Holistic Ways to Address & Prevent Chronic UTIs


written by:

Kayla Martin, MS, CNS

Persistent worry about recurrent urinary tract infections (UTIs) can cast a shadow on your life and create a constant undercurrent of discomfort and concern. We understand the toll that chronic UTIs can take on both physical and emotional health. The constant fear of discomfort and the recurrent cycles of antibiotic treatments can leave you feeling trapped in a cycle you can’t seem to break free of. 

Fortunately, there is hope beyond the conventional approach. In this article, we’ll explore the world of natural solutions that not only  alleviate your symptoms but also address the underlying factors contributing to chronic UTIs, empowering you to break free from the cycle and reclaim your health.

What is a UTI? 

Urinary Tract Infections (UTIs) are a common and often painful condition that can affect anyone at any age. These infections occur when bacteria, usually from the digestive tract, make their way into the urinary system, leading to inflammation. While antibiotics are a common course of action, a holistic approach can be pivotal in preventing and addressing chronic UTIs.

Signs and Symptoms of UTIs:

  • Painful Urination: One of the hallmark symptoms of a UTI is a burning sensation or pain during urination. This discomfort is often accompanied by a frequent urge to urinate.
  • Cloudy or Foul-Smelling Urine: Infection can lead to changes in the appearance and odor of urine. Cloudiness and a strong, unpleasant smell may indicate the presence of bacteria.
  • Lower Abdominal Pain: UTIs can cause discomfort or pressure in the lower abdomen, signaling inflammation in the bladder.
  • Urinary Urgency: Feeling the need to urinate urgently, even when the bladder is not full, is a common symptom. This urgency may be accompanied by an inability to hold urine.
  • Fatigue and Malaise: Systemic symptoms such as fatigue and feeling unwell can accompany a UTI, especially if the infection has spread to the kidneys.

What causes UTIs? 

The urinary tract comprises the kidneys, ureters, bladder, and urethra, and its primary function is to eliminate waste and excess fluids from the body. UTIs most commonly occur in the lower part of the urinary tract, affecting the bladder and urethra. The majority of UTIs are caused by Escherichia coli (E. coli) bacteria, which typically reside in the intestines.

When these bacteria enter the urethra and travel upward, they can multiply and cause infection. Women are more prone to UTIs due to their shorter urethras, making it easier for bacteria to reach the bladder. Other risk factors include: 

  • A weakened immune system
  • Urinary tract abnormalities
  • Urinary catheterization 
  • Hormonal changes 
  • Conditions that prohibit complete bladder emptying 
  • Sexual activity
  • Using spermicides or diaphragms 

Traditional Testing for UTIs 

Testing for Urinary Tract Infections (UTIs) is a crucial step in accurate diagnosis, yet common pitfalls in standard testing methods can lead to challenges in identifying and treating infections effectively. 

Traditional culture-based testing, while widely used, may not capture the full spectrum of bacterial diversity present in the urinary tract. This limitation can result in false-negative results, particularly when certain bacterial strains are slow-growing or difficult to culture. 

Polymerase Chain Reaction (PCR) testing, which detects genetic material of bacteria, offers a more sensitive alternative. However, it may also have drawbacks, like the inability to differentiate between live and dead bacteria, potentially leading to overdiagnosis. 

Another challenge lies in the detection of biofilms – communities of bacteria protected by a slimy matrix, making them resistant to both immune responses and antibiotics. Standard testing methods may struggle to identify these biofilms, complicating the accurate diagnosis and targeted treatment of chronic and recurrent UTIs. 

Advanced Testing Can Help Determine The Cause of Your UTIs

Embracing advanced testing technologies that consider the dynamic nature of bacterial communities and biofilm formation is essential for overcoming these pitfalls and ensuring a more precise and comprehensive approach to UTI testing.

At Birchwell, we’ll explore stool and vaginal testing to get a thorough look at what’s going on in the gastrointestinal and vaginal microbiomes, since we know vaginal and gut infections go hand-in-hand. We like the GI Microbiome test from US Biotek or the Evvy test to look at the vaginal microbiome.  

Low estrogen levels can increase the risk of UTIs due to the reduction in healthy Lactobacillus bacteria, thinning of vaginal tissues, and weaker bladder contractions (CITE). A comprehensive DUTCH hormone test can give us insight into your hormone levels and if they may be an underlying cause of your recurrent UTIs. 

Simple blood tests like a Complete Blood Count (CBC) and Comprehensive Metabolic Panel (CMP) also offer a window into the underlying cause of your UTIs. A CBC offers information regarding white blood cells that are often elevated during acute infection, and low in the presence of chronic infection or a suppressed immune system. If that’s the case, we’ll double down on supporting your immune system so you can get back to feeling your best. A CMP provides markers of kidney function and blood glucose levels. Elevated blood sugar can increase the risk of UTIs and other infections, while untreated UTIs can cause damage to the kidneys, making them an important focus for monitoring. 

If none of these tests generate clear results, we may suggest imaging like ultrasounds or cystoscopy to determine if your chronic UTIs are related to a urogenital anomaly, injury or other disease. 

