Saw palmetto

Saw palmetto extract has been shown to interfere with DHT activity in the prostate, inhibit the alpha-adrenergic receptor inhibitor (to support normal urinary flow) and help control inflammatory actions in the prostate gland.

Saw palmetto extracts potently and noncompetitively inhibit human alpha1-adrenoceptors in vitro.

Goepel M; Hecker U; Krege S; Rubben H; Michel MC. Prostate 1999 Feb 15;38(3):208-15.

BACKGROUND: We wanted to test whether phytotherapeutic agents used in the treatment of lower urinary tract symptoms have alpha1-adrenoceptor antagonistic properties in vitro. METHODS: Preparations of beta- sitosterol and extracts of stinging nettle, medicinal pumpkin, and saw palmetto were obtained from several pharmaceutical companies. They were tested for their ability to inhibit [3H]tamsulosin binding to human prostatic alpha1-adrenoceptors and [3H]prazosin binding to cloned human alpha1A- and alpha1B-adrenoceptors. Inhibition of phenylephrine- stimulated [3H]inositol phosphate formation by cloned receptors was also investigated.RESULTS: Up to the highest concentration which could be tested, preparations of beta-sitosterol, stinging nettle, and medicinal pumpkin were without consistent inhibitory effect in all assays. In contrast, all tested saw palmetto extracts inhibited radioligand binding to human alpha1-adrenoceptors and agonist-induced [3H]inositol phosphate formation. Saturation binding experiments in the presence of a single saw palmetto extract concentration indicated a noncompetitive antagonism. The relationship between active concentrations in vitro and recommended therapeutic doses for the saw palmetto extracts was slightly lower than that for several chemically defined alpha1-adrenoceptor antagonists.CONCLUSIONS: Saw palmetto extracts have alpha1-adrenoceptor-inhibitory properties. If bioavailability and other pharmacokinetic properties of these ingredients are similar to those of the chemically defined alpha1- adrenoceptor antagonists, alpha1-adrenoceptor antagonism might be involved in the therapeutic effects of these extracts in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction.

Boswellia extract 5-Loxin

Boswellia extract. Published studies show that normal aging and poor diet cause levels of a dangerous enzyme (5-lipoxygenase) to increase, which can affect prostate cells. A patented extract from the boswellia plant, has been shown to suppress 5-lipoxygenase (5-LOX) and other proinflammatory factors.

Urtica / Qian Ma

Nettle root extract (Urtica dioica) to help protect prostate cells against the excess estrogen levels so frequently seen in aging men.

Urtica dioica for treatment of benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled, crossover study.

Safarinejad MR.J Herb Pharmacother. 2005;5(4):1-11.

PURPOSE: To determine the effects of therapy with Urtica dioica for symptomatic relief of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). MATERIAL AND METHODS: A 6-month, double-blind, placebo-controlled, randomized, partial crossover, comparative trial of Urtica dioica with placebo in 620 patients was conducted. Patients were evaluated using the International Prostate Symptom Score (IPSS), the maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), Serum Prostatic- Specific Antigen (PSA), testosterone levels, and prostate size. At the end of 6-month trial, unblinding revealed that patients who initially received the placebo were switched to Urtica dioica. Both groups continued the medication up to 18 months. RESULTS: 558 patients (90%) completed the study (287/305, 91% in the Urtica dioica group, and 271/315, 86% in the placebo group). By intention- to-treat analysis, at the end of 6-month trial, 232 (81%) of 287 patients in the Urtica dioica group reported improved LUTS compared with 43 (16%) of 271 patients in the placebo group (P < 0.001). Both IPSS and Qmax showed greater improvement with drug than with placebo. The IPSS went from 19.8 down to 11.8 with Urtica dioica and from 19.2 to 17.7 with placebo (P = 0.002). Peak flow rates improved by 3.4 mL/s for placebo recipients and by 8.2 mL/s for treated patients (P < 0.05). In Urtica dioica group, PVR decreased from an initial value of 73 to 36 mL (P < 0.05). No appreciable change was seen in the placebo group. Serum PSA and testosterone levels were unchanged in both groups. A modest decrease in prostate size as measured by transrectal ultrasonography (TRUS) was seen in Urtica dioica group (from 40.1 cc initially to 36.3 cc; P < 0.001). There was no change in the prostate volume at the end of study with placebo. At 18-month follow-up, only patients who continued therapy, had a favorable treatment variables value. No side effects were identified in either group. CONCLUSION: In the present study, Urtica dioica had beneficial effects in the treatment of symptomatic BPH. Further clinical trials should be conducted to confirm these results before concluding that Urtica dioica is effective.

