New research suggests that the symptoms of chronic bacterial and non bacterial prostatitis can easily be confused with other conditions, such as benign prostatic hypertrophy (enlargement) and pelvic pain syndrome.

The successful treatment of these conditions depends, at least in part, on an accurate diagnosis. Yet, when a group of researchers reviewed the literature for data on how to diagnose and treat this condition, they found only small studies of poor quality.

No reference standard for clinical testing was found nor was there any clear indication of what symptoms to base a diagnosis on, although depression and certain inflammatory and immunological markers are more common in men with prostate pain.

The researchers warned against throwing medicines at men with prostate pain, but could offer no clear guidelines for diagnosis or treatment. This dearth of information indicates that many men with prostate problems may currently be receiving inappropriate, ineffective or inadequate treatment (Ann Intern Med, 2000; 133: 367-81).

On the alternative medicine/therapy side, he has had courses of high zinc intake, high vitamin C, combinations of amino acids, various herbal remedies. He takes pumpkin seeds daily. Acupuncture, reflexology and massage all have been tried.

The latest herbal remedy he is trying is Goldenseal, which I read in a herbal leaflet was good for prostate problems. The only relief he gets is from localized heat, and that is only for a short period.

The main symptoms are a burning sensation around the prostate area, which sometimes varies in type of burn. He also complains of the soles of his feet burning, but they feel normal to the touch.

Do you have any further suggestions as to treatment or therapy, and any hope that his condition will ever be resolved? E P, Leigh, Lancs……

I have been offered a beta blocker treatment called indoramin two pills a day for life for prostate problems including urine retention. Have you got any information on side effects of this particular drug? I understand indoramin has been available for three years, and users are cautioned about drowsiness, which could be exaggerated by the use of alcohol. This is all the information I have. J S, Braintree…….

A: Chronic infection of the prostate gland in the penis prostatitis can be due to an infecting bug, or it can be due to a more generalized problem. Has your doctor ever done a laboratory test to determine whether there is some infecting organism responsible? If he hasn’t, do insist that he does in your next meeting.

If nothing is found, a number of our panel members say that candida albicans can cause chronic infection of the prostate gland, as can food intolerance/allergies. It’s worth having yourself checked out by a clinical ecologist or someone familiar with candida albicans treatment to determine whether either one is at the heart of your problem.

It is true that low zinc levels could bring on prostate problems. We’re not sure what you mean by courses of high zinc; ordinarily if you’re demonstrating a low zinc level you would be kept on zinc supplementation indefinitely.

Another possible nutritional culprit is a low level of essential fatty acids (the omega-6 fatty acids), such as those found in linseed oil or safflower oil. Our panel member Nutritional expert Dr Stephen Davies has treated a number of patients with this problem on 10-15 mls twice a day of these cold pressed oils, with a nightly before bed supplement of 40-50 mg of zinc. This might even help with those patients who suffer from an enlarged prostate gland, although there is less evidence to suggest it. Leo Galland, one of our panel members, believes that zinc and EFAs can work to help prevent the problem from developing in the first place, but once it’s there, he’s never seen them reverse it.

Several herbs are gaining a reputation for helping prostate problems. Dr Galland says that a recent study in the British Journal of Urology showed that cernilton (which is flower pollen) helped cases of chronic prostatitis. (He himself has never got it to work with his own patients.)

For enlarged prostate problems, saw palmetto has reportedly shown the most benefits he says, although hawthorn has also been used.

As for indoramin (Doralese in the UK), it is actually a “selective” alpha blocker, which blocks the effects of adrenaline on the alpha receptors in arteries. This blocking allows the arteries to dilate, which causes blood pressure to drop. Those alpha blockers that are “selective” only block alpha-1 receptors, which means, in essence, that they don’t cause a rapid heart beat.

Although these drugs are mainly used for high blood pressure, they were presumably selected for you because urine retention and enlarged prostate are often caused by muscle spasms around the prostate gland. The alpha blockers block the nerves supplying these muscles; they relax and urine flows more readily. They are also supposed to help increase the volume of urine passed.

Not without some cost, however. Your doctor rightly pointed out that the drugs can make you drowsy. But he left off about another page’s worth of side effects. The more minor include listlessness, headaches, dizziness, nausea, vomiting, diarrhoea, constipation and palpitations.

Shame on him for failing to mention to you the most common and potentially serious side effect: sudden fall in blood pressure. For people over 55, this can cause collapse or bone breaking falls. Therefore, your doctor should have told you to sit or lie down while taking your first dose or take it only at bedtime. This side effect magnifies if you are over 55, so do use with caution. You should have been started on the smallest effective dose and only built up if you needed to.

The drug can aggravate angina, cause breathlessness, nervousness, hallucinations, depression, skin rashes, hair loss, fluid retention, blurred vision, catarrh, ringing in the ears, too frequent passing of urine, and, yes, impotence. So the bottom line is that you’re trading one problem for a possible host of others.

Says Dr Galland: “I wouldn’t expect an alpha blocker to be all that helpful. While it might alleviate some of the symptoms, it will never address the problem.”

One area being explored in America is the use of “hyperthermia” (warming up the prostate) in order to shrink the enlargement. A warmed (not hot) probe is inserted into the rectum to heat up the prostate. After several treatments, it should shrink down. The Atkins Center in New York is experimenting with such a technique.

Thereafter, you can try the approach of zinc and EFAs to keep it to a normal size.

Problems with the prostate occur out of all proportion to its biological importance. Up to age 30, it’s normally trouble-free but, from 30 to 50, it can become inflamed due to a bacterial infection (prostatitis). Later in life, it may become enlarged. This growth may be cancerous, but if it’s non-cancerous, it’s called benign prostatic hyperplasia (BPH).

Because the prostate surrounds the urethra, trouble with urination is usually the first sign of a problem. Symptoms include weak or intermittent urine flow, incomplete voiding, frequent or painful urination and incontinence. The difficulty with self-diagnosis is that all three prostate conditions may produce any of these symptoms.

Prostatitis is the easiest to diagnose. Because it’s caused by a bacterial infection, a simple urine culture test will often spot it.

BPH – a benign enlargement of the prostate – is more difficult to diagnose when trying to decide between it and cancer. The most elementary test is to feel for an enlarged prostate.

If indeed an enlargement is found, the next stage of diagnosis is more complex, problematical and controversial.

Twenty years ago, prostate experts thought they had found the answer when a protein was found in men’s blood that seemed to correlate with the presence of prostate cancer. Although it was quickly named ‘prostate-specific antigen’, there was soon some doubt as to how ‘specific’ the PSA test actually was.

The first major problem was that the test cannot reliably distinguish between cancerous and non-cancerous prostate enlargement. It also throws up many false positives and false negatives, so that cancers are either missed or men are subjected to unnecessary treatment (Urologe A, 2000; 39: 22-6). As one report baldly puts it: ‘. . . two-thirds of men with an elevated PSA level do not have prostate cancer’ (Semin Urol Oncol, 1996; 14: 134-8). Finally, there is considerable disagreement over what PSA levels are clinically relevant.

Despite these problems, there has been pressure to use PSA as a screening test in much the same way as mammography was once championed for breast cancer. Enthusiasts claim increased accuracy from new techniques that measure PSA density or relate the test to the patient’s age, but the results are still not clear-cut (Urol Clin North Am, 1997; 24: 323-32).

Many experts now admit to ‘a lack of credible evidence’ that PSA screening saves lives. Worse still, they say that screening has actually harmed and even killed people due to the unnecessary treatment it leads to. A recent Yale University report concluded that screening and the subsequent treatment based on often faulty diagnosis ‘can be associated with considerable morbidity and mortality in the context of a disease that is often not fatal’ (J Sci Am, 2000; 6 [Suppl 2]: S188-92).

One diagnostic test often given by doctors after a positive PSA reading is a biopsy. This involves taking ‘tissue cores’ from as many as 12 places on the prostate to look for cancer cells. The procedure is not without risk: most patients become infected from the procedure itself, 20 per cent suffer severe pain and 15 per cent are rendered impotent (J Urol, 2001; 165: 445-54). There’s also evidence that biopsies themselves may be inaccurate, often failing to detect cancerous tissue (Prostate Cancer Prostatic Dis, 2000; 3: 13-20).

