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Supplements for a healthy prostate

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Supplements for a healthy prostate

Dr Mark Stengler shares his top supplements and recipes for enlarged prostate.

The usual treatment is pharmaceuticals, but these carry risks such as sexual dysfunction, breast enlargement, fatigue, decreased libido and headaches.

Fortunately, many natural approaches, such as diet, lifestyle changes and herbal or nutritional supplements, can be very effective, both for preventing and treating symptoms. 

If you’ve been diagnosed with BPH, here are my top diet and supplement recommendations.

Symptoms of BPH

Incomplete emptying: bladder feels full even after voiding urine 

Increased frequency: need to urinate often, every hour or two 

Intermittency: the need to stop and start several times while urinating 

Urgency: sensation of needing to urinate right away 

Weak stream: a weak or feeble urinary stream 

Straining: need to push or strain to start urine flow 

Nocturia: the need to wake up more than twice per night to urinate 

Men with severe cases of BPH end up with urinary retention, leading to hospitalization or surgery.1

Supplements for a healthy prostate

DIET 

An increasing number of studies demonstrate a link between diet and BPH.1 The following are associated with higher risk of BPH:2 

• high protein intake from animal sources (but not vegetable sources) 

• high intake of unsaturated fatty acids, which contribute to damaged cell membranes and increased 5-alpha-reductase activity (the conversion of testosterone to DHT, which may fuel prostate growth) 

• high intake of foods rich in saturated fat and high in cholesterol, which can promote inflammation 

• high caloric intake, which can increase abdominal obesity and sympathetic nervous system activity 

• intake of high-glycemic foods such as bread, pasta and rice that are associated with increased serum insulin and insulin-like growth factor, which may stimulate BPH (although no association was found with the intake of high-glycemic fruit) 

• high coffee intake, which stimulates the adrenergic nervous system and smooth muscles of the prostate, which in turn can worsen BPH symptoms.

The following are associated with lower risk or improved symptoms of BPH: 

• omega-3 fatty acids (found in foods such as cold-water fish, vegetables, ground flaxseed and flaxseed oil), which reduce inflammatory compounds that create inflammation related to BPH 

• lignans (found in whole flaxseeds), which promote estrogen removal and may protect against BPH 

• garlic extract, regular consumption of which has led to improvements in disease parameters in BPH patients 

• phenols (found in cranberry and other dark-colored grapes and berries), which may help with lower urinary tract symptoms. 

The Mediterranean diet

I am a big proponent of the Mediterranean diet. It has been shown in several studies to be protective against prostate cancer, and the high amounts of plant foods, herbs and spices serve to keep the prostate healthy. 

However, I recommend modifying the traditional guidelines in order to reduce dairy as well as grain products. Most American grain products, such as breads and pastas, are so refined and unhealthy; I recommend eliminating them if possible. Even “healthier” whole grains, however, should be eaten in moderation. 

The Mediterranean diet consists of plenty of plant foods (fruits, vegetables, legumes, nuts, breads, and unrefined cereals); lots of olive oil; moderately high intake of fish; moderate consumption of alcohol; and low consumption of poultry, red meat and eggs.3

This diet is also rich in omega-3 fatty acids, as found in cold-water fish. These healthy omega-3s reduce inflammatory compounds that are related to BPH.2

Here are some tips for incorporating the Mediterranean diet into your meals:4 

• Eat more nuts and olives. 

• Begin or end each meal with a salad. 

• Add a variety of different vegetables to the menu. 

• Eat at least three servings a week of legumes (e.g., lentils, chickpeas, beans, peas).

• Reach for wine if you choose to drink alcoholic beverages (but limit yourself to no more than two five-ounce glasses a day).

SUPPLEMENTS 

As an integrative doctor, I recognize that some men with BPH do exceptionally well using solely natural approaches, while others require conventional methods as well. Approximately 40 percent of American men who choose nonsurgical treatment of BPH use herbal supplements alone or with other medications.5

After reading through the supplements recommended here, review the proper course of action for you with your health care practitioner. Just note that the recommended doses here are specifically for the prevention and treatment of BPH, not for general health purposes. 

