For BLADDER INFECTIONS, CYSTITIS, cranberry is a powerful anti-adherent remedy that prevents bacteria from attaching to the lining of the bladder and urethra. If bacteria cannot attach, they are unable to survive long or multiply. Cranberry has long been a classic remedy for urinary tract infections (UTI) caused by bacteria such as E. coli, and it has several other potent actions: It acidifies the urine making it less hospitable for bacteria, and also contains hippuric acid which can directly kill bacteria.

For centuries, healers have used botanical remedies which have been handed down to us by our ancestors. Historically, cranberries were first used by Native Americans for their medicinal properties as a treatment for bladder and kidney diseases. Reaching for cranberry juice at the first sign of a UTI is a common remedy and approximately 50 to 60% of women will develop UTIs in their lifetime.¹ Research has found, however, that most juices on the market today don’t have a sufficient concentration to be effective. Cranberries contain antioxidants called proanthocyanidins which have an anti-adherence effect, meaning that they interfere with bacteria’s ability to attach to the bladder wall. However it takes a high concentration of cranberry to prevent infection and bacterial adhesion, which is why a concentrate is superior in action. Apple and grape juice and dark chocolate also contain proanthocyanidins, but not the right kind for UTI’s: cranberry is an example of nature providing specific tools for our use.

According to recent research published in the American Journal of Obstetrics and Gynecology, 160 patients aged 23-88 years who were undergoing elective gynecological surgery had deemed to have a high probability of developing a UTI. Those given concentrated cranberry capsules had 50% fewer urinary infections compared to women receiving a placebo.²

Epidemiologic studies indicate that millions of women suffer from recurrent cystitis, a disorder typically treated with multiple courses of antibiotics, with the risk of developing resistant bacterial strains and other unpleasant side-effects. A 2013 retrospective study summarized and reviewed relevant clinical studies on cranberries. The findings shed light on the mechanism underlying the anti-adhesive properties of proanthrocyanidins, and how they are absorbed, distributed, metabolized, and excreted: Their analysis of cranberry for prevention of UTIs, and evaluation of its efficacy/safety ratio, strongly support the value of cranberry for the treatment of recurrent UTIs in young and middle-aged women.³ 

During the 1880s, German physicians observed that urinary excretion of hippuric acid increased after ingestion of cranberries. Hippuric acid is a bacteriostatic agent, and has the potential to acidify urine and kill bacteria.⁴ Following that discovery, it has been concluded that the usefulness of cranberry juice is based on the urinary excretion of hippuric acid.

Although there is debate about the conclusive evidence and action of cranberry on recurrent UTIs, results of clinical studies suggest a clinical benefit of cranberry juice in preventing UTI in some populations; especially sexually active adult women with a previous UTI. However, the potential of cranberry extract to act as a non-antibiotic alternative for preventing cystitis and thereby reducing the total amount of antibiotics prescribed for UTI, could have great public health significance. In 2003, the National Center for Complementary and Alternative Medicine, a branch of the US National Institutes of Health, announced an initiative to fund research on the role of cranberry in promoting urinary tract health. A controversial 2012 review of twenty-four clinical trials questioned the action of cranberry juice and supplements for preventing UTIs, but the selected trials were also indicated as studies of poor quality.

In our clinic, we have found that a cranberry extract concentrated to a 25:1, at 150mg daily, enhanced by a broad spectrum of botanicals that are antimicrobial, immune boosting, diuretic, and soothing for inflamed tissues, is a highly effective preventive that can head off 90% of UTIs. If a UTI begins, we increase the dose to 450mg daily total until symptoms resolve, and rarely need to prescribe antibiotics. With cranberry, we see even better efficacy with the addition of other synergistic herbs that prevent bacteria from adhering to the lining of the bladder; herbs that are activated in the urine to kill bacteria; and the botanical demulcent marshmallow which soothes inflamed membranes in the urethra and bladder.

Uva ursi or bearberry is a small evergreen shrub. Its leaves contain the quinone arbutin, which is activated in the urine to kill bacteria. Uva ursi is also a preventive: in one well-known study tracking women prone to recurring bladder infections for one year, 20% of the control group had infections, but none of the uva ursi group did. Pipsissewa is an arbutin-containing urinary antimicrobial that also has no action in the blood stream and becomes activated in the urine. Buchu is a flowering shrub native to southern Africa, and its leaves contain antibacterial volatile oils including diosphenol. It also has mucilaginous compounds that soothe the urinary tract lining, and it is a diuretic improving the flow of urine to flush through the bladder. Oregon grape root is rich in berberine, which can activate macrophages, white blood cells that engulf and kill bacteria. Berberine also prevents bacteria from adhering to human cells. Marshmallow root is a demulcent, containing soothing mucilage which adds a protective coating for the bladder and urethra, soothing burning and irritation.

Recommendation: Cranberry concentrate (25:1) 150mg daily as a preventive, or 450mg daily for UTI symptoms, or as directed by your healthcare provider. In addition, uva ursi leaf extract 300mg, buchu leaf extract 300mg, pipsissewa herb 300mg, Oregon grape root 200mg, Marshmallow root 150mg, for 150mg cranberry. Like most herbs, it is best absorbed between meals.

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