PROSTAPLUS:
plants for men
Saw palmetto extract (SPE) should
now be considered a treatment option for men with symptomatic BPH,
absent complications of the disorder. SPE is extremely safe; it is
likely to exert positive effects; many patients want it; and more
potent remedies, i.e., drugs or surgery, are generally not required
in most BPH cases. A recent meta-analysis of SPE trials from Europe
(where nearly all previous studies originated) was published in a
recent issue of the Journal of the American Medical Association concluding
that SPE improves urinary flow and decreases prostate symptoms in
men with BPH.
Non-malignant
hypertrophy of the prostate affects slightly more than half of all
men between the ages of 40 and 60. For these men, urination
is more difficult; they experience incomplete emptying of the bladder
during urination, and painful and more frequent urination at night.
Infection, incontinence and urinary bleeding usually follow.
Scientists associate this disease with an excess of testosterone in
the form of dihydrotestosterone (DHT). Testosterone is transformed
in to DHT by 5-alpha-reductase (5-AR), which increases in men
as they grow older. Though extremely common, this disease can be prevented
or treated if caught in time.
Willow-herb
(Epilobium parviflorum), one of the fetish plants of the celebrated
Maria Treben, has provided the traditional treatment for prostate
problems. This plant is also an ingredient in the famous elixir,
Swedish bitters. Recent research, notably at the Université
de Lausanne, maintains that willow-herb has anti-inflammatory properties
and an inhibitory effect on the enzymes that transform testosterone
into DHT. It is therefore a tonic for the prostate.
Stinging
nettle (Urtica dioic) and the bark of Pygeum Africanum both have anti-
inflammatory and decongestant (anti-edema) properties.
Jupiter
(Juniperus communis) and Indian corn stigma (zea mays) are excellent
diuretics and help prevent inflammation of the gallbladder.
But without
question, the ingredient that makes the leading contribution to our
formula for prostate protection is extract of palmetto leaf or saw
palmetto (Serenoa repens). In recent years, it has been extraordinarily
popular in Europe and North America in the treatment and prevention
of prostate problems. Researchers have discovered that this plant
blocks 5-AR activity, thereby lowering production of DHT, which causes
hypertrophy of the prostate. European studies have shown that in the
treatment of non-malignant hypertrophy of the prostate, palmetto leaves
are just as efficient as conventional synthetic drugs, though they
do not have any undesirable secondary effects.
Saw
Palmetto (Serenoa repens)
Saw Palmetto,
whose botanical name is Serenoa repens, is marketed to the general
public mainly as a treatment for Benign Prostatic Hyperplasia or BPH.
In the USA, the genus/species name is referred to as Serenoa repens.
Elsewhere in the world it is
referred
to as Sabal serrulatum, Sabal serulata, Sabalis serulata, Sabalis
serulatae, Serenoa serrulata, Serenoa serrulatae and many other genus/species
synonyms. Saw Palmetto, the common name, is referred to as Sabal,
Sabal Fructus, Fructus Serenoae, Sägepalme, Sägepalmenfrüchte,
and other synonyms around the world. For purposes of this website,
we will use the common name Saw Palmetto, and the genus/species name
Serenoa repens.
The benefits
of Saw Palmetto can be traced back to the early 1700's, where the
aborigines of the Florida peninsula depended largely upon the berries.
The berries were used by the American Indians to treat atrophy of
the testes, impotence, inflammation of the prostate, low libido
in men, and as a general tonic to nourish the body. Other historical
uses have included the treatment of infertility in women, treatment
of underdeveloped breasts, increased lactation, painful periods, anti-inflammatory,
appetite stimulant, and as a tonic and expectorant for mucous membranes,
particularly the bronchial passages. It has also been marketed as
an aphrodisiac for both men and women and has been called the "sex
pill of the 90's".
Today the
product is mainly used for the treatment of conditions associated
with BPH (nonmalignant enlargement of the prostate gland). Several
factors are recognized as playing a major role in the development
of BHP. First, functioning testes and a critical level of androgens
are essential to the development of BPH. Second, a change in prostatic
androgen metabolism occurs that favors the accumulation of dihydrotestosterone
(DHT), and third, an increase in the ratio of plasma estrogens to
androgens.
Recent clinical
research appears to have proven that Saw Palmetto extract is beneficial
in BPH. Its mechanism of action in the treatment of BHP is reported
that Saw Palmetto inhibits the conversion of testosterone to DHT,
the agent thought to be responsible for the enlargement of the prostrate.
