The case of L.L., a 67-year-old man who has been diagnosed with BPH, is somewhat typical and relatively mild. While his symptoms impede urination enough for his doctor to suggest medication, they are not so severe as to require surgery. L.L. would prefer to treat the disease using herbal remedies. Aside from taking Cozaar (losartan potassium) 00mg tablets for hypertension, L.L. is not on any other medication, and his blood pressure is currently under control. As L.L.s condition is not urgent, and his overall health appears to be in a good state, it should be safe for the doctor to try to satisfy his request. In the absence of other contraindications, a herbal supplement may be ideal for keeping the symptoms of BPH in check while maintaining L.Ls quality of life.
Saw palmetto or Serenoa repens is the most popular source of herbal supplements for reducing urinary problems in men. The fruit of this American dwarf palm has long been used in traditional medicine, while its extracts have gained medical acknowledgement in many parts of the world today (Kwon, 209). Its anti-androgenic and anti-inflammatory effects have been shown to arrest the enlargement of the prostate gland and improve LUTS while causing minor or no side-effects (Ye et al., 209). Although the effectiveness of saw palmetto has been occasionally contested, this may be attributed to differences in the composition of extracts (Kwon, 209). Extracts prepared with hexane have proven to be more consistently effective, making it the preferable op
tion for herbal treatment of BPH (Görne, Wegener, Kelber, Feistel, & Reichling, 207). The standard dosage of the extract is 320mg daily or 60mg twice a day, although taking more than that causes no ill effect (Görne et al., 207, p. 78). Overall, a standard daily 320mg dose of the hexane extract of saw palmetto seems to be L.L.s best herbal option for managing BPH.
Both doctors and patients should be aware of the possible complications involved in herbal supplements usage. Many of them may cause adverse drug interactions that reduce the effectiveness of other treatments. Those interactions or other side effects may also actively worsen the patients condition. Saw palmetto has few such interactions and, unlike some other herbal supplements, does not seem to cause any problems with losartan potassium in particular (Asher, Corbett, & Hawke, 207). However, saw palmetto had been tentatively connected to an increased risk of bleeding when used alongside anticoagulants (Nabavizadeh, Zangi, Kim, Bejestani, & Tabatabaei, 208). Some studies have shown side-effects such as gastrointestinal disorders, headaches, fatigue, and the common cold, but such reactions appear rare (Nabavizadeh et al., 208; Ye et al., 209). The lack of a standard formula makes it especially important to pay attention to the exact composition of the supplement. While the risks are small, L.L. needs to be informed of them, allowing him to make educated decisions and monitor himself effectively, changing the treatment quickly if necessary.