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An Interview with Dr. Rudi Moerck on Prostate Health By Dr. Mercola

DM: Dr. Joseph Mercola RM: Rudi Moerck Introduction: DM: Welcome everyone. This is Dr. Mercola. Today, I’m here with Rudi Moerck who is an expert in chemistry especially how it is applied to the supplement field. He’s had a lot of experience in the drug industry and really has brought that experience to the natural food industry. We’re welcome and delighted to have him. Today, we’re going to talk about really important topic which is prostate health. If you’re a man like either of us then it’s a really important one. If you’re not or your spouse or good friend is then they’ll certainly appreciate this information. It’s a significant issue. I think it’s something that we all need to be concerned about. We would like to discuss what the issues are and then some of the things that we can do specifically to be proactive and make sure that we don’t encounter some of these challenges. Thank you and welcome. RM: Thank you very much. Prostate health is a very important topic for men over 60, generally 60 although men over 50 in certain cases of genetic propensity, diet issues, could have issues already when they’re in their 50s or earlier. Generally, statistics are overwhelming. Men over 70 have almost a 50% chance of developing some sort of enlarged prostate. The medical doctors call that benign prostate hyperplasia. The word benign is very important because it doesn’t mean prostate cancer. It just means an enlargement of the prostate. There are many drugs on the market that are used to treat that some of which have recently had to issue warning labels that if you’re a benign prostate hyperplasia or BPH, it turns into prostate cancer that some of these drugs can actually increase the cancer or make it a much more aggressive cancer. Speak to your physician if you can an enlarged prostate and if there is any chance that you have prostate cancer, you have to be extremely careful. Any supplement that you take, you have to go through your regimen if you have cancer. Some supplements and drugs can actually feed that cancer so you have to get professional advice. The prostate drugs that are available are very potent usually involving hormonal balance in the body. They include Flomax and Avodart. Again, Google it and you’ll see that there are many hits right now as far as warnings about taking these things.

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There are also things you can do with your diet and there are things you should do generally as a male that can help mitigate this problem and there are some supplements that can be used and have been shown over a couple of hundred years now to be effective. That’s a couple of hundred years in American culture but of course the use of saw palmetto by the American Indians especially in the Southern States where the saw palmetto plant grows has been around for thousands of years and has been used for prostate health for thousands of years. DM: Before we go into saw palmetto I just wanted to highlight some of the reasons that an individual with BPH would be interested in seeking treatment. The primary one is that sleep is such a crucial part of our health and if we don’t get it, you’re going to have impaired health. We won’t be as healthy as we can be. One of the biggest complications of BPH is that you’re not going to sleep well because you will have to urinate and get up frequently throughout the night. RM: And your wife will not sleep well either. DM: Well, assuming you’re sleeping in the same bed which frequently is the case. That’s the big issue. It’s not even a direct hormonal component. It’s more of a mechanical secondary side effect of how it really impairs your sleep cycle. These drugs primarily they work on a specific enzyme called 5-alpha-reductase and they inhibit this enzyme that causes that enlargement. You mentioned some of these other hormonal components. I would like to make a distinction here too because I think even to this day many conventional experts recommend against the use of testosterone because this 5-alpha-reductase is what’s responsible for converting testosterone in the body to dihydrotestosterone or DHT which is the problem. It’s this DHT that causes it. It’s not testosterone. Healthy testosterone typically decline as they age. They’re actually responsible for preventing the problem. But it is this DHT that is the real issue. That’s where saw palmetto works and really makes a big difference. Why don’t you expand on that. RM: Generally with saw palmetto, first of all there has been 50 to 100 clinical studies on saw palmetto both in the United States and in Europe especially Europe where saw palmetto even though saw palmetto again, as I said was made by the American Indians, the Europeans picked up on this very quickly. Also, one of the first prostate drugs on the market ever in the United States was saw palmetto made by the Eli Lilly Company in 1872 I believe it was. In any case, the mechanism of action of saw palmetto is not fully clear. We are certainly not making any drug claims but the anecdotal evidence suggest that there is a reduction in the conversion of testosterone into the dihydrotestosterone and then therefore men that take saw palmetto will have slightly higher levels of testosterone in their body as you were pointing out.

