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Urinary Tract Infection Alternatives

October 10, 2012 Written by JP       [Font too small?]

A new study appearing in the journal Archives of Internal Medicine has the potential to change the way urinary tract infections are treated from this point forward. In the 12 month trial, specific probiotics (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) were compared with antibiotic therapy for the prevention of recurrent urinary infections. The test subjects in the experiment were a group of 252 postmenopausal women. The results of the research determined that supplemental probiotics were almost as effective as prescription antibiotics. By “almost”, I mean about -13.8% less effective. However, probiotic therapy features a significant advantage over antibiotic treatment – it doesn’t lead to antibiotic resistance. With antibiotic resistance, patients and physicians encounter difficulties managing both minor and serious infections. This is why preserving antibiotics for truly essential purposes is of the utmost importance.

The use of probiotics for urinary tract infections (UTIs) isn’t exactly groundbreaking. In the past, several studies have demonstrated the efficacy of a probiotic strain known as Lactobacillus crispatus (Lactin-V) in the prevention and treatment of recurrent UTIs in women. What makes the latest research most compelling is that it utilized an oral probiotic supplement. Prior studies, involving female participants, only tested the L. crispatus probiotic in the form of a vaginal suppository. In a real world setting, oral supplements tend to promote greater adherence and tolerability than “medications” administered through other means.

Currently, the biggest controversy regarding a natural approach to UTIs is the role of cranberry juice. In the scientific literature, some studies show positive results when cranberry juice or concentrated cranberry extracts are given to patients with recurrent UTIs. Other trials failed to find a statistically meaningful reduction in UTI occurrence or severity. Based on my understanding of the data, the daily use of pure, unsweetened cranberry juice and clinically-validated cranberry extracts provide the best option here. If the thought of drinking cranberry juice on an ongoing basis doesn’t appeal to you, I would consider an encapsulated extract sold commercially as Cran-Max. Another option is to look for cranberry products that also include an anti-UTI sugar called D-mannose. There is a good deal of anecdotal evidence to support its use, but very little in the way of clinical trials. A general, preventive dosage that is believed effective and safe is approximately 500 mg of Cran-Max and 1,000 mg of d-mannose twice-daily. A higher and more frequent dose of d-mannose is often recommended by naturopathic physicians when a UTI is present and antibiotics aren’t required.

Regarding the long term management of UTIs, it’s important to first address possible causes that are easily modifiable. Topping the list of helpful changes are: 1) ensuring proper hydration; 2) making sure to clean carefully after using the restroom – wiping from “front to back”; 3) urinating soon after intercourse; 4) replacing any questionable feminine products – opting for natural alternatives available in health food stores; 5) living an immune enhancing lifestyle that includes adequate sleep, a nutritious diet and regular stress management. A nutrient dense diet, along with a daily multivitamin and mineral may be especially important. Recent studies reveal that at-risk populations, such as diabetics and pregnant women, can dramatically lower the risk of UTIs by simply increasing the intake of essential nutrients, including Vitamin C from dietary and supplemental sources.

Click on the following links to learn more about the studies referenced in today’s column:

Study 1 - Lactobacilli vs Antibiotics to Prevent Urinary Tract Infections (link)

Study 2 - Randomized, Placebo-Controlled Phase 2 Trial of a Lactobacillus(link)

Study 3 - Phase I Trial of a Lactobacillus Crispatus Vaginal Suppository (link)

Study 4 - A Pilot Study Evaluating the Safety and Effectiveness of Lactobacillus (link)

Study 5 - Cranberry Juice for the Prevention of Recurrent Urinary Tract(link)

Study 6 – Cranberries vs Antibiotics to Prevent Urinary Tract Infections (link)

Study 7 – Novel Concentrated Cranberry Liquid Blend, UTI-STAT With Proantinox (link)

Study 8 - Effect of D-Mannose and D-Glucose on Escherichia Coli Bacteriuria (link)

Study 9 - Micronutrients Decrease Incidence of Common Infections in Type 2 (link)

Study 10 - Daily Intake of 100 mg Ascorbic Acid as Urinary Tract Infection (link)

Cranberry Extracts Do Not Promote Antibiotic Resistance

Source: Arch Intern Med. 2011;171(14):1270-1278. (link)

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Posted in Alternative Therapies, Nutritional Supplements, Women's Health

6 Comments to “Urinary Tract Infection Alternatives”

  1. S. Satveit Says:

    Thanks for sharing JP. That is positive news and great information.

    I just wanted to mention that women with low estrogen levels, including post menopausal women, can be prone to recurring UTI’s due to the lining of the urethra becoming thin. Balancing hormones is another natural way to prevent UTI’s in women who have low estrogen levels.

    Great blog, btw.

    S.

  2. JP Says:

    Thank you for adding that, SS.

    Even conventional practitioners are beginning to accept this option:

    http://www.discoverymedicine.com/Ariana-L-Smith/2010/12/08/estrogen-replacement-therapy-for-the-treatment-of-postmenopausal-genitourinary-tract-dysfunction/

    Be well!

    JP

  3. Ted Hutchinson Says:

    I have a non functioning bladder so have to self-catherize to pee so insert a foreign body into a sterile area 5 times daily so was prone to repeat UTI. Tried long term low dose AB’s, short high dose and long term high dose and eventually built up antibiotic resistant E Coli and ran out of effective oral AB’s.

    So used Vitamin D Stoss therapy to hit the infection with a short sharp shock (and avoid having to be hospitalized to have a intravenous AB) and followed up ever since with effective strength D3 to keep 25(OH)D around the 125nmol/l 50ng/ml level.

    Science supporting the use of D3 for UTI here.

    Vitamin D Induction of the Human Antimicrobial Peptide Cathelicidin in the Urinary Bladder.

    Antimicrobial Peptides, Innate Immunity, and the Normally Sterile Urinary Tract

    I think that using several strategies to prevent UTI is likely to be more successful than putting all your eggs in one basket. I also drink GREEN TEA, Cranberry and D Mannose if I have any doubts about the clarity/cloudiness of my pee.

    Been over 5 years now since an antibiotic so or UTI so while it’s still fingers crossed I’m confident that it’s possible to prevent UTI in everyone, even those who have to rely on catheters.

  4. JP Says:

    Excellent advice and information, Ted. Thanks a lot for sharing your successful protocol with us.

    Be well!

    JP

  5. Alicia Says:

    Many of us have heard of using cranberry juice or supplements to protect against urinary tract infections, but I had not heard of using probiotics! Due to this information, I decided to look up the data on naturalstandard.com and found that cranberries have received an evidence grade of B, or good scientific evidence, from Natural Standard, while probiotics have received an evidence grade of B, or unclear scientific evidence for UTI. This correlates well with what is portrayed in this blog post. As a pharmacy student, I feel that it is important to properly educate and counsel patients on all medications, whether prescription, over the counter, or herbal supplements. One thing that this article explicitly stated is that daily use of “pure, unsweetened cranberry juice and clinically-validated cranberry extracts provide the best option here”. Many patients may hear cranberry juice, and pick up a bottle of cranberry juice cocktail, which is more sugar than anything else. It is really important to state that purity matters for the maximum benefit. Thank you for including this information so that all readers can make informed choices!

  6. JP Says:

    Thank you, Alicia. I appreciate your comments!

    Be well!

    JP

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