Urinary tract infections (UTIs) are a common and prevalent bacterial disease that affects more than 150 million people each year. They represent a great nuisance for women, especially after menopause.
According to the US Centers for Disease Control and Prevention, the infection causes up to 13,000 deaths a year, with adult women being particularly susceptible to it. About 20 to 30% of women also experience its recurrence.
Apart from adult women, pregnant women, children, elderly patients, indwelling catheters, and neuropathic bladder patients are also at high risk of urinary tract infections.
Despite various antibiotics against UTIs, recurrence rates remain high among patients. (Most recurrences are reinfections from extra-urinary sources such as the vagina or rectum.)
This has made the creation of antibiotic (antimicrobial) resistance a concern while also creating a demand for more alternative treatments, one being supportive supplements.
Until now, supportive supplements have provided consumers with a good alternative to antimicrobials or medications. Now, popular pharmaceutical players like Pierre Fabre, STADA, Novartis, and Bausch Health have ventured into the market with their supplements.
What are the current trends for urinary tract support supplements?
UTI support supplement is a growing trend, even in the usa. According to Amz Scout Pro data, the top 50 UTI support supplement results on amazon sell $7499536 monthly on amazon alone.
Also, here is UTI support plugin interest over time in the US since 2004 and interest by region.
The main UTI support supplements on the market include:
This is the first support supplement on the list. D-mannose is a popular marketed dietary supplement for urinary tract support.
Many investigators have suggested that D-mannose (a monosaccharide naturally found in fruits) in urine may saturate the FimH structures of E. coli and block E. coli adhesion to urinary tract epithelial cells. Research reports that D-mannose supplementation reduces the risk of UTIs and recurrent UTIs.
D-mannose is emerging as a promising alternative remedy, particularly as a prophylaxis for recurrent UTI. As noted, when excreted in the urine, D-mannose inhibits Escherichia coli, the primary causative organism of UTIs, from adhering to the urothelium and creating an infection.
In 2018, a D-mannose-based product entered the German market and experienced a CAGR (compound annual growth rate) of 61% in 3 years. According to IQVIA proprietary data, the product achieved the second position in the market with more than 16% market share in 2021.
In fact, the world’s leading brand of urinary tract health supplements now uses a D-mannose product, and the number one Canadian product has a blend of D-mannose and cranberry.
Evidence from updated meta-analyses has shown that cranberry supplements may reduce the incidence of UTIs and may be useful for the prevention of rUTIs. In particular, in vitro and ex vivo investigation confirmed that proanthocyanidin, a chemical found in high concentrations in cranberries, has a dose-dependent effect on the adhesion and displacement of E coli from urothelial cells (Schmidt and Sobota, 1988).
Cranberry comes in juice and tablets and has been found to reduce the percentage of women who experience symptomatic pain. For patients seeking cranberry prophylaxis, cranberry tablets have been shown to be more cost-effective than cranberry juice (Stothers Lynn, 2002).
Cranberry may be a promising adjunctive therapy to prevent UTIs, but due to some trial limits, the conclusion should be taken with a grain of salt. More quality studies with large sample sizes are needed to verify the results.
- Ascorbic acid
Ascorbic acid (vitamin C) is another supplement that can prevent UTI by acidifying the urine. However, significant clinical evidence to support the claim in adult women is lacking.
According to the Acta Obstet Gynecol Scand survey, 110 pregnant women received ferrous sulfate 200 mg/d, folic acid 5 mg/d, and ascorbic acid 100 mg/d, or ferrous sulfate and folic acid alone daily. After three months, the presence of urinary tract infections in the group treated with ascorbic acid was much lower than in the group treated with ferrous sulfate and folic acid alone (Ochoa-Brust GJ, Fernández AR, Villanueva-Ruiz GJ, et al, 2007 ).
Furthermore, in vitro data suggested that vitamin C may have a bacteriostatic effect on urine. This impact is mediated by reducing urinary nitrite to reactive nitrogen oxides rather than lowering urinary pH (Carlsson S, Wiklund NP, Engstrand L, et al. 2001).
- methenamine salts
There are also methenamine salts, which hydrolyze in the urine to form formaldehyde and ammonia. With limited side effects, methenamine salts are agents for rUTI prophylaxis. But, there is a lack of solid clinical evidence to support its use.
