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Cranberry might decrease how quickly the body breaks down atorvastatin. This might increase the effects and side effects of atorvastatin. Avoid drinking large amounts of cranberry juice if you are taking atorvastatin.
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Cranberry is best known for preventing urinary tract infections (UTIs), commonly caused by bacteria known as Escherichia coli (E. coli). At first doctors thought cranberry worked by making urine acidic enough to kill the bacteria. Now, studies show that cranberry may prevent bacteria from attaching to the walls of the urinary tract. Good scientific studies support using cranberry either in capsules or as juice, for preventing, though not treating, UTIs.
Found primarily in North America and grown in bogs, cranberry is an evergreen shrub related to blueberry, buckberry, huckleberry, and bilberry. The cranberry bush has upright branches with leaves that are speckled underneath by tiny dots. Pink flowers blossom and red-black fruits appear during June and July.
Urinary tract infections Several studies indicate that cranberry helps prevent UTIs of the bladder and urethra (the tube that drains urine from the bladder), especially for women who have frequent UTIs. In one study of older women, cranberry juice reduced the amount of bacteria in the bladder compared to placebo. Another study showed that younger women with a history of frequent UTIs who took cranberry capsules had fewer UTIs compared to those who took placebo.
However, studies suggest that cranberry does not work once you have a UTI. That is because it helps keep bacteria from attaching to the urinary tract. But it is less effective once the bacteria have already attached. That is why cranberry is better at preventing UTIs than treating them. UTIs should be treated with conventional antibiotics.
Two studies showed that cranberry may also prevent the bacteria Helicobacter pylori (H. pylori) from attaching to stomach walls. H. pylori can cause stomach ulcers. So cranberries may play a role in preventing stomach ulcers. More research is needed to be sure cranberry helps.
You can get cranberries fresh or frozen, and in juice and concentrate forms. Dried berries are also available as tablets or capsules. Pure cranberry juice is very sour, so most juices contain a mixture of cranberries, vitamin C, and sweeteners, which may make the juice less healthy. Look for a brand of cranberry juice that has the lowest amount of added sugar or is sugar-free.
Cranberry juice as a beverage (in normal amounts) is generally considered safe to drink with no serious side effects, even for pregnant women. Cranberry supplements are considered safe for most people, although pregnant and breastfeeding women should ask their doctor before taking any supplement, including cranberry.
Cranberry has relatively high levels of oxalate, chemicals that may raise the risk of kidney stones in some people. If you have kidney stones, talk to your doctor before taking cranberry supplements or drinking a lot of cranberry juice.
Warfarin (Coumadin): Cranberry may raise the risk of bleeding, especially if you already take medications to thin the blood such as warfarin. It increases the amount of time that warfarin stays in your body. The evidence is mixed and not completely clear, so it is best to ask your doctor before you take cranberry or drink a lot of juice.
Aspirin: Like aspirin, cranberries contain salicylic acid. If you take aspirin regularly, as a blood-thinner, for example, or if you are allergic to aspirin, you should not take cranberry supplements or drink a lot of juice.
Bailey DT, Dalton C, Joseph Daugherty F, et al. Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study. Phytomedicine. 2007 Feb 10; [Epub ahead of print].
Burger O, Ofek I, Tabak M, et al. A high molecular mass constituent of cranberry juice inhibits helicobacter pylori adhesion to human gastric mucus. FEMS Immunol Med Microbiol. 2000 Dec;29(4):295-301.
Duthie SJ, Jenkinson AM, Crozier A, et al. The effects of cranberry juice consumption on antioxidant status and biomarkers relating to heart disease and cancer in healthy human volunteers. Eur J Nutr. 2006 Mar;45(2):113-22. Epub 2005 Jul 20.
Hamilton K, Bennett NC, Purdie G, Herst PM. Standardized cranberry capsules for radiation cystitis in prostate cancer patients in New Zealand: a randomized double blinded, placebo controlled pilot study. Support Care Cancer. 2015;23(1):95-102.
Kontiokari T, Sundqvist K, Nuutinen M, et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2002;322:1571-1573.
Lacombe A, McGivney C, Tadepalli S, Sun X, Wu VC. The effect of American cranberry (Vaccinium macrocarpon) constituents on the growth inhibition, membrane integrity, and injury of Escherichia coli O157:H7 and Listeria monocytogenes in comparison to Lactobacillus rhamnosus. Food Macrobiol. 2013;34(2):352-9.
Shmuely H, Yahav J, Samra Z, et al. Effect of cranberry juice on eradication of Helicobacter pylori in patients treated with antibiotics and a proton pump inhibitor. Mol Nutr Food Res. 2007 Jun;51(6):746-51.
