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Acu-Cell Disorders - Prostatitis
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PROSTATITIS & BPH:  Nutritional Causes, Prevention and Therapies
   
Most patients and many practitioners alike seem to think that Zinc is a cure-all for all prostate-related
problems, or that they all result from insufficient zinc intake, however only an enlarged prostate (benign
prostatic hypertrophy / hyperplasia, or BPH), is at times linked to below-normal cellular levels of zinc.
Subsequently, with some exceptions, vitamins or minerals used in the treatment of BPH will generally
not work for Prostatitis, or should be avoided.

Prostatitis presents with above-normal, to typically very high cellular levels of zinc, and symptoms
are invariably worsened by either supplementing extra zinc, consuming foods that are high in zinc, or
by any other aspects or dietary life style that synergistically promotes greater zinc retention.

Some individuals claim that their condition improved after supplementing zinc, but it always turns out
that they either did not have Prostatitis in the first place - i.e. they self-diagnosed their condition, or a
misdiagnosis was made by an unqualified practitioner.
However, even qualified urologists frequently disagree on the proper classification of the disorder
and/or the best course of treatment, unless a patient presents with a conclusive, lab-supported case
of acute bacterial prostatitis.
The reason is simply that the term "Prostatitis" over the years has become synonymous with a variety
of symptoms that include bacterial and non-bacterial Prostatitis, CPPS (chronic pelvic pain syndrome),
prostatodynia, proctalgia (anal / rectal pain), interstitial cystitis, and also Benign Prostatic Hypertrophy,
for which zinc supplementation may actually be indicated and beneficial.

Commonly agreed upon causes of Bacterial Prostatitis include pathogens such as escherichia coli
(E. coli), found in about 90% of patients, or proteus, enterobacter, pseudomonas, streptococcus and
staphylococcus, serratia, untreated yeast infections and STDs (sexually transmitted diseases), and
there are additional considerations of tuberculosis (tuberculous prostatitis), and other viral or bacterial
infections.
However it is commonly agreed that better than 90% of chronic prostate complaints are related to
Non-Bacterial Prostatitis (with negative laboratory findings, or no documented culture), for which
antibiotics are not effective or indicated, and where generally no particular cause is found.

When non-specific rheumatoid-types of symptoms are experienced in addition to prostate pain, a low-
level chronic systemic infection is suspect that may result secondary to oral focation (sinuses, tonsils,
teeth, gums...), or other areas in the body.  In those cases, all symptoms readily disappear when the
problem area is identified and resolved.  With odontogenic disturbances, the distal irritation is almost
always ipsilateral, so for the purpose of identifying any Prostatitis involvement, only left-sided foci would
be a consideration.

While it is recognized that Prostatitis can generate Referred Pain in other locations (usually the lower
back), both upper and lower incisors likewise are capable of triggering chronic Genitourinary Pain.
The left side involving the 1st + 2nd upper or lower odonton is prostate / uterine-specific, and the right
side involving the 1st + 2nd upper or lower odonton is bladder-specific, having the potential of causing
chronic Prostatitis (left side), or interstitial or chronic cystitis (right side).  In a couple of patients I have
been able to trace the cause to failed root canal work where their symptoms promptly and permanently
disappeared following additional endodontal intervention.

It is not unusual for some men to experience left-sided Sciatic Pain in addition to prostate pain and
burning, since most cases of non-surgical sciatica involve a  zinc / potassium ratio conflict.  Correcting
a patient's Zn/K ratio will not only resolve sciatic pain, but any related prostate pain as well, provided
zinc levels are normal.  This can be accomplished through nutritional intervention (food, supplements),
or through needle, or needle-less electro-Acupuncture.

Although the use of acupuncture would appear to be symptomatic therapy, one of the long-term effects
of embedding needles in patients' ears for ongoing pain relief includes changes in a patient's chemical
profile --- i.e. when the corresponding sciatic area in the ear was treated, there would eventually be a
change with cellular zinc and potassium levels.  This would explain the permanent pain relief some
patients experience following certain types of acupuncture treatments, unlike - or in addition to - the
supposed endorphin effect.

In some cases, stomach acid-lowering medications appear to help improve Prostatitis symptoms,
which is likely due to the calcium-raising effect that many of these types of stomach remedies exhibit.
Calcium is not only a very potent zinc antagonist, but it has significant anti-inflammatory properties as
well.  When supplementing larger amounts of calcium, it may be prudent to include higher doses of
Vitamin D for its (prostate) cancer-protective properties also.

