Treat and Prevent UTIs Without Drugs | Chris Kresser

Treat and Prevent UTIs Without Drugs

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Urinary tract infections (UTIs), which are infections anywhere along the urinary tract, including the bladder and kidneys, are the second most common type of infection in the United States. (1) Read on for five ways to prevent and treat a UTI without antibiotics.

UTI treatment without antibiotics
It is possible to get rid of a UTI without antibiotics. iStock/Tom Merton

UTIs can be caused by poor hygiene, impaired immune function, the overuse of antibiotics, the use of spermicides, and sexual intercourse. The most common cause, accounting for about 90 percent of all cases, is the transfer of Escherichia coli bacteria from the intestinal tract to the urinary tract.

For those of you who have experienced a UTI, there isn’t much you wouldn’t do to avoid another one. While I personally have never had a UTI, my patients have told me how symptoms like pain, burning, nausea, and even bloody urine can be debilitating, and for those who get chronic UTIs, the fear of infection can be enough to prevent engagement in any activities that could trigger one. For people who get them frequently, sometimes a specific cause cannot even be pinpointed. This can be frustrating and scary.

Fortunately, there are a few methods of natural UTI treatment and prevention that have worked extremely well for my patients, to the point where they no longer worry about getting a UTI.

These treatments don’t require a prescription, are inexpensive, and are completely drug-free. While your doctor may not know about them, I hope this article will help you completely avoid UTIs—or at least significantly reduce their frequency and severity. I recommend working with a Functional Medicine practitioner who is focused on treating the root cause of your UTIs.

UTIs can be debilitating, but it is possible to get relief without requiring a prescription. Check out this article for five ways to cure UTIs without antibiotics. #functionalmedicine #wellness #chriskresser

What Is the Standard Treatment for a UTI?

Doctors typically use antibiotics to treat UTIs, and the type and duration depend on your health condition and the type of bacterium found in your urine. (2) Commonly prescribed antibiotics are:

  • Trimethoprim/sulfamethoxazole (Bactrim)
  • Amoxicillin
  • Ampicillin
  • Ciprofloxacin (Cipro)

These antibiotics are often unnecessary and may cause more problems in the future by destroying the beneficial bacteria that prevent pathogenic bacteria from growing. Long-term use of antibiotics can also lead to antibiotic resistance in strains of bacteria like E. coli in the gut, and a UTI caused by these bacteria will be even more challenging to eliminate and can cause more serious issues like a kidney or bladder infection.

Furthermore, antibiotics do very little to prevent the infection from happening in the first place. So, while drugs may be an easy fix for the short term, in the long run, you will continue to be susceptible to UTIs, and these infections may be worse than if you had never taken a course of antibiotics in the first place!

UTI treatment without antibiotics
Cranberries contain D-mannose, which is an effective natural remedy for UTIs. iStock/Terryfic3D

Curing and Preventing UTIs Naturally: D-Mannose

Treating UTIs with D-Mannose

D-mannose is by far the most effective supplement for both treatment and prevention of UTIs. Similar to glucose in structure, D-mannose is a naturally occurring sugar that is found in a number of fruits, including apples, blueberries, and cranberries. (3) This sugar is the reason that cranberry juice has been commonly recommended as a UTI treatment, though it is far easier to get the recommended dosage from a supplement. D-mannose is effective because it attaches to E. coli bacteria, causing them to stick to each other and preventing them from sticking to the walls of the urinary tract. (4) The bacteria can then easily be eliminated from the body during urination.

D-mannose, even in large quantities, does not cause any adverse effects, and cannot be metabolized the way other sugars can, meaning this supplement is safe for people with diabetes and others who are avoiding sugar for any reason. This treatment is also safe for children and the elderly.

