UTI’s are the worst. Okay, maybe getting pelted by porcupine quills is just as bad, but how many porcupines are really trying to cuddle you? So like I said – the worst.
And I’m pretty sure I’m not the only one who thinks so – urinary tract infections are “the second most common type of infection in the body, accounting for about 8.1 million visits to health care providers each year.” (source) Though I haven’t had one in years, one of my children recently developed symptoms of a UTI. I wanted to avoid antibiotics if at all possible, so I tried some research-backed home remedies while keeping our pediatrician in the loop.
In this post, I’m going to share the research I found most helpful in choosing a course of action, what we did personally, and what expert resources have to say about the safety of these remedies for pregnant/nursing moms and children.
Before we jump in, though, I just want to say that “Best Boo-Boo Kisser South Of Puckett’s Gas Station” is about as official as things get for me professionally. I am not a doctor, this is not medical advice, these statements have not been evaluated by the FDA and are not meant to diagnose, treat, or cure any disease, and your medical decisions are completely up to you. If you need some convincing on this, read my full disclaimer where I say it over and over again. Also, it’s a good idea to discuss any herbs or home remedies you consider with your healthcare provider, because some herbs can interact with certain medications. Okay, moving on!
What causes a urinary tract infection?
We all know the symptoms of a UTI – a burning feeling when you urinate and frequent urges to urinate, even when very little comes out. What’s less known is that about 90% of urinary tract infections can be traced back to one bacteria – E. coli. (source 1, source 2)
Now, although there is a mutant strain of E. coli that occasionally makes headline news, most types of E. coli are either neutral toward us or beneficial when found in our digestive tract. When they migrate to our urinary tract, however, they can cause problems.
Urinary tract infections – also called bladder infections – happen when E. coli (or another bacteria/virus/yeast/pathogen) move up the urethra (the tube that empties urine out of the body) and into the bladder – and if the infection isn’t addressed properly – into the kidneys.
Are antibiotics always the best option?
Remember when antibiotics and ear infections went together like fries and ketchup? I sure do. These days, though, the American Academy of pediatrics says that most earaches are viral in nature – which means they not treatable by antibiotics – and recommends a “wait and see” approach. (source) And it’s not just that they might not help – inappropriate antibiotic use may actually increase the incidence of future ear infections! (source)
Though urinary tract infections are usually bacterial and treatable by antibiotics, I try to avoid them when possible with my family for two main reasons.
Reason #1: Antibiotics may permanently alter the microbiome
In this New York Times article, bestselling author Michael Pollan explains how our internal microbiome – the estimated one hundred trillion microbes we each carry – affect human health:
for every human cell that is intrinsic to our body, there are about 10 resident microbes — including commensals (generally harmless freeloaders) and mutualists (favor traders) and, in only a tiny number of cases, pathogens.
To the extent that we are bearers of genetic information, more than 99 percent of it is microbial. And it appears increasingly likely that this ‘second genome,’ as it is sometimes called, exerts an influence on our health as great and possibly even greater than the genes we inherit from our parents. But while your inherited genes are more or less fixed, it may be possible to reshape, even cultivate, your second genome.”
Though it was once assumed that our gut flora eventually repopulated and balanced out after a round of antibiotics, Martin Blaser of New York University’s Langone Medical Center now says that our microbiomes may never fully recover from antibiotic use.
That’s a big deal, because as Pollan explains “Disorders in our internal ecosystem — a loss of diversity, say, or a proliferation of the ‘wrong’ kind of microbes — may predispose us to obesity and a whole range of chronic diseases, as well as some infections.”
The loss of our internal microbiome doesn’t just affect us, but future generations as well. When a mom gives birth to her child, her microbiome is passed on as the baby moves through the birth canal. When her microbiome is diminished, the one the child inherits is also diminished.
Reason #2: Antibiotics may increase the likelihood of future urinary tract infections and yeast infections
In this New York Times report, antibiotic use is one of the risk factors for developing urinary tract infections. Yep, you read that right! The reason stated is that antibiotics eliminate beneficial bacteria that help to keep E. coli in check. Here’s a more in-depth analysis from Chris Kresser, LAc:
Commonly prescribed antibiotics are Bactrim, Amoxicillin, Ampicilin, and Cipro. These antibiotics are often unnecessary and may cause more problems in the future by destroying the beneficial bacteria that prevents pathogenic bacteria from growing. Long term use of antibiotics can also lead to antibiotic-resistant strains of bacteria like E. coli developing in the gut, and a UTI caused by these bacteria will be even more challenging to eliminate and can cause more serious infections like a bladder or kidney infection.
