In this episode, Dr. Kevin Chu and Dr. Justin Dubin interview Dr. Rahul Mehan to discuss the importance of prostate health, particularly as men age. They explore the concept of 'prostate puberty' and the common symptoms of an enlarged prostate. The conversation shifts to the role of supplements in managing prostate health, including their effectiveness and the risks associated with them. The doctors emphasize the importance of lifestyle changes and proper medical guidance for men experiencing prostate issues, encouraging open discussions about men's health.
Chapters
00:00 Understanding the Prostate's Role in Men's Health
03:43 The Impact of Supplements on Prostate Health
06:36 Evaluating the Effectiveness of Common Supplements
09:31 Lifestyle Changes and Their Importance
12:41 Risks and Recommendations for Prostate Supplements
15:32 Counseling Patients on Prostate Health
18:36 Final Thoughts and Resources
The ManUp Podcast: Prostate Health & Supplements – Expert Insights
Introduction
The prostate plays a central role in men's health, especially as men age. Over time, the prostate can become enlarged (benign prostatic hyperplasia, BPH), inflamed (prostatitis), or even cancerous. These changes can significantly affect quality of life, causing urinary symptoms that drive men to seek solutions—often turning to supplements before consulting a doctor.
Common Prostate Changes with Age
As men reach their 50s and 60s, the prostate often enters a phase of rapid growth—sometimes referred to as "prostate puberty."
Typical symptoms of an enlarged prostate include:
Increased urinary frequency and urgency
Nocturia (waking at night to urinate)
Dribbling after urination
Hesitancy or interrupted stream
Why Do Men Turn to Supplements?
Over half of men in the U.S. use supplements; this rises to 70% after age 70.
Supplements are easily accessible and marketed as "natural" alternatives, appealing to those hesitant to seek medical care.
The supplement industry is a multi-billion dollar business, with products like saw palmetto and others widely promoted for prostate health.
Do Prostate Supplements Work?
- Saw Palmetto: Once included in urology guidelines, large NIH trials found no significant benefit over placebo for urinary symptoms. While some smaller studies suggest possible benefits, most urologists no longer recommend it for BPH, though many patients still use it.
- Zinc: A 2022 Journal of Urology study followed over 5,000 men with prostate cancer for 11 years. Those taking low-dose zinc had lower overall and prostate cancer-specific mortality. However, very high doses may increase the risk of advanced cancer, so moderation is key.
- Quercetin & Rye Grass: Both have anti-inflammatory properties and may help men with chronic, nonbacterial prostatitis (prostate inflammation not caused by infection). Quercetin, in particular, should only be used for 2-3 months at a time due to potential kidney effects.
- Beta-Sitosterol: A plant sterol found in fruits, vegetables, nuts, and seeds. Some studies show improved urinary flow and symptom scores, though mechanisms remain unclear.
- Pygeum Africanum (African plum tree): Some small studies show improvement in urinary symptoms.
Risks and Limitations of Supplements
Side Effects: Even "natural" supplements can cause side effects similar to prescription medications. For example:
High-dose zinc may increase advanced cancer risk.
Quercetin can impact kidney function if used long-term.
Saw palmetto has rarely caused persistent sexual side effects.
Beta-sitosterol may affect libido and erectile function.
Lack of Regulation: Supplements are not FDA-regulated for quality or content, leading to potential inconsistencies in dosage and purity.
Uncertain Efficacy: Most supplements lack robust, long-term data for prevention or treatment of prostate enlargement or cancer.
Prevention vs. Treatment
There's limited evidence that supplements prevent prostate enlargement or cancer.
Most benefits, where present, are modest and may be more relevant for symptom management rather than prevention.
Lifestyle changes—diet rich in fruits and vegetables, regular exercise, and maintaining healthy weight—remain the foundation for prostate and overall health.
When to See a Doctor
Only about 2% of men with severe urinary symptoms seek medical treatment, despite the availability of effective therapies with fewer side effects than in the past.
If symptoms persist or worsen, consult a urologist for evaluation and discussion of all available options, including medical and minimally invasive surgical treatments.
Expert Counseling on Supplements
Supplements may offer some benefit, especially for inflammation-related symptoms, but expectations should be realistic.
There is little risk in trying most supplements, but they should not replace medical evaluation—especially if symptoms are severe or progressive.
Always check supplement labels for appropriate dosages (e.g., zinc: 11 mg/day is recommended) and avoid excessive intake.
Final Thoughts
Supplements can play a role in prostate health for some men, particularly for mild symptoms or those seeking a natural approach. However, they are not a substitute for medical care, and their effectiveness is often limited. Men experiencing urinary symptoms should not hesitate to seek expert advice, as many safe and effective treatments are available.
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