In addition Saw Palmetto extract inhibits the binding of DHT to receptors
thus blocking its action. It has also been shown to have an inhibitory
effect both on androgen and estrogen nuclear receptors. This is accomplished
without interfering with testosterone, follicle-stimulating hormone,
or luteinizing hormone levels. Most importantly, Saw Palmetto does
not effect PSA levels, thus it does not mask the ability of PSA tests
to detect cancer.
Saw Palmetto
Extract
The Saw
palmetto extract used in the clinical studies is a well-defined purified
fat-soluble extract containing between 85% and 95% fatty acids and
sterols. Like Proscar, the therapeutic effect of the Saw palmetto
extract appears to be due to its inhibition of dihydrotestosterone.
However, the Saw palmetto extract also inhibits the binding of dihydrostestosterone
at cellular binding sites.
Effectiveness
and safety:
Numerous
double-blind clinical studies on the Saw palmetto extract have shown
it to be effective in nearly 90% of patients usually in a period of
4 to 6 weeks. Detailed toxicity studies in animals, as well as the
results from clinical trials, indicate that the Saw palmetto extract
is without toxicity or side effect. Despite the impressive clinical
effectiveness, safety, and popularity of Saw palmetto extract in the
treatment of BPH in the United States, manufacturers are prohibited
from making any medical claims by the FDA.
An extract
of the berries from the Saw palmetto (Serenoa repens), a palm tree
native to the Southern Atlantic coast, has emerged as a popular treatment
for an enlarged prostate both in Europe and the United States. This
popularity is for good reason. Over 20 double-blind, placebo controlled
studies have demonstrated the fat-soluble extract of the Saw palmetto
berries is very effective in relieving all of the major symptoms of
benign prostatic hyperplasia (BPH) including increased nighttime urinary
frequency, the most bothersome complaint. In fact, in these studies,
the Saw palmetto extract has been shown to exert superior benefits
compared to Proscar, the standard prescription drug used in the medical
treatment of BPH.
Small
Flower Willow (Epilobium parviflorum)
Epilobium
parviflorum is a plant used in Central Europe for the treatment of
prostate disorders. Research has shown it to inhibit the
conversion of testosterone to dihydrotestosterone (DHT)
by activity of 5-alpha-reductase and aromatase((the group of enzymes
that catalyze the conversion of testosterone to estradiol) ), two
enzymes which are involved in the development of benign prostatic
hyperplasia (BPH). The main polyphenols responsible for the inhibition
of the these enzymes have been identified as oenothein A and oenothein
B, which have been identified in Epilobium parviflorum plant extracts.
Epilobium
fatty acids contents also inhibits the production and release of prostaglandin
D2 and of prostaglandin E2.
Actions:
antiadenomic, anti-androgenic, anticancer, antiedemic, antiestrogenic,
anti-inflammatory, antiprostadenomic (inhibitts prostate cancer),
antiprostatitic, antitumor, bactericide, inhibits formation of dihydrotestosterone
(DHT), liver protectant, prostate cancer preventative, reproductive
alterative, uterosedative
Traditional
use: benign prostatic hypertrophy (BPH), epididymitis, gynecomastia,
nocturia, orchialgia, orchitis, painful menstruation, prostatitis,
impotence, sex hormone disorders, testicular atrophy, urinary tract
infection
Pygeum
Africanum
While
saw palmetto extract is the far better known herbal medication to
reduce the size of an enlarged prostate, pygeum may in many cases
be superior for the treatment of the condition. Pygeum
is an evergreen tree found in the higher elevations of central and
southern Africa. Its bark, once used as a tea for relief of urinary
disorders, has been found to contain not one, but three types of compounds
that relieve the symptoms of prostate enlargement BHP (benign prostatic
hyperplasia).
Pygeum
contains three groups of active components: Phytosterols such as beta-sitosterol;
pentacyclic triterpenoids, such as ursolic and oleanic acids; and
ferulic esters of fatty alcohols, particularly the ferulic esters
of docosanol and tetra-cosanol. The phytosterols constituents, beta-sitosterol
and beta-sitosterone , particularly beta-sitosterol are found in numerous
plants and are anti-inflammatory, inhibiting the synthesis of prostaglandins.
Beta-sitosterol, the most important of the three, interferes with
the formation of prostaglandins that cause inflammation and swelling
in the prostate. Beta-sitosterol has been shown to be useful in cases
of BPH by helping to reduce the normally elevated levels of prostaglandins
in these patients. The elimination of the excess blood and vasal congestion
helps reduce the size of prostate adenomas. The pentacyclic triter-penoids
(urosolic, oleanic and crataegolic acids), also help inhibit inflammation
by blocking enzymatic activity. They are effective anti-edema agents
and also help increase the integrity of small veins and capillaries.
