What is D-mannose and how does it help with cystitis?

D-mannose impresses with its effectiveness

Although D-mannose is still relatively unknown in medicine, hundreds of thousands of people who suffer from urinary tract infections and cystitis swear by its ability to quickly eliminate and prevent these conditions in a natural way. Doctors who are already familiar with D-mannose achieve impressive results when they recommend it to patients who have previously been dependent on antibiotics.

D-mannose is a natural sugar and works because E. coli bacteria have a higher affinity for D-mannose and attach themselves to it instead of the bladder wall. This causes the bacteria to be flushed out of the urinary tract in a completely natural way via the urine flow. [1] 

Due to its rapid, side-effect-free, and reliable effect, more and more doctors are recommending D-mannose instead of antibiotics as a safe and effective therapy for treating bladder infections and urinary tract infections, as well as a preventive measure for maintaining urinary tract health.

Urinary tract infections in women and men

Urinary tract infections are very common. Every year, around eight million people in the US alone seek medical attention for this condition. [2] Around half of all women suffer from a urinary tract infection at least once in their lives.

In more than 20 percent of women, the infection is recurrent, and some suffer from three or more urinary tract infections per year. 

But men can also get bladder infections, especially if they have an enlarged prostate.

And if not nipped in the bud, the infection can travel up the urethra and spread to the entire bladder. This full-blown infection causes fever, chills, lower abdominal pain, and may result in blood in the urine.

In 90% of cases, the infection is caused by the bacterium Escherichia coli (E. coli), which enters the bladder from outside via the urethra. Women suffer from bladder infections more often than men because the opening to the urethra is closer to the anus than in men and the most likely trigger is E. coli, which lives naturally in the intestine.

However, if E. coli enters the urinary tract, the bacteria attach themselves to the lining of the bladder with finger-like protrusions, causing irritation and inflammation, which lead to the typical symptoms of a urinary tract infection, such as frequent urination, burning, pain, and discomfort.

Doctors almost always prescribe antibiotics to treat urinary tract infections.

The problem is that antibiotics not only kill harmful bacteria, but also the beneficial, health-promoting bacteria in the intestines, vagina, and urinary tract. This greatly reduces the body's own defenses, which in turn promotes new infections, such as vaginal yeast infections or recurrent bladder infections.

This creates a vicious cycle that makes antibiotic treatment necessary again and again. Therefore, a good probiotic should always be taken after every course of antibiotics to rebuild the intestinal flora. However, keep in mind that it can take several months to rebuild a healthy intestinal flora after a course of antibiotics.

D-mannose – the natural alternative

A natural treatment is the preferred choice over antibiotics. Cranberry juice is a well-known option. However, since sugar is added to most commercially available juices, drinking large amounts of cranberry juice is not ideal, as sugar can promote the very bacteria you are trying to get rid of. Cranberry capsules are more suitable. However, D-mannose is the most effective natural treatment for urinary tract infections.

In recent years, this special natural sugar has been studied and found to have similar receptors (specific binding sites) to those found on the inner wall of the bladder, where bacteria, especially E. coli, attach and cause irritation. Therefore, a high concentration of D-mannose in the urine causes the bacteria to attach themselves to D-mannose rather than to the bladder wall. The bacteria are then excreted in the urine, causing the symptoms of the urinary tract infection to disappear.

D-mannose is a simple sugar that is structurally related to glucose and occurs in small amounts in many fruits, including peaches, apples, oranges, cranberries, and blueberries. D-mannose can also be produced in the body itself. Due to various circumstances, the concentration of D-mannose in the urinary tract may be too low, preventing the body's own defense mechanism from working. D-mannose has been shown to reduce the number of bacteria in rats in a dose-dependent manner. In fact, D-mannose has also been shown to significantly reduce the number of bacteria in just one day. [3] 

 D-mannose is a safe and natural dietary supplement. Taking a sufficient amount of D-mannose powder is therefore a simple and effective treatment and can also be used to prevent urinary tract infections. [4] 

D-mannose is not metabolized and therefore has no effect on blood sugar. This also makes D-mannose a safe dietary supplement for diabetics.

D-mannose can also be taken in low doses over the long term without side effects. This is particularly important for people who suffer from recurrent urinary tract infections.

D-mannose effect

The cell walls of E. coli bacteria have tiny, finger-like protrusions called fimbriae. These allow them to attach themselves to the inner wall of the bladder and thus migrate up the ureters to the kidneys.

Because E. coli adhere to the urinary tract, they cannot be easily excreted during urination.

