What’s the lowdown?
- Despite limited studies, some people have found that taking D-mannose daily has helped to prevent and sometimes treat UTIs
- The NHS now lists D-mannose supplements as a suggested way to prevent recurring UTIs, although it is not recommended for use if you’re pregnant
- If effective, D-mannose could be a good alternative to antibiotics. This could prevent antibiotic resistance
- You can now buy D-mannose via The Lowdown
What is a urinary tract infection?
Ah, the urinary tract infection (UTI) sixth sense. Many of us can feel a UTI¹ coming from a mile away – the dreaded lower back pain, the urgency to pee more than usual – it’s enough to send you fleeing to the supermarket and chugging down litre upon litre of cranberry juice in a desperate attempt to stave off the inevitable. They’re uncomfortable and inconvenient and can affect the best of us – in fact 50% of women will suffer from a UTI at some point in their life, with a quarter going on to suffer from recurrent UTIs which can severely impact quality of life.10
The majority of UTIs are caused by Escherichia coli – a bacteria that resides in the intestine as part of normal, healthy gut flora. This bug can become problematic when it finds its way to the urinary tract and subsequently causes an infection in the bladder, urethra, or the kidneys.
UTIs are a colossal inconvenience and not nearly spoken about widely enough, and although they can affect men, women are more susceptible due to having a shorter urethra (the tube you pee from) which means bacteria have a shorter distance to travel to reach the bladder or kidneys and cause infection. Common UTI symptoms can include:
- Pain, or a burning sensation when you pee
- Pain in your lower back or tummy
- Cloudy urine
- Needing to pee more than usual
How are UTIs treated?
Antibiotics are currently the go-to treatment for recurrent UTIs. In the UK common antibiotics used to treat UTIs include:
- trimethoprim
- nitrofurantoin
- amoxicillin
- cefalexin
These antibiotics may cause side effects – nausea, vomiting, diarrhoea, headaches, to name a few. Not to mention that pesky little looming global crisis called antibiotic resistance which could mean that, over time, a UTI may no longer respond to antibiotic treatment.
A while ago, we did a Sunday Surgery session on our Instagram where loads of our community raved about taking D-mannose as a preventative measure for UTIs, so we decided to do a little digging.
What is D-mannose and how does it work?
D-mannose is a naturally-occurring, simple sugar, closely related to glucose. It is found in small amounts in food like: oranges, peaches, cranberries, apples, and coffee, and can now also be bought as a food supplement.
It’s understood that D-mannose binds to bacteria within the urinary tract, and prevents it from attaching to the cells of the bladder wall. This means it is harder for the bacteria to grow and cause symptoms of a UTI. Unable to attach to the wall, bacteria are flushed out in urine and eliminated from the urinary tract.
How much D-mannose to take for a UTI
People have found most success in taking D-mannose as a preventative measure, rather than as treatment for an active UTI. A 2016 pilot study5 which included women who had symptoms of a UTI and/or a history of recurrent UTIs concluded that taking D-mannose may be effective in both the treatment and prevention of UTIs. As D-mannose is considered a supplement, and not medication, there isn’t much indication on the exact recommended dosage of D-mannose. One clinical trial9 administered 2g of D-mannose powder dissolved in 200 mL water daily to study participants. For now, we’d suggest carefully reading and following the instructions indicated on the packaging and talking to your doctor or pharmacist beforehand.Can I take D-mannose with antibiotics?
If you have been diagnosed with an acute UTI, you may be prescribed antibiotics by your healthcare professional to treat this. D-Mannose can be used alongside prescription antibiotics.
If you have recurrent UTIs and use D-Mannose as a preventative treatment, you may avoid getting a full-blown UTI altogether; avoiding the need for antibiotics.
Does D-mannose really work?
In 2022, a review of all the research into D-mannose and UTIs was published.