The third active group, the ferulic esters (n-docosanol and tetracosanol),
long-chain fatty acids, act by inhibiting the absorption and metabolism
of cholesterol and combat enlargement by reducing levels of prolactin,
a hormone which promotes uptake of growth-promoting testosterone in
the prostate. Both prolactin and cholesterol increases binding sites
for DHT in the prostate. BPH and other cases of enlarged prostates
are characterized by containing abnormally high levels of cholesterol.
Pygeum also inhibits protein kinase C-induced proliferation of prostate
cells
European
scientists were so impressed with reports of pygeum's actions that
they began laboratory investigations into the active constituents
in the bark. This led to the development of the modern lipophilic
(fat soluble) extract used today.
Pygeum
africanum extract is available in many countries, including those
in central and eastern Europe, for the treatment of mild to moderate
BPH. Its efficacy and acceptability have been demonstrated in numerous
open and placebo-controlled studies in large populations. The present
open three-centre efficacy and safety study was conducted according
to common protocol at urology clinics in the Czech and Slovak Republics
and in Poland, in order to confirm the therapeutic profile of Pygeum
africanum in conditions of daily practice, using International Prostate
Symptom Score (IPSS) and flowmetry assessments. The changes in subjective
scores, IPSS and QoL (quality of life) after the two-month treatment
period were highly statistically significant with mean improvements
of 40% and 31%, respectively. Nocturnal frequency was reduced by 32%
and the mean reduction was again highly statistically significant.
Mean maximum urinary flow, average urinary flow and urine volume were
also statistically significantly improved, but the modest improvement
in post-voiding volume did not reach statistical significance. The
improvements, which exceeded those observed with placebo in earlier
studies, were maintained after one month without treatment indicating
an interesting persistence of clinically useful activity. Prostatic
volume and quality of sexual life remained unchanged throughout. No
treatment-related adverse effects were observed. In conclusion, under
conditions of daily practice, Pygeum africanum extract induces significant
improvement in IPSS and uroflowmetry parameters. These positive effects
are accompanied by a very satisfactory safety profile with the overall
result of a substantial improvement in QoL.
A study
by Swiss researchers R. Hartmann et al. demonstrate that extracts
of pygeum (Pygeum africanum Kalkman, Rosaceae) and nettle root (Urtica
dioica L., Urticaceae) partially blocked the action of two enzymes
involved in the body's production of dihydrotestosterone and estrogen.
The in vitro (laboratory) study showed that both pygeum and nettle
root extracts were effective in inhibiting these two enzymes (5alpha-reductase
and aromatase) and that a combination of the two plant extracts was
significantly more effective than either extract individually in blocking
aromatase activity.
Stinging
Nettle (Urtica Dioica)
Nettle
root extract was effective only at high concentrations, while pygeum
extract showed "a much higher efficacy" at lower doses.
The combination of the two extracts was as effective as pygeum against
5 a-reductase and significantly more effective than either against
aromatase. This study supports the use of combinations of these two
ingredients in the treatment of BPH. This is especially important
because pygeum bark is both expensive and limited in supply, while
nettle roots are easily produced on a large scale.
Stinging
nettle root contains both acid and neutral polysaccharides (2 glucans,
2 glucogalacturonans, and 1 arabinogalactan); sterols (0.2–1%
3-b-sitosterol, 0.05–0.2% sitosterol-3-b-D-glucoside); 0.1–0.2%
lectin U. dioica agglutinin or UDA composed of six isolectins; coumarin
(approximately 0.002–0.01% scopoletin); phenolic acids, phenylpropanoid
aldehydes, and alcohols; lignans (neo-olivil and derivatives); fatty
acids; tannins; and monoterpenes and triterpenes (Bruneton, 1995;
ESCOP, 1997; Leung and Foster, 1996; List and H"rhammer, 1979;
Newall et al., 1996; Wichtl and Bisset, 1994).
The
Commission E reported increased urinary volume, increased maximum
urinary flow, and reduced residual urine activities. Note: This preparation
relieves the symptoms of an enlarged prostate without reducing the
enlargement. Please consult a physician at regular intervals.
The
British Herbal Pharmacopoeia reported prostatic action (BHP, 1996).
