L.L. is a 67-year-old male who has been diagnosed with BPH. He is having difficulty with urination. He is currently on Cozaar 100 mg for HTN and his BP
L.L. is a 67-year-old male who has been diagnosed with BPH. He is having difficulty with urination. He is currently on Cozaar 100 mg for HTN and his BP is well controlled. He is taking no other medications. The doctor has recommended medication for his BPH, but he would like to try a herbal supplement before taking a prescription medication.
- Would you recommend a herbal supplement in L.L’s case?
- If so, what herbal supplement would he take?
- What is the recommended dosage?
- What are possible side effects of the herbal supplement?
- What warnings should you give L.L. before he starts the herbal supplement.
Expert Answer and Explanation
BPH Case Study
Benign Prostatic Hyperplasia (BPH) is a condition common for men above 50 years, in which the prostate enlarges and causes problems in urinating. When L.L., a 67-y.o pt. discovers that he has BPH, his doctor advises him to take the recommended medication but he feels that he should probably first try some herbal medication.
Recommending Herbal Supplement
I would not recommend LL to take some herbal supplements before the prescription medication as their safety and efficiency is not comparable. It is clear that he may be having prior information about the success of some of the supplements in solving some medical conditions without many implications on the body, but it is important for him to realize that his condition is not as serious, and a simple medication could help him restore his health.
Since herbal supplements are not as regulated as prescription medicine, the safety and the effects of the herbal supplements may vary depending on the individual (Thomas et al., 2017). If he has to take it, he should talk to the doctor to advise him on the best way forward.
Herbal Supplements that He Should Take
Among some of the most common herbal supplements for BPH include Pygeum, Rye grass, Saw Palmetto, and Beta-sitosterol. Beta sitosterol, for instance, helps to empty the bladder as well as create strong urine flow (Nabavizadeh et al., 2018). Pygeum also helps to create a stronger stream of urine. All these other supplements improve the health of the kidney as well as that of the prostate (Nabavizadeh et al., 2018). He should, however, note that most of these supplements are not capable of solving already-caused damage.
There is no specific dosage for these supplements. Each of them is relative on the extent of the condition. Hence, the patient should be careful not to take too much or too little. Most importantly, he should consult the doctor to learn about the effective dose (ED50) of each.
Some of the side effects of the supplements include dizziness and vomiting. Like any other drug taken orally, constipation is also a common side effect (Ückert et al., 2019). The management of side effects should go in line with the management of the specific doses. If the effects seem to be too much to bear, the patient should be flexible enough to switch to conventional drugs.
Warnings before Taking the Herbal Drugs
The most important warning that should be given to the patient is the fact that most of the herbal drugs have no specific mode of action, and their healing process is unsure. That is, unlike regular drugs, it is hard to estimate that a certain drug helps one to reach healing up to a given extent. Other warnings I would give would be about the side effects such as the dizziness. Also, the patient should be aware that these drugs are not regulated, and some of their effects are lethal.
Taking herbal supplements to control the condition of L.L. could not be an advisable decision for him, since there are many uncertainties behind these supplements. Nevertheless, some of the most recommended herbal supplements for BPH include Pygeum, Rye grass, Saw Palmetto, and Beta-sitosterol. All of them work to improve the passage of the urine by acting on the smooth muscles of the duct. He should be sure to consult an expert before using the drugs as they have different side effects as well as lethal doses.
Nabavizadeh, R., Zangi, M., Kim, M. M., Bejestani, M. Y., & Tabatabaei, S. (2018). Herbal supplements for prostate enlargement: current state of the evidence. Urology, 112, 145-150.
Thomas, D., Chughtai, B., Kini, M., & Te, A. (2017). Emerging drugs for the treatment of benign prostatic hyperplasia. Expert opinion on emerging drugs, 22(3), 201-212.
Ückert, S., Kedia, G. T., Tsikas, D., Simon, A., Bannowsky, A., & Kuczyk, M. A. (2019). Emerging drugs to target lower urinary tract symptomatology (LUTS)/benign prostatic hyperplasia (BPH): focus on the prostate. World journal of urology, 1-13.
What is the first-line treatment for hypertension and a male with BPH?
The first-line treatment for hypertension in a male with benign prostatic hyperplasia (BPH) is typically a class of medications known as alpha-blockers. These medications help relax the muscles in the prostate and bladder neck, improving urine flow and reducing symptoms of BPH, while also helping to lower blood pressure. Examples of alpha-blockers commonly used for this purpose include tamsulosin and terazosin. However, it’s important for individuals to consult with their healthcare provider for personalized treatment recommendations and monitoring.
Which drug is used to treat BPH as well as to treat HTN?
The drug used to treat both benign prostatic hyperplasia (BPH) and hypertension (HTN) is often an alpha-blocker. Alpha-blockers such as doxazosin, terazosin, and tamsulosin are commonly prescribed for BPH to relax the muscles in the prostate and bladder neck, improving urine flow. They can also help lower blood pressure by dilating blood vessels, making it easier for blood to flow. However, treatment should always be based on individual medical history and should be discussed with a healthcare provider.
What is the best antihypertensive for benign prostatic hyperplasia?
The best antihypertensive for benign prostatic hyperplasia (BPH) depends on various factors such as the individual’s overall health, medical history, and specific symptoms. However, alpha-blockers are commonly considered effective for managing both conditions simultaneously. Examples include doxazosin, terazosin, and tamsulosin, as they not only help alleviate symptoms of BPH by relaxing prostate and bladder muscles but also help lower blood pressure by dilating blood vessels. It’s essential for individuals to consult with their healthcare provider to determine the most suitable antihypertensive treatment for their condition.
What is the role of herbal supplements in the diet?
The role of herbal supplements in the diet can vary depending on the specific supplement and individual health needs. Some people use herbal supplements as a way to complement their diet and support overall health and wellness. Certain herbs are believed to have potential medicinal properties and may be used to address specific health concerns or promote particular bodily functions, such as improving digestion, boosting immunity, or reducing inflammation. However, it’s important to note that the efficacy and safety of herbal supplements can vary, and not all herbal products are regulated or supported by scientific evidence. As such, individuals should exercise caution, research potential benefits and risks, and consult with a healthcare professional before incorporating herbal supplements into their diet.
What is the latest treatment for enlarged prostate?
One of the latest treatments is called Rezum Therapy. Rezum Therapy is a minimally invasive procedure that uses water vapor to shrink the prostate tissue, relieving symptoms of BPH. It’s performed in an outpatient setting and offers a quicker recovery compared to traditional surgical options. Other recent advancements include UroLift, which involves the placement of small implants to hold the prostate lobes apart and improve urine flow, and Aquablation Therapy, which uses a robotically controlled waterjet to remove excess prostate tissue.
However, the suitability of these treatments varies for each individual, and it’s essential to consult with a urologist to determine the most appropriate option based on factors such as prostate size, symptom severity, and overall health. For the most current information, consulting a healthcare professional or referring to recent medical literature is advisable.