Symptom relief can be seen as quickly as the following day, and most symptoms of UTI are generally resolved after 48 hours of treatment. Additionally, taking D-mannose during a time where you feel you are most prone to UTIs, such as before intercourse or during prolonged antibiotic treatment, can help prevent a UTI from ever developing in the first place. This is especially helpful for those who are prone to chronic UTIs and want to be able to engage in normal life activities without fear of infection.

The typical dose of D-mannose for UTI treatment is 500 mg, in capsule or powder form, taken with or in a glass of water or juice every two to three hours for five days. It is a good practice to continue taking the supplement even after symptoms have diminished to ensure complete elimination of the bacteria in the urinary tract. This dose can also be taken as a preventive, or prophylactic, method.

While there has not been any peer-reviewed research to support the effectiveness of D-mannose in treating or preventing UTIs, clinical and anecdotal experience suggests it is highly effective for the majority of infections, both acute and chronic. Some of my patients who have used D-mannose as a UTI treatment method have even described its effects as “miraculous”—so it’s definitely worth a shot!

Four Alternative Treatments for Chronic UTIs

One caveat with D-mannose is that it is only effective with UTIs caused by E. coli infection. While this accounts for about 90 percent of cases, 10 percent will not benefit from this treatment. In this case, supplements that help disrupt biofilms can be useful in treating and preventing UTIs.

Biofilms are an accumulation of microorganisms and their extracellular products forming structured communities attached to a surface such as the lining of the urogenital tract. (5) The development of a biofilm can make infections extremely hard to treat, since they commonly return shortly after treatment is stopped.

The antibacterial resistance of pathogenic biofilms is one of the major reasons why those who get a UTI are highly susceptible to getting more in the future—if the biofilm is not completely eliminated, the infection will eventually return at some point.

1. InterFase Plus and Biofilm Defense

This is why the use of biofilm disruptors can be helpful for preventing the recurrence of chronic UTIs. The biofilm disruptors that I recommend to my patients are InterFase Plus from Klaire Labs or Biofilm Defense from Kirkman. These contain specialized enzymes to disrupt the biofilm matrix embedding potential of pathogens, and dissolve the sugar and fibrin components of most pathogenic biofilms. By destroying the biofilms, the recurrence of UTIs despite proper hygiene can be reduced. (6)

2. Lauricidin

Lauricidin is another supplement that may help in treating UTIs, particularly those that are caused by types of bacteria other than E. coli. Lauricidin (a proprietary form of monolaurin) has antiviral, antifungal, and antibacterial activity, and is specific against pathogenic bacteria so it won’t disrupt beneficial bacteria in the gut. It is highly effective at combating gram-positive bacteria in the families of: (7)

  • Streptococcus
  • Staphylococcus
  • Corynebacterium
  • Listeria
  • Bacillus
  • Clostridium

It works by disturbing the integrity of the bacterial cell membrane, blocking replication and making it easier for the immune system to destroy the pathogen. Lauricidin is only helpful, however, for UTIs not caused by E. coli, which is gram-negative and has a different kind of outer cell membrane than gram-positive bacteria.

3. Nattokinase

Nattokinase is another enzyme that has been shown to dissolve biofilms. (8) Produced by the bacteria found in the fermented food natto, this enzyme is proteolytic and can help break down the fibrin proteins that maintain the structure of biofilms.

Because of its fibrin-breaking ability, it’s important that nattokinase supplements are not taken by people with bleeding disorders, or by people who are taking Coumadin (warfarin), aspirin, or any other drug that influences blood clotting, unless supervised by a physician.

4. Apolactoferrin

Apolactoferrin (or lactoferrin) is one more supplement that I recommend to my patients with recurrent UTIs. This multifunctional protein lactoferrin is a component of the immune system with antimicrobial activity, and is part of the innate defense, found mainly in secretions and mucosal surfaces. (9)

Lactoferrin has been shown to block pathogenic biofilm development by binding to iron and causing the bacteria to “wander” across surfaces instead of forming cell clusters and biofilms. (10, 11) One study found that the amount of E. coli bacteria in the kidneys and bladder of mice was significantly reduced 24 hours after oral lactoferrin treatment, compared to a control group. (12) More research is necessary to demonstrate the effectiveness of lactoferrin in treating UTIs, but I believe it is worth trying, especially if dealing with chronic UTIs.

