Issue 3 - February 2003

The matter with bladders
Nutritional supplements fight the battle against UTIs
By Linda S. Rhodes, DC

Urinary tract infections send patients to their doctors’ offices more than 10 million times a year. And although six percent of individuals who have UTIs visit their physicians first, about 60 percent pay for out-of-pocket alternative therapies that promise natural results without side effects.
That number is forecasted to grow to 90 percent by 2010.

As patients look for alternatives for this common problem, chiropractors are positioned to help them identify the best natural solutions.

Symptoms and susceptibility
Over 90 percent of all bladder infections are caused by E. coli in the genitourinary tract, which produces classic symptoms of burning, pressure, urgency, incontinence and painful urination. Urine may be cloudy and have blood or debris.

Nursing home residents, patients with catheters, healthcare personnel and bedridden patients or their families are at higher risk due to greater exposure. Female patients are more prone due to the anatomical structure of the urethra. UTIs are also common with wheelchair-bound patients, paraplegics, quadriplegics, post-surgical patients and those who are incontinent because of aging.

UTIs can be traced to a number of different causes, including nutritional deficiencies and drug-induced imbalances in body chemistry resulting from the use of such things as oral contraceptives that alter levels of microorganisms in the body, NSAIDS like ibuprofen that deplete vitamins C or B, and other common OTC remedies such as antacids that interfere with nutrient absorption.

Alternatives to antibiotics
Physicians commonly prescribe antibiotics to relieve symptoms of UTIs. Antibiotics, however, may take several days to work and their long-term use can deplete a host of vital nutrients like calcium and magnesium (related to the onset of osteoporosis), potassium, carotenoids, enzymes, iron, zinc, copper, B3, B6, B12, folic acid and vitamins D and K (coagulation). They also reduce absorption.

The indiscriminate use of antibiotics can result in bacterial resistance that requires ever-increasing dosages. Non-selective antibiotics, including those in meat, destroy favorable flora that keep overgrowth in check. Resulting dysbiosis can itself lead to chronic bladder infections.

Supplemental solutions available
When patients manifest symptoms of bladder infections and ask you, as their primary-care physician, for advice, you can provide natural means to attack the infection, alleviate pain and encourage a return to a healthy urinary state, through nutritional supplements:

• D-Mannose. A close cousin of glucose and fructose, D-Mannose was first introduced in the United States by practicing medical doctor and author, Dr. Jonathan Wright (Nutrition & Healing newsletter) and researched at the University of Sweden. D-Mannose studies are currently underway at Cornell University.

This naturally occurring hexose sugar derived from ivory nuts relieves bladder infections in 12-24 hours for most cases and has no adverse reactions with other medications. It has no side effects, is safe for children and diabetics and is easy to administer.

An independent clinical study by a practicing urologist is tracking individual patient responses in a variety of acute and chronic UTI cases. The reports to date show rapid and replicable results using D-Mannose for men and women, including supra pubic implants, post cancer patients, MS sufferers who have lost bladder function, trauma cases and menopause due to estrogen deficiencies. It has also reduced the number of hospital visits for chronic cases that had previously required emergency room services. Results indicate D-Mannose taken daily is an effective UTI preventative, especially for age-related problems.

The D-Mannose molecule is a normal part of the physiological make-up of the bladder lining which protects it against caustic urine. Taken with plenty of water (a key element for maintaining bladder health), D-Mannose disables the E. coli by surrounding its lectin (filament arms) that bury into the mucosal wall. The bacteria are then rinsed out with normal urination. Because the microbes are not destroyed, there is no bacterial resistance and no mutation of strains. D-Mannose may also have an anti-inflammatory effect for hard-to-treat interstitial cystitis and soothes denuded tissues after cancer treatment. Because it is a natural substance found in the body, over-dosing is virtually non-existent.

• Cranberry capsules. Cranberries are historically linked to healthier bladders due to the formation of hippuric acid in the urine. They are also thought to have a high content of D-Mannose, fructose, glycoproteins, and condensed tannins, which prevent bacteria from adhering to the mucosal wall.

