My 102 year-old father-in-law moved in with us June 2015.
I found that he has to urinate 3 times per night
reviewed people's comments on web forums to see what works.
The following are the scientific studies of of what people have found to work
I have decided to try him on the best three concurrently, and perhaps later narrow down to what is needed.
Table of contents
How the herbs help - Nov 2014
The Pharmacological Effects of Natural Products and Herbs in Benign Prostatic Hyperplasia
Austin J Nutri Food Sci. 2014;2(10): 1054. full free text on-line
Summary: The pharmacological effects of plant extracts in the treatment of BPH.
| Name | Main mechanisms of action |
| Saw Palmetto extraction | 5α-reductase inhibition; blockage androgen receptors; anti-proliferation; anti-inflammatory activity; prostate smooth muscle relaxation; |
| Lycopene (tomatoe) | 5α-reductase inhibition;; anti-proliferation; anti-inflammatory; anti-oxidant activity |
| Urtica dioica extract (Stinging nettel root | WEAK 5α-reductase inhibition; Decreased action of sex hormones; |
| Pygeum africanum extract | 5α-reductase inhibition;; anti-inflammatory activity |
Summary figure
One company states that the ripest berries provide the most benefit
Saw Palmetto (been used for 2000+ years)
Note: One company states that the ripest berries provide the most benefit
JAMA - 1998: similar to finastreride, with fewer adverse events
Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia: A Systematic Review
"However, the evidence suggests that S repens improves urologic symptoms and flow measures. Compared with finasteride, S repens produces similar improvement in urinary tract symptoms and urinary flow and was associated with fewer adverse treatment events. "
Zdravniški Vestnik - 2014: efficacy 70%
Efficacy and safety of drug with plant extract of saw palmetto in patients with lower urinary tract symptoms because of benign prostatic enlargement
12 months 320 mg (Prostasan), IPSS (International Prostate Symptom Score) score reduced from 14 to 11
"patients and doctors rated the efficacy of drug as good (69.7% and 72.4%) "
Pharmacy & Pharmacology International Journal - Dec 2014: appears to be effective
Saw Palmetto, Serenoa repens, in the Treatment of Benign Prostatic Hyperplasia, Mechanisms of Action and Reasons for its Use
"Metaanalyses and systematic reviews of the trials have concluded that S. repens appears to be effective in the treatment of benign prostatic hyperplasia. "
Link includes full free text
New England Journal of Medicine - Feb 2006: small amount did not help
Saw Palmetto for Benign Prostatic Hyperplasia
In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo.
Examine.com unsure
Saw palmetto has undergone numerous trials and meta-analyses for BPH, with mixed results.
Pygeum (been used by whites for 300+ years)
Europe 1998 multicenter trial
Efficacy and Acceptability of Tadenan®(Pygeum africanum Extract) in the Treatment of Benign Prostatic Hyperplasia (BPH): A Multicentre Trial in Central Europe
2 months of 50 mg twice a day
Initially nocturia was 2.6 times per night. ==>1.8 per night (32% reduction)
Initially International Prostate Symptom Score was 16. ==> 9.6 (40% reduction)
Researchers were surprised to find that many of the benefits lasted for one month after supplementation was stopped.
Publisher wants $52 for the study
Examine.com -~20% reduction
http://examine.com/supplements/Pygeum
Urinary complications with Benign prostatic hyperplasia appear to be reduced with Pygeum supplementation in the range of 19-23% (including nocturia, residual urine volume,. . .
The bark of Pygeum tends to contain . . β-sitosterol (349-583mg/kg)
Also has a discussion on 2002 Cochrane meta-analysis of Pygeum
Beta Sitosterol (an active ingredient of Pygeum)
Life Extension Foundation - 2005
Report: Beta-Sitosterol
full free text online
Summary of Random Controlled Trials
Cochrane - July 1999 It works
Beta-sitosterols for benign prostatic hyperplasia
"The review found that beta-sitosterol treatments were well tolerated and improved urinary symptoms and flow measures in men with mild to moderate BPH." full free text for patients, otherwise the publisher charges for the study
Perhaps Vitamin K2 (already taking it)
Hypothesis: Vitamin K will reduce prostate blood vessel problems – Jan 2015