Preliminary clinical observations of men after long-term treatment
with an alcoholic extract of nettle root reported improvement of bladder
outlet obstruction symptoms and decrease in post-voiding residual
urine (Bruneton, 1995). A study of BPH patients treated with a nettle
root alcoholic fluidextract reported a 66% decrease in residual urine;
another study reported a reduction of nocturnal micturition frequency
in patients over 60 years of age after six months of treatment with
a nettle root alcoholic tincture at 5 ml daily (ESCOP, 1997; Leung
and Foster, 1996). The active substances responsible for these actions
are unknown, which makes quality control and chemical or biological
standardization of extracts difficult (Bruneton, 1995; Wichtl and
Bisset, 1994).
Uses
The
Commission E approved the internal use of nettle root for difficulty
in urination in benign prostatic hyperplasia stages 1 and 2.
ESCOP
indicates its use for symptomatic treatment of micturition disorders
[nocturia (excessive nighttime urination), pollakisuria (frequent
urination), dysuria (painful urination), or urine retention] in BPH
stages 1 and 2 (ESCOP, 1997). The French Herbal Remedies Notice to
Applicants for Marketing Authorization allows two uses of nettle root:
as an adjunctive treatment for the bladder outlet obstruction symptoms
of prostatic origin, and to enhance the renal elimination of water
(Bruneton, 1995). It is used as a diuretic for conditions of dropsy
and also for early stages of prostatitis. In African medicine it is
used to treat diarrhea and as an anthelmintic to expel intestinal
worms (List and H"rhammer, 1979).
Corn
Silk (Zea mays)
As a soothing
diuretic, Corn Silk is helpful in any irritation of the urinary system.
It is used for renal problems in children and as a urinary demulcent
combined with other herbs in the treatment of cystitis, urethritis,
prostatitis and the like. Ellingwood suggests Corn Silk
in the following conditions: catarrhalcystitis, lithaemia(stones),
bladder irritation, gonorrhoea, all catarrhal conditions
of the urinary passages, dropsies due to heart disease, edema.
Constituents
: Saponins, Allantoin, Sterols, especially [[beta]]-sitosterol and
stigmasterol, the alkaloid hordenine, Vitamins C & K, cryptoxanthin,
anthocyanins, plant acids.
Buchu
(Barosma betulina)
The standard Buchus of commerce
are obtained from three species: Barosma betulina, known as
'shorts'; B. crenulata, known 'ovals' and 'shortbroads,' and
B. serratifolia, known as 'longs.' The leaves of the firstnamed
are most valued and constitute the foliea buchu of the British
Pharmacopoeia. The Hottentots use several species, all under the common
name of 'Bucku.' The leaves have a rue-like smell, and are used by
the natives to perfume their bodies. Buchu leaves are collected while
the plant is flowering and fruiting, and are then dried and exported
from Cape Town. The bulk of the Buchu exported to London from South
Africa eventually finds its way to America, where it is used in certain
proprietary medicines.
The principal constituents of
Buchu leaves are volatile oil and mucilage (volatile
oil: diosphenol (=buchu camphor), pulegone, (+) and (-) isopulegone,
8-mercapto-p-menthan-3-one, responsible for the black currant type
odour; 8-acetylthiomenthone, piperitone epoxide (+)-menthone, (-)-isomenthone,
p-cymol, limonene, terpineol, flavonoids: rutin, diosmin, hesperidin,
quercitin and derivatives miscellaneous: vitamins of the B group)
tannin and mucilage., also diosphenol, which has antiseptic
properties, and is considered by some to be the most important constituent
of Buchu its absence from the variety known as 'Long Buchu' has led
to the exclusion of the latter leaves from the British Pharmacopoeia.
The Cape Government exercises
strict control over the gathering of Buchu leaves and has lately made
the terms and conditions more onerous, in order to prevent the wholesale
destruction of the wild plants, no person being permitted to pick
or buy Buchu without a licence. Cultivation experiments with Buchu
have been made from time to time by private persons, and during the
war experiments were conducted at the National Botanic Gardens, Kirstenbosch
(near Cape Town), the result of which (given in the South African
Journal of Industries, 1919, 2, 748) indicate that, under suitable
conditions, the commercial cultivation of Buchu should prove a success,
B. betulina, the most valuable kind, being the species alone
to be grown. The plant is particularly adapted to dry conditions,
and may be cultivated on sunny hillsides where other crops will not
succeed.
