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Exploring Natural Prostatitis Remedies

Genes Mentioned

This post is part of multi-part series shedding light on the latest treatments for common chronic conditions faced by an increasing number of Americans.

Prostate.

Just mentioning the word will get some snickers, but this little forgotten gland is crucial to every man’s health. In fact, if you are a man who would like to avoid getting cancer, the prostate is an excellent place to begin.

Approximately one in seven men will be diagnosed with prostate cancer at some point in their lifetime, and prostate cancer currently ranks as the third leading cause of cancer death for men behind only lung and colorectal cancer. Although this is a post about prostate inflammation and not prostate cancer, the principal is the same: men need to take care of their prostates from a relatively early age.

And while the vast majority of the research dollars go to prostate cancer, prostatitis, or chronic inflammation of the prostate, is often lost in the shuffle.

Yet, virtually all men will develop prostatitis at some point in their adult lifetime, and with symptoms ranging from frequent urination, to pelvic pain, and even erectile dysfunction, this disease should be on every man’s radar. 1 When you take a deep dive into the literature, it becomes clear that the umbrella term “prostatitis” actually represents multiple different infections and sources of inflammation.

As such, this post will offer a series of easy experiments men can perform at home to either better protect, or heal the prostate.

Can treating gum disease cure prostatitis?

However, before I dive into the meat of the research, I think it’s a good idea to start with an issue that everyone reading this can control for, and that’s dental hygiene.

As you’ll see reading this post, we get into issues of PH and which bacteria thrive in more acidic environments. For example, the PH of urine can dictate whether bacteria like E. coli can grow in the urinary tract. Similarly, the state of our dental hygiene also plays a role in the pathogenic load placed on the body. The issue first came on my radar when visiting with a holistic dentist recently. He developed a product that raises the PH of the mouth to make it more alkaline.

At first, I was skeptical (seems everyone is selling a supplement today), but then I did some reading.

I was surprised to see saliva referred to as containing many “host defense factors, and the PH of saliva is a biomarker for gum disease. 2 More acidic saliva correlates with more advanced gum disease, whereas more alkaline saliva is associated with better gum health.

But, here’s the kicker – gum disease and prostatitis go hand in hand. In fact, there are studies demonstrating significant improvement in prostate inflammation just by treating the gums alone. So, if you’re reading this and you have prostatitis, the first step is to visit with a holistic dentist, make sure your gums are healthy, and pay attention the acidity of your saliva.

Not sure what to eat?

Gene Food uses a proprietary algorithm to divide people into one of twenty diet types based on genetics. We score for fat metabolism, histamine clearance, carbohydrate tolerance, and more. Where do you fit?

Learn More

Is prostatitis a sexually transmitted disease?

Yes, prostatitis can be contracted through sex, so the more sexual partners a man has, the higher his odds of developing the condition. 3 4 5 6 7

Interestingly, Trichomonas vaginalis, a parasite and STD, has been found in prostate biopsies of men with prostatitis, and although it seems that E. Coli is a much more regular culprit, the prostate’s susceptibility to Trichomonas vaginalis colonization has been linked to zinc levels. The prostate is the number one home for zinc in a man’s body, and when levels get low, studies have shown these types of pathogens can take a greater foothold.

Mineral deficiencies are common in the U.S., which means supplementing with small amounts of zinc (you don’t want to overdo it with zinc as large doses can cause side effects) to see whether conditions improve could be worthwhile. As far as food is concerned, pumpkin seeds and oysters are both high in zinc.

As an added benefit, zinc supplementation has also shown some promise in maintaining the cell lining of the gut, which can prevent or help to heal leaky gut, a condition that often accompanies prostatitis, and that is marked by a breakdown of the “epithelial” wall of the gut lining, which allows pathogens and undigested food particles to enter the blood stream. 8 9 I will touch more on leaky gut later in this post.

While we are putting a focus on Trichomonas vaginalis in this discussion about zinc, ultimately, identifying the exact pathogenic bacteria causing issues in the prostate can be difficult since samples are often contaminated by the bacteria that grow in the urethra.

Antibiotics and prostate problems

Prostatitis can be contracted from sexual activity, but the very antibiotics used to treat prostatitis can, in some cases, be the culprit behind chronic inflammation of the prostate.

Ruling out fungal infection

Consider this study which appeared in the Central European Journal of Urology. The authors found that most young men presenting with prostatitis, who also had low prostate specific antigen (PSA) numbers (higher PSA means greater likelihood of prostate cancer), were suffering from a yeast infection, not bacterial prostatitis, although E. Coli was thought to be the “bridge” that brought yeast to the prostate region in the first place.

Fungal study

TypeFungal
Size1,000 men
TreatmentFluconazole, potassium citrate
Diet changesLow carb
Results80% saw improvement in symptoms

This tiny study had the same finding, but in this case, biopsies showed dual contamination with Candida Albicans and Trichomonas vaginalis.

So, as a preliminary matter, if you’re a young man suffering from what you think could be prostatitis, have your PSA labs done. Bacterial prostatitis can raise PSA numbers, so if you have low PSA numbers, you may be looking at an anti-fungal regimen rather than a course of antibiotics.

Broad-spectrum antibiotics, which is the solution offered by most urologists, will only serve to further destroy the microbial balance in the gut and urinary tract, making it that much easier for the yeast to spread. In these cases, loading up on antibiotics will only make matters worse.

An easy experiment to run if you suspect a fungal issue is to go on a type of Candida protocol for about 10 days and see how your body responds. In essence, this will involve eating zero sugar and following a low glycemic diet (meaning very low carb but NOT zero carbs).