Beta-sitosterol.  Beta-sitosterol is one of several plant sterols—compounds similar to cholesterol found in most plants, with higher amounts in rice bran, wheat germ, soybeans, corn oil, peanuts, avocados, pumpkin seeds, cashew fruit, saw palmetto and Pygeum africanum.6 Beta-sitosterol inhibits 5-alpha-reductase, an enzyme involved in BPH, and has anti-inflammatory properties.

Research shows that taking beta-sitosterol supplements can improve BPH urinary symptoms as well as patients’ quality of life.7 

Suggested dosage: 60 to 130 mg daily 

Rye pollen extract.  Rye pollen extract (also known as ryegrass flower pollen, ryegrass or flower pollen extract) is an herbal treatment that has been used in Europe for decades, and several studies demonstrate its effectiveness in reducing the symptoms of BPH. 

Recent research has shown that Cernitin, a well-researched type of rye pollen extract, regulates inflammatory chemicals known as cytokines in prostate cells and decreases androgen receptor levels.8  In one study of men with BPH, Cernitin supplements were found to improve several urinary symptoms including urgency, dysuria (difficulty urinating), nocturia (waking up to urinate at night), incomplete emptying, prolonged voiding, delayed voiding and dribbling at the end of urination. 

Overall clinical effectiveness was 85 percent, and 28 out of 79 men treated for more than one year had a decrease in average prostate volume.9

Suggested dosage: 126 mg three times daily, up to 500 mg daily 

Saw palmetto.  Saw palmetto berries and extracts are a popular herbal therapy for the treatment of BPH. Around half of German urologists prefer to prescribe plant extracts such as saw palmetto rather than pharmaceuticals for BPH.10 

Saw palmetto has multiple mechanisms that are likely responsible for reducing BPH symptoms, including effects on the conversion of testosterone into DHT and intracellular binding to receptors in the prostate.11 

In a review of 27 studies, saw palmetto was reported to be “an efficacious and well-tolerated” option for long-term medical treatment of BPH and lower urinary tract symptoms.”12 And in another review of 21 randomized controlled trials, saw palmetto produced similar improvements in urinary symptom scores to the drug finasteride, but with fewer adverse events.13 

As with other herbal therapies, saw palmetto works best for mild to moderate symptoms in the early stages of BPH. About 90 percent of men notice an improvement in mild to moderate urinary symptoms of BPH within the first four to six weeks.6 

Suggested dosage: 320 mg daily of a liposterolic (fat-soluble) extract that is standardized to 80 percent or higher fatty acid and sterol composition

Pygeum africanum.  Pygeum africanum, also known as Prunus africana, has a history of use in Africa for urinary disorders. The active components of Pygeum africanum appear to be ferulic acid esters, which lower cholesterol within the prostate and reduce metabolites that contribute to
prostate growth.
Pygeum africanum also contains sterols that reduce inflammatory compounds and testosterone accumulation within the prostate.
14 

A review of 18 randomized controlled trials involving more than 1,500 men found that those supplementing with Pygeum africanum were more than twice as likely to report an improvement in BPH symptoms.15 

Suggested dosage: 100 to 200 mg daily of a standardized extract (usually 14 percent triterpenes)

Nettle root.  Stinging nettle (Urtica dioica) root appears to be effective in treating BPH. Precisely how it works is not clear, but may be to do with the inhibition of a protein called SHBG from binding to prostate receptors, reduced conversion of testosterone into estrogens, and anti-inflammatory effects on prostate tissue.16 

In one study, more of those taking nettle (81 percent) reported improved lower urinary tract symptoms compared with patients in the placebo group (16 percent). Also, those taking nettle had a reduction in postvoid residual urine volume (the amount of urine left in the bladder after urination) and saw a modest decrease in prostate size.17 

Suggested dosage: 120 to 600 mg daily

Pine bark extract.  A patented form of French maritime pine bark extract, Pycnogenol contains several plant compounds, including procyanidins, bioflavonoids and phenolic acids, that have a number of therapeutic effects, such as reducing inflammation.

