Podcast Summary: “How to: Stop Waking Up At Night to Go Pee — Dr. G's Quick Health Tip”

The Dr. Gundry Podcast | Episode 356.B | June 19, 2025

Overview

In this focused health tip episode, Dr. Steven Gundry addresses a widespread, often frustrating problem: waking up at night to urinate (nocturia). He covers common causes in both men and women, busts myths about age-related prostate issues, and offers actionable diet, supplement, and lifestyle recommendations to help listeners achieve uninterrupted sleep. Throughout, he maintains his direct, reassuring tone, blending personal anecdotes with clinical insights drawn from decades of practice.

Key Discussion Points and Insights

1. Why Do We Wake Up to Pee at Night?

[00:25–00:33]

• Occasional nocturnal trips to the bathroom are not concerning; frequent occurrences—nightly or multiple times per night—may signal underlying issues.

2. The Male Perspective: The Enlarged Prostate

[00:33–04:30]

• Prevalence:
  • 50% of men over 50, increasing to 80% in those over 70, have enlarged prostates.
  • 1 in 9 men will experience prostate cancer.
• Symptoms:
  • Getting up 1–2 times/night to urinate.
  • Taking a while to start urination.
  • Not fully emptying the bladder.
• “Second Pee” Test:
  • “Once you finish, go do something for 10, 20 minutes and then come back and try again. You’ll notice that you have actually quite a bit of urine in your bladder.” (Dr. Gundry, 04:07)
  • Suggested double-voiding to help with night-time urination: Go 20 minutes before bed, then again right at bedtime.

3. "Enlarged Prostate Isn’t Normal" – Debunking Assumptions

[04:35–05:30]

• “One of the things that you’re not going to believe me about is that an enlarged prostate is not something that is normal as you get older. I’ll say that again: it is not normal to have an enlarged prostate as you age.” (04:45)
• Gundry links prostatic hypertrophy to leaky gut—specifically, bacterial particles passing from the rectum to the prostate and causing inflammation.
  • Personal anecdote: his own prostate normalized after he followed his gut-healing protocol.

4. Dietary Recommendations to Prevent and Reduce Night-Time Urination

[06:00–07:30]

• Adopt a gut-friendly diet to reduce inflammation and leaky gut (details in Gundry’s book Gut Check and additional podcast episodes).
• Foods to Avoid:
  • Most grain products except millet & sorghum.
  • Beans unless pressure-cooked or properly fermented.
  • Nightshades (potatoes, eggplant, tomatoes, bell peppers, goji berries) unless peeled, de-seeded, or fermented.
• Supplements:
  • Some exist for prostate health but won’t address the root cause; changing the diet is more effective.

5. Women's Health: Irritable Bladder and UTIs

[07:31–09:29]

• Common Culprits:
  • Low-grade urinary tract infections, commonly from specific strains of E. coli (often from factory-farmed chicken).
  • “The E. coli that you eat colonize your rectum and they have a direct shot from your rectum to your bladder and they set up shop inside your bladder.” (08:37)
• D-Mannose Supplementation:
  • “It’s a compound that coats E. coli and prevents them from establishing themselves in your bladder.” (09:09)
  • Dose: 500 mg, twice daily, effective for many patients.
• Other Causes:
  • Some cases aren’t infection-driven but are due to sensitivity to specific dietary lectins called aquaporins.

6. Aquaporins and Bladder Irritation

[10:35–12:30]

• Aquaporins (a type of lectin) can trigger bladder sensitivity—not previously discussed in Gundry's books.
• Found In:
  • White potatoes, spinach, corn, soybeans, tomatoes, bell peppers, and tobacco.
• Dietary Adjustment:
  • Unlike other lectins, aquaporins are in the flesh as well as skin/seeds, so peeling/de-seeding doesn't help.
  • Gundry’s advice: Temporarily eliminate these foods—including peeled/seeds-removed tomato products—if you have an irritable bladder.

