Q. Dear Terry, “I’m in my mid-50s and recently started having to get up in the middle of the night more often to urinate. I saw my doctor and he said that my prostate is slightly enlarged, but otherwise normal. His only recommendation was a prescription medication. I would like to try natural options first. What can I do?” – D.Y., Seattle, WA

A. Dear D.Y., Waking up in the middle of the night to urinate, often referred to as nocturia, can be very distressing and disruptive to sleep. When the prostate enlarges with conditions like benign prostatic hyperplasia (BPH), it can put extra pressure on the urethra and cause the bladder to contract – giving the sensation that you need to urinate.

A few of my favorite ingredients to reduce BPH symptoms include saw palmetto, zinc, beta-sitosterol, and boron. Saw palmetto has a long track record of reducing BPH symptoms. One of the reasons saw palmetto is so well-regarded for prostate health is because it inhibits an enzyme that converts testosterone into a derivative called DHT (dihydrotestosterone). Beta-sitosterol is a healthy fat from plants and has a beneficial impact on the prostate. Clinical studies have found that beta-sitosterol improves urinary symptoms and flow for men with BPH, much like saw palmetto. Boron also affects the balance of free testosterone and estrogen, and optimal levels of this mineral are a must for proper hormone metabolism.
Lastly, zinc is found in very high concentrations in the prostate. It helps the prostate develop properly, protects it from oxidative damage, and is an important component of prostatic fluid. However, zinc is not easily stored in the body for reserve use, as it is quickly depleted by things like stress, infections, and injuries. Therefore, I recommend taking 30 mg of zinc (as zinc bisglycinate chelate), 320 mg of saw palmetto (standardized to 85-95% fatty acids and 0.20-0.50% total phytosterols), 60 mg of beta-sitosterol, and 3 mg of boron (from calcium fructoborate) per day.

For bladder support, you may want to consider Angelica archangelica. Also called “Angel’s Herb”, this beautiful plant grows all over Iceland. When it comes to bladder support, this is the single, most efficacious botanical I have ever encountered. A special standardization of this herb may help anyone with nocturia, whether from BPH or other causes. Not only does angelica help to strengthen the bladder muscles, but it also helps increase bladder capacity. That means fewer trips to the bathroom and less urinary leakage.

I would take 100 mg of this herb twice per day for the first two or three days, and then you can try once per day after that. If you experience more incontinence issues in the evening, I would take it before bed and vice versa if your issues are generally in the morning and throughout the day.

When choosing a formula, I recommend finding one that features an aqueous (water) extract of angelica and is clinically studied.

Healthy Regards!

Terry . . . Naturally