Do we actually know why Prelief works?

Elmiron, steroids, antibiotics etc
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dihard
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Do we actually know why Prelief works?

Post by dihard »

"Prelief" is a pill or powder, containing calcium glycerophosphate, which prevents certain foods from causing heartburn for people who are susceptible to that. Prelief is used for preventing food-associated problems for people who suffer from interstitial cystitis; various sources blame unspecified acids in foods for causing bladder discomfort in those people (even foods that make the urine less acidic, such as orange juice, which is known to increase the pH of urine).

The makers claim, "Prelief is the only acid fighter that takes out food acid while leaving your protective stomach acid untouched. [Their emphasis.] Prelief takes the acid out of coffee, tomato sauce, fruit juices, wine, and many other of your favorite foods."

This raises several related questions: how can it neutralize food acids in the stomach, without neutralizing stomach acid? Does it neutralize only specific acids that are common in foods? If it's just a question of not taking too much Prelief, how would that be different from taking just the right dose of a calcium carbonate antacid such as Tums?

This selective 'taking the acid out of your foods but not your stomach' almost sounds too good to be true and sci-fi-ish. We know meds that tamper with stomach acid have bad side effects so something that doesn't should be revolutionary but Prelief seems relatively unknown compared to the other acid reducers that try to shut down all stomach acid. I can't find anything about how it works on the internet. Is this one of those drugs like acetaminophen where we don't actually know how it works?

Finally, and more perplexing to me: how can neutralizing acids in the stomach help someone's sensitive bladder? If food acid in the stomach causes bladder problems, why doesn't the hydrochloric acid naturally in the stomach do the same thing? Are all acids a problem, simply because of the fact that they are acids, or is it just that certain irritating substances are being lumped together and labeled 'acids'?

All this makes me think there must be some separate mechanism. And interestingly I came across a forum post where an AKPharma rep actually wrote:
As far as we know, there is no effect whatever on the pH of urine when a patient with or without IC takes Prelief. In one prospective IC clinical study that was started in Philadelphia, urine pH's were taken and not only were not raised by Prelief, they were in fact marginally, but not significantly lower - the urine was slightly more acid. Nonetheless, the patients' symptoms either decreased or disappeared, clearly indicating that the problems in IC are not a function of abnormal urine pH, but rather the decreased tolerance of the urinary epithelial cells of an IC patient to withstand the relatively mild acid challenge of normal urine. Prelief is clearly doing more than just taking acid out of foods, but since Prelief is not a drug, such a statement on the label or in advertising is not possible within present FDA regulations. Substantial experience both in the clinic and outside it, confirms Prelief's value in "promoting urinary health".


This was a 10 year old post so I'm curious if any progress has been made in understanding this compound. It seems like it actually has nothing to do with acid. This is interesting because then it must be acting in some other manner like nerves or endothelial/mast cells in the bladder/urethral lining.

All this also makes me wonder if there is value in taking it as a regular supplement like quercetin/etc rather than only in emergencies if it's having a positive effect on the bladder tissues. Is the side effect profile as good as the common prostatitis supplements? Does anyone take it regularly with good results?

Are there conclusive studies that it truly doesn't affect stomach acid (yet does with food)? I just can't wrap my head around how that is biologically/chemically possible.
Last edited by dihard on Sat Dec 24, 2016 11:30 pm, edited 1 time in total.
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webslave
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Re: Do we actually know why Prelief works?

Post by webslave »

It seems to act to enhance barriers
https://pubmed.ncbi.nlm.nih.gov/26290632
Calcium glycerophosphate (CGP) has a significant time and concentration dependent effect to attenuate increased gut permeability caused by hypoxia, cytokine stimulation, and α-gliadin peptide 31-55 (my emphasis)
They go on to say that they postulate that CGP may enhance sphingosine-1-phosphate production, and that "Gut epithelial integrity is dependent, at least in part, on sphingosine-1-phosphate generation".

Even on teeth, it acts like a varnish to protect:
https://pubmed.ncbi.nlm.nih.gov/23032201

Could be doing this in the genito-urinary tract as well, protecting inflamed epithelial cells from contact with normal urine, which can be irritating to inflamed cells.



BTW I removed the link to that forum since they do that there to our links.
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dihard
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Re: Do we actually know why Prelief works?

Post by dihard »

Interesting. Isn't that essentially what Elmiron is claiming to do, build up the urinary mucosal barriers? If prelief is able to do in a couple hours what Elmiron takes 6+ months to do with very little side effects that seems rather amazing.

So far I have been using it very sparingly because these claims just haven't made sense to me.

Mainly I'm concerned if the stomach acid claims are really true. Are there conclusive studies that it truly doesn't affect stomach acid (yet does with food)? I just can't wrap my head around how that is biologically/chemically possible.

Webslave I know you made a post a while back about buying in bulk. How often do/did you take prelief? Did you ever use it on a consistent basis rather than only after 'cheating' with certain foods?
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Re: Do we actually know why Prelief works?

Post by webslave »

That study mentions that adding Prelief to the stomach does not change pH. CGP does change pH, see study 2

I use it for stomach discomfort caused by acid foods, and I did find it useful for bladder discomfort when I was very symptomatic. It's good if you have a stomach problem with very acid foods like pizza.

Elmiron was a bit of a fizzer. :thumbdown:
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