Don’t go “keto” or zero carb as studies show that yeast can survive very effectively on ketones.

If these dietary changes provide relief, you have a decent idea that the problem is fungal in origin, especially if you have low PSA numbers. It is also a good idea to have a mycotoxin panel done to identify potential issues with toxic mold.

The Central European Journal of Urology study used fluconazole, but some men may better tolerate nystatin.

I would also note that the mechanistic justification for the low carbohydrate and anti-fungal diet in the Central European Journal of Urology could actually justify two experiments. The one I list above is the anti-fungal-diet option (very low carb), which is proven in a well designed study, however, what seems to have been lost in that approach is the suggestion that E. coli was the bridge that allowed for the invasion of Candida in the first place. The low carbohydrate diet cuts off the fuel source for Candida growth, but doesn’t address the possible source of the E. coli.

Based on the studies I cite below in the plant based protocol section of this post, it could just as easily be argued that a diet, like many plant based protocols, that work to make the urine more alkaline could be just as effective, if not more so, at healing cases of prostatitis, since the rise in urine PH would remove the fuel source for E. coli (which thrives in acidic urine) and therefore remove the “fungal bridge” to the urogenital region. In the European study, the researchers gave the subjects potassium citrate to make urine more alkaline.

The prostate is prone to infection and inflammation

The prostate sits in an anatomical position, wrapped around the urethra, and close to the rectum, that is ripe for infection.

Infection causes inflammation. 10 When the prostate is inflamed, it can become enlarged, putting pressure on the urethra and, in some cases, making it more difficult to fully empty the bladder. Urine then gets trapped and backs up, which can contribute to lingering low grade infection, even where tests come back negative.

The role of leaky gut

In addition to the retention of urine, the prostate can become infected due to a break down in the intestinal lining, sometimes called “leaky gut.”

Leaky gut is characterized by bacteria, toxins, and even undigested food, which are all meant to stay within the digestive system, leaking out into the blood stream where these invaders have the potential to cause autoimmune like reactions in some people.11

For example, men who give up gluten sometimes find that their prostate issues go away.

Presumably, this happens because gluten increases the production of zonulin, a protein that is responsible for breaking down the “intracellular tight junctions” that form the gut wall. 12 Removing gluten reduces levels of zonulin, which allows the gut to heal, stopping the release of irritants that had previously reached the blood stream where they can cause autoimmune reactions.

As a practical matter, this will overlap with the anti-fungal protocol above, but stop eating gluten for a month and see if the condition improves. There are multiple anecdotal stories online about men healing prostate issues by cutting out gluten.

And while the Paleo community has done an excellent job tagging grains as the cause of leaky gut, the reality is more complex for most men. Yes, grains, especially refined grains, can feed yeast and are contraindicated on an anti-fungal protocol, but some men will also do well to avoid saturated fat, as saturated fat has been linked to intestinal permeability as well. 13 While the saturated fat study I cite here was a study performed in mice, it’s worth mentioning because many with mast cell issues don’t respond well to high fat diets and foods, and one of the theories I will advance later in this post discusses the possibility that prostatitis is an autoimmune condition for a good number of men.

The point here is that a low-grade infection of the prostate can come from places you may not expect, including the gut.

Hidden infection

Most people have cancerous cells in their bodies, but they do not have “cancer.” The principal is the same with infection. A urologist may tell a man with prostate issues that he has no infection, but as I alluded to above, that doesn’t mean there aren’t bad bacteria present in the region that are causing problems.

However, it is important to point out that many men have identifiable infection that can be detected through lab tests.

This quote from the Journal of Clinical Microbiology Reviews is instructive:

While it is difficult to definitively extrapolate from animal models, antibiotic pharmokinetic studies with a murine model have suggested that treatment failures in chronic prostatitis are probably a result of the local microenvironment surrounding the persistent focal and well-protected small bacterial biofilms buried within the prostate gland. These conclusions support the molecular and culture data implicating bacteria as a cause of chronic idiopathic prostatitis.

As a result, the first course of treatment for men who complain of prostatitis is antibiotics.

However, antibiotics cannot penetrate the prostate effectively. Forums are full of men who claim to have had some temporary relief from antibiotic use, only to have symptoms return when antibiotics stop. This can likely be explained by the fact hat the antibiotics temporarily lower the pathogenic load in the region, but don’t address the underlying cause of the disease in the first place. Ironically, and as the studies on yeast infections above demonstrate, antibiotic use may be one of the primary contributing factors to long battles with prostatitis.

To be fair, antibiotics may have efficacy for men suffering with an acute infection. However, for chronic repeat sufferers, antibiotics are not a cure, because, as the Journal of Clinical Microbiology states, bacteria can thrive in a prostate not receiving proper blood flow due to bacteria fortified in biofilm. 14

It’s now time to bring nitric oxide into the equation.

Nitric oxide and blood flow

The blood vessels in the prostate are the smallest and most delicate in the body.

Nitric oxide (“NO”) causes blood vessels to relax so they can receive oxygenated blood. The popular erectile dysfunction drugs Cialis and Viagra work because they flood NO into the prostate region (also relieving symptoms of BPH). 15

NO is anti-pathogenic, but unfortunately, infection reduces BH4, a chemical the body needs to make NO. 16 In addition, fungal pathogens cause an uptick in the production of uric acid in the body, and high levels of uric acid also prevent the synthesis of NO. 17

So, in essence, an infected prostate loses the ability to receive NO because the body uses BH4 to fight off the invaders, rather than to synthesize NO. The uric acid mediated disruption of NOS can come from the activity of the fungal pathogen OR it can be the result of a diet too high in animal protein and sugar, as well as the result of certain genetic “mutations.”  It’s likely all three factors combine to form the serum uric acid levels of any given individual.

