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D-Mannose and UTI's - The Science Behind MINGO

  uti treatment, mingo uti drink mix, d-mannose and utis

THERE WAS A LOT OF SCIENCE THAT WENT INTO MAKING MINGO, YOUR ULTIMATE UTI DEFENCE. 

How Do You Get a UTI: The Enemy - E. Coli Bacteria

Most UTIs are caused by common bacteria “getting up in there,” or hooking on to the urinary tract and causing an infection. There are a LOT of risk factors that can lead to this dreaded process, with sexual activity being the most common and well-known cause (5,9).

The E. Coli bacteria try to adhere (hook on) to the wall of the urinary tract so they can multiply. More specifically, they attach themselves via fimbrial adhesion using their P fimbriae (bacterial grappling hooks) (15).

Urinary tract infections are a huge problem worldwide (LINK: blog - 5 Things No One Told You About UTIs) and as a result, scientists have been studying them more closely in recent years. Thankfully we’ve learned a lot about what’s going on and have been able to discover pieces of the puzzle that can be used to help. For example, it turns out that the bacterial grappling hooks are especially good at binding to cells that contain a compound called ‘mannose’ on the binding site (3,7). We also learned that E. Coli without active grappling hooks are significantly less likely to cause infections (15). More on what those discoveries mean later.

Recurrent UTIs - Why do you keep getting urinary tract infections?

For women with recurrent UTI’s, prophylactic regiments (ongoing antibiotic prescriptions) are common to help kill invading bacteria before it can multiply (12). However, long-term use of antibiotics comes with its own risks. It increases the risk of developing antibiotic resistance, which can, in turn, increase the risk of developing an untreatable UTI. In addition, antibiotics are not good at discerning good bacteria and bad bacteria. They kill it all. 

Unfortunately, once the bacteria have multiplied and caused a full-blown infection, you may need antibiotics. Those bacteria need to go or else they can develop into more serious infections, ascending up into the bladder and even the kidneys. This is important. If you think you have a UTI, go to your doctor.

The challenge, therefore shifts to stopping the process before it gets to the point where you need to go to the doctor and without relying on the continuous use of antibiotics.

It shifts to PREVENTION, denying the UTI before it starts and breaking the cycle that so many of us are familiar with:

infection -> suffering -> antibiotics -> relief -> infection ->

suffering -> antibiotics -> relief -> infection…

D-mannose and UTI's: What is deal with D-Mannose? Is it safe? What is D-Mannose?

D-mannose is an all natural UTI fighter - it's a natural bioactive monosaccharide, which is a fancy way of saying that it’s a natural simple sugar, commonly found in apples, pears, even cranberries, but in really small quantities (17).

d-mannose utis, uti treatment

When consumed, D-mannose is absorbed by the body quickly (helpful for timing doses), but excreted rather than stored long term, and it has almost no negative side effects. Some minor bloating and occasional loose stools have been reported by some users, and as a type of sugar, it’s important to be aware of how it may impact your blood sugar level at higher doses.

Health Canada has recognized the safety of D-mannose as an approved nutritional supplement (17) and supports the use of up to 180-grams per day.

Lucky for you, our MINGO formula includes 2-grams of D-mannose and a combination of supportive ingredients have been approved by Health Canada to reduce the risk of recurrent urinary tract infections in women (WOOHOO). 

How D-mannose Works - Mechanism of Action

First, D-mannose naturally binds to bacteria’s P fimbriae grappling hooks. The bacteria are very happy with this – recall the discovery that bacteria were especially good at binding to cells that contained mannose. Second, the grappling hooks are ineffective having been inhibited by the D-mannose compound. The bacteria have their hands full, so they have nothing to use to hook onto the urinary tract (1,8). Finally, when you pee, the bacteria are excreted (11) – recall the discovery that bacteria were bad at causing infections without their hooks – this is why, they just get flushed out. This glorious mechanism is strongly supported in the scientific literature (15,16) and it is the science behind why MINGO works.

(Thanks CranMed for the cute and helpful animation)

D-Mannose and UTIs: Human Trial #1

Kranjčec (2014) conducted a randomized trial among 308 women who all had a history of recurrent urinary tract infections and no other significant comorbidities (i.e. no other health issues that could confuse the scientific results). The first group received 2-grams of D-mannose powder in 200 ml of water, daily, for 6 months (n=103). The second group received a daily dose of the antibiotic Nitrofurantoin for 6 months (n=103). The third group received nothing at all for 6 months (n=102).

