Urinary tract infections (UTIs) are a common health issue, particularly for women. They can be painful, disruptive, and, if left untreated, lead to more serious complications. With frequent antibiotic use contributing to antibiotic resistance, many are turning to natural remedies for prevention. One such remedy is D-Mannose, a simple sugar believed to help prevent UTIs. But does it work? Here’s a look at the science behind D-Mannose.
What is D-Mannose?
D-Mannose is a naturally occurring sugar found in fruits like cranberries, apples, peaches, and oranges. It is also found naturally in our bodies when glucose is broken down into glycoproteins. D-mannose can also be found in the form of galactomannans (indigestible plant polysaccharides) in coffee beans, fenugreek and guar gums. However, the amount of free D-mannose from these dietary sources is small and is therefore not a significant daily source for humans (Ala-Jaakkola et al., 2022).
How Does D-Mannose Work?
D-Mannose is believed to work by preventing harmful bacteria, such as Escherichia coli (E. coli), from adhering to the bladder walls. E. coli is the most common bacteria responsible for UTIs. When D-Mannose is present in the urine, it binds to E. coli, preventing the bacteria from sticking to the bladder lining, allowing it to be flushed out during urination. Unlike glucose, it is poorly metabolized by the body and is excreted quickly in the urine. This rapid excretion plays a role in how it works to potentially prevent UTIs (Ala-Jaakkola et al., 2022).
What the Research Says
A number of studies suggest that D-Mannose may help prevent or lessen recurrent UTIs, particularly in women, who suffer from frequent infections.
Study #1: Meta Analysis of D-Mannose vs. Antibiotics Vs. Placebo
A 2020 study published in the American Journal of Obstetrics and Gynecology compared the effectiveness of D-Mannose with antibiotics (the standard prevention method) for women with recurrent UTIs. The s
tudy found that women taking D-Mannose had a lower recurrence of UTIs over a six-month period compared to those taking a placebo. In fact, the results showed that D-Mannose was almost as effective as antibiotics for preventing UTIs but without the associated risk of antibiotic resistance and side effects (Lenger et al., 2020).
Study #2: Randomized Control Trial of D-Mannose vs Antibiotics vs Placebo
Another 2014 study published in the World Journal of Urology tested a group of women with a history of recurrent UTIs by treating either with D-mannose, antibiotic, or no treatment. This study also found that D-mannose supplementation was similarly effective at reducing risk of recurrent UTI as antibiotic treatment was. Patients who took only D-mannose also had less side effects than the group who took antibiotics (Kranjčec et al., 2014).
Study #3: Systematic Review of Non-antibiotic Remedies
In a 2022 study, researchers explored the use of D-Mannose alongside other non-antibiotic treatments like cranberry extract and non-steroidal anti-inflammatory drugs (NSAIDs) for UTI prevention. Published in Pathogens, the study found that D-mannose was effective in reducing the number of UTIs, cranberry extract was inconclusive in its results, and NSAIDs did not seem to be an effective treatment for UTI. However, it is noted that no significant conclusion can be drawn from these studies due to the small sample sizes and insufficient data (Konesan et al., 2022).
How to Use D-Mannose
D-Mannose is available as a supplement in powder or capsule form. The recommended dose for UTI prevention varies anywhere from 420 mg daily to 2 g three times per day, with frequency of dosing ranging from daily to one week per month. Studies indicate that you shouldn’t exceed a dose level of 0.2 g/kg of body weight daily in long-term use, as higher doses may cause gastrointestinal disturbances (Ala-Jaakkola et al., 2022). It is always a good idea to consult with a healthcare provider before starting any new supplement, especially if you are pregnant, nursing, or have underlying health conditions.
Who Might Benefit from D-Mannose?
D-Mannose may be particularly beneficial for women who experience recurrent UTIs and are looking for a natural, antibiotic-free prevention method. It can also be an option for those who want to avoid the side effects of long-term antibiotic use or who are concerned about the growing issue of antibiotic resistance (Ala-Jaakkola et al., 2022).
Limitations and Considerations
While D-Mannose shows promise, it is not a cure-all. It may not be effective for everyone, and some people may experience mild digestive side effects like diarrhea or bloating. Additionally, if you have a UTI, it is important to seek medical treatment rather than relying on supplements alone. UTIs can lead to serious kidney infections if left untreated (Ala-Jaakkola et al., 2022).
Conclusion: Is D-Mannose Right for You?
Overall, these studies suggest that D-Mannose could be used as part of a broader strategy to maintain urinary health. However, the literature also states future studies are needed to strengthen these findings. If you suffer from recurrent UTIs and are looking for a natural remedy, D-Mannose may be worth discussing with your healthcare provider.
References
Ala-Jaakkola, R., Laitila, A., Ouwehand, A.C. et al. Role of D-mannose in urinary tract infections – a narrative review. Nutr J 21, 18 (2022). https://doi.org/10.1186/s12937-022-00769-x.
Konesan J, Liu L, Mansfield KJ. The Clinical Trial Outcomes of Cranberry, D-Mannose and NSAIDs in the Prevention or Management of Uncomplicated Urinary Tract Infections in Women: A Systematic Review. Pathogens. 2022 Dec 5;11(12):1471. doi: 10.3390/pathogens11121471. PMID: 36558804; PMCID: PMC9788503.
Kranjčec B, Papeš D, Altarac S. D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol. 2014 Feb;32(1):79-84. doi: 10.1007/s00345-013-1091-6. Epub 2013 Apr 30. PMID: 23633128.
Lenger SM, Bradley MS, Thomas DA, Bertolet MH, Lowder JL, Sutcliffe S. D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020 Aug;223(2):265.e1-265.e13. doi: 10.1016/j.ajog.2020.05.048. Epub 2020 Jun 1. PMID: 32497610; PMCID: PMC7395894.
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