Natural supplements for UTIs

Urinary tract infections (UTIs) are listed among the most common causes of infection. They are more prevalent in women and children. But men may also suffer from recurrent UTI and many complications.

Urinary tract infections in men are usually overlapped with other health problems. They typically don’t suffer from UTI, and most urinary tract symptoms appear in older men. But the majority are caused by prostate problems.

So, what is precisely a urinary infection? How can you make out urinary tract infections from other health issues? And more important yet, are there natural remedies to improve the symptoms?

What is a urinary tract infection?

A urinary tract infection is a colonization of any part of the urinary system. Pathogenic bacteria typically make this invasion or colonization. But sometimes healthy flora may also affect the urinary tract in case of overgrowth.

Depending on the infected area, we have different types of UTI. For example, a bladder infection is called cystitis. A kidney infection is called pyelonephritis. We can also talk about acute or chronic conditions depending on the time extension.

Acute infections have a sudden onset and usually resolve quickly. Chronic infections are more insidious and may have long-lasting consequences.

Another type of infection we should understand is a recurrent UTI. When urinary tract infections are recurrent, something is probably happening. It happens in patients with a compromised immune system. It is also common in people with birth malformations in the urinary tract.

In any case, patients with frequent UTI symptoms should be evaluated thoroughly. In most cases, they will have an underlying problem that should be treated to prevent further infections (1).

What are the symptoms?

UTI symptoms can be different depending on where the infection takes place. An upper UTI, located in the kidneys, usually don’t have many urinary symptoms.

Instead, patients would have a very high fever, pain in the lower back, and vomiting. In some cases, a kidney infection is associated with bladder infections. These patients would display urinary symptoms and those listed above.

But what type of urinary symptoms would you expect from lower UTI infections (2)?

• Painful urination: It is often described as a burning sensation when urinating. This type of pain is due to the irritation and inflammation of the urinary tract. It is medically known as dysuria.
  
  
• Foul-smelling urine: Patients may describe their urine is concentrated and with a foul smell.
  
  
• Increased urinary frequency: A urinary infection causes inflammation, which triggers the urination response more often. Patients may feel an urgency to urinate and may sometime wet their clothes.
  
  
• Pelvic discomfort: Inflammation in the urinary bladder causes an uncomfortable sensation in the pelvic area. The area will also become tender to the touch.

In most cases, these symptoms are found in cases of acute UTI. Chronic UTI works a bit differently and includes the following symptoms:

• Nausea and vomiting
  
  
• Fever and chills
  
  
• Fatigue, and sometimes confusion or disorientation

When we have recurrent urinary tract infections, the symptoms are usually the same as acute UTI.

What causes a urinary tract infection?

Urinary tract infections are caused by living bacteria. Escherichia coli is the most common infecting bacterium. This microorganism causes infections in the majority of women and children. In male adults, many UTIs are associated with sexually-transmitted diseases. Other cases are associated with kidney stones.

This knowledge is essential if you’re experiencing recurrent cystitis or recurrent infection of the urinary tract. Reinfection may be due to the following causes (1):

• Incorrect hygiene techniques, especially in women and children
  
  
• Kidney stones, which damage the internal linings of the urinary tract and increase the risk of infection
  
  
• Sexually-transmitted diseases, which also cause inflammation and similar symptoms

Herbs and natural supplements for UTIs

If you’re having frequent urination problems, chances are you’ve been on antibiotics very frequently. You may wonder what you can do to reduce the incidence of urinary tract infections.

There are several herbs for UTI, which not only improve the symptoms but also prevent infections. These herbal remedies are not expensive and have fewer side effects than conventional medicine.

However, it is always important to ask your doctor before starting any new treatment. Even natural supplements can interact with treatment taken by people with chronic diseases.

With this in mind, let us briefly review a few supplements to improve UTI issues:

D-mannose

This is a simple sugar found in nature, very similar to glucose. But D-mannose is extracted from the larch rod. It is not transformed into glycogen like glucose, and it is not stored in the body.

What mannose does is preventing urinary tract infections in the first place. Exogenous mannose inhibits the adhesion of bacteria in the bladder wall. Since bacteria can’t become fixed in the wall, it won’t be able to replicate and infect the area. Thus, D-mannose strengthens the urothelial barrier against disease.

Many clinical trials support the idea of using mannose as a way to prevent infections. It is a natural treatment that reduces the bacterial load without many side effects. It increases the clearance of such bacteria in the urine and reduces the risk of infection.