These small finger-like protrusions on the surface of the bacterium consist of an amino acid-sugar complex, a glycoprotein called lectin, which makes them sticky. Mannose has similar receptors to the wall of the bladder. Mannose is produced naturally by the cells and coats the inner wall of the urinary organs. [5] 

However, if insufficient mannose is produced, the body's defense mechanism does not work efficiently and the bacteria instead adhere to the inner wall of the bladder and urinary tract.

When D-mannose is ingested, it passes through the kidneys into the urine. The mannose-enriched urine bathes and coats the existing E. coli bacteria. Since D-mannose adheres even better to the lectins of E. coli than the lectins of E. coli adhere to human cells, the E. coli detaches from the bladder wall and attaches itself to the D-mannose molecules. This allows the bacteria to be effectively flushed out of the urinary tract with the urine. [6] [7] 

Another potential theory for how D-mannose works could be its relationship to the Tamm-Horsfall protein, a glycoprotein that plays a key role in the body's defense against urinary tract infections. It has even been suggested that D-mannose works primarily by promoting the activation of the Tamm-Horsfall protein. [8] 

Try D-mannose

Antibiotic therapy is increasingly being called into question as a growing number of superbugs outsmart our antibiotics and render them ineffective. Antibiotics should only be used in medicine, livestock farming, and agriculture when absolutely necessary.

Fortunately, urinary tract infections can be effectively treated without antibiotics in most cases by using D-mannose. Therefore, D-mannose should always be tried first for urinary tract infections.

It is important to know that D-mannose only works for urinary tract infections caused by the bacterium E. coli. This accounts for more than 90 percent of infections. To be sure, your doctor may order a urine culture to identify the bacteria present. This will tell you whether the infection is one of the few cases not caused by E. coli.

D-mannose is very safe to use, even over the long term, although most women and men only need to take it for a few days.

Although D-mannose is a simple sugar, very little of it is metabolized. It does not affect blood sugar regulation, even in diabetics. It does not cause any disturbance or imbalance in the body's normal microflora.

It is safe even for pregnant women and very young children. In less than 10% of cases where the infection is caused by a bacterium other than E. coli, antibiotics can be started in a timely manner.

The majority of urinary tract infections can be cured by taking D-mannose and following the hygiene steps below when symptoms first appear, and recurrence can be prevented altogether.

Occasionally, a kidney infection may develop despite preventive measures. If you suspect you have a kidney infection (symptoms include fever and back, side, groin, or abdominal pain), you should see a doctor as soon as possible.

It is crucial to prevent the infection from spreading to the kidneys, which can be life-threatening or lead to kidney failure.

D-mannose dosage and application

D-mannose is safe for both adults and children. It is effective in the treatment of acute urinary tract infections and cystitis, for prevention in women who are prone to recurrent infections, or for the prevention of urinary tract infections after sexual intercourse. [9] 

• For the treatment of urinary tract infections: 1 teaspoon (approx. 2 grams) for adults, ½ to 1 teaspoon for children, dissolved in a glass of water, repeat every two to three hours. Continue this dosage for two to three days after the symptoms have disappeared.
• For the prevention of chronic, recurrent urinary tract infections: Take 1 teaspoon daily for an indefinite period, dissolved in a glass of water.
• For the prevention of urinary tract infections after sexual intercourse: Take 1 teaspoon one hour before sexual intercourse and another teaspoon immediately afterwards.

D-mannose side effects

D-mannose is extremely safe and very well tolerated. No side effects are known to date. D-mannose can therefore be taken by all groups of people, including children, pregnant women, and breastfeeding mothers.

D-mannose can also be taken in combination with antibiotics without impairing their effectiveness or losing its own effectiveness.

D-mannose or cranberry juice – which works better?

Cranberry juice is also known to prevent and treat urinary tract infections. Scientists have found that cranberries also contain D-mannose, which prevents certain bacteria (E. coli) from sticking to the inner wall of the bladder. This means that bacteria can be flushed out during urination before they multiply and cause an infection.

Although D-mannose is found in cranberries, cranberries do not contain sufficient amounts to have the same effect as pure D-mannose powder. However, cranberry juice and cranberry extract in capsules contain proanthocyanidins, which also prevent E. coli from sticking to the urethra and bladder. [10] Cranberry extract also has an immune-stimulating effect. D-mannose and the proanthocyanidins in cranberry extract may therefore have a beneficial synergistic effect on the urinary tract when combined.

There are some problems with cranberry juice: to effectively prevent urinary tract infections, you would need to drink a glass of cranberry juice every day.

