Cranberry (Vaccinium macrocarpon)
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| Cranberry |
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There is some human evidence supporting the use of cranberry juice and
cranberry supplements to prevent urinary tract infection (UTI),
although most available studies are of poor quality. There are no clear dosing
guidelines, but given the safety of cranberry, it may be reasonable to
recommend the use of moderate amounts of cranberry juice cocktail to prevent
UTI in non-chronically ill individuals.
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Cranberry has not been shown effective as a treatment for
documented UTI. Although cranberry may be used as an adjunct therapy in some
cases, given the proven efficacy of antibiotics, cranberry should not be
considered a first line treatment.
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Cranberry has been investigated for numerous other medicinal uses, and
promising areas of investigation include prevention of H. pylori
infection, which causes gastrointestinal ulcers and dental plaque.
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American cranberry, Arandano Americano, Arandano trepador, bear berry, black
cranberry, bog cranberry, Ericaceae (family), European cranberry, grosse
moosebeere, isokarpalo, Kranbeere, Kronsbeere, large cranberry, low cranberry,
marsh apple, mountain cranberry, moosebeere, mossberry, Oxycoccus
hagerupii , Oxycoccus microcarpus ,
Oxycoccus macrocarpus , Oxycoccus palustris ,
Oxycoccus quadripetalus , pikkukarpalo, preisselbeere, ronce
d'Amerique , trailing swamp cranberry, Tsuru-kokemomo, Vaccinium
edule , Vaccinium erythrocarpum ,
Vaccinium hageruppi , Vaccinium microcarpum ,
Vaccinium occycoccus , Vaccinium plaustre ,
Vaccinium vitis .
These uses have been tested in humans or animals. Safety
and effectiveness have not always been proven. Some of these conditions are
potentially serious, and should be evaluated by a qualified healthcare provider.
| Uses based on scientific evidence |
Grade* |
| Urinary tract infection (prevention)
There are multiple studies of cranberry (juice or capsules) for the
prevention of urinary tract infections in healthy women and nursing home
residents. While no single study convincingly demonstrates the ability
of cranberry to prevent UTIs, the sum total of favorable evidence
combined with laboratory research tends to support this use. It is not
clear what dose is best.Cranberry seems to work by preventing bacteria
from sticking to cells that line the bladder. Contrary to prior belief,
urine acidification does not appear to play a role. Notably, many
studies have been sponsored by the cranberry product manufacturer Ocean
Spray®. Additional research is needed in this area before a strong
recommendation can be made.
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B |
| Antibacterial
Study results of cranberry as an antibacterial in other conditions show
conflicting results. Further study is needed before a conclusion can be
drawn.
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C |
| Antifungal
Limited laboratory research has examined the antifungal activity of
cranberry. There are no reliable human studies supporting the use of
cranberry in this area.
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C |
| Antioxidant
Based on laboratory study, cranberry may have antioxidant properties.
However, human study is lacking. Further study is needed before a
recommendation can be made.
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C |
| Antiviral
Limited laboratory research has examined the antiviral activity of
cranberry. There are no reliable human studies supporting the use of
cranberry in this area.
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C |
| B12 absorption in people using antacids
Preliminary research suggests that cranberry juice may increase vitamin
B12 absorption in patients taking drugs that reduce stomach acid, such
as proton pump inhibitors like lansoprazole (Prevacid®). However, this
effect may be due to the acidity of the juice rather than an active
component of cranberry itself. Further study is needed before a
recommendation can be made.
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C |
| Cancer prevention
Based on a small amount of laboratory research, cranberry has been
proposed for cancer prevention. Study is needed in humans before a
recommendation can be made.
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C |
| Dental plaque
Because of its activity against some bacteria, cranberry juice has been
proposed as helpful for mouth care. However, many commercial cranberry
juice products are high in sugar, and may not be suitable for this
purpose. There is not enough research in this area to make a clear
recommendation.
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C |
| Kidney stones
Based on preliminary research, it is not clear if drinking cranberry
juice increases or decreases the risk of kidney stone formation.
Cranberry juice is reported to decrease urine levels of calcium,
increase levels of urine magnesium and potassium, and increase urine
levels of oxalate.
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C |
| Memory improvement
Preliminary study results show that cranberry juice may increase overall
ability to remember. Further well-designed clinical trials are needed to
confirm these results.
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C |
| Stomach ulcers caused by H. pylori bacteria
Based on early research, cranberry may reduce the ability of H.
pylori to live in the stomach. Further research is needed to
confirm these results.
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C |
| Reduction of odor from incontinence/bladder
catheterization
There is preliminary evidence that cranberry juice may reduce urine odor
from incontinence or bladder catheterization. Further study is needed
before a recommendation can be made.
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C |
| Urine acidification
In large quantities, cranberry juice may lower urine pH, making it more
acidic. Contrary to prior opinion, urine acidification does not appear
to be the way that cranberry prevents urinary tract infections.
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C |
| Urinary tract infection (treatment)
There are no well-designed human studies of cranberry for the treatment
of urinary tract infections. Laboratory research suggests that cranberry
may not be an effective treatment when used alone, although it may be
helpful as an adjunct to other therapies such as antibiotics.
