Q:For over two and a half years my husband has suffered with chronic prostatitis (inflammation of the prostate). He has had conventional treatment antibiotics, four cystoscopies, followed by antibiotics and Flagyl on two occasions all to no avail.
On the alternative medicine/therapy side, he has had courses of high zinc intake, high vitamin C, combinations of amino acids, various herbal remedies. He takes pumpkin seeds daily. Acupuncture, reflexology and massage all have been tried.
The latest herbal remedy he is trying is Goldenseal, which I read in a herbal leaflet was good for prostate problems. The only relief he gets is from localized heat, and that is only for a short period.
The main symptoms are a burning sensation around the prostate area, which sometimes varies in type of burn. He also complains of the soles of his feet burning, but they feel normal to the touch.
Do you have any further suggestions as to treatment or therapy, and any hope that his condition will ever be resolved? E P, Leigh, Lancs......
I have been offered a beta blocker treatment called indoramin two pills a day for life for prostate problems including urine retention. Have you got any information on side effects of this particular drug? I understand indoramin has been available for three years, and users are cautioned about drowsiness, which could be exaggerated by the use of alcohol. This is all the information I have. J S, Braintree.......
A: Chronic infection of the prostate gland in the penis prostatitis can be due to an infecting bug, or it can be due to a more generalized problem. Has your doctor ever done a laboratory test to determine whether there is some infecting organism responsible? If he hasn't, do insist that he does in your next meeting.
If nothing is found, a number of our panel members say that candida albicans can cause chronic infection of the prostate gland, as can food intolerance/allergies. It's worth having yourself checked out by a clinical ecologist or someone familiar with candida albicans treatment to determine whether either one is at the heart of your problem.
It is true that low zinc levels could bring on prostate problems. We're not sure what you mean by courses of high zinc; ordinarily if you're demonstrating a low zinc level you would be kept on zinc supplementation indefinitely.
Another possible nutritional culprit is a low level of essential fatty acids (the omega-6 fatty acids), such as those found in linseed oil or safflower oil. Our panel member Nutritional expert Dr Stephen Davies has treated a number of patients with this problem on 10-15 mls twice a day of these cold pressed oils, with a nightly before bed supplement of 40-50 mg of zinc. This might even help with those patients who suffer from an enlarged prostate gland, although there is less evidence to suggest it. Leo Galland, one of our panel members, believes that zinc and EFAs can work to help prevent the problem from developing in the first place, but once it's there, he's never seen them reverse it.
Several herbs are gaining a reputation for helping prostate problems. Dr Galland says that a recent study in the British Journal of Urology showed that cernilton (which is flower pollen) helped cases of chronic prostatitis. (He himself has never got it to work with his own patients.)
For enlarged prostate problems, saw palmetto has reportedly shown the most benefits he says, although hawthorn has also been used.
As for indoramin (Doralese in the UK), it is actually a "selective" alpha blocker, which blocks the effects of adrenaline on the alpha receptors in arteries. This blocking allows the arteries to dilate, which causes blood pressure to drop. Those alpha blockers that are "selective" only block alpha-1 receptors, which means, in essence, that they don't cause a rapid heart beat.
Although these drugs are mainly used for high blood pressure, they were presumably selected for you because urine retention and enlarged prostate are often caused by muscle spasms around the prostate gland. The alpha blockers block the nerves supplying these muscles; they relax and urine flows more readily. They are also supposed to help increase the volume of urine passed.
Not without some cost, however. Your doctor rightly pointed out that the drugs can make you drowsy. But he left off about another page's worth of side effects. The more minor include listlessness, headaches, dizziness, nausea, vomiting, diarrhoea, constipation and palpitations.
Shame on him for failing to mention to you the most common and potentially serious side effect: sudden fall in blood pressure. For people over 55, this can cause collapse or bone breaking falls. Therefore, your doctor should have told you to sit or lie down while taking your first dose or take it only at bedtime. This side effect magnifies if you are over 55, so do use with caution. You should have been started on the smallest effective dose and only built up if you needed to.
The drug can aggravate angina, cause breathlessness, nervousness, hallucinations, depression, skin rashes, hair loss, fluid retention, blurred vision, catarrh, ringing in the ears, too frequent passing of urine, and, yes, impotence. So the bottom line is that you're trading one problem for a possible host of others.
Says Dr Galland: "I wouldn't expect an alpha blocker to be all that helpful. While it might alleviate some of the symptoms, it will never address the problem."
One area being explored in America is the use of "hyperthermia" (warming up the prostate) in order to shrink the enlargement. A warmed (not hot) probe is inserted into the rectum to heat up the prostate. After several treatments, it should shrink down. The Atkins Center in New York is experimenting with such a technique.
Thereafter, you can try the approach of zinc and EFAs to keep it to a normal size.