00:00 – Hi, welcome back to the channel. My name is Molly and today at Live UTI Free, we’re chatting with Mary
00:05 – Cotter about recurrent UTI. If you’re new to our channel, be sure to check out the description
00:10 – below as we’ve linked to other resources that you might find helpful. Lastly if you enjoy
00:16 – these videos, think they’re important and want to support what we do, be sure to hit subscribe
00:20 – and tick the bell so you get notified when we post new videos. And other than that, we hope
00:25 – these videos provide the insights you need to take the next step on your UTI recovery
00:30 – journey. So, joining us today is Mary Cotter. Thank you for taking the time to share your experience
00:48 – around recurrent UTI in this Clinician Insight Series. Firstly, can you tell us a little bit
00:53 – about yourself, where you’re based and how you become a nutritional therapist? Sure yes. So
00:59 – my name is Mary, I’m currently based in Scotland in the UK. I’m actually in the process of moving
01:05 – to Ireland so soon that will be changing and I am a nutritional therapist. I became a nutritional
01:15 – therapist not really through choice but through my journey and experience with chronic UTI and
01:23 – numerous different, you know problems with urinary health and that led me to switching
01:33 – careers from interiors to becoming a nutritional therapist and that was about 10 years ago and at
01:42 – that point when I retrained I was quite, I would describe it as being quite a traumatic experience
01:51 – and initially I wasn’t quite ready to talk about my experience and my journey and I started out
01:57 – specialising in irritable bowel syndrome, IBS, gut health and it was really only in the last
02:04 – few years where I decided actually you know, I do feel ready now to open up and talk, it’s just
02:11 – heartbreaking to see how many people are still struggling, going through a similar experience
02:16 – to what I did and I just feel, it just felt like a right time to really focus down and specialise in
02:25 – chronic UTI, Interstitial cystitis, you know, urinary health bladder pain symptoms, so all
02:33 – of that really is where I love to help people. That’s great, so what type of patients do you see
02:42 – with recurrent and chronic UTI? So it’s mainly women, they can be from all different ages from
02:51 – you know early 20s right up to menopause and beyond, but everybody is experiencing something along the
03:02 – lines of, you know I had a UTI, went to the doctor, had some antibiotics, but you know the symptoms
03:09 – didn’t change, went you know then you kind of go around all the houses Gynaecology, Urogynae, Urology
03:18 – and they end up you know sort of being fobbed off or told they’ve got Interstitial cystitis or
03:26 – chronic bladder pain syndrome and then they’re sort of left Googling and wondering oh my god is
03:33 – my life going to feel like this forever? And that’s typically when they find me and that’s, you know, it
03:41 – that’s typically then when we would kind of dive into their health history, what they’ve tried so
03:48 – far, look at the testing that they’ve had up until now, and just see where we can start to
03:58 – change direction and really look at the root cause and identify what’s actually at the heart of that
04:04 – chronic bladder pain and yeah that’s typically the type of person I generally work with. Okay
04:16 – so what is your typical approach when you meet someone with recurrent UTI? So initially we kind
04:25 – of take a quite a detailed health history to see what they’ve been through, other underlying
04:34 – health issues so exploring you know gut health, stress, nervous system, hormonal balance, all of
04:42 – those things but I’ve created a framework to sort of take us on a journey through all the different
04:52 – systems in the body that really benefit from support and rebalance, so the first step
04:58 – is retesting and the reason for that is as your community may be already aware of, but there’s so
05:07 – many limitations with dipstick tests and culture tests and certainly in the UK and Ireland, you
05:14 – know that’s what they will have had, through their doctors, through their urologists, and what I offer
05:21 – my clients is more advanced testing using PCR and NGS where we’re looking at the genetic material,
05:34 – but also the overall balance of bacteria in the urinary bladder because what we’re now aware of
05:43 – is that actually like any other microbiome in the body, like the gut microbiome, or the vaginal
05:51 – microbiome, the urinary bladder also has it’s own microbiome, which is made up of bacteria and that
06:01 – can be friendly bacteria, it can be bacteria that can change direction depending on, you know how
06:10 – stressed you are or how healthy you are, and then yes also there will be pathogenic bacteria at
06:17 – times also. So it’s looking at, I want to know what’s going on in that environment not just
06:25 – looking at the bad pathogens but also looking at the friendly microbes and supporting the health of
