D-Mannose for UTI: Is It a Cure?

Urinary tract infections, or UTIs, can be painful. Unfortunately, they’re also common.

Anyone can get a UTI, but you can be at a higher risk if you are female. Research shows that more than 50% of women will have a UTI in their lifetime, with about one-third of women needing antibiotic treatment for UTIs before they turn 24.

UTIs can produce pain and discomfort in the bladder and pelvic region, especially when urinating. They can also give off the feeling that you have to go to the bathroom when you don’t. With treatment, UTIs can last from a few days to about two weeks. If not treated properly, however, they can lead to more severe conditions like kidney infections. Further, some people experience recurrent UTIs, where they are prone to multiple infections a year with little relief.

Antibiotics are first-line therapy for UTIs, as UTIs are bacterial infections. But when antibiotics are overused — as can happen with recurrent UTIs — bacteria can outsmart the drug and resist its properties. In the case of UTI treatments, this isn’t hypothetical — it’s already happened. The most common bacteria that causes UTIs is E. coli, which is resistant to several standard antibiotic therapies for UTIs.

These so-called superbugs cannot be fought off by medicines. As a result, some are seeking natural remedies to cure UTIs.

Introducing: D-mannose, a natural sugar supplement that research — though limited — suggests can help fight and prevent urinary tract infections. Here’s what you need to know about how D-mannose can fight UTIs, how to take it, at what dosage and for how long.

[See: 10 Tips for Promoting a Healthy Bladder.]

What Is D-Mannose?

D-mannose is a type of sugar, or monosaccharide, that is considered a cousin to glucose. It naturally occurs in a variety of fruits and berries — including cranberries, the juice of which is touted as another UTI remedy — and also can be synthesized in the body from glucose.

[Read: Antibiotics Wrecked My Gut: What to Do Next]

Can D-Mannose Prevent or Cure UTIs?

D-mannose can be an effective UTI prevention therapy, particularly for people with recurrent UTIs, says Dr. Maria Sophocles, a board-certified OB-GYN at Women’s Healthcare of Princeton in Princeton, New Jersey.

A clinical trial on D-mannose’s use against recurrent UTIs found that the supplement was more effective than some antibiotic treatments at preventing recurrent UTIs, even when the antibiotics were used for longer periods of time. The clinical trial measured effectiveness by the time it took for participants to develop another UTI, with a longer waiting period demonstrating a stronger treatment.

D-mannose may have potential for curing active UTIs, but more research is needed to understand how well it works and at what dose, Sophocles says.

Like an off-Broadway actress waiting for her New York City debut, D-mannose hasn’t earned a title as a first-line therapy just yet, she adds. Despite the risk of antibiotic resistance, antibiotics remain the national standard for treating active UTIs.

Research is lacking on D-mannose as a whole too, so some experts say there is not enough evidence to confirm that D-mannose prevents UTIs either.

“I still don’t use D-mannose as my primary way to treat UTIs — and I think most doctors don’t,” Sophocles says. “But there is a world in which, if we can continue to show good results, we could theoretically treat UTIs without antibiotics. That would be phenomenal.”

If D-mannose is to be a first-line therapy in the future, highly powered studies are needed to prove that supplementation significantly reduces the risk of developing a UTI, Sophocles says. She adds that currently D-mannose is effective enough to be an option for people with an active UTI who have had adverse or allergic reactions to antibiotics, or as a complementary therapy.

[See: 16 Health Screenings All Women Need.]

How Much D-Mannose Should You Take?

If you get three to four UTIs a year, you have recurrent UTIs. In these cases, Sophocles recommends taking 1 gram of D-mannose daily. In trial studies on both humans and animals, doses have ranged from 200 milligrams to up to 3 grams per day.

This regimen may be a game changer for people who have struggled to find relief in the past — and for the health care fight against antibiotic resistance.

How Does D-Mannose Work?

To understand how D-mannose works, it can help to understand how UTIs form and what is needed to treat them. Let’s break it down.

UTIs are caused by bacteria, the most common being E. coli. In a UTI, the E. coli enters the urinary tract and binds to the surface of the bladder, known as the epithelial surface. When you go to the bathroom, urine gets into the mix and creates a more comfortable environment for bacteria and a less comfortable situation for you. Urine has a pH level lower than 5 making it ideal for supporting bacteria growth.

“The colonization of bacteria, the binding to the wall and the multiple bacteria binding to that wall is the step in beginning to have a true infection,” Sophocles adds. “It can grow a little like a cancer.”

D-mannose interferes with this bacteria colonization and how the bacteria stick to the bladder wall. Due to its chemical makeup, it can inhibit bacteria adhesion before a UTI develops or help disperse already-bound bacteria after a UTI has formed, clearing it out.