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Join the conversation

  1. I sent my last message before I finished typing it..basically I’ve heard that prolonged use of Furaginum might be harmful but I can’t stop using it – when I get an UTI my life stops, I can’t function, I am so afraid to go out in case there is no bathroom around and it is to painful to walk. Sometimes I’m awake all night with an extreme pain going to the toilet every 5 minutes. When I asked doctors about they always said that it just happens to people my age who are sexually active and that is that. They just tell me to look

  2. Chris thanks so much for addressing this issue!
    I have never had UTIs until I was about 26years old and started having a regular intercourse. For the first 6months to a year things were but after that everything changed. Every intercourse ended up with UTI. Some of them were so painful that I was crying in the bathroom. I’m terrified with having sex now and even stopped completely for about a year. The symptoms usually develop 24 hours later and just to point out intercourse is the only reason I get these. I take this drug Furaginum (little yellow tablets) which helps instantly every time. Nothing else helps…. I tried cranberry juice, drinking plenty of water,

  3. I have had chronic UTI Infections for over four months. Been on many different antibiotics. I started to take D-Mannose for over a week and noticed no difference and my UTI returned. Was I wrong to stop? I am back on meds. This time Macrobid for two weeks along with Bio-K. By the way, the main bacteria is always E-coli.

    I had a Cystiscopic and it was normal. If I am not better the doctor wants to do a MRI and that is so costly and perhaps IV antibiotics. I am really starting to lose it. Love feedback.

  4. Oh, and another interesting one I forgot that could be confused with a UTI is endometriosis! Endometriosis can cause pain with urination, especially deep in the pelvis, and can lead to a false diagnoses by patient or practitioner of a UTI and result in unnecessary use of antibiotics or poor response to prevention methods. If you have other symptoms of endometriosis or have a diagnoses, definitely something to keep in mind.

  5. I like this article and think prevention is definitely the best course of action for UTI’s, but I think that it’s a bit of an omission to not mention that if it persists you should get thee to a doctor. Time is definitely important here. It’s easier on your body to take a relatively short course of oral antibiotics than to develop a raging infection and have to take IV antibiotics- UTI’s that are not responding to natural treatments after only a couple days should be looked at by a nurse practitioner or doctor. Lots of important stuff down there, obviously one of the largest worry being kidney damage.

    Another good note is that lots of people think they have a UTI when, in fact, they might have something else. STI’s, yeast infection, and bacterial vaginitis may be confused with a UTI, which could be the problem behind reoccurance and lack of success behind natural prevention for specific people.

  6. I’ve had a lot of success with drinking nettle tea whenever I feel a little off and suspect a yeast infection or UTI is trying to take hold. This is more preventative than cure course of action. Gentle, yet effective.

  7. Chris,

    Excellent article!!

    In case of chronic UTI, what is the dosage you recommend of these products? Specially for Nattokinase, which has secondary effects diluting blood.

    Many thanks in advance for your support,

  8. This is a pertinent issue for me as I have a daughter with neurogenic bladder. We are using oxybutynin to regulate bladder pressure and catheterization to empty the bladder. They start them at infancy with this and amoxicillin daily for prophylaxis. This issue I have is that it would seem this style of treatment makes the patient more susceptible to biofilms due to the decreased mucus production from the anticholinergic not to mention the unknowns from such early chronic antibiotic treatment. I may speak to her urologist about some of this as it would be very easy to get the mannose in the diet. The only other question would be if coconut oil would suffice as a monolaurin source or do you need the concentrated monolaurin? What do you think?