The inhibiting effects of Urtica dioica root extracts on experimentally induced prostatic hyperplasia in the mouse.

Lichius JJ, Muth C. Planta Med. 1997 Aug;63(4):307-10.

Extracts of stinging nettle roots (Urtica dioica L. Urticaceae) are used in the treatment of benign prostatic hyperplasia (BPH). We established a BPH-model by directly implanting an urogenital sinus (UGS) into the ventral prostate gland of an adult mouse. Five differently prepared stinging nettle root extracts were tested in this model. The 20% methanolic extract was the most effective with a 51.4% inhibition of induced growth.

Dioscoreae hypoglaucae / bi xie

Bi Xie is a Chinese herb frequently indicated in the treatment of acute urinary system infection, hyperlipemia and bronchitis, etc.

Acute urinary system infections

Bi Xie Sheng Shi Tang was used to treat 26 cases of acute urinary system infections. Formula: bi xie, yi yi ren, huang bo, 12g; dan pi, chi ling, ze xie, 10g each; hua shi 30g; tong cao 5g. Water decoction, 1 dose every day. 20 cases were cured, and the curative rate was 77%.

Alpiniae / yi zhi ren

Yi Zhi Ren is a Chinese herb often used to treat gastritis, peptic ulcer, chylous urine, seminal emission, and prostatic hyperplasia, etc..

Seminal emission, premature ejaculation, frequent urination

yi zhi ren, tu si zi, shan yao, 12g each; wu yao 10g; bi xie 15g; qian shi 12g; jin ying zi 12g; dang gui, bai shao, zhi gan cao 10g each. 1 dose every day, water decoction. The method could be used in patients with seminal emission, premature ejaculation, frequent urination, impotence and prostatic hyperplasia due to Kidney deficiency.

Linderae / wu yao

Wu Yao is a Chinese herb used to treat adhesive ileus, hyperplasia of prostate, dysmenorrhea and bile reflux gastritis, etc..

Hyperplasia of prostate

wu yao, dang shen, shan yao, che qian zi, 15g each; huang qi 20g; jie geng 5g; fu ling, ze xie, dan pi, 10g each. 63 cases were treated, 28 markedly effective, 21 effective and 14 ineffective.

Acori / shi chang pu

Shi Chang Pu is a Chinese herb usually indicated in the treatment of epilepsy, pulmonary encephalopathy, coronary heart disease and atrophic gastritis.

Ligustri / nu zhen zi

Nu Zhen Zi is a Chinese herb used to treat chronic nephritis, diabetes, thrombocytopenia, hyperlipemia and acute viral hepatitis.

Chronic nephritis

Shen Yan Yang Yin Ye (containing nu zhenzi, hanliancao, haungjing, sheng di, etc.) and Shen Yan Yi Qi Tang (containing huang qi, sheng shaishen, yin yang huo, etc.) were used to treat 318 cases of chronic nephritis (earlier stage), the total effective rate was 68.87%.

Boron (as boron citrate/ aspartate/glycinate complex)

Boron to slow elevation of PSA and protect against protein-degrading enzymes in the prostate gland.

Evaluation of ecological and in vitro effects of boron on prostate cancer risk (United States).

Barranco WT, Hudak PF, Eckhert CD. Cancer Causes Control. 2007 Feb;18(1):71-7.

