Treat and Prevent UTIs Without Drugs

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Urinary tract infections (UTIs), which are infections anywhere along the urinary tract including the bladder and kidneys, are the second most common type of infection in the United States. (1) These infections can be caused by poor hygiene, impaired immune function, the overuse of antibiotics, the use of spermicides, and sexual intercourse. The most common cause, accounting for about 90 percent of all cases, is the transfer of E. coli bacteria from the intestinal tract to the urinary tract.

For those of you who have experienced a UTI, there isn’t much you wouldn’t do to avoid another one. While I personally have never had a UTI, my patients have told me how the pain, burning, nausea, and even bloody urine can be debilitating, and for those who get chronic UTIs, the fear of infection can be enough to prevent engagement in any activities that could trigger one. And for those who get them frequently, sometimes a specific cause cannot even be pinpointed. This can be frustrating and scary.

Fortunately, there are a few methods of natural treatment and prevention that have worked extremely well for my patients, to the point where they no longer worry about getting a UTI. These treatments don’t require a prescription, are inexpensive, and completely drug-free. While your doctor may not know about them, I hope this article will help you completely avoid UTIs – or at least significantly reduce their frequency and severity.

Standard Treatment

Doctors typically use antibiotics to treat urinary tract infections, and the type and duration depend on your health condition and the type of bacterium found in your urine. (2) 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!

Natural Treatment and Prevention


D-Mannose is by far the most effective supplement for both treatment and prevention of UTIs. Similar to glucose in structure, D-mannose is a naturally occurring sugar that is found in a number of fruits, including apples, blueberries, and cranberries. (3) This sugar is the reason that cranberry juice has been commonly recommended as a UTI treatment, though it is far easier to get the recommended dosage from a supplement. D-mannose is effective because it attaches to E. coli bacteria, causing them to stick to each other and preventing them from sticking to the walls of the urinary tract. (4) The bacteria can then easily be eliminated from the body during urination.

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.

The typical dose of D-mannose for UTI treatment is 500 mg, in capsule or powder form, taken in a glass of water or juice every two to three hours for five days. It is a good practice to continue taking the supplement even after symptoms have diminished to ensure complete elimination of the bacteria in the urinary tract. This dose can also be taken as a preventative, or prophylactic, method.

While there have not been any peer reviewed research to support the effectiveness of D-mannose in treating or preventing UTIs, clinical and anecdotal experience suggests it is highly effective for the majority of infections, both acute and chronic. Some of my patients who have used D-mannose as a UTI treatment method have even described its effects as “miraculous” – so it’s definitely worth a shot!

Alternative Treatments for Chronic UTIs

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.

Biofilms are an accumulation of microorganisms and their extracellular products forming structured communities attached to a surface such as the lining of the urogenital tract. (5) The development of a biofilm can make infections extremely hard to treat, since they commonly return shortly after treatment is stopped. The antibacterial resistance of pathogenic biofilms is one of the major reasons why those who get a UTI are highly susceptible to getting more in the future – if the biofilm is not completely eliminated, the infection will eventually return at some point.

This is why the use of biofilm disruptors can be helpful for preventing the recurrence of chronic UTIs. (6) The biofilm disruptors that I recommend to my patients are InterFase Plus from Klaire Labs or Biofilm Defense from Kirkman. These contain specialized enzymes to disrupt the biofilm matrix embedding potential of pathogens, and dissolve the sugar and fibrin components of most pathogenic biofilms. By destroying the biofilms, the recurrence of UTIs despite proper hygiene can be reduced. (7)

Lauricidin is another supplement that may be helpful in treating UTIs, particularly those that are caused by bacteria other than E. coli. Lauricidin (a proprietary form of monolaurin) has anti-viral, anti-fungal and anti-bacterial activity, and is specific against pathogenic bacteria so it won’t disrupt beneficial bacteria in the gut. It is highly effective at combating gram positive bacteria in the families of Streptococcus, Staphylococcus, Corynebacterium, Listeria, Bacillus, and Clostridium. (8) It works by disturbing the integrity of the bacterial cell membrane, blocking replication and making it easier for the immune system to destroy the pathogen. Lauricidin is only helpful, however, for UTIs not caused by E. coli, which is gram negative and has a different kind of outer cell membrane than gram positive bacteria.

Nattokinase from Source Naturals is another enzyme that has been shown to dissolve biofilms. (9) Produced by the bacteria found in the fermented food natto, this enzyme is proteolytic and can help break down the fibrin proteins that maintain the structure of biofilms. Because of its fibrin-breaking ability, it’s important that nattokinase supplements are not taken by people with bleeding disorders, or by people who are taking Coumadin (warfarin), aspirin, or any other drug that influences blood clotting, unless supervised by a physician.

Apolactoferrin (or lactoferrin) is one more supplement that I recommend to my patients with recurring UTIs. This multifunctional protein Lactoferrin is a component of the immune system with antimicrobial activity, and is part of the innate defense, mainly found in secretions and mucosal surfaces. (10) Lactoferrin has been shown to block pathogenic biofilm development by binding to iron and causing the bacteria to “wander” across surfaces instead of forming cell clusters and biofilms. (1112) One study found that the amount of E. coli bacteria in the kidneys and bladder of mice was significantly reduced 24 hours later by oral lactoferrin treatment, compared to a control group. (13) More research is necessary to demonstrate the effectiveness of lactoferrin in treating UTIs, but I believe it is worth trying, especially if dealing with chronic UTIs.

