405 Testosterone & DHT [30 January 2017]

An article in this morning’s National Post (January 24) prompted this topic. It reported on a University of Toronto study that found male pattern baldness was twice as accurate in predicting risk of prostate cancer than the latest DNA test. A previous study from Australia found a link between prostate cancer and vertex balding (at the top of the head) but not frontal balding (receding hairline).

The link between baldness and prostate health is not new – we’ve suspected for years that bald men are more likely to have prostate problems. The link is the male hormone testosterone (T) or, rather, the more active form dihydrotestosterone (DHT). An enzyme called 5 alpha reductase converts T to DHT. DHT is essential for male development in the fetal stage and at puberty, and plays a few roles in adults, but excess DHT causes problems. Both male pattern baldness and benign prostatic hyperplasia (BPH) or enlarged prostate, are strongly linked to high DHT levels.

Back in 1941 two researchers Charles Huggins and Clarence Hodges discovered that testosterone “activated” prostate cancer and concluded that reducing testosterone would treat it. Decades of prostate cancer treatments have been based on this idea, called the “androgen hypothesis”.

That theory is only recently being questioned. Research by Dr. Abraham Morgentaler at Harvard Medical School found the opposite to be true – that the lower the testosterone levels, the higher the risk of prostate cancer. His results make more sense – testosterone levels peak at age 20 and decline with age while prostate cancer risk increases with age. A literature search found no evidence to support the androgen hypothesis over the past 75 years. Morgentaler explains: “The persistence of the androgen hypothesis despite strong contradictory evidence teaches us how difficult it is to abandon ideas learned during our training, even in this age of evidence-based medicine.”

While the effect on cancer is uncertain, both male pattern baldness and enlarged prostate can be improved by blocking the conversion of testosterone to DHT. Several natural products are known to safely block the 5 alpha reductase enzyme responsible: saw palmetto, Pygeum bark, stinging nettle root, beta sitosterol, pumpkin seed oil and green tea. Several of these are often combined in “prostate formulas” which are available in health food stores. I wrote about these and other natural products for BPH in #158 (March 2012).

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner. Find this article on my website for links to sources and further reading.

235 Boosting Testosterone [23 Sept 2013]

Men’s production of the male hormone testosterone declines as we age, approximately 10% each decade after age 30. This brings with it a number of health problems including fatigue, hair loss, lower libido, ED, moodiness (think “grumpy old men”), increased belly fat, muscle loss, reduced bone density, BPH, and increased risk of prostate cancer. I wrote about this in April 2009 #009. Hormone therapy is not recommended because of the side effects (like testes atrophy!). A better approach is to boost your body’s natural production. But how?

Brad King in his 2008 book Beer Belly Blues describes in a humorous way, how to increase testosterone with stress reduction, exercise (resistance and interval training), diet improvements, and certain supplements.

Dr. Jonathan Wright M.D. suggests this program:
• 30-50mg zinc;
• 40,000-50,000 IU vitamin A;
• 3 mg Boron; and
• 250-750 mg Tribulus terrestris (optional).

The Institute for Natural Healing offers "5 easy ways" to raise testosterone:
1. Reduce stress – high cortisol levels reduce testosterone production
2. Get enough sleep – missing sleep can lower testosterone levels 10-15%
3. Eat sufficient healthy fats – EFAs are required for testosterone production
4. Get enough vitamin D – a precursor for sex hormones including testosterone
5. Get adequate zinc – from oysters, crab, liver, pumpkin seeds & supplements

King in Beer Belly Blues discusses additional supplements:
• whey protein isolate – increases bone and muscle
• Chrysin – inhibits conversion of testosterone to estrogen
• Maca, Horny Goat Weed and Tongkat Ali – improve sexual function
• Beta Sitosterol – reduces BPH and prostate cancer risk
• Nettle root extract – increases free testosterone and protects prostate
• Indole-3 Carbinol (I3C) – from cruciferous vegetables, suppresses “bad” estrogens
• Lycopene – promotes prostate health

Conveniently there are testosterone boosting supplement formulas available with many of these ingredients. I still recommend reading King’s book for the full picture.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

228 Omega-3 & Prostate Cancer [5 August 2013]

Men - did you see any of the headlines last week about fish oil causing prostate cancer? If so, I hope you didn’t swear off salmon and throw away your Omega-3 capsules. The evidence the headlines were based on is pretty flimsy.

In an observational study published July 10 in the Journal of the National Cancer Institute, data from the SELECT Selenium and Vitamin E Cancer Prevention Trial were extracted to examine a possible link between omega-3 levels in blood and prostate cancer risk. A positive association was found with DHA, one of the fish oil Omega-3 EFAs and both low-grade and high-grade prostate cancer (44% and 71% increase respectively).

