Johns Hopkins Health Alert
Using Phytotherapy to Treat BPH: Advice From Dr. Brian R. Matlaga
A growing number of American men are turning to "natural" therapies to treat their benign prostatic hyperplasia or BPH, with or without their doctor's knowledge. In this Health Alert from the pages of our Special Report, The Best Treatment Strategies for BPH, Hopkins urologist Dr. Brian R. Matlaga talks about the risks and benefits of using herbal supplements to treat the symptoms of BPH.
Routinely prescribed in Europe for centuries, complementary medications (plant extracts or medical botanicals) have been largely ignored by the medical establishment in the United States because of a decided lack of rigorous or conclusive studies confirming their efficacy. A major reason for the dearth of research has to do with the differences in the extraction procedures and the natural variability in plants, which make it virtually impossible to compare various products containing the same extracts.
Even so, the demand for these natural herbal products is skyrocketing. Americans now spend more than $14 billion on complementary and alternative medications, which include vitamins, minerals, herbs, and other "natural" remedies. It's estimated that approximately $1 billion is spent on prostate health.
Many of the herbal supplements for BPH are derived from roots, seed, fruits, or bark. A product may use extracts from a single plant or a combination of plants. The plant extracts used in BPH formulas may contain phytosterols, plant oils, fatty acids, and phytoestrogens. At low doses, many experts say most of the natural phytotherapeutic remedies are probably safe. Their effectiveness, however, is in doubt.
Phytotherapeutic (phyto means "plant" in Latin) agents, encompassing dietary supplements, herbs, and botanicals, were the primary form of medicine in this country until the twentieth century. While there is certainly some benefit to the plant extracts, without appropriate studies, we will never know what dosage and how often a supplement should be taken. More importantly, though, is the fact that we really have no idea what the various BPH concoctions actually contain.
One study of 27 different brands of saw palmetto (a popular over-the-counter BPH remedy) reported that only 17 included the minimum ingredients required for the supplement to be effective -- (free fatty acids should comprise 85% of the extract's weight). In fact, several of the products tested had half of the free fatty acid content that was promised on the label.
Bottom Line Advice: For patients interested in going the herbal route, buy the least expensive brand of one of the supplements and try it for a month. If no improvement in BPH symptoms occurs, try another brand for another month and then possibly a third brand. If after three months BPH symptoms have not become less bothersome, reconsider your options: Standard prescription BPH medication or surgery may be indicated.
Posted in Enlarged Prostate on January 11, 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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