Dietary Supplements and Nutraceuticals in the Management of Andrologic Disorders

      Dietary supplements and nutraceuticals are commonly used by men with erectile dysfunction, decreased libido, BPH, and concerns about developing prostate cancer. Many preparations do not contain the advertised dosages of the active ingredient or are contaminated. Dietary supplements and nutraceuticals, particularly those addressing erectile dysfunction and libido, need to undergo rigorous testing before they can be wholeheartedly recommended.
      To read this article in full you will need to make a payment
      Purchase one-time access
      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.
      Content published before 2002 is available via pay-per-view purchase only.
      Subscribe to Endocrinology and Metabolism Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Shah J.
        Erectile dysfunction through the ages.
        BJU Int. 2002; 90: 433-441
        • Eisenberg D.M.
        • et al.
        Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey.
        JAMA. 1998; 280: 1569-1575
        • Scally M.C.
        • Hodge A.
        Health supplement regulations and consumer protection rights.
        South Med J. 2000; 93: 1230-1232
        • Scally M.C.
        • Hodge A.
        • Street C.
        Prescription for change: health supplement regulations and protecting the public interest.
        J Natl Med Assoc. 2001; 93: 230-232
        • Zeisel S.H.
        Regulation of “nutraceuticals.”.
        Science. 1999; 285: 1853-1855
        • Gunther S.
        • et al.
        Demographic and health-related correlates of herbal and specialty supplement use.
        J Am Diet Assoc. 2004; 104: 27-34
        • Barqawi A.
        • et al.
        Herbal and vitamin supplement use in a prostate cancer screening population.
        Urology. 2004; 63: 288-292
      1. American Association of Clinical Endocrinologists medical guidelines for the clinical use of dietary supplements and nutraceuticals.
        Endocr Pract. 2003; 9: 417-470
        • Betz J.M.
        • White K.D.
        • der Marderosian A.H.
        Gas chromatographic determination of yohimbine in commercial yohimbe products.
        J AOAC Int. 1995; 78: 1189-1194
        • Parasrampuria J.
        • Schwartz K.
        • Petesch R.
        Quality control of dehydroepiandrosterone dietary supplement products.
        JAMA. 1998; 280: 1565
        • Chua R.
        • et al.
        Quality, labeling accuracy, and cost comparison of purified soy isoflavonoid products.
        J Altern Complement Med. 2004; 10: 1053-1060
        • Harkey M.R.
        • et al.
        Variability in commercial ginseng products: an analysis of 25 preparations.
        Am J Clin Nutr. 2001; 73: 1101-1106
        • Arlt V.M.
        • Schmeiser H.H.
        • Pfeifer G.P.
        Sequence-specific detection of aristolochic acid-DNA adducts in the human p53 gene by terminal transferase-dependent PCR.
        Carcinogenesis. 2001; 22: 133-140
        • Gratz S.R.
        • Gamble B.M.
        • Flurer R.A.
        Accurate mass measurement using Fourier transform ion cyclotron resonance mass spectrometry for structure elucidation of designer drug analogs of tadalafil, vardenafil and sildenafil in herbal and pharmaceutical matrices.
        Rapid Commun Mass Spectrom. 2006; 20: 2317-2327
        • Fleshner N.
        • et al.
        Evidence for contamination of herbal erectile dysfunction products with phosphodiesterase type 5 inhibitors.
        J Urol. 2005; 174 ([discussion: 641];[quiz: 801]): 636-641
      2. Centers R, et al. FDA cracks down on illegal sex drugs.

        • D'Ovidio K.
        • et al.
        Aflatoxins in ginseng roots.
        Food Addit Contam. 2006; 23: 174-180
        • Trucksess M.
        • et al.
        Determination of aflatoxins and ochratoxin A in ginseng and other botanical roots by immunoaffinity column cleanup and liquid chromatography with fluorescence detection.
        J AOAC Int. 2006; 89: 624-630
        • Tournas V.H.
        • Katsoudas E.
        • Miracco E.J.
        Moulds, yeasts and aerobic plate counts in ginseng supplements.
        Int J Food Microbiol. 2006; 108: 178-181
        • Kudo K.
        • et al.
        A case of poisoning in a man who drank a nutrition supplement containing methomyl, a carbamate pesticide.
        Fukuoka Igaku Zasshi. 2005; 96: 305-310
        • Rogan W.J.
        • et al.
        Recall of a lead-contaminated vitamin and mineral supplement in a clinical trial.
        Pharmacoepidemiol Drug Saf. 1999; 8: 343-350
        • Tseng Y.L.
        • Kuo F.H.
        • Sun K.H.
        Quantification and profiling of 19-norandrosterone and 19-noretiocholanolone in human urine after consumption of a nutritional supplement and norsteroids.
        J Anal Toxicol. 2005; 29: 124-134
        • Baume N.
