African pygeum

Description

African pygeum (Prunus africana ), also known as pygeum africanum, pygeum, and African plum tree, is an evergreen tree native to higher elevations of southern Africa. A 150 ft (46 m) tall member of the Rose family (Rosacea ), pygeum has been found to be useful in treating prostate problems, particularly benign prostatic hypertrophy (BPH), a condition affecting many men.

The tree's bark contains an oil with many active ingredients; waxes, fatty acids, and other less familiar compounds. Pygeum's principal biological activity is traced to a "phytosterol" compound known as beta-sitosterol. Phyto (plant) sterols are structurally similar to, but much less efficiently absorbed from the diet than, cholesterol . The biological strength of phytosterols, however, is similar to that of hormones; therefore, a very small amount seems sufficient to initiate a response. Pygeum's phytosterols are anti-inflammatory. Pygeum also reduces edema (the swelling caused by an excess of fluids), reduces levels of the hormone prolactin, lowers and inhibits cholesterol activity within the prostate. Prolactin, whose levels are increased by drinking beer, stimulates testosterone uptake by the prostate, reportedly increasing levels of a metabolite responsible for prostatic cell increases, dihydrotestosterone (di-hydro-testosterone), (DHT). Cholesterol is reported to increase the influence of DHT. BPH imlies two prostate changes: increased size and increase tissue density. These changes cause symptoms of frequent urge to urinate small volumes, reduced prostatic secretions, reduced bladder emptying. Incomplete bladder emptying increases risk of bladder infections , edema and inflammation, and possibly, prostatic cancer . Blood sugar levels and immune function have also been found to improve.

In summary, african pygeum's medicinal actions include:

• anti-inflamation
• reducing edema of the prostate
• inhibit cellular increase
• improving the natural flow of prostatic secretions
• lowering cholesterol
• regulating insulin activity, thereby affecting blood sugar levels
• regulating the immune system

Although pygeum's use is relatively new to the United States, it has been imported from Africa to Europe since the 1700s, and is still used today as a major treatment for BPH. Europeans learned of this plant's usefulness in treating what was then known as "old man's disease". It continues to be a widely popular in Europe as a remedy for BPH, especially in France where the use of African pygeum for BPH is reported to be about 80%.

General use

Pygeum is Primarily used to treat benign prostatic hypertrophy or BPH, a condition which affects men as early as their 40s, but increasingly with age: 30% of fifty year olds; 50% of sixty year olds; and nearly 80% of men 70 and older. It has been found to be of use in the related condition of chronic prostatitis, with and without prostate related sexual dysfunction , and infertility due to reduced prostatic secretions. Due to actions as an immune system "up regulator" and anti-inflammatory, pygeum is also being studied for use with other treatments for hepatitis C and HIV.

According to one source, in a double blind placebo controlled study involving 263 men on a dose of 100 mg per day of African pygeum extract for 60 days, the following improvements versus controls were observed:

• 31% decrease in "nocturia," or night-time frequency
• 24.5% decrease in "residual urine," the amount of urine left in the bladder after urination
• 17.2% increase in urine flow
• 50% increase in overall relief and feeling of wellbeing.

Two-thirds of the group using Pygeum reported feeling satisfaction. This was twice the improvement reported by the control group on placebo.

In a study on chronic prostatitis, 60% of men with urinary tract infections and nearly 80% of men without infections reported improvements using 100 mg of Pygeum extract for five to seven weeks. In the treatment of sexual dysfunction due to chronic prostatitis, a dose of 200 mg for 60 days, with or without an antibiotic, produced improvements in urination and sexual function. The few small and relatively short clinical trials of pygeum in the treatment of Hepatitis C and HIV+ infections have been statistically significant; further trials are under way in South Africa.

Preparations

Since the 1960s, in Europe, the most commonly used form is the standardized herbal extract. The process is highly technical and, for Pygeum, is designed to target extraction of the active oils using a sequence of laboratory extraction procedures. Standardization is the process whereby the targeted active ingredients are quantified and concentrated to a consistent therapeutic dose. The widely modern use of the extract form of African pygeum instead of the whole plant may derive from the discovery that the plant's activity is primarily due to its alcohol soluble phytosterols. A month's supply in capsules at a daily dosage of 100 mg, standardized to contain approximately 14% of the active beta-sitosterol ingredient, costs between $40 and $50. In some preparations, synergistic ingredients such as amino acids , other herbs, and vitamins or minerals, may be included. Studies cited used dosages of 100 mg daily; however, one study compared and found two dosages of 50 mg versus one dose of 100 mg per day had the same therapeutic effect.