D-mannose has been tested in the short and the long term. Both are apparently useful, making it a promising agent to reduce the incidence of UTI in women and children (3).

A recent study evaluated the effect of mannose on the incidence of UTI. The investigators used 2 grams of D-mannose powder in 200 ml of water. The study group took this daily for 6 months.

The other group of patients used nitrofurantoin, a popular urinary antiseptic. Only 14% of patients had a recurrent UTI in the D-mannose group. The nitrofurantoin group had 20% of incidence, and the placebo had 60% (4). 

Uva Ursi (Bearberry)

This herb has a long tradition as a herbal remedy for UTIs. It is known to reduce dysuria, the incidence of kidney stones, and chronic UTI. It is also useful as an antiseptic against gonorrhea, leukorrhea, and cases of urethritis.

Before antibiotics were introduced into the market, Uva Ursi was listed as a urinary antiseptic. It was a very important therapeutic option for patients with urinary tract infections.

Nowadays, it is not listed as a prescription drug. But it is still recommended for uncomplicated cystitis. It is also useful for other inflammatory conditions of the urinary system. Some would also use uva ursi for incontinence, urinary spasms, or as a diuretic.

Biochemical analysis of uva ursi reveals a combination of flavonoids and tannins. It also has hydroquinones, triterpenes, phenolic acids, and more. What these components do is promoting healthy urinating and electrolyte balance. It also promotes the release of kidney stones, and some people may use it as a weight-loss agent (5).

According to studies, it also has antibacterial activity. Impressively, it has similar activity to gentamicin against P. aeruginosa, E. coli, and P. mirabilis (6).

Garlic

Garlic is a popular natural remedy against various diseases, including UTI infections. It is part of the Allium genus, similar to onions, leeks, and chives, and has many functions in the body.

For example, garlic is known as a metabolizing enzyme. It accelerates enzymes in the body to release body wastes. It has diallyl disulfide and diallyl trisulphide, which are active against yeasts. Thus, it has strong antimycotic activity. In other words, it prevents the colonization of the urinary tract by fungus.

It has a few downsides as well, especially the odor. But the majority of meta-analyses and scientific studies are quite promising. That’s why it is recommended to increase the consumption of onions and garlic. They have the potential to reduce the recurrence of UTI and other infections (7).

One pathogen that often invades the urinary tract is Proteus mirabilis. A recent study had the opportunity to test the effect of garlic against this bacterium. The researchers show that garlic inhibits several virulent factors of P. mirabilis.

As a result, the bacteria are not capable of colonizing the urinary tract to the same extent. The study also evaluated the use of garlic along with antibiotics. It reported that adding garlic extract has a synergist effect when used with doxycycline. Simply put, garlic extract helps antibiotics and strengthens their action against P. mirabilis (8).

Cranberry

Cranberries are part of the Vaccinium species, along with blueberries. They are known to contain abundant antioxidants, such as anthocyanins. Cranberries have a high-water content, and also provide citric acid, malic acid, quinic acid, and others.

Many studies have evaluated the effect of cranberry in patients with recurrent UTI. The majority agree that cranberry juice is useful to reduce the incidence of infections. These trials have been performed in women because they are more susceptible to UTIs. However, it is reasonable to expect the same result in men and children.

There’s not a definite answer as to why cranberry extract works against UTIs. However, the latest reviews suggest a role of quinic acid. Quinic acid in cranberry stimulates the excretion of hippuric acid in the urine. This substance causes acidification of the urine and helps to destroy susceptible pathogens.

Other studies suggest that cranberries inhibit adherence of bacteria, similar to mannose. For these reasons, cranberry and blueberry have prophylactic potential. They can be used to help the body fight disease and reduce the chance of recurrence. (9).

A recent study about cranberries for UTI-susceptible patients evaluated this particular effect. The participants used unsweetened cranberry juice daily for 12 weeks. Then, the incidence of UTI was measured in placebo and treatment groups.

As expected, the bacterial adhesion score was decreased. Bacteria were unable to form a biofilm and grow in the uroepithelium. The urine pH changed from 6.3 to 5.8, confirming the theories above. The incidence of UTIs decreased from 88% to 33% (10).

Green tea

Green tea is one of the most popular herbal teas in Chinese herbal medicine. It is basically an infusion with Camellia sinensis, a common and widely distributed Chinese herb.