Utilizing the latest research when choosing the best treatment for UTIs is vital to providing the most optimal healing experience for patients. Having a disposal of treatments that practitioners can choose for each patient can have a massive impact on how effectively patients recover from these types of infections.

One of the ways practitioners can learn to apply different methods of UTI treatment is taking the PTP Adapt Practitioner Training Program – a 12-month program that combines functional medicine and ancestral health to help practitioners treat the root cause of disease instead of just managing symptoms.


  1. I have a UTI and have been diagnosed with antibiotic resistant ecoli ..verified by culture. It is sensitive to Macrobid and after 7 days of treatment I felt ‘cured.’ However after 4 days of stopping treatment it returned. I started d mannose yesterday as well as another course of Macrobid. Does any one have any experience like this or any suggestions.

  2. Can you tell me what product works better? Interface plus or Biofilm defense? Also, how much do I use. I’ve had IC for 6 months that came out of nowhere. I truly believe it’s an embedded infection.

  3. Good info, I knew about the d-mannose but not the other and I have no idea how to find out if it’s from E coli or what, but I have been told that nothing natural Works once it’s full-blown, I’m dealing with one now and absolutely hate taking antibiotics because I spent a fortune building up my immune system with probiotics among other thing

  4. Dr. Kresser: I have a chronic UTI, 15months. I have been infection free for no more than six days; Eight antibiotic treatments to no avail. I am not normally susceptible to UTIs. The bacteria are different now. My infection is nosocomial—from a brief hospital visit. It went into Pyelonephritis, so I am greatly concerned and must get rid of the MDR E. coli. I tried D-mannose several times, even at high doses: nothing. I am about to begin a new phase of self-guided therapy using the very biofilm disrupters you discussed here, plus phage. Previously, phage had no positive effect on my infection, but combining with biofilm disruption might work. I am hopeful. Treatment may need a full year, due to E coli’s ability to slow epithelial tissue turnover, which in the healthy state is three to six months. E. coli invade cells below the surface and form biofilm-protected intracellular colonies. I am sure you have found and read that literature, or if not you need to keep reading. Recently FDA approved phage as GRAS. There is now a dry phage supplement that claims to be effective against E. coli: UriAlive, and others, but they are all the same 4 phage. I went to Eliava, but returned without success. I wrote you before but you did not respond. I am on my own with this, and so are many others. Chronic biofilm infections are increasing, and the medical community is clueless.

  5. Hi I have suffered with uti all my life I started taking D.mannose 2wks ago as a preventative I take 1, 500mg every morning on a empty stomach so im praying this will stop me getting them. Is 500mg enough for a preventative dose.please advise thank you.

  6. THANK YOU!!! I have been struggling with recurrent UTIs. In the past a couple rounds of antibiotics has solved the problem. This past January I wound up with a killer UTI. Bactrum, Macrobid, and a round of Cipro. Got a little relief before having to go two more rounds with Bactrum and Macrobid. Everytime I’d finish a round I’d be better for a day or two, then it would start in again. The cultures said it was caused by E Coli that was sensitive to all three drugs. Still it kept coming back. Cranberry doesn’t help. D-mannose helps some. Started a probiotic specifically targeting feminine health, with a tiny bit of help. Looking for a natural answer I found your page here. Thank you for introducing me to Lactoferrin!!! I can’t believe how simple this is. WHY don’t more doctors know about this. I started taking it when my symptoms were returning after last round of Macrobid. Within a day or two I was feeling better. I’ve had 2-3 days now, where I am feeling about 100% normal. I’m not afraid of a trip to the bathroom! No pain in the evenings which was my worst time. So happy! Question…how long should I continue taking the supplement? THANK YOU, THANK YOU, THANK YOU!!!!

    • Hi Charlotte,

      Which strain of UTI did you have? Also, did you take anything else with lactoferrin??

      Thank you!

    • Charlotte, just posting hoping you come back and check this. Did Lactoferrin continue to do the trick for you? How much did you take and how long did you take it for? Thanks!

  7. Hi there,

    I had a uti infection caused by E. coli bacteria 2 months ago. I took macrobid, cipro and one other antibiotic to get rid of it. However this week my symptoms have come back despite having a negative culture. I believe my issue is Biofilms. I have ordered the Kirkman Defense you mentioned. I am waiting for it to arrive. Do you know if I’m supposed to take an antibiotic with it to ensure the bacteria is killed off?

  8. I was on microbid until I became allergic to it. I would get anot her uti a week after antibiotic treatment. I didn’t know what to try and a friend told me about D-Mannose and it cured the uti and I take 500mg a day and habe not had a uti in over 3 months.

  9. I’ve had Cipro about 4 times in the last 10 years. Last time I had tendon damage in my left foot, about 2 years ago. Until today I haven’t been able to workout without feeling it and fearing to tear it again. I wish I new before. I have an UTI right now and bought some d mannose with cranberry. I have used supplements like cranberry pills, olive leaf extract and vitamin C effectively before, but it’s not working this time. I hope this works because I get UTIs often, no matter what I do to prevent them.