Prostate Health and Naturopathic Medicine

Natural medicine has a tremendous amount to offer for both the prevention and treatment of Benign Prostatic Hyperplasia or BPH. There are many factors that you can control that influence whether of not you have prostate enlargement. BPH is thought to be due to an accumulation of testosterone in the prostate. Once within the prostate, testosterone is converted to the more potent hormone dihydrotestosterone (DHT). This compound stimulates the cells to multiply excessively, eventually causing the prostate to enlarge. There are natural substances that affect the uptake of testosterone into the prostate and interfere with the conversion of testosterone to DHT and interfere with its ability to act on the cells of the prostate.

According to a recent review article published in the British Journal of Urology, in Europe, plant based medicines are much more popular prescriptions for BPH than their synthetic counterparts. Specifically, in Germany and Austria botanical medicines are considered first line treatments for BPH; they account for more than ninety percent of all medicines used in the medical management of BPH.

  • The most well known herb for the prostate is Saw palmetto. It is a shrub that grows naturally on the east coast of U.S.
  • In many scientific /clinical studies Saw Palmetto has been shown to greatly improve the signs and symptoms of enlarged prostate.

Here’s how it works: basically, it reduces prostate enlargement by reducing the amount of hormonal stimulation of the prostate gland.

  • It inhibits the conversion of testosterone to DHT by inhibiting the activity of an enzyme 5-alpha reductase (same as Proscar and Propecia, the presciption drugs used for BPH)
  • It inhibits DHT’s intracellular binding and transport
  • Also has anti-estrogenic effects according to double blind, placebo controlled experiments. Estrogen contributes to BPH because it inhibits the breakdown and elimination of DHT.
  • Like PROSCAR it decreases the type of testosterone (DHT) that causes the cells of the prostate to proliferate. But works much better with no side effects. Head to head, saw palmetto is more effective than proscar. 90% of patients report improved flow rates.
  • Numerous studies on Saw Palmetto extract have shown it to be effective in nearly 90% of patients, usually in a period of 4-6 weeks.
  • Study (double-blind) of 110 BPH sufferers. (published in the British Journal of clinical Pharmacology) :
  • Night urination decreased by over 45%, urine flow rate increased by over 50% and urine retention decreased by 42% in the group receiving the extract vs no significant changes in the placebo group. In just 30 days!
  • Effects on Quality of Life:
    Men were asked to rank the quality of their life: Unsatisfied, satisfied, unhappy, happy delighted. Before Saw Palmetto, 43% were unsatisfied and 2% were happy. After 90 days, only 9.5% were unsatisfied and 24% were happy. The researchers speculated that the improved quality of sleep due to less night time urination was responsible…but you never know…
  • It’s berries have long history of use in folk medicine not only for treatment of prostate problems but also as an aphrodisiac and sexual rejuvenator!
  • Dose: Saw Palmetto extract standardized to contain 85-95% fatty acids and sterols , 160 mg twice per day.
  • Safety: completely safe, as no significant side effects have ever been reported in the clinical trials of the extract. Animal toxicology studies of high dosages have also shown the extract to have no toxic effects

Pygeum africannum, a tree native to Africa, also has potent effects on the male reproductive system. It is used clinically for BPH, prostatitis, male infertility and impotence. How does it work?

  • Reduces testosterone accumulation in the prostate
  • It decreases prolactin. This is significant because prolactin increases the uptake of testosterone and increases the synthesis of DHT within the prostate thus leading to BPH.
  • Also overall decreases cholesterol. Prostate tissue affected by BPH or prostate cancer tend to accumulate cholesterol content inside the prostate contributing to prostate enlargement. Lowering cholesterol overall is of benefit for BPH.
  • Also reduces inflammation of the prostate. Scientific Studies of over 600 people have concluded that pygeum effectively reduces the symptoms and clinical signs of BPH especially in early cases.

Also helps the erectile dysfunction often associated with BPH

Dose: standardized extract of 100-200 mg per day in divided doses.
Safety: Shown to be non-toxic in animal toxicology studies. Human clinical trials also confirm the lack of side effects. A few people experience gastro intestinal irritation.

Other factors

  • Diet plays a major role.
  • Studies have shown a connection between high Cholesterol and prostate disorders. Cholesterol has been shown to accumulate in enlarged or cancerous prostates.
  • Zinc supplements have been shown to reduce the size of the prostate gland and reduce symptoms of BPH in the majority of people. It affects hormone metabolism: it inhibits the activity of 5-alpha reductase, the enzyme that converts testosterone to DHT. It also inhibits prolactin secretion. People who are deficient in zinc also have higher incidences of BPH, prostatitis and prostate cancer.
  • Nuts and seeds, especially pumpkin seeds are good sources of zinc
  • Fatty acids –fish and flax seeds provide essential fatty acids that have many benefits due to their anti-inflammatory effects. People with BPH often have an underlying EFA deficiency in their prostatic and seminal secretions.
  • BEER consumption is linked to BPH. It increases prolactin levels, and effects testosterone uptake in the prostate. Alcohol consumption also decreases zinc and other nutrient levels.
  • Lycopenes are strong antioxidants found especially in tomotoes. Research has revealed low incidence of prostate cancer in people who eat a lot of spagetti, ketchup, pizza and strawberries. The common theme is tomatoes, which contain this strong anti-oxidant called lycopene.
  • Soy: soybeans are rich in phytosterols, chemicals shown to relieve BPH. The latest double blind study consisted of 200 men who received 20 mg per day of a soy extract called beta-sitosterol or placebo three times a day. They showed improved flow rates, and decreased urine retention. No change was seen in the placebo group.
  • B-Sitosterol: treats high cholesterol too. Clinical evidence suggests that it reduces the symptoms of BPH by about 50%. It significantly improves urinary symptoms, increasing maximum unitary glow and decreasing residual urine volume, but does not affect prostate size. It has been approved in Germany for oral treatment of BPH. It is also good for cancer and is good for the immune system. It inhibits prostaglandin synthesis in the prostate and has other anti-inflammatory activity. It is safe in studies lasting up to 18 months. Rarely, patients can experience nausea and other GI symptoms. Typical dose is 60-130 mg daily in total initially to control symptoms, then less to maintain (10-65 mg daily.
  • Soy foods such as tofu and soy protein powders are associated with a decrease in the risk of getting prostate cancer. Much of this protection is due to genestein – a phyto-estrogen found in soy. It blocks the body’s stronger estrogens and also inhibits 5-alpha reducase, thus reducing the stronger form of testosterone
  • Pesticides and other contaminants can have powerful hormonal effects. They certainly have been shown to increase the activity of 5-alpha reducase. Eating organic fruits, vegetables, butter, eggs and meats is a good way to reduce your pesticide load.