What is the best prostate supplement? The science isn’t exactly doing a standing ovation for most of them, but if they help you sleep through the night without six pee breaks, then maybe they’re worth a shot.
Alright, gentlemen of a certain vintage, let’s talk supplements—those little magic beans that promise everything from superhero energy to turning back the urinary clock. Once you hit 60, you’re more likely to be popping pills than popping champagne. And when it comes to your prostate, the supplement aisle looks like a botanical garden having an identity crisis.
Let’s start with the big, round elephant in the room—BPH (aka your prostate’s midlife crisis). It’s basically your prostate yelling “YOLO” and growing larger for no good reason. This results in a stream that’s more dribble than waterfall, bathroom trips that outnumber your social engagements, and that lovely “gotta go NOW” panic at 3 a.m.
So, can supplements help? Eh… maybe? Let’s break it down. Let’s find out what is the best prostate supplement from a science perspective:
🌴 Saw Palmetto
The OG of prostate supplements. For a while, it had a serious glow-up in the 90s, and everyone loved it. But when real scientists in fancy journals (like NEJM and JAMA) got involved, the buzz wore off. Turns out, it works about as well as a sugar pill. So, placebo party? Absolutely. Scientific miracle? Not quite. Still, people swear by it, so who am I to kill your botanical buzz?
🌳 Pygeum (African Cherry Tree Bark)
This bark means business. It showed some early promise—like “twice as likely to feel better” kind of promise. But the studies were shorter than your patience during a colonoscopy, so we’re not sure if it’s a fling or the real deal. Still, it shows up in a lot of multi-ingredient supplements like it’s the Beyoncé of the group.
🎃 Pumpkin Seed Extract
PSA: Pumpkin seeds aren’t just for lattes. They may help with symptoms thanks to their anti-inflammatory swagger and impressive zinc content. Studies show mild improvement, especially for bladder urgency—but again, it’s more trickle of promise than tidal wave of relief. No magic here, just maybe a slight nudge in the right direction.
🌿 Beta-Sitosterol
Sounds like a Marvel villain, but it’s just a plant cholesterol cousin. It might improve your urine flow (hallelujah) but doesn’t shrink the prostate. So, it’s more of a symptom soother than a shrink ray. GI side effects may include musical flatulence—so choose your seat wisely.
🪴 Stinging Nettle
Yes, the plant that fights back. It’s anti-inflammatory and might stop your prostate from bulking up like it’s on creatine. When combined with Saw Palmetto, it showed long-term benefits. But is still doesn’t give us the answer of what is the best prostate supplement. And it’s picky—it doesn’t play nice with iron, lithium, or blood sugar meds. It also might make you break out like a hormonal teenager. So… proceed with caution, brave warrior.
🍅 Lycopene
Tomato-based goodness! A powerful antioxidant that might slow prostate growth. But there’s no solid trial just on lycopene alone—just a buffet of mixed results. If you’re thinking of trying it, go with food sources first. Tomatoes, watermelon, and red fruit? Yes. Giant mystery pills from aisle 7? Maybe hold off.
💊 Bottom Line (or should we say bottom stream?)
Does the above help us with what is the best prostate supplement? No. Supplements are like exes: some are full of promise, some just take your money, and a few might actually help… a little. So what is the best prostate supplement? The science isn’t exactly doing a standing ovation for most of these, but if they help you sleep through the night without six pee breaks, then maybe they’re worth a shot.
Just remember: talk to your doctor before you start treating your prostate like a test kitchen. And if your symptoms are worsening, don’t just throw plants at the problem—there are medications and procedures that might actually do the job.
Because at the end of the day, the goal is simple: pee like a champ and live your best life.
Here’s the science bit, which I’ve transcribed from the brilliant Rena Malik, and her youtube’s below too.
What get’s me scratching my head, is the thousands of comments on forums, blogs and youtubes, saying how supplements have helped. Clearly they help for some people, but the science is still shaking its head.
What is the best prostate supplement?
Here’s the Rena Malik transcribe:
“Supplements. They’re everywhere. In fact, as you age, particularly over the age of 60, people are likely to report taking four or more dietary supplements.
So can supplements help your prostate? Today we’re going to cover what supplements there are that might help with prostate enlargement or symptoms related to prostate enlargement,and what is the data behind them?
Benign prostatic hyperplasia BPH or prostate enlargement is a very common condition. In fact, 80% of men at the age of 80 will have prostate enlargement.