Since mainstream medicine does not have a very good track record in the successful treatment of
Chronic Prostatitis (CP) - particularly abacterial varieties, many men look into alternative methods
trying to resolve their problem, and they frequently end up using a shotgun approach by combining all
the advice gathered from various sources.
Herbs commonly recommended for prostatitis include Pygeum, which is the bark of the African prune
tree (pygeum africanum), Stinging Nettle, and Goldenseal.  There are also a few anecdotal success
stories involving the use of Cranberry Juice, and the flavonoid Quercetin.  However, while adequate
amounts of bioflavonoids provide many health benefits, higher amounts of quercetin (recommended
by some advocates for Prostatitis) have been found to cause DNA damage in a number of rat studies.

Antibacterial remedies that have proven successful in the treatment of other inflammatory conditions
may be a consideration for Prostatitis sufferers who have not had much luck with any other alternative
remedies.  They include the regular intake of a higher dose of fresh or freeze-dried Garlic, Turmeric,
Mastic gum (Pistacia lentiscus), Sulforaphane capsules, and any of a number of Probiotic-type
(friendly bacteria) supplements consisting of Lactobacillus Acidophilus and Bifidus.

Sulforaphane, found in broccoli and other cruciferous vegetables, was originally studied for its cancer-
inhibiting properties, but was subsequently also found effective in the treatment of H. Pylori, a bacteria
responsible for causing stomach ulcers, cancer, asthma, migraine headaches, heart, gum and skin
diseases.  Broccoli sprouts contain anywhere from 30x to 50x the amount of sulforaphane compared
to the mature plants, with supplements being available from a low of 150 mcg to over 2,000 mcg / cap.

The herb Saw Palmetto, or Phytosterols are routinely recommended for the symptomatic treatment
of an Enlarged Prostate (BPH).  While some practitioners recommend these for Prostatitis also, none
of the patients I have treated for Prostatitis and who had tried either saw palmetto, beta-sitosterol, or
other sterols and sterolins, had found them to be helpful for that condition.
Since saw palmetto possesses alpha-5-reductase inhibitory activity (either inhibiting the conversion of
testosterone to dihydrotestosterone, or blocking some effects of testosterone), its use has also been
recommended in the treatment of male-pattern hair loss.

Dietary considerations include the avoidance of foods high in zinc (shellfish, herring, organ meats,
wheat germ, soybeans, dairy, and many seeds and nuts), which for some men may be difficult to follow,
so supplementing zinc antagonists (see below), may be a more convenient approach.  There are some
claims that alcohol, coffee, cola drinks, and chocolate have an adverse effect on Prostatitis as well.

While zinc is pro-inflammatory, Copper is anti-inflammatory and also a zinc antagonist, so for some of
those suffering from Prostatitis, a higher intake of copper-rich foods, or short-term Cu supplementation
can be helpful.  Unfortunately, a considerable percentage of the population suffers from Cu overload,
which would therefore prohibit additional copper intake for most Prostatitis patients.

Due to the paired association of Potassium and Zinc, high potassium-containing foods or beverages
should also be avoided because of the pro-inflammatory effect of high potassium intake on the urinary
bladder, which generally has a negative effect on the prostate as well.  For instance, chronic and acute
cystitis necessitate a potassium-lowering approach, which - with some exceptions (structural bladder
problems after surgery, or prolapse) - will resolve most chronic inflammatory bladder problem.

B-Complex has a zinc and potassium - raising effect so higher amounts should not be supplemented.
However, as mentioned above, this only applies to Prostatitis but not BPH, which may actually benefit
from an increase of these same nutrients, including potassium. (see also "Acu-Cell Nutrition" for details
on zinc / potassium, copper, and B-Complex Vitamins).

In contrast to testicular cancer, which presents with either excessively high cellular zinc levels (left side)
or excessively high cellular potassium levels (right side), Prostate Cancer is seen with both, excessive
and deficient zinc levels in addition to elevated phosphate levels, so maintaining a normal phosphorus
and zinc status is important from a preventive aspect.  It is interesting to note that prostate cancer is
also more prevalent with above-normal and below-normal free testosterone levels, necessitating a
similar preventive approach of trying to maintain normal testosterone levels throughout one's lifetime,
in addition to following general guidelines of inhibiting the aromatase enzyme to reduce estradiol.

 *        *        *

Some practical, clinical considerations in the treatment of Prostatitis and BPH:

Since there may be more than one possible cause, a detailed diary should be kept on one's daily
food and beverage intake, along with other activities (prolonged sitting...), to isolate, and subsequently
help eliminate all potential causes of either Chronic Prostatitis, occasional flare-ups of Prostatitis, and /
or other prostate-related problems, including symptoms accompanying an enlarged prostate (BPH).

