For Jerry, my 53-year-old patient from Aiea, being diagnosed with benign prostatic hyperplasia – an enlargement of the prostate gland – was actually a catalyst for a new, healthier lifestyle. Jerry came to see me because he was concerned about his recent diagnosis and wanted to find out how he could prevent the problem from getting worse. He was concerned about Proscar, the medication that his urologist had prescribed, because one side effect is impotence. Fortunately, Jerry’s case was only causing mild symptoms, so he was an excellent candidate for herbal and nutritional therapy.
It is believed that enlargement of the prostate gland is due to hormonal changes associated with aging. Also known as BPH, it affects as many as 50 to 60 percent of men over 40 years of age. It is characterized by symptoms such as increased urinary frequency, especially at night; incomplete emptying of the bladder; dribbling of urine after voiding; and change in the force or stream of the urination. The hormone testosterone plays a significant role in the development of BPH. It is thought that testosterone converts into another hormone called DHT (dihydrotestosterone), causing increased cell growth in the prostate. The conversion of testosterone to DHT is dependent on an enzyme called 5-alpha reductase, and many therapies are targeted at inhibiting this enzyme in order to reduce DHT-stimulated growth in the prostate.

I told Jerry that in Germany, 90 percent of all patients who have BPH are treated with plant-based medicines and that 50 percent of German urologists prefer herbal therapy to chemically-derived medications such as Proscar. We discussed the alternative therapies that are used to treat mild BPH.

Numerous studies have shown that an extract of saw palmetto berries can help reduce the symptoms of BPH. Saw palmetto extract can help inhibit the conversion of testosterone to DHT and inhibit the binding of DHT to cell membranes in the prostate. Studies dating back to the early 1980s show consistent positive results using saw palmetto extracts in the treatment of mild to moderate BPH. A study published in 1998 in the journal Urology demonstrated that saw palmetto extract is a well-tolerated agent that significantly improved lower urinary tract symptoms in men with BPH after two months of use. The therapeutic dose is 320 mg daily of saw palmetto’s liposterolic extract. Studies show that saw palmetto is not only effective in the reduction of BPH symptoms, but is also devoid of side effects at this dose. At higher doses men can experience side effects such as mild nausea and intestinal discomfort.

Another herbal medicine, pygeum africanum, has been used in Europe to treat BPH for many years. An international, double-blind controlled trial of pygeum africanum extract in 263 patients with BPH showed improved urinary symptoms in 66 percent of the patients. How this herb helps men with BPH is not fully understood, but the plant is known to contain beta-sitosterol, which has anti-inflammatory effects. Studies cite a daily dose of 25 to 50 mg.

Zinc is an important nutrient for maintaining good prostate health. Some studies have shown that zinc can inhibit the enzyme responsible for the conversion of testosterone to DHT. Daily intake should be 25 to 50 mg. It is important to maintain adequate zinc levels, but overdosing can cause an imbalance in copper levels. Foods high in zinc include turkey, rolled oats, mustard greens, and pumpkin seeds.

Jerry chose to take saw palmetto and pygeum africanum and changed his diet to include foods high in zinc. He also incorporated a variety of vegetables into his diet and started exercising regularly. Jerry is pleased that without having to take Proscar, he has experienced a reduction in symptoms and a dramatic improvement in his overall health.

Article was originally printed in the Honolulu Advertiser, honoluluadvertiser.com.