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Treatment

Home BPH Herbal Treatment

Compare with other Natural Therapies

Herbal Treatment of BPH
At our clinic we have seen many patients relieved of BPH symptoms using herbal strategies from TCM system.  We usually start with TCM herbs, due to ease of procurement, and utilize more complex formulations from the other TCM system if these are not sufficiently successful. In more advanced cases combining herbal treatments with western medications can create stronger results.

Some Popular Herbs Used

Saw Palmetto
Saw palmetto berry (Serenoa repens) is the most well known herb for BPH.  Herbalist reviews in great detail the scientific and traditional literature supporting its use for BPH, and explains how combining it with other herbs into an integrated formula based upon signs and symptoms yields superior clinical results.  (A Cochrane review of Saw Palmetto evidence showed mild to moderate benefits, but by itself it does not show results in advanced cases.) David also argues against the pigeonholing of this herb as useful only for BPH, mentioning benefits for cystic acne, stimulation of sexual maturation in delayed puberty and male infertility. Saw Palmetto can also be used for prostatitis.

An important saw palmetto mechanism of action is inhibition of the inflammation-promoting enzyme 5-alpha reductase, an action which it shares with stinging nettle root (Urtica dioica), another herb useful for BPH.

However, these actions are not strong enough to account for the reported results.  A closer look at the research shows that the positive actions are due to a number of related mechanisms, such as inhibition of inflammatory arachadonic acid metabolites and inhibition of epithelial growth factors.

Saw palmetto basically acts as a nutritive tonic, strengthener and normalizer (amphoteric) of the male reproductive system.  It is of course specifically helpful in improving the symptoms associated with an enlarged prostate gland.  It is also useful for genitourinary tract infections.  Numerous open and placebo-controlled studies in large populations have also demonstrated the efficacy of African pygeum bark (Pygeum africanum) in the treatment of BPH and prostate inflammation.  However, the effectiveness is less than saw palmetto, and there are some minor side effects. 

To remove venous congestion in the prostate area, I recommend a tincture of saw palmetto, stinging nettle, stoneroot, gotu kola, white sage (Salvia apiana) and horse chestnut, about 45-60 drops three to four times per day.  A commercial formulation containing a similar constellation of herbs is available from us.

Cernilton or Flower Pollen
Europeans have used a particular form of flower pollen to treat prostatitis and BPH for more than 25 years.  Produced by A.  B.  Cerncile of Sweden, the product is marketed under the name Cernilton.  Although its mechanism of action is not yet completely understood, it has been shown quite effective in several double-blind studies without any reported side effects.  It seems to be effective in both BPH and chronic prostatitis.

Chemistry Medicine for BPH

Proscar (Finasteride)
As soon as the apparent cause of BPH had been identified, the drug companies wasted little time in coming up with a chemical which could be sold to the many millions of men suffering with this problem. It seemed simple, just find a drug that inhibits the formation of 5-alpha-reductase, and everybody will be happy - and rich!

in 1992 Mercy & Company released a chemical drug called finasteride. It is sold to you as Proscar®. Early clinical trials with the drug seemed to be promising. Proscar® caused considerable decreases in BPH symptoms. What was not celebrated or even talked about in the interviews and press releases were the terrible side effects of Proscar®. Merck never mentioned the tremendously high incidence of impotence and decreased libido as well as numerous ejaculatory disorders in men taking the drug.

To further the sales of their new 'wonder' drug, Merck issued statements to the effect that their new 'pill' could reverse male pattern baldness. Now at last vanity had entered the picture and every guy from age 35 forward was willing to stand in line for the stuff.

Today Proscar® is being taken by over 650,000 men in 25 countries at a cost of $80.00 per month. This means that these desperate men are increasing the revenues of Merck's bank accounts by more than a half billion dollars every year.

Taking a closer look at the side effects and warnings for Proscar® is discomforting at best. It warns that women who are pregnant with a male child could seriously risk the child's health by even touching tablets of Proscar®. These women are also advised, for the same reason, against having intercourse without a condom if the man is taking Proscar®.

Hytrin (Terzosin Hydrochloride)
The other commonly used drug used for BPH is called terzosin hydrochloride and is made and sold by Abbott Labs under the trade name Hytrin®. This medication was originally used for hypertension. Side effects for this drug are also very annoying. They include erectile dysfunction, fatigue, dizziness, heart palpitations, sinus congestion, and in some cases, severe low blood pressure.

To make matters worse, neither of these drugs do one single thing to help your body reverse BPH. They may help alleviate some of the annoying symptoms, but the cause of the disease remains and the progression continues unabated.

What About BPH Surgery

BPH Surgery (TURP)
When drugs fail to curtail either the symptoms or progression of BPH, the physician turns to his or her next line of defense, which is surgery.

