publishing.
• The Nutrition Desk Reference, 1995, RH Garrison,Jr., E Somer, Keats Publishing

Return to top