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DM: And that’s a good thing. RM: That’s a good thing. That definitely changes the balance a little bit. It turns out that if you don’t have enough testosterone in your body it can cause all kinds of problems like gaining weight, breast enlargement in men, and problem with urinating. So saw palmetto alone or with pumpkin seed or with lycopene is an interesting thing but saw palmetto, a good grade of saw palmetto – we’ll talk about the various grades a little bit later – is important in this. It’s something that you should definitely try. The reason why you should try it rather than going immediately to a drug which now has these warning labels – there are by the way some medical drugs and in all fairness, we need to say there are some drugs that do not have this warning label that can be used. I always believe in trying something first that is natural, that is lower cost, that doesn’t have any side effects. All the chemical drugs on the market today, if you read the warning labels, if you read the sheet that comes with your tablets, I mean there is tremendous side effects. DM: The average side effect per drug is 70. RM: Right. DM: It can be as high as 500 or even higher than that. RM: The significant ones though are the ones that have over 5% of the persons taking the drug reporting major problems. The 5% hurdle is a real good number. In the prostate drugs it’s usually things like when you get up from your chair and you get dizzy. That’s not a really good thing because if your chair happens to be a canoe or your bicycle or something like that, there could be major issues with that. I think there is a couple of other things we need to say about prostate health. First of all, exercise is important. Make sure that as you get older especially if you get over 60 you got to exercise. You got to eat organic food, raw food, things rich in vitamins, rich in carotenoids, and also foods rich in lycopene. I don’t mean things like catsup with a lot of high fructose corn syrup. I mean cooked tomatoes. Tomato sauce that sort of thing is rich in lycopene. Consider a lycopene supplement also. Also, a difficult subject to talk about and that is sex. Have sex on a regular basis which involves exercising your prostate. It’s a difficult thing to talk about. I talked about it to both men and women’s groups in various things that I go to. In older people that becomes an issue because of lack of a partner and those things. It’s something that every man should think about. I know it’s hard to get men not to think about sex but I recommend sex on a regular basis. DM: Yeah.

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RM: And no matter what your age. My recommendation is a minimum of once a week. Probably two times a week for older people. DM: For ideal prostate function. RM: Use that prostate. Remember when that doesn’t happen, when a man does not have sexual activity then all the sperm, all the fluids and everything have to be reabsorbed into the body. That can cause certain immunological issues. So do that. Exercise, have sex on a regular basis, eat healthy foods (fruits and vegetables), avoid a lot of carbohydrates, eat a moderate amount of meat. If you’re a vegetarian you eat high protein things like lentils and that sort of thing. That’s very good basic stuff. DM: The other one too as you had mentioned, don’t eat many carbohydrates specifically sugar and more specifically than that fructose which will devastate insulin function or resistance and increase insulin resistance and will contribute to cancers. One of the ones you left out was exposure to sun and increasing your vitamin D levels because as far as I know, vitamin D is probably the most potent variable associated with a lower risk of prostate cancer. You don’t want to necessarily take it when you have prostate cancer although I certainly would but it’s probably most beneficial to prevent it like most things in life. So making sure you’re getting 15 nanograms per milliliter at a minimum as a base of vitamin D. RM: I think that’s very important. I think sun exposure is a good one. We’ve talked about that before. Not on your head or face but on your body, 15 to 20 minutes a day and then increase your vitamin D content if you live in a place like Chicago or New York where you don’t get that winter sun. DM: It’s difficult to give a time recommendation because it’s so variable. If someone is a fairly complexioned individual versus a deeply pigmented African-American or Middle Easterner, they’re going to require perhaps 10 times as much sun exposure or if there is clouds or pollution. There is just a lot of variables. You really have to use your judgment and never get burned which I think is the simple underlying principle. Just never get burned because that’s going to cause damage. I believe, if I’m not mistaken prostate cancer is the most common cancer in men. RM: Yes. DM: There is a bit of confusion about that because it is the most common but I don’t believe it’s the most lethal. My last memory of these numbers was that more men die with prostate cancer than from prostate cancer. I wonder if you can comment on that. RM: Again, I’m not a medical doctor. I’m a PhD, a biologist and chemist. In reading the literature, it’s very clear that many prostate cancers are extremely slow growing and that