Therefore, lingering infection means lower NO bioavailability, reduced blood flow, and greater risk for infection, or greater risk for lingering infection to better protect itself with production of biofilm. 18 Reduced BH4 also results in a process known as NOS uncoupling, which produces the free radical superoxide instead of NO.

For more on the genetics of NO production, see our NOS3 gene page.

Whether you want to call it acute bacterial, or chronic nonbacterial, prostatitis is a recurrent inflammation of the prostate caused in part by chronic decline in nitric oxide bioavailability.

The recent literature suggests that the condition referred to as chronic idiopathic (nonbacterial) prostatitis may actually have an infectious etiology.

During the past few years, molecular data and cultures performed with special media (discussed below) strongly suggested that chronic idiopathic prostatitis may actually be a cryptic bacterial infection of the prostate gland that is usually missed or undetected by routine conventional cultures in clinical microbiology laboratories.

Journal of Clinical Microbiology

Decline in the anti-pathogenic NO results in poor blood flow to the prostate, which adds an anaerobic environment to a region that sits next to multiple potential sources of infection. The stage is then set for infection to settle in, with E. Coli being one of the biggest culprits.

It is for this reason that studies have shown that use of the ED drug Cialis, actually helps heal and reduce inflammation markers in the prostate. Flooding the region with NO, reduces cytokine activity. 19

Increase in mast cells irritate the prostate

Chronic infection causes inflammation.

In response to inflammation, the body produces a greater number of localized mast cells, which makes matters worse. 20 Mast cells are produced during times of stress, as well as in response to ingesting foods or substances that trigger an allergic response. 21

Therefore, mast cell production in the bladder and prostate is basically an allergic response to inflammation that can increase the inflammatory cycle and locally suppress the immune system. 22 Remember that when provoked by a stimulus perceived as a threat to the immune system, mast cells release histamine, as well as a whole host of other inflammatory compounds. After a long period of inflammation, which has caused mast cells to pool in the prostate area, seasonal allergies can contribute to symptoms. The mast cells are there in larger numbers and will release their inflammatory cocktail in greater concentrations in areas of the body that are perceived as under attack.

I’ve written previously about pollen allergies causing anxiety, but presumably they can contribute to some types of prostatitis as well.

I get into a study focusing on an autoimmune model of prostatitis in a couple paragraphs, but many people with mast cell issues don’t do well with red meat, pork, and high fat diets. If you have allergies, cutting out saturated fat and going on more of a plant based diet for awhile could be helpful.

Not sure what to eat?

Gene Food uses a proprietary algorithm to divide people into one of twenty diet types based on genetics. We score for fat metabolism, histamine clearance, carbohydrate tolerance, and more. Where do you fit?

Learn More

Known prostatitis cures

Applying the prostate facts

Ok, so we’ve offered three overarching reasons for prostate problems:

  1. Anatomical position close to sources of infection (vulnerable to leaky gut)
  2. Small blood vessels sensitive to declines in NO
  3. Mast cell / autoimmune reaction to allergens, infection, stress

Let’s now take these three theories and apply them to the best prostatitis studies.

Quercetin

Quercetin is a mast cell stabilizer and biofilm disrupter.

Knowing this, it’s not a surprise that studies show quercetin significantly reduces symptoms of prostatitis, especially when it’s paired with bromelain, an enzyme found in pineapple juice that increases the bioavailability of quercetin. Both quercetin and bromelain act as natural antihistamines, which reduces mast cell count and eases symptoms.23 Quercetin has also been shown to increase NO levels and improve endothelial function. 24

This double blind, placebo controlled study found that quercetin and bromelain to be effective at treating prostatitis.

Quercetin study

TypeChronic non-bacterial
Size28 men
TreatmentQuercetin 500mg twice daily, and then twice daily combined with bromelain
Diet changesNone
Results67% of quercetin takers had improvement of at least 25%

Quercetin fits under the three prostate rules listed above both as a mast cell stabilizer and a biofilm disrupter.

A note on prostatitis and genetics (technical)

At a genetic level there isn’t much data out there for potential markers related to prostatitis, although SOD2 SNPs and other endogenous may play a role. One interesting study from 2002 did highlight some potential markers and interestingly identified differential treatment responses based on genetics.

The risk allele ‘A’ of rs1800896 in the IL10 gene is associated with a reduction in levels of IL-10 protein. IL-10 is a major anti-inflammatory cytokine, a protein released by cells which helps damp down the inflammatory response, and so a lack of its expression is therefore associated with chronic inflammatory disorders.

The 2002 study in patients with chronic prostatitis found that men with prostatitis were more likely to have a low IL-10 producing genotype, “suggesting autoimmunity as a potential etiology.” So, check another box for our mast cell rule there.

Interestingly, the authors also noticed that those with the “normal” ‘G’ allele of rs1800896, who also carried the risk ‘A’ allele of rs1800629 in the TNFA gene responded poorly to quercetin treatment. Which may somewhat explain the differences seen in quercetin treatment studies.

Berberine

Berberine, which I have written about previously as an anti-cancer supplement, has been shown in some animal studies to cure prostatitis. 25

Berberine study

TypeChronic non-bacterial
SizeN/A, study performed in rats
TreatmentBerberine (Note: Epithelial (gut) degeneration observed in rats with CNBP. Histidine metabolism observed as an issue contributing to CNBP. Berberine may be protective against CNBP because it resets disruptions in metabolic pathways associated with the condition.)
Diet changesN/A
ResultsBerberine reduced gut inflammation and reset metabolic pathways, which helped with CNBP

There is a community of functional medicine doctors, the most vocal being Dr. Dach in South Florida, who believe that berberine heals leaky gut. Healing of leaky gut, presumably by wiping out pathogenic bacteria, closes the doorway for bad bacteria to enter the blood stream and infect the prostate.

