Preventing UTIs naturally

QUESTION:

I’m a 47-year-old woman and have had three UTIs in the past couple of years. I don’t get on with antibiotics, so I’d love to find a natural way to prevent them. I’m familiar with the usual lifestyle advice like drinking plenty of water, going to the loo when you need to, etc. Can you recommend any effective supplements or other natural remedies?

C.T., via email

ANSWER:

Around half of all women will experience a urinary tract infection (UTI) in their lifetime, with symptoms such as a persistent urge to urinate and burning pain when urinating. Some 20 to 30 percent of these women will have a second UTI within six months,1 and as many as 6 percent will suffer three or more infections during a given year.2

These nasty infections are usually caused by bacteria entering the urinary tract via the urethra (the tube that allows urine to pass outside the body) and multiplying in the bladder. Women are especially susceptible because of their anatomy—the close proximity of the urethra to the anus and the short distance from the urethral opening to the bladder.

The conventional answer for both prevention and treatment is antibiotics, but these can come with serious side-effects, from breathing problems and liver injury (linked to nitrofurantoin) to permanent nerve damage and detachment of the retina (with fluoroquinolones).3 

There’s also the growing problem of antibiotic resistance and the havoc wreaked by the drugs on the body’s microbiome, which plays a vital role in overall health.4

But there are a number of good alternatives to antibiotics you can try to help stop you getting another UTI. Here’s our handy guide.

Dose up on D

Recent research suggests that low levels of vitamin D are linked to UTIs.5 It makes sense because vitamin D plays a key role in immune regulation and preventing infections. Work with a practitioner who can get your D levels tested and advise on the right dose for supplementation, or try a home testing kit—available via the Vitamin D Society (www.vitamindsociety.org) and Better You (www.betteryou.com), along with personalized recommendations on how much to take.

Drink cranberry juice

Cranberry juice is a popular remedy for recurrent UTIs—and there’s some solid science behind it. While there’s not much evidence that it can get rid of a UTI once you’ve got one, drinking cranberry juice or taking cranberry tablets or powder appears to be an effective preventative. 

In one pooled analysis of seven trials, taking some form of cranberry reduced the risk of UTIs by more than a quarter.6 It appears to work by stopping the bacteria that cause UTIs from sticking to the walls of the urinary tract, so it’s more likely to be flushed from the body.7

Suggested dosage: 300–500 mL/day of unsweetened cranberry juice or 400 mg of concentrated cranberry extract twice a day

Try D-mannose

This simple sugar found in fruits seems to work in a similar way to cranberry products—by preventing bacteria from sticking to the urinary tract.8 A recent review found it to be protective against recurrent UTIs, with “possibly similar effectiveness as antibiotics.”9 

D-mannose supplements are widely available online, often formulated in combination with cranberry extract.

Suggested dosage: follow the label instructions

Eat garlic

Garlic is a potent antimicrobial, and lab evidence shows that extracts of garlic are effective against multidrug-resistant bacteria involved in UTIs.10 

Try adding raw garlic to your food as much as possible, or take it as a supplement.

Suggested dosage: 1,000 mg/day aged garlic extract

Go veggie

In a recent study of Taiwanese Buddhists, a vegetarian diet was associated with a 16 percent lower risk of developing a UTI compared to meat eating. This could be because meat is a major reservoir for strains of bacteria that commonly cause UTIs, the researchers said. Or it may be more to do with vegetarian diets being rich in microbe-fighting phytochemicals that can fend off UTIs.11

More research is needed, but you could try giving up meat to see if that makes a difference (just make sure to do your research beforehand on how to eat a healthy, varied vegetarian diet). Or simply cut down on meat and focus on eating more plant-based meals including a wide variety of beneficial fruits, vegetables and nuts.

Get the good bugs

Lactobacillus-containing probiotics appear to be useful for preventing UTIs. Lactobacilli are the dominant bacteria of the vaginal flora and possess antimicrobial properties that help keep infections at bay.12 In one study of postmenopausal women prone to UTIs, a probiotic supplement containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 cut the number of recurrences by more than half over a year. The supplement wasn’t quite as effective as antibiotics, but it had the advantage of not leading to the appearance of drug-resistant bacteria or damaging the health of the all-important microbiome.4,13 Lactobacillus vaginal suppositories also seem to work well for reducing recurrent UTIs.14

Suggested dosage: choose a high-quality supplement containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, such as Optibac For Women, and follow the label instructions; or try a probiotic vaginal suppository like Gyntima Probiotica Forte 

Opt for acupuncture

Acupuncture is beneficial for both the treatment and prevention of recurrent UTIs, according to a recent review—and may be even more effective than antibiotics.15  To find an acupuncturist near you, visit www.acunow.org. 

Get help from hibiscus

Hibiscus sabdariffa, also known as roselle, is showing promise for preventing UTIs. It’s proven effective against UTI-causing bacteria,18 and a study of residents with catheters in long-term care facilities found that taking hibiscus as a drink reduced the incidence of UTIs.19

Suggested dosage: make a tea from the dried flowers (see below for how to make an herbal tea) and drink regularly

Stock up on vitamin C

Vitamin C may help prevent and treat UTIs by acidifying the urine, creating a hostile environment for infection-causing bacteria.16 In a study of pregnant women—a group prone to UTIs—those given daily supplements including 100 mg vitamin C (ascorbic acid) had significantly fewer UTIs than women given supplements without the vitamin.17

Suggested dosage: 100–5,000 mg/day ascorbic acid (or take to bowel tolerance)

Try this herbal tea remedy

For treating an active infection, herbalist Meilyr James, owner of the Herbal Clinic in Swansea, Wales (www.herbalclinic-swansea.co.uk), recommends making an herbal tea with the following herbs. 

A tea is the best way to take the herbs, says James, as the additional fluid assists with flushing and cleansing the bladder. Just remember to see a doctor if your symptoms don’t improve after a few days or get worse.

Bearberry (Arctostaphylos uva-ursi) contains the glycoside arbutin, which has antimicrobial properties, and tannins, which tighten and tone the mucous membranes of the bladder wall, helping to reduce inflammation and prevent microorganisms from attaching.

Corn silk (Zea mays). This soothing, diuretic herb contains a healing mucilage that calms inflammation and helps to relieve sensations of burning when urinating.

Buchu (Agathosma betulina).This herb has antiseptic and anti-inflammatory properties, and it encourages increased urination, which helps to flush out microorganisms. 

Meadowsweet (Filipendula ulmaria) is a urinary antiseptic with immune-stimulating properties as well as pain-relieving and anti-inflammatory effects. 

What to do:

• Combine equal parts of the dried herbs. 

• Add 15 g of herbs to 1 L of boiled water and leave to infuse for half an hour. 

• Drink over the course of the day, taking about a third each time.

Due to the high tannin content of bearberry, this tea is advised for short-term use only (up to one month). Take as soon as signs appear. For a preventative, take meadowsweet as a tea on its own