7. Other Causes for Nocturia

[12:31–16:45]

• Fluid Shifts from Swollen Legs:
  • Seen in those with congestive heart failure or leg edema. Lying down moves fluid back into circulation, burdening the kidneys.
  • Solutions: Elevate legs or perform light exercise ("exercise snacking") before bed.
• Evening Water and Alcohol Intake:
  • "That water has to go somewhere... Don’t have that glass of water before you go to bed. Secondly, please stay up after drinking alcohol..." (13:55)
• Sleep Apnea:
  • Can mimic the urge to urinate by waking patients.
  • Suggests using the Oura ring for tracking drops in oxygen and urges listeners to take snoring seriously.
  • "If your partner tells you you’re snoring, please take that seriously. That snoring is not normal." (15:10)

8. Additional Tips and Sleep Strategies

[16:46–18:45]

• For Early-Awakening Insomnia:
  • Avoid heavy meals and late alcohol.
  • GERD/heartburn may be the culprit; sleeping on the left side can help prevent reflux.
    • “Get yourself some big pillows... Or get yourself a lot of dogs. We have four dogs on our bed and...kind of force me onto my side.” (17:55–18:20)
• Natural Morning Wake-Ups:
  • Rising cortisol around 4 am is normal—sometimes early waking is a healthy physiological response.
  • Wry advice: “Get a dog and you won’t have to fight it anymore.” (20:45)

9. When to Seek Medical Help

[20:50–21:44]

• Persistent nocturia in men can eventually damage the kidneys ("obstructive uropathy").
  • “Men, a big prostate can actually damage your kidneys because you do not empty your bladder properly and urine backs up in your kidneys. It’s called obstructive uropathy and it’s a fixable condition that you want to fix.” (21:20)
• Gundry urges men with ongoing symptoms to see a urologist or their doctor.

Notable Quotes & Memorable Moments

• "It is not normal to have an enlarged prostate as you age." – Dr. Gundry (04:45)
• "Maybe, just maybe, changing your diet and eliminating leaky gut is just what you're looking for." – Dr. Gundry (05:15)
• "The E. Coli that you eat colonize your rectum and ... have a direct shot from your rectum to your bladder." – Dr. Gundry (08:37)
• "For you folks, I want you to actually get rid of your peeled and de-seeded tomatoes...and just see if that makes a difference." – Dr. Gundry (11:06)
• "That snoring is not normal. Get yourself an Oura ring… If you see that that episode correlates with you waking up wanting to go to the bathroom, then it's time to get a sleep apnea study." – Dr. Gundry (15:10–15:30)
• "Finally...get yourself dogs that don't want to get up in the middle of the night to go pee. That's a very important consideration that I'm still trying to teach my rescue dogs to do." – Dr. Gundry (18:37)
• "Persistent waking at four or five in the morning can just mean your cortisol is working properly." – Dr. Gundry (20:43)

Timestamps for Important Segments

• 00:33 – Introducing nocturia, focus on men; enlarging prostate described
• 04:45 – Debunking enlarged prostate as a “normal” part of aging
• 05:15 – Diet-connection and personal anecdote
• 07:31 – Addressing women’s urinary issues and E. coli
• 09:09 – D-Mannose supplement for UTIs explained
• 10:35 – Aquaporins and dietary advice for irritable bladder
• 13:55 – Impact of late water/alcohol; sleep hygiene tips
• 15:10–15:30 – The role of sleep apnea in night-time waking
• 17:55–18:37 – GERD, sleeping posture, and getting help from pets
• 20:43–21:20 – Rising cortisol and importance of seeking urologic care

Actionable Takeaways

• Men: Double-void before sleep, address diet/gut health, seek help if symptoms persist.
• Women: Trial of D-Mannose, avoid aquaporin-rich foods for irritable bladder, don’t underplay recurrent symptoms.
• Everyone: Optimize evening habits (limit fluid/alcohol, early light exercise), investigate disruptive snoring, and consider sleep position for GERD.
• If symptoms are persistent, consult a healthcare provider to avoid complications.

This episode delivers practical tools and myth-busting advice for anyone struggling with night-time urination—cutting through stigma and offering hope for restful sleep by targeting root causes.