Numerous plants contain cholesterol-like compounds called sitosterols and their close relatives sitosterolins. A special mixture of these called beta-sitosterol is used for the treatment of
benign prostatic hyperplasia (BPH)
.
Some conditions are luckier than others. For some mysterious reason, there seem to be more useful herbal treatments for BPH than almost any other disease. Beta-sitosterol joins
saw palmetto
,
pygeum
,
nettle
, and
grass pollen
as a moderately well-documented treatment for BPH.
Based on highly preliminary evidence, it has been suggested that sitosterols may also help
strengthen the immune system
.
2
In particular, one study suggests that beta-sitosterol can help prevent the temporary immune weakness that typically occurs during
recovery from endurance exercise
, and can lead to a post-race infection.
3
A review of the literature, published in 1999, found a total of four
double-blind placebo-controlled studies
on beta-sitosterol for BPH, enrolling a total of 519 men.
4–7
All but one of these studies found significant benefits in both perceived symptoms and objective measurements, such as urine flow rate.
The largest study followed 200 men with BPH for a period of 6 months.
8
After the trial was completed, many of the participants were followed for an additional year, during which the benefits continued.
9
Similar results were seen in a 6-month double-blind trial of 177 individuals.
10
Beta-sitosterol binds to prostate tissue and affects the metabolism of prostaglandins, substances found in the body that affect pain and inflammation.
1
However, it is not clear whether this is the correct explanation for how beta-sitosterol might help in BPH.
The daily dosage of beta-sitosterol is 60 to 135 mg. Effects usually take 4 weeks to develop.
Although detailed safety studies have not been performed, beta-sitosterol is believed to be safe. No significant side effects or drug interactions have been reported.
11 1:
Schulz V, Hansel R, Tyler VE.
Rational Phytotherapy: A Physicians' Guide to Herbal Medicine.
3rd ed. Berlin, Germany: Springer-Verlag; 1998:231.
2:
Pegel KH. The importance of sitosterol and sitosterolin in human and animal nutrition.
S Afr J Sci
. 1997;93:263–268.
3:
Bouic PJD, Clark A, Lamprecht J, et al. The effects of B-sitosterol (BSS) and B-sitosterol glucoside (BSSG) mixture on selected immune parameters of marathon runners: inhibition of post marathon immune suppression and inflammation.
Int J Sports Med.
1999;20:258–262.
4:
Wilt TJ, MacDonald R, Ishani A. Beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review.
BJU Int.
1999;83:976–983.
5:
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.
6:
Kadow C, Abrams PH. A double-blind trial of the effect of beta-sitosteryl glucoside (WA184) in the treatment of benign prostatic hyperplasia.
Eur Urol
. 1986;12:187–189.
7:
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.
8:
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.
9:
Berges RR, Kassen A, Senge T. Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up.
BJU Int.
2000;85:842–846.
10:
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.
11:
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.
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