Natural Approaches to BPH

Men's Corner

Natural Approaches to BPH ⁺

Benign prostatic hyperplasia (BPH) is a common condition in men. Over 50% of men over 60 years, and 90% of men over 70 years show symptoms of BPH.¹ BPH is a non-cancerous enlargement of the prostate gland. Urinary symptoms, such as frequency, hesitancy, straining incomplete emptying, and dribbling, occur when the gland presses against the urethra. The bladder responds by becoming thicker and irritable. Nocturnal urges to urinate interrupt sleep as the irritated bladder becomes unable to store urine normally.

Men with symptoms of BPH should see a urologist. It is important to evaluate the severity of the condition and to rule out other illnesses, such as prostate cancer. Urinary retention is serious, and putting off seeing a physician can damage your bladder.

Natural or holistic approaches to management of BPH have been shown to be useful in men with mild to moderate symptoms^2,3 Some urologists use natural treatments alone or in conjunction with allopathic treatments, especially in early or mild stages of BPH.²

Herbs

Saw Palmetto Extract is derived from the berries of the American Dwarf Palm Tree. The active ingredients are plant sterols and fatty acids. Like the drugs Proscar and Avodart, Saw Palmetto inhibits the enzyme 5-alpha reductase.⁴ This enzyme is responsible for the conversion of testosterone to dihydrotestosterone (DHT). DHT is believed to be responsible for excessive growth of prostate tissue. Saw Plametto is milder than drugs that inhibit 5-alpha reductase. These drugs have side effects such as decreased libido, impotence, and reduced ejaculatory volume.

Twenty-one clinical trials, involving over 3,000 men, and two published meta-analysis show that Saw Palmetto produces improvement in men with mild to moderate urinary symptoms of BPH. Improvement is seen in frequency, pain, hesitancy, urgency, feeling of heaviness, and urinary retention.^5,6,7Saw Palmetto does not decrease the size of the prostate, but shrinks the inner lining of the gland. Extracts also show anti-inflammatory activity. Saw Palmetto was shown to be comparable to Proscar (finasteride) in effectiveness, but better tolerated, with fewer sexual side effects.⁷ The occurrence of impotence is significantly less than finasteride, with rates comparable to placebo groups.^5,6,7,8 Saw Palmetto is considered to be safe, with only mild side effects, the most common being GI upset. The herb should be taken with food.

Unlike Proscar, Saw Palmetto does not mask prosate cancer detection by lowering PSA levels.⁹ Saw Palmetto is not as effective as class of drugs called alpha-blockers (Minipress or Flomax). Alpha-blockers relax smooth muscle in the prostate and around the bladder neck. Alpha blockers, however have significant side effects: lowered blood pressure, dizziness, heart flutters and fatigue.

A study published early in 2006 determined that saw palmetto is not effective.¹⁰This study, however, was criticized because the patients who participated in the trial may have been to far advanced for saw palmetto to have been effective (read more). Saw Palmetto is recommended by multiple international government and professional groups, such as the German Commission E, the Canadian Natural Health Products Directorate, the European Scientific Cooperative on Phytotherapy, the World Health Organization as safe and effective for mild to moderate symptoms of BPH. ¹¹

Product selection is critical for effective treatment with Saw Palmetto. Extracts, which are dosed at 160 mg twice a day, must contain 80% to 95% fatty acids.³

Pygeum comes from the bark of Pygeum Africanum, otherwise known as the African Plum tree, a member of the rose family. Active ingredients are plant phytosterols. Pygeum's actions are anti-inflammatory, anti-swelling, and restorative to prostate glandular secretions. A meta-analysis of 18 randomized controlled trials involving over 1,500 men with BPH produced data that showed pygeum provided significant improvements in urinary symptoms and flow measurements.^12,13 Improvements observed were: 1) a 19% reduction in the frequency of night time waking to void, 2) a 24% reduction in volume of urine retained in the bladder after voiding, and 3) a 23% increase in peak urine flow rates. The herb appears to quite down abnormal, hyper-active growth of prostate tissue.¹⁴