One trial study showed 74 percent of subjects (44 women and 6 men) who consumed 16 oz of pure, non-sweetened cranberry juice daily, eliminated urinary infections. Another study demonstrated that 15 ounces of cranberry juice reduces bacterial growth in the urine by 80 percent.

High sugar content of commercial juice interferes with its healing capacity, making capsules a popular means of consumption for children and adults. Cranberry capsules increase the acidity of the urine, which acts as an antibacterial. A minimum dosage of 300-400 mg twice/day or juice that is at least 30 percent concentration is required to get the desired effect.

• White willow bark. For accompanying abdominal and urethral pain, white willow bark (Salix alba) contains salicin, an anti-inflammatory component converted in the liver to acetylsalicylic acid or natural aspirin. Long used for urinary discomfort, its tannin content is effective as an antiseptic and astringent for bladder infections. Natural aspirin may reduce pain as effectively as Pyridium (Phenazopyridine), a urinary tract analgesic commonly prescribed for reducing urgency and painful urination (turns the urine bright orange). Peptic ulcer patients are advised to use caution with salicylic acid.

• Additional supplements. Vitamin C with cranberry capsules has been shown to enhance effects in the urethral mucosa. Other nutrients that aid the urinary tract include essential fatty acids (heals the epithelium), the B Complex (deficient in yeast infections), calcium and magnesium (to relieve stress), vitamin E (reduces irritation), colloidal silver (a natural antibiotic) and garlic (antifungal).

Urinary tract infections need immediate attention. Left untreated, 55 percent of UTIs ascend to the kidneys and can become potentially life threatening. Fever, nausea, back pain, scarring, loss of appetite, renal swelling and kidney failure distinguish these from bladder symptoms. The incentive is to clear out the cause of the UTI as rapidly as possible with the least invasive process. As a complementary alternative to conventional treatment, chiropractic and nutraceuticals create a healthier process of elimination.

Health editors who watch these trends report that in a try-natural-first environment, if you are providing therapeutic regimens that are nutritionally sound, convenient, economical and easy to obtain, your ratio of satisfied patients is markedly increased as well as your percentage of new cases.

Linda Rhodes, DC, is managing editor of HealthSense, a nutritional publication from the American Council on Collaborative Medicine.

References:
Pelton, Ross, R.Ph., and LaValle, James B., R.Ph. The Nutritional Cost of Prescription Drugs. Englewood, Colorado: Morton Publishing Company, 2000. Pages 2-23.
Zand, Janet, L.Ac., O.M.D., Walton, Rachel, R.N., and Rountree, Bob, M.D. Smart Medicine for a Healthier Child. Garden City Park, New York: Avery Publishing, 1994. Pages 408-414.
Murray, Michael T. The Healing Power of Herbs. Rocklin, California: Prima Publishing, 1995. Pages 350-351.
PDR for Herbal Medicine. Montvale, New York: Medical Economics Company. Second Edition, 2001. Pages 607-608.
Null, Gary, Ph.D. The Complete Encyclopedia of Natural Healing. Greenwich, Connecticul: Kensington Publishing Corp., 2001. Pages 343-348.
Balch, James F., M.D., and Balch, Phyllis A., C.N.C. Prescription for Nutritional Healing. New York, New York: Penguin Putnam, 2000. Pages 216-219.
Wright, Jonathan V., M.D. D-Mannose & Bladder Infection. Auburn, Washington: Dragon Art, 2001.
a) Michael Blue, M.D., Board Certified Urologist. Oklahoma City, Oklahoma. (clinical studies). b) Natural Business Lohas Journal. “Supplementing a Practice.” May/June 2000. Pages 55-58. c) Center for Women’s Health. CPMCNET.Columbia.edu\dept\cwh\news.html from the Irving Public Library, Irving, Texas. d) Caring for the Ages. Marilyn Larkin, Editor. Published by Lippincott Williams & Wilkins. “Diagnosing and Managing Urinary Tract Infections: Myths, Mysteries, & Realities.” Vol. 3, No. 10, October 2002. Pages 18-21.
HealthNotes Clinical Essentials. Science Based Reference of Complementary and Alternative Medicine, Vol. 1, 2000. “Drug-Herb-Supplement Depletions/Interactions.”