What is the prostate gland and why is it doing this to me?
The prostate gland lies between the bladder and external urethra and secretes a thin, milky white fluid which is high in citric acid, calcium, acid phosphatase and zinc. In addition to its function in the packaging and delivery of sperm, the prostate acts as the genital urinary systems first line of defense against infection. Enlargement of the prostate is caused by an abnormal over growth or swelling of tissue which blocks the urethra or opening from the bladder. This in turn is the cause of symptoms associated with benign prostatic hypertrophy, prostatitis or cancer.
Contrary to belief, benign prostatic hypertrophy does not necessarily develop into prostatic cancer, the second leading form of cancer in males. Rather, they are felt to be two independent processes which can cause similar symptoms. One of the problems with cancer of the prostate lies in the fact that it may be present without any detectable symptoms until its later stages. This of course can lead to its continued growth and subsequent spread throughout the body.
While there are many treatments for these conditions, they are often uncomfortable and have many undesirable side effects. Use of a few simple herbal medicines in conjunction with dietary changes offers the best alternative to standard drug and surgical therapy.

Prevention recommended by American Cancer Society.
It is recommended by the American Cancer Society that males over the age of 40 receive yearly examinations for the presence of prostatic enlargement and cancer. Prostatic cancer is the second leading form of cancer in men in the Unites States. Reluctance to undergo examination on the part of many men often causes early treatment to be postponed allowing the condition to become worse. It is only after symptoms become unbearable that many men will seek treatment. Early detection has become much simpler and more refined with the introduction of a few relatively non invasive diagnostic procedures such as blood testing, ultrasound diagnosis and urinalysis.
Under normal conditions, the cellular tissue of the prostate produces a protein termed prostatic specific antigen (PSA), so named because it is found only in the prostate gland. With increasing growth or hypertrophy, the levels of PSA will also increase in relative proportion. The nice thing about PSA is that its level can be measured by a simple blood test which makes it a good screening procedure for excess growth of the prostate. Prostatic specific antigen is also elevated with cancer of the prostate but is not diagnostic of that condition. Used in conjunction with the serum prostatic acid phosphatase level (PAP) and findings on physical examination, cancer of the prostate may often be eliminated as a cause without further testing.

So what about treatment?
Recently there have been reports about research on a new drug which will help to shrink the prostate gland thus negating surgery. Unfortunately this drug is experimental at this time and causes impotency. For the most part medicines which decrease the size of the prostate without causing impotence are already available, having been used and researched in Europe since the early 1970’s.
By themselves the medicinal plants, Serenoa repens and Pygeum africanus, have been shown to be very effective in the treatment of benign prostatic hypertrophy. Coupled with preventive measures such as dietary changes and exercise, early detection and intervention will lead to a decrease in suffering from this common affliction. These plants which are found both in the United States and Africa, have been used for centuries for treatment of prostatic and urological disorders in men. It has been only within the last few years that modern technology has made it easier to concentrate their active principles in order to achieve standardization and a higher level of effectiveness.
The berries of the plant Serenoa repens (Saw Palmetto) contain about 15% saturated and unsaturated fatty acids and sterols which have been found in studies to possess antiandrogen or testosterone properties, immune stimulating effects and reduces edema or swelling of the prostate.
Specifically, when used in clinical trials, an extract of Serenoa repens has been shown to prevent the conversion of testosterone to its more potent form resulting in a significant decrease in prostate size and relief of symptoms.
Similar to Serenoa, ingestion of the powdered bark of the tree Pygeum africanus has for centuries been reported to be a treatment for urinary disorders. Recently researchers in France have begun to scientifically examine some of the clinical observations and claims made about Pygeum africanus. Isolating its active compounds, scientists were able to conclude that the herbal preparation did in fact produce antiinflammatory, antiedema and cholesterol lowering properties. Both double blind clinical trials in humans and studies on animals clearly showed regression of symptoms associated with benign prostatic hypertrophy as well as conveying tumor blocking properties. Furthermore, a reversal of abnormally appearing tissue on histologic examination was also found. In other words, Pygeum africanus consistently reversed the effects of benign prostatic hypertrophy and were shown to aid in the prevention of prostatic cancer. In each of the studies conducted there were no toxic side effects observed, even at large doses and with prolonged usage.
Standard medical treatment for BPH involves the usage of the Transuertheral Resection of the Prostate or TURP, a surgical procedure which clears excess tissue from the urethra and requires hospitalization. While the procedure is effective, it is often uncomfortable and may have the side effect of impairment of ejaculation or impotence. Indwelling catheterization or balloon implantation may also be used to relieve pressure caused by the obstruction. Each procedure along with drug therapy has side effects which make them less than desirable. In addition, these procedures treat the symptoms rather than the cause of the disorder often necessitating further treatment as the gland continues to enlarge.
Considering the far reaching effects these conditions have on the lives of sufferers in terms of discomfort, side effects of standard treatments, and the enormous costs that are brought to bear, prevention of prostatic disorders should be undertaken by all men. Both the research literature and my own experience in clinical practice make it clear that prevention and early intervention using non toxic medications can relieve the suffering caused by this inevitable process of aging.

Dr. Tom Kruzel practices in Portland, Oregon and can be reached at (503) 667-1961

• Urinary frequency.
  
  
• Urinary urgency.
  
  
• Nocturia (needing to get up at night to urinate).
  
  
• Hesitancy with decreased force of stream.
  
  
• Terminal dribbling (the final phase of urination as slow drips).
  
  
• Sensation of incomplete emptying.
  
  
• Overflow incontinence or total retention.
  
  
• Burning on urination, chills and fever indicate infection has set in.
  
  
• Possibly palpable distended bladder.
  
  
• Enlarged, rubbery prostate on rectal exam often with loss of median
  sulcus. The median sulcus is a vertical groove in the heart-shaped gland
  which tells the examining doctor that the gland is NOT enlarged or swollen.

Conventional treatment includes surgical removal of all or part of the prostate.
Most patients improve significantly after treatment but may be rendered
impotent. Surgery is not to be taken lightly



Important questions to ask your doctor include the “rule-outs”
which means you want to be sure that the diagnosis is definite and correct.
Possible problems that could mimic BPH are:

• Neurogenic bladder.
  
  
• Acute prostatitis.
  
  
• Chronic prostatitis.
  
  
• Carcinoma.
  
  
• Other obstructive pathology.

Now, onto the information about what you can do about this diagnosis. First,
remember, men do not die from this condition unless it co-exists with prostate
cancer. The first area of non-surgical, non-drug treatment suggestion is
“Physical Medicine” which means what you can do with exercise,
water, and manipulation such as massage. Any alternative practitioner worth
their salt will tell you that the first order of business is prevention.
But, since you already have the problem there are a few exercises that
can improve circulation to the general area as well as tone the bladder.
The first is a set of movements commonly called “Kegel” exercises
which involves pulling up rhythmically on the pelvic floor (all the muscles
around the scrotum and the anus) with the lower abdominal muscles as you
exhale, and keep pulling up on the squeeze until you need to take a breath.
Repeat 10 times, 5 or 6 times daily. This can be done very discretely
— nobody needs to know you’re doing this exercise. It’s perfect for commuting,
or while you’re sitting around waiting for someone or something, or in the
shower. The other set of exercises are too complex to explain here. They
involve an ancient Chinese energy moving technique called “Qi Gong,”
widely practised in China and around the world for all sorts of complaints,
as well as for prevention. So, back to prevention. Aerobic exercise, a
minimum of 3 times weekly for 20 minutes at your target heart rate, will
do wonders for not only the prostate gland, but for your heart, lungs, bones
and mental well-being.