So people often have symptoms related to prostate enlargement. And these can be things like having a weak urinary stream, having difficulty emptying your bladder, having to wait for your stream to start, or your stream having to stop and start during urine flow.
In some cases, it can also cause going to the bathroom very often during the day or even at night, and it can cause the urge to go, gotta go, gotta go, and sometimes not even make it.
So wouldn’t it be great if we had natural supplements to help with these symptoms? Now, before I get into the data on the variety of supplements that are available, I want to let you know what supplements are.
They’re what we call phyto therapeutic products, meaning that they come from plants and so plants themselves will have variability.
And so oftentimes even if you get the same supplements in the same manufacturer, sometimes they may work better than others.
Also companies use different processes when they extract the ingredient from the plants. And so that can also vary the efficacy and the amount of the product within the supplement can vary.
What is the best prostate supplement? Saw Palmetto
In one study looking at 27 saw Palmetto products, they saw huge variability in the active ingredient, which is the free fatty acid within the saw palmetto. And that ranged from anywhere from none in the supplement to 95%.
The amount that was needed, and only 17 met the criteria for a saw Palmetto supplement, which was to have 85% of that free fatty acid component or more in the supplement.
So the way these supplements typically work is they have anti-inflammatory effects. Inflammation is one of the causes of prostate enlargement. So they have an anti-inflammatory effect. Sometimes they also interact with some of those growth factors I told you that are involved in cell proliferation, like IgG4 or insulin like growth factor and other growth factors that cause cell growth.
And lastly, sometimes they interact with the hormones DHT or the enzymes that convert them, five alpha reductase.
Now, one of the pharmaceutical drugs that we use for BPH does also affect that same enzyme called five alpha reductase, and it inhibits the conversion of testosterone to DHT. And this is actually quite effective in reducing prostate size and growth. So some of these medications are similar in that way.
So let’s start off with the most rigorously studied supplement in probably all of urology. And that’s called Sereno or Robbins or Saw Palmetto. This is a berry from a dwarf plant tree. And while the mechanism of action is not 100% clear, it’s thought to reduce inflammation. It’s also thought to reduce the conversion of testosterone to DHT by acting on the five alpha reductase enzyme.
It’s thought to inhibit the binding of dihydrotestosterone, which is the most concentrated androgen in the prostate. How this supplement works is:
1: It reduces prostate inflammation.
2: It’s thought to inhibit the conversion of testosterone to DHT by its effect on five alpha reductase. And lastly, it also may affect the binding of dihydrotestosterone two receptors in the prostate. Now let’s go over the abundance of data on South Palmetto.
So I want to start by saying this was used very often in the 90s in Europe and the United States because the early studies were very, very promising. And of course, people like taking supplements, overtaking pharmaceuticals.
And so the first study was published in the New England Journal of Medicine. Now, I have not seen many studies on supplements, with the exception of like vitamin D and magnesium.
In the large journals like the New England Journal and Jama. These are sort of the top tier medical journals that clinical doctors and clinical physicians use to assess the medical literature. And these are the type of articles that cause changes in practices, and how we take care of patients. So all the study them to talk about are randomized controlled trials.
Now, this study was also a double blinded randomized controlled trial of 225 men. And this is important because not only did they not know what they were getting, but the people who are giving the medication didn’t know what they were giving. And these men had to have moderate to severe symptoms, and they had to take saw palmetto for one year during the duration of the study at 160mg dose, twice daily.
And all these studies looked at different factors. Obviously they look at symptom scores. So they use validated questionnaires that correlate with the severity of symptoms. And they use these to sort of standardize the outcome. And they use those. They look at your flow rate, which is how fast your urine flows out, how quickly it hits the toilet in milliliters per second.
They sometimes look at prostate size. And oftentimes they also look at how well your bladder is and thinks of how much urine is left over after urinating. And in this trial they also looked at quality of life. And so in all of these measures they found no sincerely significant difference between those who took the sample and those who took a placebo pill.
Now, the reason I’ve said this many times, the reason these studies are so important is because every time you take a pill, there is a placebo effect, meaning you think it’s going to work and your brain is quite powerful, and it will tell your body that your symptoms are better. Or it may help even with some symptoms, but it’s all based on just a placebo.
