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Prostate Trouble? Try These Vitamins
Vitamins are micronutrients that are essential for the general health of the body. However, they can also provide different therapeutic benefits in the treatment of certain diseases. Some vitamins can improve prostate health and studies have shown that they can, especially, reduce the risks of prostate cancer. This article identifies the vitamins proven to relieve prostate problems and discusses the clinical trials supporting their use.
by Brad Chase
The prostate is an exocrine organ and a major part of the male reproductive system.
It is responsible for secreting the compounds that gives spermatozoa motility and energy. The prostatic fluid comes out with the first ejaculate and carries most of the spermatozoa.
The rest of the spermatozoa are ejected with seminal vesicular fluid. However, the ones released with the prostatic fluid live longer, swim faster and farther and have their genetic materials better protected.
The prostatic fluid is milk white and slightly acidic. It is composed mostly of simple sugars but it also contains a small percentage (less than 1%) of proteins such as PSA (prostate-specific antigens). The other major component of the prostatic fluid is zinc which is concentrated at 500 – 1,000 times the amount in the blood.
Being an organ of the male reproductive system, the prostate depends on male hormones such as testosterone to properly function. The most important male sex hormone in the prostate is DHT (dihydrotestosterone).
There are 3 major types of prostate problem: prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer.
Prostatitis is the medical term used to describe the inflammation of the prostate gland.
There are 4 categories of prostatitis. These are listed in the table below.
The most common of these forms of prostatitis is Category III. Category III prostatitis makes up 95% of all prostatitis cases and it is also called male chronic pelvic pain syndrome.
It can be treated with non-drug therapies such as psychotherapy and physical therapy; by pharmaceuticals such as alpha blockers, anxiolytics and antihistamine; by herbal and natural supplements; and by invasive techniques such as surgery.
Category I and II prostatitis are treated with antibiotics.
In BPH, the prostate is not inflamed but enlarged to a size that makes urination difficult. By constricting the urethra, the enlarged prostate can also make urination difficult even as the pressure on the urethra increases the frequency of urinating and the need to urinate.
BPH mostly affects older men. In the early stages, it can be treated with medications and natural supplement. But late-stage BPH needs invasive procedures and may require surgery in extreme cases.
Prostate cancer is the second most common cancer affecting older men. Unlike BPH, prostate cancer often presents with no symptoms.
Prostate cancer has an estimated fatality rate of 3% among elderly men. People with a high risk of prostate cancer include African-Americans and those with family histories of the disease.
Currently, regular testing for early detection is still not recommended due to its associated risks. Even then, it is possible to ask your physician for a test. Such tests for detecting prostate cancer include physical rectal prostate exam, blood measurement of PSA and urine measurement of EN2 (another protein known as Engrailed-2).
Vitamins are generally healthful natural micronutrients that are essential for various physiological and biochemical processes in the body.
In the treatment and prevention of prostate cancer, all vitamins can provide some benefits. However, the results of clinical studies into long-term use of most vitamins in this regard are contradictory. While all vitamins can improve health, not all of them can reduce the risk of prostate cancer in the long-term.
Vitamin C is a borderline case. It is an antioxidant that can prevent the kind of oxidative damage to the prostate that promotes BPH and prostate cancer but some studies have shown that there is hardly any benefit in the long-term.
The exceptions to this conclusion are the administration of high doses of vitamin C by intravenous route and the combination of vitamin C with other vitamins.
Discussed below are the 5 vitamins that have been conclusively demonstrated to help treat prostate problems and especially reduce the risk of prostate cancer.
Specifically, the provitamin A compound known as beta carotene is the form of vitamin A shown to help reduce the risks of certain cancers like prostate cancer.
This red-orange colored compound is found in plants and fruits such as carrots, sweet potato, pumpkin, spinach and collards.
With regards to cancer, beta carotene increases the risk of lung cancer in cigarette smokers. However, it can reduce the risk of breast and prostate cancers.
In a 1989 paper published in the journal, Cancer, a group of researchers used a case-control study to investigate the link between beta carotene and prostate cancer. In that study, 371 prostate cancer patients and controls were recruited and their diets and health habits collated with questionnaires.
The researchers discovered that those (men 68 years and younger) who consumed high levels of beta carotene-rich foods and vegetables for the longest time had the lowest risk of prostate cancer.
A similar popular study published in 1996 in the journal, Epidemiology, also reached similar conclusions.
This study spanned 30 years and the researchers concluded that beta carotene (and vitamin C) improved survival in prostate cancer patients and reduced the risk of developing the cancer in the first 19 years of the follow-up period.
Over the years, a number of other studies have been done investigating the benefits of beta carotene in preventing prostate cancer. One of the major studies, the ATBC (alpha-tocopherol beta-carotene cancer prevention study), even concluded that beta carotene increases the risk of the cancer.
However, that conclusion has been overturned by a similar, large, randomized clinical trial known as CARET. CARET or the beta-carotene and retinol efficacy trial failed to find beta carotene as a potential cause of prostate cancer.
In addition, a Harvard’s Physicians’ Health Study found that supplementation with beta carotene lowers the risk of prostate cancer especially in men who consume low amounts of carotenoid foods.
This finding was confirmed by the PLCO (prostate, lung, colorectal and ovarian cancer screening) trial in 2006.
Vitamin D is also called the sunshine vitamin. It is the only vitamin naturally produced in the body.
The body makes vitamin D in the skin from a metabolite of cholesterol and ultraviolet UVB light. Although vitamin D is required to maintain bone density, new evidences have come up regarding the importance of the vitamin to different organ-systems in the body including the heart and brain.