Another aspect of physical medicine is the use of hot and/or cold water
to treat a complaint. Some hydrotherapy methods that have worked well for
BPH are hot foot baths, which can stimulate the returning circulation from
the legs as the blood comes back up to the heart, and alternating sitz baths.
This is a marvelous naturopathic technique for all sorts of pelvic complaints.
The idea is basically to sit in a warm tub for 3 minutes or so, then get
out and transfer your backside immediately to a basin (large enough to accomodate
said backside, up to the hips) filled with COLD water. No kidding; this
means chilled water with a tray of ice cubes dumped in. Stay in there about
1 minute, then back to the warm for 3 minutes, then back to the cold, and
so on back and forth at least 3 times. The warm water relaxes the blood
flow and the cold contracts it, thereby enhancing vigorous circulatory flow
to the pelvis. Envigorating and highly effective. Also, inexpensive and
you probably have all the tools you need at home right now. A big basin,
a bathtub, hot and cold running water and a freezer with ice cubes in it.
That’s it.



It may be useful to treat the spine at the levels where the nerves serving
the pelvic area emerge. This is called Spondylotherapy and might consist
of using percussion (gentle tapping) or a sine wave current over the spinal
levels T12 or L1, L2, L3. Scoliosis or other spinal misalignments can sometimes
exaggerate protate problems. Make sure your vertebrae are all lined up.




Some people have greatly benefitted from gentle prostatic massage weekly.
Some men are actually able to perform this themselves, but the less limber
may request the therapist to instruct your spouse in the technique. It
feels good!



If you know a doctor or licensed therapist with physical medicine equipment,
ultrasound over the perineum or diathermy over the lower abdomen may help.



A critical area of health care which is finally getting deserved recognition
is the whole field of nutrition. It’s true that you are, indeed, made out
of what you eat. Think about it. The following list of supplements are
provided because it may be difficult to get these nutrients through “regular”
eating:

• Zinc 60 mg daily for one month, then the dose might be reduced. This is the MOST important nutrition to heal the prostate gland.
  
  
• Copper
  
  
• flax oil 2 Tbsp q.d.
  
  
• glycine 200 mg q.d.
  
  
• glutamic acid 200 mg q.d.
  
  
• alanine 200 mg q.d. (Dumrau, 1962)
  
  
• Selenium 100 mcg q.d. (Webber, 1985)
  
  
• Vitamin E 800-1200 I.U. q.d.
  
  
• prostate protomorphogens (glandular material from other mammals, usually cow or pig)

To begin you self-help program from “regular” food, the following
eating principles should be considered:

• vegan diet
  
  
• low sugar, low fat diet of unsaturated fats
  
  
• calorie percentages: 70% complex carbohydrates, protein 12-15%, fat 15-18%
  
  
• low cholesterol (another brochure is available on this topic)
  
  
• low Sodium/Sodium-restricted diet
  
  
• vegetarian cleansing diet or short fasts

Specific therapeutic foods to consider are:

• Omega-3 and omega-6 fatty acids: vegetable, nut, seed oils, salmon,
  herring, mackerel, sardines, walnuts, flaxseed oil, evening primrose oil,
  black currant oil; at least 1 tablespoon (RAW, cold-pressed, not used to
  cook!) daily

  
  

• estrogenic foods: animal products, apples, cherries, olives, plums,
  carrots, yams, nightshade family, peanuts, soy products, coconut, brown
  rice, barley, oats, wheat

  
  

• foods rich in Zinc and Vitamin E: squash seeds, almonds, sesame seeds,
  tahini, kelp

  
  

• raw pumpkin seeds: 25 seeds four times daily

  
  

• anise, tangerine, cherries, figs, litchi, sunflower seeds, mangos,
  seaweeds

  
  

• high fiber foods

For folks willing to make fresh juices:

• carrot
  
  
• carrot and spinach
  
  
• carrot, beet, and cucumber
  
  
• carrot, asparagus, and lettuce
  
  
• lemon juice in warm water

Of course there’s the what you SHOULDN’T eat category…Please strongly consider avoiding:

• coffee, alcohol, saturated fats, strong spices, spicy food, dairy
  products, fatty foods, fried foods, coffee, caffeine

• Apis mellifica: prostatic inflammation; discharge of prostatic fluid;
  sexual desire increased or diminished; frequent and long-lasting erections

  
  

• Argenticum metallicum: chronic enlargement in old men

  
  

• Argenticum nitricum: chronic enlargement in old men; burning in spot
  in anterior of rectum

  
  

• Baryta carbonicum: enlargement in old age

  
  

• Cannabis indica: sensation in anal region as if sitting on a ball

  
  

• Chimaphilia: tenesmus, frequent urination and general discomfort

  
  

• Conium maculatum: chronic hypertrophy with difficulty in voiding
  urine, stops and starts; leading remedy

  
  

• Ferrum picricum: one of the best remedies in the aged

  
  

• Lycopodium: pressure in the perineum near the anus while urinating

  
  

• Pulsatilla: inflammation; excessive increase of sexual passion, almost
  like priapism, with frequent and prolonged erections, ardent desire for
  coition

  
  

• Sabal serrulata: chronic/acute enlargement with difficult urination
  or burning while urinating

  
  

• Solidago: chronic enlargement; obstructed flow of urine

  
  

• Staphisagria: frequent urging to urinate with scanty discharge in
  a thin stream or by drops; burning during and after urination with urging

  
  

• Sulphur: escape of prostatic fluid, chiefly when urinating and while
  at stool

  
  

• Thuja occidentalis: frequent pressing to urinate with small discharge,
  patient strains much; stitches from rectum into the bladder; discharge of
  prostatic fluid in am on waking

Another extensively researched area of healthcare which provides benefits
without drugs, radiation or surgery is the vast field of botanical medicine.
This ancient healing art most likely began by observing animals in the
wild treating themselves for wounds, bites, rancid food and the like. Botanical
medicine is the therapeutic use of medicinal plants in a variety of forms
(tea, decoction, tincture, poultice, cream, salve, ear drops, etc.) to restore
the body and mind to full health. The following list of medicinal plants
(sometimes called “herbs” — the word drug comes from an old Flemish
word, “droog,” which means dried plant) are useful for BPH. Please
don’t use them without consulting a well-educated herbalist or naturopathic
physician. It is extremely rare for even the most open-minded of medical
doctors to have adequate training to dispense medicinal herbs.

• Agropyron repens (Triticum repens)

  
  

• Chamaelirium luteum (Helonias): prostate aches as if sitting on a
  ball

  
  

• Cucurbita pepo (squash and pumpkin): specially grown varieties; decongests
  prostate, tones bladder and sphincter

  
  

• Delphinium staphysagria (toxic): to assist other indicated remedies
  
  
  
  
• Echinacea purpurea

  
  

• Equisetum arvense: specific for; combines well with Hydrangea arborescens
  
  
  
  
• Galium aparine: prostatic irritation in aged

  
  

• Serenoa serrulata: specific for throbbing, aching dull pain, discharge,
  irritation with dysuria and dribbling in aged; may combine well with Equisetum
  arvense and Hydrangea arborescens

  
  

• Urtica dioica (leaf and root): activates metabolism

Chinese herbs are most often not only from plant species unknown in the
West, but used quite differently than Western herbs. For one thing, a Traditional
Chinese Medical (TCM) diagnosis describes the effect of the “problem”
on the patient, rather than describing the “problem” (such as
BPH) itself. A number of TCM diagnoses might be given for BPH, such as
Damp Heat in the Lower Burner. This concept will be briefly discussed below,
under the Acupoint section. It is impossible to give an intelligible treatise
on Traditional Chinese Medicine here. Please refer to the list of General
References to begin your studies of this vast and comprehensive topic.
However, in case you know a qualified Chinese herbalist, or Certified/Licensed
(through the NCCA) acupuncturist with a good grasp of herbs, the following
list may provide you with a guideline to discuss with the practitioner.