Berberine is anti-fungal and antimicrobial. It fits nicely within our three rules for prostate health listed above.

As an added benefit, berberine has been proven as a prostate healthy supplement in the context of prostate cancer where it inhibited growth of prostate cancer cells. 26

Antihistamines – prostate allergy?

To further advance this theory, this study in the Journal of Urology found that taking H1 antagonists, like Zyrtec or Claritin, helped alleviate prostatitis. Why? Just as the quercetin did, the antihistamine reduced mast cell count, thus dialing back inflammation. Genetics wise, those with AOC1 “mutations” can be more prone to histamine issues.

H1 anti-histamines study

TypeAutoimmune, mast cell
SizeUnknown
TreatmentH1 anti-histamines, testing for mast cell and nerve growth factor secretions in prostatic secretions
Diet changesNone
ResultsMen with prostatitis showed increased mast cell tryptase and nerve growth factor in expressed prostatic secretions. Treatment of experimental autoimmune prostatitis with a mast cell stabilizer combined with a histamine 1 receptor antagonist resulted in a synergistic decrease in chronic pelvic pain

Consider these two quotes:

Men with chronic pelvic pain syndrome showed increased mast cell tryptase and nerve growth factor in expressed prostatic secretions.

Treatment of experimental autoimmune prostatitis with a mast cell stabilizer combined with a histamine 1 receptor antagonist resulted in a synergistic decrease in chronic pelvic pain.

Antihistamines are mast cell stabilizers, again fitting nicely within our three rules.

Plant based diet

Try a plant based diet.

This study out of the University of Washington in St. Louis found that people with more acidic urine had greater likelihood of developing repeated urinary tract infections, especially those driven by E. Coli. Now think back to the yeast study I quoted above. The authors there believe that E. Coli was the bridge that allowed Candida and other pathogenic yeast to infect the prostate. As we don’t currently know exactly what causes prostatitis, it’s not a reach to assume that urinary tract infections could be present in symptomatic men. The UTI could then spread to the prostate or bladder, causing chronic problems. In fact, the urinary tract has its own microbiome, and certain strains of probiotics may play a role in staving off infection.

Plant based study

TypeUrinary Tract Infection (UTI)
SizeUnknown
TreatmentAlkalize urine
Diet changesNone
ResultsThose with more acidic urine at greater risk for recurrent UTI. Microbiome health also a factor. Acidic urine feeds E. Coli

High animal protein diets cause greater acidity in the urine which allows for the invasion of bad bacteria, like E. Coli, that are linked to prostate inflammation.

If too much animal protein causes acidity that proliferates E. Coli, and eventually Candida, a plant based diet that makes the urine more alkaline could be a solution to prostate issues for some men. In fact, in addition to anti-fungal drugs, the yeast infection study gave subjects potassium citrate as a means for making the urine more alkaline, and the success rate there was over 80%. For more on how potassium citrate makes the urine more alkaline, see this University of Chicago article.

In this context, it is crucial to know your blood type. Although the blood type diet has largely been debunked, it contains one sound scientific principle, which is that blood type correlates to hydrochloric acid levels in the stomach. Type A, and A+ blood types have the lowest levels of hydrochloric acid with which to digest protein. A high protein diet in these individuals may leave undigested meat fermenting in the gut, which leads to pathogens, like E. Coli, that can cause problems for the urinary tract and prostate.27 28

Last, red meat in particular has been shown to be a problem for those with mast cell issues. If chronic inflammation, or some type of under the radar autoimmune condition, has caused a localized increase in mast cells or E. Coli infection, red meat and pork are definitely to be avoided.

Bottom line is that degraded gut health caused by too much animal protein will undoubtedly be a cause of poor prostate health for many men.

See also: Do plant based diets help us live longer?

Exercise

Exercise has been shown to increase NO and as I have written about previously, increase levels of butyrate, a short chain fatty acid that helps protect the lining of the gut.

In an Italian study, 231 sedentary men were put on an exercise regimen. Those who performed aerobic exercise saw greater relief than those who lifted weights.

Why?

Exercise study

TypeChronic non-bacterial
Size231 sedentary men
TreatmentAerobic exercise and weights for 18 weeks total
Diet changesNone
ResultsBoth groups saw improvement, with the cardio group showing greatest results

Well, this study also fits nicely within our paradigm. The increases in NO help with blood flow, and the cardio helps to repair the lining of the gut, degradation of which is a key factor contributing to the development of prostate infection.

Honorable mention

Additional studies that show promise treating prostatitis:

Additional studies

TreatmentMechanismTypeResults
NAC (R)Nrf2 / BiofilmRat studyPain and inflammation reduced
Fluoroquinolones antibiotics, saw palmetto, lactobacillus sporogens, and Arbutin (R)Reduction in UropathogensHumanGroup using antibiotics plus natural supplements showed greatest reduction in symptoms
Nettles, saw palmetto, curcumin and quercetin blend plus antibiotic prulifloxacin (R)Destroyed biofilmsHumanOne month after treatment, 89.6% of patients who had received prulifloxacin and natural blend did not report any symptoms related to CBP, whilst only 27% of patients who received antibiotic therapy alone were recurrence-free

Frequent sex

Ejaculation “drains” the prostate of stored fluid. When the prostate is becoming inflamed, or has a low grade infection, ejaculation gets rid of the bad stuff that is lingering and gives a “clean slate.” This is why you see some men with prostate issues get a “massage” which is a more thorough draining of the gland performed by a urologist, but those procedures come with risk of injury, so better to just have sex.

