Benign prostatic hyperplasia / hypertrophy (BPH)

What is BPH?

Symptoms of BPH

BPH and cancer

BPH causes and risk factors

Prevention / remedies / cures / treatment for BPH

References

What is BPH?

Enlargement of the prostate gland (benign prostatic hyperplasia, benign prostatic hypertrophy or BPH) is a common problem in middle-aged and older men. The urethra is choked by an enlarged prostate gland.

BPH almost always involves hyperplasia (an increase in the number of cells) rather than hypertrophy (a growth in the size of the individual cells).

BPH rarely occurs in men under the age of 40. There is evidence of BPH in 40% of men in their 50's, nearly 70% in their 60's, and up to 90% in their seventies and eighties. In nearly half these cases, the symptoms are severe enough to need treatment. The degree of severity ranges from being a nuisance to requiring major accommodations to a person's lifestyle. The most serious situation is an inability to urinate, which may need hospitalisation and bladder catheterization. BPH is not normally painful.

Interestingly, in most men oestradiol levels start climbing from the age of fifty and peak in their late 60's. During the same period progesterone levels decline, just the opposite to oestradiol.

Symptoms of BPH

• Sleep disturbance - the need to wake to urinate frequently through the night (nocturia)
• Frequent need to urinate
• Urgency (compelling need to urinate that cannot be deferred)
• Incontinence (both while awake or sleeping)
• Weak urinary stream
• Painful urination (dysuria)
• Hesitancy (needing to wait for the stream to begin)
• Intermittency (when the stream starts and stops intermittently)
• Straining to void
• Dribbling
• Incomplete voiding may cause the proliferation of bacteria in the bladder residue and a urinary tract infection (UTI)
• Urinary bladder stones can form from the crystallisation of salts in the residual urine

BPH and cancer

Elevated and rising levels of prostate specific antigen (PSA) have a high correlation with prostate cancer. However, there is disagreement on whether BPH can lead to prostate cancer, which is one of the most common forms of cancer in men.

High levels of the female estrogen hormones and chemicals that mimic estrogen exist in our environment today. Studies show that when prostate cells are exposed to excessive estrogen, they proliferate and eventually become cancerous. Having sufficient progesterone protects against this effect, and to a lesser extent testosterone also protects. Unfortunately, as men age their levels of both progesterone and testosterone fall. This is why BPH is so common in older men, and almost unheard of in young men. As you would expect, when the low level of progesterone (and testosterone) is corrected, the BPH cellular growth (the enlargement or swelling) and even cancers are reversed.

