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October 2000

Letter from Dr. Janson
Prostate Health
Prostate Problems
Diet for Prostate Health
Lifestyle and The Prostate
Supplements for The Prostate
St. John's Wort and PMS
In the Health News
Recipe of the Month: Desserts You Can Live With
References

Letter from Dr. Janson
Dear Friends,
Although alternative medicine is increasingly in the atmosphere of medical institutions, the use of natural remedies still seems to disturb physicians when it is seen as a replacement for drug therapies. This tendency is seen in a recent medical article critical of using herbs for depression and other illnesses, followed by yet another article showing the safety and benefits of St. John’s wort for depression.

It also seems true regarding treatments for the prostate gland, for inflammation, benign prostatic hyperplasia, or cancer. Here is a review for men (and the women who love them) of a comprehensive approach to maintaining prostate health.

Prostate Health
You can do a lot with natural remedies to prevent and treat prostate problems. The prostate gland is a male organ about the size of a walnut that sits below and behind the bladder, made up of glandular tissue, ducts, muscle tissue, and fibrous tissue. It surrounds the urethra, the urine outflow tract from the bladder, and it produces prostatic fluids that combine with sperm from the testicles and other secretions to form semen. These fluids help sperm survive and improve their motility.

Some prostate muscle fibers surround the urethra and help with urination. With orgasm, the muscles push some of the prostate fluid with some of the sperm from the testicles into the urethra and out through the penis. Although it is small, its strategic location leads to far more health problems and medical care costs than would be predicted from its size alone.

Prostate Problems
More than 50 percent of men over the age of forty have prostate enlargement (benign prostatic hyperplasia, or BPH), and after eighty it is 80 to 90 percent, leading to urinary symptoms. Surgery to remove prostate tissue is a common procedure, but not always necessary. About 10 percent of men end up having prostate surgery at some time, but natural treatments may help men avoid it.

The prostate can become inflamed as a result of infection with bacteria, or even more frequently other organisms, leading to local aching, pain, and burning on urination. This prostatitis, can be acute or chronic. The prostate is also subject to cellular changes that lead to cancer, the most common cancer in men. Prostate cancers are often undiagnosed, and only found at autopsy when a man dies from other causes. As with many other cancers, diet and lifestyle may play a significant role in the development of prostate cancer.

Natural remedies are usually the best way to prevent and treat all prostate problems, including BPH, prostatitis, and cancer, although conventional treatments are sometimes necessary to relieve symptoms, pain, and obstruction of the urine flow.

Diet for Prostate Health
Diets low in saturated fat and high in carotenoids, flavonoids, antioxidants, vitamins, and minerals are beneficial for prostate health. These are primarily vegetables and fruits. Studies have linked increased consumption of animal fats to the development of advanced prostate cancer.

Protective foods also include whole grains, nuts, seeds, fish, and soy foods. For men with prostate cancer, the risk of dying from it was tripled among those with the highest animal fat consumption compared to those with the lowest. Diets that are rich in plant-based nutrients also help BPH. Avoid hydrogenated oils that interfere with normal fatty acid function.

Contamination of foods with pesticides and hormones is a further problem related to food choices. Both of these affect hormone balance, and as a result can interfere with prostate tissue. Choosing organic foods is best, especially if you choose to consume meat, chicken, and dairy products.

Lifestyle and The Prostate
Regular exercise is also helpful for prevention of BPH. Men who walked two to three hours a week had a much lower risk of developing prostate enlargement and a lower risk of ever needing prostate surgery. Physical activity also reduced symptoms in men with BPH. In general, moderate exercise also lowers cancer risks.

Smoking increases symptoms of BPH for reasons that are not clear. Perhaps it interferes with nutritional factors or hormones. It is clearly associated with increased risk of prostate cancer. Small amounts of alcohol, on the other hand, were associated with decreased symptoms. However, with larger intakes of alcohol, the apparent benefits were lost. Coffee drinking appears to increase the risk of prostate cancer but tea does not.

Supplements for The Prostate
Many supplements help relieve the urinary tract symptoms of BPH, as well as prevent and treat prostate cancer. They also help reduce the symptoms of inflammation,or prostatitis. Specific supplements for treatment include zinc and vitamin E, essential fatty acids such as GLA (240 mg from borage oil), and omega-3 oils such as flaxseed oil (1 to 2 tablespoons a day) or fish oil (600 to 1200 mg of omega-3 oils per day).