06:31 – those because they’re also involved in preventing repeat infection and bladder flares, you know they
06:41 – they’re involved in you know they form part of the immune system and produce lactic acid to prevent
06:47 – pathogen growth so they’re something that’s of great interest, that’s why we use the testing
06:54 – and with those results then, it can help remove some of the guest work and help us prioritise what
07:01 – the next step in that journey needs to be. Does it need to be antimicrobials? Or would we be better
07:08 – off focusing on probiotics that are targeted to the urinary system? Or do we need to look at the
07:16 – immune side of things and really support you know vitamin D and their stress levels and nervous
07:23 – system health. So the program I offer clients, heal your bladder program, generally takes
07:30 – people on through each step on that framework, generally at least you know, initially six months,
07:38 – some people respond really quickly, for others it might be a slightly different journey where
07:43 – we use different testing as well but that’s generally how it works. Okay and how do you work
07:51 – with other consultants in this process? So if a client requires further medical support I do
08:02 – have a network of private doctors who I refer to, there’s access to private prescriptions
08:09 – and consultations so whether they need medical support or nutritional support, they absolutely
08:19 – have a choice in which direction they go. So as a nutritional therapist my role is about supporting
08:27 – the individual so the the diagnosis would be through their doctor or urologist. What my
08:35 – role is, is about creating balance and supporting that individual as a whole so we don’t just fixate
08:43 – on the bladder or the vagina or the fact that they’ve got bloating, we’re looking at the overall
08:48 – picture and piecing it together, rather than you know a doctor’s approach is slightly different,
08:56 – they’re really fixating on the bladder and maybe overlooking what’s going on in the
09:04 – vagina which could actually be influencing when a bladder flares or you know, different episodes
09:14 – of symptoms. That’s really interesting. What is your typical treatment approach when you identify the
09:22 – infection or when you don’t identify an infection? So we use the PCR test results as a screening tool
09:33 – it’s a helpful guide to determine, okay do we need to actually start some antimicrobials or is it a
09:42 – case that actually it’s the opportunistic bacteria that are slightly out of balance and what we need
09:49 – to do is actually help crowd them out by going in with more of the good friendly bacteria and
09:58 – from there we then work on supporting their immune health so that they are their defenses are really
10:07 – robust you know, you do have to ask yourself if you’re somebody with recurring UTI or recurring
10:14 – bladder flares, why does that keep happening? why isn’t the immune system responding appropriately?
10:19 – And how can we help ourselves, you know, through food, through supplements, through diet, and the
10:27 – other important step is nervous system health because that is and I know you’ve talked about
10:37 – this before on other videos but pelvic floor function and hypertonic pelvic floor plays into
10:44 – our pain scores and the severity of our pain and we can use food and specific minerals and
10:53 – nutrients to have a really nice calming effect on the body and that’s a really important adjunct to
11:01 – having pelvic floor therapy so again it’s, you know, looking beyond just the burning symptoms
11:09 – and looking at how can we help this person calm their nervous system, relax the muscles, and again
11:17 – that’s quite a sensitive topic because so many of us have sort of been, you know it may have been
11:23 – suggested to you that, oh you just need to relax you know, you’re just stressed, it’ll all go away
11:28 – just chill out. But actually many of us, we’re in fight OR flight a lot of the time, you know
11:35 – we’re at our laptops Googling for answers. Having a chronic health condition is very stressful so
11:42 – anything we can do to try and calm and relax and reset is also going to help change how we respond
11:52 – to things and how our pain scores respond as well so, that also forms quite a big important step in
12:02 – that kind of recovery process. I think a lot of our community deal with tha,t so it’s the stress of
12:09 – not knowing where to go next when you’re dealing with these chronic UTIs, so I think having that
12:14 – is really important. Definitely. Yeah, so you mentioned gut and vaginal health, do you have
12:20 – any tips on preventing future UTIs? So I’ve got a lot of tips, some you’ll find on my website, I have a
12:29 – free ebook that you’re welcome to download called Heal Your Bladder but what I would suggest as
12:36 – a starting point is looking at foods first of all and a few obvious places to start would be things
12:45 – like blueberries, which are really rich in polyphenols that have also shown to interfere with