BPH causes and risk factors

• Zinc deficiency is the most important deficiency that causes prostate enlargement. Zinc is closely involved in the production of semen and in prostate health. Zinc assists with apoptosis in the prostate, and with the production of citric acid in semen. Zinc also prevents testosterone being converted into estrogens and DHT. Zinc deficiency is surprisingly common because this element is deficient in most foods today, and because pyroluria affects at least 10% of the population. The Grow Youthful web page on zinc has a quick and simple test for zinc deficiency. (19, 24, 25)
• Vitamin D deficiency. (11, 26)
• Sugar and refined carbohydrates. A diet high in sugar, starch and refined carbohydrates promotes high insulin levels, which stimulate the growth of prostate cells because these cells have insulin receptors. (12, 13, 14, 24) This type of diet also leads to weight gain, another risk factor for prostate problems.
• Bad oils. High consumption of fats, particularly omega-6 oils (fats from seeds, grains and nuts). These include canola, cottonseed, corn, peanut, sesame, soy and sunflower oils. (4, 9, 10)
• Dietary deficiencies. The Standard American Diet (SAD) is high in ultra-processed foods, sugar and harmful oils, and low in minerals and other nutrients. Deficiencies in iodine, vitamins C and D, omega-3 fats and other nutrients may also be responsible for the development of BPH.
• Dairy products. The consumption of milk and dairy products is associated with prostate cancer. (14, 15)
• Eggs. The consumption of eggs is associated with prostate cancer. (14, 15) Choline also has this association, apart from eggs which are a rich source of choline. (16, 17)
• Lack of sunlight. Living indoors most of the time. Being indoors means being exposed to artificial light, primarily in the blue spectrum, for large parts of the day. Vitamin D, among other hormones, will likely be deficient. (11, 26)
• Elevated growth and reproductive hormones. Prolactin, the hormone that stimulates milk production by the mammary glands, is a primary cause of BPH. The level of prolactin is raised by consuming dairy products, by having a high level of estrogen in the body, or by phytoestrogens.
• Estrogen. Aromatase is an enzyme that converts androgens (particularly testosterone) into estrogens. Aromatase is increased by the level of insulin in the body; by being fat; by the consumption of alcohol; and by the consumption of whole grains.
• Men suffering from BPH should seek aromatase inhibitors in their diets and lifestyle. Aromatase inhibitors are listed in Remedies below.
• Men who lead a sedentary western lifestyle have a much higher incidence of symptomatic BPH than men that lead a traditional or rural lifestyle. Research in China has shown a big increase in BPH among men who migrated from rural areas to cities. (3)
• Perineal constriction causing a lack of muscular flexibility, movement and drainage around the perineum and scrotum. Cyclists are subject to high perineal pressure and perineal restriction. The use of tight underpants or clothing in this area may also be a risk factor. This may lead to a restriction of the lymphatic system and constriction of lymphatic drainage. Constriction of the lymphatic system is a similar risk factor for breast cancer.
• Insufficiently frequent ejaculation. Research by Professor Graham Giles (2) found that men who ejaculated the most in their 20's, 30's and 40's later had 30% less prostate cancer than those who ejaculated the least. He suggested that "semen is a very potent and strong brew of lots of chemicals which, because of their biological reactivity, could be carcinogenic if left to lie around" and "that frequent ejaculation prevented semen from building up in the ducts, where it could potentially become carcinogenic." This argument has merit, particularly in a modern Western man who has a more toxic body. Men who cleanse their bodies using the principles in Grow Youthful (living food, regular exercise and constant movement, good breathing, sufficient water, etc) substantially reduce their risk of getting any type of cancer. Note that Professor Giles did not examine the benefits of non-ejaculatory sex, which is also likely to prevent build-up and stagnation. Nevertheless it is a reminder that men, especially healthy young men, should regularly ejaculate.

Prevention / remedies / cures / treatment for BPH

After increasing your zinc and making other changes suggested on this Grow Youthful web page, it will normally take at least a couple of months to notice a significant reduction in prostate size, but symptoms of prostate enlargement may improve quite quickly.

• Zinc. The most important element for prostate health. The Grow Youthful web page on zinc shows how to do a quick test for zinc deficiency. Red meat is the richest and most bioavailable food source of zinc. Pumpkin seeds (pepitas) are a vegetarian source of zinc (but way less than meat), which also contain phytosteroids that reduce prostate inflammation and swelling. (19, 24, 25)
  