If you have symptoms, you should also consider taking botanical products such as saw palmetto (300 to 500 mg daily of standardized extract), pygeum (50 to 75 mg), and nettle (500 to 750 mg).

Saw palmetto (Serenoa repens) is the extract of a berry from a small palm tree that grows on the southeastern coast of the United States. In many studies it has been shown to help prostate symptoms. In fact, in comparing it with the approved drug Proscar, it does a better job of reducing frequency, urgency, nighttime urinations, difficulty starting and stopping urine flow, and the amount of residual urine left in the bladder.

It has been common to recommend large doses of zinc for BPH, in the range of 100 to 150 mg daily. However, I now recommend only 30 to 80 mg. Very large doses can interfere with normal copper absorption and they may lower the good HDL cholesterol levels. When you take a variety of nutrients for prostate treatment, larger doses of zinc are unnecessary.

For prostate cancer, and other cancers, I suggest high doses of vitamin C (in the range of 10 grams a day), plus extra selenium, an anti-free radical mineral, and large doses of coenzyme Q10 (400 mg a day or more in a chewable form for better absorption). I would also add some Chinese herbs (one of the brands, called PC-SPES, has been shown to reverse prostate cancer, but it may also have some estrogenic side effects).

Other supplements for cancer may also help, including calcium D-glucarate, beta 1-3 glucan, and transfer factor, all to support immune function or detoxification. This comprehensive program prevents and treats prostate problems.

St. John’s Wort and PMS
A new article shows that St. John’s wort helps with premenstrual syndrome to relieve the anxiety and depression that often accompanies it. Although it was only a pilot study, it is an important indicator. This is only part of a complete treatment program for PMS. Women with PMS also benefit from better diets (no sugar or hydro genated oils), regular exercise, and meditation. In addition, I usually recommend supplements of GLA(240 mg), magnesium (500 to 1000 mg), vitamin E (400 IU), and vitamin B6 (250 mg) as part of a comprehensive program for PMS.

Although I covered St. John’s wort and depression in August, a new report in the September issue Psychiatric Services requires comment. An article cautioned against using herbs, such as St. John’s wort, for psychiatric symptoms, kava kava and valerian for anxiety, and ginkgo for memory, suggesting that the supportive information is not yet certain.

These authors are operating under the misconception that psychiatric drugs in common use are certain in their benefits and in their risk-benefit ratio. This is not true. Controversy abounds in this field, and the drugs have many side effects, and sometimes serious consequences.

Even though there may be faults with some of the herb studies, they consistently show benefits with minimal risk of a few mild side effects. Even these authors pointed out that in all of the controlled studies, St. John’s wort was better than placebo and as effective as the drugs, but far safer.

It seems to me that their caution is misplaced because in the same month yet another study appeared showing that St. John’s wort was better than antidepressant drugs for mild to moderate psychiatric depression. Just how much proof do they need?

Regarding ginkgo, 39 of 40 controlled studies showed benefits for memory loss, concentration, fatigue, anxiety, and depression, but still the authors were not convinced! If it were me or my family members, I would certainly want to try ginkgo, considering the side benefits of improved circulation that ginkgo provides. (I combine ginkgo with phosphatidyl serine for greater benefits to brain function.)

The review showed similar support for kava kava and valerian for anxiety and sleep disturbances.

Ginkgo and Ginseng Together
It appears from some recent reports that ginkgo and ginseng work together to improve memory and cognitive function in adults. At a meeting of the World Psychiatry Congress in Brussels, a Dr. Wesnes updated his study from 1997, reporting improved attention, concentration, and hand-eye coordination. These results confirm that natural products help the brain.

It is thought that ginkgo works on the small blood vessels in the brain to improve circulation. It is also beneficial in other circulatory disorders, such as claudication, visual disturbances, migraines, and Raynaud’s phenomenon (spasms of the blood vessels in the hands in response to cold).

A number of studies have shown that American ginseng (Panax quinquefolium) and Korean ginseng (Panax ginseng) can help memory and performance in animals when challenged with certain brain-impairing drugs.

It has also been shown that ginkgo and vitamin E can significantly delay the progression of Alzheimer’s disease. In learning-disabled children, supplements of magnesium, B-vitamins, zinc, and vitamin C can boost performance.

