TOPIC

D-Mannose vs Cranberry for UTIs – Which is best?

by Emma Scott · May 30, 2022

Reviewed Icon

Reviewed by Dr Becky Mawson on May 30, 2022

D-mannose tablets on the palm of a hand
UTIs can be incredibly uncomfortable, painful and irritating, but what's the difference between D-Mannose and Cranberry treatment? Get the lowdown on the health supplement that might become the new VIP of UTIs.

What’s the lowdown?

  • UTIs (urinary tract infections) are super common and super annoying, causing an array of symptoms including a frequent urge to wee (and when you do, it stings like crazy), a painful abdomen and the inability to empty your bladder
  • Antibiotics are the go-to therapy, but there are other treatment options to explore, which could be especially handy for those who experience recurrent UTIs (2 or more infections within a 6 month period)
  • Cranberries have been said to have a beneficial effect on UTIs for decades, but the research is mixed – they seem to be more of a preventative option than a cure for an active UTI
  • Of recent years, D-mannose (taken as a capsule or powder) has received attention as a possible UTI treatment
  • Clinical research into D-mannose is looking promising, with comparable results to that of antibiotics 
  • UTI symptoms can be similar to sexually transmitted infections (STIs) like chlamydia, so make sure you are up to date with STI screenings (either in a clinic or using and at-home test) and look out for any abnormal blisters around the vulva
  • You can buy D-mannose directly from the Lowdown
 
 

UTIs… the dreaded urinary tract infection. Usually it likes to make its presence known by causing an eye-watering sting while you wee, dull abdominal pain and the constant need to sprint to the loo! It seems unfair that something so common (it’s likely to affect at least  ⅓ of all women…lucky us) can have such irritating symptoms. 

The first port of call for treatment is typically an antibiotic, but factors such as the rise of antibiotic resistance and unpleasant side effects have resulted in increasing interest in other possible treatment options. In this article, we’re going to compare one of the most long-standing home remedies for UTIs, the humble cranberry, with one of the newer kids on the block, D-mannose.

What is a UTI?

A UTI is a collective term to describe an infection which involves the bladder, kidneys, ureter or urethra. Up to 90% of all cases are due to the bacteria Escherichia coli, which is common in the urinary tract. Many of us experience recurrent UTIs, which is where you experience 2 UTIs in a 6 month period. In fact, studies suggest that there is a 27% chance of a second infection within six months after the first. 

If you experience UTI symptoms, you may be asked to do a urine test to look for signs of  infection. Depending on the result, the advice could be to take a painkiller to manage uncomfortable symptoms and to potentially prescribe a short course of antibiotics (3 days is usually enough). However, antibiotics are not always needed and symptoms can resolve on their own.  Sometimes, the recommendation is to wait 48 hours before taking the antibiotics to see if things improve without them. 

It is important to note that if the UTI symptoms rapidly worsen, or do not respond to treatments (such as antibiotics), within a couple of days it is important to contact your healthcare team as the infection can spread to the kidney and result in complications. Important signs of worsening infection include fever, vomiting and pain over the kidney area or loin.

Now, time to take a bit of a diversion into cranberries and D-mannose. Let’s get stuck into how each of them can be beneficial, how they differ and which one might be best for you! 

Is D-mannose the same as cranberry?

D-mannose is a type of sugar which is found in fruits and vegetables. It also naturally occurs in cranberries. So, if you take cranberry juice or capsules you will also be ingesting some D-mannose.

When you take D-mannose, the body will get rid of it via the kidneys and then the urinary tract. The D-mannose then attaches to the e.coli bacteria (remember, this is the main culprit for UTIs), which prevents the bacteria from attaching to cells, multiplying and causing the infection. 

As cranberry also contains D-mannose, some sources suggest that it treats infection in the same way. However, D-mannose that can be consumed via diet is relatively low, so you wouldn’t be able to eat enough cranberries, peaches or even coffee grounds to consume an amount of D-mannose that could have a therapeutic effect!

There is, however, another compound within cranberries, known as proanthocyanidins (PACs), that could be beneficial in treating UTIs. The PACs appear to have a similar effect on e.coli, stopping the bacteria from attaching to the cells within the urinary tract. A 2010 study concluded that a daily dose of 36 mg of PACs or more had an optimal antibacterial effect in the urine.

