Use That Herbal Drug Wisely
“Sir,” she chirped, “these are good for your prostrate.” No thanks, I said. Call me a skeptic, but I never take health advice from people who can’t pronounce the names of important body parts. In fact, I think it’s wise to question just about anything you hear from someone who’s trying to sell you dietary supplements, whether it’s a store clerk, some anonymous dealer on the Internet or your brother-in-law Morty operating from the trunk of his Buick.
I didn’t say “doubt,” mind you. After all, a growing body of research suggests that some medicinal herbs and nutritional therapies--which anyone can buy without a prescription--really work. Others? You may as well pop Pez.
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Here’s the scoop on four dietary supplements that are currently being marketed as remedies for several male concerns, both medical and cosmetic.
Saw palmetto: This herb treats the annoying symptoms of an enlarged prostate about as well as standard drug therapy, according to a review published last year in the Journal of the American Medical Assn. Also known as benign prostatic hyperplasia, or BPH, an overgrown prostate squeezes the urethra, inhibiting the flow of urine.
Doctors often prescribe the drug Proscar to men with BPH, since it blocks the action of hormones that cause prostate growth. No one is sure how saw palmetto works, but it, too, may interfere with growth-causing hormones, with virtually no side effects. Proscar, meanwhile, causes a small number of men to become impotent and can mask signs of developing prostate cancer. A caveat: Saw palmetto is no miracle herb. Like Proscar, it improves urine flow by about 30%; for some men, surgery is the best solution.
Fo-ti: The Food and Drug Administration recognizes only two legitimate hair-growth drugs, Propecia and Rogaine. But that doesn’t stop herb companies from peddling products to men who are getting shiny on top. Shen Min, sold in stores and on the Internet, contains an herb derived from the root of an evergreen plant grown in Japan known as fo-ti or he-shou-wu. Fo-ti supposedly reverses the effects of aging, in particular turning gray hair back to its natural color. Web sites that sell Shen Min pitch it as an all-around more effective treatment for baldness than prescription drugs.
But there’s no scientific evidence that fo-ti regrows lost locks. In fact, the only thing known with much certainty about fo-ti is that it’s a potent laxative. Shen Min could have you spending more time in the bathroom, though you won’t necessarily be combing your new hair.
Creatine monohydrate: If you pump iron, you’ve heard of this powdered beverage, which is one of several sports supplements baseball slugger Mark McGwire has acknowledged using in the past. Your body makes a small supply of creatine; you get a tiny dose by eating meat and fish, too. Creatine fuels muscles during brief, intense exercise, such as weight lifting. A number of studies show that about two-thirds of weight lifters who add creatine monohydrate supplements to their diets develop greater strength and bigger muscles, both by allowing them to work out longer and by causing muscle cells to retain water. In one study, male body builders who took creatine supplements increased their bench press by an average of 18 pounds in just four weeks.
Yohimbe: Long before Viagra revolutionized the treatment of erectile dysfunction, or ED, there was yohimbe. Men struggling with too-frequent performance power outages turned to this herb if they didn’t like what medicine had to offer. Yohimbe is still around, and it’s the main ingredient in a number of products marketed as herbal substitutes for Viagra. Derived from a tree that grows in West Africa, yohimbe seems to encourage erections by promoting blood flow to the penis. But it can also cause some nasty side effects, including anxiety, blood pressure spikes and a racing heart. Even herbalists say this is a plant to avoid. However, men who can’t or won’t take Viagra shouldn’t rule out yohimbine hydrochloride, which is a safer, purified version of the herb. Several controlled studies have found that yohimbine, an alkaloid of yohimbe, produces at least partial improvement in about a third of men with ED who use it. One more reason to be leery of the herbal version: It’s hard to find pure product. A 1995 FDA analysis of 26 brands of yohimbe determined that over a third contained no active ingredient; although the agency doesn’t forbid the sale of yohimbe, it does include the herb on its list of over-the-counter products that are unsafe and ineffective.
Unfortunately, the FDA isn’t legally required to monitor the purity and content of dietary supplements, so any time you go herbal you’re taking a little gamble. Stick with reputable manufacturers and talk with a physician before self-treating a serious medical condition. After all, he who diagnoses his own illness has a knucklehead for a doctor.
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Timothy Gower is a freelance writer in Massachusetts and the author of “Staying at the Top of Your Game” (Avon Books, 1999). He can be reached by e-mail at [email protected].
* The Healthy Man column runs the second Monday of the month.
