Does D-mannose Help Reduce Urinary Tract Infections?

Becca is a 35-year-old female who has struggled with about two urinary tract infections (UTIs) a year for the past 2 years. At this point, she has just settled with waiting until urinary urgency, urinary frequency and burning starts before heading into the doctor’s office for a urine test and then taking the antibiotics prescribed. She is getting tired of this pattern and would like to find ways to prevent, or atleast reduce, the likelihood of an infection happening in the first place.  

If you are experiencing 2 UTIs within 6 months or 3 UTIs in 12 months than you are falling into the recurrent UTI category. UTIs are typically treated with antibiotics; however, these can have side effects including diarrhea, nausea, headache, vaginal burning, candidiasis (yeast infection) and change the body’s microbiome (healthy/good bacteria). Chronic antibiotic use can also lead to antibiotic resistance which makes it difficult to treat future UTIs. 

When compared to a placebo or “fake treatment”, D-mannose has demonstrated a protective effect against developing a UTI. When compared to preventative antibiotics, D-mannose showed similar effectiveness. Luckily, D-mannose has been found to have few negative side effects with the most common being a low incidence of diarrhea. In fact, D-mannose was found to have a lower risk of side effects than nitrofurantoin (an antibiotic).

Some people are at a higher risk of recurrent UTIs, such as those who are going through breast cancer therapy, due to the reduction of estrogen, or who have bladder changes due to nervous system involvement, like multiple sclerosis. D-mannose was found to significantly reduce UTIs in those with MS and those going through breast cancer treatment.

Unfortunately, more research is needed to better understand the dosage that should be recommended to reduce recurrent infections. This means there might be adjusting that has to be done before determining the full benefit of D-mannose. Also, there are different forms of D-mannose like powder and capsule and there is not ample research to determine which form is better.

Overall, there can be multiple contributing factors to UTIs, especially recurrent UTIs, including estrogen levels, microbiome health, nutrition, hydration, pelvic floor muscle tension, and more. It is important to address all components to reduce the risk of an infection developing. Luckily, D-mannose appears to reduce recurrent UTIs with possible similar effectiveness as antibiotics and minimal side effects are typically experienced. It is definitely worth discussing the benefits with your medical provider. Just remember to allow for appropriate adjustments in dosage and frequency to find what works best for you. 

Written by Jordan Schmidt, PT, DPT

References

Lenger, S. M., Bradley, M. S., Thomas, D. A., Bertolet, M. H., Lowder, J. L., & Sutcliffe, S. (2020). D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis. American journal of obstetrics and gynecology, 223(2), 265.e1–265.e13. https://doi.org/10.1016/j.ajog.2020.05.048