Most cranberry juices contain a lot of sugar. This impairs immune function and is a welcome food source for the E. coli bacteria that you actually want to fight. Unsweetened cranberry juice would be an option, but most people do not like the intense sour taste. Cranberry capsules are an alternative to D-mannose and many people have had good results with them. 

However, D-mannose is generally considered to be the more effective remedy and is therefore growing in popularity.

Pure, concentrated D-mannose powder is the better alternative and is 10-50 times more effective than cranberry juice. D-mannose stops most urinary tract infections within a few days and can be used for both prevention and treatment.

D-mannose – just as effective as antibiotics?

In a study involving more than 300 women who suffered from recurrent urinary tract infections, the women were given either two grams of D-mannose or 50 milligrams of an antibiotic every day for six months.

Only 15 percent of those who took D-mannose had a recurrent urinary tract infection, compared to 20 percent of the antibiotic group (both of which were significantly lower than the untreated group).[11] However, the frequency of side effects was significantly lower in the D-mannose group than in the antibiotic group.

Dr. Jonathan Wright was one of the first doctors to start treating urinary tract infections with D-mannose more than 20 years ago. Based on his experience with over 200 patients, the treatment is 85-90 percent effective.

Frequently Asked Questions About D-mannose

D-mannose has been shown to be useful for bladder infections caused by bacterial E. coli urinary tract infections (which are thought to be the cause of about 90% of cases) and some other rarer bacteria, so D-mannose is effective for most people. It may be less effective for interstitial cystitis, although some early reports from researchers suggest that it may help after prolonged use, perhaps because there are mannose receptors in the bladder wall. However, it is not yet clear why this is the case.

This varies from person to person. Some people experience relief within a few hours. For others, it may take a little longer, depending on how far the bacteria have spread.

Most symptoms disappear within a few days of continuous use of D-mannose. However, it is advisable to continue taking D-mannose for a few days longer, even if the symptoms have subsided. People who suffer from recurrent bladder infections find it helpful to take D-mannose daily over the long term. In most cases, 1/2 to 1 teaspoon per day is sufficient to remain infection-free.

This is particularly helpful for people who are prone to urinary tract infections, such as those with spinal injuries, multiple sclerosis, chronic constipation, incontinence, bedridden individuals, and any condition that affects the bladder.

Yes, D-mannose can be taken together with antibiotics. However, in most cases, D-mannose works so well that antibiotics are not necessary. If you have already started antibiotic therapy and would like to take D-mannose as well, it will not interfere with the effectiveness of the antibiotics or interact with them in any way.

If D-mannose does not clear up the bladder infection after a few days, you should see your doctor as soon as possible, as the infection may have been caused by a rarer bacterium and an untreated urinary tract infection can be dangerous.

D-mannose is a pleasantly sweet-tasting powder that is best mixed with water, but can also be stirred into fruit juice or hot drinks.

Yes. Since D-mannose is a natural type of sugar, it is considered safe to use during pregnancy. Cystitis is more common in pregnant women due to the pressure the baby puts on the bladder. However, if you are unsure or suffer from repeated bladder infections, you should consult your doctor.

Yes, D-mannose can also be taken by children in an appropriately lower dosage, as it is a special form of sugar without additives.

Yes, diabetics can also take D-mannose.

D-mannose is absorbed more slowly by the body than other types of sugar, such as glucose, and therefore causes little to no increase in blood sugar levels. D-mannose is excreted via the kidneys, bladder, and urethra. Along the way, it comes into contact with bacteria, which attach themselves to the D-mannose and are excreted in the urine.

Only a small amount of research focuses specifically on kidney infections and D-mannose. Since a kidney infection is a serious condition, it is not advisable to rely on D-mannose alone for treatment. However, if the kidney infection was caused by E. coli, then D-mannose is likely to help remove the bacteria from this area through excretion via the kidneys, so it can be taken alongside conventional treatment and also as a preventive measure.

When it comes to D-mannose, many people initially think of urinary tract health. However, this unique sugar may also offer other potential benefits. Some studies suggest that D-mannose may be useful as a ‘prebiotic’.

 Prebiotics are substances that promote the growth of beneficial bacteria in your gut. D-mannose could support your health by increasing the number of beneficial bacteria.

There is also evidence that D-mannose may help protect the gastrointestinal tract from lectins. Lectins are proteins found in beans, seeds, grains, and even some vegetables and fruits. They are difficult to digest because they are not broken down by stomach acid or digestive enzymes.

Studies show that D-mannose can help bind and block lectins, preventing them from reacting with and damaging the intestinal wall.