Cranberry is often recommended for urinary tract infections, but is it the best option? E.Coli is an acid adaptive bacterium capable of synthesising its nutritional requirements from the surrounding acids in its environment. Since cranberry produces hippuric acid in the urine, creating acidic urine conditions, it provides E.Coli and other gram negative bacteria a suitable environment in which they can multiply.
Giving cranberry juice to women with confirmed bacteriuria, considerably increases the chances of the infection recurring, with increasing severity.
This is completely at odds with almost everything you read or hear about cranberry. However, most of the information available focuses on a possible anti-adhesion effect, ignoring the feeding effect. Clinical trials of cranberry are not well conducted, with often inconclusive or negative results. However, negative results are not well publicised because people producing cranberry have no motivation to do so.
There is a small anti-adhesion effect from cranberry. We believe however, that the vast majority of bladder infection agents, the increased bacterial metabolic rate that results from the acidic urine produced by cranberry, negates any anti-adhesion benefits.
On the other hand, it seems to be the case that for most gram negative bacteria, living in alkali conditions is like living in their own waste. In alkaline urine their metabolic rate decreases, and it can take them twice as long to divide (to double). That's why taking potassium citrate, which alkalises urine can help ease the situation. Vitamin C in the form of Ascorbic Acid, which mostly ends up in the urine, makes the situation worse.
Vitamin C in the form of Ascorbic acid, taken alongside cranberry, may aggravate the situation. The body is incapable of making use of excess Vitamin C in this form, and most of it filters into the urine. This provides any bacteria present in the urine with another prime source of nutrients. A buffered form of Vitamin C should be used instead, like Calcium Ascorbate.
Another reason not to take cranberry is that it hinders the effect of antibiotics. Many antibiotics work by damaging the cell walls of bacteria. Hippuric acid in the urine (from cranberry) initially kills off the bacteria with thinner acid-susceptible cell-walls, leaving only thicker-skinned acid-resistant individuals to multiply and pass on their resistant genes. Antibiotics like penicillins and cephalosporins often don't manage to kill these thick skinned bacteria. Add to that the fact that within three generations the bacteria can fully metabolise hippuric acid, creating the Pyrenes and Amino acids they need to thrive.
Often, when somebody has been taking cranberry with antibiotics, the infection returns to full strength within a week or two of finishing the course of antibiotics.
Lactobacilli are beneficial microorganisms that maintain an acidic (low pH) environment in the vagina. Since the healthy vagina is colonised by Lactobacilli, it is often assumed that a similar low pH environment in the urine is beneficial. This is simply not true. The bladder and the vagina are entirely different environments. In the vaginal area, Lactobacilli compete with other bacteria for resources, and as a by-product, they produce hydrogen peroxide which also creates a hostile environment for bacteria. The tissues of the vagina and the Lactobaccili cells are adapted for exactly this environment, and they are healthy when the pH is low (acidic).
Urine, on the other hand is most unlikely to have Lactobacilli living in it, and bacteria that do colonise the bladder are usually pathogenic, and much tougher than Lactobaccilli. For the most part though, like Lactobaccilli, these pathogens do enjoy an acidic environment, and they don't thrive in an alkali environment. And there's the point of it... the pH environment that provides a healthy living area for friendly bacteria in the vagina also provides a healthy environment for the distinctly unfriendly bacteria in the bladder.
It is also known that if the E.Coli in your body originated from cattle fed on a high grain diet, they can be 1000 times more resistant to acid than other strains of E.Coli. These bacteria absolutely thrive in acids. They are tough little bugs that adapt to utilise the environment they are exposed to. They can even get through stomach acids intact.
Acid resistant bacteria populate the human gut when you eat meat or food contaminated with the acid-loving strains, so the very first time you contract an E.Coli infection, the bacteria can already be acid resistant. When you contract an E.Coli infection, the bacteria has invariably been at some point in a human bowel. It could be the person you just shook hands with, not from you or your partner. And since Trimethoprim is often used to prevent and treat infections in chicken and cattle, the bacteria are also likely to be genetically predisposed to Trimethoprim resistance.
