Natural AlternativeS for benign hypertrophy
As the age of a male progresses, the probability of prostate complaints increases. A mayor cause is Benign Prostatic Hyperplasia (BPH), a complaint 50% of men with age ≥ 50 have the chance to develop(1).
BPH is characterized by a hyperplasia of the prostate, in particular the stroma tissue. The normal ratio of epithelium and stroma is 1:2. With BPH the ratio increases to 1:5.
The obstruction with BPH is explained by a static component, pressure by the enlarged prostate tissue, and a dynamic component, the muscle tonus in the bladder neck, proximal urethra and prostate. The dynamic component is functionally the most important.
There are 4 main hypothesis about the pathogenesis of BPH, relating to dihydrotestosterone (DHT) concentrations, growth factors which cause cells to embryonal reawakening, increased binding capacity of sex hormone binding globulin (SHBG) and an increased concentration of prostaglandins and leukotriens(2).
BPH knows various stages, described by Alken (3 stages) and Vahlensieck (4 stages). Vahlensieck(3) included measurable criteria like urine stream and residual urine; Alken(4) was more descriptive and described the stages as follows:
Stage 1: Frequent urination (pollakisuria), interruptions of sleep because of excessive nighttime urination (nocturia), painful urination (dysuria), delays in beginning the urination and post void dribbling may occur.
Stage 2: As stage one and bladder function debility, urgency and incomplete emptying of the bladder (urine retention).
Stage 3: Complete stoppage or overflow of the bladder with decompensation of the bladder musculature. An excellent and reliable natural alternative to the treatment of an obstructive benign enlarged prostate in Alken stages 1 and 2 or Vahlensieck stages II and III.
Each nutritional combination constituent has a different point of impact in the process responsible for the healthy functioning of the prostate. The constituents allow the product to be given lifelong or intermittently(5), and show very few side effects as explained hereafter.
The composition
Capsules consists of the following active components: 428 mg Oil of Cucurbita pepo L. semen (Pumpkin seed oil); 100 mg extract of Urtica dioica L. (Stinging nettle); 50 mg extract of Orthosiphon stamineus Benth. (Java tea); 2.5 mg extract of fruits of Serenoa repens (Bartr.) Small (Saw Palmetto); 20 mg extract of the roots of Echinacea pallida (Nutt.) Nutt. (Pale Cone Flower); 60 mg ß-sitosterol; 23 mg Zinc orotate (Zn 4 mg) and 66 mg Magnesium oxide (Mg 38 mg). Other ingredients include Vitamin E, Gelatin, Glycerol, Sorbitol, Titanium dioxide, Riboflavin, ß-Carotene, Soybean oil, Lecithin, Beeswax, Orotic acid, and Silicon dioxide.
Oil of Pumpkin Seeds (Cucurbita pepo L.)
Oil of pumpkin seeds contains fatty oils, which contribute to its effect on the prostate. The Delta 7 sterols have an antiandrogenous effect by crowding dihydrotestosteron (DHT) out from the androgenous receptors(6), and as a consequence inhibit growth of the prostate. A herbal product containing pumpkin seed extract was tested for safety and therapeutic use with 2245 patients with BPH, stages I and II according to Alken. Within 12 weeks urinary symptoms as described by the International Prostate Symptom Score (IPSS) according to the American Urological Association, decreased by 41.4%. More than 96% of the patients reported no undesired side effects(7). The same product was tested during a 12-month period in a double blind, randomized and placebo controlled, multi clinical trial with 476 patients, again the IPSS improved with a minimum of 5 points with 65% of the patients(8). Complaints with reference to the urination time, the urination frequency, the urine volume, the urine stream, the residual urine and nocturia, diminish significantly through the use of pumpkin seeds. No side effects have been reported to date.
Nettle (Urtica dioica L.)
Extracts of the roots of Nettle are used. Pharmacological studies showed that Nettle root extract created morphological significant changes in prostatic adenoma cells, possibly related to competitive inhibition of the SHBG binding capacity of the extract. Clinical trials showed a decrease of 50% in nocturia frequency and an increase in 44% of the cases in micturition volumes(9). A significant decrease in prostate volume was observed in an open study with 253 BPH patients after receiving 1200 mg of a nettle extract for 12 weeks. Over 16000 patients have been treated with nettle root extract in clinical studies. Incidence of adverse effects was generally under 5%. The European Scientific Cooperative on Phytotherapy recommends stinging nettle root for symptomatic treatment of micturition disorders(10).
