Various herbal preparations and other "natural" remedies have been used to treat a variety of physical ailments for centuries. Recent surveys have shown that about two thirds of us will eventually try some type of natural health remedy. Last year, the sale of all herbal and botanical preparations in the U.S. increased nearly 70% with over 1.5 billion dollars being spent on natural health care products.

The use of plant extracts and herbal therapies to treat prostate disorders was described as early as the year 1500 BC by the ancient Egyptians. Saw Palmetto was first used by the American Indians in Florida in the early 1700's and has been reported in the medical literature for relief of prostatic enlargement and swelling since the early 1800's. Yet there is relatively little support among modern physicians in the United States for these natural remedies particularly in the treatment of prostate problems. Most American doctors believe there is insufficient scientific evidence to support the effectiveness of natural remedies and herbal products in treating prostate disorders, but European physicians routinely recommend herbal and other natural health care products as first line therapy for prostate trouble. For example, in Italy nearly half of all the medications dispensed for prostate disorders are herbal remedies while in Germany and Austria, herbal preparations are the preferred initial treatment for all but the most severe prostate problems and represent more than 90% of all the medicines dispensed for this condition.

Most natural herbal remedies are categorized as "food additives" in the United States, which means they are not regulated or approved, by the Food and Drug Administration (FDA) and are not generally eligible for patent protection. This means there is no formal regulatory or scientific review process and little financial incentive to perform conclusive clinical studies on these products. Many natural health remedies contain multiple ingredients making it difficult to identify which component might actually be responsible for any beneficial clinical response. The exact chemical composition and clinical effect of these remedies vary substantially even between different batches of the identical product by the same manufacturer because their clinical effect, biological equivalence and production methods are often not adequately tested or standardized. Nevertheless, the popularity of natural, herbal remedies is rapidly increasing in this country and many Americans would choose such a remedy if a suitable product were available.

The Most Common Natural Therapies Used For Prostate Disorders

Saw Palmetto

Saw Palmetto is the most popular plant product used for prostate problems in the world. It is prepared from an extract of the berry of the American dwarf palm tree and at least 30 different companies market this extract in some form for treatment of prostatic enlargement and voiding problems. While the exact mechanism of action of Saw Palmetto is not known for sure, it has been suggested that it works in several ways including alteration - of cholesterol and testosterone (male sex hormone) metabolism, as an anti-inflammatory and as a prostatic decongestant.

While animal studies have shown shrinkage of the prostate while taking Saw Palmetto, human studies have not shown similar reductions in prostatic size. Still, these same studies suggest that Saw Palmetto extract reduces swelling and inflammation of the prostate and some studies showed a significant improvement in urinary symptoms including improved urinary flow rate, less nocturia (getting up at night to void) and reduced burning.

In 1996, a large multicenter randomized study was published which compared Saw Palmetto with Proscar (a commonly used medication for prostatic enlargement) in men with prostate trouble. After 6 months, the study found significant and similar improvement in urinary symptoms in both groups of patients suggesting that the Saw Palmetto and Proscar were roughly equivalent in treating prostatic enlargement. The Proscar group had a larger percentage decrease in the average size of the prostate (18 % compared to 6 % with Saw Palmetto) but also had more side effects, usually impotence. No adverse effects were noted with Saw Palmetto.

A systematic scientific review of all the relevant clinical data concerning Saw Palmetto was recently published in the prestigious Journal of the American Medical Association. This November 1998 landmark article evaluated 18 different studies involving 2939 men through a rigorous review process called meta-analysis. The review was hampered due to the short duration of some of the studies, different preparations of Saw Palmetto used and differences in how the improvement of urinary symptoms was measured. Nevertheless, they concluded that Saw Palmetto significantly improved urinary symptoms caused by prostatic enlargement and was roughly equal to Proscar with fewer side effects and lower costs. Improvement was noted in urinary flow rates, urgency, hesitancy, frequency, nocturia and bladder emptying ability. Again, no significant side effects or complications were associated with the use of Saw Palmetto.

Pygeum africanum

Pygeum is a derivative of the bark of a large African evergreen tree. Several short term studies have shown that Pygeum reduces urinary symptoms of hesitancy and nocturia while improving bladder emptying ability and flow rate in 66% of patients. It is thought to work as an anti-inflammatory agent and may decrease fibrous tissue buildup particularly in the bladder neck area where the prostate meets the urinary bladder.

