Enlarged Prostate

Essential: Beta-sitosterol 90 vcapsules (BET27) - Beta-sitosterol

Essential: Prostate Support Complex 60 caps (PRO49) - Prostate Support Complex

Beta-sitosterol, a compound found in many edible plants, has also been found to be helpful for men with BPH. In one double-blind trial, 200 men with BPH received 20 mg of beta-sitosterol TID or a placebo for six months. Men receiving beta-sitosterol had a significant improvement in urinary flow and an improvement in symptoms, whereas no change was reported in men receiving the placebo. Another double-blind study reported similarly positive results using 130 mg per day of beta-sitosterol.

Rye pollen extract has improved the symptoms of BPH in preliminary trials. Double-blind trials have also reported that rye pollen extract is effective for reducing symptoms of BPH. This rye pollen extract was shown to be comparable in effect to an amino acid mixture used for BPH in a double-blind study. A double-blind comparison with pygeum resulted in significant subjective improvement in 78% of those given the rye pollen extract compared with 55% using pygeum. Research on this commercial rye pollen extract has used three to six tablets, or four capsules, per day; the effect of other pollens in men with prostate conditions has not yet been studied.

In a controlled trial, men with BPH received a supplement containing three amino acids (glycine, alanine, and glutamic acid) totaling about 760 mg TID for two weeks, then 380 mg TID for a total of three months. After three months, about half of these men reported reduced urgency, frequency, and/or less delay starting urine flow, compared to 15% or less of the men who received a placebo. Another similar controlled trial of this combination also reported positive results. Although it is not known how the amino acid combination works, it is believed to reduce the amount of swelling in prostate tissue.

In a 1941 preliminary report, 19 men with BPH were given an essential fatty acid (EFA) supplement.13 In every case, the amount of retained urine was reduced, and nighttime urination problems stopped in 69% of cases. Dribbling was eliminated in 18 of the 19 men. All men also reported improved libido and a reduction in the size of the enlarged prostate, as determined by physical examination. Because this study did not include a control group and the amount given was surprisingly small, the possibility of a placebo effect cannot be ruled out.

Despite the lack of good published research, many doctors have been impressed with the effectiveness of essential fatty acids (EFAs) in cases of BPH. A typical recommendation is one tablespoon of flaxseed oil per day, perhaps reduced to one or two teaspoons per day after several months. Because taking EFAs increases the requirement for vitamin E, most doctors recommend taking a vitamin E supplement along with EFAs. However, controlled research is needed to establish whether EFAs are helpful for BPH.

Prostatic secretions are known to contain a high concentration of zinc; that observation suggests that zinc plays a role in normal prostate function. In one preliminary study, 19 men with benign prostatic hyperplasia took 150 mg of zinc daily for two months, and then 50 to 100 mg daily. In 74% of the men, the prostate became smaller. Because this study did not include a control group, improvements may have been due to a placebo effect. Zinc also reduced prostatic size in an animal study but only when given by local injection. Although the research supporting the use of zinc is weak, many doctors recommend its use. Because supplementing with large amounts of zinc (such as 30 mg per day or more) may potentially lead to copper deficiency, most doctors recommend taking 2 to 3 mg of copper per day along with zinc.

The liposterolic extract of the saw palmetto berry has become the leading natural treatment for BPH. This extract, when used regularly, has been shown to help keep symptoms in check. Saw palmetto appears to inhibit 5-alpha-reductase, the enzyme that converts testosterone to its more active form, dihydrotestosterone (DHT). Saw palmetto also blocks DHT from binding in the prostate. Studies have used 320 mg per day of saw palmetto extract that is standardized to contain approximately 80 to 95% fatty acids.

A three-year preliminary study in Germany found that 160 mg of saw palmetto extract BID reduced nighttime urination in 73% of patients and improved urinary flow rates significantly. In a double-blind trial at various sites in Europe, 160 mg of saw palmetto extract BID treated BPH as effectively as finasteride without side effects, such as loss of libido. A one-year dose-comparison study found that 320 mg once per day was as effective as 160 mg BID in the treatment of BPH. A review of all available double-blind trials has concluded that saw palmetto is effective for treatment of men with BPH and is just as effective as, with fewer side effects than, finasteride.

Pygeum, an extract from the bark of the African tree, has been approved in Germany, France, and Italy as a remedy for BPH. Controlled studies published over the past 25 years have shown that pygeum is safe and effective for men with BPH of mild or moderate severity. These studies have used 50 to 100 mg of pygeum extract (standardized to contain 13% total sterols) BID. This herb contains three compounds that may help the prostate: pentacyclic triterpenoids, which have a diuretic action; phytosterols, which have anti-inflammatory activity; and ferulic esters, which help rid the prostate of any cholesterol deposits that accompany BPH.

Another herb for BPH is a concentrated extract made from the roots of the nettle plant. This extract may increase urinary volume and the maximum flow rate of urine in men with early-stage BPH. It has been successfully combined with both saw palmetto and pygeum to treat BPH in double-blind trials. An appropriate amount appears to be 120 mg of nettle root extract (in capsules or tablets) BID or 2 to 4 ml of tincture TID.

Pumpkin seed oil has been used in combination with saw palmetto in two double-blind human studies to effectively reduce symptoms of benign prostatic hyperplasia (BPH). Only one group of researchers has evaluated the effectiveness of pumpkin seed oil alone for BPH, but the results of their large preliminary trials have been favorable. Researchers have suggested the zinc, free fatty acid, or plant sterol content of pumpkin seeds may account for their benefit in men with BPH, but this has not been confirmed. Animal studies have shown that pumpkin seed extracts may improve the function of the bladder and urethra; this might partially account for BPH symptom relief. Pumpkin seed oil extracts standardized for fatty acid content have been used in BPH studies in the amount of 160 mg TID with meals.