Between 1984 and 1990 prostate surgery boomed. Today, urologists generate over $5 billion dollars annually by performing over 400,000 prostate operations (such as TURP). It is estimated that there are over 130,000 urologist in the United States that derive 50 percent of their business from the prostate operation alone!

Fortunately there are a number of safe and highly effective supplement available, which in clinical studies and practical applications, have been proven to be far more effective than drug therapy and far safer than surgical intervention.

The Natural Way to Prevent & Reverse BPH
The toughest part of this whole concept for me to understand is the waste of money, time and compromised health for tens of thousands of men when a safe, natural method of prostate management exists. This program has been clinically and empirically tested over and over again. The results continually show that not only is the natural program safer, but it is at least 50 percent more effective than drug therapy.

You can probably see by now why the big drug companies don't want you to have this information. Yet choice is of utmost importance, especially when you are making choices about your health. These choices, right or wrong, can affect the quality and even the quantity of your life ahead. You have the right to be informed.

In the protocol for BPH, we find benefit from vitamins, minerals, and especially selected herbs. Let's talk about some of the major players in the natural fight against BPH. Then we'll give you the complete protocol.

Herbs Treatments
Herbology is mankind's oldest form of medicine. In our desperate search for answers to many devastating diseases, we are once again returning to nature, seeking plant derived chemicals for the management of sickness. I often wonder what the state of human health might be today is we had not strayed so far away from nature and a natural way of life. The Chinese has been the pioneer in using herbs to treat various chronic diseases.

Herbal Treatment, Saw Palmetto (Serenoa Repens)
The first herb that are widely used in any prostate program is known as Serenoa repens. You may be familiar with it as saw palmetto.

Saw Palmetto Side Effects
Nausea, dizziness, decreased sex drive, and loss of appetite are some of the more bothersome side effects of saw palmetto. However, saw palmetto side effects that are potentially serious and require medical attention include unusual or unexplained bruising or bleeding, an unexplained rash, and wheezing or difficulty breathing.

Does Saw Palmetto Cause Side Effects?

People often assume that natural products are automatically free of side effects, especially dangerous side effects. However, this is simply not the case. As with any medication or supplement, problems are possible with saw palmetto (Serenoa repens).
 
(This article covers many, but not all, of the possible side effects with saw palmetto. Your healthcare provider can discuss a more complete list of saw palmetto side effects with you.)
 

Possible Saw Palmetto Side Effects

Potentially bothersome (although not usually serious) side effects of saw palmetto may include:
 

Saw Palmetto Side Effects to Report

Some side effects with saw palmetto, while occurring infrequently, are potentially serious and should be reported to your healthcare provider right away. These include but are not limited to:
 
 
 
Unpredictable side effects are also possible due to contaminants in saw palmetto products. Because herbs and supplements are not as tightly regulated as prescription or non-prescription drugs, they are sometimes contaminated with other herbs, medications, or even heavy metals. In order to avoid such problems, it is important to choose saw palmetto products that are made by trustworthy manufacturers. Your pharmacist can help you choose a good saw palmetto product.

Herbal Treatments, Pygeum Africanum
Another plant called Pygeum africanum, a native of Africa, has been used for decades in many places around the world to treat and reverse BPH.

Side effects of pygeum use may include stomach discomfort, diarrhea, constipation, nausea, dizziness, or visual disturbances. Pregnant women should not take pygeum due to the lack of scientific evidence about its safety for developing fetuses. Pygeum has not been proven safe for use by children. Care should be taken when adding pygeum to any regimen for BPH or other prostate condition.

Amino Acids, Glycine, Leanne, and Glutamic acid
The amino acids Glycine, Leanne, and Glutamic acid have shown to help relieve prostate symptoms such as getting up at night, frequency and urgency of urination, and impaired urine flow. In one clinical study, men using these three amino acids alone, with no other treatment, observed that they had an 80 percent reduction in night time awakenings and over 70 percent of them reported a reduction in the urgency to urinate.

These amino acids have never been shown to help reverse or cure BPH. That's why you need to take them with the herbs we have already discussed. Their importance and contribution, however, lies in the rapid alleviation of annoying symptoms which is why we recommend them.

Vitamins B-6, C, and E
Although we earlier introduced you to several specific nutrients paramount to the treatment of BPH, they are worth reviewing. The vitamins B-6, C, and E are crucial for several reasons. Vitamins C and E are powerful antioxidants, important in the prevention and mitigation of most chronic disease conditions. Vitamin B-6, the universal catalyst or carrier, helps all other nutrients to work better. Additionally, Vitamin B-6 has a direct effect upon prolactin levels, reducing them safely and naturally. A reduction of prolactin prevents the conversion of testosterone to dihydrotestosterone.