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if you take the proper precautions, you are going to outlive the cancer. Men that have slow growing prostate cancers and they’re 80 years old, generally speaking the surgery or any other treatment is going to be doing more damage at that age like radiation treatment and that sort of thing or surgery. Also the issues of surgery is that often prostate surgery is associated with impotence afterwards. That’s something that you have to be careful of. If you get a biopsy – even a biopsy is not straightforward for prostate cancer. DM: It actually might cause more harm than good because it starts you down this path of really entering in the conventional system for prostate treatment which involves potentially application of these very potent surgical and/or chemotherapy suggestions. RM: I recommend doing testing that involves the classical test for enlarged prostate which is your doctor doing a physical exam. I also recommend using instrumentation that does not involve radiation. So magnetic is okay. DM: Ultrasounds… RM: Ultrasound is very okay but CAT scans for instance can do more damage than good if you don’t have a really, really serious case and you need to really do the CAT scan to do the surgical procedure afterwards. The other thing is that I highly recommend that men over 50 start taking saw palmetto everyday because it certainly does not hurt. If your body doesn’t need it, it’s not going to use it. It’s not an expensive supplement. That should be 320 mg of saw palmetto oil supercritical CO2 extract. DM: There are a number of ways to take the saw palmetto out of the berry. I wonder if you can discuss that and maybe talk about the different qualities of the raw materials because there is a whole range of different products out there. I mean, saw palmetto is one of the most popular supplements on the market. I think it’s really important to have an understanding of the process that you need to go through to identify a high quality one. Because really it doesn’t make sense to take saw palmetto supplement generically, you want to figure out if something is going to really work and make a difference. It’s an effective supplement but only if it’s from a high quality source. RM: Yes. I personally believe for instance people that are getting these drugs through a medical plan or something, the prostate drugs, that there ought to be a flyer in there that says, have you tried this? Have you tried saw palmetto? Because there is fewer side effects and certainly the cost is a lot less. You know it’s lower cost for the insurance companies too. DM: It doesn’t increase the risk for prostate cancer. It decreases it.

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RM: That’s right. Let’s talk about saw palmetto. It’s one of the worst supplement areas as far as stuff being sold that is ineffective. DM: Would you say the majority of the saw palmetto products in the market are not going to work for you? RM: Absolutely. Most will not work for you because of one very simple reason. Somebody had the bright idea a few years ago to take dried saw palmetto berries, picked in Florida and grind them up and put them in a capsule. The berries themselves, those are so-called green berries do not have a lot of oil in it maybe 8-9 percent oil. So if you put 300 or 500 mg of green berry powder in a capsule, you’re only going to get 35 mg of oil. Whereas the right dose, the clinically trial dose is 320 mg. DM: So literally 90% lower than it should be. RM: Right. Almost all the supplements that are mass marketed supplements, if you go to the various mass market stores or drug and food stores, they’ll say Serenoa repens 320 mg as berry. That’s not 320 mg of oil. That’s berry powder. It does not work. That today, a drug mass in food, that is 55% of the market. It is incredibly bad stuff. DM: Bad from a perspective that it probably won’t work. RM: It gives people false hope. DM: False hope and they’re spending their money foolishly because they’re biased that the thing is going to work, it’s not going to help them and their underlying problem that they’re seeking to address is not being paid attention to. RM: I recommend that you only buy a supercritical extracted – let’s go into the various methods. Let’s say you do want to buy an oil, 320 mg is what you should take per day. DM: That’s the first step. RM: That’s the first step. And then you want to know how that oil was made. It can be made three different ways. It can made by ethanol extraction, alcohol extraction if you will. That gives a product that is going to have residues of alcohol left in it. DM: Which isn’t necessarily toxic because ethanol, people actually pay to take that on a regular basis. I mean there is a lot safer solvent than other solvents that can be used. RM: But for some religious groups for instance it would not be acceptable generally to have that. The other method is hexane extraction. That uses a chemical solvent and that leaves residues of hexane in the product. DM: Hexane is toxic.