Pygeum, which has a traditional use as an aphrodisiac, may increase androgen (male hormone) levels.³It does this without overstimulating the gland. Pygeum appears to have a direct calming effect on the bladder, an added benefit, not seen with Saw Palmetto. Preclinical research shows it calms hyper-sensitive bladders and may alleviate metabolic changes in the bladder associated with partial or complete obstruction.^3,15

Pygeum is well tolerated. Rare reports of side effects include GI discomfort or dizziness. High quality extracts are required to be effective. Extracts, which should be standardized to contain 14% triterpenes and 0.5% n-docosanol, are dosed at 50 to 100 mg twice a day.³

Stinging Nettle Root has anti-inflammatory, analgesic, anti-bacterial and anti-viral actions.³In cell cultures it inhibits growth of prostate cancer cells.¹⁶It may reduce activity of 5-alpha reductase, the enzyme responsible for the production of the "bad" male hormone, DHT. A laboratory study showed that the combination of Stinging Nettle and Pygeum worked better than either herb alone in reducing activity of two enzymes believed to be responsible for excessive growth prostate tissue: 5-alpha reductase and aromatase.²Aromatase changes testosterone to estrogen. As men age the ratio of estrogen to testosterone increases. An elevated estrogen to testosterone ratio is also believed to be responsible for excessive prostate growth.

Swedish Flower Pollen Extract (Cernitin™ manufactured by Graminex / AB Cernelle) has been used for over 40 years in Europe for BPH and prostatitis. It is a mixture of mostly rye grass pollen with other flower pollens. During the extraction of the pollens allergens are removed. Allergic reactions have not been reported in clinical trials of rye pollen extracts.²

Rye grass pollen extract, which contains beta-sterols, is anti-inflammatory on prostate tissue and relaxes urethra smooth muscle. Human studies show improvements improvement of symptoms in men with mild to moderate BPH. ^17,18,19ProstaFlow by Pure Encapsulations contains Cernitin™, the same flower pollen extract used in clinical trials.

Supplements, Vitamins, Minerals

Beta-sitosterol, a plant derived substance, has a chemical structure similar to cholesterol. It has been shown to be effective in reducing symptoms of BPH, increases urinary flow and reduces the volume of urine left in the bladder.^20,21Effective doses are in the range of 60 to 130 mg in two or three divided doses per day.

Beta-sitosterol has the added benefit of lowering cholesterol levels because it blocks absorption of cholesterol from the gut by as much as 50%. It is the active ingredient in the margarine Take Control. Pure Encapsulations makes a quality beta-sitosterol.

African wild potato, soy and pumpkin seeds contain beta-sitosterol.

Zinc and Vitamin B6 work together to maintain healthy hormone levels. Daily doses are in the range of 50 mg of B6 per day and 30 to 60 mg of zinc. Zinc supplements have been shown to shrink the prostate gland, although it is not recommended as a stand alone treatment. Long term zinc supplementation at doses greater than 40 mg a day can induce a copper deficiency.² Symptoms of copper deficiency are: anemia, low white blood cell counts, with impaired immune function and an increase in the ratio of bad cholesterol to good cholesterol (LDL/HDL). Zinc supplementation should include 2 to 3 mg of copper.

Garlic may improve symptoms of BPH. Although data for BPH symptoms is sparse, garlic has cardiovascular and immune system benefits. Dietary intake of one clove a day is associated with a 50% reduction in prostate cancer risk, according to one population based study.²² Garlitrin 4000 by Phytopharmica is a true one a day garlic that has 5,000 mcg of the active ingredient allicin per tablet.

Where to start

If, After consulting your doctor, you want to try natural therapies, Saw Palmetto is a good place to start. ProstaPro by PhytoPharmica is a quality product. Give it time, about 1 to 2 months. Saw Palmetto Plus by Pure Encapsulations is a good combination product containing saw palmetto, pygeum, pumpkin seed oil, and nettle. Alternatively Cerniten (ProstaFlo) or beta-sitosterol could be tried as stand alone products. Again, give it 1 to 2 months.