Furthermore, antibiotics do very little to prevent the infection from happening in the first place. So while drugs may be an easy fix for the short term, in the long run you will continue to be susceptible to UTIs, and these infections may be worse than if you had never taken a course of antibiotics in the first place!” (source)
In addition, according to Dr. Natasha Campbell-McBride, M.D., “the era of antibiotics gave Candida albicans [the organism that causes yeast infections] a special opportunity. The usual broad-spectrum antibiotics kill a lot of microbes in the body – the bad and the good. But they have no effect on Candida. So, after every course of antibiotics Candida is left without anything to control it, so it grows and thrives.” (source: Gut & Psychology Syndrome, p. 44) (Source that confirms Candida albicans causes yeast infections – WebMD)
In other words, along with bad bacteria, antibiotics kills certain beneficial microbes that keep Candida in check. When its competition is eliminated candida thrives, and according to WebMD this can sometimes cause yeast infections. Fortunately, according to Melanie Christner, NTP, it’s a myth that you can’t use probiotics to rebuild beneficial bacteria during a course of of antibiotics. Though one or two (or even 20) strains won’t replenish all the diverse species that were originally present, it may be wise to replenish what you can. You can read Melanie’s post on probiotic myths here.
That said, if a UTI was not quickly resolving with these methods, I would absolutely go see my doctor to make sure the infection doesn’t move into the kidneys. Because I have the MTHFR gene mutation certain antibiotics are contraindicated for me, so I have a list of ones to request ready just in case.
Fortunately, I’ve used the remedies below and that hasn’t been necessary!
Natural Home Remedies For UTI’s
Drink More Water
So this one is not rocket science, but no list of UTI remedies is complete without it. According to the U.S. Department of Health and Human Services, “Drinking lots of fluid can help flush bacteria from your system. Water is best. Most people should try for six to eight, 8-ounce glasses a day.” I would personally shoot for a bit more – do what works for you. (source)
When E. coli moves into the urinary tract, it grabs onto the bladder wall with sticky “fingers” called fimbria. D-mannose – a naturally occurring sugar that is found in cranberries, blueberries and other fruits – is thought to help dislodge it by coating the fingers and disrupting attachment, thus allowing the bacteria to be flushed out. Chris Kresser, LAc, calls it “far the most effective supplement for both treatment and prevention of UTIs.” Here’s what else he has to say:
According to Chris Kresser, LAc:
D-mannose, even in large quantities, does not cause any adverse side effects, and cannot be metabolized the way other sugars can, meaning this supplement is safe for diabetics and others who are avoiding sugar for any reason. This treatment is also safe for children and the elderly. Symptom relief can be seen as quickly as the following day, and most symptoms are generally resolved after 48 hours of treatment. Additionally, taking D-mannose during a time where you feel you are most prone to UTIs, such as prior to intercourse or during prolonged antibiotic treatment, can help prevent a UTI from ever developing in the first place. This is especially helpful for those who are prone to chronic UTIs and want to be able to engage in normal life activities without fear of infection. (source)
Unlike antibiotics that harm beneficial bacteria, D-mannose is thought to be a prebiotic, which is a substance that “may help your body by stimulating the growth of ‘good’ bacteria in your digestive system.” (source)
In one study, women who had a history of recurrent urinary tract infections were given either 2 grams of D-mannose, 50 milligrams of Nitrofurantoin (one of the preferred antibiotics for UTI’s), or no treatment. The D-mannose group had the lowest number of recurrent UTI’s (just 15%) compared to the antibiotic group (20%) and the no treatment group, which had a 60% rate of recurrent UTI. (source)
In another study, E. coli was introduced to the urinary tracts of rats and then some were given D-mannose. The rats who were given D-mannose eliminated the E. coli better than controls. (source)
Important note: According Chris Kresser, “One caveat with D-mannose is that it is only effective with UTIs caused by E. coli infection. While this accounts for about 90% of cases, there are 10% that will not benefit from this treatment. In this case, supplements that help disrupt biofilms can be useful in treating and preventing UTIs.” (You can find a list of those in his article)
I think Chris’ analysis is accurate for most cases, but I had a unique experience with my child. When his symptoms persisted after we began home remedies, I took him to see a doctor. (We were traveling so it wasn’t our regular pediatrician.) After two urinalysis tests and a three day culture all came back negative for bacterial infection, the care provider and I jointly determined – based on his other symptoms – that he most likely had a UTI that was due to a virus or another pathogen not detected on the test. Interestingly, I stopped giving him D-mannose after the initial urinalysis said he didn’t have a bacterial infection and he became more uncomfortable, so I began giving it to him again and he became increasingly more comfortable and recovered without any additional intervention. Though there is not much information on the subject, some research suggests that D-mannose may in some cases provide support with viral illnesses as well. (source)
In Prescription for Natural Cures: A Self-Care Guide For Treating Health Problems With Natural Remedies, which was written James F. Balch, M.D., Mark Stengler N.M.D, and Robin Young Balch, N.M.D, it is suggested that adults “Take 500 mg four times daily.” It is usually recommended that individuals continue taking it 2-3 days after symptoms resolve.
