Urinary tract infections are among the most common bacterial infections in women. Around 60% of women will experience at least one urinary tract infection during their lives, and reinfection rates are estimated to be as high as 80%. (5) 

Not only do urinary tract infections cause significant discomfort and pose a risk for health complications, patients who struggle with recurrent infections often require frequent repeat courses of antibiotics. Using functional medicine labs can help get to the root cause of chronic urinary tract infections, preventing future infections, reducing the use of antibiotics, and improving the overall quality of life.

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What Are Urinary Tract Infections (UTIs)?

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. UTIs are most commonly caused by bacteria, with the vast majority caused by Escherichia coli (E. coli), a type of bacteria normally found in the digestive tract.

UTIs can vary in severity and location within the urinary system. Urethritis affects the urethra, the tube that carries urine from the bladder to outside the body. Cystitis is an infection that affects the bladder. Pyelonephritis is a more severe infection affecting the kidneys. (4) 

UTIs are typically diagnosed based on symptoms, a physical examination, and urine tests. They are usually treated with antibiotics prescribed by a healthcare provider. It's essential to complete the entire course of antibiotics, even if symptoms improve, to ensure complete eradication of the infection and to prevent recurrence or antibiotic resistance. (3, 4) 

What Causes Urinary Tract Infections (UTIs)?  

UTIs are primarily caused by bacteria entering and multiplying in the urinary system. The most common causative agent is E. coli, which can cause a UTI when it migrates from the anus to the urethra and ascends to the urinary tract. Other bacteria that commonly cause UTIs include species of Klebsiella, Proteus, Enterobacter, and Enterococcus. (3)

While bacterial infections are the most common causes of UTIs, fungal infections can also lead to urinary tract infections. Candida species, specifically Candida albicans, are the most common fungi responsible for causing an estimated 6.8% of UTIs. (3) 

Several factors can contribute to the development of UTIs. UTIs are more common in women than in men due to anatomical differences; women have shorter urethras, which makes it easier for bacteria to travel from the outside to the bladder. Other risk factors include sexual activity, certain types of birth control, urinary tract obstructions, a weakened immune system, catheter use, hormonal imbalances, and other medical conditions that affect the urinary and immune systems, such as pregnancy and diabetes. (3, 4) 

Preventive measures to reduce the risk of UTIs include staying hydrated, practicing good hygiene (wiping front to back after using the toilet), urinating before and after sexual activity, avoiding irritants like feminine hygiene sprays, and addressing underlying conditions that may increase susceptibility to UTIs. (3) 

Urinary Tract Infection (UTI) Symptoms

The classic symptoms of UTI are pain with urination (dysuria), urinary frequency and urgency, and blood in the urine (hematuria). UTI symptoms can differ based on the location of the infection within the urinary tract. For example, cystitis can also present with lower abdominal pain, whereas fever, flank pain, nausea, and vomiting typically indicate pyelonephritis. (3) 

What Are the Benefits of Regular Lab Testing for Patients With Urinary Tract Infections (UTIs)?

Regular lab testing plays a crucial role in diagnosing, treating, and preventing UTIs, ensuring optimal patient care and health outcomes. If you are experiencing symptoms of a UTI, it's important to consult a healthcare provider for proper evaluation and testing.

Lab tests, such as urinalysis and urine cultures, can accurately identify indicators of infection in the urinary tract, including the presence of bacteria, white blood cells, nitrites, and leukocyte esterase. Additionally, these tests can help distinguish between bacterial and non-bacterial causes of urinary symptoms. This can determine the causative pathogen for UTI, which can guide the correct treatment choice and prevent the development of antibiotic resistance.

Specialty labs can guide healthcare providers in tailoring treatment plans based on the patient's specific condition, medical history, and underlying health conditions. These results provide valuable information for patients about their infection and its underlying causes, especially for those with recurrent infections, helping empower patients to actively participate in integrative treatment plans and implement the necessary lifestyle modifications. This integrative and holistic approach to UTI treatment leads to more effective and individualized care, increasing treatment efficacy and reducing the risk of future infections.

Top Labs to Run Bi-Annually on Patients With Urinary Tract Infections (UTIs)

Several labs can help diagnose and monitor patients with recurrent UTIs. Some labs that should be considered as part of a routine assessment for patients with UTIs are discussed below. 

Urinalysis with Culture

A urinalysis can be performed in the office or sent to a lab and is a test that examines the visual, chemical, and microscopic aspects of a single urine sample. Cloudy urine, a high urine pH, and the presence of nitrites, leukocyte esterase, red blood cells, and white blood cells are all possible findings that indicate a UTI (7). The test is reflexed to a urine culture when abnormal results are found on a urinalysis. A culture involves growing out microscopic organisms from a urine sample to identify the bacteria or yeast responsible for the infection.

CBC & CMP

A complete blood count (CBC) can show unusual increases or decreases in blood counts, including white blood cells, which are the cells responsible for fighting infection. By monitoring white blood cell levels, a CBC can help identify the early presence of infection and monitor medical treatment. 

A comprehensive metabolic panel (CMP) is a blood test that measures a variety of biomarkers related to various aspects of health. For patients at risk of or with a history of recurrent kidney infections, regularly monitoring the markers of kidney function included on a CMP is an essential aspect of a preventive health evaluation. Among other markers, a CMP also measures blood glucose; patterns of elevated blood sugar can indicate the presence of insulin resistance, prediabetes, and diabetes, which increase the risk for UTI. 

Comprehensive Stool Analysis

Opportunistic bacteria and yeast overgrowing in the gut can be easily transplanted to the urethra, allowing them access to colonize the urinary tract and cause infection (4). A comprehensive stool microbiome analysis identifies gastrointestinal dysbiotic patterns that can predispose an individual to chronic, recurrent UTIs.  

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Summary

Urinary tract infections are a common women's health concern. Chronic, recurrent UTIs are prevalent amongst the female population, given the anatomy of the urinary tract. Functional medicine doctors can help patients struggling with recurrent UTIs get to the root cause by utilizing specialty tests that isolate the causative pathogen responsible for infection and identify underlying factors that allow pathogens to colonize the urinary tract easily.