These numbers sound pretty significant, but are they? First of all, correlation does not necessarily mean causation. The lowest risk of prostate cancer in this study happened to correlate with the highest trans fatty acid levels, but no one is even suggesting that TFAs, with well-known harmful effects, prevent cancer.

Blood levels of EFAs depend on your most recent meal, not on long term eating habits, which is not included in the data. So we don’t know how much fish, if any, the men in this study ate or if they took omega-3 supplements.

The total omega-3 levels, as a percent of total blood lipids, in both groups was quite low – 3.66% in the group who got cancer and 3.62% in the group who didn’t, and the difference very slight. Yet Japanese men, who consume 8 times as much omega-3s as Americans, have a much lower prostate cancer rate.

The researchers in this study did not control for age, race or diet and other known risk factors may not have been completely accounted for. Of the men who got cancer, 53% were smokers, 64% regularly consumed alcohol and 80% were overweight or obese.

The overwhelming majority of valid studies – larger and much better designed – show that omega-3s lower cancer risk, including prostate cancer. One study from Harvard School of Public Health which followed 20,000 men for over 22 years found that men who ate fish 5 or more times per week had a 48% lower risk of prostate cancer death than those who ate fish less than once a week. And a 30 year study from Sweden concluded that eliminating fish from your diet could increase your risk of prostate cancer by up to 300%. Now that’s significant!

The only way to explain the study’s conclusions - and the news stories that promoted them – is a desire for sensational headlines and a strong anti-supplement bias. And I don’t think I’m stretching it here. One of the researchers, Alan Kristy, was quoted: “We’ve shown once again that use of nutritional supplements may be harmful.” Baloney! What they have shown is that following nutritional advice from mainstream media may be harmful.

Sources
Dr. Jonny Bowden in Huffington Post
Dr. Michael Murray
Dr Robert Rountree, Chief Medical Officer at Thorne Research, in Dr Nalini blog

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

158 Benign Prostatic Hyperplasia [26 March 2012]

This week’s topic will be of interest mainly to us older men. As we progress past our 40s, our prostate glands tend to enlarge, a condition called benign prostatic hyperplasia (BPH). Nodules growing within the prostate can block the urethra, interfering with urination resulting in incomplete emptying of the bladder, feelings of urgency to urinate, and frequent trips to the bathroom at night.

Several pharmaceutical drugs are effective at both relieving symptoms and reducing the size of the prostate, but are slow acting and not without significant side effects (which may include erectile dysfunction and loss of libido). If drug therapy fails, surgery may be considered, which is not without risk or side effects either (and doesn’t sound like fun to me!).

There are many natural herbals used for BPH like saw palmetto, pygeum, stinging nettle, and pumpkin seed. The active ingredient in these appears to be a compound called beta-sitosterol. While they do a fair job of relieving the symptoms of BPH, there is no evidence that they actually reduce the size of the prostate which is the underlying cause of the problem.

One exception among natural prostate products is defined pollen extract. Developed in Sweden and long popular in Europe, it is now available in Canada. The pollen extract is made from specific pollens – mostly rye and some other grasses – and should not be confused with bee pollen. In clinical trials defined pollen extract not only improved symptoms of BPH as well or better than the herbals but also reduced prostate size. And it acts relatively quickly with improvements noticed in just a few weeks.

The pollen extract is safe for long term use. It has been shown to lower PSA levels and shows promise in reducing the risk of prostate cancer. Trials have also shown that the pollen extract is helpful with chronic prostatitis and prostatodynia (while saw palmetto and the other herbals are not).

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

143 The Vitamin E Families [5 December 2011]

Did you see the recent news story that 400 IU of Vitamin E raises prostate cancer risk 17%? It’s typical of a number of recent news items in the popular media written by journalists who don’t dig deep enough to learn the whole truth. What the vitamin E stories didn’t say is that the supplement used was synthetic alpha tocopherol which has known toxic effects. Synthetic vitamin E (dl-alpha tocopherol or all-rac-alpha-tocopherol acetate) is best avoided – use only the biological form d-alpha tocopherol.

There are two families of vitamin E, each with four “siblings” – the better known tocopherols and their cousins the tocotrienols, each with alpha, beta, gamma and delta forms. Alpha tocopherol is the most biologically active form and is often the only E in cheaper supplements. The problem with taking only alpha tocopherol is that it displaces gamma tocopherol which is known to prevent cancer (a large study from Johns Hopkins showed a 5 fold reduction in prostate cancer risk in men who had the highest gamma tocopherol levels). A mixed E with all four forms of tocopherols is better, and those including the tocotrienol family are best.