        • et al.
        Research of stimulants and anabolic steroids in dietary supplements.
        Scand J Med Sci Sports. 2006; 16: 41-48
        • Morris C.A.
        • Avorn J.
        Internet marketing of herbal products.
        Jama. 2003; 290: 1505-1509
        • Srinivasan V.S.
        Challenges and scientific issues in the standardization of botanicals and their preparations. United States Pharmacopeia's dietary supplement verification program—a public health program.
        Life Sci. 2006; 78: 2039-2043
        • NIH Consensus Conference
        Impotence. NIH Consensus Development Panel on Impotence.
        JAMA. 1993; 270: 83-90
        • Benet A.E.
        • Melman A.
        The epidemiology of erectile dysfunction.
        Urol Clin North Am. 1995; 22: 699-709
        • Johannes C.B.
        • et al.
        Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study.
        J Urol. 2000; 163: 460-463
        • Moyad M.A.
        The placebo effect and randomized trials: analysis of alternative medicine.
        Urol Clin North Am. 2002; 29 (x): 135-155
        • Moyad M.A.
        • et al.
        Prevention and treatment of erectile dysfunction using lifestyle changes and dietary supplements: what works and what is worthless, part II.
        Urol Clin North Am. 2004; 31: 259-273
        • Montorsi F.
        • et al.
        Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies.
        Urology. 1999; 53: 1011-1018
        • Dula E.
        • et al.
        Efficacy and safety of fixed-dose and dose-optimization regimens of sublingual apomorphine versus placebo in men with erectile dysfunction. The Apomorphine Study Group.
        Urology. 2000; 56: 130-135
        • Thompson I.M.
        • et al.
        Erectile dysfunction and subsequent cardiovascular disease.
        Jama. 2005; 294: 2996-3002
        • Arlt W.
        • et al.
        Biotransformation of oral dehydroepiandrosterone in elderly men: significant increase in circulating estrogens.
        J Clin Endocrinol Metab. 1999; 84: 2170-2176
        • Pawlikowski M.
        Adrenal cortex—the next biological clock?.
        Neuro Endocrinol Lett. 2005; 26: 193-195
        • Olech E.
        • Merrill J.T.
        DHEA supplementation: the claims in perspective.
        Cleve Clin J Med. 2005; 72 (968, 970-1 passim): 965-966
        • Basar M.M.
        • et al.
        Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function.
        Urology. 2005; 66: 597-601
        • Reiter W.J.
        • et al.
        Serum dehydroepiandrosterone sulfate concentrations in men with erectile dysfunction.
        Urology. 2000; 55: 755-758
        • Feldman H.A.
        • et al.
        Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study.
        J Urol. 1994; 151: 54-61
        • Reiter W.J.
        • et al.
        Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study.
        Urology. 1999; 53 ([discussion: 594–5]): 590-594
        • Reiter W.J.
        • et al.
        Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies.
        Urol Res. 2001; 29: 278-281
        • Genazzani A.R.
        • et al.
        Long-term low-dose dehydroepiandrosterone replacement therapy in aging males with partial androgen deficiency.
        Aging Male. 2004; 7: 133-143
        • Jones J.A.
        • et al.
        Use of DHEA in a patient with advanced prostate cancer: a case report and review.
        Urology. 1997; 50: 784-788
        • Morales A.J.
        • et al.
        Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age.
        J Clin Endocrinol Metab. 1994; 78: 1360-1367
        • Araghiniknam M.
        • et al.
        Antioxidant activity of dioscorea and dehydroepiandrosterone (DHEA) in older humans.
        Life Sci. 1996; 59: PL147-PL157
        • Adimoelja A.
        Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions.
        Int J Androl. 2000; 23: 82-84
        • Horton R.
        • Tait J.F.
        Androstenedione production and interconversion rates measured in peripheral blood and studies on the possible site of its conversion to testosterone.
        J Clin Invest. 1966; 45: 301-313
        • Brown G.A.
        • et al.
        Effects of anabolic precursors on serum testosterone concentrations and adaptations to resistance training in young men.
        Int J Sport Nutr Exerc Metab. 2000; 10: 340-359
        • King D.S.
        • et al.
        Effect of oral androstenedione on serum testosterone and adaptations to resistance training in young men: a randomized controlled trial.
        Jama. 1999; 281: 2020-2028
        • Wallace M.B.
        • et al.
        Effects of dehydroepiandrosterone vs androstenedione supplementation in men.
        Med Sci Sports Exerc. 1999; 31: 1788-1792
        • Rasmussen B.B.
        • et al.
        Androstenedione does not stimulate muscle protein anabolism in young healthy men.
        J Clin Endocrinol Metab. 2000; 85: 55-59
        • Leder B.Z.
        • et al.
        Metabolism of orally administered androstenedione in young men.
        J Clin Endocrinol Metab. 2001; 86 (3654–3568)
        • Leder B.Z.
