PROSTATE ENLARGEMENT
FOR A GLAND THE SIZE OF A WALNUT, the prostate manages to cause men a lot of trouble. Basic anatomy explains the problem: the prostate wraps around the base of the urethra, the tube that transports urine from the bladder to the penis. Consequently, when the gland enlarges, it can obstruct the flow of urine.
Early symptoms of prostate enlargement commonly affect men in their mid- to late forties, though symptoms can occur earlier. A little urinary hesitation is often the first sign that something is amiss, and what once happened effortlessly seems to require a few minutes of straining to get started. A long-term sensation of pressure or urgency may develop and, over time, it becomes increasingly difficult to fully empty the bladder. This means an increased risk of bladder infection as well as distrubed sleep and restless nights from the need to make frequent trips to the toilet. In severe cases, urine can back up into the kidneys and damage them.
When the prostate gland enlarges for reasons other than cancer or infection, doctors call the condition benign prostatic hypertrophy (BPH). BPH is one of the most common of all health problems that is experienced by men. In fact, it has been estimated that 50 to 60 per cent of men between the ages of 40 and 60, and up to 90 per cent of men over 80, have some degree of BPH. Treatment can require surgery and a stay in hospital.
EATING FOR A HEALTHY PROSTATE
Herbs are only one alternative to drug treatment
for prostate enlargement. Here are a few others.
Zap problems with zinc. This mineral has been shown to inhibit an enzyme
that fosters prostate enlargement. Rich dietary sources of zinc include oysters
and other shellfish, red meat, ginger, eggs, nuts, seeds and grains. Experts
usually recommend that men with benign prostatic hypertrophy (BPH) take 25
to 60 milligrams of zinc per day.
Push the protein. High protein diets (in which 45 per cent of daily calories come from protein) have been shown to block the same enzyme that zinc affects, while diets containing less than 10 per cent protein can increase DHT (dihydrotestosterone), the `bad' testosterone. Soya protein is especially helpful. It's high in hormone-like substances called isoflavones that block the effects of excessive oestrogen as well as inhibit compounds that build DHT. It also contains compounds called phytosterols that have been shown to increase urinary flow. For optimal results, eat 90 to 120 grams of soyabeans, tofu, tempeh or powdered soya protein every day.
Go fish or go flax. Essential fatty acids derived from salmon, mackerel, haddock, cod or flaxseed can alleviate the symptoms of BPH. These oils appear to work by decreasing inflammation, which may be a contributing cause of prostate enlargement. Flaxseed is best consumed as a meal made from the fresh ground seeds. Typical dosage: Mix 2 to 4 tablespoons into a milkshake or `smoothie' or sprinkle it on food daily. If you just want to eat fish instead, 3 to 4 servings per week is recommended.
Turn on to tomatoes. These red wonders
may turn out to be the miracle food for keeping your prostate healthy. Tomatoes
are very high in lycopene, an antioxidant pigment similar to beta-carotene
but much more potent, at least where the prostate is concerned. The lycopene
in fresh tomatoes does not appear to be absorbed very well, but cooking increases
its absorbability, especially when it is combined with oil. Particularly
good dietary sources of lycopene include organic ketchup and organic tomato
puree. Lycopene is also available in tablet form. Typical dosage: 10 to 30
milligrams per day.
DON'T SELF-DIAGNOSE THIS CONDITION
The symptoms of an enlarged prostate can strike fear into the hearts of grown
men. Yet many cases of benign prostatic hypertrophy (BPH) are mild and
respond well to simple preventive treatments early on. Nevertheless, an
enlarged prostate gland, because of its location, can hide prostate cancer
by making it more difficult to diagnose. That's why if you have BPH symptoms
it's crucial not to suffer in silence - no matter how much you hate going
to the doctor. Don't put off that visit: chances are the news will be good.
Why is BPH so common? Experts believe that two things are to blame: normal hormonal changes that occur as men age and environmental factors.
