Bladder inflammation requires no treatment
DEAR DR. ROACH: I am looking for some clarification on cystitis glandularis. My 53-year-old son was recently diagnosed with this condition. He has been experiencing urinary frequency/urgency for more than two years. He is in excellent health and works out religiously, but he does smoke.
Online research provides conflicting opinions. Some sites indicate that it is an extremely rare condition, while others say that it is fairly common. Also, some sites indicate that the condition can become malignant over time.
My son’s doctor told him the condition is incurable, and he will just have to live with it. Can you please provide more information about this condition? — J.R.
ANSWER: “Cystis” is the Latin word for bladder, so “cystitis” means bladder inflammation. Persistent inflammation in the bladder, such as with chronic infection or interstitial cystitis, can lead to a change in the cells lining the bladder. They can go from normal bladder-lining (urothelial) cells to cells that look more like those in secretory glands (hence “cystitis glandularis”).
This condition in general is called “metaplasia,” but does not by itself mean that the lining of the bladder will become cancerous.
There is debate over how common this is, with autopsy studies showing areas of change in the bladder in 60% of people (who died from other causes), while other authors say it is a rare condition.
There is also argument over the degree of risk of this condition progressing to bladder cancer, but I found one well-done study of cases that estimated the risk over time to be about 9% (follow-up time averaged about four years). This is clearly higher than the risk of bladder cancer overall, since about 1% of women and 3% of men will get bladder cancer in their lifetime.
If there were evidence of chronic infection, that should be treated; otherwise, there is no treatment for cystitis glandularis beyond periodic evaluation to look for any evidence of changes to cancer. There is no clear evidence to support the frequency of examination, but annual exams have been proposed.
DEAR DR. ROACH: I’ve been taking collagen and biotin for my skin, hair and nails for months. Then, I had my A1C test done for my quarterly diabetes check. Is it true that biotin and collagen raises the A1C number? It’s been going up. — B.G.
ANSWER: Biotin is a vitamin found in many foods. It is often used by people for nail and hair disorders, although the evidence to support it isn’t very strong. However, I have had many patients report success.
Biotin interferes with several lab test results, mostly in hormone testing. The thyroid tests are most affected, as biotin causes a pattern that looks like hyperthyroid levels, even in people with normal thyroids. But it also affects other tests, too, including testosterone, progesterone and ferritin. However, I could not find any reports of interference with the A1C test.
Collagen is a structural protein, containing the amino acids necessary to build critical body structures. It is found in all meats, at much higher levels than any supplement, and there is no reason to suspect interference with lab results.
The A1C tends to go up slowly as people age or with weight gain.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.