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RM: Hexane is toxic. Also, the oil that you get out is a very nice yellow oil. It kind of looks like corn oil and it doesn’t have any of the micronutrients in it. With ethanol, you do get some of the micronutrients. It’s a darker oil. You get some chlorophyll etc. The third method is – this method is then used by the companies that are leading companies in this area – it’s the supercritical CO2 extraction. That is liquid carbon dioxide, very similar to the process that’s used to decaffeinate coffee today. Whereas years ago they used to use chlorinated solvents; today, they use supercritical CO2. What supercritical CO2 does especially ultra high pressure supercritical CO2 is it forces the liquid carbon dioxide into the berry powder, it extracts it out. The higher the pressure the more micronutrients that you’re going to get out of this – micronutrients meaning lutein, lycopene (small enough lycopene), zeaxanthin, chlorophyll. In certain oils, chlorophyll is not a good thing like edible oils. Chlorophyll and edible oils means that they’re going to go rancid faster. In saw palmetto that’s not an issue. Chlorophyll has traces of magnesium which is an essential nutrient. Also, the chlorophyll molecules itself is a good molecule. It’s why you eat green things that sort of thing. The ultra premium saw palmetto oils are organic supercritical extracted saw palmetto oils. After that it’s just ultra high pressure, super critical oils and then low pressure oils which are generally yellow oils. DM: What color is the supercritical CO2, ultra high pressure? RM: At ultra high pressure it’s very dark. It’s almost black. If you look at it very closely it’s really dark green. It’s due to the fact that there is some chlorophyll and some lutein in that. Lutein occurs naturally in the berry. The other methods don’t extract it. Then if you go to a high pressure, not ultra high pressure but high pressure then the oil becomes rose colored, a lighter oil. If you use very low pressure which most of the saw palmetto oil that’s made by supercritical extraction using very low pressure it’s just the yellow oil. It doesn’t have the micronutrients. DM: What percentage of the supplements available of saw palmetto in the market uses supercritical ultra high pressure method that really seems to be the ideal method of extracting the saw palmetto into a gel capsule? RM: Half the market is the powder which is not efficacious. The other half, the ultra high pressure is maybe 10 to 15 percent of the market and another 25% for a medium grade. DM: So literally all the ones in the market that we’re looking at – if you have 20 different brands there is only going to be one brand on average, because there’s probably more than 20 brands that is using this method. RM: One or two.

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DM: So not many. One concern – there is the different ways that you can damage nutrients. One certainly is oxygen, the other is ultraviolet light. But the third is pressure. So when you’re using these ultra high pressures does that high pressure cause any damage to the micronutrients? RM: Not if the temperature is low. One of the reasons why you can use ultra high pressure is because you can run this at a very low temperature and get a nice clean extract. DM: How low are you? RM: The temperature is typically about 100 degrees. DM: Centigrade or Fahrenheit? RM: Centigrade. Saw palmetto oil will take a lot more than that. It will take a couple of hundred degrees but at that temperature, at 100 degrees, you’re not destroying any of the micronutrients mainly because ultra high pressure CO2 has no oxygen in it. Even though carbon dioxide – well yeah, it has dioxide in it but that’s a very inert molecule. It doesn’t react like oxygen does. It’s very stable. That’s why if you breathe CO2 you die because there is… DM: That’s what they use for fire extinguishers. If you throw oxygen at a fire you obviously ignite it or accelerate it but if you throw CO2 you put it out. RM: It is the cleanest extraction method known to mankind today other than just eating the food. It is also extremely non-chemically reactive. So that’s the way to go. If you use ethanol extraction there are chemical reactions that take place with ethanol in the various components like the carotenoids do react with ethanol. I think they are still safe but it’s not the way to go. I mean, you can still drive a model (indiscernible 24:26) but that’s not the way to go. DM: Are there some evidence of the benefit of using a synergistic combination of lycopene and saw palmetto or any other micronutrients that might enhance the effect of the saw palmetto? RM: Yeah, there are a number of nutrients that have been used traditionally. One of them is pumpkin seed oil which is a good nutrient. Again, getting it from a good source organic pumpkin seed oil. That’s a good one. It’s slightly less effective than saw palmetto. And a lot of people who sell a combination of products which I think are good products. DM: It’s slightly less effective when used independently.

