D- Mannose strength

[Lacelady]

Happy New Year to you all.

I have been reading the posts about UTI ‘s and the recommendations that D-Mannose is a good supplement for this condition.

During November I was admitted to Hospital with a Kidney infection resulting from a UTI. I have been taking antibiotics on and off since the end of October. They clear up the infection but I still have discomfort when I go to the toilet.

I wondered if the D-Mannose would help clear it up, my doctor recommended Cranberry juice but I found that too acidic and it gave me acid reflux.

I was wondering what strength of D-Mannose tablets you could suggest? It is very confusing trying to decide between all the different companies and strengths.

I also read that some people developed stones and grit that irritated the bladder from taking Adcal.

would it be a good idea to stop it for a while?

just a quick note to say I am on 5mg pred , I was down to three but with all this upset I am now on 5

Thank you in anticipation of you reply’s

[PMRpro Ambassador]

I would definitely try giving up the calcium for a while or at least cut it down. It is mostly only a problem when bone density is good and there is less need of calcium to go to the bones. Drinking lots helps it flush out without forming grit too.

This

healthline.com/health/d-man...

suggests the doses shown to help in research studies. You want to identify an affordable and convenient size of tablet for the dose you choose to take. The variety I buy is 500mg capsules and I take 3 at once when I have symptoms. I have never needed to go higher or to take it for more than a few days - but I do have a low threshold for taking it.

I wish I knew why they go on about cranberry juice so much. It isn't cranberries that do it, it is the D-mannose IN the cranberry juice! Instead of developing a taste for a very acidic drink, just use the effective substance with a drink you enjoy! So much easier to carry home than gallons of juice ...

[Lacelady in reply to PMRpro]

Thank you for your quick reply. Your advice was very good as usual.

I read the article and it made it clear that it wasn’t necessarily the cure but that it helped a lot of people so I will definitely start taking it.

I will also stop the Adcal for a while.

Thank you so much

[Blearyeyed in reply to PMRpro]

It's the concentration of proanthocyanidins ( did I spell that even vaguely right , argh! Brain Fog) they can reduce the ability for the UTI bacteria to attach to the tract walls, but cranberry juice is also high in salts that can cause grit or stones if used too much too , so this is why results with juice instead of supplements is unclear.If you get a well informed urinary specialist they don't suggest drinking cranberry juice to people with recurrent UTI or kidney infection activity but suggest or prescribe the variety of D- Mannose supplement with Cranberry Extract instead.

I'm off for a CT scan on Friday for kidney and liver issues , hopefully , had to cancel twice because of infections.

[PMRpro Ambassador in reply to Blearyeyed]

You did!!! And quite!!!! The less "stuff" accompanying the active ingredient the better!

[Blearyeyed in reply to PMRpro]

I'm giving myself a gold star for spelling then , that's put a smile on my face for the rest of the day. And yes , simple minds are easily satisfied!😆😆😆🏅🐝🎓

[Jackoh]

Hi I take D- Mannose in powdered form as it is very easy to increase if needed. I take one scoop full in a very small amount of water every evening before I go to sleep as a precautionary measure. On the few times I have developed a UTI I have just taken several doses over the day for a couple of days and that has flushed the infection out. I also drink a lot of lemon water.

I am still taking HRT and have regular dexa scans. From these it appears that my bone density is fine so for about two years now I have not taken Adcal. 💐

[Lacelady in reply to Jackoh]

Thank you Jackoh for that information. It is good to hear from someone who takes the D-mannose and that it works. I have ordered some this morning. Thank you

[Poshdog in reply to Lacelady]

Like Jakoh I take a precautionary tablet every night. Works well

[Lacelady in reply to Poshdog]

Thank you I will probably do the same.

[Brikel]

my wife who has a lot of UTI’s suggested that you take cranberry tablets high strength 1 per day Available from Boots chemist

Regards

Brian

[PMRpro Ambassador in reply to Brikel]

D-mannose is the active ingredient in cranberry.

[Lacelady in reply to PMRpro]

That is what I understood from your reply. I am open to try anything to get on top of this. I do not want to end up in hospital again Thank you

[Lacelady in reply to Brikel]

Thank you Brian . I have ordered some D-mannose but if it doesn’t work I will try the cranberry tablets. Thank you for replying

[DancingBonny]

Hi Lacelady, having been in hospital 4 times with UTI's, and reactions to Covid boosters, one of the consultants recommended organic Cranberry Juice, so ordered some Loov from Amazon. It is very expensive but I have not had a UTI in the past 6 months, nor have I had the latest Booster. One of the side effects of the UTI's was brain fogs and I don't want any more of those! Whilst antibiotics helped with the infection, it took me a long time to feel back to normal from the brain fogs. At one point I couldn't even type my password into my computer which was pitiful - particularly as in a former life I used to be a top personal assistant! I had an enormous amount of help from my husband and the book he has just written "Your Conscious Brain - How it all Works and Why" by Jan de Vinter. An awful lot of doctors think that all that is required is for a patient to be given the appropriate antibiotic to kill their UTI infection, but that is just the start. You have to go home and work very hard in all the appropriate ways to fully recover your lost and bruised capabilities in the mind. If you don't do this, the probabilities are that you will not fully recover and doctors will think you have dementia,

I find the Loov cranberry juice easier to drink (I take a small amount 3 times a day) if it is shaken up well but am interested in D-mannose - hadn't heard of it but will do some research.