  9. One thing that I’ve found is that upstream infections can cause UTIs. If I am suffering from sinus problems caused by allergies and notice that I’m developing a UTI, I work doubly hard on correcting the allergy/sinus problem. And, of course, drink a lot of water.

    • unfortunately, no amount of “following the rules” post sex or hygiene fixes the problem for some of us.

  10. Thank you, thank you, thank you Chris for doing this article on UTI’s. I have been suffering with recurrent infections for years and have felt so isolated as I don’t know anyone else who gets them to the same extent. I am a therapist and have been so frustrated in not being able to find an alternative to the antibiotics I always end up going to the doctor for, after cranberry juice, and even an uva ursi supplement, haven’t worked yet AGAIN. I take probiotics regularly, but still the infection keeps coming back, and often feels like it hasn’t fully gone away even after the antibiotics, so your article has been so helpful in understanding why that might be. I am 50 and am post-menopause, and know that the lining between the urethra etc gets thinner, and bacteria can pass between more easily. When I asked my doctor if that meant I would suffer UTI’s for the rest of my life, and what could I do to prevent them, he just shrugged his shoulders. I have ordered some D-mannose (was worried I might not be able to get it in the UK but YES! I can) straightaway to try first. Thank you again for addressing this.

  11. Thank you so much for this article! In the last few years, since my immune system has gone down the tubes, I’ve been highly susceptible, and I’ve been looking everywhere for info just like this!

  12. Chris, are there any special considerations for men?

    I have the feeling that intermittent fasting (fasting during one day and 2 nights) helps, maybe because for me it improves the digestion.

  13. I’ve been improving my health and immunity for years now, and making great progress. I actually considered myself healthy for the first time in many years. And then, I’ve gotten several UTIs in the last 6 months, all were upper in my bladder/kidneys. This is very confusing and disconcerting. I usually treat them with unsweetened cranberry or blueberry juice, cranberry pills, vitamin C, and drink a lot of extra water.

  14. For decades I seem to get UTI’s during fall – ?tomato season? The rest of the year I’m fine. This year, age 65 and now on less than 50 carbs daily paleo diet, I’ve had 4 UTI’s. Which of the above suggestions should I start? Or can they be taken concurrently? Thanks.

  15. My mother who is 93 has had a series of UTI’s over the past 3 years, ending in hospitalization. She never shows what you would classify as typical symptoms – no pain, no bleeding, etc. What does happen is she goes bat-shit crazy, to be blunt. She exhibits all the symptoms of dementia or Alzheimer. These can come on in a matter of a few days – 3 or 4 – and last for a week or more. Once the infection is treated with antibiotics, the dementia disappears and she absolutely normal.

    During one hospitalization, we were told that one of the doctors at the hospital (male – middle aged) contracted a UTI and the same thing happened to him. He lost a week of his life – couldn’t remember a thing that happened during that week. My mom never remembers being crazy, she just knows something happened, but doesn’t know what.

    The lesson here, is if family member or friend, suddenly goes crazy, for no apparent reason, get them to the hospital, and have them tested for UTI. The sooner the better.

    Cheers

    P.S. We now have her on D-mannose – hoping for the best.

    • I have an 83 yr old aunt in nursing home, and her only symptoms of UTI are dementia. She is moderately incontinent, but not on catheter. I have been told by numerous health care workers that any time someone in assit living or nurs home becomes confused, they immediately check for UTI as it is a common cause. No one talks about this!

      • Yes, my old dad got urinary sepsis and went nutty enough to be transferred from the rest home to a psychiatric clinic. Fortunately after his admission they treated the cause but this did no wonders for my poor old dad’s morale, wondering why he’d been “put in the rat-house”. BTW, no one needs to be a rocket scientist to detect a UTI in their patients…the urine smells fishy or funny.

