How does D-Mannose reach the bladder?

How does D-Mannose reach the bladder?

It is very interesting to understand how the active ingredient reaches the bladder to be able to choose the best formulation.

When we talk about the oral intake of D-Mannose, we refer to the following formulations:

  • tablets
  • soluble powder
  • orosoluble powder = sublingual

D-Mannose is a monosaccharide (= sugar) that can not be assimilated by the body. This means that, unlike all other simple sugars (such as fructose, lactose or sucrose, for example), it does not degrade during the various stages of digestion. It remains intact throughout the digestive tract (mouth, stomach, small intestine and colon). Its absorption, the passage from the digestive tract to the blood flow, allows a complete molecule transfer without any alterations in the blood. This characteristic makes it a sugar that does not provide calories and does not alter blood glucose.

D-Mannose pathway regardless of its form of oral intake 

Depending on how it is taken orally, it is absorbed into the bloodstream in two ways:

  • in the mouth, by the blood capillaries present in the lower part of the tongue (sublingual formulation)
  • in the colon, by the capillaries present in the intestinal wall (this is the case of Ausilium soluble powder)

It should be noted here that:

  • the denser the formulation of D-Mannose, more its absorption site will be “far” in the digestive tract

For example, soluble D-Mannose will be absorbed faster into the colon compared to D-Mannose tablets.

  • if the absorption site is “far” in the digestive tract, the risk of loss of the active ingredient throughout the digestive tract is higher

For example, 1 g of soluble D-Mannose almost entirely reaches the blood while less than half of 1 g of D-Mannose in tablets will pass into the blood.

  • if the absorption site is “far” in the digestive tract, the risk of gastrointestinal side effects is higher

By way of example, sublingual D-Mannose never causes bloating or diarrhea; on the other hand, D-Mannose tablets have a 10 times higher risk of disorders like these. This is due to the prolonged time of permanence of D-Mannose in the intestines.

It is estimated that the maximum concentration of D-Mannose in the bladder is reached:

  • sublingual intake: after 30 minutes
  • soluble formulation: after 1 hour
  • tablet: 2 to 3 hours

This is the reason why it is recommended to urinate approximately 1 hour after the intake. This will eliminate uropathogenic germs stucked to D-Mannose immediately.

In conclusion, choosing the appropriate formulation of D-Mannose is also a guarantee of its effectiveness against pathogens:

-> sublingual for emergency measures, situations in which there is no water and with risk of swelling or diarrhea
-> soluble for acute episodes in progress and in primary prevention after acute episode resolution
-> tablets for maintenance phases after acute episodes (from 3 to 6 months without crisis) and transit disorders absence

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