A friend was so frustrated the other day that she was almost screaming across the table in the restaurant.  She said she is fed up with her doctor because he thinks that her UTI symptoms are imaginary.  She has been going back to him every other month in pain, and each time he prescribes another type of antibiotic.  She gets her hopes up because she feels better for a while, but then the symptoms are back again.

So now she says she has abandoned hope for any help from her doctor, and is looking for a solution on her own.  But now she’s confused because there are so many Over-The-Counter remedies and natural supplements available that she has no idea how to know what really works and which companies to trust for a quality product.

Does this sound familiar?  We’ve been listening to hundreds of chronic UTI patients and documenting what they’re finding out on their own.  Then we’ve turned to worldwide medical and bioscience data sources to research and verify which solutions have been tested and proven effective.

Here is a report on three ways to address chronic UTIs using natural supplements.

But first, a word about what’s causing your UTI to return over and over again: “floaters” and “nesters”.

Causes of Chronic UTIs: “Floaters” and “Nesters”

When the E Coli bacteria first enter the urinary tract and bladder, they are described as “planktonic” or what we call “floaters”.  They are present in your urine, and if you drink enough water, or take some of the cranberry supplements, you may be able to flush them out of your system without antibiotics. But if the symptoms persist after a few days, you will likely need an antibiotic to kill these “floaters” – and that should be the end of the infection.

But for 8 out of 10 women it is not; according to a publication by the National Institutes of Health, more than 80% of all chronic infections involve biofilms.  In these cases, some of the “floaters” have burrowed into the lining of the bladder where they become “nesters” or embedded UTIs.  The bacteria have figured out at least two clever ways to avoid being killed by the antibiotics:

  1. Biofilms: they surround themselves with slimy “sacs” after burrowing into the lining of the bladder which they use to prevent the antibiotics from penetrating; and
  2. ESBL’s: they produce enzymes called extended-spectrum beta-lactamases (ESBLs) that break down and destroy some commonly used antibiotics.

Treatment Option 1: Antibiotics And Cranberry 

One of the newest approaches to managing chronic UTIs is to take antibiotics to kill the “floaters”, and follow up with a very strong dose of cranberry natural supplement to prevent new bacteria from starting an infection again.

Cranberry, really?  For years, many women have said that cranberry helped them recover from a UTI.  But this natural supplement received mixed reviews regarding its efficacy in the medical and scientific studies for decades.

Then, in 2018, a scientific review of non-antibiotic options for treating UTIs entitled “Non-Antibiotic Prevention and Management of Recurring Urinary Tract Infections” produced two very positive facts about cranberries:

1) The key ingredient in cranberry that works to clear UTIs is called proanthocyanidins, or PACs.

Originally it was thought that because cranberries are acidic, they helped to bring down the pH level in the urine which was made too alkaline due to the presence of E Coli bacteria.  It was then discovered that it was the PACs in cranberries which were inhibiting the motility of E Coli bacteria as well as preventing the bacteria from attaching to the urothelium lining of the bladder.  The fructose in cranberries inhibits the adherence of type 1 fimbriae (similar to D Mannose) and the PACs affect adherence of P fimbriae which are more virulent and associated with more serious UTIs.

2) At a certain strength, PACs can be as effective as antibiotics

According to an article in Nutritional Outlook, a Cochrane review showed that 36 milligrams of proanthocyanidins per day is required to be as effective as a low-dose antibiotic for UTI prevention.

But not all forms of cranberry will contain sufficient amounts of PACS to be effective against UTI bacteria.  According to an article in HuffPost, only one out of 7 cranberry supplements had the required daily amount of PACs in a test conducted by a urology team at Weill Cornell Medical College in NY.  So, it’s important to check the concentration of PACs.

Treatment Option 2: D-Mannose

Doctor Jonathan Wright, Medical Director of The Tahoma Clinic, a graduate of Harvard University and University of Michigan, has been using D-mannose to treat patients with urinary tract infections since for over 30 years.  He says “Since the 1980s D-mannose has eliminated UTIs in 85-90 percent of all of those I’ve recommended it to.” 

D-Mannose is a rare sugar, a close relative of glucose.  It is a natural supplement extracted from fruits such as cranberries, blueberries, peaches, apples and oranges and converted into a white powder form. It is most effective against the E Coli bacteria which represents 80%-90% of all UTI’s.

The E Coli bacteria attach to the cells lining the bladder using “fimbriae” or hairy, finger-like projections. On the tip of these projections is a glycoprotein called a “lectin” that is programmed to bind to the first mannose sugar molecule it finds.  Because mannose is naturally present on the surface of the bladder lining, these bacterial fimbriae are able cling to the lining with a tight grip, prolonging the UTI symptoms.

When D-Mannose powder is consumed with water, its sugar molecules cause the bacteria which are attached to the bladder lining to let go, to bind themselves to the molecules and to be flushed out with the urine.

D-Mannose not only eliminates the “floaters”, but also deals with the “nesters”.

A recent article  in the Antibiotics Journal in 2021 entitled Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives supports the efficacy of D-Mannose with the following statement: “Our findings support and confirm that D-mannose reduces the incidence of rUTIs (recurrent UTIs) and determines a longer interval between UTI episodes, with a significant improvement in patients‘ quality of life, and therefore, its administration could be considered as one of the possible strategies to be used or to be investigated for the prevention of recurrent UTI in women.”

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Apple cider vinegar

Treatment Option 3: D-Mannose And Apple Cider Vinegar

This is the all-natural “one-two punch”.

If taken daily, the D-Mannose is continuously attracting the “floaters” which bind to its sugar molecules and washes them out with your urine, relieving the symptoms of the UTI.

However, the “nesters”, which are protected by the biofilms, and are constantly being sent into the bladder, which means that the infection is not yet gone. This is when something stronger is needed to break up the biofilm(s) and eliminate the hidden bacteria once and for all.

Several scientific and medical studies have identified acetic acid, also known as apple cider vinegar, as an effective agent against biofilms.  Here’s one example: a study published by the NIH in 2015 entitled “Antibiofilm Properties of Acetic Acid” concludes: “We have discovered that not only does acetic acid kill planktonic bacteria but it also eradicates bacteria growing in biofilms.”

Read more about biofilms and apple cider vinegar in our article entitled “Finally A Natural Solution For Chronic UTIs”

One Final Word About D-Mannose

D-Mannose is the most widely recognized and proven non-antibiotic therapy for UTIs available today.  But not all brands of D-Mannose are alike.  Here’s what to look for when purchasing this supplement:

1) Only buy 100% pure D-Mannose.  You don’t want to dilute the effectiveness of this product with additives such as cranberry, vitamin C or hibiscus.

2) Buy it in powder form, not capsules.  When mixed with water, the powder dissolves completely and has no taste.  And it goes right to the bladder where it is needed, unlike capsules which need to first be digested in your stomach and are not as effective.

3) Make sure it’s manufactured by a trusted source.  Many D-Mannose products which are being heavily advertised do not disclose where the product is made or who’s making it.   Look for a professional endorsement from doctors or pharmacists and find out if it is made in an FDA-certified manufacturing facility.