At the end of the 6 months, 98 patients (31.8%) had a recurrent UTI: 15 of them were from the D-mannose group, 21 were from the antibiotic group, and 62 were from the nothing at all group. This means that patients in the D-mannose and antibiotic group both had a significantly lower risk of a recurrent UTI episodes than those who took no treatment (RR 0.239 and 0.335, P < 0.0001).

SUMMARY: In short, 2-grams of D-mannose powder significantly reduced the risk of contracting a recurrent UTI. In addition, D-mannose performed as good as antibiotics, but without the long-term risks of antibiotic resistance, and with a significantly lower risk of short-term side effects (RR 0.276, P < 0.0001).

 

D-Mannose and UTIs: Human Trial #2

In a different randomized trial (Porru, 2014) 60 women who had 3 or more recurrent UTIs during the preceding 12-months were randomly assigned to one of two groups. The first group received 1-gram of D-mannose 3 times a day for 2 weeks, and then 1-gram 2 times a day for 22 weeks (n=30). The second group received the antibiotic Trimethoprim/Sulfamethoxazole 2 times a day for 5 days, followed by a single dose at bedtime for 1 week each month for 23 weeks (n=30). Each participant switched groups 24 weeks into the study, so they experienced both types of treatment.

This study was focused on ‘time to recurrence’; how many days until participants got a UTI. The average results were 52.7 days with the antibiotic treatment, and 200 days with the D-mannose treatment (p < 0.0001) (19), further demonstrating the upside of D-mannose over antibiotics.

A more recent pilot study (Domenici, 2016) administered 1.5-grams of D-mannose along with sodium bicarbonate, sorbitol and silicon dioxide 2 times a day for 3 days and then 1 time a day for 10 days, and then randomized into two groups. The first group received D-mannose treatments 1 week per month, every other month. The other group remained untreated. The overall rate of UTI recurrence was 4.5% in the group treated with D-mannose and 33.3% in the other group (18).

d-mannose utis, uti treatment

So, what do the studies tell us about D-mannose and UTIs?

  1. D-mannose is effective at preventing UTIs: at least as effective as antibiotics and potentially even more effective longer term. It is also effective without the short and long-term side effects of antibiotics, including antibiotic resistance. The mechanism of action (how it works) is clear and straightforward: D-mannose inhibits the bacteria’s grappling hooks and is flushed out of the system.
  2. Dosage is important . All trials have used 1.5-2.0 grams of D-mannose. Thankfully, this effective dose is just 1% of the daily limit listed by Health Canada, so we’re able to take multiple doses in a day if needed. MINGO follows these guidelines by including 2-grams (2,000-mg) of D-mannose in each serving. Lower dosages have not been proven to be effective in trials.
  3. No D-mannose regimen tested is 100% effective. While the rates of recurrence are drastically reduced, that pesky bacteria still finds a way to do its thing some of the time. D-mannose should be thought of as an effective preventative measure, but it’s not a silver bullet. MINGO supports the mechanism of action with carefully selected ingredients to help the process along. You can also be aware of the risk factors and take other precautionary measures to give D-mannose the best chance of working. 

D-Mannose sounds peachy. What else is in MINGO?

Vitamin C

MINGO contains 600-mg of Vitamin C. As an antioxidant, Vitamin C has been demonstrated to support immune system function and be bacteriostatic (i.e. it stops bacteria from reproducing). There is research that has linked Vitamin C to UTIs prevention directly. A study (Foxman, 1990) with over 1,400 college-aged women concluded that Vitamin C consumption significantly decreased the risk of developing a UTI (4). A different study (Ochoa-Brust, 2007) with 110 pregnant women found that UTI frequency was significantly lower in women receiving Vitamin C (10).

Vitamin B6

MINGO contains 10-mg of Vitamin B6. As a mild diuretic, Vitamin B6 helps increase urination and urinary flow. You need to pee for the bacteria to be flushed out, or else it’s just hanging out in your bladder, regardless of whether the grappling hooks are active or not (5).

Sodium Citrate

MINGO contains 1,500-mg of sodium citrate. Potassium or sodium citrate salts are an effective means of alkalinizing the urine. Alkaline urine can provide relief from UTI symptoms, particularly dysuria (pain when peeing) and cystis (bladder inflammation). In a study (Spooner, 1984) with 205 women suffering from UTIs, 48-hours of sodium citrate significantly improved symptoms in 80% of participants (20). In addition, urine alkalinisation and water loading (fluid intake) was shown to increase the ability of white blood cells to eliminate infecting organisms (21). Yet another reason to drink lots of water!

