Clinical Research: Effects of L-Methionine On Urinary Tract Infections in Pregnancy
Tori Hudson, ND
Author: Passaro M, Mainin G, Ambrosio F, et al.
Reference: Effects of a food supplement containing L-methionine on urinary tract infections in pregnancy: a prospective, multicenter observational study. J Altern Complement Med 2017;23(6):471-478.
Design: This prospective, multicenter, clinical study of a combination of L-methionine (400 mg), hibiscus extract(100 mg) and boswellia gum resin extract (100 mg) was conducted to investigate its effectiveness on symptoms of urinary tract infections (UTIs) and bacterial counts in pregnant women.
Participants: Pregnant women with symptomatic cystitis were recruited. They had to have one of the following symptoms: dysuria, frequent daytime urination, suprapubic pain, fever, lumbar pain or hematuria. Women were excluded if they had acute or chronic kidney disease, current or past renal colic, urolithiasis, renal cysts, renal hypertension, renal cell carcinoma, diabetes insipidus, any known allergy, acute liver failure and chronic liver disease. Women were ages 22 to 41 years. Women chose which treatment group they would enter to treat their UTI; either Group A) 1 tablet twice daily of the food supplement for 1 week or Group B) an increase in their daily fluid intake greater than 1.5 L for 1 week. Group A included 216 women and group B= 48.
Patients were similar in age, profession, duration of pregnancy, severity and scope of symptoms, liquid intake and urinary bacterial species although there were greater colony forming units in group A vs group B. Urine cultures were done at baseline and after weeks 1 and 2.
Primary outcome: The primary determinant of effectiveness was based on an improvement or resolution of symptoms and a reduction of the bacterial load.
Key findings: In group A, a negative urine culture after week 1 was found in 70% of patients. In group B, 43.2% of patients had a negative urine culture after week 1. For patients in group A, all those women whose urine culture was positive after week 1 had a bacterial count that was lower than at baseline. For women in group B, those women with a positive urine culture after week 1 had a bacterial load decrease in 81% of them and increased in 19%. The average bacterial reduction was greater in group A than in group B after 1 week. After 2 weeks, the bacterial load was measured only in those women with a positive culture after week 1, 63 women in group A and 21 in group B.
After the first week, 23.1% of women in group A and 14.6% in group B had improved symptoms, which was not statistically significant. There was however 62.5% of the women in group A who had their symptoms disappear vs 45.8% in group B. A greater percentage of women in group A reported resolution of suprapubic pain and lumbar pain after week 1, compared to group B.
Practice Implications: Urinary tract infections in pregnant women can be problematic leading to premature delivery and low infant birth weight. Antibiotics are the standard of care in conventional medicine and are responsible for 80% of the medications prescribed during pregnancy. Approximately 20-25% of pregnant women receive an antibiotic , which carries a category B risk, during their pregnancy.
Safe, effective alternatives are a welcome option for pregnant women with urinary tract infections. I have no experience using this combination or the individual ingredients in the treatment of urinary tract infections, in pregnant or non pregnant women. This product is called Acidif Plus made by Biohealth , an Italian company. It contains 400 mg of L-methionine, 100 mg of hibiscus calyx extract and 100 mg of boswellia gum resin extracts. The daily dose is one tablet twice daily and is taken for 7 days. I am not certain of this product is available in the U.S. or if it can be shipped to the U.S., although I did find it with a simple internet search.