        • et al.
        Oral androstenedione administration and serum testosterone concentrations in young men.
        JAMA. 2000; 283: 779-782
        • Brown G.A.
        • et al.
        Endocrine responses to chronic androstenedione intake in 30- to 56-year-old men.
        J Clin Endocrinol Metab. 2000; 85: 4074-4080
        • Brown G.A.
        • et al.
        Effects of androstenedione-herbal supplementation on serum sex hormone concentrations in 30- to 59-year-old men.
        Int J Vitam Nutr Res. 2001; 71: 293-301
        • Siegner Jr., A.W.
        The Food and Drug Administration's actions on ephedra and androstenedione: understanding their potential impacts on the protections of the Dietary Supplement Health and Education Act.
        Food Drug Law J. 2004; 59: 617-628
        • Bahrke M.S.
        • Yesalis C.E.
        Abuse of anabolic androgenic steroids and related substances in sport and exercise.
        Curr Opin Pharmacol. 2004; 4: 614-620
        • DesJardins M.
        Supplement use in the adolescent athlete.
        Curr Sports Med Rep. 2002; 1: 369-373
        • Lue T.F.
        • Lee K.L.
        Pharmacotherapy for erectile dysfunction.
        Chin Med J (Engl). 2000; 113: 291-298
        • Toda N.
        • Ayajiki K.
        • Okamura T.
        Nitric oxide and penile erectile function.
        Pharmacol Ther. 2005; 106: 233-266
        • Zorgniotti A.W.
        • Lizza E.F.
        Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction.
        Int J Impot Res. 1994; 6 ([discussion: 36]): 33-35
        • Chen J.
        • 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: 269-273
        • Klotz T.
        • et al.
        Effectiveness of oral L-arginine in first-line treatment of erectile dysfunction in a controlled crossover study.
        Urol Int. 1999; 63: 220-223
        • Fitzpatrick D.F.
        • Bing B.
        • Rohdewald P.
        Endothelium-dependent vascular effects of Pycnogenol.
        J Cardiovasc Pharmacol. 1998; 32: 509-515
        • Stanislavov R.
        • Nikolova V.
        Treatment of erectile dysfunction with pycnogenol and L-arginine.
        J Sex Marital Ther. 2003; 29: 207-213
        • Tam S.W.
        • Worcel M.
        • Wyllie M.
        Yohimbine: a clinical review.
        Pharmacol Ther. 2001; 91: 215-243
        • Ernst E.
        • Pittler M.H.
        Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials.
        J Urol. 1998; 159: 433-436
        • Pittler M.H.
        • Ernst E.
        Trials have shown yohimbine is effective for erectile dysfunction.
        BMJ. 1998; 317: 478
        • Susset J.G.
        • et al.
        Effect of yohimbine hydrochloride on erectile impotence: a double-blind study.
        J Urol. 1989; 141: 1360-1363
        • Guay A.T.
        • et al.
        Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?.
        Int J Impot Res. 2003; 15: 156-165
        • Kernohan A.F.
        • et al.
        An oral yohimbine/L-arginine combination (NMI 861) for the treatment of male erectile dysfunction: a pharmacokinetic, pharmacodynamic and interaction study with intravenous nitroglycerine in healthy male subjects.
        Br J Clin Pharmacol. 2005; 59: 85-93
        • Lebret T.
        • et al.
        Efficacy and safety of a novel combination of L-arginine glutamate and yohimbine hydrochloride: a new oral therapy for erectile dysfunction.
        Eur Urol. 2002; 41 ([discussion: 613]): 608-613
        • Johnson S.
        • Iazzetta J.
        • Dewar C.
        Severe Raynaud's phenomenon with yohimbine therapy for erectile dysfunction.
        J Rheumatol. 2003; 30: 2503-2505
        • Cohen A.J.
        • Bartlik B.
        Ginkgo biloba for antidepressant-induced sexual dysfunction.
        J Sex Marital Ther. 1998; 24: 139-143
        • Balon R.
        Ginkgo biloba for antidepressant-induced sexual dysfunction?.
        J Sex Marital Ther. 1999; 25: 1-2
        • Kang B.J.
        • et al.
        A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction.
        Hum Psychopharmacol. 2002; 17: 279-284
        • Wheatley D.
        Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugs.
        Hum Psychopharmacol. 2004; 19: 545-548
        • Williamson E.M.
        Interactions between herbal and conventional medicines.
        Expert Opin Drug Saf. 2005; 4: 355-378
        • Izzo A.A.
        • et al.
        Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction.
        Int J Cardiol. 2005; 98: 1-14
        • Kupiec T.
        • Raj V.
        Fatal seizures due to potential herb-drug interactions with Ginkgo biloba.
        J Anal Toxicol. 2005; 29: 755-758
        • Ramsay N.A.
        • et al.