Some research has compared placebo with methenamine hippurate in women. Although the evidence is weak, it suggests that methenamine hippurate is more effective in reducing rUTI at one year compared to placebo (Cronberg S, Welin CO, Henriksson L, et al. 1987).
Furthermore, a Cochrane review suggested that methenamine hippurate might be safe and effective for the prevention of rUTI in patients without urinary tract abnormalities (Lee BB, Simpson JM, Craig JC, Bhuta T, 2007).
- Hyaluronic acid and chondroitin sulfate
To restore the impact of the glycosaminoglycan layer of the bladder, Damiano and associates have evaluated the safety and efficacy of intravesical hyaluronic acid and chondroitin sulfate (IALURIL). (Damiano R, Cuarto G, Bava I, et al. 2011).
In particular, serial bladder instillations with IALURIL administered over one year greatly reduced UTI rates and improved urinary symptoms. The instillation was tolerated without serious side effects (Damiano R, Quarto G, Bava I, et al. 2011).
Although the study demonstrated a good form of prophylaxis, further studies are required to assess long-term results, economic feasibility, and general use.
Other strategies for the reduction and prevention of UTIs
- Growth in branded ingredients and easy-to-use forms
Aside from supporting supplements, branded ingredients are increasingly displayed on the front of packages with colorful logos to alert consumers to the products’ added value. Brand name cranberries, probiotics, hibiscus, pine bark, and pumpkin seeds are commonly found.
There is also a growing trend of easy to use non-standard forms. Water-dispersible powder sachets, chewy bars, direct, and gummies are showing their future potential as consumers want health benefits accompanied by a good experience.
This is crucial for preventatively positioned products, especially where good shape and flavor are major contributors to health benefits.
- Various positioning options
The supplements follow a consumption model to support the prevention of UTIs, leaving a curative positioning for the drugs. However, with the efficiency of substances such as D-mannose and proanthocyanidins (PACs), urinary tract supplements thrive when placed for consumption at troublesome periods and during support of conventional treatment.
In addition, there are a growing number of products positioned that address connected health areas such as urinary tract infections, incontinence, and vaginal health.
Urinary tract infections (UTIs) are one of the major infectious diseases in the world, especially among adult women. Despite the short-term effect of antibiotics on UTIs, their risk of recurrence remains.
Antimicrobials have remained the most effective type of prophylaxis for urinary tract infections, but they do have side effects. For those wishing to try non-antimicrobial prophylaxis, D-mannose, cranberry, ascorbic acid (vitamin C), and methenamine salts are good options or supportive supplements.
In the meantime, there is an opportunity to private label and easily sell your urinary tract support supplement with a good vendor like SMP Nutra. They have several UTI formula supplements in stock and ready to sell. They make it very easy to get into this particular market right now.
Using a reputable US supplement manufacturer capable of creating any nutraceutical formula is essential to maintaining a nutraceutical brand.
- Carlsson S, Wiklund NP, Engstrand L, et al. (2001). “Effects of pH, nitrite, and ascorbic acid on nonenzymatic nitric oxide generation and bacterial growth in urine”. PubMed.
- Damiano R, Cuarto G, Bava I, et al. (2011). “Prevention of recurrent urinary tract infections by intravesical administration of hyaluronic acid and chondroitin sulfate: a randomized placebo-controlled trial”. Euro Urol. two
- Cronberg S, Welin CO, Henriksson L, et al. (1987). “Prevention of recurrent acute cystitis by methenamine hippurate: long-term double-blind controlled crossover study”. Brother with J
- Lee BB, Simpson JM, Craig JC, Bhuta T. (2007). “Methenamine hippurate for the prevention of urinary tract infections”. Cochrane Database System Review.
- Ochoa-Brust GJ, Fernández AR, Villanueva-Ruiz GJ, et al. (2007). “Daily intake of 100 mg ascorbic acid as a prophylactic agent for urinary tract infections during pregnancy”. Acta Obstet Gynecol Scand.
- Schmidt DR, Sobota AE. (1988). “An examination of the antiadhesive activity of cranberry juice on urinary and non-urinary bacterial isolates”. microbes.
- Stothers Lynn. (2002). “A randomized trial to assess the efficacy and cost-effectiveness of cranberry naturopathic products as prophylaxis against urinary tract infection in women”.