• 15 g of Polygonum cuspidatum (hu zhang cao): Lower Warmer Damp-Heat

  
  

• Prostate Gland Pills (patent): Xue (Blood) Stagnation with Lower
  Warmer Damp-Heat

  
  

• Akebia 14 (patent): Lower Warmer Damp-Heat

  
  

• Xiao Ji Yin Zi: Xue (Blood) Heat

  
  

• Persica and Rhubarb C. (Tao He Cheng Qi Tang): Xue (Blood) Stagnation
  with Xue (Blood) Heat: pain on pressure on left lower quadrant, constipation,
  and urinary stoppage in strong constitution

  
  

• Rhubarb and Moutan C. (Da Huang Mu Dan Pi Tang): Large Intestine
  Damp-Heat: Pain on palpation of right abdomen, constipation, urinary stoppage
  in strong constitution

  
  

• Cinnamon and Hoelen F. (Gui Zhi Fu Ling Wan): Xue (Blood) Stagnation
  
  
  
  
• Kai Kit Pill (patent): Qi Xu (Deficiency) with Yin Xu (Deficiency)
  
  
  
  
• Rehmannia Eight F. (Jin Gui Shen Qi Wan): Kidney Yin Xu (Deficiency)
  with Kidney Yang Xu (Deficiency)

Another aspect of TCM is the use of ultra-fine “needles” which
are inserted just below the skin to remove blockages in the “vital
force,” known as “Qi” (pronounced chee). Again, the following
treatment suggestions can ONLY be applied by a qualified acupuncturist.
After assessing the whole person and palpating, consider these patterns:

Kidney Xu (Deficiency); Liver Qi Stagnation; Damp-Heat; Shi (Excess) of
the Yang Qiao Mai (Yang Motility Vessel) and/or Xu (Deficiency) of the Yin
Qiao Mai (Yin Motility Vessel); Shi (Excess) of the Ren Mai (Conception
Vessel). Once the “pattern” of dysfunction is determined, the
following acupoints may be considered. Each of the more than 400 primary
acupoints is located on a very specific place on the body’s surface, along
one of the 12 major or 2 “extra” meridians, and relates not only
to the local area, but to an organ system, a sensory system, a color, a
mood and may also have other special applications.

• Bladder 18
  
  
• Bladder 19
  
  
• Bladder 23
  
  
• Bladder 47
  
  
• Bladder 28
  
  
• Conception Vessel 4
  
  
• Conception Vessel 3
  
  
• Spleen 9
  
  
• Spleen 6
  
  
• Kidney 7

So, you think all of this has been quite esoteric. Now for something even
“further out” from mainstream medicine, with growing numbers of
followers, which likely indicates there’s something to it.

Color therapy is used ost often with thin pieces of colored plastic (“gels”)
over home or office light sources, such as a lamp. The following colors
are listed for BPH:

• lemon (helps to dissolve blood clots; acts as a chronic alterative)
  on front of body

  
  

• orange (acts as a decongestant) and indigo (an astringent, antipyic, antiemetic, and hemostatic) between genital and anal areas

  
  

• indigo and violet on prostate

  
  

• alternate blue and yellow on kidneys for 10 minutes each

  
  

• drink blue treated water

  
  

• violet on chest

A growing number of progressive thinkers like to use semi-precious stones
for their healing. The stones may be held, or placed on the affected body
part, or placed into the bottom of your drinking water. Consult someone
who knows about “healing rocks” for more ideas. Here are a few
used in BPH:

• Coral
  
  
• Pearl
  
  
• Diamond
  
  
• Topaz
  
  
• Topaz, Coral
  
  
• Carnelian
  
  
• Citrine
  
  
• Ruby
  
  
• Garnet

The mind is by far the most important aspect in your total well-being.
Psychospiritual approaches to healthcare are being used increasingly even
in the most conventional of settings. The following ideas about the origins
and treatment of BPH should provide some food for thought:

• Sexual disturbances associated with chronic masturbation, prior STD’s,
  extramarital affairs with unexpressed guilt feelings and long standing unhappy
  relationships.
  
  
• Unhappiness
  
  
• Prostate represents masculine principle.
  
  
• Mental fears weaken the masculinity. Giving up. Sexual pressure
  and guilt. Belief in aging.

• discovering the walnut
  
  
• sun’s entry

• I accept and rejoice in my masculinity.
  
  
• I love and approve of myself.
  
  
• I accept my own power.
  
  
• I am forever young in spirit.
  
  
• It is safe to be a man.

Closing thoughts:

• What is the symptom preventing me from doing? What is the symptom
  making me do?

Prostatitis

This condition is defined as an acute or chronic infection of the prostate
gland. It is generally caused by infection by chlamydia, gram-negative
enteric bacteria or neisseria gonorrhea. Signs and symptoms are different
for acut versus chronic presentations and may include, for acute bacterial
prostatitis (often seen in young males and those receiving catheterization):

• High fever with chills.
  
  
• UTI with frequency, urgency, dysuria or burning, nocturia.
  
  
• Occasional hematuria.
  
  
• Low back/testicular/perineal pain.
  
  
• Obstructive symptoms when voiding may occur.
  
  
• Boggy, markedly tender prostate.

Chronic bacterial prostatitis, the most common cause of recurrent bacteriuria
in males, may often be asymptomatic except when there are frequent UTI (urinary
tract infections). Other findings may be:

• Bacteriuria (bacteria in the urine sample)
  
  
• Bacteria found in prostate secretions.
  
  
• Prostate may feel normal on palpation, but could also feel tender
  and boggy and produce significant secretions.

Acute nonbacterial prostatitis is typically seen in young, sexually active
men. The symptoms are the same as bacterial prostatitis but no bacteria
are present. Nonbacterial prostatitis treatment is harder for conventional
physicians to treat because drugs often do not help. Make sure your doctor
is sure your condition is neither BPH nor cancer.

Here are some treatment suggestions. With the physical medicine, the approach
is similar to treating BPH:

• sitz bath: alternating (discussed under BPH)
  
  
• short cold bath
  
  
• hot foot bath: with cold compress to pelvic region
  
  
• hot enema: up to 103 degrees F may be used three to four times a day
  (great for acute cases)

Eating principles include, for acute prostatitis:

• increased fluids
  
  
• short fruit or vegetable juice fast
  
  
• vegetarian cleansing diet

And for chronic prostatitis:

• hypoallergenic/rotation diet (this means figure out your allergic
  foods and avoid them, or use them sparingly).

Extra supplements to consider:

• Zinc 50 mg daily
  
  
• essential fatty acids, such as found in flax, olive and safflower oils
  
  
• bee pollen 3 tabs daily
  
  
• evening primrose oil
  
  
• Magnesium 400 mg daily
  
  
• Vitamin E 800 I.U. daily
  
  
• Vitamin B-complex
  
  
• Vitamin B6 50 mg daily

The Western botanical approach is much the same as for BPH, because the
gland is targeted for increased specific nutrients and for enhanced blood
flow. However, because of the differing approaches to diagnosis, the Traditional
Chinese Medicine herbal formulas are somewhat different than those given
for BPH:

• Dianthus F. (Ba Zheng San): Bladder Damp-Heat: dark turbid scanty
  difficult painful urination, dry mouth, yellow greasy tongue coat; may be
  urinary retention and lower abdominal distention and pain

  
  

• Gentiana C. (Long Dan Xie Gan Wan) (available as patent); Gentiana
  12 (patent): Liverand Gall Bladder Invaded by Damp-Heat: difficult and painful
  urination with a sesnation of heal in the urethra, red tongue with yellow
  coat, bitter taste in mouth, irritability

  
  

• Lotus Seed C.: Kidney Yin Xu (Deficiency) with Empty Fire Blazing (Hsu, 1980, p. 164; Dharmananda, 1986, p. 306)

  
  

• Tokora C. (Bei Xie Fen Qing Yin) (if chronic add ligustrum (nu zhen
  zi), lysimachia (jian qian cao), cuscuta (tu si zi) and plantago (che qian
  zi)); Kai Kit Pill (patent): Kidney Failing to Grasp the Qi, including chronic
  prostatitis ; frequent urination with cloudy, dense, milky or greasy urine

  
  

• Hoelen and Polyporus F.: chronic prostatitis

  
  

• Moutan and Persica C.; Prostate Gland Pills (patent): Xue (Blood)
  Stagnation: inflammation and pain in the lower abdomen

  
  

• Blue Citrus (patent): Groin swellings

  
  

• Akebia 14 (patent): Prostate inflammation

The differentiation of acute vs. chronic prostatitis is essential to proper
treatment and should be fairly obvious from the presentation. After assessing
the person and palpating, consider these patterns:

Kidney Xu (Deficiency); Kidney Yin Xu (Deficiency) with Empty Fire Blazing;
Kidney Failing to Grasp the Qi; Bladder Damp-Heat; Liver Qi Stagnation;
Xue (Blood) Stagnation; Liver and Gall Bladder Invaded by Damp-Heat; Spleen
Xu (Deficiency); Shi (Excess) of the Ren Mai (Conception Vessel); Shi (Excess)
of the Yang Qiao Mai (Yang Motility Vessel); Shi (Excess) of the Chong Mai
(Penetrating Vessel).



