I’ve had many male patients over age 40 who are not only inconvenienced by an enlarged prostate (usually in the form of a more frequent need to urinate), but who are also concerned that they either have cancer of the prostate or that cancer is right around the corner. I’m happy to report that most of their symptoms turned out to be related to a condition known as benign prostatic hyperplasia, or BPH. And it is indeed benign: “Hyperplasia” simply means an overgrowth of cells.
BPH symptoms, which also include a weak urine stream, dribbling, and awakening at night with an urge to urinate, aren’t usually indicative of anything serious. And they don’t affect sexual function. But they can certainly be unpleasant. Prescription drugs and surgical procedures are available to alleviate your distress, though these treatments aren’t always effective or easy to tolerate.
At WholeHealth Chicago, on the other hand, we consistently see mild to moderate BPH respond very nicely to herbal and nutritional remedies. These can help ease discomfort or even prevent symptoms, and so avoid (or at least delay) the need for the more drastic conventional treatments.
What are Prostate Problems?
The prostate is a walnut-size gland, unique to men, located just beneath the bladder. Its primary role is to help produce the fluid portion of semen, the watery medium that dilutes, nourishes, protects, and transports sperm so that it can fertilize the female egg. As a man ages, his prostate enlarges, and experts estimate that more than half of all men over age 50 have an enlarged gland. This disorder, called benign prostatic hyperplasia (BPH), is by far the most common prostate problem. Because the prostate surrounds the urethra (the tube through which urine empties from the bladder), enlargement of the gland may eventually cause such symptoms as difficult, frequent, sudden, or painful urination.
As its name implies, “benign” prostate enlargement is usually noncancerous, and is not even considered a risk factor for developing cancer. Nevertheless, because the symptoms of an enlarged prostate are similar to those of cancer in the prostate, a doctor should be consulted to carefully check for prostate cancer or the other possible problem, inflammation of the prostate (prostatitis).
- Frequent, urgent need to urinate, especially at night
- Delayed, weak, or interrupted urine stream
- Difficulty urinating and emptying the bladder
- Burning sensation or pain during urination, accompanied by fever, chills, pain behind the scrotum, or painful ejaculation
- Blood in the urine
What Causes Prostate Problems?
Why the prostate normally enlarges with age remains a mystery, but male sex hormones are believed to play a role in benign prostate enlargement. In some cases, usually among younger men, an enlarged gland can be caused by prostatitis, an inflammation that results from a bacterial infection in the urinary tract. Prostatitis is sometimes seen in men who do a lot of sitting and who restrict their fluids, such as long-distance truck drivers. It is also seen in men with prostate symptoms who have had several episodes of sexually transmitted diseases.
Symptoms of prostate enlargement in men over age 55 can also be a warning sign for prostate cancer. Although there is no prevention or cure for benign prostatic hypertrophy (BPH), the condition responds well to treatment.
Treatment and Prevention
To begin, your doctor will consider doing a blood test to measure the levels of an enzyme called PSA (prostate-specific antigen) to help distinguish between a benign condition and a malignant one. A high PSA count may correspond with cancer. But the test is not extremely accurate: Someone with a low PSA may have cancer, while someone with a higher than normal PSA may not. For this reason some insurance companies won’t pay for this as a routine screening test. One recent study by the National Cancer Institute, in fact, seems to indicate that PSA may actually slow the growth of prostate cancer by preventing the formation of new blood vessels. A combination of the blood test, a urine test, an examination of the gland by a finger in the rectum, and for some an X ray of the kidney-bladder urine flow, or an ultrasound imaging of the prostate is chosen to assess the risk of cancer when the prostate is enlarged, symptoms are severe, or the PSA level is elevated.
Conventional treatment includes two classes of drugs. One (finasteride) works to reduce prostate blockage by a hormone-blocking effect. This is similar to the action of the saw palmetto extract. The other common drug (terazosin) relaxes the nerves that surround the urine tube through the prostate. Drug therapy takes several weeks before its full effect is apparent.
In cases where the BPH has continued unchecked and a severe blockage or urinary tract infections have occurred, surgery is recommended. In this procedure, called a transurethral prostatectomy, or TURP, a surgeon removes the part of the prostate which that blocks urine flow.
For mild to moderate BPH, several supplements, including a couple of very effective herbs, can be used to relieve symptoms. It may take a month or more before you notice any improvement. All of the supplements are safe to use long-term and in conjunction with any conventional drugs that your doctor may prescribe to relieve BPH symptoms. To monitor supplement effectiveness, see your doctor every six months.