Zinc
Lastly, we have a single mineral, but a very important mineral. Zinc has long been associated with male sexual health. This is because zinc is an integral part of hormone structures and a major constituent of seminal fluid and is involved in the production of sperm. When boys hit puberty, their hormone levels rise, oftentimes rapidly. This causes a depletion of zinc in the body, which can lead to a depressed immune system and such annoying side effects as acne.

As we age, a zinc deficiency can lead to impotence and prostate enlargement because the prostate tissue requires zinc to maintain its health and integrity. Further, adequate zinc also prevents the formation of dihyrotestosterone, making it a multi-purpose mineral for total prostate health.

If you have begun to notice some of the symptoms of BPH, you should being the following protocol at once. If you currently have BPH, you may use the same protocol but in higher potencies, at least for the first few months.

Protocol for the Prevention, Management, and Reversal of Benign Prostate Hyperplasia

Following are our recommendations for the management of BPH in conjunction with our Herbal Treatment.

Note: This BPH program has been clinically tested at the clinic and has been used with great success for many years.

Prostatitis and PSA  Prostatitis is the most common cause of a falsely elevated PSA, and treatment will frequently cause the PSA to return to normal.

PROSTATE SPECIFIC ANTIGEN (PSA)

The prostate produces PSA for several beneficial purposes, not simply as a response to cancer. This is why your doctor might not consider a PSA of 4 ng/ml to be particularly serious, depending on your age, race, and other factors. And, according to the NCCN, about 25 percent of men who have prostate cancer have a low PSA.

LEVELS

Numbers and Assays There is no single set of numbers for PSA. Different assays give different numbers and ranges. For example, Hybritech, the most commonly used assay,has a "normal" range of 0 to 4, while the Yang range is 0 to 2.5. Find out what test you are given, and sure to use the same test every time you have your PSA checked. Changing assays makes it difficult to tell if your PSA is stable.

PSA and Age   Because PSA rises with age (and with BPH), a level that would be alarming in a twenty-year-old could be normal for a sixty-year-old.

PSA and Race  PSA ranges differ by race. The normal, or safe, range for European-American men from 50 to 80 is 0 to 3.5 ng/ml. The range for African-American men is 0 to 2.0 ng/ml for men in their 40s, rising to 4.0 when they are in their 50s, 4.5 in their 60s, and 5.5 in their 70s. New England Journal of Medicine,1996; 335:304-310

TESTS

The PSA Test   The PSA blood test only screens for complex-serum PSA. That includes not just the PSA that might be produced in response to a cancer but also that which the prostate naturally produces and any that is the result of BPH. The value of routine PSA testing has been questioned, partly because of the number of false-positive results. However, a community-based survey found PSA levels to be highly accurate in predicting cancers. Journal of Urology, 1995;151:1283-1290 .

The Free-PSA (PSA II) Test   This test was developed to compare the amount of complex PSA with the amount of another form of PSA that is known to be produced by prostate cancers. (That form is called PSA or unbound PSA.) The free-PSA test may be given if a man's PSA level is elevated (that is, between 4 and 10) but his digital rectal exam shows nothing abnormal. A low level of free PSA indicates cancer, and the less free PSA there is in relation to total PSA, the more aggressive the tumor is likely to be. Urology 1997;49:379-384

The principal benefit of the test is that it can eliminate many unnecessary biopsies. The Hybritech Free-PSA test is reported to have detected 95% of prostate cancers. And those that it missed were mostly small and not life-threatening. Journal of the American Medical Association, May 20, 1998

Although it would seem to make sense to use the Free-PSA test instead of the usual one, its results can be misleading. (For example, prostatitis causes a reduction in Free-PSA.) In the end, a steady rise in PSA is still a better indicator of cancer.

  • Hybritech Free-PSA test
  • Free-PSA test, FAQ


THINGS THAT MAY CAUSE YOUR PSA TO RISE

Be sure to review these before you take a PSA test. An elevated reading caused by something other than cancer could cause needless anxiety.

Lab error isn't likely, but it is possible. If you have an unusually big rise in PSA, you should retest.

Infections, including prostatitis. If you have a burning feeling when urinating, and your PSA reading seems abnormally elevated, suggest to your doctor that you take antibiotics for a couple of weeks before re-testing. Be sure to stop long enough before the test to avoid having it be affected by the antibiotics (which would cause your PSA to fall).

  • About prostatitis
Benign Prostatic Hyperplasia (BPH), a noncancerous growth in the prostate that may put pressure on the urethra and lead to more frequent urination.
  • About BPH
Anything that might massage the prostate, such as long bike rides.

Ejaculation within the previous 48 hours. (Studies seem to be evenly split on whether or not this has an effect, so abstinence is the safest course.)

Any procedure that may stimulate the prostate, such as a TURP (transurethral resection of the prostate, a surgical treatment of benign prostatic tumors), a biopsy, a digital-rectal exam, or a cystoscopy (an examination of the urethra, prostate, bladder, and/or kidneys that involves a catheter-like instrument).

