As we get older, almost all of us experience a greater need to get up at night to urinate. However, excessive urination at night (called nocturia) is a symptom, not a disorder in itself.

Causes for this change include more restless sleep, an enlarged prostate, changes in muscles that control the bladder and more urine being produced.

Increased urination may occur in the early stages of kidney disease, when the kidneys can’t concentrate the urine well. It’s also common in people with heart and liver failure.

Decreased bladder capacity can be caused by obstruction of the bladder outlet, pressure on the bladder from the outside and even anxiety.

However, the most common reason for men being awakened at night to urinate is an enlarged prostate. Men with this condition have to urinate frequently because they can’t empty the bladder fully, so it fills up faster.

All willow herb species contain flavorglycosides, especially derivatives of kaempferol, quercetin, and myricetin. Epilobium parviflorum also contains b-sitosterol, various esters of sitosterol, and sitosterol glucoside have been detected. These are the compounds considered to be the active ingredients of Saw Palmetto, another major herb used for treating the prostate. Gallic-acid derivatives are also present. Gallic acid and ellagitannins are considered to be the actives associated with the drinking of green tea. Two of these macrocyclic ellagitannins, oenothein A and oenothein B, have been identified as the main constituents responsible for the inhibition of 5-alpha-reductase and aromatese enzymes. These enzymes are considered to play key roles in the cancer of the prostate.

Preliminary (in vitro) studies at the Prostate Center of Vancouver found that very low concentrations of an extract from small-flowered willow herb tea, in the micrograms per ml level, was among the most active ever seen against abnormal cells and growths of the prostate. Several extracts from Epilobium parviflorum, were evaluated in biochemical assays with 5-alpha-reductase and aromatase, two enzymes involved in the etiology of benign prostatic hyperplasia (BPH). Aqueous extracts displayed inhibition of these enzymes and the active compounds identified were macrocyclic ellagitannins, oenothein A1, B1 and B2, which can make up to 14% of crude plant extracts. Out of a total of 92 plant phenolic extracts tested, small-flowered willow herb was also found to have high antioxidant activity. Small-flowered willow herb tea is also recommended for treating urinary tract infections in women. In one study, both the large-flowered willow herb (Epilobium angustifolium) and small-flowered willow herb E. parviflorum were found to reduce inflammatory prostaglandins in the carrageenin-induced rat paw edema test; in this study, E. angustifolia was found to be 5 times more powerful than E. parviflori. Antimicrobial screening of 13 phenolic substances and 29 extracts prepared from Finnish plant materials against selected microbes found that willow herb (Epilobium angustifolium L.) was one of the most active plant extracts tested against bacteria.

Active Ingredients: As far as known, all willow herb species contain flavonoids, especially derivatives of kaempferol, quercetin, and myricetin. In E. parviflorum and E. angustifolium, b-sitosterol, various esters of sitosterol, and sitosterol glucoside have been detected. Gallic-acid derivatives may be present. Two macrocyclic ellagitannins, oenothein A and oenothein B, have been identified as the main constituents responsible for the inhibition of 5-alpha-reductase and aromatase enzymes. Quantitation of oenothein B in 10 different species of Epilobium has shown that amounts of up to 14% in the crude plant extracts are possible. [Ducrey B, Marston A, Gohring S, Hartmann RW, Hostettmann K. 1997. Inhibition of 5 alpha-reductase and aromatase by the ellagitannins oenothein A and oenothein B from Epilobium species. Planta Med 1997 Apr; 63(2): 111-4].

Similar to: Fireweed, Rosebay Willowherb, Rose-Bay Willow Herb, Rose-Bay Willow, Rosebay Willow-Herb, Willow Herb

FAMILY: Onagraceae

GENUS SPECIES: Epilobium parviflorum

TYPE: Perennial herb

PART USED: Aerial parts, leaf, root

LOCATION: Africa, Australia, Europe, New Zealand, Northern Asia, Tasmania

CHEMICALS & NUTRIENTS: Flavonoids: Guaiaverin, Quercitrin, Quercetin-3-O-beta-D-glucuronide; Steroids: beta-Sitosterol, beta-Sitosterol Caproate

SAFETY: Safe when used appropriately. ¹

REFERENCES: ¹. McGuffin, M., et al. eds. American Herbal Products Association’s Botanical Safety Handbook: Guidelines for the Safe Use and Labeling for Herbs in Commerce. Boca Raton: CRC Press LLC, 1997.

Research shows when taken for 3 months, a combination of natural products including B-sitosterol, and vitamin E compared to placebo can significantly lessen nocturia and frequency and diminish overall symptomatology of BPH. (See below for the full study.)

