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Rapid Relief for Urinary Tract Infections (the dreaded UTI)

October 2, 2024 | 24 Comments | SAFM Team

 

Help your clients avoid unnecessary courses of antibiotics!

Consider recommending a trio of Uva ursi, d-mannose, and alkalizing the urine.  D-mannose (a nonabsorbed sugar) is released from the body via urine and provokes the release of the bacterial grip on the lining of the urinary tract.  Uva ursi is a potent herbal antibacterial.  You may learn more about d-mannose here and here.

In terms of dosage, consider D-mannose at 1000mg, 2x/day, to counter an existing infection and  Uva ursi at 2-3x/day at the maximum recommended dose on the supplement label.  Note that Uva ursi is not safe for everyone; it is not recommended for children or individuals with liver disease (but still use the d-mannose on its own, which is often quite effective!).  For my clients who wrestle with chronic UTIs, I recommend they take 1000mg of d-mannose daily as a preventive measure.

I recommend alkalizing the urine (raising its pH) because Uva ursi is believed to be more effective at an alkaline pH.  You can help your clients to improve the alkalinity of their urine (and maximize the effectiveness of this remedy) by encouraging them to eliminate (at least temporarily) soda, coffee, black tea, cow dairy foods (especially cheese), too much animal protein, and grains. This means stopping any cranberry juice too for the duration of treatment (cranberry extract is fine) – a surprising step for many practitioners.  For the same reason, I would avoid Vitamin C supplements if they are in the form of ascorbic acid (of course, plentiful Vitamin C via natural food intake is very welcome). Cranberry juice can be effective in mild cases but may interfere with maximum effectiveness if the infection progresses and Uva ursi needs to be used.

Please note that alkalizing urine can promote calcium stone formation, so it is not advised for people with a history of kidney stones. In those cases, probiotics, specifically Lactobacillus species, may be more effective (read about the urobiome and probiotics here and here).

In addition to Uva ursi, many other herbal remedies were shown to be helpful for UTI recurrence and treatment, namely pomegranate extracts (various parts of the plant), cinnamon bark, stinging nettle, golden seal, and many others that are discussed here and here.

Of course, you also want to ensure your clients are drinking plenty of fresh, clean, plain water to help flush the infectious microbes from the body throughout treatment. It is also prudent to forgo sugar in all forms during the infection, as it can aggravate the inflammatory state and promote uropathogenic bacterial overgrowth.

 

To dive even deeper into the topic of urinary health, we also recommend this resource:

https://schoolafm.com/ws_clinical_know/kidney-myths-and-truths-for-practitioners/

 

 

 

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24 Questions for “Rapid Relief for Urinary Tract Infections (the dreaded UTI)”

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  1. 12
    Jennica Merica says:
    September 26, 2022 at 8:44 pm

    I have recurrent UTIs and recurrent c.diff that has required FMT. Will Uva Ursi cause a C.diff relapse like other antibiotics would?

    Reply
    • 12.1
      SAFM Team says:
      October 1, 2022 at 11:58 am

      We cannot support personal health cases in this venue, and we encourage you to seek the support of a licensed, functional medicine-trained practitioner to get to the root cause of why the UTIs and C. diff are recurring. We suggest starting your search here: https://afmccertification.com/.
      Notably, bacterial infection recurrence may not be a matter of which antibiotics or antimicrobials were chosen but rather a sign of a weakened immune system and/or overall dysbiosis.

      Reply
  2. 11
    aslı says:
    July 9, 2022 at 2:36 pm

    Hello,
    I have interstitial cystitis and SIBO. I cannot take most of herbs for IC.( aloe, D mannose, slippery elm).Uristatin is discontinued. Is there any Sıbo friendly supplements for IC?