Both cranberry extracts and D-mannose have been proven active in inhibiting the adherence of uropathogens to urinary tract epithelium and reducing bacterial colonization. There are evidence-based recommendations for the use of D-mannose or/and cranberry extracts in the prophylaxis of UTI recurrences (22,23), but few studies approached their effect for the management of acute episodes of UTI.
There were not statistically significant differences between groups with or without co-administration of cranberry extract plus D-mannose added to antibiotic therapy, except for urinary urgency/pollakiuria: P=0.024 with a 95% CI (0.198-0.015) (Table V).
The exact mechanism of action of D-mannose utilized for treatment or prevention of UTI is not completely elucidated. However, in vitro studies have demonstrated that D-mannose could be considered a primary bladder cell receptor site for uropathogenic E. coli since the first step in adhesion involves the mannose-sensitive binding of FimH (the adhesin present at the tip of type 1 pili) to bladder epithelium (31,32). Both cranberry extract and D-mannose have been investigated in several clinical studies, but the majority of the studies were uncontrolled (33). We investigated in this study the effectiveness of a supplement containing both cranberry and D-mannose added to standard antibiotic therapy in acute uncomplicated urinary tract infections. Moreover, we assessed the efficiency of the phytochemical combination in early prophylaxis of UTI recurrences. This study included female patients with acute uncomplicated UTI. The diagnosis was symptom-based, according to guideline recommendations stipulating that presence of 3 or more symptoms suggestive for UTI in women does not require urine culture for a positive diagnosis (22,23). Urine culture was performed only to determine the susceptibility of the pathogens to TMP-SMX, but it did not influence the treatment decision. In all cases of UTIs, E. coli was identified as the pathogen. The CRP was assessed to differentiate the lower from the upper UTI and to exclude the patients with pyelonephritis. Empirical treatment was initiated with TMP- SMX as recommended by guidelines, but the duration of treatment according to the protocol was 7 days instead 3-5 days as recommended by guidelines in uncomplicated cystitis, in order to gain time for the study treatment combination to act, especially in TMP-SMX-resistant cases (22,23).
Based on susceptibility tests, antimicrobial resistance of the pathogens involved to TMP-SMX was identified in 24 cases (36% of the total number of cases in cranberry extract plus D-mannose group). Nine patients, all of them with TMP-SMX-resistant strains, experienced persistence or aggravation of the symptoms during the first 7 days of treatment (47.06% in the TMP-SMX alone group and only 11% in the combined therapy group). In these cases antibiotic treatment was replaced according to susceptibility tests. After the treatment completion they were also randomized for the second step of the study. As expected, a significant decrease in severity of clinical manifestations was noted in the total study population after TMP-SMX treatment with or without study medication. Analyzing the particular sub-group of TMP-SMX-resistant patients, the percentage of resolution was low in the TMP-SMX-alone arm (37.5%), as expected, but in the TMP-SMX associated with cranberry extract plus D-mannose arm it was similar with TMP-SMX-sensitive patients at 90%. These results may have two explanations. One possible reason is that the combination of cranberry and D-mannose may have sufficient power to eradicate lower uncomplicated UTI, supposingly in accordance with data from other studies (33,34). Another motivation for the high healing percentage in TMP-SMX-resistant patients with double-treatment prescription may be the capacity of PACs+D-mannose to increase germ sensitivity to TMP-SMX's effect. Recent research has proven that bacteria become more sensitive to antimicrobials when PACs are administered simultaneously, due to a complex inhibiting effect on antibiotic resistance mechanism: they increase the bacterial cell permeability to antibiotics and diminish the activity of the multidrug efflux pumps (responsible for removing the antimicrobial from the cell); for TMP-SMX, the authors revealed a significant decrease of the minimum inhibitory concentration (MIC) when PACs were associated to antibiotic therapy, thus a decreased dose is necessary to inactivate several germs, including E. coli (33,35). The role of cranberry extract for the prevention of recurrent UTI remains under debate. There are several studies suggesting that PACs are ineffective for this prophylaxis. A meta-analysis of 24 studies with a total of 4,473 participants concluded that cranberry juice is not efficient for the prevention of UTIs (36). In this study, cranberry extract plus D-mannose significantly improved clinical manifestations after one month. Similar results were reported by Genovese et al (37) who conducted a study with a longer follow-up period and found that combination of PACs and D-mannose was associated with a lower rate of recurrences at 24 weeks. The main limitation, similar to this pilot-study, was the insufficient length of the second phase for a better assessment of the effectiveness of investigated product on prophylaxis of UTIs recurrences. 041b061a72