By Dr. Mercola

Urinary tract infections (UTIs) are the second most common type of infection in the body, sending more than eight million people to their health care providers every year in the US alone.

Women suffer from UTIs far more often than men, and more than 50 percent of women will develop a UTI during her lifetime. For about 20 percent of women, the infection becomes recurrent and some will suffer from three or more UTIs a year.

This is concerning, as the treatment most often recommended by conventional medicine is antibiotics. For those with recurrent infections, low doses of antibiotics may be prescribed daily for six months or more which increase the risk of developing antibiotic-resistant strains.

Additionally, antibiotics kill even the friendly micro-organisms in your body, leading to major disruptions in health (including an increased risk of yeast infections, among other issues, in women). If you suffer from UTIs on occasion or more frequently, there’s a natural treatment you should know about that is effective in more than 90 percent of cases.

D-Mannose Works As Well As Antibiotics in Preventing UTI Recurrence

In a study of more than 300 women with a history of recurrent UTIs, researchers treated the women with either two grams of D-mannose, 50 milligrams of an antibiotic, or no treatment daily for six months. D-Mannose is a naturally occurring sugar that’s closely related to glucose.

Only 15 percent of those taking the D-mannose had a recurrent UTI compared to 20 percent for the antibiotic group (both of which were significantly lower than the no-treatment group). However, the incidence of side effects was significantly lower in the D-mannose group than the antibiotics group.

Dr. Jonathan Wright was among the first to begin using D-mannose for UTIs some 20 years ago, and in his experience administering it to more than 200 patients, the treatment is 85-90 percent effective.

It works for treating acute UTIs, for prophylaxis in women prone to recurrent infections or for the prevention of post-intercourse UTIs, and it’s safe for both adults and children. Dr. Wright recommends the following doses:

• For treatment of UTIs: 1 teaspoon (about 2 grams) for adults, ½ to 1 teaspoon for children, dissolved in a glass of water and repeated every two to three hours. Continue for two to three days after symptoms have disappeared.
• For preventing recurring infections: Start with the dosages listed above for treatment, then gradually reduce the dose, if possible.
• For prevention of post-intercourse UTIs: Take 1 tablespoon one hour prior to intercourse and another tablespoon immediately afterward.

Why Does D-Mannose Work for Treating UTIs?

More than 90 percent of UTIs are caused by Escherichia coli (E. coli), which is normally found in your intestinal tract. Problems only arise when this ordinary bacterium is present in high numbers in places where it shouldn’t be—like your urinary system.

When normal E. coli gets into your urinary tract and multiplies, you experience the usual signs and symptoms of a UTI:

• Burning with urination
• Frequent urges to urinate
• Lower abdominal pain or aching
• Blood in your urine (sometimes, but not always)
• Cloudy urine

The cell walls of each E. coli are covered with tiny fingerlike projections called fimbria allowing them to “stick” to the inner walls of your bladder and even work their way upward to your ureter and kidneys.

Because they cling to your urinary organs, they can’t simply be washed out when you urinate. These little fingerlike projections are made of an amino acid-sugar complex, a glycoprotein called lectin, which makes them sticky.

Lectin on the bacteria’s fimbria binds to mannose, which is produced by your cells and covers the internal lining of your urinary organs. This mannose allows the bacteria to adhere to you—like Velcro. But as Dr. Wright explains, when you take D-mannose it sticks to the E. coli so it is can be effectively “rinsed” out by your urination:

“Unfortunately for the E. coli, D-mannose ‘sticks’ to E. coli lectins even better than E. coli lectins ‘stick’ to human cells. When we take a large quantity of D-mannose, almost all of it spills into the urine through our kidneys, literally ‘coating’ any E.coli present so they can no longer ‘stick’ to the inside walls of the bladder and urinary tract. The E. coli are literally rinsed away with normal urination!”

Another potential theory for why D-mannose works may be its relationship to Tamm-Horsfall protein, a glycoprotein that plays a key role in your body’s defense against UTIs. It has been suggested that D-mannose might work primarily by promoting the activation of Tamm-Horsfall protein.