Research Update
Cicero AF. Effects of a new soy/beta-sitosterol supplement on plasma lipids in moderately hypercholesterolemic subjects. J Am Diet Assoc 2002 Dec;102(12):1807-11. Atherosclerosis and Dysmetabolic Disease Study Center G. Descovich, Clinical Medicine and Applied Biotechnologies D. Campanacci, University of Bologna, Italy.
Our aim was to test the hypocholesterolemic effect of a low-dose formulation of soy proteins supplemented with isolated b-sitosterol in a ratio of 4:1 in 20 moderately hypercholesterolemic subjects. The study has been divided in three different periods of forty days each: a stabilization diet period, then a treatment period during which all subjects assumed 10 g one time a day of the tested product and, finally, a wash out period. From the end of the stabilization diet period to the end of the soy protein added in b-sitosterol supplementation we observed a 0.45 +/- 0.30 mmol/L, 0.09 +/- 0.31 mmol/L and 0.17 +/- 0.22 mmol/L mean +/- SE decrease in respectively LDL-C, TG and apoB levels, associated with a 0.12 +/- 0.25 and 0.03 +/- 0.51 mg/dL mean increase respectively in HDL-C and apoA plasma concentrations. According to this recommends, low doses of soy protein added in b-sitosterol seems to be a practical and safe alternative for patients seeking modest reductions in LDL-C (< 15%).

Preuss HG. Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH). Int Urol Nephrol 2001;33(2):217-25. Department of Physiology and Biophysics, Georgetown University Medical Center, Washington, DC 20007, USA.
Because benign prostatic hyperplasia (BPH) is relatively common, it is important to discover safe and effective means to treat this often debilitating perturbation. Accordingly, we examined the effectiveness of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) in treating symptoms of BPH. We undertook a randomized, placebo-controlled, double-blind study. Patients were enrolled from 3 urological practices in the USA. 144 subjects were randomized for study. 17 subjects eventually withdrew, leaving 70 patients in the test group and 57 in the placebo group to complete the study. Inclusion criteria consisted of a diagnosis of BPH, no evidence of cancer, and a maximal urinary flow rate between 5 and 15 ml/second. Patients received either placebo or the combined natural products for 3 months. Evaluations were performed via the American Urological Association (AUA) Symptom Index score, urinary flow rate, PSA measurement, and residual bladder volume. Nocturia showed a markedly significant decrease in severity in patients receiving the combined natural products compared to those taking placebo (p < 0.001). Daytime frequency was also lessened significantly (p < 0.04). When the average individual total AUA Symptom Index score in the test group was compared to that in the placebo group at the end of the study, the difference proved highly significant (p < 0.014). PSA measurements, maximal and average urinary flow rates, and residual volumes showed no statistically significant differences. When taken for 3 months, a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) compared to placebo can significantly lessen nocturia and frequency and diminish overall symptomatology of BPH as indicated by an improvement in the total AUA Symptom Index score. The combination of natural products caused no significant adverse side effects.

The study was conducted by researchers led by Atif B. Awad, PhD, associate professor of nutrition in the Department of Physical Therapy, Exercise and Nutrition Sciences in the UB School of Health Related Professions and director of UB’s nutrition program.
The researchers report that prostate-cancer tumors were 40% smaller in animals fed a diet enhanced with phytosterols than in animals fed a diet enhanced with cholesterol. Phytosterols is the general name for plant-based fats, which are found primarily in unfiltered vegetable oils such as virgin olive oil, peanut oil and canola oil. In cultures of prostate-cancer cells, a specific plant fat called B-sitosterol inhibited the growth of cancer cells by 70% compared with controls, results showed. Phytosterols also inhibited the ability of cancer cells to migrate and bind to membrane proteins of normal cells.

In previous pioneering work on human prostate-cancer cells (type LNCaP) they found that B-sitosterol, a fat abundant in vegetarian diets, inhibited tumor growth and reduced the level of PSA released. They also have shown that plant-based fats appear to cut the risk of prostate cancer by reducing the levels of both testosterone and certain enzymes that metabolize testosterone into more active forms, and that B-sitosterol stimulated cell death in both LNCaP prostate cancer and one type of breast cancer cells in the laboratory.
B-sitosterol is abundant in unrefined vegetable oils, such as virgin olive oil. To determine the effect of cholesterol and phytosterols on human prostate cancer cells, Awad and colleagues simulated Western and Asian diets by feeding one group of mice a mix of phytosterols and another group cholesterol with their normal food. After a two-week adaptation period, they introduced PC-3 human prostate cancer cells into both groups and maintained the mice on their respective diets for eight more weeks.

Concurrently, they conducted cell-culture studies in which PC-3 cells were exposed to three different types of dietary fat: B-sitosterol and campesterol – both phytosterols – and cholesterol. A control cell culture contained tumor cells with no supplementation. Cells were grown for three days, then counted and tested for invasiveness, adhesiveness to cell membrane proteins and ability to migrate.