The authors stated that, although the research isn’t perfect (most research was conducted in Italy, and doesn’t include many postmenopausal women), it consistently suggests that D-mannose works. This is both to prevent recurrent UTIs and to treat acute UTI symptoms.11
We’ve had countless testimonials from the Lowdown community singing D-mannose’s praises when it comes to preventing UTIs, especially after sex.
Does D-mannose cause side effects?
Again, there’s rather limited information on side effects due to the lack of studies. The most common side effect that users have mentioned is diarrhoea. One clinical trial⁷ noted fewer side effects with D-mannose compared to antibiotics.
Who should not use D-mannose?
Pregnant women should avoid taking D-mannose, as advised by the NHS. If you have symptoms of a UTI during pregnancy, speak to your healthcare provider about treatment as soon as possible to avoid complications.
D-mannose is metabolised differently to glucose, so is not considered problematic to those who have diabetes. However, it’s probably worth discussing this with your doctor beforehand. Also be mindful that many of the powder supplements found in health shops contain a high concentration of other sweeteners.
So, should I use D-mannose?
To sum up, many of our community swear by D-mannose to stave off UTIs before an infection forms – and our whole thing is listening to personal experiences when it comes to women’s health.
Research is promising that it works and there are few side effects or risks,.
The good news is that if you did want to try D-mannose to prevent UTIs, compared to the standard antibiotics, D-mannose has comparatively fewer side effects and doesn’t add to the development of antibiotic resistance in bacteria associated with UTIs.
Tags
- NHS UK, Urinary Tract Infections
- NHS UK, Nitrofurantoin
- Scribano, D., Sarshar, M., Prezioso, C., Lucarelli, M., Angeloni, A., Zagaglia, C., Palamara, A.T., & Ambrosi, C (2020) D-Mannose Treatment neither Affects Uropathogenic Escherichia coli Properties nor Induces Stable FimH Modifications. Molecules, 25(2): 316. https://doi.org/10.3390/molecules25020316
- NICE Guideline (2018, October 31), Urinary tract infection (recurrent): antimicrobial prescribing, NICE guideline [NG112]
- Domenici, L., Monti, M., Bracchi, C., Giorgini, M., Colagiovanni, V., Muzii, L., & Benedetti Panici, P. (2016) D-Mannose: a promising support for acute urinary tract infections in women. A pilot study. European Review for Medical and Pharmacological Sciences 2016;20: 2920-2925 https://www.europeanreview.org/article/11121
- Huddleston, A. (2021) D-Mannose UTI. [Podcast]. 16 May 2021. Available at: https://anchor.fm/andrea-huddleston/episodes/Ep-1-D-Mannose-UTI-e106pfa
- 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 & Gynecology, 223(2), P265.E1-265.E13 https://doi.org/10.1016/j.ajog.2020.05.048
- Franssen, M., Cook, J., Robinson, J., Williams, N., Glogowska, M., Yang, Y., Allen J., Butler, C.C., Thomas, N., Hay, A., Moore, M., & Hayward, G., (2020) D-MannosE to prevent Recurrent urinary tract InfecTions (MERIT): protocol for a randomised controlled trial. BMJ Open, 2021;11:e037128
doi:10.1136/bmjopen-2020-037128 - Kranjčec, B., Papeš, D., & Altarac, S. (2013) D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World Journal of Urology, 32, 79-84 (2014), https://doi.org/10.1007/s00345-013-1091-6
- Aydin A, Ahmed K, Zaman I, Khan MS, Dasgupta P. Recurrent urinary tract infections in women. Int Urogynecol J. 2015 Jun;26(6):795-804.
- Parazzini F, Ricci E, Fedele F, Chiaffarino F, Esposito G, Cipriani S. Systematic review of the effect of D-mannose with or without other drugs in the treatment of symptoms of urinary tract infections/cystitis (Review). Biomed Rep. 2022 Jun 15;17(2):69.
Li Sa is a medical writer and previously trained as a microbiology clinical scientist with the NHS. She is passionate about making science clear and accessible to everyone and has worked in creating digital science content for children, and even worked as a science presenter at kids events! She also works as a freelance scientific proofreader and music reviewer.
