Setting the record straight Q: I'm confused by what seem to be conflicting claims for herbal treatment of prostate enlargement. Does stinging nettle decrease or increase the amount of testosterone? And what is DHT? Is it good or bad? What does it do? JVW: You've got plenty of company when it comes to being confused about these issues. Thanks to patent medicine companies eager to sell prescription medications, the medical establishment believes that DHT is the cause of benign prostatic hypertrophy (BPH). But that's just part of the misinformation that makes treating hormonally related conditions in men so controversial, even within the alternative medicine community. Now, to answer your questions: It's true that BPH is associated with declining testosterone due to aging, but there's a metabolite of testosterone known as dihydrotestosterone (DHT) that actually increases within the prostate in men with BPH. That may be why, as I mentioned, the establishment believes DHT stimulates prostate-gland growth. It's certainly why the modern BPH drugs target DHT production. They were developed to inhibit the enzyme known as 5-alpha-reductrase -- the enzyme that helps convert testosterone into DHT. The fact that DHT is present along with BPH, however, does not mean that DHT causes prostate enlargement. In fact, clinical studies show it does the exact opposite. In 37 men ages 55 to 70 who received DHT through the skin daily for over 19 months, high plasma levels of DHT significantly reduced prostate size. This study found that these benefits occurred along with changes in the levels of sex hormone binding globulin (SHBG) and non SHBG-bound testosterone. The science here gets complicated, but it might help to explain why the use of stinging nettles can increase your testosterone. SHBG is a protein that permanently binds with testosterone. As you age, your SHBG levels rise, and your level of free testosterone falls. Your body can't use testosterone that's bound, so it doesn't provide any benefit. But components of stinging nettle extract bind to the SHBG, "freeing" the testosterone. Research suggests that this elevates the levels of free testosterone circulating in the body. And added free testosterone may help restore the balance between estradiol and testosterone, removing a major stimulus to prostate growth. There are other treatments for BPH besides stinging nettle. Perhaps best known is saw palmetto, which has been found as effective as Proscar (finasteride) in treating BPH -- and significantly better than the drug in terms of adverse sexual effects. But when it comes to prevention, I'm willing to bet that no man ever got BPH because of a deficiency of saw palmetto or stinging nettle. In my own practice, I've observed that men who try diet and supplemental essential nutrients first almost always experience a big decrease and sometimes even a complete elimination of their BPH symptoms. As I've said before, BPH may actually be a symptom of zinc and/or essential fatty acid (EFA) insufficiency for some men. (Of course, those essential nutrients should include selenium, vitamins E and D, and lycopene.) What is...lycopene? Lycopene is a red pigment found predominantly in tomatoes and some other fruits that gives them their color. Lycopene has been found to significantly reduce the risk of prostate cancer. Sources: "Transdermal dihydrotestosterone treatment of 'andropause.'" Ann Med 1993; 25(3): 235-241
"The effects of extracts of the roots of the stinging nettle (Urtica dioica) on the interaction of SHBG with its receptor on human prostate membranes." Planta Medica 1994; 61: 31-32
"Lignans from roots of Urtica dioica and their metabolites bind to human sex hormone binding globulin (SHBG)." Planta Medica 1997; 63: 529-532.
"Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients." Prostate 1996; 29: 231-240 | 
