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Men's Prostate and Testosterone Health

Last updated: October-9,2022

Men's Prostate and Testosterone Health

According to Nutritional Outlook[i], a leading category of growth for the health condition category of supplements in 2020 was men’s health. Now consider that two of the top men’s health issues are prostate and testosterone health, both of which are associated with men who are middle-aged and older.

Approximately 6,000 men turn 50 every day and 1 turns 60 every 15 seconds[ii] — and the Natural Marketing Institute has reported that much of this market is underserved, representing a huge market potential for supplement business owners.

Clearly, there is a solid market for men’s health supplements, and this article will provide an overview of some of the top nutraceuticals in this category. But first, let’s examine prostate and testosterone health issues.

Prostate Health

Benign prostatic hyperplasia (BPH), is a common enlargement of the prostate gland as a man ages. Though the prostate continues to grow during most of a man's life, the enlargement doesn’t usually cause symptoms before age 40, but more than half of men in their sixties, and as many as 90 percent in their seventies and eighties have some symptoms of BPH. These are typically referred to as lower urinary tract symptoms (LUTS) and include incomplete bladder emptying, frequent urges to urinate during the day and at night. However, it should be understood that LUTS and BPH are not equivalent. While all BPH includes LUTS, not all LUTS are reflective of BPH.

Testosterone Health and Related Nutraceuticals

Aging is often associated with a decline in men’s testosterone levels. In fact, testosterone levels in men fall progressively with age, and a significant number of men over the age of 60 years have serum T levels that are below the lower limits of young adult men (age 20-30 years).[iii] The fact is, research[iv],[v] shows that men experience a gradual and progressive decline in total testosterone levels at the rate of about 1-2% per year beginning in their thirties. This can be problematic since a decline in testosterone may result in a reduction in libido and sexual function. It can also impact energy levels, cognitive health, motivation, and more. It is no surprise that prescriptions for testosterone have become more and more common in men 50 years and older.

Nutraceuticals for Prostate and Testosterone Health

And now for the part you’ve all been waiting for - the overview of evidence-based nutraceuticals which help promote healthy prostate function (and reduce LUTS), and help increase testosterone levels.

  • Shilajit – This mineral pitch secreted from sedimentary rocks (largely in the Himalayas[vi]) is said to carry the healing power of these great mountains[vii], and is an important natural remedy of the Ayurvedic materia medica used extensively for the management of male reproductive health.[viii],[ix] Furthermore, shilajit has an extensive history of use in Ayurvedic medicine as an aphrodisiac,[x],[xi],[xii],[xiii],[xiv] and its safety has been well documented based on animal and human studies.[xv] Specific studies on shilajit have shown that it was able to help support healthy testosterone and sperm levels in men.[xvi],[xvii]
  • Ashwagandha – The root of ashwagandha (Withania somnifera) has been used in Ayurvedic medicine[xviii] for over 3,000 years and has been said to have value as a tonic, aphrodisiac, and stimulant.[xix],[xx] Modern studies on ashwagandha root extract have demonstrated its effectiveness for promoting healthy testosterone and sperm levels[xxi], as well as reduce markers of muscle breakdown while reducing body fat.[xxii]
  • Longjack – Also known as Eurycoma longifolia Jack or Tongkat Ali, the root of this Asian herb was traditionally used for its aphrodisiac activity to enhance male sexual performance.[xxiii],[xxiv],[xxv],[xxvi],[xxvii] Modern scientific research has also demonstrated this benefit, apparently as a result of promoting healthy serum testosterone levels.[xxviii],[xxix]
  • Saw Palmetto – This western herb has been shown to help prevent the conversion of testosterone to dihydrotestosterone (DHT), which may help maintain healthy testosterone levels, and may also help reduce LUTS. Indeed, multiple human studies have demonstrated the effectiveness of this herbal extract in promoting prostate health and reducing the number of different urinary symptoms in men.[xxx],[xxxi],[xxxii],[xxxiii],[xxxiv]
  • Citrulline – This amino acid is converted in the body to arginine, thereby increasing plasma levels of arginine in the human body.[xxxv] And what is really so exciting about citrulline is that it seems to increase plasma arginine levels better than taking the amino acid arginine itself,[xxxvi] which also results in increasing NO levels.
  • Pygeum – This African herb has been extensively researched for its ability to help improve LUTS-related symptoms, support prostate health, and promote a better quality of life with research on it for prostate health.[xxxvii],[xxxviii],[xxxix],[xl],[xli],[xlii]
  • Vitamin D – This relationship between vitamin D and LUTS was demonstrated in the National Health and Nutrition Examination Survey, where a majority of men with LUTS (89%) had insufficient vitamin D levels. The researchers concluded, "Vitamin D insufficiency and deficiency are highly prevalent among adult men in the US, and vitamin D deficiency is associated with moderate-severe UI and the presence of at least one LUTS."[xliii] In addition, the survey found that men with higher levels of vitamin D tend to have higher levels of testosterone[xliv],[xlv],[xlvi], and correcting vitamin D deficiency resulted in an increase in testosterone.[xlvii]
  • Arginine – This amino acid is a precursor (building material) for the synthesis of nitric oxide (NO).[xlviii] Supplemental sources of L-arginine appear to augment NO production[xlix], with the result being a measurable increase in blood flow (i.e. vasodilatation).[l] Studies have shown that this increase in blood flow is also beneficial in supporting healthy erectile function in men.[li],[lii]
  • Beet powder – Beets naturally contain nitrates. As it turns out, nitrate is chemically similar to NO, and the body can recycle nitrate into NO. The best part about it is that this NO producing pathway can take place in hypoxic (low oxygen) situations[liii] — which means that nitrate can produce NO for you whatever you’re doing: strength-training, aerobic exercise, or just sitting still.