        Complimentary and alternative medicine use among patients starting warfarin.
        Br J Haematol. 2005; 130: 777-780
        • Kim J.Y.
        • et al.
        Induction of nitric oxide synthase by saponins of heat-processed ginseng.
        Biosci Biotechnol Biochem. 2005; 69: 891-895
        • Choi Y.D.
        • Rha K.H.
        • Choi H.K.
        In vitro and in vivo experimental effect of Korean red ginseng on erection.
        J Urol. 1999; 162: 1508-1511
        • Choi Y.D.
        • Xin Z.C.
        • Choi H.K.
        Effect of Korean red ginseng on the rabbit corpus cavernosal smooth muscle.
        Int J Impot Res. 1998; 10: 37-43
        • Ryu J.K.
        • et al.
        Free radical-scavenging activity of Korean red ginseng for erectile dysfunction in non-insulin-dependent diabetes mellitus rats.
        Urology. 2005; 65: 611-615
        • Kang K.S.
        • et al.
        Study on the nitric oxide scavenging effects of ginseng and its compounds.
        J Agric Food Chem. 2006; 54: 2558-2562
        • Choi H.K.
        • Seong D.H.
        • Rha K.H.
        Clinical efficacy of Korean red ginseng for erectile dysfunction.
        Int J Impot Res. 1995; 7: 181-186
        • Hong B.
        • et al.
        A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report.
        J Urol. 2002; 168: 2070-2073
        • Price A.
        • Gazewood J.
        Korean red ginseng effective for treatment of erectile dysfunction.
        J Fam Pract. 2003; 52: 20-21
        • Cipolla M.J.
        • et al.
        Propionyl-L-carnitine dilates human subcutaneous arteries through an endothelium-dependent mechanism.
        J Vasc Surg. 1999; 29: 1097-1103
        • Cavallini G.
        • et al.
        Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging.
        Urology. 2004; 63: 641-646
        • Gentile V.
        • et al.
        Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes.
        Curr Med Res Opin. 2004; 20: 1377-1384
        • Cavallini G.
        • et al.
        Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy.
        Urology. 2005; 66: 1080-1085
        • Eng J.
        • et al.
        A population-based survey of complementary and alternative medicine use in men recently diagnosed with prostate cancer.
        Integr Cancer Ther. 2003; 2: 212-216
        • Chan J.M.
        • et al.
        Total and specific complementary and alternative medicine use in a large cohort of men with prostate cancer.
        Urology. 2005; 66: 1223-1228
        • Barnes P.M.
        • et al.
        Complementary and alternative medicine use among adults: United States, 2002.
        Adv Data. 2004; : 1-19
        • Carraro J.C.
        • et al.
        Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients.
        Prostate. 1996; 29 ([discussion: 241–2]): 231-240
        • Boyle P.
        • et al.
        Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia.
        BJU Int. 2004; 93: 751-756
        • Gerber G.S.
        • et al.
        Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms.
        Urology. 2001; 58 ([discussion: 964–5]): 960-964
        • Beckman T.J.
        • Mynderse L.A.
        Evaluation and medical management of benign prostatic hyperplasia.
        Mayo Clin Proc. 2005; 80: 1356-1362
        • Bent S.
        • et al.
        Saw palmetto for benign prostatic hyperplasia.
        N Engl J Med. 2006; 354: 557-566
        • Chan J.M.
        • Gann P.H.
        • Giovannucci E.L.
        Role of diet in prostate cancer development and progression.
        J Clin Oncol. 2005; 23: 8152-8160
        • Anlasik T.
        • et al.
        Dietary habits are major determinants of the plasma antioxidant status in healthy elderly subjects.
        Br J Nutr. 2005; 94: 639-642
        • Sies H.
        • Stahl W.
        • Sevanian A.
        Nutritional, dietary and postprandial oxidative stress.
        J Nutr. 2005; 135: 969-972
        • Di Mascio P.
        • et al.
        Carotenoids, tocopherols and thiols as biological singlet molecular oxygen quenchers.
        Biochem Soc Trans. 1990; 18: 1054-1056
        • Clinton S.K.
        • et al.
        cis-trans lycopene isomers, carotenoids, and retinol in the human prostate.
        Cancer Epidemiol Biomarkers Prev. 1996; 5: 823-833
        • Giovannucci E.
        A review of epidemiologic studies of tomatoes, lycopene, and prostate cancer.
        Exp Biol Med (Maywood). 2002; 227: 852-859
        • Giovannucci E.
        Tomato products, lycopene, and prostate cancer: a review of the epidemiological literature.
        J Nutr. 2005; 135: 2030S-2031S
        • Giovannucci E.
        • et al.
        Intake of carotenoids and retinol in relation to risk of prostate cancer.
        J Natl Cancer Inst. 1995; 87: 1767-1776
        • Giovannucci E.
