Is D-mannose Better Than Cranberry for UTI?
D-mannose, a type of sugar, has become a popular alternative treatment for preventing and treating urinary tract infections 6. Unfortunately, nearly all the evidence on the effectiveness of D-mannose is anecdotal, without clinical studies to back it up. Cranberry, on the other hand, has shown some benefit in preventing but not treating urinary tract infections in clinical studies 6. If you think you have a urinary tract infection, talk with your doctor; you will most likely need antibiotics. Don't take D-mannose or cranberry to treat a UTI without medical approval.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Proponents of D-mannose claim that taking supplements can block certain types of Escherichia coli bacteria from clinging to the bladder walls and allowing an infection to settle there. D-mannose only affects E. coli bacterial growth in the bladder; while other bacteria can also cause urinary tract infections, E. coli causes between 80 and 85 percent of all urinary tract infections, according to pharmacist Cate Sibley. Cranberry, once thought to prevent UTIs by making the urine acidic, is now known to prevent E. coli and other gram-negative bacteria from sticking to the bladder walls.
Dosage of Cranberry Extract for UTIs
Clinical studies on the effects of D-mannose in people have not been conducted. An animal study conducted by researchers from Northwestern University and reported in the 1983 "Urological Research" found that D-mannose decreased bacteria concentration in rats inoculated with E. coli bacteria. Urologist Michael Blue, M.D., conducted a study of 60 of his own patients who reported symptoms of UTI. Of those diagnosed with UTI, 71 percent of the women reported improvement. Of those who did not have a positive culture of bacteria in the urine but who had symptoms, 94 percent of the women reported improvement. Men with diagnosed E. coli infection had significant improvement taking D-mannose.
- Clinical studies on the effects of D-mannose in people have not been conducted.
- An animal study conducted by researchers from Northwestern University and reported in the 1983 "Urological Research" found that D-mannose decreased bacteria concentration in rats inoculated with E. coli bacteria.
Study results on the benefits of cranberry for UTI prophylaxis have been mixed. A British January 2008 Cochrane Database Systematic Review of 10 studies reported that cranberry had value in preventing UTIs in women with a history of recurrent UTI 6. Evidence was not conclusive in other groups. More research is needed before cranberry is recommended for this use.
- Study results on the benefits of cranberry for UTI prophylaxis have been mixed.
Risks of Cranberry Pills
Not all E. coli bacterial infections respond to D-mannose, including some of the most dangerous types, NYU Langone Medical Center warns 1. Other types of bacteria also do not respond to this treatment, because they lack mannose-sensitive pilli, threadlike structures that allow E. coli bacteria to attach to D-mannose. Cranberry has not proven effective in treating UTIs, but may help prevent them, according to Darren Lynch, M.D., of Beth Israel Medical Center, in the December 2004 issue of the "American Family Physician." Using either supplement to treat UTI could allow a simple UTI to ascend to the kidneys, causing serious infection 5. See your doctor if you think you have a UTI.
Dosage of Cranberry Extract for UTIs
Risks of Cranberry Pills
Does Cranberry Juice Prevent Kidney Stones?
What Are the Benefits of D-Mannose?
Cranberry Juice & Kidney Failure
Causes of Leukocytes in the Urine During Pregnancy
Cranberry Juice & Your Bladder at Night
Foods to Eat When You Have Urinary Tract Infection
Cranberry Juice for Bacterial Vaginosis
What Are the Benefits of Cranberry Concentrate?
- NYU Langone Medical Center; Mannose; February 2011
- Healing Therapies: D-Mannose
- "Urological Research"; Effect of D-mannose and D-glucose on Escherichia Coli Bacteriuria in Rats; E. Michaels, et al.; November 1982
- "Molecular Nutrition and Food Research"; A Systematic Review of the Evidence for Cranberries and Blueberries in UTI Prevention; R. Jepson, et al.; June 2007
- "American Family Physician"; Cranberry for Prevention of Urinary Tract Infections; Darren Lynch, M.D., et al.; December 2004
- Cochrane Database Systematic Review; Cranberries for Preventing Urinary Tract Infections; R. Jepson, et al.; January 2008
- Ahmed H, Davies F, Francis N, Farewell D, Butler C, Paranjothy S. Long-term antibiotics for prevention of recurrent urinary tract infection in older adults: systematic review and meta-analysis of randomised trials. BMJ Open. 2017;7(5):e015233. doi:10.1136/bmjopen-2016-015233
- Wellens A, Garofalo C, Nguyen H, et al. Intervening with urinary tract infections using anti-adhesives based on the crystal structure of the FimH-oligomannose-3 complex. PLoS One. 2008;3(4):e2040. doi:10.1371/journal.pone.0002040
- 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;32(1):79-84. doi:10.1007/s00345-013-1091-6
- Domenici L, Monti M, Bracchi C, et al. D-mannose: a promising support for acute urinary tract infections in women. A pilot study. Eur Rev Med Pharmacol Sci. 2016;20(13):2920-5.
- Aydin A, Ahmed K, Zaman I, Khan MS, Dasgupta P. Recurrent urinary tract infections in women. Int Urogynecol J. 2015;26(6):795-804. doi:10.1007/s00192-014-2569-5
- NIH National Library of Medicine. D-mannose for the prevention of UTIs in multiple sclerosis. Updated July 3, 2015.
A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.