    Reply
    • 11.1
      SAFM Team says:
      July 14, 2022 at 5:55 am

      IC and SIBO very often go hand in hand – here is a study that may be of interest to you:
      https://pubmed.ncbi.nlm.nih.gov/17932763/
      It is a complex dynamic to unravel that would benefit from a comprehensive approach to address the root cause of the SIBO and IC. We highly recommend working with a functional medicine-trained practitioner to choose the most suitable supplement options in your particular case, as there are many possible options and the choice will depend on the unique context of your body biochemistry and history. You may want to start your search here:
      https://afmccertification.com/

      Reply
  3. 10
    Tanya says:
    February 21, 2022 at 10:55 am

    Can you recommend a specific formula with Uva Ursi?

    Reply
    • 10.1
      SAFM Team says:
      February 26, 2022 at 7:36 am

      There are many good formulas on the market available from various manufacturers. One of our favorites has been Uristatin from Thorne, but alas it is discontinued. Other ones include the tincture from Wishgarden Herbs called “Bladder Buddy” and Usnea Uva Ursi Supreme from Gaia Herbs. There are also many capsule forms, eg. Now and Douglas Labs.

      Reply
  4. 9
    Kristina says:
    November 21, 2021 at 10:04 am

    I am SHOCKED reading about the fact one should avoid Vit. C in ascorbic acid form. The rationale you provide makes sense, but I’m just shocked this point is not stressed in most other articles.
    QUESTION: Is Sodium Ascorbate a safe form of Vit. C to use? Will this not impact the acidity of the urine?

    Reply
    • 9.1
      SAFM Team says:
      November 27, 2021 at 8:10 am

      Sodium ascorbate is a salt of ascorbic acid that upon digestion will have the same acidifying result on the urine pH as ascorbate itself. Please keep in mind that plentiful vitamin C via natural food intake is very welcome and would not have the same effect as the synthetic and concentrated vitamin C forms.

      Reply
  5. 8
    Christy Lonergan says:
    August 23, 2021 at 10:55 am

    How long do you recommend taking the D-Mannose and Uva Ursi for an existing UTI infection? Until symptoms stop or for several days or a week longer?

    Reply
  6. 7
    Sara Kuijten says:
    March 24, 2021 at 12:12 pm

    I was wondering would a supplement like Uristatin be ok to take alongside antibiotics? I have a patient who is on long-term antibiotics with about 90% recovery but she can’t seem to eradicate the chronic UTI completely and is now looking for alternatives but worried about coming off the antibiotics as she ‘flares’ when she has tried in the past. I was thinking perhaps a combination of Uristatin and d-mannose may help to eliminate the last of the infection. thanks

    Reply
    • 7.1
      SAFM Team says:
      April 1, 2021 at 4:31 pm

      Theoretically there are no concerns about taking them together, but the antimicrobials in Uristatin are not something she would want to take long term. More importantly I would cast a broader lens to understand what would be causing the infection to be chronic. Some possibilities include suppressed immune function, dehydration or not urinating after sexual intercourse.

      Reply
  7. 6
    Julie Hager says:
    September 8, 2020 at 11:10 am

    A female 51-yr old client with interstitial cystitis asked me if the D Mannose & Uva Ursi combination for UTI would have any positive effects for IC?
    Her urine cultures are always negative yet she has the typical urinary symptoms of frequency, pain, burning with urination, thus the IC diagnosis. It’s my understanding this combination is used for active urinary tract infections only. I wanted to double-check that in fact with IC the DMannose would be ineffective unless she had a history of E. coli infections to prevent the E. coli from adhering to the bladder wall. She has removed histamine, oxalates and acidic foods, boosted her immune system, addressed mineral and vitamin deficiencies, gut imbalances, working on stress, sleep is ok, waiting on a Dutch test with her Naturopath, her thyroid panel is ok, she’s using Quercetin and histamine block DAO each day, stinging nettle tea, DGL, with no relief of symptoms. She’s desperate and asked me about trying the D Mannose/Uva Ursi combo just to see if helps somehow.