There’s no active ingredient in that pill. And so it’s important to differentiate what is a placebo effect. It was a true effect of the actual treatment that you’re giving. So in the next study, which was published in Jama, the journal of the American Medical Association, in 2011. Now this was also a double blind, randomized controlled trial. It was over 11 different centers in North America, and it recruited over 300 men.
Doses were escalated, meaning that they started with getting 320mg a day of saw palmetto, which is the same that they were getting in that last study. They then increased the dose to double that and then triple that to see if there was any difference. And they followed the study over 72 weeks. So it was not a short study.
And what they found over those three years was that there was really, again, no statistically significant difference in all the parameters that they investigated.
It was not a short study, and what they found over those three years was that there was really, again, no statistically significant difference in all the parameters that they investigated. Now, remember, the last study in the New England Journal was moderate to severe lots. This study was actually a group of people who probably had more mild symptoms. They were younger overall.
They were less symptomatic. They had better flow rates and lower PSA. Now PSA is a blood test that is often used for screening of prostate cancer, but it also can be used as a surrogate for prostate size. Because the larger your prostate is, the more PSA it makes. This is also been studied so much that they created what’s called a Cochrane review.
Cochrane reviews are sort of a well respected organization, the Cochrane Review Organization, that creates systematic reviews of all the data in literature and in fact Saw Palmetto went through, I think, three Cochrane reviews, the last one being in 2012, because it was they saw this new Jama article. They had to incorporate it into the systematic review into and analyze all the data from all the studies together.
To come up with a definitive plan is Palmetto actually helpful in this review? They include 17 randomized controlled trials with over 2000 patients. These patients were about 64 years of age. Most of them were white, and they had moderate to severe symptoms based on their symptom scores. When they focused on the high quality, long duration studies that analyzed those specifically, they again saw no significant difference in symptom score or flow rate with Super Meadow compared to placebo.
So I will say this is actually a really good example of what happens in the field of science, right? We start off with smaller studies. Usually they’re less, you know, they receive less funding. They’re less of interest. And so they’re smaller duration studies. And we may see promising results. But when we follow this data for years with larger numbers of patients, that difference may become diluted and actually not be significant.
It means that it may not make a difference that’s clinically meaningful to patients. What do I do with meadow? I still offer it to patients if they are wanting to try a supplement option, because I do find that some patients still do see a benefit, however, that I always tell them the data did not show a benefit. So this is essentially maybe a drain on your wallet and may not be helpful.
But for some people they would much rather take either that or take that with other medications to avoid a surgical procedure for an enlarged prostate. And again, this is about what you want and what you need. Now supplemental is generally very, very safe, has very little side effects. It can affect blood clients. If you’re going to have a major procedure, generally it’s a good idea to stop it two weeks before, but otherwise it’s pretty safe.
Most people tolerate it pretty well. And I will say that generally speaking, any supplement or anything you take can have G.I side effects. So nausea, vomiting and changes in bowel habits. So if that occurs I think obviously you can stop it and make sure that those symptoms improve. And if they persist that’s important to see your primary care doctor to make sure it’s nothing more serious.
What is the best prostate supplement? Pygmy Africana
The next supplement is called Pygmy Africana. Now this is from the bark of an African cherry tree, and the fruit that it produces are African cherries or African plums, however you want to call it. But that’s where the word pigeon comes from. And this works by a multitude of actions. First off, it reduces five alpha reductase activities that prevents the conversion of testosterone to dihydrotestosterone and also inhibits the anti receptor from binding so that it reduces signaling.
And by that way it’s supposed to reduce prostate cell growth. There was also so many studies on this that they also had a Cochrane review that was published in 2002. This also included 18 randomized controlled trials with over 1500 men. And however, it’s important to note that these studies were really short in duration. It was about 64 days.
And in this review, they actually did see a benefit. People who took the pygmies in this short duration were twice as likely to show an improvement in overall symptoms. There it is, the need to your day and night by about 90%. The amount of volume of urine left over after urinating in the bladder by about 24%, and they increased their full peak urinary flow by another 23%.
So it did see an improvement. And the dose they took range from 100 to 200mg. Now there were some side effects again most common where G.I side effects and nausea, abdominal discomfort things like that. But despite this positive review. So while they saw a positive improvement, I don’t believe there’s been any subsequent longer term studies that have shown benefit with this particular supplement.
Now, I see it a lot in combination with saw palmetto in terms of the supplements that have multiple ingredients in them. And so perhaps maybe together they do see a better benefit. But generally speaking, like I said, these days are really small. The outcomes were not standardized. It was a really short duration, so hard to tell if it’s really going to help in the long term.