In fact, studies have shown that men who ejaculate more have lower incidence of prostate cancer.

Having said that, the issue of draining the prostate cuts two ways. In one sense, getting rid of stored fluid has shown promise for many men. However, let’s think back for a second to the discussion of zinc and Trichomonas vaginalis infection of the prostate, which seems to hinge on the zinc levels in that organ. You know what drains the prostate of zinc? You guessed it, ejaculating. So, it would seem, that at least for some men, excessive ejaculation, especially from masturbation since it offers very little in the way of, well, “benefits,” could be doing more harm than good. We do have studies that show that the prostate drained of zinc is more prone to infection.

Experiment: long term not ejaculating isn’t good for the prostate, but a short course, perhaps two weeks, of abstaining from what could be your favorite past time (while still engaging in sex) might do you some good, and give your prostate time to heal, if in fact it’s excessive masturbation that has been an irritant.

Note: some urologists would disagree that abstention from ejaculation improves zinc levels in the prostate. There are however, communities of men who swear by the practice, so I’ve offered the idea here as an experiment to consider if you’re facing a chronic case of inflammation you can’t seem to shake. See also this Reddit thread.

Top supplements for prostatitis

SupplementStudyDurationResultNotes
QuercetinQuercetin in men with category III chronic prostatitis (R)1 month67% of quercetin takers had improvement of at least 25%Quercetin and bromelain found to be effective at treating prostatitis
BerberineBerberine Ameliorates Nonbacterial Prostatitis via Multi-Target Metabolic Network Regulation (R)One weekReduced gut inflammation and reset metabolic pathways in ratsBerberine may be protective against CNBP
AntihistaminesRole of mast cells in male chronic pelvic pain (R)UnknownTaking H1 antagonists, like Zyrtec or Claritin, helped alleviate prostatitisMast cells "may be potential targets for therapeutic intervention in men with chronic prostatitis/chronic pelvic pain syndrome"
NACN-acetylcysteine Ameliorates Prostatitis via miR-141 Regulating Keap1/Nrf2 Signaling (R)UnknownNAC relieved the carrageenan-induced CNP in ratsmiR-141 inhibitor could reduce the effect of NAC on prostatitis
Saw palmetto, lactobacillus sporogens, and Arbutin with fluoroquinolones antibioticsChronic bacterial prostatitis: efficacy of short-lasting antibiotic therapy with prulifloxacin in association with saw palmetto extract, lactobacillus sporogens and arbutin (R)2 monthsAntibiotic group combined with natural supplements saw most reduction in symptomsSerenoa repens, lactobacillus sporogens and arbutin show better control and recurrence rate than antibiotics alone
Nettles, saw palmetto, curcumin, and quercetin blend with antibiotic prulifloxacinSerenoa repens associated with Urtica dioica and curcumin and quercitin extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients (R)14 daysNearly 90% of patients who took prulifloxacin with natural treatments had reduced symptoms; after 6 months, all patients in this group had no recurrence of the diseaseThe association of S. repens, U. dioica, quercitin and curcumin extracts is able to improve the clinical efficacy of prulifloxacin in patients affected by CBP

Closing thoughts

Lab testing is the first step if you suspect you have an issue with your prostate, or if you’re interested in taking a proactive role in keeping it healthy.

If you’re 40 or younger and have low PSA, it’s likely your prostate issue is fungal.

If PSA is elevated, more traditional paths are worth looking into, possibly even antibiotics, especially when they are paired with the nutrients listed above. But don’t rely on a pill of any kind. The goal is to change lifestyle factors that are contributing to a low grade infection. On this path, understanding blood type is important as it may determine the amount of animal protein you can handle.

Per the Washington University study, take a look at the acidity of your urine. If it’s highly acidic, you may have the perfect recipe for E. Coli colonization. Transitioning to a vegetarian diet could be what your body needs to alkalize your urinary tract which will have the effect of making it harder for pathogenic bacteria to thrive. You may also want to consider potassium citrate to accelerate this goal, especially if you find yourself taking biofilm disrupting supplements, such as NAC, that are highly acidic.

But don’t stop with antioxidants. Assuming you find high-quality strains that work for you, using probiotics will help to crowd out the bad guys. Strains I would look at: B. Longum, L. Plantarum, soil-based probiotics such as Prescript Assist, and even non-pathogenic yeast strains like S. Boulardii.

Last, gut health must be a focus for all men, especially in these circumstances. Embarking on a protocol to heal the gut could be just what the doctor ordered to shut down issues with leaky gut and the autoimmunity that goes with it.

John O'Connor

John O'Connor is the founder of Gene Food, a nutrigenomic startup helping people all over the world personalize nutrition. John is the host of the Gene Food Podcast and a health coach trained at Duke's Integrative Medicine Program. Read his full bio here.

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54 Comments

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  1. Chris says:

    this is the first online search I’ve found that lists this condition clearly and informatively.
    thanks.

  2. Daniel says:

    Hello John.

    I was diagnosed with acute prostatitis in 12/05/2018. I’m 27 years old, about 20 quilos overweight (idk if it matters, all that weight was gained last year) and live in Brazil.

    I did 10 days of levofloxacin, started feeling pain in the achilles tendon on my left foot, which caused my doctor to order me to immediately stop and start taking bactrim (he seemed very serious about this side effect, so much so that he told me to meet him in a sunday to get the bactrim prescription, so I wouldn’t have to go a day without antibiotics until monday.). Took 10 days of bactrim to a total of 20 days of antibiotics.

