(Berkeley Wellness)
Beta sitosterol, a plant substance, is probably best known for helping to lower cholesterol. Can it help benign prostatic hyperplasia (BPH), enlargement of the prostate gland that occurs in older men?
BPH is not a sign of cancer, but its symptoms, including increased urinary frequency and difficulty in urination, are unpleasant. There are prescription drugs that shrink the prostate, but many men search for nonprescription remedies. One leading supplement is beta sitosterol, a plant chemical found in fruits, vegetables, and nuts. Beta sitosterol is also found in plant products promoted as treatments for BPH, notably saw palmetto, stinging nettle, rye pollen, and pumpkin seeds. Like other plant sterols, beta sitosterol can lower cholesterol, which is why sterols are added to some margarines and other foods—a usage approved by the FDA.
Beta sitosterol from many sources, including saw palmetto, has been extensively studied, with some positive results. Plant sterols clearly have some effect on the male hormone system and prostate. In 1999 the Cochrane Collaboration (independent reviewers of scientific evidence) looked at four large, well-designed clinical studies and concluded that beta sitosterol may help relieve the urinary symptoms caused by BPH. They noted, however, that research into long-term effects was still needed.
In 2009, an evaluation of newer evidence was less enthusiastic. The researchers, from the Cleveland Clinic and other noted urology centers, concluded in Reviews in Urology that while “nutraceuticals” (including beta sitosterol) had shown some potential in treating BPH and other prostate disorders, nothing was certain. Herbal preparations, they warned, “may have drastically different composition, durability, contaminants, and even efficacy.” They found that while the best evidence was for saw palmetto, even those studies were not convincing. A well-designed study in the New England Journal of Medicine in 2006, however, found that saw palmetto is not an effective treatment for BPH symptoms.
Bottom line: If you have BPH and are considering a beta sitosterol supplement or other herbal treatment, talk with your doctor first. You may find something that helps, but supplements carry risks, just as prescription drugs do. There are drugs with proven benefits, and their side effects are better understood. Another advantage: your insurance should cover the drugs.