[PMRpro Ambassador in reply to DancingBonny]

The link I gave further up the page gives a lot of information. As I say, it is the active ingredient in cranberry juice.

UTIs are the most common cause of confusion in elderly patients brought to the ED - should ALWAYS be looked at first. Play a major role in sepsis in the elderly too.

[Lacelady in reply to PMRpro]

Thank you for the article it was very informative. When I was taken into hospital shivering and shaking uncontrollably I did wonder if it was sepsis but no one said so. Luckily I recovered quickly with the antibiotics.

[Lacelady in reply to DancingBonny]

Thank you for that information it does ring a bell with me as I was very confused during the worst of my infection. When I was taken in to hospital I was not sure what day or time it was but I recovered quit quickly. I hope I am thinking clearly now.

[Blearyeyed]

I take D-Mannose with Cranberry Extract prescribed by my consultant because of recurrent UTIs and kidney infections. The dose I was prescribed is 2 800mg capsules a day , which should give an absorbed amount of 1000-1200mg.

I did give an explanation in replies to Pro about the reason for cranberry extract but change in advice on drinking juice if you want a look.

I don't take extra Calcium supplements ( except for the smaller dose in a combined vitamin pill ) so I don't take Adcal , but I do take Vitamin D , it's important to find a replacement Vitamin D supplement if you stop taking Adcal. I was asked about Adcal by the Specialist and they did say that they would have stopped it while symptoms were ongoing.

The D- Mannose generally keeps my UTI under control , or when I do get a yearly bout of kidney infection it helps reduce the symptoms and reduces how many courses of antibiotics I need to take.

You do also need to be prepared to drink the recommended fluid intake each day and get a lot of exercise going to the bathroom .

You usually need a kidney function test and check of electrolytes to make sure you haven't lost too many salts and have an imbalance after your infection.

I'm off for a scan this week as my symptoms continue , and if yours are too after a number of antibiotic courses , or you have very intense pain or swelling in the kidney or bladder before urinating, I would suggest speaking to the GP and asking for further tests or examination. There is a possibility of grit or kidney or urinary tract stones causing the issue. Even a small amount which needs to pass naturally causes a large amount of pain and can cause recurrent infections.

But it's worth making sure that there are not stones there that would need extra monitoring or intervention to break up.

[Lacelady in reply to Blearyeyed]

Thank you for the very informative information. This is all new to me I have never a UTI or kidney infection before so I was interested in you opinion. It seems that a lot of people suffer with it as if PMR/GCA isn’t enough. I am pining my hoops on the D+mannose to keep it at bay, however I am planning to go back to the doctor soon if nothing improves. I did wonder about asking to see a Urologist as I feel taking antibiotics week after week can not be good.

Thank you

[Blearyeyed in reply to Lacelady]

Unfortunately, unless you get to the point if suffering recurrent UTis or Kidney infections they do follow guidelines which try you on first line , then second line antibiotics and so on until the strain is cleared.The D- Mannose with cranberry extract helps the symptoms of a UTI, or can help prevent the infection in the urinary tract , so even if you don't use it all year round it is worth taking it from the end of summer during the winter months when the circumstances make it more likely to get a UTI.

The D- Mannose does not do much to help reduce a kidney infection , but if you have a kidney infection without starting with a UTI it can help reduce the chance of getting a UTI as well.

The D- Mannose with cranberry extract is used because although D - Mannose comes from cranberry their are two active ingredients in the combined supplement doing two things. The D- Mannose is a monosaccharide , simple sugar , which changes the acid balance of the urine making the urinary tract a less welcome home for bacterias that don't like acidic environments. The Cranberry Extract contains a higher concentration of polyanthocyanidins , which can cause a change in the tract wall making it less easy for bacterias to attach to. Much like any supplement the success of it often depends on the patient and their own history.

A reason that UTIs and bladder infections are more common while taking steroids is that collagen production is effected which means that everything which contains connective tissue and muscle can become less elastic or taut , meaning that urine may remain in the tract after urination making it more likely for bacteria to have chance to reproduce. Another reason is the effect on sugar balance. Lastly , higher steroid doses can cause reduced immunity making it easier for the infection to develop and harder to treat.