Order D-Mannose from The Lowdown

Differences between D-mannose and cranberry

ComparisonD-mannoseCranberry
How do you take it?– Capsule
– Powder (mix with water)
– Capsule
– Juice
What do the research studies suggest?Research is promising, showing statistically significant results vs placebo. In one study, the results show that with the patient group who were administered D-mannose, 12.5% had bacteria in urine after 2-month follow-up versus 90% of the control group (that didn’t take D-mannose)Mixed!
Some studies show improvement (a 2017 meta analysis reduced incidences of recurrent UTI by 26%), whereas some deem cranberry as ineffective – however, a rate of up to 55% withdrawal from studies could account for some of the mixed results
How does it compare to antibiotics?Shows comparable effectiveness to antibiotics. This is particularly in terms of the preventative effects.Research does not support that cranberries have comparable effectiveness to antibiotics
Preventative effects / recurrent UTIsIn one 2014 study, D-mannose was more effective than the antibiotic trimethoprim/sulfamethoxazole in preventing recurrent infection in 60 womenClinical research shows that the daily dosage of cranberries could reduce up to 50% of recurrent UTIs by inhibiting the number of bacteria in the urine
Side effects*– Can cause diarrhoea
– If you have diabetes, taking D-mannose can make it more difficult to control your blood sugar – please consult your GP before taking D-mannose
– Reflux
– Nausea
– Frequent bowel movements

*If you’re pregnant and experiencing UTI symptoms it is important to speak to a healthcare professional, especially if symptoms worsen or the infection isn’t responding to treatment.

So, D-mannose vs cranberry – which is best?

It’s often the way with medical research but caveat number one is that both D-mannose and cranberry treatments for UTIs need further study through well-designed clinical trials in order to make a totally conclusive statement.

But, from the studies that are out there, and given the comparisons with antibiotics, there seem to be more significant results when evaluating the effects of D-mannose. Furthermore, while D-mannose seems to both prevent future infections and reduce symptoms of an active UTI, cranberries strengths appear to be more on the preventive side.

One potential factor which limits the favourable results for cranberry is that there are no standard formulations. The benefits of the PACs have been well documented but because of the widely varying amounts of cranberry given to participants in studies, this may be why the results are mixed. 

Can I take cranberry and D-mannose together?

Yes, you certainly can taken cranberry and D-mannose at the same time! One 2020 study concluded that administering D-mannose with cranberry extract showed ‘an increase in effectiveness when used in combination with empirical treatment for uncomplicated UTIs.’ So, not only is it safe to take both together, but the overall treatment looks to be more effective. 

Where can I buy D-mannose? 

At the Lowdown we want to make life that bit easier for you, so you can now buy D-mannose capsules directly from us ! If you have any concerns around UTI symptoms, or you’re curious about D-mannose or any other treatments, our lovely team of women’s health GPs are always around for a chat. Alternatively, if you suffer with pain from recurring UTIs, our resident pelvic health physiotherapist may be able to help.

Need help? Talk to our doctors about a women's health issue

Tags
  1. Salvatore, S., Salvatore, S., Cattoni, E., Serati, M., Sorice, P., Torella, M. Urinary tract infections in women. European Journal of Obstetrics & Gynaecology & Reproductive Biology, 2011.
  2. Beerepoot, M., Ter Riet., G., Nys, S. Cranberries vs Antibiotics to Prevent Urinary Tract Infections. A Randomized Double-blind Noninferiority Trial in Premenopausal Women Arch Intern Med, 2011
  3. Hisano, M., Bruschini, H., Nicodemo, A. C., Srougi. M. Cranberries and lower urinary tract infection prevention Clinics (Sao Paolo), 2012.
  4. De Nunzio, C., Bartoletti, R., Tubaro, A., Simonato, A., Ficarra, V. Role of D-Mannose in the Prevention of Recurrent Uncomplicated Cystitis: State of the Art and Future Perspectives Antibiotics. 2021
  5. Fu, Z., Liska, D., Talan, D., Chung, M. Cranberry Reduces the Risk of Urinary Tract Infection Recurrence in Otherwise Healthy Women: A Systematic Review and Meta-Analysis. Journal of Nutrition. 2017
  6. Ala-Jaakkola, R., Laitila, A., Ouwehand, A. C., Lehtoranta, L. Role of D-mannose in urinary tract infections – a narrative review. Nutrition Journal. 2022
  7. NHS. Urinary tract infections (UTIs)
  8. NHS Sepsis
  9. Howell, A.B., Botto, H., Combescure, C et. al. Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infectious Diseases. 2010. 
  10. Domenici, L., Monti, M., Bracchi, C. et. al. D-mannose: a promising support for acute urinary tract infections in women. A pilot study. European Review for Medical and Pharmacological Sciences. 2016. 
  11. Porru, D., Parmigiani, A., Tinelli, C. et al. Oral D-mannose in recurrent urinary tract infections in women: a pilot study. Journal of Clinical Urology. 2014.

Emma is a Pharmacology & Physiology graduate with a huge passion for women’s health. Outside of work you’ll find her with a nose in a book, open water swimming or charging around with her standard poodle Zeki!