  Ensure you get at least 25 mg of elemental zinc per day. If you are a vegetarian or a vegan, or you have pyroluria, you may need to increase this by 50%.
• Vitamin D. (11, 26)
• No sugar, no refined carbohydrates. Cut out all foods containing any added sugar. Avoid carbohydrate foods made with white flour like bread and pastries; avoid rice, pasta, all dried fruits, sweet fruits and anything even slightly sweet that will spike your blood glucose level. (12, 13)
• Aromatase inhibitors. The most potent aromatase inhibitor is fresh lemon peel. (20, 21, 22) Blend a whole medium-sized lemon with some water, and drink this every day. It will take months to notice a significant improvement, but remember this is a problem that took years to develop. Other aromatase inhibitors include cruciferous vegetables like broccoli, cabbage, rocket (arugula) and kale; fried white button mushrooms; flax seeds; green tea. It is also essential to reduce the level of blood insulin by avoiding sugar and carbs, and to fast. Avoid alcohol and grains in all forms. (18)
• Fasting. Both a restricted-time eating window every day, and regular fasts lasting one or more days, are effective in reducing or completely healing a swollen prostate, in addition to healing numerous other degenerative diseases.
• Avoid dairy products, which are high in prolactin, estrogen and other steroid hormones. Prolactin, the hormone that stimulates mammary glands and milk production, is strongly associated with BPH. Estrogen and insulin are two hormones associated with growth. Dairy products contain various forms of estrogen which make a calf grow quickly. Do everything possible to minimise estrogen and insulin to avoid unwanted growth of the prostate. The most important to avoid are milk, store-bought yogurts, non-artisan cheeses, all products containing milk powders, milk solids, whey, casein, caseinates, lactose and protein powders - the worst being ice cream, sweet yogurts and all low-fat dairy products. (14, 15)
• Avoid estrogen, estrogen look-alikes, and foreign hormones like bovine prolactin from dairy milk, for example. Avoid all soy products, especially white soy products, and everything made with soy. Soy beans are estrogenic. (19, 24, 25)
• Avoid omega-6 oils. Research shows that vegetable oils extracted from nuts, grains, seeds and legumes raise the risk of prostate cancer (and all other cancers). (3, 4, 7, 8, 9, 10, 14)
• Avoid eggs. (14, 15)
• Reduce but still include a little saturated fat in your diet to prevent prostate cancer. (14)
• Good oils to use for prostate health are extra virgin, first pressed, fresh and genuine olive oil, macadamia oil, and to a lesser extent, coconut oil. Coconut oil contains lauric acid, and olive oil contains phytosteroids, which both help to reduce prostate inflammation and prostate swelling. (14, 15)
• Get more vitamin D from sunlight. Get out in the sun, get lots of natural sunlight into your eyes and onto your skin all over your body every day. Eat in the sunlight. Walk and exercise in the sunlight. If you are living in a high latitude and suffering badly from your illness, you may have to move to a location closer to the equator (less than 20 degrees latitude). To test how successful sunlight is, enjoy your next holiday/vacation in a place close to the equator. Spend your days outdoors. Get up and out of bed so you can watch the sunrise. Do not wear sunglasses. Do not use sunscreens. Of course, take care not to get sunburned or even slightly red. (11)
• Exercise. Regular exercise has a strong protective effect against cancers generally. Avoid sustained periods of inactivity. (7, 8, 14) More intense aerobic cardiovascular exercise a couple of times per week, even for short periods, is very effective. High intensity interval training (HIIT) is particularly effective for prostate health. Check with a health professional before starting HIIT, and start gently. In 2013 a study (5) showed that acute exercise protects against and even prevents prostate cancer cell growth. Another study (6) in 2016 showed an even stronger effect of exercise in cancer prevention.
• Lycopene, a carotenoid available in cooked red vegetables (especially tomatoes) and fruits is helpful in the prevention of BPH. To make it bio-available, it needs to be cooked with oil - think of a delicious marinara sauce prepared with ripe tomatoes, basil, garlic and olive oil. The frying should be at low temperature, such as a mix of water and oil. (14, 23)
• Cayenne pepper.
• Passionflower tea. This herb is a rich source of chrysin, a flavonoid which helps normalise the levels of hormones such as testosterone and estrogen. Chrysin also activates GABA, a calming neurotransmitter, and lowers cortisol. Passionflower helps if you are stressed, tense or anxious.
• Stinging nettle is widespread and common, and is normally regarded as a weed. The leaves are edible and bitter, and may also be blanched before eating. You can easily grow this plant in a small garden or planter box, and harvest the roots yourself to make stinging nettle root tea. The root can also be purchased in powder or capsule form. Consuming the root helps normalise the levels of hormones such as testosterone and estrogen.
• Green tea. 3-5 cups per day of green tea show significant improvement in prostate hypertrophy. Moderate coffee consumption is also beneficial.
• Saw palmetto.
• Vitamin C sufficiency is important. Do not supplement with ascorbic acid. Preferably get vitamin C from raw salads and non-sweet fruits like lemons.
• Reduce stress. Try to avoid stimulants like caffeine, nicotine, alcohol and other drugs. Take time out, start meditating, review how you are living your life (again, Grow Youthful can help here). (7, 8)
• Bee pollen. Research has shown that it can help with prostate inflammation. (1)
• Yoga, loose perineum. BPH is significantly lower among Indian men who spend their lives sitting and working cross legged. A traditional Ayurvedic remedy for BPH and other prostate problems is yoga. For example, the yoga pose of mula bandha or root lock works on the pelvic floor region by gently contracting and releasing the perineum (the muscle between the genitals and the anus). Other poses that open the hip area will also be suggested by a yoga therapist.
• Moringa is a widely used Indian and Ayurvedic herb which can be purchased in a powder form. Moringa works as an anti-inflammatory and also supresses tumour growth.
• Iodine.
• Borax may help prostate cancer (but does little to assist with BPH.)
• Apple cider vinegar.
• Gum turpentine.
• Kerosene.
• Stop smoking. (14)
• See details of remedies recommended by Grow Youthful visitors, and their experience with them.

