Urinary tract infections (also known as UTIs) are one of the most common infections women experience. It is also one of the most common presentations to doctor’s offices. They are unpleasant and if not treated, can lead to much more serious problems. It astounded me the number of antibiotic scripts we filled for women suffering common UTI from my time working in an integrative pharmacy. Whilst some situations require antibiotics, they are not needed for all.

Natural treatment has the upper hand for acute UTI and prevention of reoccurrence than antibiotics. They work with the body to fight off the infection and don’t cause a loss of our innate protective bacteria.

What are UTIs caused by?

UTI are most commonly caused by a group of bacteria called E Coli. There are many different strains of E Coli, which is why antibiotics don’t always work. In some rarer cases, UTI can be caused by fungi or amoeba which need more specific treatment. A simple urine culture from your doctor will determine this.

A UTI can affect any part of the urinary system (urethra, bladder, ureters or kidneys) and occurs when this bacteria makes its way up the urethra and/or into the bladder and begins to proliferate. The bacteria can also ascend up the ureters and into the kidneys, which is more serious and does need fast medical attention.

UTIs are more common in women due to the fact that our urethras are closer to the anus and are much shorter than men’s’. They are common during menopause due to hormonal changes impacting the body’s pH. And they also frequently occur with new sexual partners or if you’re run down and your immune system is struggling.

What are the symptoms of a UTI?

Our body responds to these unwelcome guests by staging an immune response which results in inflammation. Which is why the typical symptoms are:

• burning and pain on urination
• needing to pee frequently (because the bladder walls are being constantly irritated)
• fever
• feeling off-key
• cloudy, dark or bloody urine

In this post, I’ll share with you effective natural treatment options that prevent the need to use antibiotics. In some cases antibiotics are required, this post will help you to know the difference.

If your symptoms don’t improve or continue to get worse after 36-48 hours of natural treatment, please see your medical doctor.

How to treat a UTI with natural medicine

Natural medicines are effective at preventing, treating and recovering from UTI. I’ve seen them work time and time again. For women who are experiencing chronic infections, these guidelines can be a game-changer. Before I jump into specific herbal and nutritional medicines, let’s consider diet and lifestyle first.

Diet

What to avoid…

• Avoid sugar (including soft drinks/soda), alcohol and caffeine (black tea, coffee, and energy drinks).
• Citrus (except for lemon), chocolate and tomatoes can all be irritating to the bladder.
• Wheat and dairy can often be an issue when there are chronic or reoccurring infections.

 

Enjoy these medicinal foods…

• The number one factor here is water. Water, water, water. Add some slices of lemon, mint or fresh herbs from your garden to keep things interesting. Water flushes out the whole urinary tract system.  Think of a stagnant pond versus a flowing river. Which is more likely to overcome an algae bloom? Easy answer right
• Bone broths when made with knuckle and marrow bones provide a plethora of soothing gelatine and collagen. These are very calming and repairing to the lining of the UTI especially in chronic infections. You can include garlic, onions, and orange colored vegetables for extra immune kicks. For long-term prevention, the herbs reishi and astragalus are fantastic additions to your broth.
• Berries and purple coloured foods. You have probably heard of cranberry being useful for UTI (which is coming further down). Cranberry contains a group of compounds that are very similar to those found in blue and purple colored foods. They’re called anthocyanins for those interested(Howell, 2007). These compounds prevent bacteria being able to adhere to the walls of the urinary tract system and they also cool down inflammation. Think:
  • berries – particularly blueberries, blackberries and elderberries
  • purple cabbage
  • beetroot
  • purple potatoes.
• Nettle – you may be lucky enough to have a farmer’s market that sells nettle. Or if you live in the country, it’s a very common weed. Nettle is a supreme nourisher for the bladder and kidneys. It builds resilience and supports the immune system. It is a very versatile plant that can be made into tea or used much the same way as you would spinach or rocket. You can make pesto, pop it into soups and broth and make a vinegar that you can use in salads.
• Fermented foods – these foods are all teeming with probiotics that support our own good bacteria. Natural yogurt with no added sugar is an easy addition to your diet, or a 1/4 of sauerkraut as a condiment to your meal. (Falagas et al., 2006; Kontiokari et al., 2003; Whiteside et al., 2015).
  