This tea is highly regarded as an antioxidant, reducing the risk of cardiovascular disease. But that’s not the end of it. Camellia sinensis also has an antimicrobial effect when administered in the right dose. This effect is evident in many bacterial strains, and one of them is E. coli.

The antibacterial effect of green tea is given by catechins, a polyphenolic component. Epicatechin-3-gallate and Epigallocatechin-3-gallate are probably the most important. However, only Epicatechin-3-gallate is excreted into the urine. When it does, it has an antimicrobial effect through several mechanisms (11):

• These polyphenols are potent anti-inflammatories. UTI symptoms are made worse by inflammation. Thus, green tea will potentially reduce the clinical symptoms of urinary infections.
  
  
• Catechins promote healthy communication between white blood cells. They induce the production of certain cytokines. These substances are important to promote immunity and fight microbes.
  
  
• Polyphenols in green tea reduce the expression of a substance called TNF alpha. E. coli uses this substance to invade the urinary epithelium.
  
  
• Green tea components create complexes that destroy the membrane of E. coli.
  
  
• Epicatechin-3-gallate inhibits gyrase enzymes and the replication of bacterial DNA.
  
  
• It also inhibits the release of toxins in certain E. coli variants.

Clinical trials evaluating the effect of green tea show promising results. One study published in 2019 reported that only 3 days of treatment with green tea was enough to reduce symptoms in women with UTIs. Thus, it is a potential treatment along with antibiotics to feel better and control symptoms faster (12).

Probiotics

A research insight article published in 2011 evaluated the scientific basis of using probiotics to prevent UTIs. Probiotics are living strains of certain bacteria. Instead of colonizing and damaging the host, they are beneficial.

They take their place in the mucosa and prevent colonization by harmful bacteria. They would also synthesize vitamins and stimulate our immunity. All of this potentially prevents bacterial infection. This effect is commonly used in the human gut, but the same happens in the urethra.

Similar to the human gut, the vagina has many Lactobacillus species as normal flora. The vagina and urethra are close to each other. Thus, their microbiomes are always interacting. Some studies show that women with recurrent UTIs do not have enough lactobacilli. Moreover, using antibiotics over and over again may add up to the problem.

For that reason, a clinical trial was made to analyze women with recurrent UTIs. Some of them received antimicrobials, and the rest received intravaginal probiotics. Only 15% of women in the probiotic group developed recurrent UTIs. Recurrence was 27% in the placebo group. This clearly shows the risk reduction by using probiotics (13).

However, we will rarely find probiotic suppositories, and they are not useful in men. Is it possible to have similar results with oral probiotics? According to many clinical trials, even oral probiotics can change vaginal colonization. Thus, the rationale for using oral probiotics to reduce UTIs is very reasonable (14).

Tips for preventing a urinary tract infection

As noted, recurring infections of the urinary tract usually have a reason. Thus, if that’s your case, be sure to find the reason.

Ask your doctor. You may have kidney stone problems without even realizing it. Or maybe your symptoms are not due to a urinary infection but a sexually-transmitted disease instead.

There are many alternatives to prevent UTIs in cases of recurrence. For example, nitrofurantoin and methenamine hippurate. But these drugs need to be prescribed by a doctor.

There are still other natural treatments to prevent urinary tract infections:

• Apple cider vinegar: Some people may use apple cider vinegar to prevent UTIs. Note that this is not a remedy to treat active UTIs. There’s also not sufficient evidence to back up claims, but it works for some.
  
  

• Forskolin: It is obtained from the Indian coleus, and used in Ayurvedic medicine. Apparently, what it does is increasing the effectiveness of antibiotic treatment. It does not have any antibiotic potential by itself (15). 
  
  
• Corn silk: You may know corn silk as the silky threads you always discard after peeling corncobs. It has many health benefits, and one of them is reducing UTI symptoms (16).

Conclusion

Herbal medicine can be very helpful in treating UTIs. There are many health applications of day-to-day herbs and natural products. A few examples include green tea, garlic, and corn silk. They may help you control UTI symptoms, and in some cases, inhibit bacterial growth and contribute with their own antimicrobial effects.

Natural remedies are unlikely to have side effects. However, it is recommended to inform your doctor before starting to use one of these.

Remember that recurrent UTIs usually have an overlapped problem we need to solve beforehand. But as you find the real cause, remedies like mannose, cranberry juice, and probiotics can make their contribution in reducing the incidence and severity of urinary tract infections. 

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