Selenium

Selenium is a trace element that has been reported to significantly reduce the rate of prostate cancer in one European study. Those patients taking a Selenium supplement had a 66% reduction in their overall risk of prostate cancer compared to people who didn't take the extra Selenium. While this one study cannot be considered definitive, many people and doctors (including me) are taking additional Selenium until a conclusive study can be conducted. Its been suggested that Selenium may enhance the general health and natural immunity of the prostate. If so, it may also benefit people with prostate infections (prostatitis) and enlargement. Selenium may also enhance either the penetration of other agents into the prostate or their effect on that organ. Some people believe that Selenium is best absorbed when it can be found in a natural source such as garlic grown in Selenium enriched soil.

Other Herbal and Natural Remedies

Ginkgo biloba has been linked to improved circulation. If this is correct, it may help reduce prostatic inflammation and swelling. Its been suggested that Echinacea may also help stimulate the immune system and could be of some benefit in various prostate disorders.

Zinc has long been linked to the prostate where it may enhance the immune system, prevent cancer, improve overall prostatic health and exert an anti-inflammatory effect. Pumpkin seeds have been proposed as a natural source of zinc.

A number of other herbal products, plant extracts, amino acids, vitamins and minerals have been proposed as being helpful in some way to prostatic health. These include Vitamins B-6, C and E as well as the amino acids glutamine, glycine and L-alanine. Other herbal extracts would include unicorn root, uva ursi, stinging nettle and Radix uricae as well as various pollen extracts and phytosterols (plant substances that are chemically related to cholesterol; not available in the U.S.)

"PEENUTS": A Unique Combination of Natural Remedies For Prostate Disease

Several years ago, Colorado urologist Ronald E. Wheeler M.D. begin) studying ways to make the prostate healthier. He analyzed and studied all the various herbal and natural remedies including the ones mentioned here. Eventually, he stumbled upon a unique formula that seemed to work exceptionally well in reducing urinary symptoms due to prostate problems. I he conducted a prospective placebo controlled double blinded clinical study to verify the effectiveness of leis preparation arid fouled substantial, sustained relief whenever leis compound was used. Every single prostate patient tested showed significant improvement in at least some of their urinary symptoms within two months. Sixty nine percent reported either relief or improvement in nearly all of their urinary symptoms. (Symptoms studied included nocturia, urinary frequency, urgency, intermittency of the urinary stream, incomplete emptying, weak stream size or flow arid the need to strain or push to void.)

A second Study showed surprising activity ill treating prostatitis which is often resistant to conventional therapy with antibiotics, muscle relaxants and anti-inflammatory agents. These unusually encouraging results are thought to be due to the unique formula which seems to allow the various ingredients to work together, enhancing their effect to make the prostate healthier and less obstructive.

The product was named "PEENUTS" which stands for "Power to Empty Every time while Never Urinating Too Soon". A grant application to the National Institutes of Health (NIH) is being prepared to study the long term benefits and effects of "PEENUTS" in treating enlarged prostates, prostatitis and even prostate cancer. The formula is so exceptional and unique that a special patent application is pending.

"PEENUTS" contains Saw Palmetto, Pygeum, Garlic naturally enriched with Selenium, Echinacea, Ginkgo biloba, stinging nettle, pumpkin seeds, zinc, amino acids, anti-oxidants, vitamins, minerals and various other natural herbal ingredients. It's manufactured to rigorous quality standards similar to standard prescription medicines, so each bottle is bio-equivalent and produces the same clinical effect.

"PEENUTS" is the only herbal product we recommend for patients who desire a natural remedy for their prostate problem. It's usually taken twice a day either with or without food and costs $75 for a two-month supply or about $1.25 per day. For more information about "PEENU7S" call Lorain Surgical Specialties at 440-985-9898.

The information contained herein is intended for your interest only. No attempt is made to suggest that the herbs, extracts, amino acids, vitamins or minerals and their reported benefits actually exist or work as staled. Readers are asked to review the literature (including thus article) and make up their own mind regarding the possible use of any of these agents. Readers are reminded that the herbal products mentioned including "PEENUTS" are not approved by the Food and Drug Administration for the treatment of any specific or general prostate disorder. Readers are further cautioned not to take any medication, including those that can be purchased at health food stores or over the counter, without first consulting their physicians.