Hormone levels shift for men in mid-life just as they do for women. Research shows that testosterone - the predominant male hormone - begins to decline while oestrogen and prolactin - the 'female' hormones - show a relative increase. As blood levels of testosterone drop, however, the rate of this hormone's conversion into a compound called dihydrotestosterone (DHT) actually increases, especially in the prostate gland. Enlarged prostates can have four to six times the normal amount of DHT. And there lies the problem: DHT makes prostate cells grow.
Certain toxic organic chemicals appear to make DHT build up in the prostate. Many of these toxins are residues of industrial solvents and pesticides. Cadmium, a toxic heavy metal, has been shown to increase prostatic DHT. So has elevated cholesterol. Fortunately, this increased production of DHT can be blocked by dietary changes, some drugs and herbs.
DRUG TREATMENT
Alpha-Adrenergic Receptor Antagonists
Terazosin (Hytrin), doxazosin (Cardura), prazosin (Hypovase).
Function: relax the smooth muscles of the prostate and bladder neck to allow
easier urination. Side effects: fatigue, dry mouth, headaches, dizziness,
low blood pressure.
Other Drugs
Finasteride (Proscar). Function: decreases blood levels of dihydrotestosterone
and the size of the prostate gland; effective in only about 30 per cent of
men. Side effects: loss of libido, impotence.
HERBAL REMEDIES
Saw Palmetto (Serenoa repens)
Although this plant grows wild in the coastal regions of Florida, south Carolina
and Georgia, most of the research on its clinical effects has occurred in
Germany, France and Italy. Urologists in these countries have been successfully
treating BPH with an extract of saw palmetto berries for
many years. More than 17 studies confirm its effectiveness and safety; one
compared it to finasteride and found that the herb worked just as well as
the drug but with fewer side effects. Typical dosage: 160 milligrams of a
fat-soluble extract standardised to contain 85 to 95 per cent fatty acids
and sterols, two times per day, for several months. (It may take that long
before the saw palmetto's full effect is achieved, but it can safely be taken
indefinitely.)
Pygeum (Prunus africanum)
This evergreen prune tree grows in the mountains of Africa. Extracts made
from its bark have been used in Europe for more than 30 years to treat BPH.
The bark appears to contain compounds that work together to decrease swelling
and inflammation in the prostate and to block the detrimental effects of
testosterone. At least nine published studies involving hundreds of men have
demonstrated that pygeum improves urinary flow, decreases night-time urination,
and enhances quality of life for those with BPH. While the herb appears.
to work well, especially in combination with saw palmetto, one concern is
that pygeum has been overharvested and is on the verge of becoming an endangered
species. Therefore some herbalists recommend saving pygeum for when other
herbs haven't worked. Typical dosage: 50 to 100 milligrams of a product standardised
to contain 14 per cent triterpenes and 0.5 per cent n-docosanol two times
per day. Caution: some men may experience mild stomach upset when taking
pygeum.
Stinging Nettle (Urtica dioica)
Herbalists have long used this common weed as a diuretic. While it has not
been studied as thoroughly as saw palmetto or pygeum, research has shown
that extracts of the root do have antiinflammatory properties and can
relieve symptoms of an enlarged prostate. Since stinging nettle root does
not appear to shrink an enlarged gland, it is best used in combination with
saw palmetto. Typical dosage: 300 to 600 milligrams of nettle root extract
per day; or to 1 teaspoon of tincture per day. Caution: may cause mild upset
stomach or occasional diarrhoea.
Pumpkin (Curcubita pepo)
Raw pumpkin seeds have long been a popular folk remedy for expelling intestinal
worms and parasites. In the Ukraine they are also used to treat prostate
inflammation. Pumpkin seed oil is often combined with saw palmetto in formulas
for BPH. Researchers have found that pumpkin seed oil increases urine flow;
it also contains other ingredients that might help BPH. Typical dosage: about
3 tablespoons of ground seeds per day; or 500 to 600 milligrams of pumpkin
seed oil in capsules per day.
