A herbal supplement is recommended due to the presence of a single symptom of obstruction, i.e., difficulty with micturition. This implies that the severity of the illness is mild. At this stage, the patient does not require urgent interventions, thus providing a prime entry point for the use of herbal remedies before progression to other pharmacological methods. It is used for relief of the symptoms and prevents further progression of the disease. It eliminates the risk of the adverse effects of pharmacological management, reducing both physiological and financial costs.
An example of an herbal supplement that can be used is Prunus Africana. The remedy is extracted from the plant’s bark and used to make capsules. In traditional African societies, the bark was pound to powder and drunk as a tea for a variety of maladies which included urinary complaints, especially in older men. The plant contains the active compound beta-sitosterol, which is responsible for the alleviation of the lower urinary tract symptoms. Its dosage is 60mg given twice a day (Rakel, 2018). The dosage can be reduced to 30mg given over the same frequency once symptoms start to improve (Rakel, 2018). The supplement mainly acts by the inhibition of the synthesis of prostaglandins and 5-alpha reductase activity. Thus, congestion within the prostate is reduced. The inhibition of the reductase enzyme also reduces the hyperplasia of the organ. With the reduction in the size of the obstruction, the urinary symptoms of the patient are reduced.
Some of the side effects of beta-sitosterol include nausea, diarrhea, bloating, constipation, or indigestion (Rakel, 2018). These occur mainly because the supplement is taken orally. It has also been thought to lead to some cases of erectile dysfunction and reduction in libido. It may worsen sitosterolemia, a rare disease identified by elevated levels of the supplement in the blood. These individuals are susceptible to early cardiovascular accidents.
Before the patient begins the medication, he should be advised that the herbal supplement is mainly a trial run and an attempt to manage his condition conservatively. The supplement does not supersede the use of pharmacological management. If he experiences a further aggravation of symptoms while taking the supplements, a follow-up visit should be made for the prescription of pharmacological drugs such as 5-alpha reductase inhibitors or alpha-adrenergic blockers. He should also be advised that he should continue with his regimen for hypertension. Despite the supplement’s role in managing cholesterol levels in the blood, he should continue with the current regimen as it is effectively managing his hypertension.
The use of the herbal supplement should not negate the use of an effective pharmacological agent. The doctor should also advise the patient on the possible side effects, especially the gastrointestinal symptoms. The pills should thus be taken two or three hours after meals when food has transited the gut. This reduces the severity of the symptoms. He should not stop taking the supplements unless the adverse effects are severe and debilitating. The reduction in libido is a temporary side effect that will pass with longer use of the supplement. Improved sexual function was seen in patients who took 200mg of the supplement for at least two months (Nyamai & Arika, 2016). He should be informed of this as one of the possible side effects and reassured of its resolution. Finally, the patient should be informed that the herbal supplement is not a cure but merely a method of reducing symptoms and improving his functionality.
References
Nyamai, D., & Arika, W. (2016). Herbal management of benign prostatic hyperplasia. Journal of Cancer Science & Therapy, 8(5), 130-134. Web.
Rakel, D. (2018). Integrative medicine (4th ed., pp. 601-607). Philadelphia, PA: Elsevier.