Pitfalls of Conventional Treatment for UTIs 

The conventional treatment of UTIs predominantly relies on antibiotics, a powerful tool that targets and eliminates bacterial infections. However, this approach is not without its downsides. One significant concern is the impact on the delicate balance of the gut microbiome. Antibiotics, while targeting the infectious bacteria, can also disrupt the beneficial bacteria in the digestive system and the vaginal flora. This disruption may lead to gastrointestinal complications such as diarrhea, constipation, and an increased susceptibility to opportunistic infection. Antibiotics may also lead to a yeast infection or other issues like Candida. In fact, approximately 22% of women receiving antibiotics for a UTI develop a candida overgrowth shortly after. 

In addition to the potential long-term consequences on gut health and antibiotic resistance, there are also immediate side effects. Nausea, diarrhea, and allergic reactions are common reactions that can impact a patient’s overall well-being during the course of treatment. This may lead to a challenging trade-off between addressing the UTI and managing the adverse effects of the medication.

As UTIs can become recurrent, the repeated use of antibiotics raises concerns about the development of a dependency cycle. Over time, the body may become less responsive to these medications, necessitating higher doses or alternative antibiotics for effective treatment. This cycle can compromise the immune system and create a challenging scenario where the conventional approach may lose its efficacy, leaving you in search of alternative solutions.

Although you may prefer to avoid antibiotics, it’s important to know that UTIs can turn into kidney infections. If you’re experiencing a fever, chills, nausea, vomiting, low back or one sided pain, you should see your doctor. Overusing antibiotics is harmful, but using them in appropriate circumstances, like during a kidney infection, is a health promoting choice. The rest of this article will focus on ways to naturally treat and prevent a UTI with gentle remedies, hopefully preventing the need for antibiotics. 

Alternative & Holistic Treatment Options for UTIs 

Alternative treatment options for Urinary Tract Infections (UTIs) encompass a range of natural remedies, lifestyle changes, and complementary therapies. The best alternative treatment option for UTIs is prevention, and we’ll get to that in a moment! In the meantime, try these tips to support your immune system and fight off a UTI before turning to antibiotics. If you’ve tried antibiotics in the past and they don’t work for you, these are great alternatives. 

Eat an Immune Boosting Diet

First things first, we want you to maintain an overall healthy diet to support your immune system in fighting off and preventing recurrent UTIs.

Including a variety of colorful fruits and vegetables into your daily rotation will provide antioxidants and polyphenols that the immune system needs to flourish.

Incorporating high quality protein at every meal – like grass-fed, grass-finished beef, wild caught fish, organic free range eggs and chicken, and organic edamame or tofu – will help your body recover, repair, build new antibodies, and support overall immunity. 

Adding healthy fats from olive oil, avocado, nuts, seeds, full fat dairy, and some coconut products helps modulate the immune response and reduce overall inflammation. 

Reduce Intake of Foods That Feed Bad Bacteria. Limiting your intake of sugar, refined carbohydrates, and alcohol is important. If your UTIs are caused by a Candida or yeast overgrowth, we encourage you to be even more diligent about removing these foods, in addition to dairy, since they may promote the overgrowth of yeast in your body. 

Supplements for Treating and Preventing UTIs 

1. D-Mannose

This natural sugar found in some fruits, especially cranberries, prevents bacteria from adhering to and colonizing the urinary tract lining. It has been shown to effectively treat and prevent UTIs. During an active infection, take 500 mg every 2-3 hours for 5 days or until your symptoms resolve. For prevention, 1 gram a day is sufficient. 

2. Uva Ursi (Bearberry)

Uva ursi has been used traditionally to treat UTIs due to its potential antibacterial properties. It’s often used in combination with anti-microbial herbs. We like Uristatin by Thorne because it contains uva ursi, echinacea, and berberine to kill unwanted bacteria and support the immune system. Take 3 capsules four times a day until symptoms subside. 

3. Cranberry Supplements

Cranberry products in the form of capsules, tablets, powders, or unsweetened juice keep E. coli bacteria from adhering to the lining of the bladder wall and causing an infection. Concentrated cranberry products have been shown to be as effective as antibiotics in treating UTIs in older women, with the added benefits of being cheaper and having fewer side effects. Cranberry products help reduce the risk of UTIs in females by up to 51% in women who struggle with recurrent infections. To treat an active infection, take 1,000 mg three times a day for a week. As a preventative measure, 1000 mg can be taken daily. Our favorite is Ellura.

4. Antimicrobial Herbs

Some herbs, like goldenseal, Oregon grape, oregano oil, tea tree oil and garlic have antimicrobial properties and have been explored as potential remedies for UTIs. We like Biocidin Botanicals because it contains a blend of many antimicrobial herbs and comes in a liquid or capsule form. It can be used during an infection and slowly increased from 1 capsule daily to 3 capsules twice a day. Preventatively, 1 capsule a day is sufficient. 