9 Key Ingredients to Include in a Men's Health Dietary Supplement  - Infographic

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[i] Grebow J. Dietary supplement sales success post-COVID: How can industry keep the momentum going after the pandemic? Nutritional Outlook. May 26, 2021. Retrieved July 16, 2021 from https://www.nutritionaloutlook.com/view/dietary-supplement-sales-success-post-covid-how-can-industry-keep-the-momentum-going-after-the-pandemic.

[ii] Wang C, Nieschlag E, Swerdloff R, Behre HM. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol. 2008;159:507–514.

[iii] Matsumoto AM. Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men. Journal of Gerontology. 2002. 57A(2):M76–M99.

[iv] Araujo AB, Wittert GA. Endocrinology of the Aging Male. Best Pract Res Clin Endocrinol Metab. 2011 April ; 25(2): 303–319.

[v] Ghosal, S. The aroma principles of Gomutra and Karpuragandha Shilajit. Indian J Indg Med 1994;11:11–14.

[vi] David, F. and Vasant, L. 2001. The Yoga of Herbs. Twin Lakes, WI: Lotus Press.

[vii] Sharma, P.V. 1998. Charaka Samhita. Chowkhambha Orientalia Chikitsasthana, Varanasi, Karaprchitiya RasayanaPada, 4th Edition, Volume 2. Varanasi, U.P., India: Chowkhambha Orientlia Chikitsasthana.

[viii] Ravindra S, Reeta M, Sanka jyoti D, Swapnali D, Rama MA. Management of Male Infertility: Ayurvedic Approach. In Res J Pharm. 2013;4(6):6-7.

[ix] Panigrahi D, Suresh P. Shilajatu The Panacea: A Review. Int J Ayu Pharm Chem. 2014;1(1):85-95.

[x] Firke AC, Pargunde S. Shuddha Shilajatu with its pharmacological actions. PunarnaV. 2014;2(3):1-9.

[xi] Pattonder RK, Chandola HM, Vyas SN. Clinical efficacy of Shilajatu (Asphaltum) processed with Agnimantha (Clerodendrum phlomidis Linn.) in Sthaulya (obesity). Ayu. 2011 Oct;32(4):526-31.

[xii] Agarwal SP, Khanna R, Karmarkar R, Anwer MK, Khar RK. Shilajit: a review. Phytother Res. 2007 May;21(5):401-5.

[xiii] Biswas TK, Pandit S, Mondal S, Biswas SK, Jana U, Ghosh T, Tripathi PC, Debnath PK, Auddy RG, Auddy B. Clinical evaluation of spermatogenic activity of processed Shilajit in oligospermia. Andrologia. 2010 Feb;42(1):48-56.