If You Have a UTI, Try D-Mannose First

The antibiotic pipeline is running dry as an increasing number of superbugs are outsmarting our antibiotics. We are at the beginning of the end of the antibiotic age, which will change modern medicine as we know it if overuse isn’t curbed soon. So the use of antibiotics cannot be taken lightly, and along with transforming our use of antibiotics in agriculture, we must also reserve them for medical use only when absolutely necessary.

In the majority of cases, UTIs can be effectively treated without antibiotics by using D-mannose. This is why, if you have a UTI, you should try D-mannose first. It’s important to note that D-mannose only works for UTIs caused by E. coli, This represents 90 percent (or more) of infections. If you want to be sure, your physician can order a urine culture to identify the bacteria present, so you’ll know if yours is one of the minority of cases not caused by E. coli. As Dr. Wright explained:

“D-mannose is very safe, even for long-term use, although most women (or the very occasional man) with single episodes of bladder or urinary tract infection will only need it for a few days at most. Although D-mannose is a simple sugar, very little of it is metabolized. It doesn’t interfere with blood sugar regulation, even for diabetics. It creates no disruption or imbalance in normal body microflora. It’s safe even for pregnant women and very small children. In the less than 10% of cases where the infection is a bacteria other than E. coli, antibiotics can be started in plenty of time.”

The majority of urinary tract infections can be cured when symptoms first arise, or prevented altogether, using D-mannose and the hygiene steps outline below. Occasionally, despite preventative measures, a kidney infection can develop. If you suspect you have a kidney infection (symptoms include fever and pain in your back, side, groin, or abdomen) it might be necessary to see a physician and use an antibiotic so the infection does not spread to your kidney, where it can become life threatening or lead to the loss of the kidney.

What About Cranberry Juice for UTIs?

Many people are aware of the home remedy of drinking cranberry juice for UTIs, and this is because the active ingredient in cranberry juice is D-mannose. D-mannose can actually be derived from berries, peaches, apples, and some other plants. So why not drink cranberry juice instead of taking D-mannose in supplement form?

The amount of D-mannose in cranberry juice is significantly less, making it much less effective. Plus, cranberry juice is high in sugar, which adds stress to your immune system and can fuel the growth of pathogenic bacteria in your gut. Pure D-mannose is about 10-50 times stronger than cranberry, non-toxic and completely safe, with NO adverse effects.

Unlike the large amounts of fructose you’d get by consuming a lot of cranberry juice, D-mannose does not convert to glycogen or get stored in your liver. Only very small amounts of D-mannose are metabolized, so it doesn’t interfere with blood sugar regulation or produce metabolic stresses. D-mannose is more like glucose, which every cell in your body is designed to use (but your body absorbs D-mannose much more slowly than glucose). Most of the D-mannose is filtered through your kidneys and routed to your bladder, then quickly excreted in your urine, making it ideal for people with diabetes or anyone who is not interested in drinking sugary fruit juice.

Natural Steps to a Healthy Urinary System

The most important factor in the overall health of your urinary tract is drinking plenty of pure, fresh water every day. Adequate hydration is extremely important for preventing UTIs (not to mention, is the number one risk factor for kidney stones). As a woman, there are additional hygiene steps you can take to maintain a healthy urinary tract:

• Urinate when you feel the need. Don’t resist the urge to go
• Wipe from front to back to prevent bacteria from entering your urethra
• Take showers instead of tub baths. Avoid hot tubs/Jacuzzis
• Cleanse your genital area prior to sexual intercourse
• Avoid using feminine hygiene sprays, which may irritate your urethra, and use only white unscented toilet paper to avoid potential dye reactions, or better yet—a bidet

In addition, a healthy diet is key in supporting your urinary tract health. Frequent consumption of fermented foods in particular, such as kefir, sauerkraut, and other fermented vegetables, is great for your overall health—including your urinary system.