What about cranberry or blueberry juice?
I’m usually a fan of whole-food based supplements, but it’s typically recommended that individuals with UTI’s avoid sugar. Juice – even unsweetened – contains fructose, and for that reason I personally would opt for D-mannose.
According to Allen Douma, M.D., of the Chicago Tribune, “vitamin C has been shown to be effective in the prevention and self-care treatment of urinary-tract infections.” (source) When offering advice on preventing urinary tract infections, the Johns Hopkins Medicine health library states that “Large amounts of vitamin C limit the growth of some bacteria by acidifying the urine. Vitamin C supplements have the same effect.”
In Prescription for Natural Cures: A Self-Care Guide For Treating Health Problems With Natural Remedies, which was written James F. Balch, M.D., Mark Stengler N.M.D, and Robin Young Balch, N.M.D, it is suggested that adults “Take 1,000 mg four to five times daily.”
Note: Most vitamin C – even the stuff that says it is derived from something natural like sago palm – is synthetically produced. Personally, I opt for whole-food vitamin C supplements like acerola cherry powder or dried baobab fruit – you can find my favorites in the Superfoods and Supplements Section of my Shopping Guide.
According to the University of Maryland Medical Center, “Uva ursi (Arctostaphylos uva ursi), also known as bearberry (because bears like eating the fruit), has been used medicinally since the 2nd century. Native Americans used it as a remedy for urinary tract infections. In fact, until the discovery of sulfa drugs and antibiotics, uva ursi was a common treatment for bladder-related infections.
Through modern day scientific research in test tubes and animals, researchers have discovered that uva ursi’s ability to fight infection are due to several chemicals, including arbutin and hydroquinone. The herb also contains tannins that have astringent effects, helping to shrink and tighten mucous membranes in the body. In turn, that helps reduce inflammation and fight infection.
Today, uva ursi is sometimes used to treat urinary tract infections (UTIs) and cystitis (bladder inflammation). One preliminary study found that uva ursi, when combined with dandelion root and leaf, helped prevent recurrent UTIs.” (source)
In Prescription for Natural Cures: A Self-Care Guide For Treating Health Problems With Natural Remedies, which was written James F. Balch, M.D., Mark Stengler N.M.D, and Robin Young Balch, N.M.D, it is suggested that adults “Take a standardized extract of 250 mg of arbutin or 5 ml of the tincture form four times daily.” (Arbutin is converted into hydroquinone in the body. Hydroquinone is the component of uva ursi that is thought to be helpful for UTI’s.)
The University of Maryland Medical Center states that “One of the chemicals in uva ursi, hydroquinone, can damage the liver. You should only take uva ursi for short periods, no longer than 5 days, under a health care provider’s supervision. You should not take a series of doses of uva ursi more than 5 times in 1 year. DO NOT take more than the recommended doses.” Also, children and “Women who are pregnant or breastfeeding, and people with high blood pressure, should not take uva ursi. People who have Crohn disease, digestive problems, kidney or liver disease, or ulcers should not take uva ursi.” (source)
Also, according to Herb Wisdom, “Because Uva Ursi requires an alkaline urine for its antimicrobial properties to work, those taking Uva Ursi should avoid eating acidic foods like citrus, pineapple, tomato. Prescription drugs such as ammonium chloride, non-prescription products such as vitamin C, herbals such as rose hips, and foods such as cranberry juice may all make the urine more acidic in nature.” (source)
“Garlic extract may be an effective weapon against multi-drug resistant strains of pathogenic bacteria associated with urinary tract infections (UTI), according to a recent study published in the Pertanika Journal of Tropical Agricultural Science,” writes Science Daily.
Though the amount used was not mentioned, there are several garlic extracts sold at health food stores and online that have suggested usage guidelines.