OBJECTIVE: To determine: (1) the correlation of prostate cancer incidence and mortality with groundwater boron and selenium concentrations; and (2) the impact of boron on prostate cancer cell proliferation during co-treatment with alternative chemo-preventative agents, along with boron pre-treatment effects on cell sensitivity to ionizing radiation. METHODS: For regression analysis, data on prostate cancer incidence and mortality were obtained from the Texas Cancer Registry, while groundwater boron and selenium concentrations were derived from the Texas Water Development Board. Cultured DU-145 prostate cancer cells were used to assess the impact of boric acid on cell proliferation when applied in combination with selenomethionine and genistein, or preceding radiation exposure. RESULTS: Groundwater boron levels correlated with a decrease in prostate cancer incidence (R = 0.6) and mortality (R = 0.6) in state planning regions, whereas selenium did not (R = 0.1; R = 0.2). Growth inhibition was greater during combined treatments of boric acid and selenomethionine, or boric acid and genistein, versus singular treatments. 8-day boric acid pre-exposure enhanced the toxicity of ionizing radiation treatment, while dose-dependently decreasing the expression of anti-apoptotic protein Bcl-2. CONCLUSIONS: Increased groundwater boron concentrations, across the state of Texas, correlate with reduced risk of prostate cancer incidence and mortality. Also, boric acid improves the anti-proliferative effectiveness of chemo-preventative agents, selenomethionine and genistein, while enhancing ionizing radiation cell kill.

Beta-sitosterol

Beta-sitosterol is the most active constituent in pygeum to relax smooth muscle tone of the urethra, counteract DHT, and help regulate inflammatory reactions.

Beta-sitosterol for the treatment of benign prostatic hyperplasia

Wilt TJ; MacDonald R; Ishani A. BJU Int 1999 Jun;83(9):976-83

OBJECTIVES: To conduct a systematic review of the evidence for the efficacy of beta-sitosterol in men with symptomatic benign prostatic hyperplasia (BPH).METHODS : Studies were identified through Medlinetrade mark (1966-98), EMBASEtrade mark, Phytodok, the Cochrane Library, bibliographies of identified trials and review articles, and contact with study authors and pharmaceutical companies. Randomized trials were included if: men had symptomatic BPH; plant extract preparations contained beta-sitosterols; a control group received placebo or a pharmacological therapy; and treatment duration was >/=30 days. Study characteristics, demographic information, enrolment criteria and outcomes were extracted.RESULTS: Four trials comprising a total of 519 men met the inclusion criteria. All were double-blind and lasted 4-26 weeks. Three studies used nonglucosidic beta-sitosterols and one used a preparation that contained only beta-sitosterol-beta-d- glucoside. Compared with placebo, beta-sitosterol improved urinary symptom scores and flow measures. For the two studies reporting the International Prostate Symptom Score (IPSS), the weighted mean difference (WMD) against placebo was -4.9 IPSS points (95% confidence interval, CI,-6.3 to-3.5). The WMD for peak urinary flow rate was 3.91 mL/s (95% CI 0.91 to 6.90, four studies) and for residual volume the WMD was -28.62 mL (95% CI-41.42 to-15.83, four studies). beta- sitosterol did not reduce prostate size. The trial using pure beta- sitosterol-beta-d-glucoside (WA184) showed no improvement in urinary flow measures. Withdrawal rates for men assigned to beta-sitosterol and placebo were 7.8% and 8.0% (not significant), respectively.CONCLUSION: beta-sitosterol improves urological symptoms and flow measures. However, the existing studies are limited by short treatment duration and lack of standardized beta-sitosterol preparations. Their long-term effectiveness, safety and ability to prevent the complications of BPH are unknown.

Clinical effects of beta-sitosterol (phytosterol) on benign prostatic hyperplasia: preliminary study

Kobayashi Y; Sugaya Y; Tokue A. Hinyokika Kiyo 1998 Dec;44(12):865-8.

Phytosterol derived from plants has long been used for the medical treatment of benign prostatic hyperplasia (BPH) in Europe but not in Japan. The efficacy of phytosterol was evaluated in patients with manifestations of urinary outlet obstruction caused by BPH. Phytosterol containing 180 mg of sitosterol per day was given to 12 patients with BPH in two or three divided doses for three months. The symptoms were assessed monthly using the International Prostate Symptom Score (IPSS) and quality-of-life (QOL) score while the objective findings including the urinary flow, prostatic volume, and residual urine volume were assessed after three months of treatment of BPH. The IPSS and QOL scores showed significant improvement (p < 0.05), and the peak flow rate and residual urine volume showed slight but not significant improvement.