Editor’s note: The following content is provided as a personal story, only. It is not intended to be medical advice. If you experience any health problem, consult a licensed healthcare professional.
It wasn’t until listening to a passage in Micheal Pollan’s audiobook, Caffeine, did I consider my frequent urination a problem. According to sleep specialists, we need a solid seven hours of uninterrupted sleep every night both for our day to day health as well as longevity. Our nightly slumber supports our immune system, prevents Alzheimer’s, regulates our blood sugar while a lack of proper rest is associated with all major psychiatric conditions including depression and suicidal ideation. Further, our brain never completely recovers from the loss of sleep. My goal is to get a minimum of seven hours of uninterrupted sleep every night and the first order of business is to identify the cause of my nocturnal bladder problem.
Frequent urination in middle-age men is a common butt of jokes in television and Hollywood movies. I accepted by its prevalence that it was a normal part of life. I considered the need to pee a couple of times a night, known as Nocturia, as a rite of passage, a notion I only now feel compelled to question.
Nocturia is more often a symptom of something more concerning ranging from enlargement of the prostate to untreated diabetes to consuming too much liquid. As a forty-eight-year-old man, I’m in, what I consider to be, ideal health. I’m neurotic-adjacent with my nutrition and on good weeks, I get in five to six workouts. I test my blood twice a year and keep up to date with my check-ups, including the uncomfortable ones ie. prostate.
Many medical outlets recommended limiting, or ceasing completely, coffee intake. However, when I dug deeper I found that caffeine is one of the most studied psychoactive compounds in history and associated with longer life. Caffeine can stay active for up to twelve hours so not drinking it too late in the day is a more acceptable compromise than giving up the daily dose that I enjoy.
Given my health, I elected to try natural remedies before I put my doctor on the case. The first thing I did was limit my caffeine and water intake later in the day. I limited my coffee to two cups consumed before 10 am, around three 10 oz glasses of water throughout the day, and no liquid after 5:30 pm. I drank coffee alternatives like lion’s mane, cordyceps, or Chaga mushroom elixirs or sometimes just a cup of decaf. I suffered a few morning headaches and I savored those first cups of coffee a little too much, think Gollum holding his precious. Sadly, the discomfort was in vain, nocturia persisted.
An entry on Healthline.com recommended strengthening the pelvic floor can provide better bladder control. This was accomplished with an exercise called Kegel. The best example I found that describes how to perform Kegel exercises is to stop urination halfway to identify what muscles I was using. It was recommended to contract this muscle for a few seconds for ten intervals a few times per day on both an empty and full bladder. The Mayo Clinic points out that it may take months to realize any improvement in bladder control but I figured this couldn’t be a harmful muscle to exercise (side note: Kegel exercises are also associated with improved sexual performance).
To rule out any more concerning possibilities, I described to my doctor what I was doing. Predictably, she wanted to analyze my urine and blood. She explained how my antidiuretic hormone (ADH) which tells my kidney how much water to preserve as well as telling my body to hit the pause button while I sleep might not be operating effectively. She suggested I do a twenty-four-hour urine sample meaning I’d have to pee in a bucket for an entire day and bring said bucket in for analysis. In the current COVID-19 climate I’d have to wait a couple of weeks before said urine festival so I turned back to my quest for a natural remedy. I decided to keep a diary of how much fluid I consumed and expelled so I did what any sane(ish?) person would do, I created a spreadsheet with associated charts to visualize the data.
Keeping hydrated sits at the top of our nutrition paradigm but I was never really taught how much was optimal. I remember the 8×8 Rule which is eight 8 oz glasses per day. The 8×8 Rule originated from nutritionist Dr. Fredrick J Stare in the US in 1974 who recommended 6 to 8 glasses of water per day which was later adopted in the UK by the National Health Service (NHS). It seems the 8×8 Rule proved to be more market-friendly than information based on any substantive research. The 8×8 recommendation was questioned in 2002 at Dartmouth Medical School in an extensively researched, peer-reviewed paper that found that there was no evidence to support the 8×8 recommendation. The Mayo Clinic recommends that we ought to replace the amount of fluid we lose which can vary per individual from their sex, activity level, and environment. The recommendation includes fluid from all sources including beverages and food. A 2016 study by Galloway demonstrated that coffee, tea, even beer was just as hydrating as water. A separate recommendation from Harvard Medical School suggests four to six cups per day and also included fluid found in all drinks and food.
The Mayo Clinic (and many other sources) provided a method to identify my hydration level by looking down at the color of my urine. Even when diluted in toilet water the shade of fluid can tell me how hydrated my body is. I’d heard this before and assumed the lighter on the spectrum the better. Wrong. My normally clear urine was an indication of overhydration. Healthline.com’s urine color chart ranges from clear to burnt orange, with an optimum urine shade resembling lemonade or light beer, contrasted by an appropriately named amber color that suggests you may need to hydrate. It’s important to note that certain foods cause discoloration such as beets, aloe, fava beans, and rhubarb among others. I’m fairly active, albeit less so in these times of COVID-19, but after the fruit, vegetables, coffee, and water, I was consuming around fifteen cups of fluid per day! I’ve been overhydrating, something my clearer-than-lemonade urine confirms.
My first drink in the morning was a few glasses of water before my coffee to honor the god of hydration. I now have about half of a cup to quench my thirst. If I feel I want more, I drink more. I enjoy a couple of cups of coffee with maybe a sip of water in between. I consume less full glasses of water, opting for a few sips of water, and keep my coffee consumption before 3 pm. When my water intake, including food and all drinks, fell to eight cups I peed less throughout the day. I Kegel a few times per day and consume little to no liquid in the evening. After a few days on this new fluid schedule, I’m no longer woken up throughout the night by a need to pee.
I am not a doctor and this is not medical advice, but this is what worked for me. I did keep my doctor apprised and I’ve ruled out anything more serious, something I’d encourage anyone with nocturia to do.
If you believe in the work we are doing here at The Good Men Project and want to join our calls on a regular basis, please join us as a Premium Member, today.
All Premium Members get to view The Good Men Project with NO ADS.
Need more info? A complete list of benefits is here.
Photo credit: Shutterstock