A Go-To Functional Medicine Guide For Overcoming UTIs

A Go-To Functional Medicine Guide For Overcoming UTIs Dr. Will Cole

If you’ve ever had a urinary tract infection (UTI) or worse — recurring UTIs — I’d bet you’re pretty motivated to prevent another one. After all, UTIs can cause symptoms like frequent urination, pain and burning with urination, tiredness, pain in the back or side below your ribs, nausea and/or vomiting, dark, cloudy, or reddish urine, an overwhelming urge to urinate but an inability to pass more than a small amount of urine, and unbelievably uncomfortable pressure above the pubic bone. 

Not exactly a walk in the park, is it? 

Unfortunately, a ton of women suffer from UTIs. In fact, about 50 to 60 percent of women (1) have at least one in their lifetime and about one-third of women (2) will require antibiotic treatment for a UTI by the age of 24 and many women suffer from recurrent UTIs.  

That’s the bad news. The good news is that there are quite a few steps you can take to not only relieve the symptoms of a UTI but also reduce the likelihood of needing antibiotics, and even prevent UTIs from occurring in the first place. Read on for the full picture.


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A functional medicine perspective on UTIs

Urinary tract infections occur when there is an infection in the urinary tract. The most common cause of UTIs is bacteria — mainly Escherichia coli, which are responsible for about 80 to 85% (3) of all UTIs — but viruses and fungi can also cause an infection. A UTI is a more general term for the type of infection; in reality, the infections can occur in the ureters, bladder, urethra, or even the kidneys, which have the important job of filtering your blood and producing urine.  

If you have a UTI and see your primary care doctor, most likely they will prescribe you one of the following antibiotics to treat the specific bacteria causing the infection: 

  • Nitrofurantoin
  • Sulfonamides 
  • Amoxicillin
  • Cephalosporins
  • Trimethoprim/sulfamethoxazole 
  • Doxycycline
  • Quinolones 

Typically, a UTI is no big deal and goes away with antibiotics, but if you have recurring UTIs, your doctor may suggest going on low-dose antibiotics to take regularly. This is something you want to avoid if you can. Antibiotics can cause side effects and disrupt your gut microbiome, which can sabotage your digestion, your mood, your energy levels, and even your immune system. Before you go this route, I recommend trying lifestyle changes to prevent recurring UTIs. 

Lifestyle changes to prevent UTIs

Lifestyle changes is an umbrella term to describe any non-pharmaceutical or surgical treatment for your health woes. This can mean supplements, herbs, dietary changes, and changes in the products you use, how often you exercise, and even how you relax and manage stress.  

1. Try D-mannose

D-mannose is a naturally occurring sugar that is found in foods like apples, blueberries, and cranberries. D-mannose is effective at preventing UTIs because it’s known for binding themselves to E.coli bacteria (4) (remember when I told you that E. coli causes upwards of 80% of UTIs?) and making sure they get eliminated through the urine instead of sticking to the walls of the urinary tract. This has been studied on humans; for example, a study tested the effects of 2 grams of D-mannose powder in 200 ml of water daily for 6 months and found that it significantly lowered the incidence of recurrent UTIs and has fewer side effects than Nitrofurantoin, an antibiotic commonly used for recurrent UTIs.  

You can take D-mannose daily in a glass of water to prevent UTIs; or, if you think you might be getting one, increase your dose to a few times a day.

2. Hydrate

If you’re suffering from recurrent UTIs, this might seem overly simple. But the truth is, regular urination can help flush bacteria from the urinary tract to prevent infections — and the best way to pee frequently is to drink a ton of water. Research supports this; for example, a 2003 study on 141 girls (5) showed that infrequent urination and low fluid intake are both associated with recurrent UTIs.

3. Take probiotics

Probiotics are most often known for improving digestive health, but the truth is, supporting a healthy microbiome can benefit your health in more ways than one. For example, the use of probiotics can enhance your immune system, which can help you prevent infections — including UTIs. In fact, one study found that taking the beneficial bacteria Lactobacillus (6) helped cut recurrent UTIs in a group of women by about half. 

A word on cranberry juice 

The most common lifestyle remedy for UTIs is probably cranberry juice, which is a source of a lot of debate. Studies have come out both supporting the use of cranberry juice and also debunking its value entirely. (7) Personally, I think that cranberry juice’s vitamin C content and D-mannose content means that it makes sense as a UTI prevention method, so if it works for you — keep doing what you’re doing. Just make sure that if you are taking cranberry juice to prevent UTIs, make sure it’s pure, unsweetened cranberry juice instead of a high-sugar cranberry juice cocktail. 

So there you have it! If you do come down with a UTI, try not to stress (this will only make things worse!). Just take your D-mannose, pop a probiotic, and put a heating pad on any painful areas. You can also avoid bladder irritating foods — like alcohol, caffeine, and spicy and acidic foods — and of course, drink plenty of water. 

Recurrent UTIs require a truly functional medicine approach because if left untreated, they can turn into a serious infection. The good news is that as long as you keep in close touch with your doctor and take antibiotics if your UTI becomes severe, there are a ton of lifestyle remedies that you can also lean on.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

Photo: unsplash.com


  1. Rahn DD. Urinary tract infections: contemporary management. Urol Nurs. 2008;28(5):333-342.
  2. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am. J Med. 2002;113 Suppl 1A:5S-13S. doi:10.1016/s0002-9343(02)01054-9
  3. Staphylococcus Saprophyticus Science Direct. https://www.sciencedirect.com/topics/immunology-and-microbiology/staphylococcus-saprophyticus#:~:text=The%20most%20common%20UTI%2Dcausing,infections%20in%20some%20rare%20cases.
  4. Michaels EK, Chmiel JS, Plotkin BJ, Schaeffer AJ. Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats. Urol Res. 1983;11(2):97-102. doi:10.1007/BF00256954
  5. Mazzola BL, von Vigier RO, Marchand S, Tönz M, Bianchetti MG. Behavioral and functional abnormalities linked with recurrent urinary tract infections in girls. J Nephrol. 2003;16(1):133-138.
  6. Grin PM, Kowalewska PM, Alhazzan W, Fox-Robichaud AE. Lactobacillus for preventing recurrent urinary tract infections in women: meta-analysis. Can J Urol. 2013;20(1):6607-6614.
  7. Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD001321. DOI:10.1002/14651858.CD001321.pub5.

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Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.

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