In the Health News
•A diet that is mainly vegetarian lowers both blood pressure and homocysteine levels, but it is better to include some fish, nuts, and seeds in the diet. In the hypertension study, the diet was reduced in fats, red meats, sweets, and sugar-containing beverages (Conlin PR, et al., Am J Hypertens 2000 Sep;13(9):949-55), but adding whole grains, nuts, and the animal products (not red meat) improved results, probably because the omega-3 oils in fish and nuts have an antihypertensive effect. In the homocysteine study (Appel LJ, Circulation 2000 Aug 22;102:852-857) the combination diet also was better at lowering homocysteine, a risk factor for heart disease. These authors conclude that it is clear that heart disease is the result of adverse lifestyle habits, and that it is preventable.

• I used to say that if someone needed high dose B12 they would have to take injections, but in recent studies (Delpre G, et al., Lancet 1999 Aug 28;354(9180):740-1) it turns out that sublingual B12 in high doses is adequate for most purposes. Daily doses of 1000 to 2000 mcg provide significant increases in blood levels in only a few days (although it is possible that some people might benefit even more from injections).

Diet and Disease
• Another study refutes the position of antagonists to whole grains in the diet (Liu S, et al., Am J Public Health 2000 Sep;90(9):1409-15). This report shows that whole grains (whole wheat, brown rice,oatmeal, etc.) reduce the risk of type 2 diabetes, while refined grains increased the risk. The results were not explained by dietary fiber, magnesium, or vitamin E intake. The authors speculate that the benefit might be due to phytochemicals or antioxidants other than the usual vitamins.

Recipe of the Month
Desserts You Can Live With

We all like some treats, and here is a healthy one. Buy some silken tofu (custardy consistency) and put it in a food processor (I use a VitaMix) with frozen bananas, carob powder, natural vanilla, and a small amount of honey or maple syrup–it makes a great pudding, served with some shredded almonds and coconut on top.

Another simple dessert idea: bake a banana in its peel (with a small slit in it) until its soft and the peel is black, squeeze it open from the ends, add a few drops of vanilla, a sprinkle of cinnamon, and serve it in the skin with a spoon. It is a real treat, takes little effort, and it will wow your guests.

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References

Prostate Health:
Hayes RB, et al., Dietary factors and risks for prostate cancer
among blacks and whites in the United States. Cancer Epidemiol
Biomarkers Prev 1999 Jan;8(1):25-34.

Hebert JR, et al., Nutritional and socioeconomic factors in
relation to prostate cancer mortality: a cross-national study.
J Natl Cancer Inst 1998 Nov 4;90(21):1637-47.

Fradet Y, et al., Dietary fat and prostate cancer progression
and survival. Eur Urol 1999;35(5-6):388-91.

Platz EA, et al., Physical activity and benign prostatic
hyperplasia. Arch Intern Med 1998 Nov 23;158(21):2349-56.

Platz EA, et al., Alcohol consumption, cigarette smoking,
and risk of benign prostatic hyperplasia. Am J
Epidemiol 1999 Jan 15;149(2):106-15.

Pfeifer BL, et al., PC-SPES, a dietary supplement for the
treatment of hormone-refractory prostate cancer.
BJU Int 2000 Mar;85(4):481-5.

St. John's Wort and PMS:
Beaubrun G, Gray GE A review of herbal medicines for psychiatric
disorders. Psychiatr Serv 2000 Sep;51(9):1130-4.

Woelk H, Comparison of St John’s wort and imipramine for
treating depression: randomised controlled trial.
BMJ 2000 Sep 2;321(7260):536-539.

Stevinson C, Ernst E, A pilot study of Hypericum perforatum
for the treatment of premenstrual syndrome.
BJOG 2000 Jul;107(7):870-6.

Ginkgo and Ginseng:
Wesnes KA, et al., The cognitive, subjective, and physical
effects of a ginkgo biloba/panax ginseng combination in
healthy volunteers with neurasthenic complaints.
Psychopharmacol Bull 1997;33(4):677-83.

Wesnes K, as reported in Prescription for Health, 2000 Sep.

Oken BS, et al., The efficacy of Ginkgo biloba on cognitive
function in Alzheimer disease.
Arch Neurol 1998 Nov;55(11):1409-15.

Carlton RM, et al., Rational dosages of nutrients have a
prolonged effect on learning disabilities.
Altern Ther Health Med 2000 May;6(3):85-91.

 


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CONSULTATIONS:

From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
Rothfeld Center for Integrative Medicine in Waltham, Massachusetts. For appointments, send an email to make arrangements, or call: 386-409-7747.

I primarily do phone consultations, as well as email and instant messaging consults.


Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.

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