References and Suggested Read

Barry, M.: Epidemiology and Natural History of Benign Prostatic Hyperplasia. Urologic Clinics of North America. Vol. 17, pp 495-507, 1990

Barlet, A. et al: Efficacy of Pygeuni africanum Extract in the Treatment of Micturitional Disorders Due to Benign Prostatic Hyperplasia. Evaluation of Objective and Subjective Parameters. A Multicenter Randomized, Double-Blind Trial. Wiener Klinische Wochenschrift Vol. 102, pp 667-673, 1990

Bassi, P. et al: Standardized Pygeum africanum Extract in the Treatment of Benign Prostatic Hypertrophy: A Controlled Clinical Study Vs. Placebo. Minerva Urologica a Nefrologica Wisdom in Urology and Nephrology] Vol. 39, pp 45-50, 1987

Berry, SL, Coffey, DS, Walsh, PC, and Ewing, LL.: The Development of Human Benign Prostatic Hyperplasia With Age. Journal of Urology. Vol. 132, pp 474-479, 1984

Buck, AC: Phytotherapy for the Prostate. British Journal of Urology. Vol. 78, pp 325-336, 1996

Carraro, JC, Raynaud, JP, Koch, G, et al: Comparison of Phytotherapy With Finasteride in the Treatment of Benign Prostate Hyperplasia: A Randomized International Study of 1,098 Patients. Prostate. Vol. 29, pp 231-240, 1996

Champault G, Patel, JC and Bonard, AM: A Double-Blind Trial of yin Extract of the Plant Seronoa repens in Benign Prostatic Hyperplasia. British Journal of Clinical Pharmacology. Vol. 18, pp 461-462, 1984

Christensen, MM and Bruskewitz RC.: Clinical Manifestations of Benign Prostatic Hyperplasia and the Indications For Therapeutic Intervention. Urologic Clinics of North America. Vol. 17, pp 509-516, 1990

DiSilverio, F, Flammia, GP, Sciarra, A, et al: Plant Extracts in Benign Prostatic Hyperplasia. Minerva Urologica a Nefrologica [Wisdom in Urology and Nephrology] Vol. 45, pp 143-149, 1993

Dreikorn, K and Richter, R.: Conservative Nonhormonal Treatment of Patients With Benign Prostatic Hyperplasia. In: New Developments in Biosciences: Prostatic Hyperplasia. Ackerman, R. and Schroeder, FH. eds., Walter de Gruyter & Co. Publishers, Berlin Germany pp 109-131, 1989

Eisenberg, DM, Kessler, RC, Foster, C., et al: Unconventional Medicine in the United States: Prevalence, Costs, and Patterns of Use. New England Journal of Medicine. Vol. 328, pp 246-252, 1993

Ernst, E.: Harmless Herbs- A Review of the Recent Literature. American Journal of Medicine. Vol. 104, pp 170-178, 1998

Feinblatt, HM and Gant, JC.: Palliative Treatment of Benign Prostatic Hypertrophy: Value of Glycine, Alanine, Glutamic Acid Combination. Journal of the Maine Medical Association. 1958

Gerber, G.: Effect of Saw Palmetto on PSA. American Urological Association Abstract, 1997

Guess, HA.: Benign Prostatic Hyperplasia Antecedents and Natural History. Epidemiology Review. Vol. 14, pp 131-153, 1992

Hendler, SS.: The Doctor's Vitamin & Mineral Encyclopedia, Simon & Schuster, 1990 Kusche, J.: Good Clinical Practice and Phytotherapy. Methods of Experimental Clinical Pharmacology. Vol. 15, pp 241-247, 1993

Levin, RM, Riffaud, JP, Bellamy, F, et al: Protective Effect of Tadenan on Bladder Function Secondary to Partial Outlet Obstruction. Journal of Urology. Vol. 155, pp 1466-1470, 1996

Lowe, FC and Ku, JC.: Phytotherapy in Treatment of Benign Prostatic Hyperplasia: A Critical Review. Urology. Vol. 48, pp 1220, 1996

McConnell, JD, Barry, MJ and Bruskewitz, RC.: Benign Prostatic Hyperplasia. Agency for Health Care Policy and Research, Public Health Service. Clinical Practice Guideline No. 8, AHCPR publication 94-0582, 1994

Nitti, V,: Alternative Therapies for BPH: Phytotherapy. Streamline. Vol. 1, pp 7-10, 1998

Pitchford, P.: Healing With Whole Foods, Original Tradition & Modern Medicine. North Atlantic Books, 1993

Rhodes, L, Primka, RL, Berman, C, et al: Comparison of Finasteride (Proscar), A 5 Alpha Reductase Inhibitor, and Various Commercial Plant Extracts In Vitro and In Vivo 5 Alpha Reductase Inhibition. Prostate. Vol. 22, pp 43-51, 1993

Tyler, VE.: The Honest Herbal. Pharmaceutical Products Press, Third Edition, 1993

Tyler, VE.: Herbs of Choice. Pharmaceutical Products Press, 1994

Wheeler, R.: Personal Communication. Unpublished Data.

Wilt, TJ, Ishani, A, Stark, G.: Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia: A Systematic Review. Journal of the American Medical Association. Vol. 280, pp 1604-1609, 1998