  Image from Nitty Gritty Life

Practical Lifestyle Tips

• Urinate as soon as you have the urge and ensure you pee right after sex. I know it can be a bit of a mood killer, but it is essential to flush out your urethra.
• Natural fiber underwear! Oh so so important. Pure cotton or bamboo are easy to find in shops or online. – Avoid tight-fitting pants and avoid synthetic gym wear. When you don’t need to wear underwear, don’t (to bed for instance and if you are wearing a flowy long skirt around the home). Let your nether-regions breathe.
• For the same reason, avoid using pads with a plastic underside. Stick to organic cotton tampons, menstrual cups or cloth pads (and be sure to change them every 4 hours).
• Avoid vaginal douches, diaphragms, and spermicides.
• After going to the toilet, make sure you wipe front to back as micro-portions of feces (a.k.a poop) is a common cause of UTI.
• Avoid wearing G-strings or thongs. They create a direct link from the anus to the urethra.
• If you engage in anal sex, you need to be extra careful with hygiene as this does increase your likelihood of UTI significantly. If you switch between anal and vaginal sex make sure you’re both cleaning in between. If your sexual partner is male and is uncircumcised, it is very helpful for him to thoroughly clean his foreskin before intimacy.

 

Natural Medicines

The diet and lifestyle guidelines are the most important to follow. All the best natural medicines in the world won’t go very far if these changes are not made. Where the natural medicines come into their own is when you want to avoid taking antibiotics.

I’ll take you through my three protocols for prevention, treatment, and recovery that I use with my patients.

Prevention of UTIs.

1. Follow all the diet and lifestyle tips from this blog post.
2. Cranberry and D-mannose. Cranberry extract is easily found in health food stores and pharmacies. D-mannose is still not that well known yet in Australia. D-mannose is a naturally occurring compound that is very active at preventing the bacteria adhering to the bladder wall. I have found the combination to be superior to cranberry alone. Take (dosage) once daily and an additional dose after intimacy (Howell, 2007.; Kranjčec et al., 2014).
3. Probiotic -if you have had a recent round of antibiotics or suffer from other digestive issues such as bloating, diarrhea or constipation, taking a specific probiotic is very helpful. I recommend formulas that contain strains of Lactobacillus rhamnosus GR-1 and L. reuteri RC-14, as these are the strains that clinical studies have been performed on (Falagas et al., 2006). If you’re a fermenting keen bean, empty a couple of these probiotic capsules of these into your next batch of yogurt culture and you’ll be creating a UTI specific yogurt for yourself.  Two such probiotics are Jarrow’s FemDophilus or Blackmore’s Women’s Flora Balance.

Take 1 capsule daily.

Acute Infection

1. Follow all the diet and lifestyle advice. Include 4 cloves of raw garlic into your diet daily as it is active against a number bacterial species (Mansour et al., 2014)
2. Increase your dose of cranberry and D-mannose to 1-2 twice a day.
3. Increase your probiotic to 1 four times a day.
4. Take 1000mg of vitamin C four times a day.
5. Take ural or 1/2 teaspoon of bicarb soda in a water four times a day. These alkalise the urine and allow the following herbal tea to work more effectively (“Uva Ursi (Arctostaphylos uva-ursi),” 2015).
6. UTI tea or a herbal capsule equivalent.

There are many variations that can be made on this tea, but this is a good base. You can source high-quality herbs through Southern Light Herbs and Tasmanian Highland Herbs in Australia. In the US and Canada, Mountain Rose Herbs is the pick:

20g Buchu and/or 20g Uva ursi (antimicrobials)

20g Corn silk or 20g marshmallow root (soothers)

30g Clivers, nettle or violet leaves (lymphatic clearers – which is a component of the immune system).

