Let’s talk about D-Mannose with Gigi

There are many testimonies of people who have defeated cystitis (and everything related to it) thanks to D-Mannose (myself included) in this blog.

I must admit I have found this “miraculous” solution (natural, without side effects and really effective) only because I moved to Italy (I had never read nor heard about D-Mannose before).

Furthermore, I think doctors would have laughed at me if I had dared to tell them about “managing” my cystitis with … some sugar (not caloric at all)!

I started to drag all my friends to the forums in order to help them and then, little by little, I have found Deakos, I have my own blog in french, etc.

But here comes the problem.

Four years later, things have not changed much. I still get many messages that say “doctors do not know about it”, “my pharmacist says I have to be careful with it”, “no one talks about that”.

In short, this mind narrowness is exasperating and I don’t know how long it will last.

People who know me, know that I am an eternal positive and optimistic person. I believe that even the smallest victory deserves to be celebrated, shouted and spread.

So, I would love to share with you the few victories of these last months (years):

A double page on a French magazine:

An article on a famous Spanish natural health site:

Recurrent cystitis: causes, treatment and prevention

Recurrent acute cystitis is a very common pathology in women (one in two has it) and a frequent consultation in E.R. In this article, we review its pathophysiology, risk factors and treatment, as well as preventive uses of D-Mannose, a natural alternative to treat recurrent urinary tract infections.

What is recurrent cystitis?

Cystitis is a bladder inflammation that, in most cases, is caused by the presence of pathogenic microorganisms in the urinary tract. We talk about recurrent cystitis when four or more acute episodes have occurred in a period of twelve months1.

In these cases, it is advisable to take into account the clinical history of the patient to accurately identify the causes that lead to the repetition of these episodes.

The complete and definitive resolution of recurrent cystitis cannot reside in a single episode approach, but must necessarily take into account the factors that predispose and precipitate the crises, in order to prevent the establishment, migration and proliferation of the uropathogenic germs.

With this strategy, it will be possible to increase the period of time between acute episodes, reduce the intake of antibiotics, restore the correct intestinal and vaginal eubiosis as well as the physiological immune defenses to finally reach a complete resolution.

Possible causes and prevention methods

In addition to generic prevention (sufficient daily hydration, adequate nutrition, correct intimate hygiene, etc.), it is possible to implement an individual preventive approach, based on the factors that predispose and trigger cystitis episodes.

Recent research has identified the ability of uropathogenic germs to produce a bacterial biofilm2 . This organic peculiarity would explain the phenomenon of recidivism, that is to say, the tendency to develop frequent acute episodes in short times.

When cystitis is recurrent, this biofilm is present in more than 80% of cases3 and is the main factor that predisposes the problem to become chronic.

On the other hand, precipitating factors of acute episodes are even more heterogeneous among subjects with recurrent cystitis. For example, the prevention of post-coital cystitis cannot be managed in the same way as that of menopause-related cystitis.

D-Mannose: an excellent ally for prevention

D-Mannose is a simple sugar. It is poorly assimilated by the body with very low impact on the glycemic index. It can be used by all patients in any moment of life. It has numerous advantages: it can be used during pregnancy and lactation or by diabetic or celiac subjects. It can also be taken for prolonged periods (for example, in patients with urinary catheters without risk of overdose, addiction or interaction with therapies or food supplements).

D-Mannose is effective as prevention, during acute and maintenance phase  against bacteria such as E. coli, Proteus, Klebsiella, Streptococcus, Shigella, etc1.

In association with N-acetylcysteine (NAC) and Lactoferrin, D-Mannose allows a natural approach against biofilm. In fact, NAC has mucolytic effect, it can break down pathogenic biofilms while D-Mannose intercepts free bacteria (inhibiting their adhesive capacity and allowing their elimination naturally through the urine flow) while Lactoferrin inhibits yeasts2 growth.

Unlike the antibiotic, D-Mannose does not kill bacteria, but eliminates them naturally through the urine flow. This aspect has many advantages:

  • does not produce inflammatory toxins that damage the bladder wall
  • does not imply the formation of free radicals (organic waste of bacteria destroyed by the antibiotic) that cause oxidative damage and that can bind minerals in the urine, leading to the formation of stones. Toxins and free radicals are often responsible for the prolongation of symptoms even after the resolution of the acute episode and increase the risk of chronic pain

D-Mannose is not perceived by bacteria as “enemy” so they will not develop any resistance and its effectiveness will remain unchanged over time, even after long periods of intake.

Doctor Ettore de Angelis, Deakos Srl Scientific Director


  1. Oral D-mannose in recurrent urinary tract infections in women: A pilot study. D Porru, A Parmigiani, C Tinelli, D Barletta, D Choussos, C Di Franco, V Bobbi, S Bassi, O Miller, B Gardella, RE Nappi, A Spinillo and B Rovereto, Journal of Clinical Urology ,201X, Vol XX(X) 1–6 © British Association of Urological Surgeons 2013
  2. MINERVA GINECOL 2014;66:497-512 A. GRAZIOTTIN, P. P. ZANELLO, G. D’ERRICO Cistiti e vaginiti recidivanti: ruolo dei biofilm e delle persister cells. Dalla fisiopatologia a nuove strategie terapeutiche
  3. Science. 1999 Mar 19;283(5409):1837, 1839. Forging a link between biofilms and disease. Potera C.

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