Java tea (Orthosiphon stamineus Benth.)
The main components of Orthosiphon stamineus Benth. leaves and extracts are the pharmacologically active polyphenols: the polymethoxylated flavonoids and the caffeic acid derivatives(11). In addition a high proportion of Potassium is found. Orthosiphon leaves are known for their diuretic effect. In animal tests diuretic flow increased as well as the secretion of urinary sodium(12). Another effect is the antibacterial activity attributed to the caffeic acid derivatives. The European Scientific Cooperative on Phytotherapy recommends Java Tea for irrigation of the urinary tract, especially in cases of inflammation(13).
Pale cone flower
(Echinacea pallida (Nutt.) Nutt.) Much research, being more than 350 scientific studies in the past 50 years, has been undertaken into the effectiveness of Echinacea, particularly directed at its immunity-stimulating effects. Uses supported by clinical data mention preparations of Radix Echinaceae administered orally in supportive therapy for infections of the urinary tract(14).
Saw Palmetto (Serenoa repens (Bartr.) Small)
The fruit of this small palm tree is used for making the extract. The main active compounds are free fatty acids and phytosterols like ß-sitosterol. The three fatty acids in the saponifiable fraction inhibit 5∂-reductase, an enzyme catalyzing the conversion of testosterone into dihydrotestosterone(15,16). In both open and clinical investigations a reduction of BPH symptoms: nocturia, residual urine, increase in the urine stream, decrease in the dysuria, appeared to occur. The World Health Organization does mention that it relieves the symptoms but does not have an effect on the size of the prostate(17).
ß-sitosterol
ß-sitosterol is the mayor phytosterol in higher plants(18). A systematic review of available trials where ß-sitosterol was assessed on urinary symptoms and flow measures in men with benign prostatic hyperplasia concluded: "The evidence suggests non-glucosidic B-sitosterols improve urinary symptoms and flow measures"(19). No decrease in prostate volume could be demonstrated.
Zinc and Magnesium
In comparison with other organs, the human prostate is characterized by a high Zinc and Magnesium content. Magnesium and Zinc play an important role as an activator of enzymes(20). The major function of the prostate is to accumulate and secrete extraordinary high levels of citrate. The prostate accumulates Zinc in its citrate-producing prostate epithelial cells. Zinc has a role in preventing oxidation of the citrate formed and inhibits cell growth(21,22).
Pharmacological profile
The active components will support inhibition of the growth of the cells of the Prostate gland (Stinging nettle and Zinc), support relieve of the symptoms of Benign Prostate Hyperplasia, resulting in lesser frequency of urination and nocturia, and increase in urine stream (Pumpkin seed oil, Saw Palmetto and ß-sitosterol), as well as protection against inflammation of the urinary tract (Java tea and Pale Cone Flower) and general nutrition of the prostate gland (Magnesium), to ensure a healthy functioning of the prostate.
Guidance for use
Should be considered a phyto medicine and can be taken for a long period of time. Because of its effect on androgen and estrogen metabolism, woman, and children under the age of 12 should not use. Its diuretic properties make it unsuitable for patients with edema due to impaired heart and kidney function. Gastrointestinal complaints have been registered with the use of Urtica preparations; as such it is recommended to take just before or after a meal.
Recommended dosage
Take 1 capsule 3 times a day for one month. Thereafter, a maintenance dose of 1-2 capsules daily may be taken.
Download more scientific info.
You will need Adobe Acrobat Reader to open and print any PDF documents. Click on the Acrobat Reader icon to download this free program.
Click here for benign hypertrophy products
Literature
(1) Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, O'Leary MP, Puppo P, Robertson C, Giuliano F., Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7)., Eur Urol. 2003 Dec; 44(6): 637-49. PMID: 14644114.
(2) E/S/C/O/P monographs, second edition 2003, page 529-530. ISBN 1-901964-07-8.
(3) Vahlensieck W, Fabricius PG. Benigne Prostatahyperplasie (BPH). Therapeutische möglichkeiten durch medikamentöse Therapie. Therapiewoche 1996; 33: 1796-802.