And generally speaking, when you take supplements, that’s usually not a quick onset. Like what do you take of pharmaceutical medication? Those are really sort of concentrated to have just the active ingredient in them. And so they work a lot quicker. Whereas supplements you generally have to take a couple months or at least a month to see a true benefit.
So I’m not really sure if this would be replicated in longer term studies.
What is the best prostate supplement? Pumpkin seed
The next segment is called curvature pepo or pumpkin seed. And so pumpkin seed usually comes in an extract either an oil or a supplement pill form. And it works by again affecting the five alpha reductase enzyme. It also has a huge anti-inflammatory component, and in fact, in rat studies it has been shown to increase nitric oxide, which can then allow for smooth muscle relaxation.
So that can also help relax the prostate and allow for improvement in symptoms. Additionally, pumpkin seeds have really high levels of zinc and the prostate is one of the organs in the fire that has high concentration of zinc. So the zinc itself is thought to ameliorate some of the symptoms. Now, it’s important to note in your extract that you decide to take.
If you decide to take it after watching this, that there are high levels of phosphate, zinc, as I mentioned, magnesium and manganese and a lot of pumpkin seed extracts. So if you, for example, are taking another magnesium supplement, you don’t want to take both. Or if you have kidney issues, you don’t want high levels of phosphates. So you want to avoid something like this.
So always no matter what supplement you take, check the ingredients on the back because you don’t want to excessively take any one ingredient. Again, we’re focusing on studies that are randomized controlled trials. So here they had a randomized controlled trial looking at men getting two 500mg of pumpkin seed extract versus the control over 12 months. And they accrued about 476 men.
They did see a significant improvement in symptoms based on validated questionnaires, a 65% improvement in the pumpkin seed group versus a 54% improvement in the control group. Now, that’s a huge placebo effect, 54%. That’s pretty high. They didn’t see an improvement. Other factors like flow rate, residual urine left over PSA levels and the size of the prostate. There was again another study very similar to this 1400 patients that were randomized to receive either the pumpkin seed extract of 500mg or the pumpkin seed itself of five grams twice a day compared to placebo.
And again, they did see an improvement in symptom scores, but they weren’t sure if it was really clinically significant so it doesn’t really help us with the question of what is the best prostate supplement.
So generally speaking, I think in terms of pumpkin seed, I’ve seen a lot of stuff on social media about pumpkin seed extract, pumpkin seed oil, and I think there may be a benefit, but if we’re not seeing changes in the other parameters like how quick your urine is flowing, which is usually the big one that I like to see is that your flow is better, then it may not be useful, but I think that also it does have some beneficial effects on the bladder itself, so it may improve some of the overactive bladder symptoms like going off dinner, got to go, gotta go, or having to wake up at night, which isn’t really assessed by these other parameters like prostate volume and residual urine, but it may overall help with those symptoms.
What is the best prostate supplement? Beta-sitosterol
The next supplement is Beta-sitosterol. So this is a very common molecule that’s found in a lot of cell membranes. That’s similar to cholesterol. And it’s of plant cereals. It’s very highly abundant. But it works in one way as an anti-inflammatory.
And it also has what we call pro a pop tilted mechanism. So it actually helps sort of kill off some of the cells that are growing in the prostate.
And that’s the theory anyway. So again this is also seen most commonly in sort of combination supplements. But this was studied again in a Cochrane review. This was published in 1999. And it has five randomized controlled trials included in it with over 500 men. And so in these two in the control and the supplement group, they saw an improvement in symptoms.
But they also saw an improvement in flow rate is important. But they did not see an improvement in overall prostate size. So it doesn’t cause prostate shrinkage. It may improve urinary flow rate. Side effects again are GI related. So gas constipation, diarrhea but otherwise generally pretty well tolerated. And that moves us on to the last one for today which is stinging nettle or Utica diosa.
What is the best prostate supplement? Stinging nettle
So this is a perennial plant that’s usually found in damp soils and abandoned fields. And typically people will use the root extract for the benefit of something so similar to beta side of sterile. It has anti-inflammatory and anti growth essentially factors. It will inhibit some of the growth factors that are responsible for BPH growth.