In one study, men taking Pycnogenol and following a standard protocol of routine exercise, hydration and a low-sugar/low-salt diet saw significant improvements in BPH symptoms compared to those following the standard protcol alone or those taking the drugs finasteride
or
dutasteride.18 

Suggested dosage: 150 mg Pycnogenol daily (but if you are on anticoagulant therapy, check with your doctor before using this supplement)

Zinc. The mineral zinc is found in high concentrations in the prostate.19 It plays a vital role as a constituent of prostatic fluid as well as influencing healthy prostate development and functioning. 

Higher zinc intake (more than 23 mg) is associated with a lower risk of BPH.20 One study found a significant decrease in prostate zinc levels in men with BPH as compared to normal prostate tissue.21 

High-zinc food sources include shellfish, beef and other red meats, nuts, and legumes. 

Suggested dosage: for long-term usage, 25 to 30 mg daily, with meals 

Vitamin D.  Prostate tissue has vitamin D receptors, which influence prostate tissue metabolism and the ability to control inflammation. Research suggests that men over the age of 50 with lower urinary tract symptoms have lower levels of vitamin D than men without.22 Another study found a link between vitamin D deficiency and urinary symptoms associated with prostate growth, as found with BPH, and noted that low vitamin D promotes cell proliferation and apoptosis in healthy prostate cells.23 

Suggested dosage: 2,000 to 5,000 IU daily, with a meal (but, ideally, get your levels tested first to determine the dosage you should be on)

Essential fatty acids. Levels of omega-3 fatty acids are significantly decreased in men with BPH.24 In one study of men with BPH and lower urinary tract symptoms, those who took omega-3s alongside the BPH drugs tamsulosin and finasteride showed greater improvements in urinary symptoms and more improvement in prostate volume after six months compared to those taking the drugs alone.25 

Suggested dosage: 1,000 mg daily of EPA and DHA (but check with your doctor before supplementing if you are on blood-thinning or anticoagulant medications)

Recipes 

In general, I recommend a modified Mediterranean diet full of organic plant foods (especially fruits and vegetables), free of dairy and low in animal products. Here are some fantastic recipes you can incorporate that are packed with beneficial nutrients to keep your prostate healthy.

Anti-Inflammatory Carrot-Apple Juice 

Makes 1 cup (serves 1) 

This sweet, orange-hued juice features ingredients that help combat prostate inflammation. 

Ingredients

1 cup diced sweet apple, such as Pink Lady (unpeeled) 

½ cup thinly sliced carrot 

¼ cup fresh orange juice 

1 coin (about ¼ tsp) peeled fresh ginger root

¼ tsp salt 

Pinch of ground turmeric 

 Method

1) Add all of the ingredients plus ¼ cup water to a high-speed blender. 

2) Purée until smooth, for 1 to 2 minutes.

Black Bean Soup with Cumin and Oregano 

Makes 6 cups (serves 3) 

Full of antioxidant-rich black beans, vegetables and citrus, this creamy vegan soup is satisfying and low in fat. Feel free to top with a dollop of plain, unsweetened plant-based yogurt, such as cashew yogurt. 

Ingredients

1 tablespoon extra-virgin olive oil 

1 medium red onion, chopped (about 2 cups) 

1 medium orange or yellow bell pepper, chopped (about 1 cup) 

4 tsp sliced garlic (about 5 cloves) 

1 tsp cumin 

1 teaspoon oregano 

One 29-oz BPA-free
can black beans, rinsed and drained 

3 cups low-sodium vegetable broth
or stock 

½ cup fresh
orange juice 

1 tsp salt

Method 

1) Heat the oil in a medium saucepot over medium-high heat. 

2) Once hot, add the onion, bell pepper, garlic, cumin and oregano, and sauté until the onion is soft, about 8 minutes (do not let the vegetables brown). 

3) Stir in the beans, broth, juice, and salt, and bring to a boil over high heat. 

4) Once boiling, cover the pot and reduce the heat to medium-low. Simmer for 20 minutes. 

5) Using an immersion blender, carefully puree in the pot until smooth. Alternatively, you may purée in batches in a blender.