[xiv] Stohs, S.J. Safety and efficacy of shilajit (mumie, moomiyo). Phytother Res 2014;28:475-9.

[xv] Biswas TK, Pandit S, Mondal S, Biswas SK, Jana U, Ghosh T, Tripathi PC, Debnath PK, Auddy RG, Auddy B. Clinical evaluation of spermatogenic activity of processed Shilajit in oligospermia. Andrologia. 2010 Feb;42(1):48-56.

[xvi] Pandit S, Biswas S, Jana U, De RK, Mukhopadhyay SC, Biswas TK. Clinical evaluation of purified shilajit on testosterone levels in healthy volunteers. Research Unit, J. B. Roy State Ayurvedic Medical College and Hospital, Department of Health and Family Welfare, Government of West Bengal, Kolkata, India. Submitted for publication. 2014.

[xvii] Anonymous. Monograph. Withania somnifera. Altern Med Rev 2004;9:211-4.

[xviii] Singh, N., Bhalla, M., de Jager, P. and Gilca, M. An Overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med 2011;8:208-13.

[xix] Uddin, Q., Samiulla, L., Singh, V.K. and Jamil, S.S. Phytochemical and Pharmacological Profile of Withania somnifera Dunal: A Review. JAPS 2012;2:170-5.

[xx] Ambiye, V.R., Langade, D., Dongre, S., Aptikar, P., Kulkarni, M. and Dongre, A. Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study. Evid Based Complement Alternat Med 2013;571420:6.

[xxi] Sachin, W. Effects of Ashwagandha Root Extract (Withania somnifera) on Muscle Strength, Size and Recovery, Testosterone, and Body Fat in Healthy Adults. Unpublished;2014:25 pgs.

[xxii] Bhat R, Karim AA. Tongkat Ali (Eurycoma longifolia Jack): a review on its ethnobotany and pharmacological importance. Fitoterapia. 2010 Oct;81(7):669-79.

[xxiii] Ramawat KG (Ed.). Herbal Drugs: Ethnomedicine to Modern Medicine. Heidelberg: Springer-Verlag;2009:76.

[xxiv] Handa SS, Rakesh DD, Vasisht K. Compendium of Medicinal and Aromatic Plants – Volume II: Asia. Trieste, Italy: ICS-UNIDO; 2006:81.

[xxv] Singh R, Singh S, Jeyabalan G, Ali A. An Overview on Traditional Medicinal Plants as Aphrodisiac Agent. Journal of Pharmacognosy and Phytochemistry. 2012;1(4):43-56.

[xxvi] Samuel AJ, Kalusalingam A, Chellappan DK, Gopinath R, Radhamani S, Husain HA, Muruganandham V, Promwichit P. Ethnomedical survey of plants used by the Orang Asli in Kampung Bawong, Perak, West Malaysia. J Ethnobiol Ethnomed. 2010 Feb 7;6:5.

[xxvii] Tambi MIM, Saad JM. Water-soluble extract of Eurycoma longifolia Jack soluble extract as a potential natural energizer for healthy aging men. Specialist Reproductive Research Center, National Population & Family Development Board, Ministry of Women & Family Development, Malaysia. 2000:9 pgs.

[xxviii] Tambi MI. Nutrients and Botanicals for optimizing Men’s Health. Examining the evidence for Eurycoma longifolia longjack, the Malaysian Ginseng in men’s health. Asian Journal of Andrology. 2009;11(5 suppl):37-38.

[xxix] Mantovani F. Serenoa repens in benign prostatic hypertrophy: analysis of 2 Italian studies. Minerva Urol Nefrol. 2010;62(4):335-40. [Abstract only]

[xxx] McPartland JM, Pruitt PL. Benign prostatic hyperplasia treated with saw palmetto: a literature search and an experimental case study. J Am Osteopath Assoc. 2000;100(2):89-96.

[xxxi] Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA. 1998;280(18):1604-9.

[xxxii] Gerber GS. Saw palmetto for the treatment of men with lower urinary tract symptoms. J Urol. 2000;163(5):1408-12. [Abstract only]

[xxxiii] Boyle P, Robertson C, Lowe F, Roehrborn C. Meta-analysis of clinical trials of permixon in the treatment of symptomatic benign prostatic hyperplasia. Urology. 2000;55(4):533-9. [Abstract only]

[xxxiv] Dhanakoti SN, Brosnan JT, Herzberg GR, Brosnan ME. Renal arginine synthesis: studies in vitro and in vivo. Am J Physiol 1990; 259:E437-E442.