Lowering cellular zinc levels through diet and supplementation provides the most effective, safest,
and cheapest treatment approach for the great majority of Chronic Prostatitis sufferers, with the most
common zinc antagonists consisting of Vitamin C, Calcium with Vit D, Selenium, Folic Acid, Vitamin A,
Vitamin B1, and at times Iron - but rarely Copper - as individually indicated.

If digestive problems (i.e. bowel disturbances) accompany flare-ups of Prostatitis, one should look
into a potential intolerance to specific foods or beverages, including diets containing a lot of hot spices
(chili / black pepper, cajun, curry), or a high oxalic acid content such as found in rhubarb, Swiss chard,
spinach, parsley, beets / beet greens, carrots, peanuts, or cocoa products.  Some berries (particularly
blueberries), can also cause flare-ups of Prostatitis in prone individuals.

Foods contaminated with pathogens such as E.coli, that may be present on greens or lettuce (even
after careful washing), or in under-cooked meats, are a well-known trigger for Bacterial Prostatitis.
If antibiotics have failed to improve the symptoms of Bacterial Prostatitis, a combination of cranberry
juice or extract, and sulforaphane caps in the 500 mcg / day range - or 2,000 mcg twice a week - may
be an option following an initially higher dose of 2,000 - 6,000 mcg / day, until symptoms are brought
under control.
The use of prostate and bacteria-specific Nosodes may be required in more resistant cases, which
however are usually only available through a medical practitioner.  [Nosodes are remedies that are
made up of pathogens or diseased tissue of the same type as being treated, but are highly potentized
to trigger an immune response].

If left-sided sciatica accompanies prostate pain, providing relief for sciatica usually reduces prostate
pain as well.  While supplementing zinc alone would theoretically help left-sided sciatica, this is rarely
done in practice since the low zinc / high potassium ratio won't change -- i.e. as zinc levels increase,
so will potassium levels, so instead, one needs to supplement Chelated Chromium in the 1000 mcg -
3000 mcg range, since chromium supports zinc retention, while lowering potassium at the same time.
Subsequently, one's zinc / potassium ratio normalizes, and with it any spinal alignment problems.
However, zinc may be added if its levels are well below normal and if the pain is not due to Prostatitis.
Needle acupuncture, or especially needle-less electro-acupuncture may also be a consideration, which
will simultaneously provide relief from sciatic and prostatic pain.

If nutritional supplements are used to treat Benign Prostatic Hypertrophy, then Chelated Zinc in the
15-100 mg range, depending on its deficiency, may be part of a formulation to help shrink the prostate,
which may include Pygeum, Nettle Root extract, Saw Palmetto, Vitamin A, Pumpkin Seed Oil,
Melatonin, and Ginseng.  With the exception of Prostatitis, eating Pumpkin Seeds regularly provides
all-round benefits for many urinary / prostate-related problems, while many cold and allergy types-of
medications have a reputation of worsening symptoms of an enlarged prostate.

Since a declining testosterone / estrogen ratio is a major contributing factor in the development of
Benign Prostatic Hypertrophy, a more simplified approach - to reduce estradiol levels - consists of
using Milk Thistle along with zinc and potassium, which not only eases the symptoms of BPH, but
reduces the risk of prostate cancer as well.

Chronic Prostatitis can develop secondary to suffering from ongoing bouts of Interstitial Cystitis,
in which case a higher intake of supplemental potassium will resolve the cystitis, and any symptoms
related to Prostatitis.  Since the average adult male requires close to 5,000 mg or more of potassium
per day, the actual amounts required through supplementation (to keep bladder / prostate-related
symptoms under control), depend on a patient's androgen status (DHEA), whose decline with age
reduces potassium retention (requiring higher intake), and they depend on how much potassium one
gets from the diet.
A meal containing beans and potatoes may provide twice as much potassium as a meal consisting of
chicken and rice, so supplemental requirements could range from a few hundred mg, to over a couple
of thousand mg of potassium per day, depending also on other high-potassium sources consumed
such as bananas, or other potassium-rich fruit.  
Excessive potassium intake may trigger symptoms
ranging from frequent urination, to those of a bladder infection (cystitis), which unfortunately are also
similar to those symptoms experienced with a
low potassium status (interstitial cystitis).

Just like acute, chronic, or interstitial cystitis go hand in hand with abnormally high, or abnormally low
cellular levels of potassium (save for structural causes), Prostatitis and Benign Prostatic Hypertrophy
go hand in hand with abnormally high cellular levels of zinc (prostatitis), and often below-normal cellular
levels of zinc (BPH).

    When there is a history of Prostatitis, zinc should be used with caution when treating an enlarged
    prostate, otherwise one may simply trade one set of symptoms (BPH) for another (Prostatitis).