    • I did the same thing with my mother-in-law. She had four ‘psychotic episodes’ that landed her in a psych ward–only to find out it was a UTI. I had the home start giving her mannose everyday, and she hasn’t had one since. Imagine the health care savings for this very common problem. It’s almost criminal that it isn’t given out routinely. Why did I, a layperson who fortunately had discovered mannose for myself, have to solve this vey serious medical issue? Frustrating!!

  16. My urologist wants me to take ongoing low dose maintanance macrodantin for chronic cystitis and I declined. Would any of the supplements be good for this condition?

    • Jill, did you end up taking the macrodantin long term, my renal specialist has just recommended I do the same, and although its 1 x 50mg tablet / day I am still worried about the long term affects.

    • Jared,
      There is no minimum age for UTI’s although they are more common in adults that children. I work in a Pediatric ICU and we see babies suffering from them. It definitely needs investigation as to why a three year old has one.
      For little girls, always wiping front to back then good handwashing is a good thing to reinforce.

  17. I have found drinking parsley tea to be very effective when I have a UTI coming on. It has worked quite quickly for me. I steep 4 teaspoons of minced parsley in 4 cups of boiling water for 20 minutes and then strain out the parsley, then drink it throughout the day. I will drink the tea for several days to makes sure that the infection has cleared.

    • Thank you for this important article! I suffer from recurrent UTIs and have been trying to find an effective natural prevention and treatment for years. My issue is I’m currently trying to get pregnant, and many of the suggested natural treatments (such as massive doses of vitamin C, per Dr. Christiane Northrup) are incompatible with that project. D-Mannose works like a charm for me as both a prevention and a treatment, but I sadly discovered that there are patent applications out there for use of D-Mannose as a contraceptive, and have since stopped using it. Chris, what do you think of this? Here are the links:

      http://patentscope.wipo.int/search/en/WO2003020288
      http://www.google.com/patents/US6753319

      Also, are the other preventions/treatments you suggest in this article safe while trying to conceive (won’t interfere with conception or implantation)? Thanks again!

      • Hi Noel,

        I know this is an old post, but I wanted to see if you learned anything more about safe prevention/treatment of UTIs while trying to conceive? I have been taking mannose for 2 months while trying to conceive, not knowing about the possible contraceptive effect until yesterday. I was devastated when Iread the patent. Thanks for any additional info you may have gathered on this!

        Leslie

        • Hi Leslie,

          I never received a response about this from Chris or anyone on this thread. I did check with my urologist — she read the patent, and then did a little more research herself. She said that because she could not find a single scientific paper written by the authors of the patent, nor any other scientific paper on D-Mannose’ possible contraceptive effects, she felt that I would be safe taking it while trying to conceive. She highly recommends D-Mannose over antibiotics or any other supplement.

          BUT, I do not feel comfortable using it myself while trying to conceive — I just can’t take that chance that I would be undermining my efforts! It’s maddening that there seems to be no way to know for sure. So I’m taking the better safe than sorry approach and won’t be using it until after I’ve given birth. For now, I’m back on antibiotics, which is awful. 🙁

          Have you learned of any natural methods of preventing or treating UTIs that are safe while trying to conceive? It seems there’s plenty of information out there about what’s safe or not safe during pregnancy, but not so much about what’s okay while trying to GET pregnant.

          -Noel

          • Hi Noel,

            Thanks so much for your response. It is really nice to connect with someone struggling with the same difficulties. I am new in my search, but like you, haven’t come across anything definitive yet that is not contraindicated for conception.

            I contacted my obgyn and mentioned the patent and possible contraceptive effect of D-Mannose, but she had a similar response to your urologist and could not see why it would be problematic. It seems like because the available literature suggests safety during pregnancy and breastfeeding, doctors believe this applies to pre-pregnancy as well. I am in the same boat as you and no longer feel comfortable taking D-Mannose while trying to conceive – as it feels totally counter-productive. I’ve been searching the web for stories of women taking D-Mannose and successfully conceiving, but I haven’t come across any yet.