        • et al.
        A prospective study of tomato products, lycopene, and prostate cancer risk.
        J Natl Cancer Inst. 2002; 94: 391-398
        • Wu K.
        • et al.
        Plasma and dietary carotenoids, and the risk of prostate cancer: a nested case-control study.
        Cancer Epidemiol Biomarkers Prev. 2004; 13: 260-269
        • Lu Q.Y.
        • et al.
        Inverse associations between plasma lycopene and other carotenoids and prostate cancer.
        Cancer Epidemiol Biomarkers Prev. 2001; 10: 749-756
        • Vogt T.M.
        • et al.
        Serum lycopene, other serum carotenoids, and risk of prostate cancer in US Blacks and Whites.
        Am J Epidemiol. 2002; 155: 1023-1032
        • Etminan M.
        • Takkouche B.
        • Caamano-Isorna F.
        The role of tomato products and lycopene in the prevention of prostate cancer: a meta-analysis of observational studies.
        Cancer Epidemiol Biomarkers Prev. 2004; 13: 340-345
        • Cohen J.H.
        • Kristal A.R.
        • Stanford J.L.
        Fruit and vegetable intakes and prostate cancer risk.
        J Natl Cancer Inst. 2000; 92: 61-68
        • Kolonel L.N.
        • et al.
        Vegetables, fruits, legumes and prostate cancer: a multiethnic case-control study.
        Cancer Epidemiol Biomarkers Prev. 2000; 9: 795-804
        • Le Marchand L.
        • et al.
        Vegetable and fruit consumption in relation to prostate cancer risk in Hawaii: a reevaluation of the effect of dietary beta-carotene.
        Am J Epidemiol. 1991; 133: 215-219
        • Hayes R.B.
        • et al.
        Dietary factors and risks for prostate cancer among blacks and whites in the United States.
        Cancer Epidemiol Biomarkers Prev. 1999; 8: 25-34
        • Kirsh V.A.
        • et al.
        A prospective study of lycopene and tomato product intake and risk of prostate cancer.
        Cancer Epidemiol Biomarkers Prev. 2006; 15: 92-98
        • Cook N.R.
        • et al.
        Beta-carotene supplementation for patients with low baseline levels and decreased risks of total and prostate carcinoma.
        Cancer. 1999; 86: 1783-1792
        • Kirsh V.A.
        • et al.
        Supplemental and dietary vitamin E, beta-carotene, and vitamin C intakes and prostate cancer risk.
        J Natl Cancer Inst. 2006; 98: 245-254
        • Heinonen O.P.
        • et al.
        Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial.
        J Natl Cancer Inst. 1998; 90: 440-446
        • Gann P.H.
        • et al.
        Lower prostate cancer risk in men with elevated plasma lycopene levels: results of a prospective analysis.
        Cancer Res. 1999; 59: 1225-1230
        • Goodman G.E.
        • et al.
        The association between lung and prostate cancer risk, and serum micronutrients: results and lessons learned from beta-carotene and retinol efficacy trial.
        Cancer Epidemiol Biomarkers Prev. 2003; 12: 518-526
        • Eichholzer M.
        • et al.
        Smoking, plasma vitamins C, E, retinol, and carotene, and fatal prostate cancer: seventeen-year follow-up of the prospective basel study.
        Prostate. 1999; 38: 189-198
        • Stahelin H.B.
        • et al.
        Plasma antioxidant vitamins and subsequent cancer mortality in the 12-year follow-up of the prospective Basel Study.
        Am J Epidemiol. 1991; 133: 766-775
        • Vlajinac H.D.
        • et al.
        Diet and prostate cancer: a case-control study.
        Eur J Cancer. 1997; 33: 101-107
        • Tzonou A.
        • et al.
        Diet and cancer of the prostate: a case-control study in Greece.
        Int J Cancer. 1999; 80: 704-708
        • Deneo-Pellegrini H.
        • et al.
        Foods, nutrients and prostate cancer: a case-control study in Uruguay.
        Br J Cancer. 1999; 80: 591-597
        • Chan J.M.
        • et al.
        Supplemental vitamin E intake and prostate cancer risk in a large cohort of men in the United States.
        Cancer Epidemiol Biomarkers Prev. 1999; 8: 893-899
        • Hartman T.J.
        • et al.
        The association between baseline vitamin E, selenium, and prostate cancer in the alpha-tocopherol, beta-carotene cancer prevention study.
        Cancer Epidemiol Biomarkers Prev. 1998; 7: 335-340
        • Rodriguez C.
        • et al.
        Vitamin E supplements and risk of prostate cancer in U.S. men.
        Cancer Epidemiol Biomarkers Prev. 2004; 13: 378-382
        • Hsing A.W.
        • et al.
        Serologic precursors of cancer. Retinol, carotenoids, and tocopherol and risk of prostate cancer.