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C |
| Urostomy care
It is proposed that skin irritation at urostomy sites may be related to
urine pH. Cranberry juice can lower urine pH, and has been tested for
this purpose. Further study is needed before a recommendation can be
made.
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C |
| Chronic urinary tract infection prevention:
children with neurogenic bladder
There is preliminary evidence that cranberry is not effective in
preventing urinary tract infections in children with neurogenic bladder.
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D |
| Radiation therapy side effects (prostate cancer)
There is preliminary evidence that cranberry is not effective in
preventing urinary symptoms related to pelvic radiation therapy in
patients with prostate cancer.
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D |
*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.
Grading rationale
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often
have not been thoroughly tested in humans, and safety and effectiveness have
not always been proven. Some of these conditions are potentially serious, and
should be evaluated by a qualified healthcare provider.
Anorexia, anti-inflammatory, bladder conditions, bladder infections, blood
disorders, cancer treatment, decontamination (of meats), diuresis (increasing
urine flow), gall bladder stones, improving brain function, influenza, liver
disorders, recurrent cystitis, rheumatoid arthritis, scurvy, stomach ailments,
vomiting, wound care.
The below doses are based on scientific research,
publications, traditional use, or expert opinion. Many herbs and supplements
have not been thoroughly tested, and safety and effectiveness may not be proven.
Brands may be made differently, with variable ingredients, even within the same
brand. The below doses may not apply to all products. You should read product
labels, and discuss doses with a qualified healthcare provider before starting
therapy.
Adults (18 years and older)
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For urinary tract infection prevention , the recommended
doses range from 90 to 480 milliliters (3 to 16 ounces) of cranberry cocktail
twice daily, or 15 to 30 milliliters of unsweetened 100% cranberry juice
daily. 300 milliliters per day (10 ounces) of commercially available cranberry
cocktail (Ocean Spray®) has been used in well-designed research.
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Other forms of cranberry used include capsules, concentrate and tinctures.
Between one and six 300 to 400 milligram capsules of hard gelatin concentrated
cranberry juice extract, twice daily by mouth, given with water 1 hour before
meals or 2 hours after meals has been used. One and a half ounces of frozen
juice concentrate twice daily by mouth has been used, as well as 4 to 5
milliliters of cranberry tincture three times daily by mouth. One study
suggests that 500 milliliters of cranberry juice with 1,500 milliliters of
water was sufficient in helping prevent the formation of oxalate kidney
stones.
Children (younger than 18 years)
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There is not enough scientific evidence to recommend cranberry supplementation
in children (beyond amounts found in a normal balanced diet).
The U.S. Food and Drug Administration does not strictly
regulate herbs and supplements. There is no guarantee of strength, purity or
safety of products, and effects may vary. You should always read product labels.
If you have a medical condition, or are taking other drugs, herbs, or
supplements, you should speak with a qualified healthcare provider before
starting a new therapy. Consult a healthcare provider immediately if you
experience side effects.
Allergies
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Cranberry should be avoided by people with allergy/hypersensitivity to Vaccinium
species (cranberries and blueberries).
Side Effects and Warnings
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Patients with diabetes or glucose intolerance may want to drink sugar-free
cranberry juice to avoid a high sugar intake. High doses of cranberry may
cause stomach distress and diarrhea, or may increase the risk of kidney stones
in people with a history of oxalate stones. Some commercially available
products are high in calories. On average, six ounces of cranberry juice
contains approximately 100 calories. One study shows the possibility for
occurrence of vaginal yeast infections in those women who often consume
cranberry juice, although this has not been proven.
Pregnancy and Breastfeeding
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Safety has not been determined in pregnancy and breastfeeding, although
cranberry juice is believed to be safe in amounts commonly found in foods.
Many tinctures contain high levels of alcohol and should be avoided during
pregnancy.
Most herbs and supplements have not been thoroughly
tested for interactions with other herbs, supplements, drugs, or foods. The
interactions listed below are based on reports in scientific publications,
laboratory experiments, or traditional use. You should always read product
labels. If you have a medical condition, or are taking other drugs, herbs, or
supplements, you should speak with a qualified healthcare provider before
starting a new therapy.
Interactions with Drugs
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In theory, due to its acidic pH, cranberry juice may counteract antacids.
Cranberry juice theoretically may increase the effects of antibiotics in the
urinary tract and increase the excretion of some drugs in the urine. Cranberry
juice may increase absorption of vitamin B12 in patients using proton pump
inhibitors such as esomeprazole (Nexium®).
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Some cranberry tinctures may have high alcohol content and lead to vomiting if
used with the drug disulfiram (Antabuse®) or metronidazole (Flagyl®).
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Although controversial, some studies have shown that taking the prescription
blood thinner warfarin (Coumadin®) and cranberry products at the same time
can elevate the INR which could increase the risk of bleeding.
Interactions with Herbs and Dietary Supplements
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In theory, cranberry juice may increase the excretion of some herbs or
supplements in the urine.
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Theoretically cranberry products may increase the risk of bleeding in people
taking other herbs or supplements like garlic or danshen.
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Inhibition of H. pylori bacteria, which may lead to
gastrointestinal ulcers, may be increased when oregano and cranberry are taken
together.