Herbs in alphabetical order
Pygeum, as represented in the herb market, is the bark of an African tree of the family Rosaceae, Prunus africana (Hook. f) Kalkman, whose common name derives from the now obsolete botanical designation Pygeum africanum Hook. f. The tree is present in highland mountain forests in Africa and Madagascar, occurring in Afromontane forest "islands" from 4,500 to 6,000 feet. Surrounding forests have been clear-cut for forest products and agricultural land, limiting the tree's habitat. The bark harvest, primarily taken from the wild in Cameroon, Kenya, Tanzania, Madagascar, as well as the Democratic Republic of Congo (the former Zaire), has had a devastating effect on wild populations of the species. This overexploitation sparked conservation concerns, resulting in the species being listed in Appendix II of CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora) in order to monitor species in international trade.
The fresh bark, leaf, and fruits contain amygalin, yielding hydrocyanic acid when crushed; hence, they have an almond flavor. In Africa, the fresh leaves have been mixed with milk to produce a subsitute for almond milk. In African counties the bark is used by traditional healers for inflammation, kidney disease, malaria, stomachache, and fever, among other uses. In Natal, the bark is infused in milk and used to treat problems of difficult urination. In Cameroon, the bark has been used to treat fever and madness and has a local reputation as an aphrodisiac. The root and bark have traditionally been used in southern, eastern, and central Africa for inflammation of the prostate gland and kidney disease.
Folkloric use in Africa attracted the attention of European researchers, and a patent was issued in 1966 for use of a pygeum bark extract in the treatment of benign prostatic hyperplasia (BPH). The bark contains pentacyclic terpenes, including ursolic, oleanolic, and crataegolic acids, plus n-docosanol and n-teracosanol as described active constituents. Phytosterols present, including beta-sitosterol, beta-sitosterone, and campesterol, may contribute to biological activity. Pygeum products are standardized to contain 14 percent triterpenes and 0.5 percent n-docosanol.
Similar to saw palmetto berry and stinging nettle root, the bark of pygeum is valued in European phytotherapy for the treatment of benign prostatic hypertrophy. Primary clinical experience for the extract has centered in France and Italy, rather than Germany, where saw palmetto extracts dominate the market for BPH phytotherapy. Pharmacological studies have shown that the extract possesses anti-inflammatory activity (by inhibiting enzymes involved in depolymerization of proteoglycans in prostate connective tissue), reduces cholesterol levels in the prostate (limiting androgen synthesis), and inhibits prostaglandin synthesis. It has also been shown to increase prostatic secretions in both rats and humans, along with improving the composition of seminal fluid.
In the past two decades, twenty-six clinical trials have been
conducted on pygeum extracts, at a dose of 100 to 200 mg per day, half of
which were double-blinded versus placebo. The results indicate
positive effects in the treatment of symptoms associated with BPH such as
difficulty in urination, frequent nighttime urge to urinate, and a
reduction of residual urine volume. Transient side effects involving
gastrointestinal irritation (inducing nausea and abdominal pain) have been
reported in clinical trials.
In conventional medicine in France, the fat-soluble extract of pygeum bark has become the primary treatment for an enlarged prostate gland. A decoction of the bark may reduce the severity of chronic prostate inflammation, and it may also help reverse male sterility when this is due to insufficient prostate secretions. In combination with other plants, pygeum may be valuable ill the treatment of prostatic cancer.
HABITAT AND CULTIVATION
Pygeum is native to Africa. Pygeum is still harvested from the wild, but severe shortages have led to the establishment of commercial farming.
Trials carried out in France in the 1960s established that pygeum extract has positive effects on the prostate gland. Specifically, the extract increases glandular secretions and reduces levels of cholesterol within the organ. In most Western countries, surgery is the main option for enlarged prostates, but in France pygeum is prescribed in 81% of cases.
HOW MUCH TO TAKE
The accepted form of pygeum used in Europe for treatment of BPH is a lipophilic extract standardized to 13% total sterols (typically calculated as beta-sitosterol). The recommended dose is 50-100 mg two times per day. Pygeum should be monitored over at least a six- to nine-month period to determine efficacy. As is the case with all BPH treatments, close medical supervision is of the utmost importance.
SIDE EFFECTS AND CAUTIONS
Side effects to the lipophilic extract of pygeum are rare. In clinical studies, there were very rare reports of mild gastrointestinal irritation in some patients.