The Role of D-Mannose in Promoting Urinary Health

Cranberries, oranges, and apples on a colorful table cloth.

D-Mannose is a naturally occurring simple sugar found in fruits — such as cranberries, apples, and oranges — that is often taken as a supplement to promote urinary health.

D-Mannose is a naturally occurring simple sugar found in fruits — such as cranberries, apples, and oranges — that is often taken as a supplement to promote urinary health. Unlike other sugars, D-Mannose is not metabolized by the body and is excreted largely unchanged in the urine. Its primary benefit lies in its ability to bind to bacteria in the urinary tract; thereby, ensuring that bacteria is flushed out of the urinary tract.


This article explains the benefits of D-Mannose for urinary health and also discusses its use during pregnancy and lactation, safety in children, and general usage guidelines and considerations.

What Is D-Mannose?

D-Mannose is a type of sugar that is related to glucose. It occurs naturally in several fruits and is also produced in small amounts by the human body (1). Unlike glucose, which is readily metabolized by the body for energy, D-Mannose is primarily filtered out by the kidneys and excreted in the urine (1). This unique property makes D-Mannose particularly useful in the urinary tract, where it can help manage infections by interfering with the ability of bacteria to adhere to the walls of the bladder and urinary tract (2). As a result, D-Mannose is often used as a natural supplement to promote urinary health.

How Does D-Mannose Support Urinary Health?

D-Mannose works by making it so that E. coli bacteria, the most common cause of UTIs (3), is less able to stick to the walls of the urinary tract. E. coli bacteria have tiny finger-like projections (fimbriae) with sticky ends (adhesins) that are normally able to attach to the bladder lining. When D-Mannose binds to adhesins, it can make it difficult for bacteria to latch onto the urinary tract walls. Instead, the bacteria are washed out of the body during urination, helping to maintain urinary health (4).

Use During Pregnancy & Lactation

Urinary health is particularly important during pregnancy, and many pregnant women report occasional urinary tract symptoms (5). Antibiotics are frequently prescribed for urinary symptoms, even during pregnancy, and are associated with adverse effects and the risk of antibiotic resistance (6).


Because D-Mannose is excreted mostly unchanged in the urine, it is largely considered to be safe for use during pregnancy (7,8). However, pregnant women should always consult their healthcare providers if they suspect they have a urinary tract infection or before starting D-Mannose to ensure appropriate dosing and monitoring.


Although there aren’t many studies at present, D-Mannose is generally considered low risk for use during lactation. Because D-Mannose is minimally absorbed into the bloodstream, it is assumed that very little, if any, makes it into the breastmilk and as such it poses little risk to the nursing infant. 

Use in Children

Recently, a small study was conducted on the safety and efficacy of D-Mannose for kids aged 7-17, showing that D-Mannose was both safe and effective when used prophylactically (9). It is important to consult your child’s doctor if you suspect they have a urinary tract infection.

How Long Should I Take D-Mannose?

The duration of D-Mannose use varies based on the intended purpose. For the temporary relief of mild urinary tract symptoms, D-Mannose is typically administered until the resolution of symptoms, which usually occurs within a few days. For long-term maintained health, especially in individuals with a history of recurrent UTIs, D-Mannose can be taken daily in lower doses. 


Please be aware that these are general guidelines and not personal medical advice. Always consult your doctor if you suspect you are dealing with an infection.

Safety Considerations

While D-Mannose is generally considered safe, individuals with diabetes should monitor their blood sugar levels as D-Mannose is a simple sugar. Although it has minimal impact on blood glucose, caution is still advised. As with any supplement, there is a rare potential for allergic reactions and discontinuation should be considered if adverse effects are observed.

Summary

D-Mannose is a naturally occurring simple sugar that can be taken as a supplement to support urinary health due to its ability to prevent bacterial adhesion to the urinary tract. Because the body does not absorb much D-Mannose, it is mostly considered to be safe — even for pregnant women, nursing mothers, and children although there haven’t been many studies done in these populations yet. People who are diabetic should consult with a doctor before using D-Mannose because it is a simple sugar and it may have the potential to affect blood glucose levels.

References:

  1. Scaglione, F., Minghetti, P., Ambrosio, F., Ernst, B., Ficarra, V., Gobbi, M., Naber, K., & Schellekens, H. (2023). Nature of the Interaction of Alpha-D-Mannose and Escherichia coli Bacteria, and Implications for its Regulatory Classification. A Delphi Panel European Consensus Based on Chemistry and Legal Evidence. Therapeutic innovation & regulatory science, 57(6), 1153–1166. https://doi.org/10.1007/s43441-023-00548-8

  2. Cooper, T. E., Teng, C., Howell, M., Teixeira-Pinto, A., Jaure, A., & Wong, G. (2022). D-mannose for preventing and treating urinary tract infections. The Cochrane database of systematic reviews, 8(8), CD013608. https://doi.org/10.1002/14651858.CD013608.pub2

  3. Zhou, Y., Zhou, Z., Zheng, L., Gong, Z., Li, Y., Jin, Y., Huang, Y., & Chi, M. (2023). Urinary Tract Infections Caused by Uropathogenic Escherichia coli: Mechanisms of Infection and Treatment Options. International journal of molecular sciences, 24(13), 10537. https://doi.org/10.3390/ijms241310537

  4. Kranjčec, B., Papeš, D., & Altarac, S. (2014). D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial. World journal of urology, 32(1), 79–84. https://doi.org/10.1007/s00345-013-1091-6

  5. Matuszkiewicz-Rowińska, J., Małyszko, J., & Wieliczko, M. (2015). Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. Archives of medical science : AMS, 11(1), 67–77. https://doi.org/10.5114/aoms.2013.39202

  6. Norwitz, E. R., & Greenberg, J. A. (2009). Antibiotics in pregnancy: are they safe?. Reviews in obstetrics & gynecology, 2(3), 135–136.

  7. Wagenlehner, F., Lorenz, H., Ewald, O., & Gerke, P. (2022). Why d-Mannose May Be as Efficient as Antibiotics in the Treatment of Acute Uncomplicated Lower Urinary Tract Infections-Preliminary Considerations and Conclusions from a Non-Interventional Study. Antibiotics (Basel, Switzerland), 11(3), 314. https://doi.org/10.3390/antibiotics11030314

  8. Gromova, O. A., Torshin, I. Yu., & Tetruashvili, N. K. (2019). Systematic analysis of research on D-mannose and the prospects for its use in recurrent infections of the urinary tract in women of reproductive age. Obstetrics, Gynecology and Reproduction, 13(2), 119–131. https://doi.org/10.17749/2313-7347.2019.13.2.119-131

  9. Brownlee EM, Blore C, Wragg R, Patel M, McCarthy L (2020) D-Mannose Reduces the Risk of UTI in Complex Paediatric Urology Patients. Arch Pediatr 5: 180. DOI: 10.29011/2575-825X.100180

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