Benign Prostatic Hyperplaisa (BPH ) 
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Alternative TreatmentsThe goal of benign prostatic hyperplasia (BPH) treatment is to reduce excessive cell growth by inhibiting the conversion of testosterone into the more potent hormone dihydrotestosterone (DHT) and by preventing estrogen from attaching to receptors in prostate tissue.
From a naturopathic viewpoint, this is accomplished through nutrition and the use of supplements and herbs.
Supplements are intended to provide nutritional support. Because a supplement or a recommended dose may not be appropriate for all persons, a physician should be consulted before using any product. Recommended doses follow:
Beta-sitosterol
Beta-sitosterol, a compound found in many edible plants, has been found to be helpful for men with BPH.
60 – 120 mg daily in 3 divided doses may help reduce symptoms. Beta-sitosterol also lowers cholesterol (a higher dose of 500 mg 3 times daily is required), which is important since high cholesterol levels can cause prostatic hyperplasia.
Clinical Results
In one double-blind trial, 200 men with BPH received 20 mg of beta-sitosterol three times a day 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. 2)
Another double-blind study reported similarly positive results using 130 mg per day of beta-sitosterol.3)
Flower pollen 
Follow product directions. It has been used in Europe for over 25 years to treat BPH. Flower pollen is not the same as bee pollen.
Rye pollen extract has improved the symptoms of BPH in preliminary trials. 4 5 6) Double-blind trials have also reported that rye pollen extract is effective for reducing symptoms of BPH 7 8) This rye pollen extract was shown to be comparable in effect to an amino acid mixture used for BPH in a double-blind study.9) 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.10 )
Amino acids – The combination of glycine, alinine, and glutamic acid (200 mg of each daily) reduces urinary urgency, urinary frequency, and delayed micturition (initiation of flow).
Flaxseed meal – Grind and eat 2-4 tbsp daily. An alternative is to take 1 tbsp of flaxseed oil daily. Flaxseed oil is a good source of the essential fatty acid (EFA) alpha-linolenic acid (an omega-3 fatty acid).
Zinc picolinate – 30–50 mg daily. Zinc competes with copper for absorption; therefore, when supplementing long term with zinc, copper should also be supplemented. There are supplements available that contain both zinc and copper.
Although the therapeutic properties of the American saw palmetto have long been known to offer significant relief for the symptoms of prostate complaints, recent clinical trials have now confirmed the effectiveness of this plant-based natural remedy as a successful treatment for prostate hyperplasis.
The fruit of the saw palmetto relieves symptoms associated with the early stages of prostate hyperplasis and slows down the progress of the condition.
Saw Palmetto Extract has restorative properties that could defer the need for more powerful medication or even surgical intervention altogether.
Today, more and more practitioners of conventional medicine are coming to regard this naturally-acting plant-based remedy as their first choice in the early treatment of BPH.
The recommended dosage is 320 mg of extract daily.
Clinical Results
The fat-soluble 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.16) Saw palmetto appears to inhibit 5-alpha-reductase, the enzyme that converts testosterone to its more active form, dihydrotestosterone (DHT).
A three-year preliminary study in Germany found that 160 mg of saw palmetto extract taken twice daily reduced nighttime urination in 73% of patients and improved urinary flow rates significantly.18)
In a double-blind trial at various sites in Europe, 160 mg of saw palmetto extract taken twice per day treated BPH as effectively as finasteride without side effects, such as loss of libido.19 )
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, the drug finasteride.21)
Stinging nettles (Urtica dioica)
Nettle’s root affects hormones and proteins that carry sex hormones (such as testosterone or estrogen) in the human body. This may explain why it helps benign prostatic hyperplasia (BPH).2)
Although less frequently used alone like saw palmetto or pygeum, some limited clinical trials suggest benefit of nettle root extract for men with milder forms of BPH.3).
Recommended dosage is 120 mg daily.
Herbal medicines usually do not have side effects when used appropriately and at suggested doses. Occasionally, an herb at the prescribed dose causes stomach upset or headache.
Pygeum (Pygeum africanum)
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.23)
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. Recommended dosage is 100-200 mg of extract 2 times daily.
References
1. Platz EA, Kawachi I, Rimm EB, et al. Physical activity and benign prostatic hyperplasia. Arch Intern Med 1998;158:2349–56.
2. Berges RR, Windeler J, Trampisch HJ, et al. Randomized, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Lancet 1995;345:1529–32.
3. Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of ß-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol 1997;80:427–32.
4. Horii A, Iwai S, Maekawa M, Tsujita M. Clinical evaluation of Cernilton in the treatment of the benign prostatic hypertrophy. Hinyokika Kiyo 1985;31:739–45 (in Japanese).
5. Ueda K, Jinno H, Tsujimura S. Clinical evaluation of Cernilton® on benign prostatic hyperplasia. Hinyokika Kiyo 1985;31:187–91 [in Japanese].