Remember, diet, exercise, and stress reduction are also important. Go through your cupboard and throw out all product that contain transfats (partly hydrogenated oils) or shortening. Eat fish or supplement fish oil. Use only fresh, minimally processed oils, such as extra virgin olive oil, flax, grape seed, or pumpkin seed oils. Get them at a whole foods store. Reduce omega-6 oils (corn, soy, safflower) and increase omega-3 oils (fish, flax oil). Reduce sugar and refined carbohydrates. Get rid of the chips and snack on nuts and seeds. Pumpkin seeds, walnuts and pecans are good choices.

⁺These statements have not been approved by the Food and Drug Administration. They are not intended to diagnose, treat, prevent or cure any disease. They are for information purposes only.

natural holistic approaches to BPH Benign Prostatic Hyperplasia Saw Palmetto Pygeum Stinging Nettle ProstaFlow ProstaPro Swedish Flower Pollen Extract

References:

1) National Kidney and Urologic Disease Information Clearing House, NIH, Feb, 2004 Link

2) Dr. Katz's Guide to Prostate Health, From Conventional to Holistic Therapies. Dr. Aaron E. Katz, MD, Freedom Press, 2006

3) Natural Medicines Comprehensive DataBase, Pharmacist's Letter / Perscriber's Letter, Jeff Jellin, Editor

4) Di Silverio F, Monti S, Sciarra A, et al. Effects of long-term treatment with Serenoa repens (Permixon) on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia. Prostate 1998;37:77-83.

5) Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998;280:1604-9.

6) Wilt T, Ishani A, Mac Donald R. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst rev 2002;(3):CD001423.

7) Gerber GS. Saw palmetto for the treatment of men with lower urinary tract symptoms. J Urol 2000;163:1408-12

8) Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40.

9) Gerber GS, Zagaja GP, Bales GT, et al. Saw palmetto (Serenoa repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Urol 1998;51:1003-7.

10) Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med 2006;354:557-66.

11) Herbalgram.org: New Clinical Trial on Saw Palmetto Inconsistent with Positive Results in Previous Studies, Clinical Evidence Supports Use of Saw Palmetto for Mild to Moderate Prostate Problems. Link

12) Wilt T, Ishani A, Mac Donald R, et al. Pygeum africanum for benign prostatic hyperplasia. Cochrane Database Syst Rev 2002;CD001044.

13) Ishani A, MacDonald R, Nelson D, et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med 2000;109:654-64.

14) Levin RM, Das AK. A scientific basis for the therapeutic effects of Pygeum africanum and Serenoa repens. Urol Res 2000;28:201-9.

15) Pygeum Africanum, Alternative Medicine Review, Vol 7 No1, 2002 Link

16) Konrad L, Muller HH, Lenz C, et al. Antiproliferative effect on human prostate cancer cells by a stinging nettle root (Urtica dioica) extract. Planta Med 2000;66:44-7.

17) Buck AC, Cox R, Rees RW, et al. Treatment of outflow tract obstruction due to benign prostatic hyperplasia with the pollen extract, cernilton. A double-blind, placebo-controlled study. Br J Urol 1990;66:398-404.

18) Rugendorff EW, Weidner W, Ebeling L, Buck AC. Results of treatment with pollen extract (Cernilton N) in chronic prostatitis and prostatodynia. Br J Urol 1993;71:433-8.

19) Yasumoto R, Kawanishi H, Tsujino T, et al. Clinical evaluation of long-term treatment using cernitin pollen extract in patients with benign prostatic hyperplasia. Clin Ther 1995;17:82-7.

20) Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol 1997;80:427-32.

21) Wilt TJ, MacDonald R, Ishani A. beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review. BJU Int 1999;83:976-83.

22) Key TJ, Silcocks PB, Davey GK, et al. A case-control study of diet and prostate cancer. Br J Cancer 1997;76:678-87.