Because several of the supplements used to relieve symptoms of prostate enlargement are also used for other age-related problems, someone with a family history of BPH would be wise to include these supplements in a preventive nutrition program starting in the midlife years (ages 40 to 50).
Just a reminder: If you have a serious medical condition, it’s always a wise idea to talk with your doctor before beginning a supplement program.
How Supplements Can Help
One of the most important nutrients for men with BPH is zinc, which has been shown not only to relieve symptoms, but also to reduce the size of an enlarged prostate. Because zinc can interfere with the body’s absorption of copper, another essential nutrient, be sure to switch to a multimineral supplement with a balanced amount of zinc and copper after two months of taking a zinc replacement supplement.
As for beneficial herbs, start with saw palmetto, the best researched of all the herbs believed to relieve symptoms of BPH. It may also reduce the swelling and inflammation of prostatitis. If results are not satisfactory with saw palmetto alone, add pygeum africanum, which has anti-inflammatory properties. Either of these herbs can be combined with nettle root, which may enhance their effectiveness.
Flaxseed oil is also recommended. Its essential fatty acids help prevent swelling and inflammation.
Get supplement dosages and tips in our WholeHealth Chicago Supplement Recommendations for Prostate Problems.
Avoid antihistamines and other over-the-counter cold remedies, which can make symptoms worse.
To reduce the need to urinate so frequently, stay away from caffeinated and alcoholic beverages, particularly beer. Before bedtime, consume fewer liquids.
Foods rich in soy, such as tofu, contain substances (isoflavones) that may also protect the prostate and ward off cancer.
If you purchase commercial supplement mixtures geared for prostate health, check labels carefully. Many do not contain enough of the prostate-healthy vitamins and herbs to be effective.
Review your prescription medicines with your doctor. Interference with urine flow is a side effect of many medications.
When to Call a Doctor
- If blood appears in your urine or semen
- If you have any symptoms of an enlarged prostate gland. Although not a medical emergency, try to get an office checkup at your earliest convenience.
- If you are between ages 50 and 75, especially with a history of prostate cancer in your family. Get a regular men’s health checkup at least every two or three years.
- If you have chills, fever, back pain, or inability to pass urine from the bladder with a history of prostate symptoms, seek medical care immediately.
From David Edelberg, M.D. at WholeHealth Chicago: I suggest using most of the supplements on a daily basis, depending on the severity of your BPH symptoms. Speaking as a prostate owner myself, currently symptom-free and hoping to remain that way, I can endorse everything on the list.
How to Take the Supplements
I suggest using most of the supplements on a daily basis, depending on the severity of your BPH symptoms. Conveniently, a number of these substances–including saw palmetto, pygeum africanum, beta-sitosterol, nettle, and zinc/copper–are often combined in various “prostate health” products. Some combination products list numerous ingredients, but the amount of each ingredient may be too small to be of benefit. If you want to use a combination product, you’ll have to do a lot of label reading and make a lot of painstaking comparisons. Ultimately, the combination product you select should contain the therapeutic dose levels we suggest for each individual herb or supplement.
Many of the supplements recommended here have anti-inflammatory properties that can help to reduce swelling. In addition, the herb saw palmetto also appears to alter levels of several hormones that contribute to prostate growth. Flaxseed oil provides an additional source of symptom relief.
Particularly if you already have symptoms of BPH and are taking medications for it, or if surgery has been mentioned as a possible step, try pulling out all the stops: Take the entire program for four months, using carefully selected combination products simply for convenience whenever possible. You needn’t stop your conventional medicines while on this program, but after a few months, you may be able to discontinue your medicines and reduce your supplements considerably.
Once you’ve reached a reasonable level of comfort, you can probably reduce your daily maintenance regimen to one or two combination prostate products (containing saw palmetto and balanced minerals, with or without pygeum), plus the healthy fatty acids in flaxseed oil that should be part of your general anti-aging preventive program.
For special consideration
If prostate cancer runs in your family, try eating more soybean products and tomatoes, both of which have been proven to protect against this disease. If these dietary changes are too difficult, consider adding soy extract (2500 mg capsules, standardized to contain 5% soy isoflavones, each morning) and lycopene (10 mg each morning). Lycopene is a tomato-based antioxidant, an excellent source of prostate cancer protection. Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions. The Healing Path for Prostate Problems provides more extensive therapeutic information about this condition.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.