Benign prostatic hyperplasia (BPH) affects 50% of men over 50 and 80% over 70. Several supplements have credible evidence for symptom relief, though none match the efficacy of prescription 5-alpha-reductase inhibitors or alpha-blockers.
- Saw palmetto (320 mg/day of liposterolic extract): Mixed evidence. Best-quality trials (CAMUS 2011) showed no significant benefit, but earlier meta-analyses did. Effect size, if present, is small.
- Beta-sitosterol (60β130 mg/day): A 1999 BJU International meta-analysis found meaningful improvement in urinary flow and symptoms over 4β6 weeks.
- Pygeum africanum (100β200 mg/day): Cochrane 2002 review found modest symptom improvement.
- Pumpkin seed oil (320 mg/day): Small RCTs show improvement in nocturia and IPSS scores.
- Zinc (15β30 mg/day): Prostate tissue concentrates zinc; deficiency correction may help.
- Products claiming to "shrink the prostate" β no supplement does this reliably
- Untested herbal blends marketed for "men's health"
- Combinations with stimulants (coffee berry, green tea extract) that may worsen urinary symptoms
- Saw palmetto extracts not standardized to 85β95% fatty acids
Extract standardization, dose fidelity to RCT protocols, transparency on what the evidence actually shows (not overpromising), and third-party testing. We flag products that imply replacement of medical care for prostate symptoms.