After a thorough physical exam, the doctor should consider acupoints from
the following selection (quite different from those for BPH):

• Governing Vessel-4
  
  
• Urinary Bladder18
  
  
• Urinary Bladder-23
  
  
• Urinary Bladder-47
  
  
• Urinary Bladder-28
  
  
• Urinary Bladder-57
  
  
• Large Intestine-11
  
  
• Large Intestine-4
  
  
• Lung-7
  
  
• Conception Vessel-4
  
  
• Spleen-9
  
  
• Kidney-7
  
  
• Kidney-6
  
  
• Liver-3
  
  
• Liver-2
  
  
• Gall Bladder-34

Typically each acupuntrue session involves placement of 4 to 20 “needles”
based on the diagnosis. These needles very rarey cause pain; the unusual
sensation is that of the Qi (vital force) “grabbing” the needle,
which often causes a dull ache or momentary twinge.



And now let us consider a very different modality, from a different culture,
but that, like acupuncture, works with your vital force. This is the science
of homeopathy. The most often chosen homeopathic remedies for prostatitis
are somewhat similar to those chosen for BPH, but with a stronger slant
towards healing inflammation due to infection, which is the key element
differentiating prostatitis from BPH.

• Aconitum napellus: initial stage

  
  

• Belladonna: throbbing

  
  

• Chimaphilia: with hypertrophy of prostate, frequent urination and
  discomfort

  
  

• Conium maculatum: with enlarged gland

  
  

• Ferrum picricum: best remedy for prostatic enlargement and inflammation
  in the aged

  
  

• Lycopodium: enlarged prostate and inflammation, when there is pressure
  in the perineum near the anus while urinating

  
  

• Sabal serrulata: inflammation and enlargement when the gland is hot,
  swollen and painful; in senile cases

  
  

• Spongia tosta: hypertrophy, spermatic cord and testicles are red
  and swollen

  
  

• Thuja occidentalis: hypertrophy and inflammation, frequent pressing
  to urinate with small discharge, discharge of prostatic fluid in morning
  on waking

Flower essences most frequently chosen for prostatis are dill or garlic.



Healing colors are, for acute prostatitis, turquoise directed towards
the front of the body and blue, which promotes relaxation, lowers high temperatures
and reduces inflamed tissue when directed towards the gland as much as possible.
For chronic postatitis use lemon (helps to dissolve blood clots). With
enlargement of the gland (BPH), plus infection (prostatitis), orange acts
as a decongestant and indigo acts as an astringent (to tonify boggy tissues),
antipyic (reducing pus formation), and hemostatic (reducing bleeding and
inflammation.



Psychospiritual metaphors and correlations for inflammation to consider
revolve around the “inflammatory” feeling of fear, especially
as it expresses through anger. Examples of this kind of thinking are often
described in a telling manner: inflamed thinking; seeing red; seething with
anger and frustration about conditions in one’s life. Remember too that
the prostate represents masculine principle.



If you have an astrological bent you may want to look at what’s going on
with conjunctions with your birth chart indicators: Perhaps Mars, Pluto,
or a planet in Scorpio are afflicted.



And the all-important mental connection, true for almost all disease, includes
the power of the spoken word, spoken lovingly to yourself. Consider the
following affirmations:

• (for inflammation) My thinking is peaceful, calm, and centered.
  I am willing to change all patterns of criticism. I love and approve of
  myself.

  
  

• It is safe to be a man.

Those who are prone to inflammations are attempting to avoid conflicts.
Questions that arise may be useful to explore in a more conventional psychotherapeutic
context:

• What conflict in my life am I failing to see? hear? feel?
  
  
• What conflict am I dodging? What is my relationship to it?
  
  
• What conflict am I failing to admit to?

Prostate Cancer

Finally, the most serious diagnosis for the prostate gland will be briefly
discussed. As a very general rule of thumb, carcinoma (cancer) is usually
best treated with a COMBINATION of conventional therapies (in fact one of
the most effective chemotherapy regimes is the one for prostate cancer,
in terms of relatively few side effects and a good cure rate, especially
with early detection) and supportive complementary treatments, which will
be discussed below.



Prostate cancer is very rarely seen in males under 50 years old, and is
rated third in cancer deaths in male patients over the age of 65 (behind
lung and colon). Most are adenocarcinomas. They are associated with benign
prostatic hypertrophy (BPH), but there is no specific causative link. Cancer
can be tricky. Signs and symptoms may not present at all. Or you might
experience urinary frequency, urgency or needing to pee during the night.
A physician will often find a firm, hard prostate on rectal digital exam.



The role of healthy eating can not be overemphasized in both prevention
and reversal of cancer. In general, the eating principles with prostate
cancer are based on alkalinizing the system. Alkaline fasts must be undertaken
under physician supervision — a physician well versed in therapeutic fasting,
and with a good grip on nutritional biochemistry.



Therapeutic foods to consider are:

• pumpkin seeds (raw) dosage: 25 four times daily
  
  
• anise, tangerine, cherries, figs, litchi, sunflower seeds, mangos, seaweeds
  
  
• Zinc-rich foods, squash seeds, almonds, sesame seeds, tahini, Vitamin
  E rich foods, kelp

Additional supplements, geared towards resolving malignancy, as opposed
to specifically towards the prostate, are:

• Vitamin A (high doses, under physician guidance)
  
  
• Selenium
  
  
• Zinc

The botanicals listed are, again, geared to halting the progression of cancerous
growth, and to ameliorating the side-effects of chemotherapy. They are listed
alphabetically, and with their particular restorative function. For doses
and duration please consult a qualified herbalist or naturopath.

• Avena sativa: nervous debility of convalescence

  
  

• Baptisia tinctoria: for tumorous or malignant conditions

  
  

• Berberis aquifolium: dyscrasiae due to cancerous cachexia

  
  

• Conium maculatum (toxic): pain of cancer

  
  

• Echinacea spp.: increases interferon production, purifies blood
  

  
  

• Gentiana lutea: bitter: promotes appetite, improves digestion in
  chronic debility

  
  

• Phytolacca decandra (toxic): carcinoma, adenoma; hard, swollen lymph
  nodes, especially in the pelvic region

  
  

• Rumex crispus: early stages of cancer; to prevent

  
  

• Taraxacum officinale: loss of appetite, weak digestion

  
  

• Trifolium pratense: alterative; purifies blood, cancerous diathesis;
  with daily use: patients are slower in developing carcinoma after excision
  

  
  

• Viola odorata: malignant disease, neoplasm in alimentary canal; after
  tumor extirpation to protect from metastases. Combines well with Galium
  aparine

  
  

• Viscum album (toxic): tumor-inhibiting effects reported, main use
  as follow-up therapy after surgery or radiation. Extracts available: Iscador
  (Weleda), Phenesol (Madaus), Helixior

The famous “Hoxsey” herbal formula for malignancy also deserves
mention here. It is comprised of:

Glycyrrhiza glabra, 12 g.

Trifolium pratense, 12 g.

Arctium lappa, 6 g.

Stillingia sylvatica (toxic), 6 g.

Berberis aquifolium, 6 g.

Phytolacca decandra (toxic), 6 g.

Rhamnus purshiana, 3 g.

Rhamnus frangula (toxic), 3 g.

Xanthoxylum americanum, 3 g.

To mix up the formula, combine the dry herbs, place in 3 cups of water and
simmer for 10-15 minutes. Cool, strain and store in a dark glass jar.
Dose: use 2-4 tbsp. tea in a third cup water adding 1-2 drops of saturated
potassium iodide and 5-11 drops strong iodine (Lugol’s) solution. Take
four times daily, with food, and again before bed.



