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BETA-SITOSTEROL
Beta-sitosterol appears to act like the prescription drug finasteride (Proscar), which inhibits activity of 5-alpha-reductase and is used to treat BPH. When beta-sitosterol is taken at high doses and along with other sterols, it has been shown to reduce levels of total cholesterol and low-density lipoprotein (LDL) cholesterol by reducing the amount of cholesterol the body absorbs, which in turn may inhibit the production of dihydrotestosterone (DHT). There is also some evidence that beta-sitosterol may boost immunity.
Beta-sitosterol is a type of phytosterol (a plant-derived, cholesterol-like substance) found in a number of plants, including saw palmetto, rice bran, soybeans, pumpkin seed, peanuts, and pecans. Although beta-sitosterol has a structure similar to cholesterol, it does not act like cholesterol.
Beta-Sitosterol and BPH
In a study published in Lancet, 200 men with BPH took 20 mg of beta-sitosterol or placebo three times a day for six months. At the end of six months, the researchers observed an increase in maximum urine flow rate from a baseline of 9.9 mL/second to 15.2 mL/second, as well as a decrease in mean residual urinary volume from 65.8 mL at baseline to 30.4 mL. No changes were reported in men who had taken placebo. (Berges 1995)
After unblinding the 6 month trial from the previous Berges study (1995), men in both the beta-sitosterol and placebo groups were given the option of staying on the trial for an additional 12 months while taking beta-sitosterol. There were 117 men total who were taking 20 mg of beta-sitosterol three times a day. In a follow-up study that evaluated durability of response to beta-sitosterol, the beneficial effects for beta-sitosterol were found to be maintained during an additional 18 months of observation. (Berges 2000)
In 1997, there was a report of a six-month randomized, double-blind, placebo-controlled clinical trial that evaluated the efficacy and safety of 130 mg free beta-sitosterol compared with placebo in 177 men who had BPH. The International Prostate Symptom Score (IPSS) was the main oiutcome variable, along with changes in qualify of life, peak urinary flow rate (Qmax), and post-void residual urinary volume. After six months, the researchers observed significant improvements over placebo in men who received beta-sitosterol in all factors. The authors concluded that “these results show that beta-sitosterol is an effective option in the treatment of BPH.”(Klippel 1997)
A subsequent review of all existing studies at that time (2000) of beta-sitosterol in men who had BPH was conducted and reported in Cochrane Databases of Systematic Reviews.. Four randomized, placebo-controlled, double-blind trials that involved 519 men were evaluated. The investigators found that beta-sitosterols improve urinary symptom scores, peak urine flow, and residual volume. Beta-sitosterols did not reduce the size of the prostate. The reviewers concluded that beta-sitosterols “improve urinary symptoms and flow measures.” (Wilt 1999)
Beta-Sitosterol and Prostate Cancer
In the fight against prostate cancer, beta-sitosterol has demonstrated some limited benefit. A study conducted in France showed that beta-sitosterol induced low growth inhibition on prostate cancer cells. (Jourdain 2006)
When purchasing beta-sitosterol, make sure the supplement label clearly states the amount of beta-sitosterol in the product. If beta-sitosterol is just one of several plant sterols in the supplement, the beta-sitosterol should make up at least 50 percent of the total amount of sterols in the product. Potential side effects include nausea, gas, and diarrhea.
To increase absorption, beta-sitosterol should be taken on an empty stomach. Typically it takes about four weeks before the effects of beta-sitosterol are apparent. The dosage can be reduced once symptoms improve; consult a knowledgeable healthcare provider for more information on how to use beta-sitosterol.
Questions about Beta-sitosterol
Q. Dr. Geo. Great article about beta sitosterol, especially the advice to take it on an empty stomach to increase absorption when using it for BPH. Can you clarify the statement ”When purchasing beta-sitosterol, look for products designed to treat BPH and not those for treating high cholesterol.” Are the formulations different such that only the BPH formulation is well absorbed (as opposed to the cholesterol reducing formula which is designed to bind cholesterol in the gut and not be absorbed?
Kevin
A. Plant sterols (also known as stanols) supplements often contain ingredients other than beta-sitosterol, based on whether they are for BPH or for lowering cholesterol. For example, beta-sitosterol supplement is targeted for BPH and prostate health while beta-sitosterol, along with all the other phytosterols (campesterol campestanol, and sitostanol) are used combined to lower cholesterol. So if the primary goal is to obtain prostate health then a mixed phytosterol supplement with higher concentrations of beta-sitosterol levels (above 60 mg) should be used. Consumers should look at the amount of beta-sitosterol in the product and make sure they are getting the amount their healthcare provider recommends.
References
Berges RR, Kassen A, Senge T. Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up. BJU Int 2000 May; 85(7):842-6.
Berges RR, Windeler J, Trampisch HJ, et al. Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group. Lancet 1995; 345:1529-1532.
HealthLibrary: http://healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe33da65dd4&chunkiid=21555
Jourdain C et al. In-vitro effects of polyphenols from cocoa and beta-sitosterol on the growth of human prostate cancer and normal cells. Eur J Cancer Prev 2006 Aug; 15(4): 353-61
Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. German BPH-Phyto Study group. Br J Urol 1997; 80:427-432.
Wilt TJ et al. A beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review. BJU Int 1999 Jun; 83(9): 976-83