Jurisdiction

Disclaimer and Privacy Policy



Men's Corner Natural Approaches to BPH ⁺ Benign prostatic hyperplasia (BPH) is a common condition in men. Over 50% of men over 60 years, and 90% of men over 70 years show symptoms of BPH.¹ BPH is a non-cancerous enlargement of the prostate gland. Urinary symptoms, such as frequency, hesitancy, straining incomplete emptying, and dribbling, occur when the gland presses against the urethra. The bladder responds by becoming thicker and irritable. Nocturnal urges to urinate interrupt sleep as the irritated bladder becomes unable to store urine normally. Men with symptoms of BPH should see a urologist. It is important to evaluate the severity of the condition and to rule out other illnesses, such as prostate cancer. Urinary retention is serious, and putting off seeing a physician can damage your bladder. Natural or holistic approaches to management of BPH have been shown to be useful in men with mild to moderate symptoms^2,3 Some urologists use natural treatments alone or in conjunction with allopathic treatments, especially in early or mild stages of BPH.² Herbs *Saw Palmetto Extract* is derived from the berries of the American Dwarf Palm Tree. The active ingredients are plant sterols and fatty acids. Like the drugs Proscar and Avodart, Saw Palmetto inhibits the enzyme 5-alpha reductase.⁴ This enzyme is responsible for the conversion of testosterone to dihydrotestosterone (DHT). DHT is believed to be responsible for excessive growth of prostate tissue. Saw Plametto is milder than drugs that inhibit 5-alpha reductase. These drugs have side effects such as decreased libido, impotence, and reduced ejaculatory volume. Twenty-one clinical trials, involving over 3,000 men, and two published meta-analysis show that Saw Palmetto produces improvement in men with mild to moderate urinary symptoms of BPH. Improvement is seen in frequency, pain, hesitancy, urgency, feeling of heaviness, and urinary retention.^5,6,7Saw Palmetto does not decrease the size of the prostate, but shrinks the inner lining of the gland. Extracts also show anti-inflammatory activity. Saw Palmetto was shown to be comparable to Proscar (finasteride) in effectiveness, but better tolerated, with fewer sexual side effects.⁷ The occurrence of impotence is significantly less than finasteride, with rates comparable to placebo groups.^5,6,7,8 Saw Palmetto is considered to be safe, with only mild side effects, the most common being GI upset. The herb should be taken with food. Unlike Proscar, Saw Palmetto does not mask prosate cancer detection by lowering PSA levels.⁹ Saw Palmetto is not as effective as class of drugs called alpha-blockers (Minipress or Flomax). Alpha-blockers relax smooth muscle in the prostate and around the bladder neck. Alpha blockers, however have significant side effects: lowered blood pressure, dizziness, heart flutters and fatigue. A study published early in 2006 determined that saw palmetto is not effective.¹⁰This study, however, was criticized because the patients who participated in the trial may have been to far advanced for saw palmetto to have been effective (read more). Saw Palmetto is recommended by multiple international government and professional groups, such as the German Commission E, the Canadian Natural Health Products Directorate, the European Scientific Cooperative on Phytotherapy, the World Health Organization as safe and effective for mild to moderate symptoms of BPH. ¹¹ Product selection is critical for effective treatment with Saw Palmetto. Extracts, which are dosed at 160 mg twice a day, must contain 80% to 95% fatty acids.³ Pygeum comes from the bark of Pygeum Africanum, otherwise known as the African Plum tree, a member of the rose family. Active ingredients are plant phytosterols. Pygeum's actions are anti-inflammatory, anti-swelling, and restorative to prostate glandular secretions. A meta-analysis of 18 randomized controlled trials involving over 1,500 men with BPH produced data that showed pygeum provided significant improvements in urinary symptoms and flow measurements.^12,13 Improvements observed were: 1) a 19% reduction in the frequency of night time waking to void, 2) a 24% reduction in volume of urine retained in the bladder after voiding, and 3) a 23% increase in peak urine flow rates. The herb appears to quite down abnormal, hyper-active growth of prostate tissue.