Buchu has long been known at the
Cape as a stimulant tonic and remedy for stomachic troubles, where
it is infused in Brandy and known as Buchu Brandy. Its use was learnt
from the Hottentots. It was introdueed into official medicine in Great
Britain in 1821 as a remedy for cystitis urethritis, nephritis and
catarrh of the bladder.
Buchu may
be used in any infection of the genito-urinary system, such as cystitis,
urethritis and prostatitis. Its healing and soothing
properties indicate its use together with other relevant remedies
in many conditions of this system, especially useful where dysuria
is part of the symptom picture. The oil content may be too irritating
for people with a history of major kidney disease. Ellingwood
says that " it acts directly upon the urinary apparatus, stimulating
the kidneys . . . by its tonic and restorative influence. It relieves
irritation of the bladder and urethra, and is valuable in catarrh
of the bladder, pyelitis and gonorrhoea."
Juniper
Berries (Juniperus communis)
Juniper
Berries make an excellent antiseptic in conditions such as cystitis.
The essential oil present is quite stimulating to the kidney nephrons
and so this herb should be avoided in kidney disease. The bitter action
aids digestion and eases flatulent colic. It is used in rheumatism
and arthritis. Externally, is eases pain in the joints or muscles.
Constituents
:
Volatile
oil, containing mainly myrcene, sabinene andx-pinene, with
4-cineole, p-cymene, camphene, limonene, [[beta]]-pinene,
terpin-4--ol, y-terpinene, x-thujene.
Condensed
tannins; (+)-afzelechin, (-)-epiafzelechin, (+)-catechin, (-)-epicatechin,
(+)-gallocatechin and (+)-epigallocatechin l, 4-dimethyl-3-cyclohexen-l-yl,
methyl ketone
Diterpene
acids; myreocommunic, communic, sandaracopimaric, isopimaric, torulosic
acids and other diterpenes such as geijerone. Miscellaneous; sugars,
resin, vitamin C.
References:
Isolation
of the antiphlogistic principle from Epilobium angustifolium]. Hiermann
A; Reidlinger M; Juan H; Sametz W. Planta Med, 57(4):357-60 1991 Aug.
Inhibition
of 5 alpha-reductase and aromatase by the ellagitannins oenothein
A and oenothein B from Eqilobium species. Ducrey B; Marston A; Gohring
S; Hartmann RW; Hostettmann K.. Planta Med, 63(2):111-114 1997 Apr.
Determination
of oenothein B as the active 5-alpha-reductase-inhibiting principle
of the folk medicine Epilobium parviflorum. Lesuisse D, et al. J Nat
Prod, 59(5):490-492 1996 May.
Polyphenols
from Bulgarian medicinal plants with anti-infectious activity. Ivancheva
S; Manolova N; Serkedjieva J; Dimov V; Ivanovska N. Basic Life Sci,
59():717-28 1992.
Breza
J, Dzurny O, Borowka A, Hanus T, Petrik R, Blane G, Chadha-Boreham
H. Efficacy and acceptability of Pygeum africanum extract in the treatment
of benign prostatic hyperplasia (BPH): a multicentre trial in central
Europe. Department of Urology, University Hospital, Bratislava, Slovak
Republic.
Bassi,
P. et al. (1987) Standardized extract of Pygeum africanum in the treatment
of benign prostate hypertrophy. Minerva Urologica 39:45.
Hartmann,
R.W., Mark, M., and Soldati, F. 1996. Inhibition of 5 alpha-reductase
and aromatase by PHL-00801 (Prostatonin®), a combination of PY
102 (Pygeum africanum) and UR 102 (Uritca dioica) extracts. Phytomedicine
3(2):121-128.
Marcoli,
M. et al. (1985) New trends in Andro. Sci. 1:39.
Mowrey,
D. (1990) Guaranteed Potency Herbs. A compilation of writings on the
subject.
Simans,
A.J. et-al., (1998). “Passing Problems: Prostate and Prunus”.
ii.Flamm, J. et-al., (1979). “An urodynamic study of pateints
with benign prostatic hypertropohy treated conservatively with phytotherapy
or testosterone”. Wein Kin Wochenschr; 91: 622-627.
Thieblot,
L. et al. (1971) Action preventive d'un extrait d'ecorce de plante
africaine "Pygeum africanum" sur l'adenome prostatique experimental
chez le rat. (Preventative action of an African plant extract, "Pygeum
africanum" on experimental prostate adenoma in the rat) Therapie
26:575.
Zurita,
E.L. et al (1984) Treatment of prostatic hypertrophy with extract
African prunus. Rev. Bras. Med. 41:48.
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