information on nutrients, diet, lifestyle & research on treatment
Enlarged prostate (non-malignant) is a problem for one half of all 50-year-old men. This is the condition known as benign prostatic hyperplasia (BPH).
Men who are physically active experience fewer symptoms associated with BPH. Research has substantiated that physical activity is linked to fewer occurrences of BPH, less surgery for BPH, and fewer symptoms: men who walked for several hours a week had 1/4 the risk of benign prostatic hyperplasia compared with those men who did not walk for exercise.
The prostate gland rings around the neck of mens' urethra and bladder. Its primary function is to contribute to seminal fluid. If the prostate becomes enlarged, it can cause a number of symptoms. Enlargement is thought to be connected to changing testosterone levels as men age.
Research shows that nutrients, diet and lifestyle considerations can help reduce the symptoms associated with an enlarged prostrate.
The most common symptom of BPH is that men have to urinate more frequently (night-time especially) and they find they have less caliber and force while doing so, often only dribbling. With too much enlargement, not only does urination become impossible or difficult, but the risk of kidney disease and urinary tract infection grows. A medical professional can generally detect an enlarged prostate via a rectal examination.
Drugs are available that can decrease urinary symptoms in about half of people with BPH, although it is not clear whether these drugs slow the progression of the condition. However, one of these drugs (finasteride- Proscar®) causes erectile dysfunction (impotence) in about 5% of men who take it. Medical professionals often suggest surgery if there are severe symptoms or if complete urinary blockage is a high risk. Although prostate surgery has a good rate of success, it also has a higher complications rate than drug therapy.
Self Help for Enlarged Prostate
Nutritional Supplement Treatment Options
Beta-sitosterol is a natural fatty compound found edible plants such as avocado, nuts, fava beans, favabeans, wheat germ and soybeans. In one double-blind study 200 patients with BPH were given 20 mg of beta-sitosterol 3 times daily or a placebo for 6 months. Those patients given the beta-sitosterol experienced a marked improvement in their urinary symptoms, but the patients given the placebo reported no change. Similar results were reported form another double-blind study with 130mg/daily beta-sitosterol.
Rye Pollen Extract
In both preliminary trials and double-blind studies it has been found that rye pollen extract helps BPH symptoms. Rye pollen extract has been demonstrated to have a similar effect to an amino acid mixture (see below) recommended for BPH. Similarly, rye pollen extract has been found to be even more effective than pygeum with marked improvement reported subjectively in 78% of patients receiving the pollen extract. (55% subjective improvement reported with pygeum.)
In one study patients experiencing BPH were given a combination of glycine, alanine, and glutamic acid, about 760mg 3 times daily for 2 weeks, then 380mg 3 times daily for an additional 2 1/2 months. After the three month period, about 1/2 of the patients subjectively reported reduced need to urinate, less frequency, and/or less delay in starting their urine flow, compared not more than 15% of the placebo patients. Yet another study of these 3 amino acids also reported good results. It is noted that this therapy relieves swelling and edema in not only the prostate but in neighboring tissues. Edema is an important indicator for protein deficiency so these amino acids may facilitate the digestion of protein.
Essential Fatty Acid
In an older study 19 men received an essential fatty acid (EFA) supplement. The amount of urine held in the bladder was lowered for all of the patients, dribbling stopped for almost all the patients, and difficulties in night-time urination ceased in 69% of the patients. The patients reported a reduction in the prostate size and improved libido. There was no control and the amount of fatty acid provided was small, so a placebo effect is possible.
More research needs to be done on EFA treatment. It appears to be quite effective for BPH. The usual recommendation is a tablespoon flaxseed oil daily, and after several months, then only 1-2 teaspoons daily. Note: Taking EFAs increases vitamin E requirements, so most medical professionals recommend vitamin E supplement in addition.
Prostate gland secretions contain concentrated zinc which suggests that zinc has a part of normal prostatic functioning. In one trial (but no control group), 19 men were given 150mg/daily zinc for 2 months, and then 50-100mg/daily. The prostate shrank in 74% of the patients. When given by injection locally, zinc also reduced prostate size in animal testing. The research for use of zinc is not strong or substantiated, but many medical professionals do recommend it but if you do supplement with zinc you need to add 2-3mg daily copper because zinc in large doses can lead to copper deficiency.
Botanical Treatment Options
Herbal supplements are considered standard medical treatment in Europ for BPH and they are available without prescription, but men taking them should check with their physician.
Saw Palmetto Berry
Saw Palmentto extract should contain 80-95% fatty acid, discussed above. The oily plant sterol (liposterolic) extract of saw palmetto berry is one of the primary natural treatments. It has been demonstrated that it helps reduce BPH symptoms. Testosterone is converted to dihydrotestosterone (DHT) by the enzyme 5-alpha-reductase and saw palmetto inhibits 5-alpha-reductase. Saw palmetto therefore limits DHT in the prostate gland. Medical professionals generally recommend 320mg/daily.
It was found that 160mg of saw palmetto extract twice a day lowered night-time urination for 73% of the men in a 3-year German study. Additionally, they noted better urine flow rate. Another double-blind European study found that 160mg of twice a day treated BPH as efficiently as the drug finasteride without any side effects. And another study designed to compare dosages, found that 320mg/once daily was as effective as half as much twice a day.
Pygeum is an African cherry tree bark extract that is approved in Germany, France, and Italy as a BPH remedy. A number of published studies ever since the 70s have demonstrated that it is effective and safe for patients mild or moderate BPH. These studies have tested 50-100mg pygeum extract (13% total sterols, standardized) twice a day. Pygeum comprises three natural plant compounds seem to assist the prostate: phytosterols (reduce inflammation), pentacyclic triterpenoids (diuretic effect), and ferulic esters (remove cholesterol deposits from prostate).
The extract from the ever-useful nettle plant roots appear to increase both the volume and flow rate during urination for patients with mild BPH. Nettle has been used along with pygeum and saw palmetto in double-blind trials. Doctors generally recommend 120mg/twice daily for capsules or tabs, and 2-4ml of nettle tincture 3 times a day.
Pumpkin Seed Oil or Extract
Pumpkin seed oil has also been combined with saw palmetto in studies with good results. But regarding pumpkin seed alone, for many years only large preliminary trials in the 60s were accomplished and they did report good results. Other European studies in 1990, 1998 and 2000 substantiated these early trials. Two controlled German studies involving either 500 or 1000 patients found that symptoms improved in 65% of the men, although 54% of the patients also reported results. Researchers believe that fatty acids, zinc and/or plant sterols in pumpkin seeds may bring the benefit. Studies of animals find that 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 extracts may assist the functioning of the uretha and bladder. The recommended dosage (as employed in the research) is 160mg three times daily with meals.
See Studies on EPH.