Add 4 heaped tablespoons of this mix to 4 cups of boiling water.  Allow to steep for at least 20 minutes. Drink 1/2 cup every 2 hours.

Chronic and Reoccurring Infections

This is unfortunately very common with UTIs, especially when antibiotics have been the first line treatment. The urinary tract can fall into a vicious cycle called an ‘infection loop’ where the antibiotics kill both the offending bacteria and our good bacteria. Because our good bacteria protect us against infections, when they are depleted, we are more vulnerable to infections.

This protocol helps to tonify, rebuild and re-establish microbial balance:

1. All the general diet and lifestyle tips with a particular emphasis on the bone broth with the added astragalus, reishi and nettle.
2. Cranberry and mannose – same as in prevention.
3. Probiotic – same as in prevention.
4. Specific tonics for bladder and kidney.

 

Bladder:

If your infections have remained in your bladder, couch grass (Agropyron repens) is an excellent bladder tonic. It is anti-inflammatory and rich in silica which is restoring to the lining of the bladder. It is particularly useful when there is residual irritation and when you still need to go the bathroom frequently.

I use a fresh plant tincture with patients: 1-2ml three times a day.

You can also purchase the root (go organic) and make into a tea or add to broth. Use 1 heaped tablespoon per 1 cup of water. To extract the most amount of soothing qualities, allow the herbs to soak in cold water overnight, then bring to boil, simmer for 10 minutes then allow to steep until cooled. Enjoy 2-3 cups a day.

Kidney:

If the infections have gone to your kidneys, nettle (Urtica dioica) seed is a specific kidney tonic that will help with recovery. The seed is considered a nourishing tonic and rejuvenative. It helps to cleanse the blood and clear tissue wastes.

I use an extract and prescribe 2ml three times a day.

The seeds are very easy to weave into your diet. Aim to include 2 tablespoons daily.

What to take for the pain?

If you would like a natural option, wild yam root extract or cramp bark are both very useful. Take 1ml of either every 4-6 hours.  Paracetamol is a reliable pain reliever that is preferable to Ibuprofen as it is processed through the liver as opposed to the kidneys.

What if you’re pregnant?

UTIs are common during pregnancy and do require a different approach. A modified version of the protocol that is safe for pregnancy is:

1. Follow all of the diet and lifestyle advice (just exclude the astragalus and reishi from the broth as these don’t have enough data for safety during pregnancy)
2. Take the cranberry and D-mannose as directed
3. Take the probiotic as directed
4. Take echinacea root extract, 1 drop for every 1kg of body weight every 4 hours until symptoms are gone and then 20 drops three times a day for a few more days (Romm, 2010).

 

When to see the doctor

It is important that you know what to look for that indicates that the infection is getting worse. Some cases need medical care. If you are experiencing:

Blood in urine

Symptoms have not responded to the natural treatment and/or are getting worse within 36 hours

Cold sweats, nausea, dizziness or back pain, it is likely that the infection has travelled to your kidneys. Please seek medical attention immediately.

Clinical Pearls

From my women’s health practice, I have found that the following are all important considerations that are not often discussed with conventional healthcare practitioners.

Treat your partner too

Whether your partner is male, female, cisgender or transgender, these all apply. Some people can be what we call “asymptomatic carriers” meaning, they carry the bacteria that is causing your symptoms, but they don’t experience symptoms. This is because their unique bacterial makeup is able to keep these species in check. I recommend that they take:

Cranberry and D-Mannose twice a day

If you are getting regular infections, you can both do a “round” of two weeks of 4 cloves of raw garlic + the echinacea and goldenseal combination at 2ml three times a day.

A word on hormonal contraception.