5. Probiotics

Maintaining a healthy balance of gut bacteria with probiotics can support overall immune function, potentially reducing the risk of UTIs. Probiotics containing Lactobacillus are specifically important for the urinary tract in women. Fem-Dophilus by Jarrow Formulas contains Lacticaseibacillus rhamnosus and Limosilactobacillus reuteri species that support vaginal and urinary tract health. It can be used as a suppository during acute infections or taken orally. Spore-based probiotics like Ortho Spore IG by Ortho Molecular can be taken simultaneously to support the gut’s immune response. 

It’s important to note that these alternative treatments may vary in effectiveness, and individual responses can differ. While some people may find relief from incorporating these alternatives, others may require a combination of conventional and alternative approaches. Always consult with a healthcare professional for personalized advice. 

You can sign up and purchase supplements directly from our online pharmacy called Fullscript, here.  

Risk Factors for Recurrent UTIs  

Recurrent (UTIs) can be attributed to a variety of risk factors that make individuals susceptible to frequent episodes. 

Women are generally more prone to UTIs due to their shorter urethras, facilitating easier entry of bacteria into the bladder. 

Sexual activity, especially in women, can introduce bacteria into the urethra, increasing the risk of infection. 

The use of certain types of birth control, like spermicides and diaphragms, can contribute to an altered vaginal environment that promotes bacterial growth. 

Postmenopausal women may experience changes in hormonal levels leading to a thinner urethral lining, making it more susceptible to infection. 

Any condition impacting the immune system, like diabetes or HIV, weakens the body’s ability to fend off infections and may increase the risk of recurrent UTIs.  

Additional variables that increase susceptibility include anatomical abnormalities, such as kidney stones or structural issues in the urinary tract, which can create pockets for bacteria to thrive. 

The overuse of antibiotics, while treating one infection, can disrupt the balance of the microbiome, paving the way for future UTIs. 

A comprehensive understanding of these risk factors is crucial for developing targeted preventive strategies and empowering you to make informed decisions about how you treat, manage, and prevent recurrent UTIs.

Preventative strategies for recurrent UTIs 

Preventative strategies for recurrent Urinary Tract Infections (UTIs) involve a holistic approach to address various contributing factors. Here are key strategies to reduce the risk of recurrent UTIs:

Urinate Regularly and Completely: 

Avoid holding urine for prolonged periods, as this can create a conducive environment for bacterial growth. Thoroughly empty your bladder during each bathroom visit to completely flush the urine and bacteria out of your bladder. 

Post-Sexual Hygiene: 

Urinating after sexual activity helps flush out bacteria that may have entered the urethra during intercourse. Good sexual hygiene practices are crucial for preventing UTIs, particularly in women. If you are prone to UTIs, consider using coconut oil as lube (natural antimicrobial), using a vaginal probiotic suppository after, and taking d-mannose and/or cranberry extract preventively after sex

Adequate Hydration:

Drinking plenty of water helps flush bacteria from the urinary tract, preventing colonization and reducing the risk of infection.

Good Hygiene Practices: 

Wiping front to back after using the toilet helps prevent the spread of bacteria from the anal area to the urethra. Using gentle, fragrance-free soaps and avoiding irritants can also promote a healthy genital environment.

Avoid Irritants: 

Steer clear of potential irritants like harsh soaps, spermicides, and feminine hygiene sprays that can disrupt the natural balance of the genital area.

Appropriate Birth Control Methods: 

Discussing alternative birth control methods with a healthcare provider, particularly if using spermicides or diaphragms has been associated with recurrent UTIs, can help find a solution that minimizes infection risk. 

Wear Loose, Dry Clothing: 

Loose clothing and cotton underwear allow for breathability to keep things dry. Make sure you’re completely drying off after a shower and change out of your sweaty workout clothes as quickly as possible. Maintaining a clean, dry environment prevents the growth of pathogenic bacteria. 

Regular Health Check-ups: 

Addressing underlying health conditions, such as diabetes, that may compromise the immune system can be crucial in preventing recurrent UTIs.

Final Thoughts 

By incorporating these preventative strategies into your daily life, you can significantly reduce the frequency and severity of infections, leading to improved urinary tract health and overall well-being. At Birchwell, we’ll tailor these strategies to your individual needs, easing your constant worry about getting another infection, and getting you back to living your most vibrant life. 


Feeling better is possible. Meet with one of our practitioners to find out if 1:1 Functional Medicine Consulting is right for you.

Book a complimentary discovery call

Anya is a Registered Dietitian, Functional Medicine Practitioner and founder of Birchwell, a virtual integrative health clinic based in New York City.

She specializes in helping her clients identify the root cause of their health concerns through advanced lab testing and her comprehensive assessment. She uses functional diet, supplement, and lifestyle strategies to address any imbalances in the body. Through her integrative and functional nutrition practice, Anya has helped hundreds of adult women and men fix their gut health (e.g. SIBO, reflux, candida, etc.), balance their hormones (e.g. PCOS, peri-menopause, estrogen dominance, etc.), clear their acne or eczema, boost their energy and performance, combat anxiety and depression, improve their body composition, reduce their joint pain - and more.

Anya Rosen, MS, RD, LD, IFNCP, CPT

About the founder


on the



recently on the journal