    Symptons only started getting mildly better after day 8 of levofloxacin and a dose of tramal. Only in the last 3 days of bactrim, e.g., last 3 days of the 20 day cycle, did I start feeling considerably better, the symptoms became very faint and I felt my life was getting back on track.

    On the 28th of december, 3 days after taking my last bactrim pill, the pain and burning sensation came back very strong, and ever since it has come and gone, it oscilates between mildly annoying to very strong, when it’s very strong I can’t sleep or concentrate on my studies (I’m a graduate student).

    After the symptoms came back my doctor told me to do some tests, and all these came negative for bacteria, all tests done 10 days after finishing antibiotics: sperm culture, urine culture, gram urine (idk what it is), and all kinds of STDs you can imagine, herpes, chlamydia, hiv, etc etc, trichosoma vaginalis and so on. Everything came negative, I don’t even have herpes. To be honest I’m unsurprised as I’ve only had sex with 4 different women all my life, one of whom is my girlfriend for 2 years now, and I’ve never had sex without condoms (even with my gf), the only sexual experience I had without condoms were oral sex from my gf (multiple times) and one single blowjob from this girl I hooked up with in march, 2016, a one night stand.

    There is only one test with results pending: fungal culture, apparently it can take up to a month. But the urologist said he’s 100% sure it will come negative.

    Both my urologist and my endocrinologist said that the symptons will likely disappear gradually within the next few months and that I should try to carry on with my life, exercise myself etc, I hope that is the case, but I was wondering if you have any opinions on my situation?

    My total PSA came 0.56 and free PSA 0.13, for a ratio of 0.23

    Do you think my doctor could be wrong and this could be fungal after all?

    It should be said that the unbearable blinding pain I felt at the beginning of the antibiotic cycle has not come back, I do feel intense pain sometimes but that was quite a different ballpark, I couldn’t even stand still or walk properly, so it’s hard to say that the antibiotics didnt do anything to help.. so there must have been some bacteria at the beginning, right?

    • Daniel says:

      Forgot to mention the exact area where I feel pain, it’s always in the perineum region, between scrotum and anus, and many times it goes to the anus itself, and tip of the penis, always accompanied by a hot burning sensation, nowadays it’s more burning sensation than pain itself, although they often are kinda the same. It also irradiates to my legs sometimes.

      • Johnny says:

        Just a shot in the dark, but I was told my a Uerologist just this past Tuesday that I hold tension in my Pelvic Floor. She insisted I had no real issue except that. So, I’m on this journey to relax my perineum. I do feel relief when resting, although it can ache in my testes and lower back sitting. I feel my best during the first hour of waking.. before the stress of the day and I’ve been on my feet extensively. Hopefully this helps you. I have found some relief from yoga, stretches, and meditation. I’m also going to cut out the meat and supplement with what John recommended in the article. I have been married for 9 years.. no infections found. So, this has really thrown me for a loop. Cheers, Johnny

  3. Mo says:

    Hello,
    Thanks a lot for this great article.
    I have recurrent hemospermia every 3 or 4 years lasting for few months.
    I had all kind of blood, urine and ultrasound tests and examinations, the different doctors I went to have never find any explanation to my condition.
    I am trying to understand my conditions. After reading your research I am starting to thing that I have an undetected prostitis causing an inflammation and the blood in semen.
    I will try the anti fungal medicine and start the quercetin for one month. hope it will work.
    Thanks again.

  4. Bill says:

    Thank you so much for taking the time to write this article. It is the best i have found and is so incredibly helpful.

    I am a 39 year old male in excellent health, very physically active. I have developed (presumably) bacterial or fungal prostatitis after getting urethritis and then taking a sequence of ineffective antibiotics, (Suprax –> Zithromycin –>Doxycycline –>Metronidazole (Flagil)–> Moxifloxacin –>Ciprofloxacin)

    Right around the metronidazole stage, the symptoms moved from urethritis to prostatitis, as evidenced by discomfort in my pereneum which had not been present before. Also, often a burning sensation in my prostate after ejaculation. Two different cycles of Ciprofloxacin (14 day and 28 day) alleviated the symptoms temporarily, but within a few days the urethritis symptoms were back and worse than ever. In sum, it seems like I have inadvertantly given myself pretty bad prosthetitis.

    Adding insult to injury, after taking a total of 6 weeks of the ciprofloxacin (a fluorquinalone), i can feel the effects as tingling in my fingers and toes and stiffness/joint pain in my feet and knees. I sure wish i had done my homework before taking the Cipro for so long! I am not sure if these symptoms will ever go away, but i am disappointed that a small thing has created potentially life-long physical issues!

    Anyway, I will try to prostate massage and ejaculation along with probiotics and some of the other ideas here. Hoping for the best! Any advice is welcome!

  5. Noah says:

    Thank your for this great info, both in the article and the comments. I’m 36 years old and been suffering from flare-ups of CP/CPPS for 5 years. Urologists find no traces of bacteria, but put me on antibiotics for 6 weeks anyway, which had no effect on my condition. For a year I was able to control flare ups with pygeum and oregano oil supplements. Also changed diet to remove gluten, refined sugar, dairy, corn and soy, and that seemed to help as well (*The Immune system Recovery plan, by Dr Susan Blum is a phenomenal book on autoimmune conditions and natural remedies). Recently had another massive flare up (first in almost 2 years – admittedly I lapsed from my strict diet while on vacation which I suspect was a factor). A few weeks ago I thought I’d try some other options – Quercetin, garlic and Horse Chestnut. Recovery from recent flare up has been slow.