Tocopherols are best known for their antioxidant properties – protecting our cells from damage by free radicals and other carcinogens (cancer causing chemicals). Tocopherols also promote heart and circulation health, enhance the immune system, protect the brain, help with PMS and menopausal symptoms, improve fertility, prevent cataracts, and slow the aging process.

Recent studies of tocotrienols are very promising, especially in cancer prevention. Studies are showing that delta tocotrienol induces aptosis (cell death) in cancer cells. Tocotrienols may also slow angiogenesis – the development of new blood vessels to feed growing tumours. Tocotrienols are also many times more efficient at finding and neutralizing free radicals than the tocopherols.

I would like to see the study referred to in my introduction repeated using a natural complete vitamin E. The results would likely be quite different.

Main sources: mercola.com and Cancer Defeated Newsletter #138, November 27, 2011

This article is intended for educational purposes only; for medical advice consult your licensed health practitioner.

050 Resveratrol [15 February 2010]

Resveratrol is a new natural health product that has been in the news recently, and is now available as a nutritional supplement.

Resveratrol is a polyphenol found in the skins and seeds of many fruits and berries, including grapes, and occurs in small amounts in red wine. This may at least partly explain the French Paradox – that people in France have healthy cardiovascular systems despite eating an unhealthy diet, smoking, and drinking.

Studies have so far found an amazing variety of benefits. Resveratrol:
• is a powerful antioxidant that protects the body from free radicals including the dangerous ROS (reactive oxygen species) from tobacco smoke;
• lowers the risk of many types of cancer including liver, breast, prostate & colon;
• has powerful anti-inflammatory properties that help protect the heart, liver and brain;
• helps control blood sugar and prevent obesity;
• improves prostate health, increasing urine flow;
• lowers blood pressure and increases cardiovascular health;
• improves cholesterol by lowering LDL and increasing HDL blood lipids;
• increases energy and speeds recovery from exertion;
• appears to have anti-aging properties – animal studies show increased life-spans of 15% to 60%.

Resveratrol can be increased in your diet by consuming more grape skins and seeds, certain berries and fruits, and by drinking more red wine. To get enough for a therapeutic dose however will be a problem. Different sources suggested 20mg, 50 mg, and 100-500 mg as being optimal for different benefits. Even the lower dose would require drinking several bottles of wine daily, which would be detrimental for its alcohol, sugar and calories. And fruits and berries are high in sugar so should be eaten in moderation. Thus the best source of resveratrol is in a supplement form, commonly extracted from grape skins & seeds or from Japanese Knotweed.

One caution – some of the above benefits are known only from animal studies and not yet proven in humans. Several human trials are underway and there should be more information available in the coming years. So far no negative side effects have been observed at normal doses although several temporary side effects were noted at doses over 500 mg.

So, is resveratrol another passing fad or a modern “fountain of youth”? Time will tell, but meanwhile there’s no good reason not to experience some of the benefits for yourself.

This article is intended for educational purposes only; for medical advice consult your licensed health practitioner.

009 Male Menopause [27 April 2009]

Men go through menopause too, but it's more gradual than in women. It's also more insidious in its effects on men's health. The good news though is that to a significant extent, male menopause is reversible.

A man's testosterone levels are optimal in his 20s. Starting in his 30s production of this important hormone declines steadily until by age 60 he has lost 60%. This decline, considered normal by the medical profession, leads to a wide range of health problems, many quite serious.

Low testosterone is linked to a loss of muscle mass and increased fat, especially abdominal fat. The fat compounds the problem because an enzyme called aromatase occurring in fat cells converts testosterone into estrogen.

The list of conditions caused by low testosterone include the obvious ones of hair loss, loss of muscle mass, ED and low libido, but also more serious ones like increased body fat, bone density loss, prostate enlargement, prostate cancer (once thought to be caused by excess testosterone!), cardiovascular problems, diabetes, aching joints, insomnia, moodiness (think "grumpy old men") and depression. Sound familiar, guys?

Sports nutritionist Brad King, in his informative and humorous book "Beer Belly Blues" describes all these problems and how they are connected to low testosterone. He warns against hormone replacement therapy - taking synthetic testosterone by injection or patch - because of the serious side effects. Instead he describes how the body's own production of testosterone can be increased safely and effectively with a combination of specific exercise, dietary changes and supplementation. For more on this subject see www.beerbellyblues.com

This article is intended for educational purposes only; for medical advice consult your licensed health practitioner.