If you are stopping the Adcal temporarily, do get a Vitamin D supplement , as low Vitamin D can cause an increase in pain and reduce bone and nerve health. BetterYou spray with Vitamin K 2 is very good . You should also consider increasing your consumption of Calcium from foods. Probiotic yoghurt is the best source containing about 42% of your daily need in 8ozs , or a couple of servings it has double the calcium content of other dairy products. Dark green leafy veg , especially Curly Kale , Broccoli and Spinach. Salmon , including tinned. Hard cheese. Beans. Almonds and almond butters . Soya , if you are allowed it . Fruits high in calcium are Oranges , blackberries , guava and papaya.

[Lacelady in reply to Blearyeyed]

I am really beginning to understand how this works. Thank you for your help. I did wonder if as you say in your other post that things needed to heal after all the antibiotics and infection. It seemed logical to me.

[PMRpro Ambassador in reply to Lacelady]

The question is whether the symptoms of cystitis are due to an infection or something else. Urgency can be due to irritable bladder which often accompanies PMR and also taking pred, pain on urinating can be due to mechanical irritation which can sometimes happen if you take calcium supplements and calcium grit forms because of too much calcium or concentrated urine.

If it is either of those - abx won't make a difference, nor if it is the wrong abx for the bacteria causing an infection.

[Blearyeyed in reply to PMRpro]

Yes, people also forget even if they had an infection , or cystitis, the inflammation and damage caused while suffering with a urinary condition can cause some pain and irritation for weeks after the original infection or problem has cleared up. The system is sensitive and needs time to heal, discomfort or urgency can continue for some time.

Irritable bladder or Irritable UT are common as you say with no underlying infection.

Thrush as a side effect of using antibiotics can also effect the bladder and UT and can often be the cause of the continuing symptoms unless that is diagnosed and treated too.

Kegle exercises can help in the recovery period , and help reduce the chances of urinary issues in the first place. They are well worth doing , especially if you take long term steroids.

[Lacelady in reply to PMRpro]

I thin the reason that I was given three different antibiotics was because through the tests they decided I was on the wrong ones initially. Thank you

[PMRpro Ambassador in reply to Lacelady]

All too often they DON'T do a culture. Did the third one work?

[Blearyeyed in reply to PMRpro]

Drives me insane , as it is such a false economy. As often the first and second courses are those that are cheapest and most common to get results , but not everyone has the most common infections so they've taken two courses if antibiotics unnecessarily, and probably made them less efficient because of the build up of resistance when they are the ones you need.The other thing that annoys me is that they are very resistant in giving the antibiotic for a longer course in the first place if the patient already has a chronic condition or is on medication which might mean the infection will take longer to treat.

They are too desperate to follow course guidelines which are based on treatment for generally healthy people. I know they have to be conscious of not causing antibiotic resistance , but all the fiddling about , short doses and cost cutting is more likely to cause the resistance when they jump from one short course to another .

[PMRpro Ambassador in reply to Blearyeyed]

Yeah - but what they do is causing resistance: not giving a long enough course and having to go back for another attempt having built up the bacteria muscles on not enough abx.

[Blearyeyed in reply to PMRpro]

Exactly, drives me mad. The amount of times it took for them to believe me when I said , it's a kidney infection , I don't have cystitis, I have no pain or burning when urinating , the pain is in my kidneys not my tract or my bladder. You just read that , I'm sure I put it simply enough , didn't I?Trouble us they also do a urine test which comes back from the lab with just the simple statement of, UTI treat as recommended, or , kidney infection treat as recommended, but they don't spend the nominal extra cost to have the lab check and specify the bacterial strain. If they did that they could give you the appropriate antibiotic straight away preventing unnecessary overuse of ineffective treatments in the first place.

[PMRpro Ambassador in reply to Blearyeyed]

I put a sterile sample in (being on tocilizumab) and the stupid Italian female only specified a DIP for the lab to do. I'd done that myself before I rang them. So next day I got a phone call telling me I needed to take another specimen in for culture. A process that was going to take me over 3 hours. All she'd had to do was request dip and culture as appropriate. She wasted over 24 hours - and by the time I'd have got there the lab would have just shoved it in the fridge for the weekend. And she wanted to explain to ME WHY they needed a culture. I worked in the labs!!!!

[Lacelady in reply to PMRpro]

That must have been very frustrating for you, having the delay . The team at A&E were really on the ball and soon fixed me up with a drip so that I felt a lot beer in the morning.

[Lacelady in reply to Blearyeyed]

The doctors and the nurse practitioner only did a dip test but sent it off to the lab that was when they said I was on the wrong antibiotic. However I had been on two lots by then.

[Lacelady in reply to PMRpro]

Yes, it was the one they gave me in hospital I recovered quite quickly once they had established that it was in my kidneys.