I have had a second bout of klebsiella pneumoniae infecting my bladder which, for me, results in an increase in urinary urgency and seems to maybe have caused a slight flare of my osteitis pubis. I completed this round of antibiotics and I want to avoid having these two issues again since my ART simulation is on Monday and hopefully I will get to begin treatment within a week or at most two. Cranberry juice has long been offered up as a claimed way to either fight or prevent UTIs, but it seems that the concentration in the urine is important:
Is a cranberry extract beneficial or is there something else that could be looked into? Which one gives the best concentration? Any personal experiences to share?
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farmanerd
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The urologist peed all over my cranberry parade. I had been giving my husband AZO and promoting cranberry juice (pure, expensive, bitter kind), but the urologist told him it wasn't possible to consume it in quantities that would make a difference.
I like your turn of phrase, "The urologist peed all over my cranberry parade." My wife pushed the 100% cranberry juice on me during my first UTI and I dutifully drank it. If nothing else, it did provide hydration and vitamin C.
I would certainly drink 100 % cranberry juice in high quantities for the next couple of days. If nothing else, it keeps you very weel hydrated. But it is true in my experience and the experience of many of my clients that it does help to clear out infections particularly UTI.
These klebsiella pneumoniae infections are really strange. I mean, how do we get them? And, once we have them, they seem to be able to get to everywhere in our system and infect everything. And they are so difficult to treat. I am really hoping for you that you are over that now.
It's the last thing you'll want to take when you are having ART. It, or any acidic liquid, stimulates the kidneys to produce more urine. The urinary irritation and urethral swelling from the ART can block up your bladder and cause urinary retention.
On Monday, I will talk to my RO about anything that I might be considering. With a positive margin at my bladder resection, things may get a bit irritated if that is in the radiation profile -- another question to ask.
Amy B. Locke MD, FAAFP, ABIHM, in Integrative Medicine (Fourth Edition), 2018
Cranberry (Vaccinium macrocarpon)
Cranberry juice and powder have successfully been used to prevent urinary tract infection. The use of cranberry dates back to Native American tribes who used it for the treatment of urinary conditions. Historically, cranberry was thought to work by acidifying urine, yet recent studies have shown effects with minimal change in urine pH.41 The presumed active compounds, proanthocyanidins (PACs), inhibit bacterial adhesion to the bladder wall and decrease bacterial virulence.42,43 In a small trial, a dose of 72 mg of PAC was effective against E. coli infection, with the effect appearing to be dose dependent.42 The optimal dose of cranberry for the treatment of UTI is currently unknown.
Heterogeneity among the results of previous studies has made practical advice difficult, with variations in the dose and type of cranberry product making comparisons particularly challenging. A 2012 Cochrane review evaluated 24 randomized trials using cranberry juice or capsules and found some evidence that cranberry juice may decrease the frequency of UTI in susceptible women but found a high dropout rate, likely related to difficulty adhering to daily juice consumption.44 In several trials, cranberry was found to be similarly effective to antibiotics. Optimal dosing could not be determined by these studies, with the authors concluding that cranberry juice should not be recommended and cranberry extract should be studied more thoroughly. A more recent trial in postsurgical patients found a 50% reduction in UTI compared to placebo among women administered two capsules bid (equivalent to two 8-oz glasses of cranberry juice daily).45
Other trials have examined recurrent UTI in a more general population of women. In a randomized control trial, cranberry juice was compared to cranberry powder and a placebo in sexually active women.46 The incidence of recurrent UTI was found to be reduced by approximately 30% in both cranberry groups. The doses used in this study were 250 mL of cranberry juice three times daily and concentrated cranberry juice tablets twice daily. The size of the tablets used was not disclosed. A separate trial used only 30 mL of cranberry-lingonberry concentrate daily, with a 20% risk reduction in recurrence observed.47 Small studies that have shown success with cranberry tablets have used 400 to 800 mg doses twice daily.48,49 The size and design of these studies may limit extrapolation to larger populations. A trial randomizing older women to 500 mg of cranberry extract or 100 mg of trimethoprim found equal efficacy in the prevention of UTI50; however, a trial in younger women comparing 500 mg of cranberry extract to TMP/SMX found cranberry to be inferior.51 Cranberry was also associated with a significantly lower rate of antibiotic resistance. Further studies are required to determine the most effective doses and frequency of cranberry supplementation.
Although cranberry products are frequently used to treat acute infection, the efficacy of this approach has not been studied.52
Dosage
16 oz (500 mL) of unsweetened cranberry juice daily or cranberry extract 500 mg daily to 400–800 mg bid.