Precautions

Precautions noted include recommendations to seek the guidance of a healthcare professional, and not to self treat. Pygeum may cause a hormonal shift, and is not recommended for children. Also noted: pygeum may require several weeks to months to make a noticeable difference; studies noted reported benefits at ranges of five to eight weeks. One source reported pygeum relieves symptoms but does not reduce prostatic size. Another study specifically stated that the active components of pygeum have symptom reversal and prevention characteristics.

Side effects

Pygeum appears to be relatively safe and non-toxic. One report noted rare occurrences of diarrhea, dizziness , disturbed vision, gastric pain and constipation . One study reported satisfactory safety profiles after 12 months of using 100 mg daily in 174 subjects. In animal studies it was reported that dogs and rats given amounts equivalent to more than 500 times the therapeutic dose showed no adverse effects, and amounts equivalent to 50 times the therapeutic dose had no effect on fertility. In vivo and in vitro studies showed no carcinogenic effects, In fact, pygeum's constituents have been found to be anti-carcinogenic. The National Institute of Health (NIH), in 2002, established a grant for a randomized controlled clinical study involving 3,100 men, in order to learn more about the medical potential of this alternative therapy, due to increased BPH diagnoses as the population ages.

Interactions

Synergistic supplements may facilitate benefits. One report advised dietary adjustments to enhance beneficial result. Dietary recommendations to improve prostatic health included avoiding the irritants of coffee and tobacco; eating pumpkin seeds for their zinc and Omega 3 anti-inflammatory content; increasing other dietary sources of Omega 3s, including the cold water fishes salmon, sardines, and mackerel; taking antioxidants and a good multiple vitamin; and the synergistic herb saw palmetto (Serenoa repens ), said to be more effective than the pharmaceutical for BPH, Proscar, at inhibiting the conversion of testosterone to its metabolite DHT, implicated in prostatic cell increases. Vitamins E (400 IU) and B₆ (50–100 mg) were suggested to synergistically reduce prolactin levels. It was also noted that 200 mcg of selenium daily reduce the risk of prostate cancer .

No unfavorable interactions were noted. Common sense might suggest that any lifestyle habit that aggravates prostate health, for example, a high cholesterol, high fat, high red meat, low fiber diet, frequent and high intake of beer, and lack of exercise may decrease the effectiveness of pygeum or other medications indicated for prostate health. Because pygeum has been found to upregulate immunity, its use may be contra-indicated where immune system upregulation is undesirable. No unfavorable herb-drug interactions have been noted.

Resources

BOOKS

Chevallier, Andrew. The Encyclopedia of Medicinal Plants. D.K. Publishing. 1996.

PERIODICALS

Miller, N.D., Alan L. "Benign Prostatic Hyperplasia, Nutritional and Botanical Therapeutic Options." Alternative Medicine Review 1.1. (2001).

Patrick, N.D., Lyn. "Hepatits C: Epidemiology and Review of Complementary/Alternative Medicine Treatments." Alternative Medicine Review. (2001).

OTHER

Brown, Don. "The Male Dilemma: Relief For Prostate Problems." Total Health 12 June 1990. [cited May 7, 2004]. <http://galenet.galegroup.com/servlet/HWRC> Record#A8994271>.

Iyker, Robert. "Men's Health: Straight Talk On Your Health and Life." Natural Health April 1999. <http://www.findarticles.com>.

"The National Institutes of Health is Proceeding on a Study to Determine if the Dietary Supplement Ingredients…Saw Palmetto and Pygeum." Food Chemical News 43.52. February 11, 2002. [cited May 7, 2004]. <http://galenet.galegroup.com/servlet/HWRC>.

"Pygeum africanum (Prunus Africana ) (African plum tree)." Alternative Medicine Review 7.1. February 2002. [cited May 7, 2004]. <http://galenet.galegroup.com/servlet/HWRC>.

Katy Nelson, N.D.