D-Mannose does it work to prevent urinary tract infections (UTIs)?
D-Mannose is a sugar found naturally in certain fruits (cranberries, tomatoes) and vegetables (cabbage, beans).
If taken as a regular dietary supplement, alongside other lifestyle changes, it can help prevent UTIs. Some studies support its use.
Is it true that it was used in animals first?
Historically, people have been using D-Mannose to treat UTIs in animals with success. Since they were finding it as effective as an antibiotic in some cases, it was a natural step to see if it could also work in humans.
What does D-Mannose do?
D-Mannose entangles the projections that bacteria like E. coli have to help them attach to the bladder wall. This prevents them from sticking to the wall; hence, they can be easily flushed out when one empties the bladder.
What is the dose of D-Mannose that I should take?
Studies have used 420 mg daily to 3 grams in powder or tablet form. The usual dose that I recommend patients start on is 2G.
It exists in tablet or powder form, and you can buy it online or from a health shop.
What are the natural sources of D-Mannose?
D-Mannose occurs naturally in cranberries, black and red currants, peaches, green beans, cabbage, tomatoes, oranges, apples, aloe vera, mangos, and seaweed.
Are there scientific studies to prove D-Mannose efficacy?
An article in the World Journal of Urology looked at how D-Mannose (powder form) worked with or without the antibiotic nitrofurantoin for six months in about 300 women with a history of recurrent UTIs. Despite a lower risk of recurrent UTIs in women without treatment, the effect could not be translated to all taking the supplement.
A systemic review looking at 7 studies could not conclude its positive effect, unlike another one looking at 8 other studies that found a protective effect.
In conclusion, there is not yet enough evidence to categorically state if there is a protective or preventative effect. When I recommend it to patients, I inform them that it may help, but it's more of a hit-and-miss.
Can D-Mannose replace the standard practice?
The simple answer is no.
D-Mannose forms part of the armamentarium. The most important aspect is
· Drinking plenty of fluids, using the colour of urine as a gauge of hydration,
· keep good hygiene practices,
· avoid the use of chemicals that dry the vaginal lining,
· make sure that the bowels are opened regularly,
· wear cotton underwear,
· Wash underwear with soap only and avoid fabric softener.
What are the symptoms of a UTI? Can D-Mannose also help in an acute infection?
During an active UTI (burning or stinging of urine, urinary frequency, fever, suprapubic pain, feeling unwell, blood in the urine, cloudy and foul-smelling urine), always send urine to be analysed for culture and sensitivity. If indicated, have an antibiotic, and yes, you can, in addition, increase the dosage of D-Mannose.
During an active UTI, D-Mannose has been shown to help speed the resolution. These studies have low numbers and limited follow-up, so they must be interpreted cautiously.
How would I know that my UTI signs are going away?
The symptoms of burning or stinging of urine, urinary frequency, fever, suprapubic pain, feeling unwell and emptying only a few drops of urine should improve day after day.
UTIs can steal a lot of energy from one's body, and when they are recurrent, they can cause anxiety, lack of sleep, and tiredness. It may take longer to recover from them.
If D-Mannose is sugar, does it have side effects?
The common side effects of D-Mannose are bloating and loose stools. If these happen, one needs to decrease the dose from 2G daily to 1G as a first step. If the side effects still persist, then one needs to stop the supplement.
I am diabetic; can I take D-Mannose?
D-Mannose can potentially lead to higher sugar levels in diabetic patients. Rather than having higher doses, one would start at 1 gram daily or even 500mg. If the sugar control is not affected, one may increase the dose; however, if it gets out of control, it is best to stop it and find an alternative.
Is there a role for D-Mannose in pregnant females and children?
There have not been any studies on these situations, and hence, D-Mannose cannot be recommended.
Can I start on D-Mannose? Can a pharmacist prescribe them?
D-Mannose is a non-prescription item that is safe to take for most people. You can purchase it online or from a health shop.
Asking your NHS pharmacist for support is another option if you struggle to get D-Mannose. If you are still in doubt, talk with your NHS consultant or private urologist, who can guide you further. Remember that as a stand-alone, it has limited value. Patients with recurrent UTIs must tackle the issue from multiple angles to get on top of the situation.
Are there other alternatives to D-Mannose?
One can consider the following;
- Hipprex
- Hyaluronic Acid bladder instillations
- Oestrogen cream or pessary
- Prophylactic antibiotics in cases where trigger factors like sexual intercourse are identified.
- Vaccine
