Many readers of Nutrition & Healing are aware of my friend and colleague Dr. Alan R. Gaby. He is a former Professor at Bastyr University’s College of Naturopathic Medicine, and voted ‘Professor of the Year’ more than once in his time spent teaching there. For over 30 years, Dr. Gaby and I have taught a four-day seminar called Nutritional Therapy in Medical Practice.
In 2011, Dr. Gaby published Nutritional Medicine, a comprehensive textbook on the use of dietary modifications, nutritional supplements, and other natural substances for the prevention and treatment of more than 400 health conditions. Nutritional Medicine contains over 15,000 references to the medical literature, and contains an incredible 900,000 words. (See www.doctorgaby.com/book.html for more information.)
Dr. Gaby also writes a regular column for the Townsend Letter, a publication for naturally inclined doctors, nurses, and other health care practitioners. He (very kindly) titled his column in the May 2014 issue: ‘Dr. Wright Does It Again: D-mannose for UTI Prophylaxis Validated in a Clinical Trial.’
Individualized medicine focuses on ‘YOU’
I wasn’t actually involved in the clinical trial published in the British Journal of Urology International.1 Like most health care practitioners, I find that the massive amounts of time and money required for the sort of clinical trials done by universities make them impossible to do on my own. Despite that, ‘clinical trials’ of another sort take place nearly every day, performed by lone health care practitioners like myself. These trials usually involve just one patient with a health problem for which, despite many attempts, there has been no solution.
In such cases, if a logical and harmless (or relatively safe) solution exists for a problem that has had no relief, that solution is suggested. The case essentially becomes a ‘clinical trial’ of one. If it works to solve the problem, it’s a successful clinical trial. After that success, the solution is then typically suggested to others with the same health problem.
And that’s the key difference between ‘standard of care’ medicine and ‘individualized medicine’. In individualized medicine, your doctor focuses on trying to help you get better.
By contrast, in standard of care medicine, rather than working for you, your doctor is bound by the constraints of various government agencies who insist on one solution for a problem. If those pre-selected treatments don’t work you’re often referred to a specialist who is also bound by the ‘same standard of care’!
D-mannose banishing UTIs for over 30 years
Using D-mannose to treat urinary tract infections (UTIs) is one of those solutions that falls outside of the ‘approved’ list of treatments. This is despite the fact that it has been successfully used to treat E. coli UTIs since the early 1980s.
At that time Tahoma Clinic was located in semi-rural Kent, Washington. A couple – we’ll call them Mum and Dad – came in with their daughter who wasn’t more than nine or 10 years old, likely younger. Mum brought in several three-ring binders with her daughter’s medical records neatly separated into categories, including nearly every doctor visit, lab test, and hospitalization she had ever had.
Dad was there mostly to provide support, although he kept his arms crossed for nearly the whole time the family was in my office. The few questions he asked carried a distinctly sceptical tone.
Mum explained that the doctors at Children’s Hospital in Seattle (an excellent and caring institution) had told them to prepare for their daughter to have a kidney transplant in the next few years, as she had one urinary tract and kidney infection after another since she was very small, and her kidneys were getting weaker. Previously effective antibiotics were no longer working, and she was having increasingly severe reactions to the few that remained.
When asked if she had the results of urine cultures in her daughter’s records, Mum quickly pulled out several of them. All were positive for the most common cause of UTIs, E.coli (for the technically inclined Escherichia coli).
Coincidently (although some would probably say it’s no coincidence) a few weeks before this family’s first visit I had read a research report titled Effect of Carbohydrates on Adherence of E. coli to Human Urinary Tract Epithelial Cells.2 E. coli bacteria cause such a large proportion of UTIs because, unlike most other bacteria, they’re capable of attaching themselves (adhering) to the surface lining of the entire urinary tract. The researchers reported that D-mannose could stop E. coli from adhering to the lining of the bladder and urinary tract. I thought it reasonable to conclude that E.coli might literally be ‘flushed away’ from the bladder and urinary tract, even if they weren’t actually killed.
Fortunately, D-mannose is a sugar with known functions in human metabolism. It’s only known adverse effects – then and now – are gas, loose stools and even diarrhoea if too much of the sugar is used. I explained the research and told Mum and Dad that I felt it was worth a try, as the potential benefits were much greater than the very minor risks.
The urinary tract infection cleared within days!
It appeared that even sceptical Dad was on board when Mum agreed D-mannose couldn’t hurt, and when she pointed out that there really weren’t any alternatives. I told them I would special-order it from a chemical supply house and we’d call them when it arrived.
The rest is history, as they say. My young patient’s UTI cleared within a few days. At first, she was given more D-mannose only when infections occurred, but they were so frequent that Mum and Dad decided to just keep her on the sugar continuously. She was able to stop the D-mannose with no further recurrent infections when full puberty arrived and her oestrogens and other hormones assumed the job of protecting her urinary tract.
I started to recommend D-mannose as the first-line treatment for any UTI, with the understanding that if symptoms don’t start to lessen within 24 hours or less an actual germ-killing treatment, such as an antibiotic, will likely be needed. Since the 1980s D-mannose has eliminated UTIs in 85-90 per cent of all of those I’ve recommended it to. As E.coli is responsible for 85-90 per cent of all UTIs, this makes sense.
Word spread slowly at first, but today D-mannose is found almost everywhere – health food stores, online and even some regular pharmacies. D-mannose isn’t patentable so there’s lots of healthy competition among suppliers and as a result it remains inexpensive.
Dr. Gaby wrote: “The discovery of the D-mannose as a treatment for UTIs was an important medical advance…” I’m grateful and honoured that he wrote about my part in its origin, and that he pointed out that finally, approximately 30 years after it was first used, the first controlled research study ‘proving’ what hundreds of thousands of us already knew – that D-mannose successfully eliminates most UTIs – was published.
The D-mannose story is an excellent example of a successful ‘clinical trial’ in individualized medicine. It perfectly illustrates a trial in which a logical, harmless (or relatively safe) solution is successfully used on an individual with an ‘unsolvable’ health problem. Using ‘standard of care’ medicine, this remedy would not be available, even now.
Wishing you the best of health,
Dr. Jonathan V. Wright
Nutrition & Healing
Vol. 8, Issue 10 – October 2014
Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.