    Reply
  8. 5
    Christine Vielhauer says:
    July 4, 2019 at 4:00 pm

    Well, Tracy here’s one that I’m not sure you’ve seen before.
    A 23-year-old male had sexual intercourse (no condom) with a new female partner.
    Shortly thereafter he started experiencing some burning while urinating and after 10 days after went to a walk-in clinic and got tested for a UTI and all STD’s.
    As soon as they looked at it, they said they saw some unusual things in there that should not have been there. They asked him if he had just had intercourse before coming there. He said no, it had been about 10 days. When the lab work came back they again explained that he was negative for all STD’s but that the lab work detected Atopobium vaginae and Gardnerella vaginalis. They mentioned maybe his partner had BV but otherwise, they (2 different doctors in the office) couldn’t explain it. They suggested lots of water and probiotics. This has me very curious! Have you ever seen this?

    Reply
  9. 4
    Julia LC van Opzeeland says:
    May 17, 2019 at 1:53 pm

    In one of the studies, you posted the link to I saw that the probiotics given for UTI treatment were: L. rhamnosus, L. acidophilus, S. thermophilus, B. bifidum, and L. bulgaricus, living cells not less than 2 billion.
    Are the probiotics enough for UTI treatment?

    Reply
    • 4.1
      SAFM Team says:
      June 2, 2019 at 3:34 pm

      Probiotics on their own have not been shown to be reliably effective for the UTI treatment. They are a helpful addition to other interventions such as those mentioned in the article above. Probiotics can certainly serve as an effective UTI preventive measure for someone who is suffering from recurring UTIs – please see the answer to the questions below in this thread.

      Reply
  10. 3
    Julie Hager says:
    March 8, 2019 at 8:56 am

    Potential client, during our consultation I learned that she has a long-lasting embedded infection resulting in urinary symptoms. Microgen testing showed Enterococcus faecalis. The naturopath has tried multiple antimicrobials and biofilm with no relief. I researched Enterococcus and learned it’s resistant to antibiotics and even biofilm disruptors.
    I help women with interstitial cystitis (IC) and I can see that embedded infections with multiple bacteria besides E. coli are common. I had IC for years and through diet, lifestyle, and natural treatments was able to put it in remission. My approach generally treats IC as autoimmune, always address gut, common for IBS, SIBO, Candida root cause among many other factors especially diet/lifestyle choices contributing to IC.
    Can you provide any insight on treating these stubborn long lasting embedded urinary infections that aren’t E. coli and are resistant to treatments and biofilm disruptors?

    Reply
    • 3.1
      SAFM Team says:
      March 15, 2019 at 5:56 pm

      When faced with such stubborn urinary tract infections (UTIs), the first thing to consider is the strength and ability of the immune system to protect the body against foreign invaders and then also why the body is allowing one pathogen after another. Is there a sympathetic dominance that is suppressing the immune system, if so what is the cause of that. Or, is there a need for immune system nourishment: vit A and D, zinc and B vitamins – is that due to lack of nutrients in the food or due to food digestion and nutrient absorption issues or due to nutrient transport in the tissues.
      Common issues that drive chronic UTIs are:
      – insufficient hydration – as mundane as it sounds so many people struggle with that and it needs to be affirmed, as constant flushing allows for the active removal of pathogens from the bladder. What’s also key here is promoting and maintaining the alkalinity of the urine vs the acidic pH that helps the pathogens to grow. Therefore, if a person drinks plenty of water but is having a hard time with achieving alkaline pH of the urine this may be a great situation when alkaline water can be helpful.
      – low-grade kidney stones that can cause physical damage in the kidneys and directly lead to the ‘revolving door’ of UTIs; this is a comprehensive post that you may be interested to follow up on:
      https://schoolafm.com/ws_clinical_know/kidney-stones-remedy-recurrence/
      – practicing sanitary wiping is another one of those ‘mundane’ concepts, but if there is any debilitation or issue with this simple process this can very easily lead to fecal contamination and infection. Interestingly, that’s the most common route of Enterococcus UTI.