Traditional Chinese Medicine therapies will not be discussed in great detail
here because it is critical to not hope that they would suffice, alone,
to treat cancer. However, the following guidelines towards understanding
a TCM diagnosis are offered:

• Zeng Ye Tang plus chrysanthemum flower (ju hua), trichosanthes root
  (tian hua fen), glehnia (sha shen), dioscorea (shan yao) and moutan bark
  (mu dan pi): Large Intestine Dryness: oral side-effects of radiation therapy:
  dryness that is worse at night, irritability, dry tongue, rapid thin pulse
  

  
  

• Dang Gui Ji Xue Teng Tang: Qi Xu (Deficiency) with Xue Xu (Blood
  Deficiency): leukopenia or thrombocytopenia during radiation therapy or
  chemotherapy

  
  

• Hoelen Five Herbs F. (Wu Ling San): side-effects from radiation.
  
  
  
  
• Ji Xue Teng Qin Gao Pian (patent): increases white blood count.
  
  
  
  
• Ci Wu Jia Pian (patent): Qi Xu (Deficiency) with Kidney Jing Xu (Essence
  Deficiency): enhances immune system, helps protect body from radiation;
  inhibits metastasis.

  
  

• He Che Da Zao Wan (patent): Kidney Yin Xu (Deficiency)

  
  

• Ling Zhi Feng Wang Jiang (patent): Qi Xu (Deficiency) with Xue Xu
  (Blood Deficiency)

  
  

• Chih-ko and Curcuma C. (patent): All tumors

  
  

• Blue Citrus (patent): Groin swellings

Homeopathic remedies that might be chosen are:

• Conium maculatum: stony, hard prostate, inability to have erections
  but high sex drive; intermittent urination in old people; urine flows and
  stops; weight like a stone in perineum

  
  

• Crotalus horridus: cancer with hematuria

  
  

• Iodatum: incontinence of urine; complete prostration of strength
  and general emaciation; worse from external warmth

  
  

• Psorinum: discharge of prostatic fluid before urinating; several
  organs flabby, torpid; aversion to coitus

  
  

• Selenium: lot of sexual activity that led to debility, masturbation;
  worse in hot weather, after sleep and anything that causes relaxation; involuntary
  dribbling

  
  

• Sulphur: offensive sweat around genitals

  
  

• Thuja occidentalis: pain, burning on urination or ejaculation; lot
  of sexual problems; frequent and urgent desire to urinate

Flower essences to consider:

• aloe vera
  
  
• dandelion
  
  
• mallow

Colors to work with:

• lemon (helps to dissolve blood clots; acts as a chronic alterative)
  
  
  
• indigo (an astringent, antipyic, antiemetic, and hemostatic) on area
  
  
• orange (acts as a decongestant) on area may further reduce mass.

Metaphors and correlations to ponder:

• The prostate represents the masculine principle.

  
  

• Loss of sexual function after surgery is more likely to be related
  to the patient feeling unattractive, to lack of information, or to lackof support in dealing with postoperative psychological reactions than to surgical loss of sexually-responsive tissue. Many sexual problems will
  be solved by just the chance to discuss them; patients need to hear that
  their sexual concerns are completely normal.

  
  

• Comprehensive cancer management should include members of the medical
  discipline who provide holistic and humanistic treatment. One team member
  should be both a qualified sex therapist and psychotherapist. This individual
  should be introduced to patients at the onset of treatment, be involved
  in a preoperative assessment, during hospital stay, and during the post-operative
  period.

dandelion

burdock

yellow dock

cascara sagrada

Chinese rhubarb (caution, use small amounts, for not more than 2 weeks)


Intestinal Gas (Flatulence)

The Prostate and Hormonal Changes

The truth is, around the age of 40, testosterone levels begin to decline in men. Although not as significant and all-encompassing as the hormonal changes women experience during menopause, it does have some definite effects. And they are not all positive! As testosterone levels decline, there is also an increase in one of its metabolites, called dihydrotestosterone. This hormone causes overproduction (called hyperplasia) of cells within the prostate gland, which ultimately result in enlargement of these tissues.

Benign Prostate Hyperplasia — BPH

This process is called benign prostatic hyperplasia or benign prostatic hypertrophy– often simply called BPH. Because the prostate sits beneath the bladder, when inflamed it may put pressure on the urethra, creating a variety of uncomfortable urinary complaints. Quite simply, the enlarged prostate obstructs the flow of urine. This results in symptoms of incomplete emptying of the bladder, dribbling, difficulty starting urination, reduced force of the stream, frequent urination of small amounts, and sometimes the inability to urinate at all.

The data varies, but BPH interferes with the urinary system to some degree in up to 80% of men over the age of 60. It is reported that at least 50% of men over the age of 45 have some prostate enlargement, whether it is accompanied by symptoms or not. These numbers characterize benign prostatic hyperplasia as an “epidemic” rather than an isolated health concern that is troublesome to a small group of men.

Other Prostate Conditions

A secondary health problem often associated with BPH is actual infection in the prostate gland. Incomplete emptying causes “stagnation” in the bladder, which sometimes results in a bacterial infection. However, in only 5% of the cases can an identifiable bacteria be cultured from the prostatic fluids.

Cancer of the prostate also needs to be mentioned. This year the American Cancer Society estimates that 165,000 men in the US will be diagnosed with prostate cancer and 35,000 will die of it. Presently, the only malignancy killing more men is lung cancer. The overall incidence has soared 39% since 1973. However, prostate cancer is rare before the age of 50. It occurs in at least 50% of men who live to be 80 and beyond, the average age of diagnosis being 73. And men who are over 65, African-American, or whose fathers had prostate cancer are at greatest risk for developing it (1).

Western Treatment

The purpose of this article is to focus on the treatment and prevention of BPH rather than cancer of the prostate. Conservative measures for an enlarged prostate include prostatic massage and reducing or eliminating coffee and alcohol. Antibiotics are frequently prescribed whether an identifiable pathogen is present or not. And surgery is considered in some of the more serious cases of prostate enlargement, as well as for some individuals with cancer.

In terms of Western drugs, Proscar is the currently the most widely prescribed. Available for only the last few years, it slows down the formation of dihydrotestosterone, the “bad” hormone that increases cell growth in the prostate. It does so by inhibiting the action of an enzyme called 5-alpha reductase, responsible for the conversion of testosterone to dihydrotestosterone. Clinically speaking, Proscar shrinks enlarged prostatic tissue, but its effects are sometimes slow– from 3 to 12 months for a change in urinary symptoms. Proscar is an expensive medication, with annual costs of approximately $600 to $700. And it must be taken for life, even though the full range of its side-effects will not be known for some time.

Herbal Medicine for the Prostate

On the bright side, natural therapies have a long history of use in this country and abroad to support optimal prostate health. Saw Palmetto (Serenoa repens berry) has been traditionally used in treating male urogenital conditions. Serenoa is a small palm tree indigenous to the Atlantic seaboard from South Carolina to Florida. It produces a small berry that contains approximately 1.5% fat made up of fatty acids and sterols which affect testosterone metabolism. Like the drug Proscar, it too is a 5-alpha reductase inhibitor– blocking the formation of dihydrotestosterone, which is responsible for prostate enlargement. In addition, no toxicity has been reported for Saw Palmetto.

Recent research on this herb shows what clinical medicine has known for centuries– it works! Since 1983, there have been numerous double-blind trials involving hundreds of patients. All of the studies show that Saw Palmetto extract is effective for both subjective and objective measurements of prostatic enlargement (2). For instance, in one study of 110 men with BPH symptoms, the herb decreased night-time urination by 45%, increased urinary flow rate over 50%, and reduced post-urination residual volume (the amount of urine left in the bladder after urination) by 42% (3). Other studies show that Saw Palmetto extract selectively antagonizes 52% of the dihydrotestosterone receptors in the prostate, thus inhibiting the hormone from binding to them, and therefore minimizing its stimulation of cell growth (4).

For men suffering from prostate enlargement, Saw Palmetto is the place to start. You may use a capsule that contains what is called a “lipophilic” extract. This is merely a standardized concentrate of the fat soluble sterols in the berry which have been shown to be responsible for its beneficial activity. You may also consider a liquid extract. And the herb may be used alone or in a combination. In either case, take one dose three times daily for at least one month before evaluating its effectiveness. For those who do not have symptoms, considering taking the herb three times daily for one to two weeks out of the month for prevention.

