Urinary tract infections (UTIs) are a common prevalent bacterial disease affecting more than 150 million people yearly. They represent a major bother for women, especially after menopause.
According to the US Centers for Disease Control and Prevention, the infection causes up to 13,000 deaths yearly, with adult women particularly susceptible to it. About 20 to 30% of women also experience its recurrence.
Aside from adult women, pregnant women, children, elderly patients, indwelling catheters, and neuropathic bladder patients also have a high risk of UTIs.
Despite various antibiotics against UTIs, the recurrence rates remain high among the patients. (Most recurrences are reinfection from extra-urinary sources like the vagina or rectum).
This has made the creation of antibiotic resistance (Antimicrobials) a concern while causing a demand for more alternative treatments, one of such is support supplements.
So far, the support supplements have provided consumers with a good alternative compared to Antimicrobials or drugs. 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?
Also, here’s the UTI support supplement interest over time in the US from 2004 and interest by region.
The main UTI support supplements in 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 researchers have suggested that D-mannose (a monosaccharide naturally found in fruits) in urine may saturate E. coli FimH structures and block E. coli adhesion to urinary tract epithelial cells. The research reports that D-mannose supplement reduces the risk of UTIs and recurrent UTIs.
D-mannose is becoming a promising alternative remedy, particularly as a prophylaxis for a recurrent UTI. As stated, when excreted via urine, D-mannose inhibits Escherichia coli, the major UTIs causative organism, from attaching to urothelium and creating an infection.
In 2018, a D-mannose-based product entered the German market and saw a 61% 3-year CAGR (compound annual growth rate). According to proprietary IQVIA data, the product clinched the second position in the market with over 16% market share in 2021.
In fact, the leading urinary tract health supplement brand globally now uses a D-mannose product, and the number one Canadian product has a mixture of D-mannose and cranberry.
Evidence from updated meta-analyses has shown that cranberry supplements may reduce the incidence of UTIs and may be helpful for rUTI prevention. In particular, the In vitro and ex vivo research confirmed that proanthocyanidin, a chemical seen in high concentration in cranberries, has a dose-dependent effect on E Coli adherence to and displacement from urothelial cells (Schmidt and Sobota, 1988).
Cranberry comes with juice and tablets, found to reduce the percentage of women experiencing symptomatic pain. For patients looking to take cranberry prophylaxis, cranberry tablets have shown to be more cost-effective than cranberry juice (Stothers Lynn, 2002).
Cranberry may be a promising adjuvant therapy for avoiding UTIs, but for some limits in trials, the conclusion should be taken with caution. More quality studies with large sample sizes are needed to verify the results.
Ascorbic acid (vitamin C) is another supplement that may prevent rUTI by urine acidification. However, significant clinical evidence that supports 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 daily ferrous sulfate and folic acid only. After three months, the presence of urinary infections in the ascorbic acid-treated group was greatly lesser than in the ferrous sulfate and folic acid-only group (Ochoa-Brust GJ, Fernández AR, Villanueva-Ruiz GJ, et al, 2007).
Also, In vitro data suggested that vitamin C may provide a bacteriostatic impact in the urine. This impact is mediated by urinary nitrite reduction to reactive nitrogen oxides instead of reducing urinary pH (Carlsson S, Wiklund NP, Engstrand L, et al. 2001).
There are also Methenamine salts, which are hydrolyzed in the urine to form formaldehyde and ammonia. With limited side effects, methenamine salts are agents for rUTI prophylaxis. But, there’s a lack of strong clinical evidence to support their use.
Some research has compared placebo with methenamine hippurate in women. Though the evidence is weak, it suggests that methenamine hippurate is more efficient in reducing rUTI in a year compared to a placebo (Cronberg S, Welin CO, Henriksson L, et al. 1987).
Also, a Cochrane review stated that methenamine hippurate might be safe and efficient for the prevention of rUTI in patients with no urinary tract abnormalities (Lee BB, Simpson JM, Craig JC, Bhuta T, 2007).
Hyaluronic Acid and Chondroitin Sulphate
To restore the impact of the bladder glycosaminoglycan layer, Damiano and associates have evaluated the safety and efficacy of intravesical hyaluronic acid and chondroitin sulfate (IALURIL). (Damiano R, Quarto G, Bava I, et al. 2011).
In particular, the serial bladder instillations with IALURIL administered over one year greatly reduced UTI rates and enhanced urinary symptoms. The instillation was tolerated without serious side effects (Damiano R, Quarto G, Bava I, et al. 2011).
Though the study demonstrated a good form of prophylaxis, more study is required to assess the long-term outcomes, economic feasibility, and general use.
Other strategies for the reduction and prevention of UTIs
Growth in Branded ingredients and User-friendly forms
Aside from the support supplements, branded ingredients are increasingly displayed on the front of packages with colorful logos to alert consumers to the products’ added value. Branded cranberries, probiotics, hibiscus, pine bark, and pumpkin seeds are commonly found.
There’s also a rising trend of user-friendly, non-standard forms. Water-dispersible powder sachets, chewable, direct sticks, and gummies are showing their future potential as consumers want health benefits to come with a good experience.
This is crucial for products with preventive positioning, especially where good form and taste are important contributors to health benefits.
Diverse positioning options
Supplements follow a consumption model to support the prevention of UTIs, leaving curative positioning for drugs. However, with the efficiency of substances like D-mannose and proanthocyanidins (PACs), urinary tract supplements thrive when positioned for consumption in problematic periods and during support for conventional treatment.
In addition, there’s a growing number of positioned products that address connected health areas like UTIs, incontinence, and vaginal health.
Urinary tract infections (UTIs) are one of the leading 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 continued to be the most efficient type of prophylaxis for UTIs, but they 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 support supplements.
Meanwhile, there’s an opportunity to private label and sell your urinary tract support supplement easily with a good supplier 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 reliable supplement manufacturer in the US capable of creating any nutraceutical formula is essential for sustaining 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, Quarto G, Bava I, et al. (2011). “Prevention of recurrent urinary tract infections by intravesical administration of hyaluronic acid and chondroitin sulphate: a placebo-controlled randomized trial.” Eur Urol. 2
Cronberg S, Welin CO, Henriksson L, et al. (1987). “Prevention of recurrent acute cystitis by methenamine hippurate: double-blind controlled crossover long term study.” Br Med J.
Lee BB, Simpson JM, Craig JC, Bhuta T. (2007). “Methenamine hippurate for preventing urinary tract infections.” Cochrane Database Syst Rev.
Ochoa-Brust GJ, Fernández AR, Villanueva-Ruiz GJ, et al. (2007). “Daily intake of 100 mg ascorbic acid as a urinary tract infection prophylactic agent during pregnancy.” Acta Obstet Gynecol Scand.
Schmidt DR, Sobota AE. (1988). “An examination of the anti-adherence activity of cranberry juice on urinary and nonurinary bacterial isolates.” Microbios.
Stothers Lynn. (2002). “A randomized trial to evaluate effectiveness and cost-effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women.”