Maryjane Mashunkashey, 63, was plagued by exhaustion — until she discovered the shocking culprit: a sneaky urinary tract infection, also known as a silent UTI. Unrecognized and untreated urinary tract infections (UTIs) can quickly turn into more serious conditions, and they're more likely to strike women than men. But, what is a silent UTI, exactly? Read on to find out more about this condition — plus the simple fix that can restore your vitality.
Silent UTIs: How it starts
“That weekend was supposed to be so fun. I always looked forward to hosting my grandchildren, who lived 45 miles away, overnight. But this time my extreme fatigue stole most of the energy and joy from our precious time together. The strange thing: It wasn’t the ‘I probably did too much yesterday’ kind of tired. It was concerning. That heavy blanket of fatigue covered me the rest of the week. All I wanted to do was lie down, and that just wasn’t like me — I’m not a napping kind of person," says Maryjane.
She visited her doctor to ask about the exhaustion, but her doctor couldn't provide an answer.
“This wasn’t like other health issues I’d had in the past, though. Years earlier I was prone to urinary tract infections. I once had six in the span of six months. I dreaded that unmistakable backache, the painful urination and the urgency to pee, not to mention the doctors’ appointments and prescription co-pays for all those antibiotics. Thankfully, I seemed to have outgrown UTIs, but this new health complaint was such a mystery...it worried me," says Maryjane.
Silent UTI infections
While on vacation, Maryjane's exhaustion got worse. By the second day, her sneaky symptoms had her frightened enough to visit the emergency room closest to her hotel.
“When the doctor told me it was a UTI, I was stunned. ‘I don’t believe it,’ I responded. ‘I don’t have any of the symptoms. None whatsoever! Yet there was the proof on my chart, confirmed through a urine test. After my history of UTIs, I felt I was somewhat of an expert. I thought I knew how to recognize them. But this infection completely snuck up on me."
What is a silent UTI?
While the most common UTI symptoms include burning with urination, frequent urination, a sense of urgency to urinate, and pain in the area of the bladder, those symptoms don't always appear in older adults. "It's not unusual to see a patient in her upper 70s or older who gets infections without symptoms," says Dr. George Flesh, director of urogynecology and pelvic reconstructive surgery for Harvard Vanguard Medical Associates, according to Harvard Health Publishing. Some experts believe that's because the symptoms of a UTI are actually caused by the immune system's fight against the infection, and the immune systems of older people may not fight as fiercely.
“Though I’d never heard the term before, I found out there was such a thing as a ‘hidden’ or ‘silent’ UTI. Looking back, I realized that every time I’d suffered a UTI, I always felt fatigue first. It was my body’s way of trying to fight off infection," says Maryjane.
“After that ER visit, I took the antibiotics the doctor prescribed and headed home. I reclined my seat and relaxed the whole ride, knowing I finally had the information I needed to spot infections early so they wouldn’t damage my system and make me miss out on work and family fun.
“Sure enough, several months later I started feeling exhausted again. My gut reaction was to power through it, but then I remembered my vacation. Being proactive, I quickly asked my doctor to test my urine. As I suspected, it was another sneaky UTI," she says. "I felt empowered knowing I didn’t have to suffer for days or weeks before more serious symptoms may have shown up."
How to prevent a silent UTI
“I was so grateful my newfound knowledge was helping me improve my life. But I wasn’t satisfied with early detection. I wanted to find a way to prevent UTI infections. So I kept pressing my doctor and I guess I finally asked the right question because I learned that taking vitamin C at bedtime can prevent bacteria from building up in the system. The doctor explained that C allows healthy acid to rest in the bladder overnight so that the harmful acid in urine can’t take hold. I started taking 1,000 mg each night and I haven’t had a single flare-up in years," says Maryjane.
Vitamin C not only helps ward off UTIs, it can also outsmart stress. So say Canadian researchers in The American Journal of Clinical Nutrition. They gave 52 people who were deficient in vitamin C a daily dose of 500 mg and tracked their moods for 8 days. The results? Study subjects experienced a 71 percent drop in symptoms including fatigue, sadness and irritability, as well as a 51 percent decrease in anxiety. According to the study authors, vitamin C plays a crucial role in balancing the brain chemicals that rule our emotional response to stress.
Silent UTI symptoms
Silent UTI infections may not come with the typical symptoms women are used to associating with a urinary tract infection — namely, a burning sensation when peeing, a feeling of pain in the lower abdomen, and a near-constant urge to empty the bladder.
A major sign of a silent UTI? Extreme tiredness, like Maryjane experienced. If you have unexplained fatigue, a sneaky urinary tract infection could be to blame. A few more telltale signs that may be present:
Can you have a silent UTI?
The scary truth: Up to 50 percent of women with energy-draining UTIs go undiagnosed, mainly because these women don't experience any of the "typical" symptoms they'd normally associate with other UTIs they've had before.
"At least 80 percent of women will get a urinary tract infection (UTI) in their lifetime," says Laura Corio, M.D., an ob-gyn in New York City. But, she adds, as many as 1 in 5 UTIs don’t cause the red flags most women associate with the infections, like burning or frequent urges to urinate. Instead, women notice fatigue, lower-back pain and muscle aches — subtle symptoms they (and their doctors) don’t link to UTIs. As a result, says Pamela Peeke, M.D., author of Body-for-LIFE for Women, up to half of “silent” UTIs go undiagnosed.
Women are most at risk for UTIs in the summer, since heat can cause bacterial growth in the urethra. Risk also rises with age, as levels of estrogen, which help bolster the production of antimicrobial proteins in the bladder, drop. Once an infection takes hold, the body revs its immune system, leading to inflammation that impairs the function of every system in the body. The result? Fatigue, body aches, weakness and nausea.
Silent UTIs: How to treat them
You can diagnose a UTI with an at-home urine test, like AZO UTI Test Strips, says Dr. Corio. If it’s positive, see your doctor for confirmation, then try the tips below to nix the infection and restore energy.
The first line of treatment: prescription antibiotics, which kill infectious bacteria and relieve symptoms in days.
Drinking kefir or fermented milk 3 times a week can cut your risk of getting another UTI by 79 percent, say scientists in The American Journal of Clinical Nutrition. One to try: Bio-K Plus ($19 for a 6-pack, health-food stores). Also smart: upping your intake of vitamin C via grapefruit or unsweetened cranberry juice. This will acidify the bladder, making it less hospitable to unhealthy bacteria.
A version of this article first appeared in our print magazine.