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Herbal alternatives to antibiotics for bladder infections

Inflammation of the urinary bladder

There are around 150 million cases of bladder infections worldwide every year. 25-30% of women will have at least one bladder infection during their lifetime. The infection is mainly caused by coli bacteria (Escheria coli), which are transmitted through the intestines.

Women have a higher risk due to their shorter urinary tract. If the mucous membranes at the entrance to the vagina are colonized by intestinal coliform bacteria, the risk is particularly high.

Many women get urinary tract infections after menopause because their mucous membranes dry out as a result of reduced estrogen levels.

Coli bacteria are a natural part of the natural microflora in the intestine, but not in the bladder. When coli bacteria enter the urinary tract and bladder, the immune system's white blood cells are attracted and symptoms of cystitis appear.
If the infection is not treated, in around 5% of cases the bacteria penetrate the urethra into the renal pelvis and cause inflammation of the kidneys (pyelonephritis).

Antibiotics are generally used in the treatment of inflammation of the urinary bladder.dR effective, but have some side effects and there are mainlya the risk of resistance developing. Additionally, antibiotics do not treat the underlying cause, such as a weak immune system.

The big advantage of naturopathic approaches is that, if implemented consistently, they are at least as effective as antibiotics. The main difference is that they do not cause any negative side effects, but at the same time they strengthen the immune system and thus contribute to causal and not just symptomatic treatment. A reinfection is therefore significantly less likely to occur. After antibiotic therapy, on the other hand, there is a risk that the immune system will be weakened due to the intestinal flora now being affected, often leading to fungal infections (intestinal fungus and/or vaginal thrush) and, not infrequently, the next bladder infection very soon.




Study situation on the use of micronutrients as an alternative to antibiotic therapy


D-Mannose can help with urinary tract infections and bladder infections and can often replace antibiotics that have many side effects. D-mannose is a type of sugar that is related to glucose but is rarely metabolized in the body. D-mannose is instead excreted in the urine. On its way through the bladder, D-mannose binds to the bacteria that cause urinary tract infections and bladder infections. Bound to the D-mannose, the bacteria can no longer hold on to the bladder wall (cf. Hung, Chia-Suei, et al. "Structural basis of tropism of Escherichia coli to the bladder during urinary tract infection."Molecular microbiology 44.4 (2002): 903-915).

The preventive effect of D-mannose was confirmed in a clinical study in Croatia (cf. Kranjčec Bojana, Dino Pape, and Silvio Altarac. "D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial."World journal of urology 32.1 (2014): 79-84): 308 women with acute cystitis who had repeatedly suffered from urinary tract infections in the past were divided into three groups after the usual treatment with antibiotics:

For six months, group 1 received 2 grams of D-mannose daily, group 2 received 50 mg of the antibiotic nitrofurantoin daily during the same period, and group 3 did not carry out any prophylactic measures and therefore served as a control group. A total of 98 women suffered from another bladder infection during the study period, 62 of whom were in the control group. At least 21 women in the antibiotic group developed another bladder infection and only 15 women in the D-mannose group. The researchers concluded their study by saying that D-mannose is very suitable for preventing urinary tract infections and bladder infections - especially for people who suffer from recurring bladder infections.


On behalf of the Institute for Quality and Efficiency in Healthcare (IQWiG), it was investigated whether herbal remedies help with recurring cystitis. The scientists' conclusion: The preventive use of Cranberry preparations can be useful in women with uncomplicated recurring cystitis. In comparison with a placebo treatment, there is an indication based on several randomized controlled studies that the infection will not return or will only return later.

To answer the question of whether herbal remedies help with recurring, uncomplicated bladder infections, the scientific team commissioned by IQWiG identified 15 suitable studies. Most of the included studies examined preparations containing cranberries. Here there is an indication of a benefit of cranberry compared to placebo - both in terms of the recurrence rate of the urinary tract infection and in terms of the time until the first recurrence (recurrence). With regard to the prevention of recurrences, in addition to the cranberry preparations, there is evidence of a additional benefit , i.e. an added value, compared to treatment with antibiotics alone, for a preparation made from lovage root, rosemary leaves and centaury.


Various observational studies and one clinical study each prove that the vegetable mustard oils from Nasturtium and Horseradish are effective and well tolerated for uncomplicated respiratory tract infections and bladder infections and even Taken long-term can reduce the relapse rate of urinary and respiratory infections.

Numerous studies show that the mustard oils it contains have antibacterial, anti-inflammatory and antiviral effects. This showed, among other things,athat only by combining the mustard oils of both plants is a particularly strong effect against many different types of bacteria achieved. In addition to a direct growth-inhibiting and germ-killing effect, mustard oils also have an effect on bacterial biofilm formation and the penetration of bacteria into the cells of the inner wall of the bladder (internalization). According to current knowledge, these are essential mechanisms, especially with regard to recurring bladder infections. In addition, the mustard oils intervene in the signaling pathways that are relevant for mediating inflammation and thus help to alleviate the often very painful symptoms of a bladder infection.