      In the vein of solutions, as I said earlier I would focus on addressing the root causes of the immune system weakness and also support the body with creating an alkaline environment and with probiotics. Friendly bacteria can help the body bring better microbial balance in the urinary tract:
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134985/
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283390/
      https://www.researchgate.net/publication/309381091_Probiotics_for_Prophylaxis_and_Treatment_of_Urinary_Tract_Infections_in_Children

      Reply
  11. 2
    Nathalie. Keane says:
    January 28, 2018 at 7:35 am

    Tracy, I have a female patient who is 73 and has had repeated E. coli Bladder infections for years. Every time she is being prescribed antibiotics. She has seen multiple specialists to no avail. I have helped her with basics… gut health, hygiene, water, not keeping the urine in the bladder too long, insomnia, food sensitivities, etc.. I read about your recommendation with the D-Mannose and Uristatin. Is this effective as preventative measure? Her PCP suggested to be on a low dose of antibiotics taken daily for 6 months, and of course, I am am not really happy about this. Thank you.

    Reply
    • 2.1
      SAFM Team says:
      February 7, 2018 at 9:55 am

      If the infections are chronic, there is likely another factor at play, perhaps with suppressed immunity or non-optimal pH in the urinary tract. I would check to be sure Vitamin D, vitamin A, and RBC zinc are optimal. I imagine you have already considered stress as a potential immunosuppressant and ensured adequate WBC level in basic blood work. Often infections are chronic due to poor clearance because of small kidney stones? Perhaps something to consider in looking at a urinalysis? If she is sexually active, make sure she is urinating after intercourse to help rebalance pH (semen is very alkaline and can promote microbial imbalance). But as you well surmise, the repeated antibiotics (i.e. constant triage) are not doing anything to help her to retain strong microbial balance in the urinary tract. I would definitely 1000mg d-mannose twice daily to help with prevention and also the juice of one full lemon daily squeezed into her glasses of water (the citrate helps to counter the most common – oxalate – stones). The Uristatin includes uva ursi as an herbal antimicrobial, so I don’t recommend this for ongoing, preventive use. But I have seen Uristatin taken at full dose (e.g. 3 caps, 3x daily, for 10-14 days) wipe out many UTIs and bladder infections from e coli *if* it it started immediately upon the first twinges of a brewing, infectious dynamic. Time is of the essence. It could also be that other infectious dynamics in her body are preventing the immune system from focusing fully on the bladder issues (e.g. chronic viral load), or toxicity may also be involved. As you well said, ongoing hydration with plain, clear water is key. I would also avoid all daily black tea intake given its possible role in kidney stones. If d-mannose is not sufficient, I have also had clients add to this twice daily use of Dr. Schulze’s Kidney tincture to prevent recurrence (again, an herbal remedy – just taken in a little water on an empty stomach).

      Reply
  12. 1
    Jean Sharry says:
    May 22, 2017 at 10:17 am

    Tracy-
    In a previous Q&A about UTIs, you mentioned Gaia Herbs “Urinary Support”. That item has been discontinued. Would you recommend Thorne Research – Uristatin as a replacement?
    Thanks!

    Reply
    • 1.1
      SAFM Team says:
      May 29, 2017 at 8:23 pm

      It depends on the situation. As the Q&A you reference mentions (thanks for the catch on the discontinuation), I most recommend d-mannose for prevention of UTIs or bladder infections (e.g. Pure Encapsulations: https://www.pureformulas.com/dmannose-powder-50-grams-by-pure-encapsulations.html ). Taking d-mannose two or three times daily may be able to wipe out a brewing infection too if the response is strong and swift. If symptoms worsen, however, I do definitely recommend going right away to Thorne’s Uristatin – and taking it three times daily for about 10-15 days (again, a strong response is usually necessary to avoid the need for antibiotic drugs). I have recommended this particular Thorne product *many* times with excellent results.

      Reply
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