According to John Mersch, MD, FAAP, one remedy that has shown to be safe and possibly effective in children is pineapple. He writes, “This fruit contains a chemical (bromelain) that reportedly possesses anti-inflammatory properties and thus reduces UTI symptoms.” (source)
Just as with cranberry juice, many individuals opt to use the supplement form because it is more concentrated and doesn’t contain sugar. When considering supplements, I wanted to pass along this information I found via C.S. Mott Children’s Hospital regarding the type that has been studied,
Taking bromelain during a UTI may enhance antibiotic effectiveness. The proteolytic enzymes, bromelain (from pineapple) and trypsin may enhance the effectiveness of antibiotics in people with a UTI. In a double-blind trial, people with UTIs received antibiotics plus either bromelain/trypsin in combination (400 mg per day for two days) or a placebo. One hundred percent of those who received the enzymes had a resolution of theirinfection, compared with only 46% of those given the placebo.26 This study used enteric-coated tablets. Enteric-coating prevents stomach acid from partially destroying the bromelain. Most commercially available bromelain products today are not enteric-coated, and it is not known if non-enteric coated preparations would be as effective.” (source)
Raw Apple Cider Vinegar
Though there is not any research on apple cider vinegar, it has long been used in folk medicine as a remedy for urinary tract infections. Like vitamin C and citrus products, it is thought to acidify the urine, thus inhibiting the growth of certain types of bacteria.
Dinah-Marie of Cultured Palate recommends 2 or more tablespoons of raw apple cider vinegar in 8 oz. of water either every hour (for active symptoms), or 2-3 times a day as symptoms resolve. You can read more about her approach here.
Goldenseal & Echinacea
Though I was not able to find any studies to support their use, Goldenseal and Echinacea are both considered traditional remedies for urinary tract infections. Christopher Hobbs, PhD, LAc, A.H.G, calls these two herbs the “Dynamic Duo” and recommends them for UTI’s. (source)
You can find Dr. Hobbs recommendations for using them here.
Honorable mention: probiotics
Though there are no studies that support the use of probiotics as a treatment for urinary tract infections, research suggests that probiotics may be helpful in reducing the incidence of recurring infections. (source)
According to Natalie Lamb Dip, NT, CNM, who serves as a technical advisor to Probiotics International Ltd.:
The ability of probiotic interventions in the management of UTIs has long been considered and is now supported by increasing clinical evidence for a growing number of specific strains. There is a close correlation between the loss of the normal genital microbiota, particularly Lactobacillus species, and an increased incidence of UTIs, therefore suggesting that repletion may be beneficial.”
Several probiotic supplements have been specially formulated to include strains that are thought to support urinary tract health. Fem-Dophilus is one of them.
What I didn’t include: baking soda
Baking soda lowers the pH of urine so that it doesn’t burn. Though pain relief is a good thing and possibly appropriate at times, some folks think it’s a better idea to raise pH and kill the pathogenic microbes rather than lower it and ease discomfort.
What if the UTI isn’t due to e. coli?
As I mentioned in the section above on D-mannose, my child continued to have UTI symptoms despite two urinalysis tests and a three day urine culture coming back negative for bacteria. While waiting to see his pediatrician and discuss additional tests, I came across this article from Chris Kresser, LAc which addresses remedies for UTI’s that are not due to E. coli.
I ordered some of the supplements, but thankfully my child’s symptoms resolved the next day so I’m keeping them on hand in case they are needed in the future. They’re considered helpful for more than just UTI’s, and I’m glad I learned about them. I followed up with pedi’s office about my suspicions that the UTI might be viral (which is not common) or due to another pathogen not detected on the test, and it was agreed that was most likely the case.
- Avoid caffeine, alcohol, carbonated drinks, and foods that may irritate your urinary tract (for some people this can be chocolate, for others it might be spicy food)
- Wear loose clothing and cotton underwear.
When to see a doctor
According to WebMD, “Watchful waiting is a wait-and-see approach. If you get better on your own, you won’t need treatment. If you get worse, you and your doctor will decide what to do next.
In adults, home treatment for minor urinary tract infections (UTIs) often resolves the problem. Home treatment includes drinking plenty of water and urinating often, emptying the bladder each time.
Try home treatment for 1 to 2 days if your symptoms are minor.
If your symptoms last longer than 1 to 2 days or are severe, seek medical help.
Watchful waiting is not appropriate if you:
- Have diabetes or an impaired immune system.
- Are pregnant
- Are older than 65.”
They add that you should call a doctor if you:
- “Have had UTI symptoms previously and have those symptoms again.
- Have minor symptoms of a UTI that do not clear up in 1 to 2 days, such as pain or burning when you urinate, foul-smelling urine, or the urge to urinate frequently while passing only small amounts of urine.
- Notice blood or pus in your urine.
- Have symptoms of a UTI and you have diabetes.
- Have been taking antibiotics for a UTI but your symptoms do not improve or they come back (recur) after improving temporarily.
And you should call a doctor IMMEDIATELY if you experience:
- “Nausea and vomiting.
- Fever and chills.
- Pain in the flank, which is felt just below the rib cage and above the waist on one or both sides of the back, or lower belly pain.”
- Do you have any favorite home remedies for UTI symptoms not mentioned above?