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RM: Right. DM: But probably when it’s used – because it is a different mechanism of action. So synergistically together we’re better than either independently? RM: Yes. That’s an acceptable additive to saw palmetto. But again, you have to be careful what that ratio is because saw palmetto oil costs a lot more than pumpkin seed oil. Some people – supplement suppliers may load the thing up with pumpkin seed oil and very little saw palmetto oil. Really the flagship in this is saw palmetto and yes it would be great if you added some pumpkin seed oil. It is effective but be careful of that ratio. DM: So the threshold of what you want on a daily dose of saw palmetto is about 325 mg. RM: Minimum. DM: But you can go higher. RM: You can go higher. It’s not necessary. I would not go more than twice that. I have to also mention that the fatty acids in saw palmetto are free fatty acids. They’re very acidic. If you take a lot of it, it could cause some stomach upset. I recommend taking it with food, take one of them a day. DM: Again, it’s a fat soluble supplement and you want to be really careful not to take those on an empty stomach because you won’t absorb it that well. It will just be excreted. I personally am a strong believer in consuming healthy eggs as you are. Eggs have this phenomenal phospholipid which is probably about the best food you could possibly eat to absorb a fat soluble nutrient or supplement like astaxanthin or saw palmetto. So I would take it with eggs is the best. RM: Yeah. DM: Or any other fat if you’re not using eggs. RM: You know I’m a big believer in eggs also. We both are. But good eggs. DM: High quality. RM: Yes. The other nutrient that you mentioned is lycopene. There is a growing body of evidence that lycopene is beneficial to prostate health. In fact it’s extremely fast growing literature based on that. The most interesting thing for me as a scientist was that they did some tracer studies not in humans but in animals. Just as a disclaimer, I am not a proponent of testing in animals and only testing that is non-destructive or non-hurting of the animals would be

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good. What they did in this case is they used some very short lived radioisotopes that are commonly used even in people. They go away very quickly just as a diagnostic test. I just wanted to clear that up. I feel very strongly about avoiding animal testing when possible. DM: Many of our readers feel the same way. RM: But in the test it shows that of all the carotenoids, lycopene is the one that accumulates in the prostate of male animals. That’s true of humans also. It is a very potent antioxidant. And so much damage to organs and to membranes and of course the prostate is a very important organ. It just so happens to have the urinary tract that goes right through the middle of it. So that when the prostate starts growing or swelling it will cut off urinary flow. It turns out that there has been some good reports of lycopene helping that. It is also one that is being investigated to prevent prostate cancer. I’m not making any claims about that. I’m just saying it’s being investigated for that and it’s something that I’m going to keep an eye on. It’s very interesting. DM: Thank you for providing that new information about lycopene. This can be a useful tool but there are other treatment options that people have if they have prostate problems. I’m wondering if you could just comment on those from your experience and understanding. RM: We talked earlier about biopsies and that sort of thing and that’s a problem. But the important thing is that if you get prostate cancer or you suspect you have prostate cancer is to look at all the potential treatment options. Also, talk to your doctor or your dietician about your diet and there are some guidelines that should be observed. I would look at the supplements you’re taking, also the drugs that you’re taking and seriously listen to them about the various options. There are options that involve surgery. There are options that involve radioactive implants. There are options that involve microsurgery. All these things are available to the medical profession but before you do any of them, determine whether you have an aggressive form of the cancer or not. That will be the guiding light. Speak to your physician or your healthcare provider and talk to them about is it an aggressive form, look at your age. If it’s a non-aggressive form, if it’s a slow growing cancer then you want to monitor it over time, adjust your diet, look at your drug regimen or your supplement regimen and really get some professional advice. I also recommend a dietician but also get several opinions. DM: I have to give you some feedback on that because my experience is that most all dieticians and physicians are pretty ignorant or clueless about nutrition especially