¹⁴ Pygeum, which has a traditional use as an aphrodisiac, may increase androgen (male hormone) levels.³It does this without overstimulating the gland. Pygeum appears to have a direct calming effect on the bladder, an added benefit, not seen with Saw Palmetto. Preclinical research shows it calms hyper-sensitive bladders and may alleviate metabolic changes in the bladder associated with partial or complete obstruction.^3,15 Pygeum is well tolerated. Rare reports of side effects include GI discomfort or dizziness. High quality extracts are required to be effective. Extracts, which should be standardized to contain 14% triterpenes and 0.5% n-docosanol, are dosed at 50 to 100 mg twice a day.³ Stinging Nettle Root has anti-inflammatory, analgesic, anti-bacterial and anti-viral actions.³In cell cultures it inhibits growth of prostate cancer cells.¹⁶It may reduce activity of 5-alpha reductase, the enzyme responsible for the production of the "bad" male hormone, DHT. A laboratory study showed that the combination of Stinging Nettle and Pygeum worked better than either herb alone in reducing activity of two enzymes believed to be responsible for excessive growth prostate tissue: 5-alpha reductase and aromatase.²Aromatase changes testosterone to estrogen. As men age the ratio of estrogen to testosterone increases. An elevated estrogen to testosterone ratio is also believed to be responsible for excessive prostate growth. Swedish Flower Pollen Extract (Cernitin™ manufactured by Graminex / AB Cernelle) has been used for over 40 years in Europe for BPH and prostatitis. It is a mixture of mostly rye grass pollen with other flower pollens. During the extraction of the pollens allergens are removed. Allergic reactions have not been reported in clinical trials of rye pollen extracts.² Rye grass pollen extract, which contains beta-sterols, is anti-inflammatory on prostate tissue and relaxes urethra smooth muscle. Human studies show improvements improvement of symptoms in men with mild to moderate BPH. ^17,18,19ProstaFlow by Pure Encapsulations contains Cernitin™, the same flower pollen extract used in clinical trials. Supplements, Vitamins, Minerals Beta-sitosterol, a plant derived substance, has a chemical structure similar to cholesterol. It has been shown to be effective in reducing symptoms of BPH, increases urinary flow and reduces the volume of urine left in the bladder.^20,21Effective doses are in the range of 60 to 130 mg in two or three divided doses per day. Beta-sitosterol has the added benefit of lowering cholesterol levels because it blocks absorption of cholesterol from the gut by as much as 50%. It is the active ingredient in the margarine Take Control. Pure Encapsulations makes a quality beta-sitosterol. African wild potato, soy and pumpkin seeds contain beta-sitosterol. Zinc and Vitamin B6 work together to maintain healthy hormone levels. Daily doses are in the range of 50 mg of B6 per day and 30 to 60 mg of zinc. Zinc supplements have been shown to shrink the prostate gland, although it is not recommended as a stand alone treatment. Long term zinc supplementation at doses greater than 40 mg a day can induce a copper deficiency.² Symptoms of copper deficiency are: anemia, low white blood cell counts, with impaired immune function and an increase in the ratio of bad cholesterol to good cholesterol (LDL/HDL). Zinc supplementation should include 2 to 3 mg of copper. Garlic may improve symptoms of BPH. Although data for BPH symptoms is sparse, garlic has cardiovascular and immune system benefits. Dietary intake of one clove a day is associated with a 50% reduction in prostate cancer risk, according to one population based study.