            I have had chronic UTIs for years, triggered by intercourse. Previously, I would take about 4 cranberry extract pills immediately after intercourse, and that generally did the job; but I would still get UTI’s about 3 times/year. I discovered D-Mannose two months ago after my cranberry method was unsuccessful and could not bear the idea of another round of antibiotics, especially while trying to conceive (despite some safe options). The D-Mannose, in treatment-mode, worked like a charm, and since that time, I have been taking 1/2 tsp of powder following intercourse…until yesterday when I was horrified to learn of the possible contraceptive effect. UGH.

            I have also recently read that cranberry extract can also have a possible contraceptive effect due to the acidic environment in can create…have you read this as well? Not sure whether to give that up. I have never taken macrobid or other low-dosage antibiotics, and I would rather avoid that, but perhaps that is what my next option will have to be. I have been researching other herbal supplements, but like you said, there is limited info about impact on conception. I just found this journal article and haven’t read it thoroughly yet, but I thought I would pass it along. I may even try to contact the author to see if she has any suggestions…

            http://www.thorne.com/altmedrev/.fulltext/13/3/227.pdf

            I will definitely keep you posted if I learn of any promising interventions/preventions that jive with baby-making efforts! Thanks for the information, input and support!

            Best,
            Leslie

            • Hi Noel and Leslie,
              I used to get reoccuring utis but the my pharmacist recommended Ethical Nutrients Urinary Tract Support Tablets. I think they are great,I’m not sure if they would live up to your standards but it is another option for you to look into. I haven’t had a uti since taking them.

              Hope that helps,

              Zoe

            • Leslie & Noel,
              Have either of you found a product that works for UTI’s and is safe to use while pregnant? I’ve been taking D Mannose but now that I’m pregnant I feel I should stop. Any suggestions?
              Thanks,
              L

              • Hi Lacey,

                Congratulations on your pregnancy! I am actually 6 months along myself. Sorry to hear you have a uti! To my knowledge, D-Mannose is safe to take while pregnant and breastfeeding. The issue I was concerned about was taking it while trying to conceive, as there may be a possible contraceptive effect (which would be no good for baby making efforts). As soon as I stopped taking the mannose, I actually got pregnant and luckily haven’t had an infection during pregnancy yet. But, I believe there is no harm in continuing the mannose while pregnant, if you feel comfortable. Definitely double check with your dr, but as far as my personal research goes, it seems ok!

                Feel good and take care!

                • Hi Leslie,
                  Congrats on getting pregnant! From what you’ve said it sounds like D-Mannose is VERY unsafe during pregnancy. If it was keeping you from getting pregnant in the first place how could it NOT be harmful to a developing baby? It would be like taking birth control pills after finding out your pregnant. I wouldn’t want to take anything that is strong enough to keep my body from getting pregnant while I’m carrying a baby. I found this post further down in the comments from Chris Kresser who says that D-mannose is NOT safe during pregnancy.

                  “Chris Kresser
                  NOVEMBER 27, 2012 AT 6:07 PM

                  The supplements I mentioned in that article aren’t safe during pregnancy. Or more accurately, we don’t know if they’re safe during pregnancy and we never will know because finding out would be unethical. Cranberry extract (pills) or 100% cranberry juice is worth a try and safe during pregnancy. It helps prevent bacteria from adhering to the UT lining.”

                  Sounds like the only safe thing to take during pregnancy is cranberry juice and cranberrypills. I’m glad you haven’t gotten a UTI since you’ve gotten pregnant and make sure if you do to stay away from the D-Mannose.

            • I highly recommend Acupuncture for trying to conceive/maintain pregnancies. Also, keep in mind that it seems to me, fertility changes over the years. Just because you may have a hard time while younger (in twenties) doesn’t mean you won’t become more fertile in your 30’s or 40’s. I know a woman who could not conceive in her 30s, only to have one at 40, 41, 42, and 43!