What's New and What's Best For Prostate Health?

Is your prostate gland too large? How would you know? Well, do you have any of the following symptoms: difficulty initiating urination, decreased caliber of flow, frequent urination, frequent visits to the bathroom at night, dribbling, or a sensation of incomplete emptying of the bladder? If so, your prostate may be in need of a new health program. What can you do, short of having your prostate cut back down to size by the surgeon?

As information about new prostate-enhancing substances appears in the medical literature, we continue to provide you with the information. The latest news is about boron, because of its newly discovered role in reducing the risk for prostate cancer.

Following is a brief review of all the known prostate-enhancing nutrients except for the new one, boron, which is discussed separately in the sidebar.

Saw Palmetto
Saw palmetto, or dwarf palm, is a Caribbean shrub from whose berries an extract is made that has a long history of use in treating prostate problems. It blocks the action of an enzyme, 5-alpha-reductase, that converts testosterone to a more potent form called dihydrotestosterone (DHT) in the liver. DHT is believed to be the principal cause of prostate enlargement, a condition called benign prostatic hyperplasia, or BPH. Saw palmetto alleviates the symptoms of this condition. It usually takes at least six months to reach peak efficacy.

 
 The fabled 20-mule team hauling borax in the desert Southwest.

Scientific studies of the benefits of saw palmetto have been accumulating, leading to a renewed interest in this herbal remedy in the United States. A major study on it was published in 1998 in the Journal of the American Medical Association.1 The authors concluded that saw palmetto improves urinary tract symptoms and urinary flow by anywhere from 24% to 43%. These results are about the same as those obtained with the prostate drug finasteride, but they are accompanied by fewer and milder side effects. In particular, the rate of erectile dysfunction associated with finasteride is 4.9%, whereas with saw palmetto it is only 1.1% (not much higher than the placebo figure of 0.7%).

Zinc
This essential element, which plays a vital role in a wide spectrum of bodily functions, including many aspects of hormone metabolism, was shown as long ago as the 1970s to reduce the size of the prostate gland and to diminish symptoms in most patients.2 It has also been shown to be a 5-alpha-reductase inhibitor, which, as we have seen, is advantageous. For these reasons, and more, adequate zinc intake is considered to be essential for prostate health.

Lycopene
This is the now famous "tomato chemical" that has received so much attention for its anticancer properties, especially against prostate cancer. A chemical cousin of beta-carotene, it is a powerful antioxidant. In a recent study published in Cancer Research, the authors identified lycopene as ". . . the carotenoid with the clearest inverse relation to the development of prostate cancer. . . . These data provide further evidence that increased consumption of tomato products and other lycopene-containing foods might reduce the occurrence or progression of prostate cancer."3

Vitamin D
This "sunlight" vitamin, known primarily for its role in calcium metabolism and the treatment of osteoporosis, is thought by many scientists to be more a hormone than a vitamin. Be that as it may, it turns out that a deficiency of vitamin D is linked to prostate cancer and high levels of PSA, the biomarker for that cancer.4

Vitamin E
Vitamin E is actually a family of compounds called tocopherols, of which alpha-tocopherol is the most common. Collectively, these molecules are powerful antioxidants whose value in that regard is well known. A Finnish study published recently showed a correlation between alpha-tocopherol supplementation and large reductions in the incidence of prostate cancer (32% lower) and in mortality from prostate cancer (41% lower).5

Mixed Tocopherols/Tocotrienols
While vitamin E is one of the most researched substances in medicine, it actually encompasses as many as eight different compounds. One of these, gamma-tocopherol, has recently been found to control the growth of a human prostate cancer cell line in vitro and to be superior to alpha-tocopherol in terms of cell inhibition.6 Mixed tocopherols/tocotrienols contain gamma-tocopherol.

Vitamin B2
A Japanese study about a decade ago revealed that vitamin B2 (riboflavin) is an effective inhibitor of 5-alpha-reductase.7 A one-to-one, age- and race-matched case-control study found that blacks over the age of 50 who had lower levels of prostate cancer had higher levels of riboflavin.8 Every such avenue toward reducing the body's production of DHT is worth pursuing in the interest of prostate health.