12:54 – how certain bacteria adhere to the lining of the urethra. So we’ve probably all heard about cranberry,
13:01 – but blueberries also contain similar polyphenols that work in a similar way and often I find
13:07 – they’re just easier to fit into the diet. Pumpkin seeds are also a great one for symptoms like
13:14 – urgency, frequency, and they’re just a nice thing to incorporate quite easily in food to support
13:22 – urinary health. The other big thing that I focus in on with clients as part of my program
13:29 – is Vitamin D testing. Vitamin D is really really key because, if you are prone to infections, having
13:40 – optimal levels, not just scraping by with like okay, you’re not deficient but you know it’s not
13:46 – amazing. It does play an integral part to the risk of recurrence of UTI so making sure you’re
13:55 – either supplementing through the winter months. There is trace amounts of vitamin D in
14:00 – food but we’re really relying on sun exposure and exposing our skin to the sun but again most
14:08 – of us, like we’re indoors a lot of the time, so foods you know, eggs, mushrooms, oily fish would have
14:15 – small amounts of vitamin D there. And the other thing to consider then, would be you know, your
14:24 – those probiotics and looking at foods that will naturally provide a source and again depending on
14:31 – where you are in that journey, they may or may not be suitable straight away. You would maybe need to
14:37 – start slowly with them but a few examples would be like homemade Kefir, raw sauerkraut, beetroot
14:45 – kraut, miso paste, and again you know just going really slowly with them but that would be a way of
14:53 – getting some of these probiotics through food, but I guess the beauty of working with a nutritional
14:58 – therapist is that we are uniquely trained in the use of supplements and we would be able to
15:04 – tailor a plan for you depending on like what your symptoms are, is it a chronic UTI? is it a recurring
15:11 – UTI picture? Like it would really vary depending on what that person is presenting with. It’s not
15:17 – really kind of, here is a probiotic it’ll work for everything, unfortunately. Yeah they would kind
15:25 – of be a few things and certainly like in terms of immune health, thinking about zinc also. Zinc is
15:32 – in a lot of nuts, seeds, quinoa, lamb, shellfish. It’s really important for immune health and
15:41 – that’s kind of where I would you know, if you’re at home wondering what you can do that’s kind of an
15:46 – easy place to start. Yeah, no that’s amazing. Thank you that’s some really interesting tips. So how can
15:52 – patients get in touch with you? So you’ll find me on Instagram mainly on at Mary Cotter Nutrition
16:02 – My website is Marycotternutrition.com please feel free to get in touch through my website and
16:09 – don’t be shy, drop me a DM on Instagram, I’d love to connect with you and share some resources with
16:16 – you, and help get you started. And the last thing I just want to say on the diet side of things is
16:23 – that many of the people who come to work with me are coming really from a place of fear and anxiety
16:32 – around food and that was my experience as well, way back when I was going through this, you know you
16:39 – go online and you think oh avoid anything acidic, you’ve got to avoid tomato, citrus, all of that and
16:46 – I think a really turn, a key turning point on my journey was when I was working with a nutritionist
16:54 – helping me understand actually foods pH changes on digestion and it’s metabolised in the body so I
17:04 – think what I really want to get across is, please don’t fear food, that’s actually the very thing
17:10 – that’s going to help you get stronger, build up your defenses and respond well. If all you’re
17:20 – doing is cutting out foods and fearing chances, you’re going to lose weight, become depleted
17:26 – and actually feel much worse and again I dive into that in more detail on my website and on
17:33 – Instagram. Okay that’s amazing, well thank you Mary for providing us with some valuable information
17:40 – from the nutritional perspective connection in recurrent UTI. We will include your details in the
17:45 – description below for anyone who would like to get in contact. Thanks so much for watching, I hope you
17:51 – found this video helpful. You’re always welcome to reach out to ask more information about clinicians
17:56 – who specialize in recurrent and chronic UTI. Our contact is in the description below. If you’d like
18:01 – to learn more about this or related topics, be sure to check out our other videos or head over to
18:07 – liveutifree.com for other articles on current UTI treatment options. Of course, if you like
18:12 – what we’re doing on the channel, make sure to hit the subscribe button here on YouTube and tick the
18:17 – bell so you get notifications about future videos. Thanks so much for joining us for our Clinician
18:22 – Insight Series. If you have suggestions for who we should interview next, be sure to drop us a comment