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Fungal Urinary Tract Infections

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Introduction / full article

Fungal Urinary Tract Infections

ID 791

Fungal Urinary Tract Infections

Fungal urinary tract infections usually affect the kidneys and bladder. Fungal infection in the lower urinary tract is often associated with urinary catheter use and antibiotic therapy. There are rarely symptoms when someone has a fungal urinary tract infection in the lower urinary tract, though some patients experience pain while urinating or frequent urges to urinate. Traces of blood may also be found in the urine. One type of fungal urinary tract infection is renal candidiasis, which involves the gastrointestinal tract.

Efficacy of Alternative and Other Treatments According to GRADE* Ranking

Vitamin A [1, 31, 32, 33, 34, 35, 36, 37]

Please note, this management does not treat the condition itself. It may mildly help in preventing some symptoms, and even then has insufficient evidence to back up this claim at present. This acts as a preventative treatment, and not necessarily symptomatic relief.

Recommendation: Strongly in favor. Vitamin A may help to prevent urinary tract infections due to its role in the body's immune function.

Grade of Evidence: High quality of evidence.

Pokeweed Antiviral Protein (PAP) [1, 26, 27, 28, 29, 30]

Please note, this management does not treat the condition itself. It may mildly help with some symptoms, and even then has insufficient evidence to back up this claim at present. Warning: all parts of the pokeweed plant (Phytolacca americana) are poisonous and should not be ingested. Thorough cooking reduces toxicity. The effects of improperly prepared plant material may include vomiting, diarrhoea, cramps, headache, confusion, convulsions, low blood pressure, heart block, and death. Only plant extracts (PAP) or thoroughly prepared plants should be ingested, and even then, only under professional medical guidance.

Recommendation: No recommendation. There is insufficient evidence to support claims that PAP helps to treat fungal infections.

Grade of Evidence: Very low quality of evidence.

Pau D'Arco (Lapachol, Tabebuia impetiginosa, Tabebuia heptaphylla) [1, 25]

Please note, this treatment has potentially serious side effects. Some chemicals in the plant are known to be toxic. High doses are known to affect the liver and kidneys. Even at low doses, chemicals in the plant may interfere with blood clotting, causing excess bleeding and anaemia. Pau D'Arco should be avoided, especially by pregnant or breastfeeding women.

Recommendation: Strongly against. There is insufficient evidence to support claims that Pau D'Arco helps to treat fungal infections. Combined with its potentially harmful side effects if taken without supervision from a doctor or pharmacist, there is enough reason to avoid this treatment.

Grade of Evidence: Very low quality of evidence.

Kava (Piper methysticum) [1, 21, 22, 23, 24]

Warning: in rare cases, kava may lead to liver failure and other life-threatening problems. The FDA warns that people who have had liver problems, or who are taking medications that may affect the liver, should check with their doctors before taking kava. Other side effects include headache, upset stomach, drowsiness, weight loss, bloody urine, and muscle weakness.

Recommendation: No recommendation. There is insufficient evidence to support claims that kava helps to treat symptoms of fungal infection. More research is needed.

Grade of Evidence: Very low quality of evidence.

Gotu Kola (Centella asiatica, Hydrocotyle asiatica) [3, 15, 16, 17, 18, 19, 20]

Please note, this management does not treat the condition itself. It may mildly help with some symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation. There is insufficient evidence to support claims that Gotu Kola helps in the treatment of fungal urinary tract infections in any way. More research is needed.

Grade of Evidence: Low quality of evidence.

Goldenseal (Hydrastis canadensis) [3, 8, 9, 10, 11, 12, 13, 14]

Please note, this management does not treat the condition itself. It may mildly help with some symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly against. There is insufficient evidence to support claims that Goldenseal helps to treat urinary tract infections. More studies are needed. Goldenseal may produce toxic effects, including depression, constipation, rapid heartbeat, stomach pain, mouth ulcers, and vomiting.

Grade of Evidence: Low quality of evidence.

Echinacea Purpurea [3, 4, 5, 6, 7]

Please note, this management does not treat the condition itself. It may mildly help with some symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation. Evidence has shown that Echinacea has no effect in the treatment or prevention of urinary tract infections.

Grade of Evidence: Moderate quality of evidence.

* GRADE Working Group: www.gradeworkinggroup.org

Summary References

Treatments:

  1. Malani AN, Kauffman CA. Candida urinary tract infections: treatment options. Expert Review of Anti-Infective Therapy. 2007 Apr;5(2):277-84.
  2. Sobel JD, Vazquez JA. Fungal infections of the urinary tract. World Journal of Urology. 1999 Dec;17(6):410-4.
  3. Ades T, Alteri R, Gansler T, Yeargin P. Complete Guide to Complementary & Alternative Cancer Therapies. American Cancer Society, Atlanta USA, 2009.
  4. American Cancer Society: Echinacea
  5. NCCAM: Echinacea at a glance
  6. PubMed PMID: 16049208
  7. Medical News Today: Echinacea
  8. American Cancer Society: Goldenseal
  9. NCCAM: Goldenseal
  10. Tierra M. The Way of Herbs. New York: Pocket Books; 1998.
  11. Grieve M. A Modern Herbal. New York: Dover Publications; 1971.
  12. Mills S, Bone K. Principles and Practice of Phytotherapy. Philadelphia: Churchill Livingstone; 2000.
  13. Tice R. Goldenseal and Two of Its Constituent Alkaloids: Berberine and Hydrastine. Research Triangle Park: National Institute of Environmental Health Sciences; 1997.
  14. Henriette's Herbal: Hydrastis
  15. Winston D, Maimes S. Adaptogens: Herbs for Strength, Stamina, and Stress Relief. 2007; pp. 226-227.
  16. Bradwejn J, Zhou Y, Koszycki D, Shlik J. A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects. Journal of Clinical Psychopharmacology. 2000;20(6):680-684.
  17. Hausen BM. Centella asiatica (Indian pennywort), an effective therapeutic but a weak sensitizer. Contact Dermatitis. 1993;29(4):175-179.
  18. Cataldo A, Gasbarro V, et al. Effectiveness of the combination of alpha tocopherol, rutin, melilotus, and Centella asiatica in the treatment of patients with chronic venous insufficiency. Minerva Cardioangiologica. 2001 Apr;49(2):159-163.
  19. Wikipedia: Gotu Kola medicinal effects
  20. American Cancer Society: Gotu Kola
  21. CSIRO publication on kava
  22. American Cancer Society: Kava
  23. Kava safety library
  24. NCCAM: Kava
  25. American Cancer Society: Pau D'Arco
  26. Canadian Poisonous Plants Information System: Pokeweed
  27. Plants for a Future: Phytolacca americana
  28. PubMed PMID: 315368
  29. MedlinePlus: Pokeweed poisoning
  30. American Cancer Society: Pokeweed
  31. MedlinePlus Natural Medicines: Vitamin A
  32. MedlinePlus: Vitamin A
  33. NIH Office of Dietary Supplements: Vitamin A
  34. WHO: Vitamin A deficiency
  35. Latham ME. Human Nutrition in the Developing World. FAO Food and Nutrition Paper. Food & Agriculture Organization of the United Nations; 1997. ISBN 92-5-103818-X.
  36. Sommer A. Vitamin A Deficiency and Its Consequences: A Field Guide to Detection and Control. Geneva: World Health Organization; 1995. ISBN 92-4-154478-3.
  37. UNICEF: A World Fit for Children

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