(4) Alken CE. Konservative Behandlung des Prostata-Adenoms und Stadien-Enteilung. Urologe B 1973; 13: 95-8.
(5) Vahlensieck W Jr., [With alpha blockers, finasteride and nettle root against benign prostatic hyperplasia. Which patients are helped by conservative therapy?], MMW Fortschr Med. 2002 Apr 18; 144(16): 33-6. PMID: 12043098.
(6) Schilcher H, Dunzendorfer U, Ascali F., Delta 7-sterole; das prostatotrope Wirkprinzip in Kürbissamen?, Urologe 1987 B27:316-319.
(7) Friederich M, Theurer C, Schiebel-Schlosser G., Prosta Pink Forte capsules in the treatment of benign prostatic hyperplasia. Multicentric surveillance study in 2245 patietns., Forsch Komplementarmed Klass Naturheilkd 2000 Aug; 7(4): 200-4. PMID: 11025395.
(8) D.Bach, Placebokontrollierts Langzeittherapiestudie mit Kürbissamenextrakt bei BPH-bedingten Miktionsbeschwerden., Uruloge [B]2000 Okt; 40: 437-443.
(9) Vontobel HP, Herzog R, Rutishauser G, Kres H., [Results of a double-blind study on the effectiveness of ERU (extractum radicis Urticae) capsules in conservative treatment of benign prostatic hyperplasia], Urologe A. 1985 Jan; 24(1): 49-51. PMID: 2580383.
(10) E/S/C/O/P monographs, second edition 2003, Urticae Radix, page 528-532. ISBN 1-901964-07-8.
(11) Olah NK, Radu L, Mogosan C, Hanganu D, Gocan S., Phytochemical and pharmacological studies on Orthosiphon stamineus Benth. (Lamiaceae) hydroalcoholic extracts., J Pharm Biomed Anal. 2003 Sep 15; 33(1): 117-23. PMID: 12946538.
(12) Beaux D, Fleurentin J, Mortier F., Effect of extracts of Orthosiphon stamineus Benth, Hieracium pilosella L., Sambucus nigra L. and Arctostaphylos uva-ursi (L.) Spreng. in rats., Phytother Res. 1999 May; 13(3): 222-5. PMID: 10353162.
(13) E/S/C/O/P monographs, second edition 2003, Orthosiphonis folium, page 354-358. ISBN 1-901964-07-8.
(14) WHO Monographs on Selected Medicinal Plants, Vol 1, Radix Echinaceae page 125-35, ISBN 92 4 154517 8, WHO Geneva, 1999, update Jan. 2003.
(15) E/S/C/O/P monographs, second edition 2003, Serenoae repentis fructus, page 477-78. ISBN 1-901964-07-8.
(16) Niederprum HJ, Schweikert HU, Thuroff JW, Zanker KS., Testosterone 5∂-reductase inhibition by free fatty acids from Sabal serrulata fruits.
Phytomedicine 1994;1:127-33. PMID: 8526353.
(17) WHO monographs on selected medicinal plants volume 2.Fructus Serenoae Repentis 285-99 World Health Organisation Geneva.
(18) Monograph. Plant sterols and sterolins., Altern Med Rev. 2001 Apr; 6(2): 203-6. PMID: 11302782.
(19) Wilt T, Ishani A, MacDonald R, Stark G, Mulrow C, Lau J., Beta-sitosterols for benign prostatic hyperplasia., Cochrane Database Syst Rev. 2000;
(2): CD001043. PMID: 10796740.
(20) Dutkiewicz S., Zinc and magnesium serum levels in patients with benign prostatic hyperplasia (BPH) before and after prazosin therapy.,
Mater Med Pol. 1995 Jan-Mar; 27(1): 15-7. PMID: 8569270.
(21) Costello LC, Franklin RB, Novel role of zinc in the regulation of prostate citrate metabolism and its implications in prostate cancer.,
Prostate. 1998 Jun 1; 35(4): 285-96. PMID: 9609552.
(22) Feng P, Li TL, Guan ZX, Franklin RB, Costello LC., Direct effect of zinc on mitochondrial apoptogenesis in prostate cells.,
Prostate. 2002 Sep 1; 52(4): 311-8. PMID: 12210492.