D-Mannose and Hibiscus Extract Review

One of the most common infections seen in women is urinary tract infections (UTI). According to research studies, as many as 11 percent of women over the age of 18, experience at least one episode of UTIs every year. Some speculate higher estimates as many women with UTIs do not seek medical attention. In addition, some women such as the elderly experience a higher rate of UTIs.  

In the U.S., urinary tract infections complaints make up more than 7 million doctor visits annually, including an additional more than 2 million visits for cystitis, a severe UTI complication involving the kidneys. The bacterium E. coli, reportedly is the cause of 90% of UTIs, showcasing great resilience, such as the ability to survive in the human body. Furthermore research indicates E.coli has the ability to transform, and evade antibiotic therapy. Although a common UTI appears harmless, the infection spreading to the kidneys can result in development of cystitis, which is quite serious.

While isolated cases of UTIs may be tolerable, some women may find themselves dealing with recurrent UTIs. The definition of a recurrent UTI is 2 infections in 6 months or 3 or more infections in 1 year. In addition to the bacterium evading detection from antibiotic therapy, in some cases such therapy also wipes out normal bacterial flora in the process, which can be damaging to the body.

Another issue found with long term use of antibiotics is the development of resistant bacteria strains in the gut. This can further lead to UTIs caused by these resistant bacteria that are harder to combat, proving to be even more damaging to the individual’s health.

Furthermore, this happens despite taking standard antibiotic therapy, and can significantly impact one’s quality of life. As a result, alternative methods have been sought after including the use of supplemental D-mannose, and Hibiscus extracts.

D-mannose And UTI Prevention 

Molecular structure of D-mannose from the US Library of Medicine

D-mannose is a simple sugar that is very similar to glucose. It absorbs very quickly into the body and is excreted through the urinary tract. Since it cannot be converted to glycogen, it is not stored in the body. This is beneficial as research has shown that higher doses do not result in side effects on the human metabolism. 

To understand how it works, one must first understand what happens in the urinary tract. Bacteria such as E. coli (known as UPEC, Uropathogenetic Escherichia coli), Salmonella spp., Proteus mirabilis and other bacteria attach to the urinary tract cell surface, leading to the start of a urinary tract infection (UTI). On the cell wall of E. coli bacteria, there are some small finger-like projections that include multifaceted molecules known as lectins on their surface. These molecules serve as an adhesive that attaches the bacteria to the bladder wall, preventing it from leaving the body along with urine.

Research shows that lectins exhibit a greater affinity for D-mannose than the urinary tract walls. Consequently, by consuming supplemental D-Mannose, absorption occurs in the gut, then filtration happens in the kidneys, and the D-Mannose is transported into the urine, where it binds with E-coli’s lectin. This inhibits and blocks the lectins and bacteria from latching and binding to the urinary tract wall.

Ultimately by binding to the free D-mannose, rather than the cell surface, the bacteria are forced out with the urinary flow, thus eliminating them from the urinary tract. The scientific reasoning behind this is that since there is a higher bacteria urine clearance, this decreases the number of available bacteria, thus decreasing the risk of developing a UTI. Along with its effectiveness, some studies show the D-mannose is highly tolerable and safe, over an extended period of time.

Hibiscus Extracts Role In UTI Prevention      

Majority of the world’s therapeutic care is based on medicinal plants. Hibiscus sabdariffa L. (HS), also known as roselle is a plant of the Malvaceae family that is widely available in subtropical and tropical areas globally. It is considered non toxic, and known to be cardioprotective, anti-hypertensive, antioxidative, and hypocholesterolemic.

Research In vitro studies have shown the effectiveness of HS in demonstrated the efficacy of HS in hindering pathogenic E. coli strains, such as enterohemorrhagic E.coli O157:H7 (EHEC), as well as uropathogenic E. coli (UPEC).

Further clinical research results report a decrease in UTI incidence rates in patients who drank hibiscus extracts. A central part of a UTI is renal inflammation, as the kidneys can be heavily impacted. As an anti-inflammatory agent, the HS drink inhibited the activation of certain inflammatory factors, such as LPS-induced nuclear factor-κB (NF-κB). HS also contains anti-microbial agents such as flavonoids and pro-anthocyanidins, which inhibit bacteria like E coli, from attaching to the bladder wall. 

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