Turkey-Corn-Tomato Sauté 

Makes 10 cups (serves about 5) 

Similar to a sloppy joe mixture (but without the added sugar), this quick-to-prepare entrée is loaded with antioxidant-rich tomatoes and corn. Lean turkey is a healthful way to glean protein and is an underused meat. Serve this dish with cooked whole grains such as brown rice. 

Ingredients

2 Tbsp avocado oil, divided 

2 lb 99% lean ground turkey or chicken 

2½ tsp cumin, divided 

2½ tsp garlic powder, divided 

1½ tsp salt, divided 

2 cups small-diced red and orange bell peppers (about 2 peppers) 

1¼ cup small-diced red onion (about 1 small onion) 

4 tsp thinly sliced garlic 

One 28-oz BPA-free can whole peeled plum tomatoes 

One 15-oz BPA-free can cooked corn kernels 

Method

1) Heat half of the oil in a 10- to 12-inch nonstick sauté pan with a minimum of 2-inch (5 cm)-high sides over medium-high heat. 

2) When the oil is hot, add the turkey in one layer, 2 teaspoons each of the cumin and garlic powder, and 1 teaspoon of the salt, and sauté, breaking the meat up with a wooden spoon, until it becomes opaque (about 8 minutes). Set the cooked turkey aside. 

3) Add the remaining oil and the bell pepper, onion, garlic, and remaining ½ teaspoon each of salt, garlic powder and cumin to the pan. Sauté until the pepper is soft, about 12 minutes. Add the tomatoes and crush a bit with a potato masher. Stir in the corn. Increase the heat to high and cook, stirring, for about 3 minutes.

 

Adapted from Healing the Prostate by Dr Mark Stengler (Hay House, 2021)

SYMPTOMS OF BPH References

1 

 Benign Prostatic Hyperplasia (BPH) Patient Guide, e-book reprint (Urology Care Foundation, 2020), www.urologyhealth.org)

 

References

1 

Curr Opin Urol, 2014; 24: 10–4

2 

Clin Nutr ESPEN, 2019; 33: 5–11

3 

Eur Urol, 2014; 65: 887–94

4 

“A Practical Guide to the Mediterranean Diet,” Harvard Health Blog, March 21, 2019. www.health.harvard.edu/blog

5 

Medicine, 2019; 98: e14023

6 

“Benign Prostatic Hyperplasia,” in Textbook of Natural Medicine, eds. Michael T. Murray and Joseph E. Pizzorno, 4th ed. reprint (St. Louis, MO: Churchill Livingston, 2013), 1266

7 

Cochrane Database Syst Rev, 2000; (2): CD001043; Lancet, 1995; 345: 1529–32; BJU Int, 1997; 80: 427–32

8 

Phytother Res, 2019; 33: 2457–64

9 

Clin Ther, 1995; 17: 82–7

10

N Engl J Med, 2006; 354: 557–66

11 

“Serenoa repens (Saw Palmetto),” in Textbook of Natural Medicine, eds. Michael T. Murray and Joseph E. Pizzorno, 4th ed. reprint (St. Louis, MO: Churchill Livingston, 2013), 1267

12

BJU Int, 2018; 122: 1049–65

13

Cochrane Database Syst Rev, 2009; (2): CD001423

14

“Pygeum africanum (Bitter Almond),” in Textbook of Natural Medicine, eds. Michael T. Murray and Joseph E. Pizzorno, 4th ed. reprint (St. Louis, MO: Churchill Livingston, 2013), 1002

15

Cochrane Database Syst Rev, 1998; (1): CD001044

16

Phytomedicine, 2007; 14: 568–79

17

J Herb Pharmacother, 2005; 5: 1–11

18

Minerva Med, 2018; 109: 280–4 

19

PLoS One, 2016; 11: e0165956

20

Am J Epidemiol, 2008; 167: 925–34

21

Indian J Urol, 2011; 27: 14–8

22

Urol Ann, 2017; 9: 170–3

23

Urology, 2011; 78: 1292–7

24

Clin Biochem, 1999; 32: 405–9

25

Inflammopharmacology, 2017; 25: 451–58

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