The amino acid L-methionine has a urinary acidifying effect: the body needs approx. 0.5 g/day methionine. If you consume more than 1.5 g/day, the body has to break down the excess. This breakdown produces sulfate, which is excreted via the kidneys. Protons are secreted into the urine and it becomes acidic.

This effect is exploited in the treatment of urinary tract diseases, in which an acidic pH value in the urine inhibits the attachment of bacteria to the urothelial cells and inhibits bacterial growth. In addition, methionine inhibits the formation of kidney stones, improves stone solubility and supports the effect of certain antibiotics.




The effect of the pumpkin was first discovered in the 16th century. Century described in connection with the urinary tract. Today we know that the effective ingredients can be found in its seeds, i.e. the pumpkin seeds. Their positive effect on the bladder has been scientifically investigated many times. It is noteworthy that these active ingredients are not contained in the popular pumpkin seed oil, as is often assumed, but only in the shell of the pumpkin seeds.

Pumpkin seeds are indicated for strengthening and strengthening bladder function as well as for treating irritable bladder and micturition problems in BPH. Phytosterols isolated from pumpkin seeds have been shown to have anti-inflammatory, antimicrobial, prostatotropic and urodynamic effects. In addition to the specific phytosterols, non-specific ingredients such as unsaturated fatty acids, certain amino acids, vitamins, minerals and trace elements can also be involved in the therapeutic effect of pumpkin seeds.

The calming and regulating effect of oil pumpkin seeds on the bladder ("bladder tonic") was already described in reports from the 1960s. Later, the effect of 6 g of pumpkin seeds daily was tested in 101 patients with irritable bladders in an open study. During the treatment, the symptoms and the micturition index (daily urine volume/number of micturitions) improved: After eight weeks of treatment, the average urine volume per micturition had increased by almost 60%. Too frequent and painful urination had noticeably decreased. Over 80% of patients reported a subjective improvement.


In addition to its wound-healing power, the Goldenrod was credited with another therapeutic property centuries ago: its diuretic effect. This has been confirmed by modern phytotherapy. Goldenrod herb is now indicated for flushing therapy for inflammatory diseases of the urinary tract and for preventative treatment of urinary stones and kidney grit. Effective ingredients include flavonoids, saponins and phenol glycosides. In addition to the diuretic effect, goldenrod herb has also been proven to have anti-inflammatory, analgesic and mild spasmolytic properties. They prove to be beneficial for urinary tract infections, such as bladder infections.

The ingredients contained in Rosemary include:a essential oils, tannins, flavonoids, bitter substances and resins. In folk medicine, rosemary is mainly used to stimulate the flow of bile and urine, for wounds and eczema as well as for gastrointestinal complaints.

lovage or The lovage root is also one of the tried and tested medicinal plants when it comes to natural therapy for bladder infections, kidney problems and urinary stone disease. For example, the essential oils contained in lovage promote...a the excretion of urine via the kidneys - they have a diuretic effect, as it is called in technical jargon. The urinary tract is therefore flushed more intensively. This indirectly makes it more difficult for bacteria to adhere to the mucous membrane and is flushed out in the urine.

A clinical study (cf. Wagenlehner, F.M et al.: Urol Int 2018; 101:327-336) with over 600 patients from 2018 compared a combination of rosemary, lovage and centaury with the most commonly prescribed antibiotic therapy for acute, uncomplicated cystitis. The result: 84% of the women in the herbal supplement group did not need any additional antibiotics. Both treatment strategies were equivalent in terms of time to onset of effect and reduction of symptoms. And compared to antibiotic therapy, fewer gastrointestinal complaints were observed with the plant-three combination.


Zinc contributes to the maintenance of a normal immune system: white blood cells such as Macrophages use zinc as a toxic weapon to fight bacterial infections.

Vitamin D increases the production of cathelicidin, an antimicrobial peptide that may be able to reduce the penetration of infectious microorganisms into the bladder mucosa by attaching to the adhesive particles of pathogens such as E. coli binds (a similar mechanism to D-mannose) and stimulates the immune response. This is confirmed by a study of postmenopausal women, which found that women deficient in this vitamin were more likely to suffer from urinary tract infections. The study compared the vitamin D levels of women with recurrent infections with those of women who did not experience such episodes and found significantly lower vitamin D levels in the first group (9.8 ng/ ml compared to an average of 23 ng/ml).


Vitamin A contributes to the normal function of the (bladder) mucosa.

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