The Effect of Vitamin E on Urinary Tract Infection: Recovery and Recurrence

Urinary tract infections in women can affect the lower urinary tract which includes the bladder and urethra or the upper urinary tract which includes the kidneys.  Uropathogens from the intestinal flora colonize the area around the opening of the vagina and then ascend the urethra to the bladder and potentially to the kidneys.  In the bladder it is called cystitis and in the kidney it is called pyelonephritis.   Recurrent urinary tract infections (UTIs) are defined as having two or more acute UTIs within 6 months or three or more within a year. Recurrent UTIs are further classified as either a relapse of an infection one just had, or a reinfection.   A relapse is caused by the same infectious organism within 2 weeks of completing treatment for the initial infection.  A reinfection occurs after two weeks of treatment or following a normal culture.

The current study randomized 88 female patients ages 18 and older who had a lower UTI.  There were two groups: one received a standard 3-day course of antibiotic and a placebo, and the other received the antibiotic and also the vitamin E 100 IU per day for 6 months.  Patients were assessed at 3-5 days after starting antibiotics, and then at 3 and 6 months.

After 3 days, the antibiotic and vitamin E group showed a significant improvement in urinary frequency and dysuria compared to the antibiotic/placebo group.  Urgency of urination did not differ between the two groups.  At 3 months and at 6 months, UTI recurrence was significantly lower in the vitamin E group and in addition, recovery time was significantly shorter .

Commentary:

Recurring UTIs can be common in reproductive aged women.  Evolving research highlights the role of oxidative stress in UTIs and thus the serum levels of total antioxidants may influence the susceptibility one has to UTIs.  Vitamins A and E may also help prevent scarring of the kidneys secondary to pyelonephritis.  Vitamin E can have protective anti-inflammatory effects by reducing lipid peroxidation and oxidative damage.  It has also been shown to decrease biofilm production… which means it can help prevent the formation of a defense shield that protects the bacteria from being destroyed by the antibiotic.  There is also some evidence that vitamin E may enhance the efficacy of antibiotics used to treat bacterial infections, including UTIs.  This could explain the lower recurrence rates in the antibiotic/vitamin E group.

My take home from this would not necessarily be to give every reproductive aged woman vitamin E along with an antibiotic (if she needed one), for uncomplicated UTIs.  But I will employ this strategy in women with recurring UTIs.  I also will not hesitate to utilize this strategy in postmenopausal women.   Keep in mind though, that natural medicine is very strong in treating acute and recurrent UTIs in women.  Mannose, cranberry, Lactobacillus crispatus (sometimes oral and sometimes vaginal regimens), berberine lead the way, with postmenopausal women needing vaginal/vulvar low dose estrogen twice a week to help prevent recurrence.

The other aspect I like very much about this trial, is that vitamin E 100 IU is inexpensive with an excellent safety profile.

Reference: Mafakher H, Ebrahimzadeh A, Sahebnasagh A, Ramezani M, Avan R.  Effect of vitamin E supplementation on recovery and recurrence prevention in women with lower urinary tract infections: A triple-blind randomized clinical trial.  Clin Nutr ESPEN 2026 Feb:71:102876