Precautions
Moderate interaction with warfarin is possible.
Many cranberry beverage products on the market contain only a small amount of cranberry juice and a significant amount of sweeteners. These may have a minimal impact on the urinary tract and a potentially negative impact on overall health.
Besides cranberries you could take D-Mannose 2 grams a day and get a prescription for methenamine 1 gram tablets twice a day. Best of luck with the UTI and your treatment.
If you are concerned about getting an UTI and the RO does not want you to take anything that could acidify the urine, you could talk with an internal medicine doctor about prophylaxis of UTI with Bactrim or other antibiotics:
I have been taking cranberry juice and cranberry pills for years lots of people tell me it doesn't do anything, doesn't work for men,etc. But when I get that urgent feeling it works for me.
Patiemts sometimes take UTIStat with success----description:
UTI-Stat with Proantinox is a natural urinary tract cleansing complex containing a proprietary blend of concentrated Cranberry Proanthocyanidins, Ascorbic Acid, D-Mannose, FOS and Bromelain - to inhibit adhesion of infection causing E-coli bacteria to urinary tract walls, increase urinary acidity to create a less tolerable environment for E. Coli, and stimulate the growth of probiotic bacteria in the small and large intestines. UTI-Stat has been shown effective in reducing symptomatic UTIs, including urgency and frequency of urination, when used in conjunction with hydration and a hygiene program. UTI-Stat helps to support urinary tract health and prevent recurrence of infection. Each one ounce (30 ml) serving of UTI-Stat with Proantinox provides as much cranberry proanthocyanidins as approximately five 450 mg cranberry tablets (equivalent to 16 eight oz glasses of cranberry juice cocktail).
My PT mentioned that there was something that was more specific for E-coli, perhaps UTI-stat is it, and she never mentioned the name after I told her my infection was klebsiella pneumoniae (kp). During a quick search, I didn't find any mention of UTI-stat and kp. I'll look further today and maybe query my URO or his PA on the issue.
Thank you for the info. Does heat get applied when concentrating, possibly decomposing some compounds, is that why cold-pressed is preferred? Why an empty stomach?
The 'from concentrate' that I just had . . . Aaaaaack! I can see why participants in studies could have a hard time staying compliant with dosing. Need to go to the nearby Fresh Thyme to see what they have.
I also have read about & used D-Mannose capsules. I have used the brand Solaray. I think the specific dosage to your symptoms is key to it effectively working. But please do some of your own research. You may need to take 3 or 4 capsules at once with a tiny about of water, (you don’t want to flush it out yet) you wait 40 mins & let it stick to the bad guys then start drinking water. The hope is to begin flushing out that bacteria. At first, I believe you can do this bigger dosage, then taper off after a few days & do a “maintenance” dose. But again, please research this as I’m not 100% certain for your specific case. I’d stay away from cranberry juice, and any juice for that matter. Good luck!
I felt a bit like a dog with his tail between his legs when I wrote this post. I am so glad for all of the posters on this forum. Darn watery eyes from ADT again!
“ Dog in heat”. That cracks me up. Don’t worry about misty eyes farmanerd . After fours years of no T,...I sometimes cry for no reason at all. All part of the getting in touch with our feminine side amigo .
During my radiation treatment as it began to burn when i urinated I was told to drink the nasty stuff. Not the sweet good cranberry juice. I had to mix it to drink as much as they wanted plus I took the pills. It did work to stop the burning. I don’t think it was infection.
Some people take mannose (an indigestible sugar) to prevent adhesion of the bacteria to the bladder wall. My wife is taking it and it seems to be helping her. And if you’re taking antibiotics, then taking mannose along with the antibiotics may improve the outcome. Cheers, Phil
I had burning on urination for a year after Braccy---two bouts of antibiotics had no effect but a handfull of dried cranberries a day for three weeks fixed the problem jim
Antibiotics kill your good gut bacteria. Cranberry & Pomegranates repair it. As a matter of fact I was just listening to a podcast where a DR talked about the “only people that immunotherapy works for happen to have a specific bacteria in gut that actually comes from polyphenols from those two items & unfortunately a lot of cancer patients have to take antibiotics so it may be why immunotherapy is fixing less than 20%”.
We were getting IV’s Of tons of polyphenols but now are going to make our own suppositories. It’s just too hard to drink enough!
But yes, that’s a great place to start! Just not the sugar kind ;(
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