Pygeum
It has long been known that a standardized extract of the bark of Pygeum africanum, a large evergreen tree native to southern Africa, is effective in reducing the symptoms and clinical signs of enlarged prostate.9,10 This extract contains a variety of fat-soluble sterols and fatty acids that are believed to reduce prostatic inflammation and draw out deleterious substances that bind to the walls of the prostate. Its modes of action are likely to be partly similar to and partly different from those of saw palmetto, so it is beneficial to combine the two extracts in the same formulation. Pygeum has been in widespread use in Europe for several decades for the treatment of genitourinary disorders.

Stinging Nettle
Stinging nettle, Urtica dioica, is a common, perennial Eurasian herb, not to be confused with the completely different stinging nettle that is native to the southeastern United States. Extracts of U. dioica have long been used in the treatment of urinary tract disorders, as well as gout and rheumatism. This herbal remedy has also been found to be effective against the symptoms of enlarged prostate, especially when used in combination with pygeum extract.8

Both of these extracts are believed to be 5-alpha-reductase inhibitors, and both also apparently inhibit the enzyme aromatase, which converts testosterone into the female sex hormone estradiol. Inhibition of aromatase is beneficial because estradiol, in addition to supplanting testosterone, stimulates the growth of prostate cells - exactly what those with BPH do not want.

Green Tea
Epidemiological studies show that in Asian countries, the incidence of prostate cancer is low compared to the West, and they indicate that green tea is a possible explanation for the difference.11 Indeed, studies on the biological effects of green tea have proved that one of its active ingredients, the polyphenol EGCG, induces cell death in human prostate cancer cells in vitro.12

Resveratrol
If this name sounds familiar, it's probably because you're a wine enthusiast and have read about the benefits to cardiovascular health of resveratrol, a polyphenolic compound found in red wine as well as a variety of other foods. To add to those benefits, resveratrol has also been found to be an effective inhibitor, in laboratory experiments, of the growth of prostate cancer cells.13 Although these results have yet to be confirmed in animal or human studies, it seems reasonable to ingest the safe, natural compound resveratrol as a precaution.

Boron May Help Prevent Prostate Cancer
Boron is a vital trace element in our diet, yet most of us do not get enough of it, according to nutritionists.1 That's bad news, because boron plays an important role in calcium metabolism and is believed to be essential for healthy bones and joints. The good news, however, is not just that it's easy to supplement with boron, but also that doing so may provide a hitherto unexpected health benefit for men. A new study has revealed an inverse correlation between boron consumption and prostate cancer.2

Using a database of 7651 healthy older men and 76 men with prostate cancer who participated in the National Health and Nutrition Examination Study, the researchers ranked the men according to their rates of boron consumption. These rates were calculated from detailed dietary information provided by the men, using the known boron composition of 1944 different foods.3

What emerged from this analysis was a striking dose-response effect of boron consumption: the higher the boron intake, the lower the risk for prostate cancer. Men who consumed at least 1.8 mg/day had less than one-third the risk of men who consumed less than 0.9 mg/day. This effect was seen for prostate cancer but not for any other cancer or chronic disease.

These findings suggest that boosting men's boron levels is more than just a good idea - it could be a lifesaver. Our ancestors typically consumed much more boron than we do, because they ate more fruits, vegetables, and nuts, and less meat and processed foods, than we do. The best dietary sources of boron are fruits, nuts, and red wine.

References

  1. Nielsen FH. The justification for providing dietary guidance for the nutritional intake of boron. Biol Trace Elem Res 1998;66:319-30.
  2. Raloff J. Boosting boron could be healthful. Science News 2001 Apr14;159(15):228.
  3. Rainey CJ, Nyquist LA, Christensen RE, Strong PL, Culver BD,
    Coughlin JR. Daily boron intake from the American diet. J Am Diet Assoc 1999;99:335-40.