References

1. Buck A.C., et al. Treatment Of Outflow Tract Obstruction Due To Benign Prostatic Hyperplasia With The Pollen Extract Cernilton, A Double-Blind, Placebo-Controlled Study. British Journal of Urology 66:398-404. 1990.

2. Professor Graham Giles. Cancer Council, Victoria, Australia. British Journal of Urology, July 2003.

3. T. Colin Campbell. The China Study. Startling Implications for Diet, Weight Loss and Long-Term Health. BenBella Books, 2006.

4. Lloyd JC et al. Effect of isocaloric low fat diet on prostate cancer xenograft progression in a hormone deprivation model. Journal of Urology 2010 Apr;183(4):1619-24.

5. Helene Rundqvist, Martin Augsten, Anna Stromberg, Eric Rullman, Sara Mijwel, Pedram Kharaziha, Theocharis Panaretakis, Thomas Gustafsson, Arne Ostman. Effect of Acute Exercise on Prostate Cancer Cell Growth. PLoS ONE 8(7): e67579. doi:10.1371/journal.pone.0067579. Published 5 July 2013.

6. Line Pedersen, Manja Idorn, Gitte H. Olofsson, Britt Lauenborg, Intawat Nookaew, Rasmus Hvass Hansen, Helle Hjorth Johannesen, Jurgen C. Becker, Katrine S. Pedersen, Christine Dethlefsen, Jens Nielsen, Julie Gehl, Bente K. Pedersen, Per thor Straten, Pernille Hojman. Voluntary Running Suppresses Tumor Growth through Epinephrine- and IL-6-Dependent NK Cell Mobilization and Redistribution. Cell Metabolism, Volume 23, Issue 3, p554-562, 8 March 2016.

7. Ornish D, Weidner G, Fair WR, Marlin R, Pettengill EB, Raisin CJ, Dunn-Emke S, Crutchfield L, Jacobs FN, Barnard RJ, Aronson WJ, McCormac P, McKnight DJ, Fein JD, Dnistrian AM, Weinstein J, Ngo TH, Mendell NR, Carroll PR. Intensive lifestyle changes may affect the progression of prostate cancer. Journal of Urology. September 2005. 174(3):1065-9; discussion 1069-70.

8. Dean Ornish, Mark Jesus M. Magbanua, Gerdi Weidner, Vivian Weinberg, Colleen Kemp, Christopher Green, Michael D. Mattie, Ruth Marlin, Jeff Simko, Katsuto Shinohara, Christopher M. Haqq, Peter R. Carroll. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proceedings of the National Academy of Sciences. 17 June 2008. 105(24): 8369-8374. Published online 2008 Jun 16. doi: 10.1073/pnas.0803080105. PMCID: PMC2430265.

9. R James Barnard, Tung H Ngo, Pak-Shan Leung, William J Aronson, Lawrence A Golding. A low-fat diet and / or strenuous exercise alters the IGF axis in vivo and reduces prostate tumor cell growth in vitro. Prostate. 2003 Aug 1;56(3):201-6. PMID: 12772189.

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11. Trude Eid Robsahm, Steinar Tretli, Arne Dahlback, Johan Moan. Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway). Cancer Causes & Control. March 2004, Volume 15, Issue 2, pp 149-158.

12. Benjamin N Breyer 1, Aruna V Sarma. Hyperglycemia and insulin resistance and the risk of BPH/LUTS: an update of recent literature. Curr Urol Rep. 2014 Dec; 15(12): 462. doi: 10.1007/s11934-014-0462-x

13. Wolfgang Kopp. Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension? Nutr Metab Insights. 2018 May 8;11:1178638818773072. doi: 10.1177/1178638818773072. eCollection 2018.

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16. Richman EL, Kenfield SA, Stampfer MJ, Giovannucci EL, Zeisel SH, Willett WC, et al. Choline intake and risk of lethal prostate cancer: incidence and survival. Am J Clin Nutr. 2012;96:855-863.

17. Johansson M, Van Guelpen B, Vollset SE, Hultdin J, Bergh A, Key T, et al. One-carbon metabolism and prostate cancer risk: prospective investigation of seven circulating B vitamins and metabolites. Cancer Epidemiol Biomark Prev. 2009;18:1538-1543.

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