Pygeum africanum (Bitter Almond)

Chapter 118 Pygeum africanum (Bitter Almond)

Pygeum africanum (family: Rosaceae)

Synonym: Prunus africanum

Common names: bitter almond, red stinkwood

image Chemical Composition

The major active components of the bark are as follows:

The pentacyclic triterpenic components are ursolic acid (Figure 118-2), oleanolic acid, crataegolic acid, and their derivatives. The sterolic fraction is composed mainly of β-sitosterol and β-sitosterone (Figure 118-3). The fatty acids range from C12 to C24 and the important ferulic acid esters are those bound to n-tetracosanol and n-docosanol.14

image Pharmacology

Pharmacologic screening of various extracts prepared with solvents of differing degrees of polarity indicated that the highest activity was found in lipophilic extracts.1 This finding is interesting in light of pygeum’s historical administration in lipophilic media (palm oil or milk). Virtually all of the pharmacologic research featured a pygeum extract standardized to contain 14% triterpenes, including β-sitosterol and 0.5% n-docosanol. This extract was extensively studied in both experimental animal studies and clinical trials with humans.

The primary target organ for pygeum’s effects in men is the prostate. The three major active components of pygeum appear to exert different, yet complementary, effects in benign prostatic hyperplasia (BPH). In addition, pygeum was shown to enhance the secretions of the prostate and bulbourethral glands, in terms of both quantity and quality.

Ferulic Acid Esters

The esters of ferulic acid act primarily on the endocrine system. Studies in animals showed docosanol reduced levels of luteinizing hormone and testosterone while raising adrenal steroid secretion of both adrenal androgens and corticosteroids.6,7 Docosanol also significantly lowers serum prolactin levels. This reduction of prolactin is quite significant, because prolactin increases both the uptake of testosterone and the synthesis of dihydrotestosterone within the prostate. The accumulation of testosterone within the prostate and its subsequent conversion to the more potent dihydrotestosterone is thought to be the major contributing factor to the hyperplasia of the prostatic cells observed in BPH.8 Although traces of docosanol are present in pygeum, the esterification with ferulic acid results in greater bioavailability and activity.2,4,9

Ferulic acid esters and the sterol fraction of pygeum exert cholesterol-lowering action systemically as well as within the prostate.9 Breakdown products of cholesterol were shown to accumulate in prostate tissue affected with either BPH or cancer.8 These metabolites of cholesterol initiate degeneration of prostatic cells, which can promote prostatic enlargement. Drugs that lower cholesterol levels were shown to have a favorable influence on BPH, preventing the accumulation of cholesterol in prostatic cells and limiting subsequent formation of damaging cholesterol metabolites. The lowering of intraprostatic cholesterol content is an important aspect of the pharmacology of pygeum.

The sterolic fraction is also endowed with competitive action against testosterone accumulation within the prostate. In addition, the sterols of pygeum were also shown to reduce inflammation by preventing the intraprostatic formation of inflammatory prostaglandins.9,10

image Clinical Applications

Prostate Disorders

The pharmacologic actions of the standardized pygeum extract support its use in prostate disorders, BPH in particular. Adding further support are the results of numerous clinical trials in more than 600 patients.1234 These studies consistently demonstrated that pygeum effectively reduces the symptoms and clinical signs of BPH, especially in early cases. However, it must be pointed out that improvement is largely symptomatic, because the reductions in size of the prostate and in residual urine content of the bladder are modest. The results of the clinical trials on pygeum are given in Table 118-1. A discussion of some of the most important aspects of these studies follows.

Sep 12, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Pygeum africanum (Bitter Almond)

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