“When (D-mannose) reaches the bladder, it can act as a decoy for harmful bacteria,” explains Dr. Lisa Lawless, a clinical psychotherapist specializing in sexual wellness, and CEO of Holistic Wisdom Inc., a sex education site and sex toy retailer in Bend, Oregon. “This means it can potentially help prevent infections and provide better bladder health overall.”

Despite it’s bacteria-clearing powers, however, D-mannose has a low pH level and will not help with acidifying urine. So, to best fight bacteria colonization and growth, some experts suggest pairing the supplement with a remedy like cranberry juice, which will provide this acidity.

Lawless says that she has taken D-mannose paired with cranberry juice to fight off UTIs of her own, and found the combo to work well.

In addition, appropriate hygiene and hydration are key in fighting and preventing UTIs, Sophocles says. That can look like drinking water throughout the day, ensuring you are wiping properly when you use the bathroom — as in, wiping front to back until you are dry, but not rubbing too hard to cause irritation — and wearing clean, dry clothes. Changing out of sweaty clothes immediately after working out or out of wet bathing suits after swimming can be good habits to support UTI prevention.

How Long Does It Take for D-Mannose to Cure a UTI?

D-mannose is not Food and Drug Administration-approved as a cure for a UTI. While this doesn’t mean it can’t be in the future with further research, this does mean there is limited guidance on how D-mannose should be used. Put simply, researchers have not confirmed if d-mannose can cure a UTI, or after how long.

D-mannose is not FDA-approved for preventing UTIs, either. However, there is slightly more research on this area of treatment which correlates to more guidance. For people who have recurrent UTIs, Sophocles recommends taking the supplement once a day, though you should discuss with your doctor. The length of time you continue with it may depend on success or other factors, like how well you are keeping up with hygiene and hydration, along with individual susceptibility to the infection.

Some patients and doctors are wary of using treatments that are not FDA-approved, and you do not need to take anything you are not comfortable with. However, Sophocles encourages an open mind to d-mannose based on the studies and research that exists.

A lot of classically trained physicians are skeptical about non-prescription treatment methods, she says. “I’m hopeful that the more physicians read studies on the effectiveness of this, the more can turn to this as a non-antibiotic way to help reduce UTI recurrence.”

How Much Does D-Mannose Cost?

You can buy D-mannose online or at your local pharmacy. Prices can vary greatly depending on brand and quantity, ranging from about $12 to $45 per bottle for bottles containing about 30 to 40 servings. D-mannose supplements come in many forms, including capsules, gummies and powders. Some are combined with cranberry supplements.

D-Mannose Side Effects

One major plus about D-mannose is that it brings about very few side effects, making it a relatively safe therapy to explore. But like everything we put into our body, there are impacts to consider.

— D-mannose impact on the kidneys.

— D-mannose impact on blood sugar levels.

— Being pregnant or breastfeeding.

D-mannose impact on the kidneys

Because D-mannose travels through the urine, it could impact or strain the kidneys but more research is needed to see if this is a risk.

D-mannose impact on blood sugar levels

Because D-mannose is a type of sugar, it may have an impact on blood sugar levels — which could be a red flag for people with conditions like diabetes who are trying to lower their blood sugar. But while some experts warn against D-mannose for this reason, others say the supplement could have a supportive effect.

Taking D-mannose is not akin to taking glucose tablets, and the body absorbs D-mannose slower than it does some other sugars. D-mannose has a lower glycemic index than glucose and is less likely to affect or spike blood sugar levels. Further, some studies say that taking D-mannose could even decrease risks for autoimmune diseases and diabetes.

Being pregnant or breastfeeding

More research is needed on how D-mannose impacts people who are pregnant or breastfeeding. To stay on the safe side, some experts recommend pregnant people refrain from using D-mannose until consulting with a health care professional.

Dr. Nisarg Patel, an OB-GYN with Clinic Spots in India, says that while “D-mannose is generally considered safe and well-tolerated,” it’s important to consult a doctor before starting the supplement, especially if you have underlying conditions like diabetes or a kidney problem. People may also experience side effects like bloating, diarrhea or loose stools if taking too high of a dose, he says.

Bottom Line

If you have recurring UTIs, it might not be a bad idea to add D-mannose to your prevention routine — but consult with your doctor first. Staying hydrated, practicing good hygiene and making a habit of preventive measures like going to the bathroom after sex can also help stave off UTIs.

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D-Mannose for UTI: Is It a Cure? originally appeared on usnews.com

Update 04/10/24: This story was previously published at an earlier date and has been updated with new information.

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