Natural Urinary-Tract Health
[Home] [Therapies]




Laurance Johnston, Ph.D.

This article discusses various natural alternatives, such as cranberries, blueberries, and the sugar D-mannose, that fight urinary tract infections (UTI) and, by so doing, help preserve the future effectiveness of life-saving antibiotics. 

UTIs can be an aggravating, recurring health problem for individuals with spinal cord injury (SCI) and dysfunction (SCD). According to the Agency for Health Care Policy and ResearBlueberries contain similar UTI-fighting substances as, 80% of those with spinal cord injury will experience UTIs within 16 years of injury; UTIs are the most frequent secondary medical complication during acute care and rehabilitation; and urinary-system disorders are the fifth most common primary or secondary cause of death.

Seventy to ninety percent of persons with multiple sclerosis (MS) eventually develop bladder dysfunction, and, as a result, a predisposition to UTIs.  For MS patients over age 65, these infections are the primary or secondary diagnosis for nearly one-third of hospitalizations.

In the general population, about 90% of UTIs are caused by E. coli bacteria, which although a normal part of our intestinal miroflora, do not belong in our urinary system.  In the case of SCD, a diversity of bacteria in addition to E. Coli can cause UTIs.

Antibiotics – A Double-edged Sword?

For more than a half-century, people with spinal cord injury and dysfunction have relied on antibiotics to control UTIs. The development of these drugs stems back to 1928 when British microbiologist and eventual Nobel Laureate Alexander Fleming observed that bacterial growth was inhibited by a penicillin-producing mold. Although infection-fighting molds have been a part of mankind’s healing armamentarium since antiquity and noted by scientists before Fleming, penicillin became the first antibiotic isolated from one. The exigencies of World War II resulted in penicillin’s production in sufficient quantities for general use, including the treatment of the Paralyzed Veterans of America’s founders.

Since then, scientists have developed a multitude of potent antibiotics. In my case, as a graduate student, I help elucidate the molecular mechanism of vancomycin, now an antibiotic of last resort in resistant infections.

Although antibiotics have greatly increased the life expectancy of people with spinal cord injury and dysfunction, reliance on them has ominous future implications given the growth of antibiotic-resistant bacteria. For example, every year, 2 million hospital patients acquire infections that that they did not have when they entered the hospital; of these, 80,000 die. Statistics such as these are especially relevant to infection- and hospitalization-prone individuals with paralysis and clearly indicate the need to maintain antibiotic effectiveness.

In spite of their clear importance, every time you use antibiotics you short-circuit your body’s inherent healing potential, cumulatively compromising your long-term health. You may be winning the immediate health-care battle, but you are setting yourself up to lose the war.

Furthermore, in spite of commonly held assumptions that bacteria are the “bad guys,” optimal health requires that we maintain a symbiotic, health-enhancing partnership with them.  For example, many different bacteria that live within our digestive system are essential for proper digestion and chronic health.  Every time we use an antibiotic, we undercut this bacterial partnership. By killing off the ”good guys,” we create a void that may be filled by health-compromising pathogens or antibiotic-resistant bacteria that now have no competition for growth.

This theme was emphasized in a March 28, 2003 Science magazine article (Gilmore & Ferretti), which stated that "Not only does the highly evolved gut flora community extend the processing of undigested food to the benefit of the host, but it also contributes to host defense by limiting colonization of the gastrointestinal tract by pathogens." The article notes that at least 500 different microbes live in the gut.

Unfortunately, we also face a huge exposure to antibiotic residues through meat and poultry consumption. In this country annually, 25-million pounds of antibiotics (8X human medicine use) are fed to livestock and poultry, not for therapeutic reasons but to promote economic-efficient growth.  By fostering development of resistant bacteria, this practice may ultimately render useless the antibiotics that have been a cornerstone of SCD healthcare.

To reduce your vulnerability to the seemingly inevitable erosion of antibiotic power, use when feasible and prudent various alternatives for enhancing urinary-tract health and attempt to hold in reserve the heavy-duty antibiotic artillery for major medical crises. For most of these innocuous alternatives, there is little to lose and potentially much to gain.

Nutritional Approaches:

Cranberries & Blueberries:  Cranberry products are a traditional UTI-fighting folk remedy that has been embraced by the SCD community. In an article posted on (click on CareCure Community and scroll down to the “Cranberry and UTI” article), Dr. Wise Young, one of the nation’s preeminent SCI physicians (Piscataway, NJ), says that more than 40% of those with SCI take cranberry concentrates. The article summarizes the results of more than 40 scientific studies evaluating cranberries’ infection-fighting properties.