²² Garlitrin 4000 by Phytopharmica is a true one a day garlic that has 5,000 mcg of the active ingredient allicin per tablet. Where to start If, After consulting your doctor, you want to try natural therapies, Saw Palmetto is a good place to start. ProstaPro by PhytoPharmica is a quality product. Give it time, about 1 to 2 months. Saw Palmetto Plus by Pure Encapsulations is a good combination product containing saw palmetto, pygeum, pumpkin seed oil, and nettle. Alternatively Cerniten (ProstaFlo) or beta-sitosterol could be tried as stand alone products. Again, give it 1 to 2 months. Remember, diet, exercise, and stress reduction are also important. Go through your cupboard and throw out all product that contain transfats (partly hydrogenated oils) or shortening. Eat fish or supplement fish oil. Use only fresh, minimally processed oils, such as extra virgin olive oil, flax, grape seed, or pumpkin seed oils. Get them at a whole foods store. Reduce omega-6 oils (corn, soy, safflower) and increase omega-3 oils (fish, flax oil). Reduce sugar and refined carbohydrates. Get rid of the chips and snack on nuts and seeds. Pumpkin seeds, walnuts and pecans are good choices. ⁺These statements have not been approved by the Food and Drug Administration. They are not intended to diagnose, treat, prevent or cure any disease. They are for information purposes only. natural holistic approaches to BPH Benign Prostatic Hyperplasia Saw Palmetto Pygeum Stinging Nettle ProstaFlow ProstaPro Swedish Flower Pollen Extract References: 1) National Kidney and Urologic Disease Information Clearing House, NIH, Feb, 2004 Link 2) Dr. Katz's Guide to Prostate Health, From Conventional to Holistic Therapies. Dr. Aaron E. Katz, MD, Freedom Press, 2006 3) Natural Medicines Comprehensive DataBase, Pharmacist's Letter / Perscriber's Letter, Jeff Jellin, Editor 4) Di Silverio F, Monti S, Sciarra A, et al. Effects of long-term treatment with Serenoa repens (Permixon) on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia. Prostate 1998;37:77-83. 5) Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998;280:1604-9. 6) Wilt T, Ishani A, Mac Donald R. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst rev 2002;(3):CD001423. 7) Gerber GS. Saw palmetto for the treatment of men with lower urinary tract symptoms. J Urol 2000;163:1408-12 8) Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40. 9) Gerber GS, Zagaja GP, Bales GT, et al. Saw palmetto (Serenoa repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Urol 1998;51:1003-7. 10) Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med 2006;354:557-66. 11) Herbalgram.org: New Clinical Trial on Saw Palmetto Inconsistent with Positive Results in Previous Studies, Clinical Evidence Supports Use of Saw Palmetto for Mild to Moderate Prostate Problems. Link 12) Wilt T, Ishani A, Mac Donald R, et al. Pygeum africanum for benign prostatic hyperplasia. Cochrane Database Syst Rev 2002;CD001044. 13) Ishani A, MacDonald R, Nelson D, et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med 2000;109:654-64. 14) Levin RM, Das AK. A scientific basis for the therapeutic effects of Pygeum africanum and Serenoa repens. Urol Res 2000;28:201-9. 15) Pygeum Africanum, Alternative Medicine Review, Vol 7 No1, 2002 Link 16) Konrad L, Muller HH, Lenz C, et al. Antiproliferative effect on human prostate cancer cells by a stinging nettle root (Urtica dioica) extract. Planta Med 2000;66:44-7. 17) Buck AC, Cox R, Rees RW, et al. Treatment of outflow tract obstruction due to benign prostatic hyperplasia with the pollen extract, cernilton. A double-blind, placebo-controlled study. Br J Urol 1990;66:398-404. 18) Rugendorff EW, Weidner W, Ebeling L, Buck AC. Results of treatment with pollen extract (Cernilton N) in chronic prostatitis and prostatodynia. Br J Urol 1993;71:433-8. 19) Yasumoto R, Kawanishi H, Tsujino T, et al. Clinical evaluation of long-term treatment using cernitin pollen extract in patients with benign prostatic hyperplasia. Clin Ther 1995;17:82-7. 20) Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol 1997;80:427-32. 21) Wilt TJ, MacDonald R, Ishani A. beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review. BJU Int 1999;83:976-83. 22) Key TJ, Silcocks PB, Davey GK, et al. A case-control study of diet and prostate cancer. Br J Cancer 1997;76:678-87. Jurisdiction Disclaimer and Privacy Policy		Buy ProstaFlo ProstaFlow by Pure Encapsulations contains Cernitin™ Swedish Flower Pollen Extract. ProstaFlow Product Data Sheet Saw Palmetto Plus by Pure Encapsulations contains Saw Palmetto, Pygeum, Nettle Root and Pumpkin Seed Oil Saw Palmetto Plus #60 softgels Saw Palmetto Plus #120 softgels Saw Palmetto Plus #250 softgels Beta-sitosterol Beta-Sitosterol Product Data Sheet Shop Men's Health Saw Palmetto Complex Comment On NEJM Saw Palmetto Study February 2006 PureWeigh Weight Management NanoGreens 10 ProGreens Home