Mark came to see me a few months ago for what he called “plumbing problems.” His symptoms sounded miserable — he had to get up at least five times during the night to urinate, and he frequently had the feeling he couldn’t get everything out, even when the initial urge to go was fairly intense.
Mark told me he was not the kind of guy who frequented acupuncture clinics, so I could tell he was desperate to try anything that could offer relief. He had heard about the herb saw palmetto (Serenoa repens), which was a major reason for his coming to see me. After a lengthy discussion and examination, I was convinced that Mark had an excess condition underlying the prostate problem. His tongue had a thick yellow coating toward the back, and he did not report symptoms of a deficien- cy pattern, such as fatigue, depression, chronic lower back pain or ringing in the ears. In the view of Traditional Chinese Medicine, an excess heat condition like the one Mark exhibited could underlie an inflammatory condition, which might involve the prostate gland. Inflammation can go along with prostate enlargement, and when chronic, can increase the risk of eventual prostate cancer.
Conventional Medical Options
Medical science doesn’t understand why a man’s prostate gland is likely to start growing after midlife, perhaps around the time of “men-o-pause,” but it is so common that the incidence is greater than 50 percent after 60 years of age, and is as high as 90 percent by age 85. This condition is known as benign prostatic hyperplasia (BPH), which simply means prostate enlargement. Changing hormone levels, especially the testosterone-to-estrogen ratio, is a usual explanation.
BPH is a common reason a man might come into an acupuncture and herbal clinic, perhaps because many men understandably don’t like the sound of some of the modern treatments for the ailment, which are reputed to lead to a fairly high incidence of impotence. These surgical treatments include transurethral resection of the prostate (TURP) or transurethral incision of the prostate (TUIP), the most common procedures. These surgeries show a 30 to 40 percent better chance of reducing symptoms, at least in the short term, than watchful waiting. However, surgery has a 24 to 40 percent higher incidence of impotence associated with it.
Besides surgery, drugs often are prescribed to block the action of the hormone testosterone, which sometimes gives some relief, but also with major side effects, including impotence.
A Healthy Diet is Important
Mark and I talked about gradually adding foods that protect against cancer, also increasingly common as a man ages. Good choices include daily helpings of beans, fresh fruits and vegetables, whole grains, garlic and onions. He also agreed to eat less red meat and focus more on beans and whole grains as protein sources.
Foods that can help reduce inflammation in the gland include flaxseeds, olive oil and wild fish, such as salmon and halibut.
An Effective Herbal Program
Mark’s initial herbal program consisted of saw palmetto. It is the most widely scientifically studied herb for the prostate, demonstrating a fair level of certainty about its effectiveness for relieving symptoms of BPH with few, if any, side effects. My father used it for years and had great success. We found that a double dose worked best for Mark (about 360 mg, twice daily with meals). I now have enough experience with saw palmetto to have faith in it, and often recommend it as a first line of treatment, especially before resorting to drugs or surgery.
Nettle (Urtica dioica) root extract is also helpful, according to some clinical trials, and the two herbs often can be found blended together in prostate health products. I don’t recommend using the widely advertised herb pygeum (Prunus africana) because the plant is endangered in some areas of Africa where it is grown.
I also gave Mark a second formula that included some urinary tract-cleansing and heat-removing herbs. These included Oregon grape root (Mahonia aquifolium), cleavers (Galium aparine), horsetail (Equisetum arvense) and the green parts of nettle. These can be found in various combinations in prostate or urinary tract formulas.
Slow, Steady Results
Mark took the saw palmetto and other herbs for several months, and didn’t notice much for the first six weeks or so. I thought we’d need to re-evaluate the program, but at one weekly visit, he told me that during the previous week, he only had to get up twice during the night. This was really exciting for him, and he wanted to continue with the herbs. I made some small adjustments to the herbal blend, adding more soothing herbs like marshmallow root (Althaea officinalis). After two more weeks, he agreed to try some marshmallow and plantain leaf (Plantago spp.) tea. This combination provides major soothing power because of the high mucilage content of the herbs.
In another two weeks he was urinating only once a night, a situation that has stayed fairly stable over the last several months. He also has less discomfort and burning.
Mark always had been curious about acupuncture needles but never wanted to try a treatment. He told me he had problems with needles, even as a kid. Though the acupuncture needles are solid and thin as a hair, he still resisted. I have had great results with regular acupuncture treatments for relieving symptoms of BPH, but fortunately, herbs alone also can provide excellent relief. This is true especially for conditions like BPH, which respond well to rebalancing the underlying constitutional condition.
Because studies show BPH has a high level of response to placebo treatments, the symptoms of the condition often are tied to some emotional responses and even one’s belief about health and disease. So, I’m never sure about the nature of the results for this condition until the improvement continues for at least several months. Mark continued to improve and now comes in every few months for a reassessment and some modifications to his formula.
Christopher Hobbs’ case studies are gleaned from his 30 years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the correspondence course Foundations of Herbalism; www.foundationsofherbalism.com.
“Case Studies” is not intended to replace the advice of your health- care provider.
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