Just to show how complicated the relationship between prostate health and the possible use of supplements might be, I’m going to talk briefly about a study which was conducted in 2006. This study investigated the relationship between multivitamin use and risk of prostate cancer. It was reported in the Journal of the National Cancer Institute, volume 99, issue 10, pages 754-764.
Karla Lawson and her colleagues followed the health of over 290,000 men enrolled in The National Institute Of Health Diet and Health study. All these men were cancer free in 1995, and were followed over five years to see how their health changed. In these five years, just over 10,200 men were diagnosed with prostate cancer.
The use of multivitamins was investigated in the men who developed prostate cancer so that the risk or any possible association between cancer and multivitamin supplement use could be established.
In brief, the authors found a link between excessive use of multivitamins — that is to say, more than seven times a week — and the development of advanced and fatal prostate cancers. In fact, among the men who took a multivitamin supplement more than seven times every week, the rate of cancer was 143.8 per 100,000 man-years for advanced cancer, and 18.9 per 100,000 man-years for fatal prostate cancers.
The comparative rates in men who had never taken multivitamins were 113.4 and 11.4. Interestingly enough, it turned out that the association was strongest where men were also taking selenium, zinc or beta-carotene.
I should say that this is only a conclusion reached among men who were taking excessive multivitamins — regular use of the multivitamin supplement does not show any sign of any increased association with prostate cancer.
One of the problems with this finding is that it doesn’t take into account any other factors. It may be, for example, that older men who are more likely to develop prostate cancer are the ones who tend to take excessive levels of multivitamins, so the association between multivitamin use and cancer is not absolutely proven. All we can say is that there is a link which may be cause for concern, and deserves further investigation.
And of course if men take general health supplements specifically as prostate supplements, there may be unexpected consequences. Let’s look at this in more detail.
Possible bias in the experiment was acknowledged by the investigators. For example, i’s possible those men taking multivitamins are more conscious of their health problems. They might therefore be more likely to have regular prostate screening of some kind, and so they may form a population which is more likely to show up in a study like this.
However there appears to be a link between health supplements in the form of multivitamin use and fatal prostate cancer, at least when consumption of multivitamins is excessive. Indeed, if you read the study it seems probable that it’s actually the combination of micronutrients and multivitamins that is the underlying factor causing the increased risk of prostate cancer.
So Are Prostate Supplements Safe?
They also discovered that almost half of men who are defined as having a high risk of prostate cancer took one or more supplements to try and prevent prostate cancer. These high-risk groups included men of African American origin and those with a family history of prostate cancer. In total the men were taking a variety of up to 40 supplements between them.
The most common multivitamin supplements, in decreasing order of popularity were vitamins E and C, zinc, calcium selenium micronutrients, saw Palmetto, soy isoflavones, and flax seeds. All of these prostate health supplements have a place in the medical care of the prostate, but excessive consumption, particularly in combination with multivitamins, may be doing more harm than good.
Another study also reported in the Journal of the National Cancer Institute, volume 95, number 13, July 2003, investigated the link between zinc prostate health supplements and the risk of prostate cancer. The author starts by making the observation that zinc is found in high concentrations in the prostate gland.
This suggests that it may play a role in prostate health. So investigating the link between zinc consumption and prostate cancer risk may clearly be helpful to men trying to avoid cancer. The authors studied nearly 47,000 United States men from 1986 to 2000. They discovered that during this time 2901 cases of prostate cancer were diagnosed, of which 434 were advanced cases.
In fact taking prostate health supplements of zinc at levels of up to 100 mg a day was not associated with prostate cancer risk. However, the men who had more than 100 mg a day of zinc as a health supplement showed a relatively high risk of developing advanced prostate cancer. Even worse, those who had been taking it more than 10 years showed an even higher risk. This suggests that taking too much Zinc supplementation for too long may play a role in the development cancer and prostate.
Now, I don’t want to be scaremongering here, because there is no doubt that health supplements, particularly when taken for prostate health, can be beneficial. The danger, as with everything, lies in over-consumption.
One of the extraordinary thing is that this study is that it reveals about 15% of the United States population uses health supplements that contain zinc. And indeed up to 10% of men consuming zinc supplements consume two or three times the recommended daily intake. (This is about 11 mg per day in men.) The concentration of zinc appears to be higher in the tissues of the prostate than anywhere else in the body. However, prostate tissue that has become cancerous shows lower levels of zinc than the normal surrounding tissue.
One suggestion that has emerged from such research is that high levels of zinc may protect against prostate cancer. Regrettably, as is so often the case, other studies suggest that high zinc prostate may increase prostate cancer risk. If you would like more information on the scientific studies, you can get it from the article. I don’t intend to recount the evidence here.
To Supplement Or Not To Supplement?
So just what is the effect of prostate health supplements on the risk of cancer? Of course one of the questions about supplements is whether or not they actually reach the organs that they are intended to support. We don’t even know if taking a zinc supplement actually changes the level of zinc inside the prostate.