Instead, it is better to reduce any dietary or supplemental zinc antagonists to prevent a lowering of zinc,
and at the same time follow a testosterone-boosting and estrogen-lowering strategy to maintain normal
zinc levels.  This can be accomplished with supplements such as Puncture Vine (tribulus terrestris),
the flavonoid Chrysin + Piperine (a pepper extract to help absorb chrysin), any form of Ginseng, wild
green Oats (avena sativa), Nettle Root extract, or Muira Puama (ptychopetalum olacoides), which
either boost testosterone levels, or reduce SHBG (sex hormone-binding globulin).  SHBG is increased
through some herbs, and many commonly prescribed drugs that interfere with normal liver functions.

Low zinc levels - particularly post middle age or andropause - frequently go hand in hand with lowered
potassium levels, which can be a cause or contributing factor with Erectile Dysfunctions (impotence),
and a host of cardiac, urinary, or hormonal / metabolic health problems, including weight gain.  Regular
intake of substances that negatively affect liver
functions (Tylenol, marijuana, alcohol...), can lead to the
same consequences.

Extra Zinc and/or Pantothenic Acid (Vitamin B5) in the 100 -1000 mg range may help resolve the
occasional presence of blood in semen (hematospermia), if due to a low zinc / high phosphorus ratio.

On the other hand, chronic bleeding from the prostate is made worse by insufficient calcium intake
(or a low Ca / Mg ratio), inadequate flavonoid and Vitamin C intake, a high intake of supplements or
spices with blood-thinning properties such as ginkgo biloba, fish oils, Vitamin E, garlic, turmeric, high
oxalic acid sources (see above), alcohol, regular / high consumption of cranberry juice, and even heart-
healthy foods such as walnuts.  Saw Palmetto, and to some lesser extent pygeum, prolong bleeding
time, so they will aggravate pre-existing bleeding from the prostate.

Infrequent mild bleeding from the prostate may respond to supplementing 100 - 300 mcg of Vitamin K
(K1 or K2) per day if due to varicosis or similar vascular degeneration, while 250 - 500 mg of Vit B5,
and/or one or two 6 mg doses of chelated Copper (if low) help stop bleeding if due to an occasional
dietary trigger (e.g. high oxalic acid).  To prevent nausea, copper needs to be taken with non-acidic
beverages or food.  If blood thinners are prescribed, an adjustment to the dose may have to be made
by the attending physician.

If side effects are not an issue, the drug Finasteride (Proscar) has been shown to be effective against
bleeding from the prostate by inhibiting the growth of small blood vessels within the prostate when due
to Benign Prostatic Hypertrophy.
Drug-less intervention consisting of extra Potassium, Zinc, Copper (unless high), and Milk Thistle
will usually improve BPH-related blood in semen, and resolve BPH-related bleeding from the prostate,
provided the criteria mentioned above are met (avoiding extra dietary or supplemental blood thinners).

When starting out with normal zinc levels and a healthy prostate, and then - for whatever reason -
one begins to supplement high amounts of nutrients such as calcium, copper, selenium, Vitamin C, or
folic acid, this will over time create below-normal levels of zinc (unless zinc is on the high side to begin
with), which will eventually have negative implications on one's prostate.
The same situation applies in reverse.  Even by supplementing an individually correct amount of zinc
for an enlarged prostate (BPH), one still has to deal with the potential antagonism of zinc on any of the
above-mentioned nutrients (Zn antagonists), which over time may get depleted, and as a result may
require supplementation as well.

Long-distance driving - or otherwise prolonged sitting - can trigger prostate pain or burning in men
whose prostate has a tendency to swell, or has started to enlarge (usually post middle age), and where
any undue pressure, including from constipation, irritates the prostate.  Getting one's favorite home
or work chair custom upholstered to create additional O or U-shaped padding on the seat will provide
significant relief for many of these patients by reducing the pressure from the central part of the seat to
the perineum.

Habitually holding one's urine is considered to be a possible cause or contributing factor with
Prostatitis by eventually damaging the prostate, with the theory being that only housebroken dogs
seem to develop that condition.

Empirical data suggests that frequent ejaculations are helpful to reduce flare-ups of Prostatitis,
and a number of research studies found that they also help reduce the risk of prostate cancer.

From personal, clinical experience, lowering zinc levels through dietary or supplemental intervention
has proven to be the most effective method to bring Prostatitis quickly under control, while an enlarged
prostate (Benign Prostatic Hypertrophy) may benefit from extra zinc intake, however the control of its
symptoms frequently requires the additional support of other prostate-specific nutrients.  ¤

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Copyright © 2000-2008  Ronald Roth          Acu-Cell Disorders: Prostatitis
  
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