First I wish to say this is my first post in this Forum which I have been looking at for quite a while and where I find lot of competence, enthusiasm but also that healthy dose of skepticism I love to see, e.g. in the supplementation area.
With this specific post I am looking at comments, sharing experience and receive bullets to discuss with my doctors on a sound scientific basis.
Lower Urinary Tract Symptoms (LUTS). I have mild symptoms of benign prostatic hyperplasia (BPH). It went improving on frequency and urgency. Night waking ups almost completely disappeared. I am using the LEF Ultra Natural Prostate formula since now several years and it is showing to be as much effective as a non pharmacological product can be. Also, I think the acupuncture sessions I run have been beneficial (there are studies on that and BPH). However, I need to retest the Post Void Residual (PVR) soon. Last measurement (about 2 months ago) has shown ~100 mL (not bad from 200-300 mL, I think a positive synergistic effect between low dose tamsulosin (my only regular medication as I did not find a "natural" equivalent) and natural prostate support formulations as the above mentioned). Also flow clearly improved using tamsulosin (0.2-0.4 mg) and I keep using it (again, even if I would like to find a "natural" equivalent).
Hormones. I had interesting results (last July) after one year. The values and % increases/decreases are:
• DHEA-S 196.2 from 38.5 (+410%) (50-377) (supplemented)
• Estradiol E2 12.0 from 10.6 (+13%) (11-44)
• Testosterone 565 from 444 (+27%) (282-1101)
• Free T (calc.) 98.6 from 72.9 (+35%) (26-167)
• DHT 13.9 from 49.3 (-72%) (14-107)
• Progesterone 251.6 (94-189)
• SHBG 43 from 42 nmol/l (+2%) (14-71)
The PSA has increased to 1.98. Despite my urologist found my prostate small I think it is getting larger with age (now 56) but so far he did not consider useful I use finasteride to shrink it. A linear fit to PSA values since 6 years shows a low velocity increase 0.05 ng/mL/year. A test using http://www.usrf.org/...A_Velocity.html over the past 3 years gives: 0.3 ng/mL/year (“ low risk”).
A nice result is that while my testosterone increased to the same level I had after a 3 months cycle of transdermal supplementation (a kind of test I did a couple of years ago) w/o doing nothing special, DHT drastically lowered and Estradiol (E2) seems in check.
The only way I can explain this is the 5-alpha-reductase enzyme inhibition by the LEF formula worked to avoid conversion to DHT and yet did not cause trouble increasing too much the E2 by blocking one of the two testosterone conversion channels (I read somewhere some express concerns in using saw palmetto over long time for this reason). I also strongly suspect more potency and effectiveness in the LEF formula as it went from product nos 975, 1275, 1475 and currently 1495 (I would not know how to retrieve easily the differences though). For completeness, I have also been using ketoconazole 2% shampoo 1-2x/week, pumpkin seeds extract and tocotrienols for my hair and I think all have been shown to have some DHT interference effects.
I also wonder if the alpha adrenergic receptor inhibition effect of the LEF formula compounds will also continue to show up in my PVR in the next test but this, I am afraid, will be masked by the tamsulosin therapy. In any case synergy is probably better that laser focused interventions.
For the first time I tested my progesterone which looks ok.
I have been using DHEA (25 mg) as I have been constantly found deficient. As expected the DHEA-S level increased despite not yet optimal (but I am always cautious on this when BPH). I am considering 7-Keto even if I feel jury is not out if yes/not this changes hormonal status.
Overall libido and performance are very good.
Have several questions, in order of importance:
• Should I continue with (low dose) DHEA? Should I try 7-Keto? One expert advice I once got was to supplement DHEA when both DHEA and testosterone are deficient. However, I must say I feel more comfortable seeing my DHEA also in norm with testosterone already OK.
• Should I continue using tamsulosin? Any natural replacement? I could not find one in my research. I am reacting well to this well known and largely used medication, no (felt) side effects but concerns on long term usage.
• Should I continue with testosterone replacing cycles from time to time?
• Should I consider using finasteride (or dutasteride) when considering side effects (much more important than with tamsulosin, e.g. potential masking of PSA growth)? The CombAT study support the use of both tamsulosin and dutasteride in terms of efficacy on BPH.
Thank you in advance and truly appreciate any advice and comment your feel to provide!