We do know is that excessive levels of zinc certainly have undesirable effects, affecting the immune system adversely, and perhaps also inhibiting the effect of cancer protecting compounds in the body.
I should say, however, that these conclusions have been reached in studies where the intake supplements has been extremely high. They may have no relevance to normal supplementation levels. But even the slightest suggestion that taking zinc supplements, even at levels thought to be normal, increases the chances of developing prostate cancer, need to be investigated.
Among men taking zinc supplements, this supplemental source of zinc may represent a third of their total intake, which is a very significant proportion. The fact remains, of course, that the researchers found no association between the use of zinc supplements and prostate cancer risk at doses up to 100 mg per day. Only over this level would it appear that the use of zinc as a prostate health supplement may present greater risk of harm than benefit.
And this risk increases if men have been taking supplemental zinc prostate health for 10 years or more. The authors admit that there is no evidence to explain how excessive zinc supplementation is linked to advanced prostate cancer, but the conclusions they reached should be heeded by every man who wants to maintain his prostate health. In essence, the message is “take supplements in moderation”.
Natural Prostate Supplements
Work by Edward Giovannucci and his colleagues, reported in the International Journal of Cancer, volume 121, issue seven, pages 1571 — 1578, was designed to study the risk factors for prostate cancer.
They examined 10 factors ranging from cigarette smoking, through family history, to the intake of various health supplements in order to investigate the relationship between various lifestyle factors (including use of health supplements) and advanced prostate cancer.
Although they didn’t specifically investigate micronutrients like zinc and selenium, they did investigate the risk of increased lycopene intake, and the risk of supplemental calcium and alpha linolenic acid.
One interesting observation they make is that men from countries where there is a low incidence of prostate cancer may show high levels when they migrate to countries with intrinsically high rates of prostate cancer.
This strongly implies that lifestyle factors and diet, which could well include the use of prostate health supplements, may be responsible for the development of prostate cancer. But there are many forms of prostate cancer, which complicates the study of cause and effect. Risk factors may be different in different groups of men. It is therefore wrong to assume that the risk factors for all types of prostate cancer are the same.
Giovannucci and his colleagues studied research on 51,500 US men for their investigation. As previously mentioned, they considered the possible link between 10 lifestyle factors and prostate cancer. By looking at hospital records, and studying the questionnaires completed by men who developed prostate cancer, they were able to link various lifestyle factors and nutritional supplements and prostate health.
They looked at the link between these factors and both mild forms of prostate cancer and fatal prostate cancer. What they found was that increased lycopene intake, in the form of higher tomato sauce, was associated with decreased risk of prostate cancer. By contrast, high alpha linolenic acid intake was associated with an increased risk. There also seems to be an increased risk of cancer associated with high calcium intake.
Does this mean these natural prostate supplements are safe or not?
Admittedly this study looked at some very specific factors, but it does bear out what I’ve already said: that is, supplements should be used with care. Certainly the idea that nutritional supplements for prostate health can be taken in large quantities is simply wrong. There is evidence that several supplements taken in excess can adversely affect prostate health.
Of course, the other thing that complicates studies like this is that cancer is probably caused by several factors working in combination, and studying factors and diet or lifestyle in isolation may simply not give you the right answers.
And as if that weren’t enough, what complicates this problem even more is that people tend to want simple answers. In other words, men who feel they may be at risk of prostate cancer would probably like a simple list of recommended prostate health supplements. And that’s not an easy thing to produce from this research.
To understand the difficulty, think about body mass index. This study looked at body mass index and any possible association with prostate cancer. In general, it seems that there is no overall association between BMI and total prostate cancer. But when you look at in more detail at turns out there’s an inverse association in younger men, and a positive association in older men.
Furthermore, if you look at different types of cancer, BMI is positively associated with fatal prostate cancer, particularly in older men. So why does BMI associate differently with prostate cancer in different age groups? We don’t know, but the possibility is that it’s something to do with hormone levels such as testosterone and oestradiol, which change over lifespan and are influenced by BMI. To make things even more complicated, we know that BMI is itself influenced by these hormones.
In general terms, what this probably means is that modest exercise, low body weight, physical fitness, and the modest use of a variety of supplements is going to be beneficial for the majority of men.
So How To Decide Which Prostate Health Supplements To Use?
A study in the Journal of Nutrition by Silke Schwartz and colleagues suggested that lycopene showed promise as a nutritional supplement for the prevention of prostate cancer. She investigated 40 patients with benign prostatic hyperplasia, or BPH.
She compared the effects of supplementation with lycopene for six months with men in a control group who did not receive nutritional supplement. Lycopene is a carotenoid, and there seems to be clear evidence from this study is that it inhibited the development of prostate enlargement in the group of men taking the supplement.
This would therefore appear to be a very useful prostate health supplement for men: men were given 50 mg per day of lycopene. This might therefore be helpful guideline for men seeking a suitable nutritional supplements prostate health at a safe level.