In addition to acidifying urine, cranberries contain substances that inhibit bacteria from attaching to the bladder lining and, as such, promoting the flushing out of bacteria with the urine stream. These anti-bacterial substances include tannin-like compounds called proanthocyanidins and potentially the sugar D-mannose (see below).

Cranberries’ UTI-fighting ability is supported by an ever-growing body of scientific evidence Although more research is needed on SCD-associated UTI’s, a recent pilot study (Reid, et al, Spinal Cord, January 2001) indicated that drinking cranberry juice greatly reduced bacterial attachment to cells lining the bladder in subjects with SCI. Promisingly, this was a broad-spectrum, anti-bacterial effect not limited to merely E. coli, the UTI-causing culprit in the general population.

To avoid excess sugar, consume unsweetened - albeit lip-puckering - cranberry juice, cranberry extract capsules, or naturally sweet blueberries, which scientists have shown to contain similar UTI-fighting substances.

Cranberry & SCI Update

Linsemeyer et al (New Jersey, USA) randomized 21 subjects to receive either a cranberry tablet or inactive placebo for four weeks (2004). After a one-week washout period, the subjects who had received the cranberry supplement were now given the placebo and vice versa. No statistical difference was noted between the placebo and cranberry groups as measured by several UTI-indicative criteria. Furthermore, urinary acidity did not differ between the treatment groups.

In another example, Waites and colleagues (Alabama, USA) compared 26 subjects with SCI who received a two-gram daily dose of cranberry extract in capsule form for six months with 22 placebo-treated subjects (2004). The investigators concluded that the cranberry extract did not reduce UTIs.

Lee and associates (Australia) evaluated the effects of cranberry tablets in preventing UTIs in 78 subjects with SCI (2007). Subjects consumed an 800-milligram dose of cranberry twice daily for six months. No difference in UTI incidence was noted between cranberry and placebo-treated groups.


D-mannose:  Studies suggest that D-mannose is 10 times more effective than cranberries in dislodging E. coli bacteria from the bladder wall, and, as such, can ameliorate more than 90% of UTIs in 24-48 hours.

In addition to reading many impressive testimonials from able-bodied consumers whose recurring UTI’s have been successfully treated with the product, I talked to several D-mannose users with SCI:

Stephanie, an artist friend who has had recurring UTI’s, says D-mannose was “a wonderful UTI product.”  She adds “ I take several glasses of water a day with a half teaspoon of the powdered D-mannose. I am absolutely positive that it has stabilized my bladder condition to the effect of better control, easier to empty, and the discomfort “tightness” or burning is gone. U-tract is a necessity in my daily life!!"

Richard also testified to D-mannose’s effectiveness. A retired teacher and long-time member of the Paralyzed Veterans of America, he told me that his UTI frequency had greatly increased with age until he was routinely afflicted with one that required antibiotic therapy every 40 days. About a year ago, he started prophylactically taking D-mannose and feels that it has made a huge difference, noting that “most of the time now, my urine is more clear and lacking of the characteristic UTI-associated odor.” He says the product has greatly decreased his UTI incidence.

Another PVA member David stated that he is a "D-mannose fan." He notes "I’ve had numerous urinary tract infections for 25 years and was starting to run out of effective antibiotics. Since I started taking it six months ago, I've not had a UTI."


Mechanism of Action: D-mannose is a naturally occurring sugar similar in structure to but metabolized differently from, glucose (a component of table sugar). Because the body metabolizes only small amounts of D-mannose and excretes the rest in the urine, it doesn’t interfere with blood-sugar regulation even in diabetics.

The cell wall of the UTI-causing E. coli bacteria has tiny finger-like projections that contain complex molecules called lectins on their surfaces. These lectins are cellular glue that binds the bacteria to the bladder wall so they cannot be readily rinsed out by urination.  However, because D-mannose molecules will glom on to these lectins and fill up all of the bacterial anchoring sites, the bacteria can no longer attach to the bladder wall and are, therefore, flushed away. In other words, unlike antibiotics, D-mannose does not kill any bacteria, whether they are good or bad, but simply helps to displace them.

Visualize the bacteria as burrs sticking to the lining of your clothes unless they are so covered with lint that they fall away. Essentially, D-mannose represents the molecular lint that makes the bacterial burrs fall away from your urinary-tract lining.


To help preserve the future effectiveness of life-saving antibiotics, consider using nutritional alternatives to enhance urinary tract health, such as cranberries, blueberries, or D-mannose. Who knows? You may lose your UTI chill on blueberry fill!

Adapted from article appearing in Paraplegia News, June, 2002 (For subscriptions, go to


Keep posted on new therapies, treatments, potential cures, and developments!

Sign up for Newsletter!