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Urinary Tract Infections

A urinary tract infection (UTI) is an infection of the bladder or kidneys. UTI’s are more common in women than men and can involve various bacteria. Bacteria can enter through the urethra and travel up to the bladder causing cystitis or bladder infection. If it travels further up through the ureters, it can then lead to a kidney infection or pyelonephritis. In men, bladder infections may affect the prostate gland, leading to prostatitis.

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Urinary Tract Infections

Urinary tract infections are one of the most common bacterial infections. In a previous National Ambulatory Medical Care Survey, UTI’s accounted for nearly 1 million emergency room visits and 7 million office visits. Almost half of all women experience a UTI in their lifetime.1

Symptoms of UTIs include:

  • lower abdominal pain
  • urinary frequency and urgency
  • blood in urine (hematuria)
  • burning with urination (dysuria).

If the infection involves the kidneys, symptoms may include fever, back pain, nausea, and vomiting.

Risk factors of UTIs include:

  • having intercourse
  • diabetes mellitus
  • pregnancy
  • neurological impairment (e.g. multiple sclerosis or spinal cord injury)
  • enlarged prostate
  • kidney stones
  • vaginal dryness in women
  • poor hygiene
  • dehydration
  • anatomical defects in urinary tract
  • use of catheters

Lifestyle and behavioral factors do have an influence on bladder health.2 Poor nutrition that impairs the immune system, causes inflammation, and disrupts the beneficial flora of the gut also contributes to recurrent UTIs.3 Washing well with water after a bowel movement to remove any film of bacteria from feces on the skin is helpful to prevent future infections.

  1. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med 2002, 113 Suppl 1A:5s-13s.
  2. Burgio KL, Newman DK, Rosenberg MT, Sampselle C. Impact of behaviour and lifestyle on bladder health. Int J Clin Pract 2013, 67:495-504.
  3. Hoyme UB, Schneede P. [Gynaecological and obstetrical aspects of recurrent urinary tract infections]. Urologe A 2006, 45:457-463.

Action Plan


  • A Nutritarian diet with a variety of micronutrients boosts immunity and increases the beneficial bacteria in the gut and vagina, thus decreasing the risk of UTIs in the future.
  • Uncomplicated UTIs, without symptoms of a kidney infection, may be prevented and sometimes effectively treated with D-mannose and cranberry tablets, which prevent the adherence of E.coli bacteria to the bladder wall.1
  • If antibiotics are needed, use probiotics for 2-3 months after completing the course to reinoculate your gut with beneficial flora.
  • Hydrate with water throughout the day.


  • A UTI can only be diagnosed accurately with a urine culture done by your physician.
  • Urinary tract infections in men that lead to prostatitis require longer courses of antibiotics.
  • To prevent a future UTI, urinate after intercourse, wear cotton underwear, wipe front to back, and wash after bowel movements with soap and water.

Find additional help

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  1. Micali S, Isgro G, Bianchi G, et al. Cranberry and recurrent cystitis: more than marketing? Crit Rev Food Sci Nutr 2014, 54:1063-1075.

Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


My five year old daughter never had trouble with UTIs until about six months ago. Out of the blue she started complaining about it hurting when she went potty. Within two hours, she had a high fever, was urinating frequently (several times an hour), and would scream and writhe while on the toilet. I took her to the doctor the next day and she tested positive for bacteria in her urine and was given amoxicillin. After three days she was no better, and her doctor prescribed a different, stronger antibiotic. It finally disappeared after two weeks. But since then she has had round after round of UTIs, followed by a yeast infection (from the antibiotics, no doubt) and another UTI. I don’t want to give her antibiotics anymore, but when she screams and cries all day long from the pain I don’t know what else can "fix it." I know there must be an underlying problem, but we don’t know what it is or how to treat it.


Pure cranberry juice or cranberry extract daily, as well as D-mannose may help prevent or even treat a UTI early on. Since she is getting frequent UTIs, of course, you’ll need to evaluate whether it is a hygiene issue (her not wiping correctly), which is the most common cause at her age, or if there is any anatomical issues with her urinary tract that might be contributing to her heightened risk of infection. If this had not been evaluated already, she needs to get those tests done, starting with a renal ultrasound. Make sure that she is taking probiotics for at least a few months because of her recent antibiotic use.


I have been getting urinary tract infections off and on for the past year. I am currently on an antibiotic for 10 days. Would either of the following supplements help if I took them on a daily basis for urinary tract health and prevention: Cran-actin and/or d-mannose?


If you are having frequent urinary tract infections, you need to wash your bottom with soap and water after every bowel movement and after sexual activity, too. That is more important than using the supplements. Second, 10 days of antibiotics are not needed for a UTI, usually three to six days is sufficient, and 10 days could increase risk to your digestive tract. If you are not eating a high nutrient, Nutritarian diet, do not delay.

D-mannose and cranberry juice tabs twice daily can help prevent future infection, and some people even respond to them effectively when they have an infection (which requires increased dosages and frequency of use), but if not responding within 36 hours, begin antibiotics. Take them continually, two tabs of each every two hours, while awake.

If taking on a daily basis just use one tab of each twice a day.


I have a urinary tract infection confirmed by a home test eight days ago. I have been taking D-Mannose. It has improved but not resolved. Is it ok to keep using the D-Mannose, or do I need to take the antibiotics?


In addition to eating perfectly and D-mannose, taking a few cranberry tablets five times a day could also be useful. To answer your question, the severity of the infection and the degree of improvement to this point has to be considered. If you have no fever and it has improved significantly, perhaps a urine culture that measures the severity at this point would be helpful.