  6. Will says:

    Finally my symptoms of a chronic prostatitis are gone.

    Went to a urologist when I had symptoms of a prostatitis. Got the results of research that it was non bacterial and there was no cure. Was told to get used to live with flare ups every now and then. After some serious high fever flare ups I was determined to find a way to get better.

    The inflammation was affecting the sciatica nerves as well and lost my sex drive.

    My partner found aBrazilian doctor advising to take N-acetylcysteine for prostatitis which is a bio available amino acid stimulating your system making natural antioxidants cleaning up, among others the lungs and the prostate gland. This man is Fantastic. He also advised to take 2x a day an Iodine solution, lugol. This cures all of the inflammation taking place in your body. Have been taking this for 3 months and had not a single flare up, even better I got my mojo back. Great stuff which has been available since ages. Cheap and effective. I hope you all find health again.

  7. ls1 says:

    Thank you for your collaborated study and putting this document together. Since the urologists do not quite understand the underlying causes of this horrible condition, this give some guidance and light. I did not see any information, however on how garlic may work for this chronic ailment. I did, however find information here. Please look into this and add if you see it as appropriate.

    https://www.ncbi.nlm.nih.gov/pubmed/19375896

  8. Z. says:

    Hey John O’ Connor, my name is Zach I’ve been suffering with awful infection. Doctors can’t ever find anything wrong. I’m 24 years old, and I live in Austin, TX same as you . If you know anyone out here I should go to u would really appreciate it. I just want to be happy and healthy again!

  9. Rohit says:

    Dear Mr. O’conner,
    I have been facing chronic prostatitis for the last 4 months.
    My symptoms
    Burning in urinary track. No burnin while urinating.
    Lower abdominal pain some time
    very very itch skin (specially in feets)
    Muscular Pain in Buttocks

    I have taken Doxycyline for 15 days initially then Levoflaxocin for more than one month. this didn’t help much. Initially all my culture reports (urine, semen) are negative.
    Currently my
    PSA level = 0.50
    ESR=3
    Urine routine= No Becteria, Pus cells 3-4, epthelial cells 3-4
    Urine Culture= Insignificant growth of E.Coli

    Initially i was dignosed with CPPS now there is finding of E.Coli in Urine Culture.
    I am not getting proper medical advice in Delhi (India).

    Would you please suggest me an action to be taken to fully cure it. I would be grateful to you.

    regards

    • bradford holt says:

      I took so many antibiotics and prostate kept getting worse, peeing 80 times a day 1/2 ounce at a time. They wanted to remove prostate. Idiots. Found out it was fungal infection caused by antibiotics. Went to doctor in manila and he milked the prostate every day for ten days. The first 6 days I was screaming it hurt so bad. It only lasted 5 minutes. on tenth day back to normal. milked out the infection. I get a flair up usually once a year and have girl friend massage and it goes away. And to think doctors wanted to remove and ruin my life. Dumbbells

  10. Omer says:

    Dear Mr. O’conner,
    I think it’s such a good thing that you placed this well prepared and most up to date best rendered information. With repetetive flare ups containing blood in urine and semen and keep hearing “no bacteria, no cure, but stick to antibiotics as it won’t help, but yet so we stay with the protocol!” from different urologists in different countries. You feel so alone and so hopeless and an artical like yours gives the hope most of all so I can throw back at least an educated piece of stone to that beast lurking in pitch black and biting when ever.
    Thank you man, god bless…

  11. Lauri says:

    What laboratory tests would be recommended for chronic prostatis for a full picture? Many doctors in my area have been somewhat useless in treating this and have not taken the possibility of dietary help seriously, so now I’m thinking of taking a laboratory panel myself. I had and still have stomach issues before this prostatis began.

  12. Derick says:

    Thank you so much John for this article! I have struggled with symptoms or chronice prostatitis for the last 10 years, along with other gastrointestinal “issues”, Been eating red meat pretty heavy for the last year due to being diagnosed with b12 deficiency, it also seems as though my prostate symptoms and digestive issues have gotten worse along with the heavier consumption of red meat, last Monday I had made an app with a urologist to begin the journey to attempt to fix the urinary issues and out of sheer desperation I stumbled across this article through a google search “natural cures for prostate infection”, well it resonated very well with me on the red meat/leaky gut connection, so I stopped that day at a vitamin shoppe and bought Berberine, Arginine for the NO, and also Quercetin w/Bromelain, since then my symptoms have been virtually non existent! Ive also all but cut out the red meat give or take a steak or 2. But still yet so far so good. Thanks again John!

    • Knox says:

      Hi Derick I am curious if your prostate symptoms have gone away. Are you are still taking the Quercetin? How long did it take for your symptoms to resolve? I’ve been having this weird feeling in the scrotum area and my testicles, mainly my left testicle; I’m not sure if it’s actually my testicle or something near my left testicle that’s giving that weird feeling. I have also been urinating more than usual. That being said I’ve been drinking a ton of water. Went to the doctor and had a testicle exam for lumps as well as had blood work and STD check which everything was perfect. Before my blood work and STD results came back, they gave me a round of Doxycycline to kill any infection. Any info would be appreciated.
      thank you!

  13. Michael says:

    In my case, i am totally sure that bacterial biofilms is the Key. If we can’t disruptive them, so taking antibiotics is totally useless and dangerous.
    I Hope one day New generation of antibiotics will appear to break up biofilms.

    • Dave says:

      I bought a tool to massage my own prostate off the internet.
      I used that tool to massage my prostate and I believe break up the biofilm and get fresh blood to my prostate.
      I did that about 15 times, ejaculation after each time and I don’t have any symptoms anymore and that was over 5 years ago.
      I think they website was high island health or something like that.

