Can Cranberry Juice Really Treat My UTI?
Article by Maya Tu
I am pretty sure we have all heard of treating UTIs (urinary tract infections) with cranberry juice, but is there actually any scientific evidence to suggest it's an effective treatment method or is it actually a bit of a myth? This blog post will get to the bottom of the research to answer those questions!
Let’s start at the beginning…
What are Urinary Tract Infections?
As the name suggests, a UTI is an infection that can occur in any part of the urinary system. So this includes the urethra, bladder, kidneys and ureters (1). That being said, most infections, usually caused by the bacterium Escherichia coli, are seen in the bladder and the urethra, which are part of the lower urinary tract (1). Unfortunately, UTIs are a very common health issue, with women being at a greater risk of developing them compared to men. Symptoms include, a strong urge to urinate, a burning feeling when urinating, pelvic pain and also needing to urinate often. They can be painful as well as annoying, and it is important for them to be treated quickly as UTIs can spread to the kidneys if left for too long untreated.
Treatment options usually include antibiotics as the first type of treatment to be administered. And depending on the type of bacteria found, causing the UTI, a specific antibiotic will be recommended. Despite this, there has been debate about whether other treatment methods are successful. It isn’t recommended to continuously use antibiotics as they can reduce the good bacteria found in the gut, reducing the microbial diversity, as well as increasing the likelihood for antibiotic resistance (2). And so for individuals who are prone to UTIs, looking for an alternative option can seem appealing.
These alternative treatment methods include cranberry products, including cranberry juice and cranberry extract, in both tablet and capsule forms. But do these really work?
Cranberry Products as Treatment
What makes cranberries a possible treatment for UTIs? Research highlights that cranberries may have antibacterial properties that help to manage and possibly reduce symptoms of UTIs (3). The mechanisms require further research but cranberries contain proanthocyanidins (PACs) which may prevent adherence of bacteria to epithelial cells lining the urinary tract, reducing symptoms (4). Interestingly, the current clinical trials suggest that the effects of cranberries are prophylactic, meaning they protect against or prevent the recurrence of infection, but despite this, it is important to know that this is much less effective in individuals who are at a higher risk of developing UTIs (3). Therefore, consuming cranberries may be more beneficial to those who are at a lower risk of developing them.
When compared to antibiotics, cranberry products show little benefit in symptom management and there does not seem to be a difference in risk of UTIs when different doses of PACs are given but research indicates that further evidence is required to understand whether efficacy differs between the types of product and duration of therapy (4). It is also important to consider how these products differ depending on age groups. Research is currently controversial when it comes to whether these products are effective in elderly individuals.
Evidently, individuals should not rely on cranberry juice or cranberry products, as the evidence and efficacy are not strong enough, but possibly use them as complementary therapy alongside antibiotics to reduce symptoms during the infection and possibly prevent risk of recurrence.
Other Options
There are a few other options that could be tried, however, the evidence for taking them after the infection has already started is very limited.
Sodium Citrate
Sodium citrate sachets can be used, as they work to make urine less acidic, therefore reducing the burning sensation that can be experienced during a UTI. These kinds of alkalising agents, however, can sometimes interact with antibiotics, influencing the behaviour of the antibiotics and can therefore cause potential patient harm (5). Unfortunately, these kinds of products, which are often accessible over the counter or even in supermarkets, are sold without the supervision of healthcare professionals, and therefore need additional warnings written on packs. Ultimately, they may help certain symptoms, however, consulting a healthcare professional prior to choosing these products is key.
D-mannose
D-mannose, a type of sugar found in cranberries and pineapple, has been researched for its potential ability to treat UTIs as well as prevent recurrent UTIs. The mechanisms involved are similar to that of cranberry products. D-mannose helps to prevent the adhesion of bacteria onto uroepithelial cells and this allows for the pathogens to then be cleared by urine (6). Research shows that D-mannose administration can reduce the recurrence rate significantly and increase the time to onset of UTI (6). Similarly, it was observed that compared to antibiotics, the time to UTI recurrence was also longer, therefore suggesting that D-mannose could be used instead of antibiotics, reducing the risk of antibiotic resistance (6). It is important to note that these observations are based on women with acute uncomplicated UTIs (like cystitis or lower tract UTI), not based on other causes or types of UTIs.
Probiotics
Finally, there has been some research to suggest that there is a depletion of urinary microbiota in women who are more susceptible to UTIs compared to healthy individuals and therefore, one could infer that supplementation by consuming probiotics could reduce these infection rates (7). There is some evidence that shows this, however, determining the appropriate bacteria strain, dose and viability is required before relying on probiotics as a treatment.
Summary
Overall, there is a strong body of evidence analysing antibiotics, and further research, especially clinical trials, is required to properly understand the efficacy, possible side effects and correct dosage of alternative treatment options. The first-line treatments offered are therefore still antibiotics. That being said, using the other options, including cranberry products, may be beneficial alongside antibiotics as a type of complementary therapy to reduce symptoms and reduce the risk of a recurrent infection. Making sure to seek guidance from a health professional is the best recommendation before trying any of the above treatment methods.
This blog was written by Maya Tu. Maya graduated with a First-Class Honours in BSc Nutrition and has just completed her Master's in Clinical and Public Health Nutrition, graduating with Distinction. She is a part of Jamie Oliver’s nutrition team and has a passion for childhood and sports nutrition.
References
Mayo Clinic. (2022). Urinary Tract Infection (UTI). https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447 [Accessed 14th June 2024]
Patangia, D. V., Anthony Ryan, C., Dempsey, E., Paul Ross, R., & Stanton, C. (2022). Impact of antibiotics on the human microbiome and consequences for host health. MicrobiologyOpen, 11(1), e1260. https://doi.org/10.1002/mbo3.1260
Mantzorou, M., & Giaginis, C. (2018). Cranberry Consumption Against Urinary Tract Infections: Clinical Stateof- the-Art and Future Perspectives. Current pharmaceutical biotechnology, 19(13), 1049–1063. https://doi.org/10.2174/1389201020666181206104129
Mantzorou, M., & Giaginis, C. (2018). Cranberry Consumption Against Urinary Tract Infections: Clinical Stateof- the-Art and Future Perspectives. Current pharmaceutical biotechnology, 19(13), 1049–1063. https://doi.org/10.2174/1389201020666181206104129
Kavanagh O. N. (2022). Alkalising agents in urinary tract infections: theoretical contraindications, interactions and synergy. Therapeutic advances in drug safety, 13, 20420986221080794. https://doi.org/10.1177/20420986221080794
Wagenlehner, F., Lorenz, H., Ewald, O., & Gerke, P. (2022). Why d-Mannose May Be as Efficient as Antibiotics in the Treatment of Acute Uncomplicated Lower Urinary Tract Infections-Preliminary Considerations and Conclusions from a Non-Interventional Study. Antibiotics (Basel, Switzerland), 11(3), 314. https://doi.org/10.3390/antibiotics11030314
Akgül, T., & Karakan, T. (2018). The role of probiotics in women with recurrent urinary tract infections. Turkish journal of urology, 44(5), 377–383. https://doi.org/10.5152/tud.2018.48742