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Numerous plants contain cholesterol-like compounds called sitosterols and their close relatives sitosterolins. A special mixture of these called beta-sitosterol is used for the treatment of benign prostatic hyperplasia (BPH) .

What Is Beta-Sitosterol Used for Today?

Some conditions are luckier than others. For some mysterious reason, there seem to be more useful herbal treatments for BPH than almost any other disease. Beta-sitosterol joins saw palmetto , pygeum , nettle , and grass pollen as a moderately well-documented treatment for BPH.

Based on highly preliminary evidence, it has been suggested that sitosterols may also help strengthen the immune system . 2 In particular, one study suggests that beta-sitosterol can help prevent the temporary immune weakness that typically occurs during recovery from endurance exercise , and can lead to a post-race infection. 3

What Is the Scientific Evidence for Beta-Sitosterol?

A review of the literature, published in 1999, found a total of four double-blind placebo-controlled studies on beta-sitosterol for BPH, enrolling a total of 519 men. 4-7 All but one of these studies found significant benefits in both perceived symptoms and objective measurements, such as urine flow rate.

The largest study followed 200 men with BPH for a period of 6 months. 8 After the trial was completed, many of the participants were followed for an additional year, during which the benefits continued. 9 Similar results were seen in a 6-month, double-blind trial of 177 individuals. 10

Beta-sitosterol binds to prostate tissue and affects the metabolism of prostaglandins, substances found in the body that affect pain and inflammation. 1 However, it is not clear whether this is the correct explanation for how beta-sitosterol might help in BPH.

Dosage

The daily dosage of beta-sitosterol is 60 to 135 mg. Effects usually take 4 weeks to develop.

Safety Issues

Although detailed safety studies have not been performed, beta-sitosterol is believed to be safe. No significant side effects or drug interactions have been reported. 11

Revision Information

  • 1

    Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer-Verlag; 1998:231.

  • 2

    Pegel KH. The importance of sitosterol and sitosterolin in human and animal nutrition. S Afr J Sci . 1997;93:263-268.

  • 3

    Bouic PJD, Clark A, Lamprecht J, et al. The effects of B-sitosterol (BSS) and B-sitosterol glucoside (BSSG) mixture on selected immune parameters of marathon runners: inhibition of post marathon immune suppression and inflammation. Int J Sports Med. 1999;20:258-262.

  • 4

    Wilt TJ, MacDonald R, Ishani A. Beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review. BJU Int. 1999;83:976-983.

  • 5

    Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. German BPH-Phyto Study group. Br J Urol . 1997;80:427-432.

  • 6

    Kadow C, Abrams PH. A double-blind trial of the effect of beta-sitosteryl glucoside (WA184) in the treatment of benign prostatic hyperplasia. Eur Urol . 1986;12:187-189.

  • 7

    Berges RR, Windeler J, Trampisch HJ, et al. Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group. Lancet. 1995;345:1529-1532.

  • 8

    Berges RR, Windeler J, Trampisch HJ, et al. Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group. Lancet . 1995;345:1529-1532.

  • 9

    Berges RR, Kassen A, Senge T. Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up. BJU Int. 2000;85:842-846.

  • 10

    Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. German BPH-Phyto Study group. Br J Urol . 1997;80:427-432.

  • 11

    Berges RR, Windeler J, Trampisch HJ, et al. Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group. Lancet . 1995;345:1529-1532.