Two other botanicals deserve mention here. Although not as widely studied as Saw Palmetto berry, both Nettle and Pygeum have been shown to be effective for symptoms of BPH. One recent study shows that Nettle (Urtica dioica root) inhibits membrane activity of the prostate, which may subsequently suppress prostate cell metabolism and growth (5). This, of course, reduces inflammation and enlargement of these tissues. And Pygeum (Pygeum africanum bark) contains “pyto-sterols” which have been shown to have anti-inflammatory properties. In clinical trials, extract of Pygeum was found to reduce symptoms of enlarged prostate, and is available as an over-the-counter medication for BPH in Europe (6). Both Nettle and Pygeum may be used alone, or combined with Saw Palmetto for a more effective protocol for prostate health.

When an enlarged prostate is accompanied by actual infection, botanicals with anti-microbial properties are indicated. In these cases, both Echinacea (E. angustifolia or E. purpurea) and Goldenseal (Hydrastis canadensis) may also be considered as part of a program. Studies show that Echinacea and Goldenseal possess anti-viral and anti-bacterial properties, and each has considerable traditional use in America for treating and preventing infections, although there are no studies directly associating them to the prostate.

The Benefits of Nutrition

In terms of nutritional medicine, practitioners have been using Zinc for decades to support a healthy prostate. This beneficial mineral is deficient in many American diets, and is needed for proper immune function as well as prostate health. Zinc has been shown to reduce the size of the prostate and reduce symptoms of BPH by inhibiting the activity of 5-alpha reductase (7,8). Zinc may be taken in a dosage of from 20 to 60 mg per day, and it combines well with the botanical remedies mentioned above. In addition, nutritionists find that Vitamin E, in doses ranging from 50 iu to 400 iu per day, is often effective for BPH. Furthermore, that dosage range reduces cardio-vascular risk and provides antioxidant protection for the body (9).

Homeopathy and BPH

Homeopathy is also a useful tool for treating the prostate. The remedy Sabal serrulata (which is actually Saw Palmetto in homeopathic dilution!) is often effective in treating prostatitis. According to Boericke’s Materia Medica, it is useful for irritation of the genito-urinary system, including enlargement of the prostate and its resulting urinary symptoms (10). If Sabal fails, you may consider other remedies, including the Staphysagria, Thuja, Merc, or Causticum. Lower potencies– 3X, 6X, or 12X– taken three to four times daily usually provide good results. Obviously, it is best to consult a Materia Medica or your health care practitioner to find the appropriate remedy for your case or constitution.

Tonic Herbs and Prevention

One note about prevention according to Traditional Chinese Medicine (TCM). The Chinese, who are masters at treatment before illness, believe that as age progresses the “energy” of the reproductive and hormonal systems weaken. The practitioner of TCM will often use tonic herbs in order to strengthen body function, which maintains a higher level of resistance and naturally helps to prevent disease. American Ginseng (Panax quinquefolius root) and Siberian Ginseng (Eleutherococcus senticosus root) are two of these widely used toning herbs that are especially helpful for men over the age of 40. After the acute symptoms of prostatitis are resolved, these tonic remedies may be used to support energy in general and the urogenital tract in specific. They are best taken in combination as a liquid extract, tablet, capsule, or tea for a month following an acute episode of BPH. They may be used preventatively one or two weeks per month.

A Rotational Program for Prostate Health

So, you ask, how do I begin? Although all cases of enlarged prostate need to be treated individually, the following is a simple rotational program for optimal prostate health for men in their 40’s and 50’s:

• WEEK 1
  
  Herbal support:
  1. Use Saw Palmetto, or a Saw Palmetto-based formula
  Suggested use: One dose, three times daily

  Nutritional support:
  1. Use a Zinc supplement
  Suggested use: 10-20 mg, three times daily

• WEEK 2
  
  Herbal support:
  1. Use an herbal tonic formula including Siberian & American Ginseng
  Suggested use: One dose, two times daily

  
  Nutritional support:
  1. Use a Vitamin E supplement
  Suggested use: 50-200 iu’s, two times daily

• WEEK 3
  
  Herbal support:
  1. Use Saw Palmetto, or a Saw Palmetto-based formula
  Suggested use: One dose, three times daily

  
  Nutritional support:
  1. Use a Zinc supplement
  Suggested use: 10-20 mg, three times daily

• WEEK 4
  
  Herbal support:
  1. Use an herbal tonic formula including Siberian & American Ginseng
  Suggested use: One dose, two times daily

  
  Nutritional support:
  1. Use a Vitamin E supplement
  Suggested use: 50-200 iu’s, two times daily

  
  

Note: With acute symptoms of BPH, use both the herbal and nutritional support remedies for up to one month. Also, include the appropriate homeopathic medicine and consider the addition of an Echinacea and Goldenseal combination.

The above is a sampling of the many options available for men interested in the treatment and prevention of prostate problems. This era in medical care is very exciting for many men who now have the opportunity to take better care of their health.

1. Cited in article, Harvard Health Letter, February, 1994
   
2. Cited in article, Health and Healing, Julian Whitaker, March 1992
   
3. Chempault, et al, Medical treatment of prostatic adenoma, Annals of Urology, 1984
   
4. Sultan, et al, Inhibition of androgen metabolism, Journal of Steroid Biochemistry, 1984
   
5. Hirano, et al, Effects of stinging nettle root…, Planta Medica, 1994
   
6. Bassi, Standardized extract of Pygeum africanum in the treatment of BPH, Minerva Urologica, 1987
   
7. Leake, et al, The effect of zinc…, Journal of Steroid Biochemistry, 1984
   
8. Judd, et al, Zinc… inhibits prolactin secretion, Brain Research, 1984
   
9. Stampfer, et al, Vitamin E consumption…, New England Journal of Medicine, June, 1993
   
10. Boerick, Materia Medica with Repertory, 1927,, p. 562

Janet Zand, OMD, L. Ac., is a respected naturopathic physician who lives and practices in the Los Angeles area. She has developed a unique and effective method of combining herbal medicine with nutrition, homeopathy and acupuncture. Her credentials include a Doctor of Naturopathy, Doctor of Oriental Medicine, and Certified Acupuncturist. Dr. Zand has over fifteen years of clinical experience treating with natural medicine, as well as having formulated her own line of herbal supplements.

Although you might feel embarrassed if you have urinary incontinence, you should nevertheless let your doctor know about it. It could be a symptom of a disorder that could lead to more trouble if not treated.

Causes


In most cases, the problem is curable and treatable.

Two categories of urinary incontinence are acute incontinence and persistent incontinence.

The acute form is generally a symptom of a new illness or condition (e.g., bladder infection, inflammation of the prostate, urethra or vagina, and constipation).

Side effects of some medications, such as water pills, tranquilizers, and antihistamines can also result in acute urinary incontinence.

Acute urinary incontinence comes on suddenly. It is often easily reversed when the condition that caused it is treated.

Persistent incontinence comes on gradually over time. It lingers or remains, even after other conditions or illnesses have been treated. There are many types of persistent incontinence. The 3 types that account for 80 percent of cases are:

• Stress Incontinence – Urine leaks out when there is a sudden rise in pressure in the abdomen (belly). The amount ranges from small leaks to large spills. This usually happens with coughing, sneezing, laughing, lifting, jumping, running, or with straining to have a bowel movement. Stress incontinence is more common in women than in men.
• Urge Incontinence – This inability to control the bladder when the urge to urinate occurs comes on suddenly, so there is often not enough time to make it to the toilet. This type typically results in large accidents. It can be caused by a number of things, including an enlarged prostate gland, a spinal cord injury, multiple sclerosis, or Parkinson’s disease.
• Mixed Incontinence – This type has elements of both stress and urge incontinence.

Other types of persistent incontinence are:

• Overflow Incontinence – Constant dribbling of urine occurs because the bladder overfills. This may be due to an enlarged prostate, diabetes, or multiple sclerosis.
• Functional Incontinence – With this, a person has trouble getting to the bathroom fast enough, even though he or she has bladder control. This can happen in a person who is physically challenged.
• Total Incontinence – In this rare type, with complete loss of bladder control, urine leakage can be continual.