It may even inhibit the connection of sex hormone binding globulin to receptors in the prostate itself. There was no good high quality. So it was stinging nettle by itself. But there was one where it was combined with saw palmetto, or in the study called saba fruit. In this way, they’re randomized to receive 150mg of saw palmetto with 120mg of the root extract of stinging nettle twice a day compared to the placebo.
And they followed these people for up to 48 weeks. And after 48 weeks, they were then all given the active supplement to up to 96 weeks. And so based on this, they again saw an improvement in symptoms and urinary flow rates, with both together over 96 weeks. And so that does again show a that’s a pretty good rigorous long term study that’s shown a benefit.
Stinging nettle has a little bit more sort of reactions that you need to be aware of. One is that it can interact with iron. So if you take the iron it can reduce the efficacy of the iron. You’re taking it off course can cause the same GI effects. Some people do get swelling or hives or others who have dermatologic issues, although that’s quite rare.
And if you’re taking lithium or blood thinners, you want to avoid taking the stinging nettle. Also, if you’re diabetic, stinging nettle can have sort of a hypoglycemic effect. So you want to watch that with your diabetes medications. That may not be a good idea to take those together. If you’re taking diuretics, stinging nettle can also decrease your body’s potassium, which can be dangerous if combined with the wrong diuretics. So if you’re any of those categories, I would just avoid taking stinging nettle altogether. So again, it doesn’t really help us with the question of what is the best prostate supplement.
What is the best prostate supplement? Lycopene
Next is Lycopene, which is a powerful carotenoid that has an anti-inflammatory effect. It also is a strong antioxidant, and it can slow prostate growth by the way it interacts with certain growth factors like IGF one, to help reduce the growth of the prostate. So in terms of studies with lycopene, there’s no randomized controlled trials on lycopene by itself. But there have been reviews looking at sort of all the published researcher.
And I will say it’s extremely variable. They’ve seen doses from anywhere to ten milligrams twice a day, up to 500mg twice a day. They follow people for up to six months, and they’ve done it on a large number about 2000 patients. If you look at all the data together and they’ve shown some benefit. But again, these days are really variable and you cannot confirm this without a randomized controlled trial.
So until there are randomized controlled trials that go head to head with lycopene and placebo, it’s really hard to say if this truly works. And if you are going to try lycopene, I’d say start with the food grade first rather than taking supplements. So add some tomato paste into your diet, or tomatoes or watermelon, or any other food that has lycopene and see if that helps with your symptoms.
Again, lycopene in terms of tomato based products can be a bladder irritant. So if you are experiencing irritation from eating those things that may be taking a supplement may be better. But again, I can’t say if it’s truly effective. The only randomized controlled trials we have, as I mentioned, are with other things like saw Palmetto and selenium where they did see a benefit.
And also just know that lycopene can affect blood clotting. So if you are taking lycopene to stop it a couple of weeks before surgery so that you don’t have any adverse bleeding during surgery. So in terms of BPH, these are probably the most rigorously studied supplements. And the one that has the most that is supplemental, ultimately did not show a benefit.
But still I think highly used. And it does help for some individual patients. And then the other ones, you know, there’s some data but not as robust as saw palmetto. And ultimately I think if you are having bothersome BPH symptoms, of course my concern is your quality of life and improving that quality of life. And so if these supplements help you get there, that’s great. But when it comes to ‘what is the best prostate supplement’ science says there isn’t one.
There’s also, of course, a number of medications that you can take or procedures that you can get done if it’s becoming too bothersome. Really the biggest concern as a urologist is that over time when you have a large prostate blocking the bladder, it can affect bladder function. It can make the bladder not squeeze as strongly as it used to, because it keeps pushing urine through the prostate for years and years, which can create a problem.
And so in terms of that, if you are symptoms are getting worse or having symptoms very young, I encourage you to consider doing something to alleviate those symptoms and either start medication or consider a procedure. Because you’re young and you’ve got many, many years to live and it could become a problem as you age. But at the end of the day, we just want you to feel better and hopefully live a happy, healthy and fulfilled life.”
You can watch it on youtube here.
So what is the best prostate supplement from a science point of view? Well, you’ve only have to read the transcribe or watch the youtube there isn’t one.
That doesn’t mean they won’t help you – they may give you relief just from the placebo effect. Personally, I got lots of relief from pumpkin seeds and stinging nettle root.
But here’s the kicker, I don’t care if it is just placebo. Who cares what it is, if it works?
So there you go. What is the best prostate supplement? It’s down to you, because science is still shaking its head.