Read more about MINGO  a drink mix that prevents occasional and recurrent urinary tract infections. Your ultimate UTI defense.

 

References

  1. Altarac, S and 1, Papeš, D. “Use of d-mannose in prophylaxis of recurrent urinary tract infections (UTIs) in women.” BJU International, Vol. 113, Issue 1. 2014.
  2. Bates, JM, et al. “Tamm-Horsfall protein knockout mice are more prone to urinary   tract infection: rapid communication.” Kidney International, Vol. 65, Issue 3. 2004.
  3. Bergsten, G, et al. “Escherichia coli, fimbriae, bacterial persistence and host response induction in the human urinary tract.” Journal of Medical Microbiology, Vol. 295, Issue 6. 2005.
  4. Foxman, B and Chi, JW. “Health behavior and urinary tract infection in college-aged women.” Journal of Clinical Epidemiology, Vol. 43, pages 329-337. 1990.
  5. Head, K. “Natural Approaches to Prevention and Treatment of Infections of the Lower Urinary Tract.” Alternative Medicine Review, Vol. 13, Issue 3. 2008.
  6. Kaye, D. “Antibacterial activity of human urine.” Journal of Clinical Investigation, Vol. 47, Issue 10. 1968.
  7. Krogfelt, K, et al. “Direct evidence that the FimH protein is the mannose-specific adhesin of Escherichia coli type 1 fimbriae.” Infection and Immunology, Vol. 58, Issue 6. 1990.
  8. Michaels, EK, et al. Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats. Urological Research, Vol. 11, Issue 2. 1983.
  9. National Kidney and Urological Diseases Information Clearinghouse. “Urinary Tract Infections in Adults.” NIH. http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/. (2012).
  10. Ochoa-Brust GJ, et al. “Daily intake of 100 mg ascorbic acid as urinary tract infection prophylactic agent during pregnancy.” Gynecologica Scandenavia, Vol. 86, pages 783-787. 2007.
  11. Ofek, I, et al. “Mannose-specific adherence of E. coli freshly excreted in the urine of patients with urinary tract infections, and of isolates subcultured from the infected urine.” Infection and Immunity, Vol. 34, Issue 3. 1981.
  12. Pallet, A and Hand, K. “Complicated urinary tract infections: practical solutions for the treatment of multiresistant Gram-negative bacteria." Antimicrobial Chemotherapy, Vol. 65, Issue 3. 2010.
  13. Serafini-Cessi, F, et al. “N-Glycans carried by Tamm-Horsfall glycoprotein have a crucial role in the defense against urinary tract diseases.” Glycoconjugate Journal, Vol. 22, Issue 7. 2005.
  14. Shepherd, AK and Pottinger, PS. “"Management of urinary tract infections in the era of increasing antimicrobial resistance.". The Medical Clinics of North America, Vol. 97, Issue 4. 2013.
  15. Wullt, B. “The role of P fimbriae for Escherichia coli establishment and mucosal inflammation in the human urinary tract.” International Journal of Antimicrobial Agents, Vol. 21, Issue 6. 2003.
  16. NATURE COMMUNICATIONS | 7:10738 | DOI: 10.1038/ncomms10738 | www.nature.com/naturecommunications
  17. See - Comprehensive Reviews in Food Science and Food Safety Vol. 00, 2016 D-Mannose: Properties, Production, and Applications:
  18. See - D-mannose: a promising support for acute urinary tract infections in women. A pilot study – “European Review for Medical and Pharmacological Sciences” 2016; 20: 2920-2925
  19. “Oral D-mannose in recurrent urinary tract infections in women: a pilot study” Journal of Clinical Urology 2014, Vol. 7(3) 208–213
  20. Spooner JB. Alkalinisation in the management of cystitis. J Int Med Res 1984;12:30-34
  21. Eur. J. Clin. Microbial. Infect. Dis., July 1993, p. 534-539 “Effect of Alkalinisation and Increased Fluid Intake on Bacterial Phagocytosis and Killing in Urine”
  22. (VET REF) Ref King SS, Young DA, Nequin LG, Carnevale EM. Use of specific sugars toinhibit bacterial adherence to equine endometrium in vitro. Am J Vet Res 2000; 61: 446–9 
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mingo uti prevention drink mix