I've used the d-mannose for quite sometime. My urologist said proven fact that cranberry is great for bladder health/infection. So sometime ago I was introduced to cran-actin with d-mannose. A wonderful combination for bladder health. My advisor who owns a local health food store said "I bet it's the tinnactic acid in tea...my daughter said it irritates her bladder and seems to increase spasms. Bottomline is I use cran-actin with d-mannose whenever I have a symptom or known exposure that my cause problems. Love it. Certainly recommend it too.