Prostate formulas...are they necessary?

[Maximus220rr]

Hello guys I am 36 yes old and have been on trt for a few years and was wondering should I be taking a prostate formula? I use have used them here and there as just a preventive from bad dht and just overall prostate health. Just was wondering if I even need to use them or can I do without?
Thanks

 

[Vince Carter]

If you're PSA is being monitored and is healthy, there's no need to worry, and there is no "bad DHT". What is bad is using these prostate pills that are filled with Saw Palmetto, which is a known Androgen, BLOCKER.

 

[Maximus220rr]

Thanks vince! I will stop taking them. Prostate and hormones get tested every 6 months and all is good just was taking them so I could protect the prostate for the future. I didn't know saw palmetto was bad.

 

[Vince Carter]

Thanks vince! I will stop taking them. Prostate and hormones get tested every 6 months and all is good just was taking them so I could protect the prostate for the future. I didn't know saw palmetto was bad.

That's just my feeling, I recommend reading on your own and making your own choice in that regard.

 

[Nelson Vergel]

Here is some information and a paper attached.

Saw Palmetto

The mechanism of saw palmetto is poorly defined. Investigators have proposed antiandrogenic activity via 5-alpha reductase inhibition and subsequent prevention of the conversion of testosterone to dihydrotestosterone,[SUP]7[/SUP] an antiinflammatory effect,[SUP]16[/SUP]competitive inhibition of androgen binding, decrease in the bioavailability of the sex hormone–binding globulin (SHBG),[SUP]15[/SUP] and inhibition of growth factor–induced prostatic cell proliferation.[SUP]16, 20 and 21
[/SUP]
In 2009, a detailed Cochrane Review analyzed 9 RCTs of saw palmetto with 2053 total patients. Five trials with 820 patients evaluated saw palmetto alone or combined with nettle root, beta-sitosterol, vitamin E, or tamsulosin versus placebo.[SUP]22, 23, 24, 25 and 26[/SUP] Four trials with 1233 participants evaluated saw palmetto alone versus control.[SUP]27, 28, 29 and 30[/SUP]The most common commercialized extract of saw palmetto was Permixon (Pierre Fabre Médicament, Castres, France). The review concluded that saw palmetto was well tolerated but failed to improve urinary symptom score compared with placebo.[SUP]10[/SUP]

A recent Italian study was conducted to evaluate the effect of saw palmetto in reducing intraoperative and postoperative complications of men undergoing surgical treatment (TURP or open prostatectomy) for BPH. The 114 patients were randomized to receive either pretreatment with saw palmetto or no pretreatment. No intraoperative complications occurred and no blood transfusions were required in the pretreatment group (P<.001). Additionally, the postoperative course was statistically significantly more favorable in the pretreatment group. This study suggests that pretreatment with saw palmetto before surgery for BPH is an effective measure for decreasing potential intraoperative and postoperative complications. [SUP]31[/SUP]


The CAMUS study was designed to specifically address areas of uncertainty raised by the STEP study. First, the investigators decided against a single dose of the extract in favor of a dose-ranging approach, starting with the widely used dosage of 320 mg/d (in a single dose for participant convenience), followed by a doubling, then tripling of the initial dose over the follow-up period. Second, because of the lipophilic nature of many of the extract’s constituents, it was also felt that several months at each dose would be required to provide a fair test of efficacy; therefore, dose escalations were done at 6-month intervals. Third, the saw palmetto extract chosen was produced by an experienced manufacturer using an extraction technique (ethanolic extraction) different from the CO[SUB]2[/SUB]extraction technique used to manufacture the product tested in the STEP study.


The inclusion criteria specified in the final protocol for the CAMUS required that participants be men aged at least 45 years, with an AUASI score between 8 and 24 and a peak urinary flow rate greater than 4 mL/s. Exclusion criteria were any prior procedure for BPH, taking a drug known to affect urinary function, serum creatinine greater than 2.0 mg/dL, evidence of liver dysfunction or coagulopathy (or anticoagulant use) at baseline, prostrate-specific antigen (PSA) greater than 10 ng/mL, urinary incontinence, cancer in the prior 5 years or cancer of the prostate or bladder at any time, neurologic condition affecting urinary function, and evidence of prostatitis or recurrent urinary tract infection. The primary outcome was change in the AUASI; secondary outcomes included participant global assessment of urinary function, the BPH Impact Index, peak uroflow, postresidual urine volume, PSA level, measurements of sexual and ejaculatory function, incontinence, perceived sleep quality, and the NIH Chronic Prostatitis Index. Assessments of symptomatic adverse events and detailed laboratory measurements were conducted at regular intervals.[SUP]63[/SUP]

Recruitment for the CAMUS study was completed in April 2009 and the final participant was closed out in October 2010. Results of the trial are expected to be published in 2011. The CAMUS study is the largest placebo-controlled trial of saw palmetto to date and the only one to include a dose-ranging protocol.[SUP]10[/SUP] The results of this study will provide the most definitive test of the efficacy of saw palmetto in men with LUTS and will likely have a major impact on future studies of botanic therapies for BPH as well as the clinical use of saw palmetto extracts.

 

[Nelson Vergel]

The Effect of Increasing Doses of Saw Palmetto Fruit Extract on Serum Prostate Specific Antigen: Analysis of the CAMUS Randomized Trial

The Journal of Urology
Volume 189, Issue 2, February 2013, Pages 486–492

Purpose

Saw palmetto extracts are used to treat lower urinary tract symptoms in men despite level I evidence that saw palmetto is ineffective in reducing these lower urinary tract symptoms. We determined whether higher doses of saw palmetto as studied in the CAMUS (Complementary and Alternative Medicine for Urologic Symptoms) trial affect serum prostate specific antigen levels.

Materials and Methods

The CAMUS trial was a randomized, placebo controlled, double-blind, multicenter, North American trial conducted between June 5, 2008 and October 10, 2012, in which 369 men older than 45 years with an AUA symptom score of 8 to 24 were randomly assigned to placebo or dose escalation of saw palmetto, which consisted of 320 mg for the first 24 weeks, 640 mg for the next 24 weeks and 960 mg for the last 24 weeks of this 72-week trial. Serum prostate specific antigen levels were obtained at baseline and at weeks 24, 48 and 72, and were compared between treatment groups using the pooled t test and Fisher's exact test.

Results

Serum prostate specific antigen was similar at baseline for the placebo (mean ± SD 1.93 ± 1.59 ng/ml) and saw palmetto groups (2.20 ± 1.95, p = 0.16). Changes in prostate specific antigen during the study were similar, with a mean change in the placebo group of 0.16 ± 1.08 ng/ml and 0.23 ± 0.83 ng/ml in the saw palmetto group (p = 0.50). In addition, no differential effect on serum prostate specific antigen was observed between treatment arms when the groups were stratified by baseline prostate specific antigen.

Conclusions

Saw palmetto extract does not affect serum prostate specific antigen more than placebo, even at relatively high doses.

 

[Nelson Vergel]

Does Testosterone Cause Prostate Cancer? Can Men Treated for Prostate Cancer Use TRT?

 

[Nelson Vergel]

Little evidence that testosterone causes or worsens prostate enlargement

 

[Nelson Vergel]

Video and Transcript: Myths and Facts about Testosterone and Prostate Cancer