To act, the bioactive form of vitamin D binds to vitamin D receptors. These receptors are found in different organs and are present on prostate cells.
A number of studies have established that vitamin D deficiency is indeed linked with an increased risk of prostate cancer.
Some experts suggest that vitamin D receptor polymorphism (mutated vitamin D receptors) may contribute to prostate problems. However, there is no conclusive proof for this theory. In fact, one study did not find the link between this receptor polymorphism and prostate cancer.
In a study published in 1998 in the journal, Cancer Epidemiology, Biomarkers & Prevention, a group of researchers investigated possible increased risk of prostate cancer in 3 types of vitamin D receptor polymorphism.
The results of this study found no such link between the receptor polymorphism and prostate cancer except in men older than 61 years and with low plasma 25-hydroxyvitamin D levels.
A 1993 study published in the same journal evaluated the link between prostate cancer and two vitamin metabolites (25-hydroxyvitamin D and 1, 25-dihydroxyvitamin D). For this study, the researchers measured the vitamin levels from the 250,000 serum samples collected over 7 years.
The results of the study showed that low levels of 1, 25-dihydroxyvitamin D increases the risk of prostate cancer in men older than 57 years.
In a 1997 study published in the journal, Urology, a group of researchers investigated the effect of 1, 25-dihydroxyvitamin D on the growth and metastasis of tumors (in vivo and in vitro) in the prostate glands of a line of rat models.
This study showed that vitamin D can prevent the differentiation and spread of prostate cancer cells.
A similar study done on human prostate cancer cell lines was published in 1993 in the journal, Endocrinology. The researchers demonstrated that 1, 25-dihydroxyvitamin D stopped the proliferation and differentiation of human prostate carcinoma cells.
This result confirms that the benefits of vitamin D in improving prostate health especially for prostate cancer patients.
Clearly, as demonstrated by the studies mentioned above and a lot more, vitamin D is important to prostate health. While there is a need for more studies to determine how best to use it to treat and prevent prostate cancer, there is no doubt that the anti-inflammatory, immunomodulatory and even antioxidant properties of vitamin D are beneficial to the prostate.
Vitamin E refers to a group of eight (four tocopherols and four tocotrienols) fat-soluble compounds. Of these, the two most popular vitamers are alpha and gamma tocopherols.
The association between vitamin E and prostate cancer has been a rather controversial one. While some studies show that vitamin E can reduce the risk of this cancer, others conclude that the vitamin increases the risk of prostate cancer.
The most damning study linking vitamin E to increased risk of prostate cancer is the SELECT trials.
This large, multi-center study involved more than 35,000 men and some of its results were published in 2011 in The Journal of the American Medical Association.
SELECT or selenium and vitamin E cancer prevention trial concluded that dietary supplementation of vitamin E can significantly (17%) increase the risk of prostate cancer among healthy men.
However, this study is deeply flawed and other studies before and after it did not replicate this conclusion. First, only one form of the eight vitamers of vitamin E was used in the SELECT study. This vitamers is alpha tocopherol, and it is not as active as gamma tocopherol.
Secondly, the result of the study showed that selenium reduces the risk of prostate cancer and the combination of selenium and vitamin E reduced this risk even further. This is a rather anomalous conclusion. If vitamin E increases the risk of the cancer, the combination of selenium and vitamin E should perform lesser than selenium alone.
Lastly, the 17% significance reported was only relative risk and not absolute risk. Even with the design faults and statistical errors of the SELECT study, vitamin E performed closer to placebo and selenium in absolute terms.
A 1999 cohort study published in the journal, Cancer Epidemiology, Biomarkers and Prevention showed that vitamin E supplementation can reduce the risk of prostate cancer especially among smokers.
A 2007 study published in the same journal showed that gamma tocopherol obtained from diet outperforms alpha tocopherol supplement (like the one used in the SELECT trial) and can indeed reduce the risk of prostate cancer.
A paper published in the Proceedings of the National Academy of Sciences in the United States of America in 2002 showed that vitamin E improved prostate health and reduced the risk of prostate cancer by suppressing PSA (prostate-specific antigen) and androgen receptors in the prostate.
Large studies seem to agree that vitamin E supplementation reduces the risk of prostate cancer among smokers (past and present) even when there is no consensus of such protection among non-smokers.
Vitamin K also refers to a group of fat-soluble compounds. The 2 natural vitamers of vitamin K are vitamin K1 or phylloquinone and vitamin K2 or menaquinone.
Unlike the synthetic vitamins K3, K4 and K5, these natural forms of vitamin K are non-toxic.
The anticancer effects of vitamin K is well-studied. It has been shown to be useful in the prevention and treatment of cancers affecting the liver, lung, breast, colon, stomach and the oral cavity.
The combination of vitamins C and K has been proven to be effective in the treatment of prostate cancer. These 2 vitamins were combined in a 100:1 ratio respectively. The cytotoxic effect of the combination works by a unique mechanism involving the separation of the cytoplasm from the nucleus of each cancer cell.
The combination of vitamins C and K had 5 – 20 times the efficacy of each of the two vitamins in the treatment of prostate cancer.
In a 2002 study published in the journal, American Society for Clinical Nutrition, the relationship between dietary vitamin K and the risk of prostate cancer was investigated in the EPIC (European Prospective Investigation into Cancer and Nutrition)-Heidelberg trial.
This long-term, cohort study tested the anticarcinogenic activities of vitamin K1 and K2.
The result of the study showed that vitamin K2, and not vitamin K1, is associated with reduced risk of prostate cancer.
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