[xxxv] Yearick ES, Nadeau RG. Serum amino acid response to isocaloric test meals. Am J Clin Nutr 1967; 20: 338-344

[xxxvi] Barlet A, Albrecht J, Aubert A, et al. [Efficacy of Pygeum africanum extract in the medical therapy of urination disorders due to benign prostatic hyperplasia: evaluation of objective and subjective parameters. A placebo-controlled, double-blind, multicenter study]. Wien Klin Wochenschr 1990;102:667-73.

[xxxvii] Breza J, Dzurny O, Borowka A, et al. Efficacy and acceptability of tadenan (Pygeum africanum extract) in the treatment of benign prostatic hyperplasia (BPH): a multicentre trial in central Europe. Curr Med Res Opin 1998;14:127-39.

[xxxviii] Andro MC, Riffaud JP. Pygeum africanum extract for the treatment of patients with benign prostatic hyperplasia. A review of 25 years of published experience. Curr Ther Res 1995;56:796-817.

[xxxix] Chatelain C, Autet W, Brackman F. Comparison of once and twice daily dosage forms of Pygeum africanum extract in patients with benign prostatic hyperplasia: a randomized, double-blind study, with long-term open label extension. Urology 1999;54:473-8.

[xl] Ishani A, MacDonald R, Nelson D, et al. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med 2000;109:654-64.

[xli] Wilt T, Ishani A, Mac Donald R, et al. Pygeum africanum for benign prostatic hyperplasia. Cochrane Database Syst Rev 2002;CD001044. [Abstract only]

[xlii] Vaughan CP, Johnson TM 2nd, Goode PS, et al. Vitamin D and lower urinary tract symptoms among US men: results from the 2005–2006 National Health and Nutrition Examination Survey. Urology. 2011; 78(6):1292–1297

[xliii] Nimptsch K, Platz EA, Willett WC, Giovannucci E. Association between plasma 25-OH vitamin D and testosterone levels in men. Clin Endocrinol (Oxf). 2012 Jan 2. doi: 10.1111/j.1365-2265.2012.04332.x. [Epub ahead of print]

[xliv] Lee DM, Tajar A, Pye SR, et al. Association of hypogonadism with vitamin D status: the European Male Ageing Study. Eur J Endocrinol. 2012 Jan;166(1):77-85.

[xlv] Wehr E, Pilz S, Boehm BO, März W, Obermayer-Pietsch B. Association of vitamin D status with serum androgen levels in men. Clin Endocrinol (Oxf). 2010 Aug;73(2):243-8.

[xlvi] Pilz S, Frisch S, Koertke H, Kuhn J, Dreier J, Obermayer-Pietsch B, Wehr E, Zittermann A. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011 Mar;43(3):223-5.

[xlvii] Tapiero H, Mathe G, Couvreur P, et al. I. Arginine. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie (France) 2002; 56(9):439-45.

[xlviii] Nonami Y. The role of nitric oxide in cardiac surgery. Surgery today (JAPAN) 1997; 27(7):583-92.

[xlix] Cheng JW, Baldwin SN, Balwin SN. L-arginine in the management of cardiovascular diseases. Annals of pharmacotherapy 2001; 35(6):755-64.

[l] Chen J, Wollman Y, Chernichovsky T, et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int 1999;83:269-73.

[li] Zorgniotti AW, Lizza EF. Effect of Large Doses of the Nitric Oxide Precursor, L-Arginine, on Erectile Dysfunction. Int J Impot Res 1994; 6:33-5.

[lii] ibid.

[liii] ibid.

August 1st, 2013

About the Author:

Gene Bruno

Gene Bruno, MS, MHS, RH(AHG) - Mr. Bruno possesses over 43 years of dietary supplement industry experience. With a Master's degree in nutrition and a second Master's degree in herbal medicine, he has a proven track record of formulating innovative, evidence-based dietary supplements. Mr. Bruno currently serves as both the Senior Director of Product Innovation at Twinlab Corporation and Professor of Nutraceutical Science at Huntington University of Health Sciences.