Treatment


Care and treatment for urinary incontinence will depend on the type and cause(s). The first step is to find out if there is an underlying problem and to correct it. Treatment can also include pelvic floor exercises, called Kegel exercises, and other self-care measures (see Self-Care Tips in this section on pages 172-173). Medication, collagen injections (for a certain type of stress incontinence), or surgery to correct the specific problem may be needed.

Your primary doctor may evaluate and treat your incontinence or send you to a urologist, a doctor who specializes in treating problems of the bladder and urinary tract.

Questions to Ask

Have you lost control of your bladder after an injury to your spine or back?
Do you have these problems? Fever and shaking chills Back pain (sometimes severe) in one or both sides of the lower back or just at your midline Nausea and vomiting
Does your loss of bladder control come with any of these symptoms? Loss of consciousness Inability to speak or slurred speech Loss of sight, double or blurred vision Sudden, severe headaches Paralysis, weakness, or loss of sensation in an arm or leg and/or the face on the same side of the body Change in personality, behavior, and/or emotions Confusion and dizziness
Is the loss of bladder control more than temporary after surgery or an abdominal injury?
Do you have any of these problems? Burning Frequent urination Blood in the urine or cloudy urine Abdominal or low back pain
With the loss of bladder control, do you have diabetes or any of these symptoms of diabetes? Extreme thirst Unusual hunger Excessive loss or gain in weight Blurred vision Easy fatigue, drowsiness Slow healing of cuts and/or infections
If you are a man, do you have any of these problems? Dribbling urine and/or feeling the need to urinate again after you have finished urinating Voiding small amounts of urine often during the day The need to urinate while sleeping An intense and sudden need to urinate often A slow, weak, or interrupted stream of urine
Do you leak urine when you cough, sneeze, laugh, jump, run, or lift heavy objects?
Did you lose some bladder control only after taking a new medicine or after taking a higher dose of a medicine you were already taking?

Self-Care Tips

• Avoid or limit drinks, foods, and medicines that have caffeine (e.g., coffee, tea, colas, chocolate, and No-Doz).
• Limit carbonated drinks, alcohol, citrus juices, greasy and spicy foods, and items that have artificial sweeteners. These can irritate the bladder.
• Drink 1–2 quarts of water throughout the day.
• Go to the bathroom often, even if you don’t feel the urge. When you urinate, empty your bladder as much as you can. Relax for a minute or two and then try to go again. Keep a diary of when you have episodes of incontinence. If you find that you have accidents every 3 hours, for example, empty your bladder every 21/2 hours. Use an alarm clock or wristwatch with an alarm to remind you.
• Wear clothes you can remove quickly and easily when you use the bathroom. Examples are elastic-waist bottoms and items with velcro closures or snaps instead of buttons and zippers. Also, look for belts that are easy to undo, or don’t wear belts at all.
• Wear absorbent pads or briefs.
• Ask your doctor if you would benefit from using self-catheters. A self-catheter is a clear, straw-like device, usually made of flexible plastic, that you insert into the opening of the urethra; it helps you empty your bladder completely. Your doctor will need to show you how to use one. You need a prescription for self-catheters.
• Empty your bladder before you leave the house, take a nap, and go to bed.
• Keep the pathway to your bathroom free of clutter and well lit. Make sure the bathroom door is left open until you use it.
• Use an elevated toilet seat and grab bars if these will make it easier for you to get on and off the toilet.
• Keep a bedpan, plastic urinal (for men), or portable commode chair near your bed. You can get these at medical supply stores and drugstores.

Kegel Exercises


To strengthen your pelvic floor muscles, do Kegel exercises . They can help treat or cure stress incontinence. Even elderly women who have leaked urine for years can benefit greatly from these exercises. Here’s how to do them:

• First, identify where your pelvic floor muscles are. One way to do this is to start to urinate, then hold back and try to stop. If you can slow the stream of urine, even a little, you are using the right muscles. You should feel muscles squeezing around your urethra and anus.
• Next, relax your body, close your eyes and just imagine that you are going to urinate and then hold back from doing so. You should feel the muscles squeeze like you did in the step before this one.
• Squeeze the muscles for 3 seconds and then relax them for 3 seconds. When you squeeze and relax, count slowly. Start out doing this 3 times a day. Gradually work up to 3 sets of 10 contractions, holding each one for 10 seconds at a time. You can do them in lying, sitting, and/or standing positions.
• Women can also use pelvic weights prescribed by their doctor. A woman inserts a weighted cone into the vagina and squeezes the correct muscles to keep the weight from falling out.
• When you do these exercises:
  • Do not tense the muscles in your belly or buttocks.
  • Do not hold your breath, clench your fists or teeth, or make a face.
  • If you are not sure you’re doing the exercise right, consult your doctor.
• Squeeze your pelvic floor muscles right before and during whatever it is (coughing, sneezing, jumping, etc.) that causes you to lose urine. Relax the muscles once the activity is over.
• It may take several months to benefit from pelvic floor exercises and you have to keep doing them daily to maintain their benefit.

Usually, they have many treatment alternatives but they have no information about their choices. One example of effective alternatives is the reduction in blood pressure that meditation produces. Others are the dietary changes and exercise programs that lead to lowered cholesterol. Since the medical treatments for these two conditions are often more dangerous than the problems, it is worth seeking safer alternatives.

Dr. Dean Ornish has shown that patients with heart disease can often avoid surgery and reverse their heart disease with a combination of a low-fat diet, meditation, and exercise. Norman Cousins healed his ankylosing spondylitis (a form of arthritis of the spine) with laughter and high doses of vitamin C. He wrote about his experience in the New England Journal of Medicine, and followed this article with a book, The Anatomy of an Illness. Many patients have cured their digestive disturbances simply by avoiding certain foods.

Over and over, we are seeing the results of lifestyle changes in health care. A recent scientific medical conference put on by the American College for Advancement in Medicine was entitled: Lifestyle Medicine—Medicine for the Nineties. Researchers and physicians both attended and taught at this scientific meeting. Much of it related to the role of dietary supplements in medical therapy.

Dietary supplements are amongg the safest and most effective choices in health care. They are almost free of side effects, they are easy to take, they are relatively inexpensive, and they usually enhance many life functions besides the specific condition for which they are being given. Following is an example of how nutritionally oriented physicians might use supplements as part of the treatment for a specific health problem. This is a suggestion that is supported in the medical literature and in the experience of many physicians.

Remember this is an example, not a prescription for you, and the supplement list is in addition to many other health practices. Other supplements may be helpful, and you may not need all of these to get results. For more information on any one supplement, look for its description in Dietary Supplements. No one program is appropriate for everybody, but these suggestions are good starting points from which individual programs can be modified.

Prostate enlargement (benign prostatic hypertrophy or BPH) is a common affliction in men as they age. The prostate gland sits beneath the bladder and surrounds the urethra, the outflow channel for urine. Symptoms of enlargement include difficulty starting or stopping urination, frequent urination, urination at night, slow urine flow and a frequent sense of urgency to urinate. Surgery to remove some of the prostate tissue is commonly performed if the symptoms become severe enough.

There are many healthy approaches to managing prostate enlargement. If the symptoms are not severe, there is no risk from trying the alternatives to surgery. The new medication for BPH, finasteride or Proscar®, is not as effective as the herbs and other dietary supplements, and it has potential side effects. Adding pumpkin seeds to your diet is claimed to be helpful by many patients. They contain zinc and essential fatty acids that may help the condition. The following program of supplements is what I recommend for management of prostate problems:

	AM	PM
Basic Multiple Formula	3	3
Vitamin C 1000 mg	3	3
Magnesium aspartate 200 mg	1	1
GLA 240 mg (from borage oil)	1
Vitamin E 400 IU natural mixed	1	1
Saw palmetto standardized 160 mg	1	1
Pygeum africanum 25 mg	1	1
Nettle (Urtica dioica) standardized 125 mg	1	1
Zinc 50 mg		1