      • Bill says:

        Wow Dave,

        This sounds like a promising course of action, but I am not sure i can handle self-prostate massage, which requires anal insertion of the massage device. Lots of weird porn links related to this, but do you have any practical advice for a guy who really doesn’t feel comfortable with anal insertion?

        Cheers,
        Bill

  14. Jasper says:

    Excellent Article ! – have been researching almost everything on Prostatitis for several years – had Prostatitis in 2012 – took the usual doctor prescribed drugs – Levaquin – stopped after 7 days – rear calves started hurting when running and then of course I research Levaquin and stopped immediately, then did Bactrim, Cefdinir – basically anything the doc felt might work without any real thought behind root problem. Decided after my own extensive research on every chat/forum board that exists to do Quercetin and Graminex Grass pollen and in maybe 3 – 5 months it diminished to almost faint level and then by itself over couple more months was essentially completely gone. Shoot forward now to 2018 and rode a bike for first time in years for an extended time and it came back but not at level of original so now back on Quercetin/Bromelain (Now Foods) and Swanson Graminex Flower pollen – I also throw in ACV in tea and Allicinmax which is natural garlic derived anitfungal and antibacterial in one. Not sure of which one makes the difference but the full group seems to diminish prostatitis over time. It is too bad doctors don’t think of these alternatives and risk people taking flouraquinalones that can ruin your life.

    • omer says:

      Hi Jasper,
      Had my first episode in 2015. At the time I was riding extensively in Toronto. By then,I thought it was all cured with the antibiotics, but stopped riding just in case. I was healed completely, or so I thought. Rode back again for the first time in last summer. Darn thing was back in days, first with a painfull substance ever! Three episodes since last summer and counting.
      I am convinced that there is a certain correlation with riding and prostatitis. Too bad people don’t know or warned abouth by cycle sellers or clubs I don’t think!
      Rgrds.

      • Jasper says:

        Hi Omer,
        Yes I always got numb as a young guy when riding but a quick shake/massage brought blood back and numbness went away but Yes biking does cause this – called cyclist syndrome by others. Yes the best bike seats are from RIDO – a UK company that keep butt up a half inch or so in order to keep perineal area off seat. But for me never riding a bike, horse, motorcycle or jet ski ever again – pain is worse than fun from those – I can walk 🙂 or drive car instead.

  15. Greg says:

    Thank you for this John. I believe I have Cpps but my doctor seems utterly clueless. Your article gives me hope that 1 there is a way to manage it and 2 I’m not going mad.
    Also of interest to share with guys suffering is this article below on the benefits of meditation in managing the condition.
    Again, thank you!

    Prostatitis: ‘How I meditated away chronic pelvic pain’
    BBC News US. The BBC’s Henri Astier explains how mindfulness helped him beat the curse of chronic pelvic pain.

  16. Sanwar says:

    This is a great article I have red so far. This article discuss real scenario of infected prostatitis.
    Many thanks to author. I will help meal lot and for future knowledge.

      • Roy says:

        So what would be some options of being the root cause for chronic non bacterial prostatitis? I’ve had bouts of it every 6months to a year, antibiotics and steroids have always helped me get symptoms back to normal and hardly noticeable (even though no infection shows up in urine), but caffeine and stimulants combined with sexual activity will cause symptoms to flare up.

        • I’m not sure those words “non bacterial” have much meaning as the physicians that use them add this condition to a long list of chronic conditions that there isn’t a “cure” for. I wrote this post to highlight the best data – one study I keep coming back to, Central European Journal of Urology, talks about E. Coli as the “bridge” that brings Candida to the region, which is why they put subjects on potassium citrate in addition to anti-fungals, because it alkalizes the urine. E. Coli can’t survive in alkaline urine per the Wash U. study. So, one option I highlight in the post is an acid load via excess animal protein that allows for both the fungal and bacterial infection to take place. Against the backdrop of all this is a response from the immune system, which is where the mast cell stuff comes in.

  17. Jake says:

    Hi John,

    Really interesting article, thanks.

    Been having Chronic Prostatitis for over 9 months now even though at the start I wasn’t aware it was the prostate (didn’t have any prostate pain), just thought it was reoccurring virus.
    After semen exams I have had three bouts of antobiotics with different bacteria showing up each time. Like many, I’m feeling pretty desperate.
    I tried oregano oil drops for 2 weeks which helped significantly, but then trying thereafter stopped working.
    My symtoms are racey heart, genital discomfort, insomnia, chills, ED. I even sneeze when I can feel it coming back on after antibiotics (that for the most part don’t really help). No Candida present.
    Would it be advisable to try a bout of antihistamines? (If so which and how long for). I had read that there can be side effects though and that could make things worse??!

    Looking forward to your reply, thanks.

    • Jake, based on the best studies we have, if you’re a younger man (40 or younger) you want to get your PSA labs done. If the PSA numbers are low, the Central European Journal of Urology study would indicate a fungal issue. Oregano is an anti-fungal. And just because antibiotics help temporarily, that doesn’t mean the issue is bacterial. The CJU study speculates that E. Coli is the “bridge” that allows fungal pathogens to enter that region of the body in the first place, so under that theory, the microbes work in tandem. If PSA is low, and based on the repeated courses of antibiotics, it’s worth keeping an eye on fungal. I can’t advise any course of action, that is for your doctor, but you could certainly discuss with him or her the possibility of an H1 antagonist as those don’t cause the side effects I think you’re concerned about. Fungal pathogens cause mast cells to degranulate.

  18. Tyler says:

    One of the better articles I have read on this subject. Thank you for your time on this.

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