BPH, Jade Chamber & Beta-sitosterol

by Bob Flaws, Dipl. Ac. & C.H., Lic. Ac., FNAAOM, FRCHM

Keywords: Chinese medicine, Chinese herbal medicine, benign prostatic hypertrophy (BPH), beta -sitosterol

Benign prostatic hypertrophy or hyperplasia (BPH) is an extremely common condition which affects 75% of North American and European men by age 50. Swelling and enlargement of the prostate results in decreased flow of urine with urinary retention, frequency, incomplete emptying, nocturia, and terminal dribbling. After age 60, half of all men will require some form of medical treatment for BPH at some point in their life. At present, the main Western medical treatments for BPH are all surgical. These treatments do not reduce the size of the prostate but simply increase the size of the urethra, therefore, freeing the flow of urination. Like fibrocystic breast disease, breast cancer, and uterine myomas (or fibroids) in women, it is hypothesized that BPH is due to a relative hyperestrogenosis associated with the aging of the gonads. In both men and women, the hormone estrogen is counterbalanced in the body by the hormones progesterone and testosterone. These hormones are manufactured in the body from the building blocks of sterols. This is why the names of these hormones all contain the root "stero." Unfortunately, testosterone in men begins to decline by age 40, and, with insufficient progesterone, what testosterone is produced may be converted into the dangerous dihydrotestosterone (DHT) associated with BPH and prostate cancer.

Yin and yang are the bedrock of professional Chinese medical theory. They are the foundations of naturalistic Chinese medicine, and, in Chinese medicine, estrogen is relatively yin and progesterone and testosterone are both relatively yang. When yin is excess in the body, yin fluids, dampness, phlegm, and turbidity collect and accumulate, leading to tissue hyperplasia and dysfunction of the qi mechanism's movement and transformation. In this case, the treatment principles are to supplement the yang qi while draining yin repletion, transform phlegm and seep dampness. Because blood and fluids move together, it is typically also necessary to quicken the blood and transform or dispel stasis. From a purely Chinese medical point of view, this is exactly what Blue Poppy Herbs' Jade Chamber is designed to do. This formula contains Chinese medicinals to strongly supplement the source qi, transform phlegm and eliminate dampness, quicken the blood and dispel stasis for the treatment of the symptoms of benign prostatic hypertrophy.

Within this formula, Di Fu Zi disinhibits dampness, frees the flow and disinhibits the lower burner. In terms of treating dampness, it is the ruling medicinal in this formula. Even though Di Fu Zi is bitter and cold in flavor and nature, Zhang Xi-chun used it in formulas for the treatment of both yang vacuity inhibited urination and yin vacuity inhibited urination. This medicinal has also been used traditionally to treat liver vacuity dimming of vision as well as sparrow blindness. This suggests that, although this medicinal is attacking and draining, it is not excessively attacking and draining and may have some liver-kidney supplementing ability. This may, in part, be explained by its also being sweet. Zhu Ling, Qu Mai, Tong Cao, and Dong Kui Zi disinhibit urination and free the flow of strangury. These are the ministers assisting Di Fu Zi in seeping dampness from the lower burner and freeing the flow of urination. Huang Qin clears heat and eliminates dampness, while Zhi Mu drains fire and hardens yin. Specifically, Huang Qin clears heat from the lungs, liver-gallbladder, stomach, and intestines. Typically, men with this condition have a tendency to spleen vacuity causing dampness pouring downward as well as stomach heat (associated with liver depression/depressive heat). Since "the kidneys are the sluice-gate of the stomach," if the stomach is hot and, therefore, hyperactive, it may send to many fluids downward to the kidneys and bladder for excretion. The inclusion of Huang Qin in this formula helps deal with this stomach heat and the role it plays in the overall disease mechanisms causing this condition. Hai Zao, Bai Jiang Cao, Chi Shao, Wang Bu Liu Xing, Zao Jiao Ci, and Di Long soften the hard and scatter nodulation (or binding), free the flow of the orifices and open blockage. Because "blood and fluids move together" and because phlegm is nothing other than congealed fluids, enduring dampness commonly becomes complicated by blood stasis and phlegm which then all bind together. In particular, Bai Jiang Cao is an excellent medicinal for quickening the blood in the lower burner when blood stasis is combined with damp heat, while Di Long is especially effective in freeing the flow of urination inhibited by heat binding in the bladder. According to modern research, Wang Bu Liu Xing is especially effective for treating benign prostatic hyertrophy. Because Zhi Mu supplements yin, its inclusion in this formula also addresses the incipient yin vacuity often found in late middle-aged men with prostatism. Huang Qi and Dang Shen supplement the source qi in order to invigorate the qi transformation. Supplementing the source qi provides the power to transform stasis. Sheng Ma and Zhi Shi upbear yang and move the qi, thus diffusing and freeing the flow of the qi mechanism. One upbears while the other downbears. When dampness pouring downward due to spleen vacuity combines with liver depression transforming heat, damp heat is all the more likely to be engendered. In that case, one must upbear yang to resolve depression and promote the division of clear and turbid. Thus, this formula treats root and branch simultaneously.

Phytosterols are plant fats. Chemically, they are made up of a 17-carbon 4-ring structure. They never exist on their own but are always found in combination with their glucosides. There are four major plant sterols: brassicasterol, campesterol, sitosterol, and stigmasterol. The typical Western diet contains 200-300mg of phytosterols per day. Phytosterols produce a wide spectrum of biological activities in humans and animals. Beta_sitosterol is the most important phytosterol in our diet. Modern research has shown that beta-sitosterol has many healthful benefits. It lowers cholesterol and triglycerides, it lower blood glucose levels in those that are hyperglycemic, and it is antibacterial, antifungal, and antiviral. In addition, beta-sitosterol also improves blood parameters in various ways. For instance, it increase fibrinolysis and plasminogen activity. Beta-sitosterol also improves T-cell and natural killer (NK) cell activity, thus boosting the immune function. In terms of the prostate, beta-sitosterol has been posited as the active ingredient in Saw Palmetto berries and Pygeum Africanum, two popular herbal supplements for ameliorating BPH. Dozens of studies conducted all around the world prove that beta-sitosterol can achieve marked lasting effects in the treatment of BPH. For instance, the Veterans Administration in Minneapolis has concluded that beta-sitosterol has "the greatest efficacy amongst phytotherapeutic substances" on the remedial treatment of prostatism. Interestingly, a number of ingredients in Jade Chamber are know to be particuklarly high in beta-sitosterol as described by Hong-yen Hsu in Oriental Materia Medica: A Concise Guide (OHAI, Long Beach, CA, 1986). These include Radix Astragali Membranacei (Huang Qi), Herba Patriniae Heterophyllae (Bai Jiang Cao), Radix Scutellariae Baicalensis (Huang Qin), and Rhizoma Cimicifugae (Sheng Ma).

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