        J Natl Cancer Inst. 1990; 82: 941-946
        • Hayes R.B.
        • et al.
        Serum retinol and prostate cancer.
        Cancer. 1988; 62: 2021-2026
        • Hernaandez J.
        • et al.
        The modulation of prostate cancer risk with alpha-tocopherol: a pilot randomized, controlled clinical trial.
        J Urol. 2005; 174: 519-522
        • Huang H.Y.
        • et al.
        Prospective study of antioxidant micronutrients in the blood and the risk of developing prostate cancer.
        Am J Epidemiol. 2003; 157: 335-344
        • Giovannucci E.
        Gamma-tocopherol: a new player in prostate cancer prevention?.
        J Natl Cancer Inst. 2000; 92: 1966-1967
        • Redman C.
        • et al.
        Involvement of polyamines in selenomethionine induced apoptosis and mitotic alterations in human tumor cells.
        Carcinogenesis. 1997; 18: 1195-1202
        • Griffin A.C.
        Role of selenium in the chemoprevention of cancer.
        Adv Cancer Res. 1979; 29: 419-442
        • Waters D.J.
        • et al.
        Effects of dietary selenium supplementation on DNA damage and apoptosis in canine prostate.
        J Natl Cancer Inst. 2003; 95: 237-241
        • Chun J.Y.
        • et al.
        Mechanisms of selenium down-regulation of androgen receptor signaling in prostate cancer.
        Mol Cancer Ther. 2006; 5: 913-918
        • Lee S.O.
        • et al.
        Selenium disrupts estrogen signaling by altering estrogen receptor expression and ligand binding in human breast cancer cells.
        Cancer Res. 2005; 65: 3487-3492
        • Dong Y.
        • et al.
        Prostate specific antigen expression is down-regulated by selenium through disruption of androgen receptor signaling.
        Cancer Res. 2004; 64: 19-22
        • van den Brandt P.A.
        • et al.
        Toenail selenium levels and the subsequent risk of prostate cancer: a prospective cohort study.
        Cancer Epidemiol Biomarkers Prev. 2003; 12: 866-871
        • Ozmen H.
        • et al.
        Comparison of the concentration of trace metals (Ni, Zn, Co, Cu and Se), Fe, vitamins A, C and E, and lipid peroxidation in patients with prostate cancer.
        Clin Chem Lab Med. 2006; 44: 175-179
        • Li H.
        • et al.
        A prospective study of plasma selenium levels and prostate cancer risk.
        J Natl Cancer Inst. 2004; 96: 696-703
        • Nomura A.M.
        • et al.
        Serum selenium and subsequent risk of prostate cancer.
        Cancer Epidemiol Biomarkers Prev. 2000; 9: 883-887
        • Yoshizawa K.
        • et al.
        Study of prediagnostic selenium level in toenails and the risk of advanced prostate cancer.
        J Natl Cancer Inst. 1998; 90: 1219-1224
        • Lipsky K.
        • et al.
        Selenium levels of patients with newly diagnosed prostate cancer compared with control group.
        Urology. 2004; 63: 912-916
        • Nyman D.W.
        • et al.
        Selenium and selenomethionine levels in prostate cancer patients.
        Cancer Detect Prev. 2004; 28: 8-16
        • Kumar N.B.
        • et al.
        The specific role of isoflavones in reducing prostate cancer risk.
        Prostate. 2004; 59: 141-147
        • Ghadirian P.
        • et al.
        A case-control study of toenail selenium and cancer of the breast, colon, and prostate.
        Cancer Detect Prev. 2000; 24: 305-313
        • Duffield-Lillico A.J.
        • et al.
        Selenium supplementation, baseline plasma selenium status and incidence of prostate cancer: an analysis of the complete treatment period of the Nutritional Prevention of Cancer Trial.
        BJU Int. 2003; 91: 608-612
        • Duffield-Lillico A.J.
        • et al.
        Baseline characteristics and the effect of selenium supplementation on cancer incidence in a randomized clinical trial: a summary report of the Nutritional Prevention of Cancer Trial.
        Cancer Epidemiol Biomarkers Prev. 2002; 11: 630-639
        • Meyer F.
        • et al.
        Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial.
        Int J Cancer. 2005; 116: 182-186
        • Hoenjet K.M.
        • et al.
        Effect of a nutritional supplement containing vitamin E, selenium, vitamin C and coenzyme Q10 on serum PSA in patients with hormonally untreated carcinoma of the prostate: a randomised placebo-controlled study.
        Eur Urol. 2005; 47 ([discussion: 439–40]): 433-439
        • Klein E.A.
        Selenium and vitamin E cancer prevention trial.
        Ann N Y Acad Sci. 2004; 1031: 234-241
        • Lippman S.M.
        • et al.
        Designing the Selenium and Vitamin E Cancer Prevention Trial (SELECT).