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conventionally trained because they’re getting their education from clueless conventional medical doctors or companies like Coca Cola that are really educating them. They believe artificial sweeteners are fine. There are no problems with it. There are no problems with sugar. They’re clueless about insulin resistance. That’s something we really addressed well on our site over the last 13 years or so. So if you want information about nutrition then just go to our site. We have a link on our homepage that goes to a hundred page nutrition plan. It walks people through three different levels of either beginner, intermediate or advanced stages and goes through all the details. I mean certainly if you have a natural healthcare clinician and you’ve got a certified clinical nutritionist absolutely take advantage of that. But the traditional approach, you’ll get is just misinformation. Well intentioned. They believe it’s true. They’re not trying to hurt or harm anyone but they’re operating under principles that just don’t work. So we have to be really careful. Because diet is really one of the most important tools we have. It’s simple and if you make poor choices there you’re really going to sabotage yourself unintentionally. Supplements are great. I think it’s a phenomenal idea to consider adding a potent 5-alpha-reductase inhibitor that’s natural like from saw palmetto done from a high quality process like you described but that’s just in addition to. The number one source of calories in this country is high fructose corn syrup. That’s the absolute highest level of calories that people are getting from. So if you’re having 125 gm of fructose a day, I really don’t think that saw palmetto is going to help you very much. You’ve got to have a priority. You’ve got to optimize your biochemistry from a nutritional perspective first, get that down, make sure your vitamin D level is therapeutic, make sure you’re exercising, make sure your insulin resistance is low then you add on these supplements that can have phenomenal and important synergy because otherwise you are trying to stop your car with the foot slammed down on the accelerator. It may work but you’re going to damage your car and it’s not going to work anywhere near as effectively as you take your foot off the accelerator. RM: I agree and that’s one of the reasons why in my own diet, I avoid certain fruits even that are high in fructose. I eat mostly berries which do have some fructose in them but you’re getting a good shot of vitamins, water soluble antioxidants – blackberries, blueberries… DM: Fruits are great. I’m frequently criticized for my position on them. I think they are phenomenal especially berries. I have an orchard in my backyard of about 20 different fruit trees and some berries but the problem is that 85% of the people have too much fructose in their diet already. They’re taking 75 grams. Once you go above 25 grams it’s sort of the threshold at which you start experience these metabolic complications.

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If you’re fructose level is below and you’re eating healthy and you’re following a good program then it’s great. You can even go higher occasionally like anything as long as your average is going to be down below 25 grams but most people aren’t. RM: But certain fruits have a moderate or modest nutritional value. DM: Sure like limes are a classic example and lemons have virtually no fructose in them at all. Others are lower but fruits are very high in fructose just like figs or dates and things like that. RM: Apples. DM: Apples especially a big apple. One of those fruits could definitely… RM: I’m a berry guy. DM: Berries are good too and cherries especially this time of year. RM: This time of year yeah. DM: Any closing words? RM: Yes. On prostate health is, get good exercise. Eat a good diet low in fructose. Exercise your prostate in another way once or twice a week. Start saw palmetto supplements when you’re in the 50s even if you do not have an issue. It’s completely safe that way. Look into lycopene as a supplement. Again, you can get lycopene from cooked tomatoes. If you’re an Italian-American, you probably get enough lycopene. If you don’t eat a lot of cooked tomatoes… DM: Because you’re going to absorb more of the lycopene when it’s cooked as opposed to eating a raw tomato. RM: Correct. DM: Because normally raw is a better way to have most food but in this case… RM: Catsup is not a good source of lycopene. DM: But it’s cooked. RM: Because there is a lot of sugar in it. DM: Yeah most do but there are actually some that have very low sugar and are made from organic tomatoes.

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RM: Also, lead a healthy lifestyle. The other thing that we didn’t mention before is watch your alcohol consumption. I always say no more than three drinks a day. Ideally two drinks a day. No alcohol consumption is not good. DM: Some people would disagree with that but it’s an area for a whole other discussion. I thank you for sharing your insights on this rally important topic and really bringing to light some of the important distinctions as to what differentiates a high quality from a low quality saw palmetto supplement because most of us are really unaware of those details because we’re not involved in the industry like you are. I appreciate you sharing that and giving us the tools, the resources, the information we need in this important area so that we can continue to take control of our health.