Bladder Control Depends on Healthy Choices As We Age

By Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

April 4, 2022

Bladder Control Depends on Healthy Choices As We Age

Have you noticed all the ads and products in the “bladder control aisle” in the market? Adult diapers and incontinence products now sell more than infant diapers. About 20 percent of adults over 65 have lost some degree of bladder control. Rather than assume this is because of age, it’s important to wonder why this problem is occurring. Just like nutrition and diet plays a key role in vision, hearing, and brain health, it also is an important factor in healthy bladder control.

Common Factors That Affect Bladder Control

Urinary continence, that is the voluntary ability to hold urine in your bladder without leakage, is something that most take for granted - until they run into issues. Loss of urinary control is affected by older age and other factors unrelated to advanced age including pregnancy, childbirth, menopause, larger waist size, obesity, prostate enlargement, some medications, urinary tract infections, and constipation. Increased bladder leakage concerns occur with other health challenges like asthma, arthritis, cancer, heart disease, depression, urinary tract infections, diabetes and metabolic syndrome.

Bladder control issues are linked with autonomic nervous system “tone” changes, bladder muscle sensitivity, endothelial and vascular dysfunction, chronic inflammation, and increased oxidative stress. In premenopausal women, lower estrogen and progesterone levels affect collagen in the bladder. This may contribute to stress urinary leakage.

Various foods, beverages, and medications can challenge bladder control. Alcohol, caffeine, carbonated beverages, artificial sweeteners, chocolate, chili peppers, citrus fruit, spicy foods, and blood pressure and heart medications, muscle relaxers, and sedatives may also be a trigger.

High fat/high calorie diets contribute to poor urinary control. A study that involved 5800 women, 40 years of age and older, evaluated bladder control issues with diet and nutrient status. Those who consumed a high fat diet (total fat, saturated fats, and monounsaturated fats) for one year, were more likely to experience stress incontinence.

Trans-fats, white flour, white sugar, processed foods, high vegetable oil intake, alcohol, soda pop and other sugar rich beverages contribute to diet-induced inflammation. A pro-inflammatory diet has been related to higher incidence of urinary incontinence in women 20-65 years old.

Environmental Toxins Affect Bladder Control

An emerging body of evidence also points to environmental toxins like Bisphenol A (BPA) and other compounds like polycholorinated biphenyls (PCB) affecting bladder control. Animal studies showed that chemical exposures during preborn and early infancy development of male offspring changed bladder function later in life.

Think about the plastics and plasticizers in your environment. They are everywhere and are even likely hiding in bladder control products used for infants and adults.

More information about endocrine disrupting compounds may be found at:

Endocrine Disruptor Compounds and Your Hormones

Feminine Hygiene Products: Protect Yourself From Hidden Toxins

Precocious Puberty – A Growing Dilemma for Today’s Children

High Copper Levels

Concerns also exist with imbalance of nutrients. A March 2021 study evaluated zinc and copper levels in women with various types of urinary leakage concerns. Results showed several types of urinary concerns were found in women with high blood levels of copper. Women over the age of 50 were most impacted. Zinc levels were within range.

This makes me question the prevalent use birth control pills and copper IUDs that can readily contribute to high copper levels in your body. Some women also have a genetic tendency to retain copper. Have these birth control measures that affect copper metabolism led to bladder control difficulties in some women? If you have bladder control concerns and use birth control, get a blood test to measure your copper levels.

Vitamin B12, Folate and Thiamin

Bladder continence and control depends upon healthy nerve function related to the myelin or fatty sheath covering. This requires vitamin B12, folate, thiamin, choline and other nutrients for normal neurological function and signals.

Vitamin B12 also affects collagen and pelvic floor musculature involved with urinary control. In a recent study, women with urinary incontinence had a blood test average of 300 pg/mL while the control group average was about 600 pg/mL of vitamin B12. Women with lower vitamin B12 levels experienced more bladder control symptoms for longer compared to those with good levels.

Lower vitamin B12 status occurs commonly with aging and poor absorption of vitamin B12. It is important to note that “Normal blood levels of vitamin B12 or the metabolic marker methylmalonic acid do not exclude symptomatic B12 deficiency” according to a Mayo Clinic Proceedings publication.

Sufficient folate also affects neurological control of your bladder. A case study from 1975 demonstrated that loss of urinary control happened because of an anti-seizure medication depleted folate levels in the patient. Once folate levels were restored, urinary control returned.

Vitamin B1 (thiamin) is also necessary for urinary control. Significant risk factors for low thiamin intake include gastric bypass surgery, alcohol use, and white flour/white sugar/high carbohydrate intake. Insufficient dietary intake, poor absorption, and medication induced nutrient depletions affect individuals of all ages. This can certainly contribute to the increase of bladder control difficulties.

You can learn more at:

Are You Taking Folate or Folic Acid? Read This First

Vitamin B12 Essential for Energy, Mood, and Overall Health

Vitamin B1/Thiamin – Are You Getting Enough?

B Vitamin Deficiency: Are You at Risk?

Vitamin D

Your bladder contains vitamin D receptor sites throughout the tissues, but especially the “bladder detrusor muscle”. This specialized smooth muscle directly affects urinary control. Current research supports a positive link with adequate vitamin D and urinary control, while low vitamin D levels may contribute to urinary leakage. How long can your body go with low vitamin D levels before something doesn’t work well? It’s not worth finding out.

More information about vitamin D may be found at

New Discoveries Highlight the Importance of Vitamin D

Vitamin D and Your Immune System – Are You Getting Enough?


Melatonin also plays a substantial role in healthy bladder function and aging. It functions as a powerful antioxidant and modulates neurotransmitters, which helps calm down bladder irritability. We lose melatonin production with age and with artificial and nighttime light and blue light exposure.

On a slightly different note than urinary leakage, awakening to urinate more than twice per night has been linked with lower melatonin levels.

You must ask - have the last several decades and 24/7 around the clock living along with the environmental chemicals, pro-inflammatory calorie rich-nutrient poor diets contributed the increasing prevalence of poor bladder control? These factors are certainly linked with increased inflammation, obesity, diabetes, sleep quality and more.


Your bladder and urinary tract are not a sterile environment like it once was thought. New diagnostic techniques have shown a unique balance of microbiota or beneficial germs called the “urobiome” in the urinary tract, just like your gut and respiratory tract.

Recent findings show that urinary tract dysbiosis or disruption of the urobiome is linked with various changes in bladder control. The natural flora is acquired during delivery from vaginal birth and from gastrointestinal flora. Antibiotics disrupt normal flora.

Weight Loss and Physical Fitness

Studies show that being physically active and fit is associated with better urinary tract control in post-menopausal women. A randomized controlled trial published in the New England Journal of Medicine demonstrated the effectiveness for weight loss and urinary control. Women who lost on average 17 pounds over the course of the 6 month study reduced urinary incontinence episodes by 70 percent or more.

The ability to “hold it” until the next available rest room may not be as easy as the years go by. Worries about a big sneeze and the next “uh-oh” may limit social activities. It is easy to attribute bladder control accidents to age, stress, changing hormone levels, but these concerns happen in young adults too.

Weight loss, increased physical activity and fitness, a whole foods diet, beneficial urobiome flora support, and key nutrients like vitamins B1, B12, and folate, vitamin D, and as well as balanced copper and melatonin levels impact bladder control. These modifiable factors can be supported and changed. Aging well is a necessity at all stages in life. Proactive support now can make a big difference for healthy aging later on.

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