        J Natl Cancer Inst. 2005; 97: 94-102
        • Drake E.N.
        Cancer chemoprevention: selenium as a prooxidant, not an antioxidant.
        Med Hypotheses. 2006; 67: 318-322
        • Platz E.A.
        • et al.
        Alcohol intake, drinking patterns, and risk of prostate cancer in a large prospective cohort study.
        Am J Epidemiol. 2004; 159: 444-453
        • Barba M.
        • et al.
        Lifetime total and beverage specific–alcohol intake and prostate cancer risk: a case-control study.
        Nutr J. 2004; 3: 23
        • Sharpe C.R.
        • Siemiatycki J.
        Case-control study of alcohol consumption and prostate cancer risk in Montreal, Canada.
        Cancer Causes Control. 2001; 12: 589-598
        • Schoonen W.M.
        • et al.
        Alcohol consumption and risk of prostate cancer in middle-aged men.
        Int J Cancer. 2005; 113: 133-140
        • Jain M.G.
        • et al.
        Alcohol and other beverage use and prostate cancer risk among Canadian men.
        Int J Cancer. 1998; 78: 707-711
        • Heilbrun L.K.
        • Nomura A.
        • Stemmermann G.N.
        Black tea consumption and cancer risk: a prospective study.
        Br J Cancer. 1986; 54: 677-683
        • Jian L.
        • et al.
        Protective effect of green tea against prostate cancer: a case-control study in southeast China.
        Int J Cancer. 2004; 108: 130-135
        • Sonoda T.
        • et al.
        A case-control study of diet and prostate cancer in Japan: possible protective effect of traditional Japanese diet.
        Cancer Sci. 2004; 95: 238-242
        • Kinlen L.J.
        • et al.
        Tea consumption and cancer.
        Br J Cancer. 1988; 58: 397-401
        • Bettuzzi S.
        • et al.
        Chemoprevention of human prostate cancer by oral administration of green tea catechins in volunteers with high-grade prostate intraepithelial neoplasia: a preliminary report from a one-year proof-of-principle study.
        Cancer Res. 2006; 66: 1234-1240
        • Graham H.N.
        Green tea composition, consumption, and polyphenol chemistry.
        Prev Med. 1992; 21: 334-350
        • Sharpe C.R.
        • Siemiatycki J.
        Consumption of non-alcoholic beverages and prostate cancer risk.
        Eur J Cancer Prev. 2002; 11: 497-501
        • Slattery M.L.
        • West D.W.
        Smoking, alcohol, coffee, tea, caffeine, and theobromine: risk of prostate cancer in Utah (United States).
        Cancer Causes Control. 1993; 4: 559-563
        • Ellison L.F.
        Tea and other beverage consumption and prostate cancer risk: a Canadian retrospective cohort study.
        Eur J Cancer Prev. 2000; 9: 125-130
        • Jatoi A.
        • et al.
        A phase II trial of green tea in the treatment of patients with androgen independent metastatic prostate carcinoma.
        Cancer. 2003; 97: 1442-1446
        • Lee A.H.
        • et al.
        Protective effects of green tea against prostate cancer.
        Expert Rev Anticancer Ther. 2006; 6: 507-513
        • Albrecht M.
        • et al.
        Pomegranate extracts potently suppress proliferation, xenograft growth, and invasion of human prostate cancer cells.
        J Med Food. 2004; 7: 274-283
        • Pantuck A.J.
        • et al.
        Phase II study of pomegranate juice for men with rising prostate-specific antigen following surgery or radiation for prostate cancer.
        Clin Cancer Res. 2006; 12: 4018-4026
        • Holzbeierlein J.M.
        • McIntosh J.
        • Thrasher J.B.
        The role of soy phytoestrogens in prostate cancer.
        Curr Opin Urol. 2005; 15: 17-22
        • Lee M.M.
        • et al.
        Soy and isoflavone consumption in relation to prostate cancer risk in China.
        Cancer Epidemiol Biomarkers Prev. 2003; 12: 665-668
        • Jacobsen B.K.
        • Knutsen S.F.
        • Fraser G.E.
        Does high soy milk intake reduce prostate cancer incidence? The Adventist Health Study (United States).
        Cancer Causes Control. 1998; 9: 553-557
        • Hebert J.R.
        • et al.
        Nutritional and socioeconomic factors in relation to prostate cancer mortality: a cross-national study.
        J Natl Cancer Inst. 1998; 90: 1637-1647
        • Nomura A.M.
        • et al.
        Cohort study of tofu intake and prostate cancer: no apparent association.
        Cancer Epidemiol Biomarkers Prev. 2004; 13: 2277-2279
        • Strom S.S.
        • et al.
        Phytoestrogen intake and prostate cancer: a case-control study using a new database.
        Nutr Cancer. 1999; 33: 20-25
        • Maskarinec G.
        • et al.