Selenomethionine
Selenium is a nutrient trace element that is essential for disease prevention and for the proper functioning of many bodily systems, including the prostate gland. Deficiency of this element has been associated with both heart disease and cancer. A recent laboratory study of the effects of selenomethionine (a seleno-organic compound that occurs naturally in some cereal grains and vegetables14) has shown that it is an effective inhibitor of the growth of prostate cancer cells.15

All the substances mentioned above are safe, natural products that are known to help protect and support prostate function, by inhibiting the development of BPH or prostate cancer, or both.

References

  1. Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C. Saw palmetto extracts for treatment of benign prostatic hyperplasia. JAMA 1998 Nov 11;280(18):1604-9. Erratum: JAMA 1999 Feb 10;281(6):515.
  2. Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine, rev. 2nd ed. Prima Health, Rocklin, CA, 1998, pp. 755-6.
  3. Gann PH, Ma J, Giovannucci E, Willett W, Sacks FM, Hennekens CH, Stampfer MJ. Lower prostate cancer risk in men with elevated plasmalycopene levels: results of a prospective analysis. Cancer Res 1999 Mar15;59(6):1225-30.
  4. Wilczek H. Importance of vitamin D in prostatic carcinoma. Cas Lek Cesk 1996;135:716-8.
  5. Heinonen OP, Albanes D, Virtamo J, Taylor PR, Huttunen JK, Hartman AM, Haapakoski J, Malila N, Rautalahti M, Ripatti S, Maenpaa H, Teerenhovi L, Koss L, Virolainen M, Edwards BK. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 1998 Mar 18;90(6):440-6.
  6. Moyad MA, Brumfield SK, Pienta KJ. Vitamin E, alpha- and gamma-tocopherol, and prostate cancer. Semin Urol Oncol 1999 May;17(2):85-90.
  7. Nakayama O, Yagi M, Kiyoto S, Okuhara M, Kohsaka M. Riboflavin, a testosterone 5-alpha-reductase inhibitor. J Antibiot (Tokyo) 1990 Dec;43(12):1615-6.
  8. Kaul L, Heshmat MY, Kovi J, Jackson MA, Jackson AG, Jones GW, Edson M, Enterline JP, Worrell RG, Perry SL. The role of diet in prostate cancer. Nutr Cancer 1987;9(2-3):123-8.
  9. Krzeski T, Kazon M, Borkowski A, Witeska A, Kuczera J. Combined extracts of Urtica dioica and Pygeum africanum in the treatment of benign prostatic hyperplasia: double-blind comparison of two doses. Clin Ther 1993;15(6):1011-20.
  10. Barlet A, Albrecht J, Aubert A, Fischer M, Grof F, Grothuesmann HG, Masson JC, Mazeman E, Mermon R, Reichelt H, et al. Efficacy of Pygeum africanum extract in the medical therapy of urination disorders due to benign prostatic hyperplasia: evaluation of objective and subjective parameters. A placebo-controlled, double-blind, multicenter study. Wien Klin Wochenschr 1990;102:667-73.
  11. Gupta S et al. Prostate cancer chemoprevention by green tea. Semin Urol Oncol 1999 May;17(2):70-6.
  12. Paschka AG, Butler R, Young CY-F. Induction of apoptosis in prostate cancer cell lines by the green tea component (-)-epigallocatechin-3-gallate. Cancer Lett 1998;130:1-7.
  13. Hsieh T, Wu JM. Differential effects on growth, cell cycle arrest, and induction of apoptosis by resveratrol in human prostate cancer cell lines. Exp Cell Res 1999;249:109-15.
  14. Barceloux DG. Selenium. J Toxicol Clin Toxicol 1999;37(2):145-72.
  15. Redman C, Scott JA, Baines AT, Basye JL, Clark LC, Calley C, Roe D, Payne CM, Nelson MA. Inhibitory effect of selenomethionine on the growth of three selected human tumor cell lines. Cancer Lett 1998 Mar 13;125(1-2):103-10.