There a lot of anecdotal evidence suggesting that women on hormonal birth control (i.e. the pill, mini-pill, Mirena IUD) are more susceptible to UTI. There is not a lot of funded clinical research available, but in my clinical experience, I have seen this association frequently. The pill affects our good-bacteria which play a big role in protecting us from infections. Both the Mirena IUD and the pill, due to their progestin content, lower our internal pH which creates a more accommodating environment for the not so great bacteria. Diet, lifestyle and natural medicine diminish these effects, but it is a risk you need to consider. If you are experiencing ongoing UTI, reconsider your birth control strategy. There are many equally effective natural options out there such as the fertility awareness method.

UTI Test Strips

You can buy urinary test strips that provide you with valuable information. The important values to look at are the:

• pH (a measure of acidity)
• protein
• leucocytes (fancy name for your immune cells).
• erythrocytes (fancy name for blood cells)

The power of having these handy is if you feel you have a UTI coming on and you’re unsure, you can simply test your own urine and see if an infection is underway.

If so typically your pH will be low and leucocytes will be present. If you have protein, high levels of leucocytes and blood, it’s a sign you will need extra help and get a proper urine culture done (a.k.a see your medical doctor).

The strips are useful to measure if your chosen treatment is working as you will see the leukocytes going up or down. It’s very useful and very empowering.  I recommend “Multistix Reagent Test Strips” you can get them online or ask your pharmacy to order them in for you.

Going deeper

In holistic medicine the urinary tract under the guardianship of the water element. Water governs the realms of the emotions, relating to our intimate partners and our essence (also referred to as Jing in Chinese medicine). When we are emotionally depleted, our urinary system can become more vulnerable. Take a moment to ask yourself:

Are you feeling nourished and nurtured on an emotional level presently?

Are you pissed off about anything or anyone?

Are you communicating truthfully and fully in your intimate relationships?

If you do come up with some charged answers, write about it, talk to someone, hold ceremony – whatever you need to do to engage and work through it.

Have I convinced you that there is a lot you can do yourself when it comes to UTIs?  Please share if you have any other essential go-to, I would love to hear from you xx

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With love,

 

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References

Falagas, M.E., Betsi, G.I., Tokas, T., Athanasiou, S., 2006. Probiotics for Prevention of Recurrent Urinary Tract Infections in Women. Drugs 66, 1253–1261. doi:10.2165/00003495-200666090-00007

Howell, A., n.d. Bioactive compounds in cranberries and their role in prevention of urinary tract infections – 2007 – Molecular Nutrition & Food Research – Wiley Online Library [WWW Document]. URL http://onlinelibrary.wiley.com/doi/10.1002/mnfr.200700038/full   (accessed 7.26.17).

Kontiokari, T., Laitinen, J., Järvi, L., Pokka, T., Sundqvist, K., Uhari, M., 2003. Dietary factors protecting women from urinary tract infection. Am J Clin Nutr 77, 600–604.

Kranjčec, B., Papeš, D., Altarac, S., 2014. d-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World J Urol 32, 79–84. doi:10.1007/s00345-013-1091-6

Mansour, A., Hariri, E., Shelh, S., Irani, R., Mroueh, M., 2014. Efficient and Cost-Effective Alternative Treatment for Recurrent Urinary Tract Infections and Interstitial Cystitis in Women: A Two-Case Report [WWW Document]. Case Reports in Medicine. doi:10.1155/2014/698758

Uva Ursi (Arctostaphylos uva-ursi): A Review of Clinical Therapeutics by the American Herbal Pharmacopeia®, 2015. . Alternative and Complementary Therapies 21, 180–181. doi:10.1089/act.2015.29013.uva

Whiteside, S.A., Razvi, H., Dave, S., Reid, G., Burton, J.P., 2015. The microbiome of the urinary tract—a role beyond infection. Nat Rev Urol 12, 81–90. doi:10.1038/nrurol.2014.361