        Serum prostate-specific antigen but not testosterone levels decrease in a randomized soy intervention among men.
        Eur J Clin Nutr. 2006;
        • McCarty M.F.
        Isoflavones made simple—genistein's agonist activity for the beta-type estrogen receptor mediates their health benefits.
        Med Hypotheses. 2006; 66: 1093-1114
        • Costello L.C.
        • et al.
        Zinc and prostate cancer: a critical scientific, medical, and public interest issue (United States).
        Cancer Causes Control. 2005; 16: 901-915
        • Moyad M.A.
        Lifestyle/dietary supplement partial androgen suppression and/or estrogen manipulation. A novel PSA reducer and preventive/treatment option for prostate cancer?.
        Urol Clin North Am. 2002; 29 (ix): 115-124
        • Dhar N.K.
        • et al.
        Distribution and concentration of zinc in the subcellular fractions of benign hyperplastic and malignant neoplastic human prostate.
        Exp Mol Pathol. 1973; 19: 139-142
        • Kristal A.R.
        • et al.
        Vitamin and mineral supplement use is associated with reduced risk of prostate cancer.
        Cancer Epidemiol Biomarkers Prev. 1999; 8: 887-892
        • Key T.J.
        • et al.
        A case-control study of diet and prostate cancer.
        Br J Cancer. 1997; 76: 678-687
        • West D.W.
        • et al.
        Adult dietary intake and prostate cancer risk in Utah: a case-control study with special emphasis on aggressive tumors.
        Cancer Causes Control. 1991; 2: 85-94
        • Andersson S.O.
        • et al.
        Energy, nutrient intake and prostate cancer risk: a population-based case-control study in Sweden.
        Int J Cancer. 1996; 68: 716-722
        • Leitzmann M.F.
        • et al.
        Zinc supplement use and risk of prostate cancer.
        J Natl Cancer Inst. 2003; 95: 1004-1007
        • Kolonel L.N.
        • Yoshizawa C.N.
        • Hankin J.H.
        Diet and prostatic cancer: a case-control study in Hawaii.
        Am J Epidemiol. 1988; 127: 999-1012
        • Sperling H.
        • et al.
        An extract from the bark of Aspidosperma quebracho blanco binds to human penile alpha-adrenoceptors.
        J Urol. 2002; 168: 160-163
        • Choi J.
        • et al.
        Antinociceptive anti-inflammatory effect of Monotropein isolated from the root of Morinda officinalis.
        Biol Pharm Bull. 2005; 28: 1915-1918
        • Di Rocco A.
        • et al.
        A pilot study of L-methionine for the treatment of AIDS-associated myelopathy.
        Neurology. 1998; 51: 266-268
        • James J.S.
        Frequent urination, leg cramps, leg weakness, erection difficulties: HIV myelopathy amino acid study.
        AIDS Treat News. 2000; : 3-4
        • Hitiris N.
        • Barrett J.A.
        • Brodie M.J.
        Erectile dysfunction associated with pregabalin add-on treatment in patients with partial seizures: five case reports.
        Epilepsy Behav. 2006; 8: 418-421
        • Hong J.H.
        • et al.
        The effects of curcumin on the invasiveness of prostate cancer in vitro and in vivo.
        Prostate Cancer Prostatic Dis. 2006; 9: 147-152
        • Zamble A.
        • et al.
        Paullinia pinnata extracts rich in polyphenols promote vascular relaxation via endothelium-dependent mechanisms.
        J Cardiovasc Pharmacol. 2006; 47: 599-608
        • Safarinejad M.R.
        Urtica dioica for treatment of benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled, crossover study.
        J Herb Pharmacother. 2005; 5: 1-11
        • Sokeland J.
        Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome.
        BJU Int. 2000; 86: 439-442
        • Lopatkin N.A.
        • et al.
        [Combined extract of Sabal palm and nettle in the treatment of patients with lower urinary tract symptoms in double blind, placebo-controlled trial].
        Urologiia. 2006; (12, 14–9 [in Russian])
        • Melo E.A.
        • et al.
        Evaluating the efficiency of a combination of Pygeum africanum and stinging nettle (Urtica dioica) extracts in treating benign prostatic hyperplasia (BPH): double-blind, randomized, placebo controlled trial.
        Int Braz J Urol. 2002; 28: 418-425
        • Wilt T.
        • et al.
        Pygeum africanum for benign prostatic hyperplasia.
        Cochrane Database Syst Rev. 2002; 1 (CD001044)
        • Klippel K.F.
        • Hiltl D.M.
        • 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
        • Berges R.R.
        • Kassen A.
        • Senge T.
        Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up.
        BJU Int. 2000; 85: 842-846
        • MacDonald R.
        • et al.
        A systematic review of Cernilton for the treatment of benign prostatic hyperplasia.
        BJU Int. 2000; 85: 836-841