6. Hayashi J, Mitsui H, Yamakawa G, et al. Clinical evaluation of Cernilton in benign prostatic hypertrophy. Hinyokika Kiyo 1986;32:135–41 [in Japanese].
7. Buck AC, Cox R, Rees RW, et al. Treatment of outflow tract obstruction due to benign prostatic hyperplasia with the pollen extract, cernilton. A double-blind, placebo-controlled study. Br J Urol 1990;66:398–404.
8. Becker H, Ebeling L. Conservative therapy of benign prostatic hyperplasia (BPH) with Cernilton. Urologe (B) 1988;28:301–6 [in German].
9. Maekawa M, Kishimoto T, Yasumoto R, et al. Clinical evaluation of Cernilton on benign prostatic hypertrophy—a multiple center double-blind study with Paraprost. Hinyokika Kiyo 1990;36:495–516 [in Japanese].
10. Dutkiewicz S. Usefulness of Cernilton® in the treatment of benign prostatic hyperplasia. Int Urol Nephrol 1996;28:49–53.
11. Damrau F. Benign prostatic hypertrophy: amino acid therapy for symptomatic relief. J Am Geriatr Soc 1962;10:426–30.
12. Feinblatt HM, Gant JC. Palliative treatment of benign prostatic hypertrophy: value of glycine, alanine, glutamic acid combination. J Maine Med Assoc 1958;46:99–102.
13. Hart JP, Cooper WL. Vitamin F in the treatment of prostatic hypertrophy. Report Number 1, Lee Foundation for Nutritional Research, Milwaukee, Wisconsin, 1941.
14. Bush IM, Berman E, Nourkayhan S, et al. Zinc and the prostate. Presented at the annual meeting of the American Medical Association Chicago, 1974.
15. Fahim MS, Fahim Z, Der R, Harman J. Zinc treatment for reduction of hyperplasia of prostate. Fed Proc 1976;35(3):361.
16. Schneider HJ, Honold E, Mashur T. Treatment of benign prostatic hyperplasia. Results of a surveillance study in the practices of urological specialists using a combined plant-base preparation. Fortschr Med 1995;113:37–40.
17. Koch E, Biber A. Pharmacological effects of sabal and urtica extracts as a basis for a rational medication of benign prostatic hyperplasia. Urologe 1994;334:90–5.
18. Bach D, Ebeling L. Long-term drug treatment of benign prostatic hyperplasia—results of a prospective 3-year multicenter study using Sabal extract IDS 89. Phytomedicine 1996;3:105–11.
19. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231–40.
20. Braeckman J, Bruhwyler J, Vandekerckhove K, Géczy J. Efficacy and safety of the extract of Serenoa repens in the treatment of benign prostatic hyperplasia: therapeutic equivalence between twice and once daily dosage forms. Phytotherapy Res 1997;11:558–63.
21. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia. A systematic review. JAMA 1998;280:1604–9.
22. Durak I, Yilmaz E, Devrim E, et al. Consumption of aqueous garlic extract leads to significant improvement in patients with benign prostatic hyperplasia and prostate cancer. Nutr Res 2003;23:199–204.
23. Andro MC, Riffaud JP. Pygeum africanum extract for the treatment of patients with benign prostatic hyperplasia: a review of 25 years of published experience. Curr Ther Res 1995;56:796–817.
24. Koch E, Biber A. Pharmacological effects of sabal and urtica extracts as a basis for a rational medication of benign prostatic hyperplasia. Urologe 1994;334:90–5.
25. Metzker H, Kieser M, Hölscher U. Efficacy of a combined Sabal-Urtica preparation in the treatment of benign prostatic hyperplasia (BPH). Urologe [B] 1996;36:292–300.
26. Carbin BE, Eliasson R. Treatment by Curbicin in benign prostatic hyperplasia (BPH). Swed J Biol Med 1989;2:7–9 [in Swedish].
27. Carbin BE, Larsson B, Lindahl O. Treatment of benign prostatic hyperplasia with phytosterols. Br J Urol 1990;66:639–41 [in Swedish].
28. Schiebel-Schlosser G, Friederich M. Phytotherapy pf BPH with pumpkin seeds—a multicenter clinical trial. Zeits Phytother 1998;19:71–6.
29. Friederich M, Theurer C, Schiebel-Schlosser G. Prosta Fink Forte capsules in the treatment of benign prostatic hyperplasia. Multicentric surveillance study in 2245 patients. Forsch Komplementarmed Klass Naturheilkd 2000;7:200–4 [in German].
30. Zhang X, Ouyang JZ, Zhang YS, et al. Effect of the extracts of pumpkin seeds on the urodynamics of rabbits: an experimental study. J Tongji Med Univ 1994;14:235–8.
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