The cycle: E.Coli and Klebsiella (and some other gram negative uropathogens) have 'burst cycle' population explosions that occur under optimum feeding conditions. It goes like this: you drink cranberry, which makes the urine acidic, then there is a build up of uric acid in the bladder. Within a short period of time when the acidic urine makes its way into your bladder. The E.Coli in the bladder burst into a frenzied multiplication cycle, doubling the size of their colony in the next 20 to 30 minutes. They convert the acids in your urine into alkalis and endotoxins. As the urine becomes more alkaline, and the bacteria are effectively living in their own waste, they slow down their multiplication rates by as much as 100%. You consume a little more Cranberry, and start the process off again, doubling in size in the next 20 to 30 minutes. It's not that they can't metabolise alkalis, but they don't seem to be so efficient at that.
If you ask: Where did you hear that cranberry could be helpful?
The answer is usually: That's what everyone says. Everyone says cranberry is the thing for UTIs.
So it's a self-perpetuating urban myth. But unfortunately it's not harmless, not funny, and not true.
An October 2016 U.S. Study on the effects of cranberry shows older women taking cranberry capsules over the course of a year failed to stave off urinary tract infections (UTIs).
It's a well known fact that many people contract bacterial cystitis when they are dehydrated and build up a high level of urea (uric acid) in the urine. There must be some bacteria present for any bacterial infection, but the cystitis happens because the bacteria have an ideal acidic environment in which to multiply out of control. You get an understanding of the hardiness of E.Coli when you consider that urea is a powerful antiseptic.
By avoiding acidic foods (cranberry, alcohol, red meat, coffee), you reduce the acids that are one of the bacteria's primary sources of nutrition, effectively starving them. We recommend using a citrate salt like potassium citrate, magnesium citrate, calcium citrate or sodium citrate to make the urine more alkaline. But as always, consult a good nutritionist about any dietary changes.
When you first take cranberry, it kills off any bacteria that cannot survive the acidic environment, and in any colony of bacteria there will be some weaker individuals. So cranberry usually provides, initial and very temporary relief that is quickly followed by considerable worsening of the symptoms. Our customers have repeatedly told us this. This is because the bacteria that weren't killed off by the cranberry, proliferate and mutate to thrive in an acidic environment. Just like the reproductive mechanism that produces antibiotic resistant bacteria.
Until very recently it was believed that the acid in cranberry killed the uropathogens. But that's not what happens. As explained, they adapt quickly to acidic conditions, so you just end up with a concentration of much more resilient E.Coli.
If you have even once had a bladder infection or UTI, taking cranberry makes it more likely that further infections will follow. You are putting yourself at risk of recurrent cystitis. This is because there are likely to be some remaining bacteria lodged in the bladder, behind biofilms, lying dormant waiting for the right conditions to start multiplying again. And as explained, once they get into your urine again, they feed on the acids cranberry provides.
You get a first time urine infection - you get antibiotics. You take cranberry at the same time, and because you are helping the bacteria to grow, and making them tougher (more resistant), the antibiotic fails. You opt for more antibiotics, drink even more cranberry, and here you are now reading this page, still struggling with infections, perhaps years later.
Note: The above information refers to gram-negative bacteria like E.Coli and Klebsiella. This covers the vast majority of bladder infections. However, cranberry may be slightly useful against Proteus type infections. Unlike E.Coli, Proteus types generally multiply slower in acid urine. This can be deduced logically from the fact that P. mirabilis produces urease, and splits urea to produce CO2 and NH3 to increase pH and increase uroepithelium toxicity. Essentially having the exact opposite effects of E.Coli, which produce alkalis. Summarising, this boils down to the fact that if you have a Proteus infection, cranberry and vitamin C might actually be a good option. To reinforce this point, the few customers out of many thousands who said cranberry was actually helping them, ultimately discovered they had Proteus mirabilis infections. You are more likely to contract Proteus if you have recently been catheterised in hospital, or had a bladder operation.
Generally speaking, with the rarer, antibiotic resistant, or mixed bacterial type infections, it is best to have infections specifically identified at a specialist lab. If Proteus is identified, also ask which type. The susceptibility of Proteus to particular antibiotics varies with type. The doctor will be guessing unless they know the specific strain that is affecting you.
Once you know which pathogen, or which combination of pathogens, is causing your infection, you will be better equipped to fight it. Just as knowing that cranberry can make most urine infections worse, better equips you to deal with E.Coli and Klebsiella related infections.
If antibiotics are continually failing for the following infections, you need to find a natural way to beat the bacteria. Or you could end up being hospitalised, subjected to strong broad-spectrum antibiotics dripped intravenously in doses that may permanently destroy your immune system.
Supplementing your diet with D-Mannose can provide additional bladder and urinary tract support when experiencing the following infections.
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