Eight weeks after inoculation, tumors in phytosterol-fed mice were 40-43% smaller than tumors in cholesterol-fed mice, researchers found. In addition, phytosterol-fed mice showed half the rate of PC-3 cell metastasis to other organs. In the cell-culture experiments, the number of cancer cells in the cholesterol-supplemented medium increased by 18% over three days, while tumor cells decreased by 70% and 14% in B-sitosterol and campesterol-supplemented media, respectively, compared with the control. Phytosterol-treated PC-3 tumor cells were 78% less invasive than controls, compared with a 43% increase in invasiveness for cholesterol-exposed cells. Cholesterol also increased cell migration by 67%, while B-sitosterol and campesterol decreased migration by 93% and 60%, respectively, compared with controls. Both phytosterols reduced tumor-cell adhesion to the cell-membrane protein laminin, and B-sitosterol reduced adhesion to the protein fibronectin. Cholesterol increased PC-3 binding to one type of collagen, the primary protein of all connective tissue.

“The findings demonstrate that the consumption of foods rich in phytosterols is beneficial to protect from prostate cancer,” Awad said.

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A notable benefit is the promotion of healthy cholesterol and triglyceride levels. Over thirty years ago studies showed this effect with no change in diet or exercise and since then over 50 articles have been published in international medical journals for studies done on both humans and laboratory animals. You need to take about 300mg a day and this can be split in order to take 150mg in the AM and 150mg in the PM. If you do lower your fat intake and exercise the results could be much more dramatic of course, but in these studies there were no changes in either to get results. Common sense tells you to cut down or cut out saturated animal fat, dairy and especially unnatural hydrogenated fats which are found in so many of our processed foods. Surprisingly the intake of vegetable oils does not raise cholesterol or triglyceride levels. However vegetable oils generally contain high amounts of omega-6 fatty acids (which are very different from healthful omega-3 fatty acids) that have been shown to contribute to such conditions as arthritis and prostate disease.

Human studies were published in journals such as Canadian Journal of Biochemistry, Scandinavian Journal of Gastrology, Journal of Lipid Research, American Journal of Clinical Nutrition, Joshi Eiyo Daigaku Kiyo, Clinica Chimica Acta, Journal of Clinical Investigation, Metabolism Clinical Experiments, Current Thera peutic Research and Canadian Journal of Physiology and Pharmacology. With this overwhelming proof of the effectiveness of a safe, natural, inexpensive plant extract with no material side effects you would think doctors would be giving this to all their patients with high cholesterol levels. Instead they are given prescription drugs with side effects that aren’t known entirely or even very effective in reducing cholesterol. A good source of it though can be found in Epilobium Parviflorum.

Studies have been done in other areas of illness that suggest beta-sitosterol may have great potential in many other areas such as diabetes, blood clotting, ulcers, atherosclerosis and inflammation. Since beta-sitosterol is found in nearly all our vegetables it makes sense that this really a necessary nutrient and will be so recognized in the future.

The results confirm previous studies that have found associations between pesticide use and risk of prostate cancer among farmers.

Researchers analyzed 55,332 farmers and nursery workers who worked with pesticides in Iowa and North Carolina.

Among the participants, 566 new cases of prostate cancer developed between 1993 and 1999, compared to 495 that would normally be expected.

Compared to the general population, the farmers who used pesticides had a 14 percent greater risk of developing prostate cancer.

Six pesticides, chlorpyrifos, coumaphos, fonofos, phorate, permethrin and butylate, raised the prostate cancer risk in men with a history of the disease, while one pesticide, methyl bromide, raised the risk in all of the men.

About 30,000 U.S. men will die of prostate cancer this year and more than 220,000 will be diagnosed, according to the American Cancer Society. The largest risk factors for the disease include age and family history. Additionally, African-American men have higher rates of prostate cancer than other ethnicities.

Reuter’s Health May 1, 2003

Making dietary changes and exercising on a regular basis may slow the progress of prostate cancer.

Studies from around the world suggest that staying within a healthy weight range and eating more plant-based foods and fewer animal products can possibly delay or prevent the development of prostate cancer.

Evidence is mounting that foods rich in vitamin E and the mineral selenium may dramatically decrease both the incidence of prostate cancer and the risk of dying from it.

Men who take those nutritional supplements in certain doses actually suffer less prostate cancer and a lower mortality rate due to prostate cancer.

Researchers recommend that men increase their intake of these vitamins and minerals through whole foods. Seafood, meat and Brazil nuts are good selenium sources, while vegetable oils, sweet potatoes, avocados, and nuts are rich in vitamin E.

Men who consume higher levels of lycopene, a nutrient found in most tomato products, have also been shown to have a lower risk of prostate cancer.

American Dietetic Association’s Annual Meeting St. Louis October 22, 2001

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