  • biopsy    
  • digital rectal exam    
  • cystoscopy    
  • TURP
Brachytherapy Men who have been seeded should not expect to have a stable PSA for the first two years and should be aware of the phenomenon called the "one-year bump." This seems to apply to both Palladium (Pd-103) and Iodine (I-125) seed treatments. This comment by Dr. Dattoli was reported on SeedPods:
PSAs are often noted to unexpectedly rise within 12-24 months and then fall back to nadir levels (typically with the aid of medications used to treat prostatitis, such as antibiotics, Ibuprofen, Hytrin, Cardura, or Flomax. Even though there is no precise explanation, reasons postulated include radiation-related tissue changes. The important thing is that patients be aware of this phenomenon and not panic if it occurs.

THINGS THAT MAY CAUSE YOUR PSA TO FALL

More things to remember when you have your PSA tested. A misleadingly low reading caused by one of these might lead to a delay in treatment. If you must take one of these medications for an extended period, you should have your PSA tested before you begin and again in six months to get an idea of how much the drug (or rest) has affected it.

Proscar (finasteride), which is used to treat BPH, and Propecia, which is the same drug but marketed for hair restoration.

  • About Proscar
Drugs used for hormone blockade, notably Zoladex (goserlin), Lupron (leuprolide), Eulexin (flutamide), and Casodex (bicalutamide).
  • About hormone blockade
Saw palmetto, an herb sold in drugstores and health-food shops, which some men use in hopes of treating BPH.
  • About saw palmetto and BPH
PC-SPES, a mixture of herbs currently being tested as a possible treatment for prostate cancer.
  • About PC-SPES
Medications used to treat prostatitis, such as antibiotics, Ibuprofen, Hytrin, Cardura, and Flomax (from the one-year bump comment, above)


PSA AFTER TREATMENT

"Safe" levels following treatment vary according to the procedure. If the PSA level rises above a certain number, the cancer is probably active again. However, lower numbers do not necessarily mean freedom from disease.
  • Information about assays
After External-Beam Radiation Therapy 0.2 ng/ml or less is excellent. DeKalb Medical Center suggests that a PSA higher than 0.5 means the cancer will recur. In Prostate & Cancer, Dr. Sheldon Marks says it should be under 1.0.

After External Beam Radiation Therapy plus Brachytherapy According to Critz et al., "the definition of disease freedom for radiotherapy should be men who achieve and maintain a PSA nadir of 0.2 ng/mL or less." New England Journal of Medicine, January 2000 Others place it higher.

After Brachytherapy under 1.0, according to Brachytherapy Made Complicated, the textbook by Drs. Wallner, Blasko, and Dattoli (but see one-year bump)

After a Radical Prostatectomy theoretically 0.0, but 0.1 ng/ml is okay. According to Daniel W. Chan, Director of Clinical Chemistry at Johns Hopkins, 0.2 is the point of biological recurrence. DeKalb puts the crucial point at 0.5.

After Cryotherapy The Crittenton website seems to say that less than 0.5 ng/ml is safe. NEMC.org puts it at no higher than 0.3.

These figures may not be accurate for everyone. For example, one brachytherapist has several patients who have had a steady PSA of 2.0 for many years. Technically, they have suffered biochemical failure, yet they are alive and well more than a decade later.

PSA Velocity

A single elevated reading is not significant, but a steady rise over a series of readings is. The rate of change in PSA level, the velocity, is the key factor. A rise of more than 0.75 ng/ml over one year is cause for concern.

PSA Anxiety

Many men worry excessively about PSA levels following treatment. A slight shift upwards is likely to panic them, and the fear may end up doing more harm than the rise in PSA.

According to Dr. Susan Slovin of Memorial Sloan Kettering Cancer Center, a rising PSA does not always indicate cancer or a recurrence. Moreover, even a steady rise and a very high PSA do not necessarily mean that a man will die of prostate cancer. A recent study suggests that a rising PSA "may indicate that the body is attempting to fight cancer by producing its own antiangiogenic proteins." The authors suggest that it may even be feasible to introduce PSA into the body as part of a treatment for cancer. Journal of the National Cancer Institute 1999;91:1635-1640

One problem, according to pathologist Dr. Chan of Johns Hopkins, is that PSA tests today are ultrasensitive. "From day to day, the results could vary—it could be 0.03, or maybe even 0.05." He, too, emphasizes that biochemical recurrence does not indicate an immediate problem, adding "People need to understand that it might take months or even years before there is any clinical physical evidence." Prostate Cancer Update newsletter, Vol. V, No. 1

Salvage

If a rising PSA suggests a recurrence at some point following treatment, you should discuss possible salvage procedures with your doctors.

 

Prostatitis Treatment Center China