I forgot I ran across this a 2 years ago as many with PCa diagnosis are very interested in Sulforaphane due to a lot of excitement from a few studies a few years ago. (This fueled an explosion of supplements on Amazon.)
This however is one of the more expensive supplements and my jury is still out on whether it's basically a waste of money at $30-$60 a month depending on brand and dosage.
Essentially, the PSA lowering effect, in my opinion, is due Sulforaphane reducing Testosterone and DHT levels. Since there are no long-term studies, the big question this leaves in my mind is are people taking these supplements unknowingly just started a mild form of ADT prematurely and reducing the time for the cancer to start the adaptation to become castration free thereby lowering longevity of "real' ADT later?
This reminds me of the debacle over PC-SPES that was a combination of supplements that got a lot of hype only to find it also contained the drug was diethylstilbestrol (also called diethylstilboestrol). Diethylstilbestrol is a hormone therapy.
Interestingly my primary treatment Urologist, Dr. Daniel Lin at University of Washington, Fred Hutchinson Cancer Institute, did a Sulforphane Study years ago I forgot to ask him about. The results were published (probably as required to keep getting the grant money) but there was never anything published in PubMed by him. But if you look at the results, you see large changes in Testosterone.
To me, you might as well be taking low-dose Finasteride and save some money versus buying BROQ. LOL.
Not to say Sulforphane may have other benefits. But if I had to put my money on the cause of the PSA doubling time decrease of Sulforphane, I'd bet on the lower T effect.
I think the main risk here is that if you were in the early biochemical recurrence phase, Sulforaphane supplements could mask your actual PSA which might make you delay salvage RT longer than you should. Or one could argue, slowing PSA rise in general is a good thing no matter what stage you are at. Which will bring me to another topic later regarding early Dutasteride/Finasteride use.
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In a published randomized clinical trial in biochemically recurrent men of sulforaphane vs placebo, the researchers found that "the serum testosterone levels did not differ between the sulforaphane- and placebo-treated men throughout the trial..."
It was a small trial (n=78, 6 months, bioavailable cold press, biochemically recurrent after RP), and the population was different than the smaller, briefer trial in Seattle (n=45, 5 weeks, purified extract - less bioavailable, low/intermediate risk prior to treatment).
The mechanism of action remains uncertain, but several have been investigated in lab studies. None thinks testosterone inhibition is the mechanism:
Until we know more, it should be avoided while using radiation or immunotherapies, like all supplements.
I think it is not very bioavailable without the enzyme myrosinase, so if one is taking an extract, it should be cold-pressed and raw broccoli or broccoli sprouts should be eaten at the same time.
Good points. The study showing hair regrowth benefits due to reduced T and DHT was on mice and I imagine the equivalent dosage as a supplement in humans would be impractical for something that has modest effect on PSA dynamics.
From a larger perspective it sure is a supplement maker's dream as (1) prostate cancer is very prevalent and (2) there's so much out there about the anti-cancer potential of cruciferous vegetables. A lot of these supplement manufacturers commission a trial to use as ammunition in marketing their products.
Of all the links you listed only the study with conflict of interested claimed no change in Testosterone.
"N. Mottet has received a commercial research grant from and is a consultant/advisory board member of Nutrinov" Nutrinov makes Prostaphane.
So we have a study by a supplement maker claiming no change. A small study not commercially commissioned showing a clear decrease, and study on mice showing a clear decrease in both T and DHT. And none of the other links you provided appear to have even bothered to test T and DHT levels.
The vast majority of positive evidence is not related to human studies. And even Dr. Jed Fahey in a more recent interview since the prostaphane human study came out is highly skeptical about the effectiveness of any sulforphane supplement on the market being able to deliver enough bioavailable sulforphane to really have a very significant, long-term, durable positive effect. This article sums it up nicely:
"There is limited knowledge on the appropriate dosage of sulforaphane that can be administered to humans in a clinical setting. For example, there is a disconnect between doses administered in animal models and allowable doses in humans. Doses ranging from 5 to 100 mg/kg of sulforaphane reduce tumors in animal models [5,19]. For a 70 kg human, this translates to 350–7000 mg/kg, which is significantly above the upper threshold of tolerable doses. As reported by a recent study, administration of low doses of sulforaphane to human subjects shows no positive result"
I know Jarrows Broccomax is standardized to 3.5% Sulforphane Glucosinilate (SGS). So 350mg SGS would require a 10,000 mg dose. LOL.
The more I read about sulforaphane the more the supps are looking like snake oil.
"The study showing hair regrowth benefits due to reduced T and DHT was on mice " I have no idea what makes hair grow on mice, do you? I think female mice are as hairy as male mice, so your conclusions are unwarranted. I think your suspicions about the influence of the manufacturer are unwarranted too. The researchers seem to have good credentials.
The studies didn't measure T and DHT levels because the suspicion that sulforaphane affects that is only in your imagination - the best evidence is that it has no effect on T levels.
The link you gave says the opposite of what you believe. Did you read it? It says,"Based on the evidence presented in this review, we conclude that sulforaphane is a promising chemopreventive phytocompound capable of preventing the progression of prostate cancer."
Only clinical trials matter for patients. There have been no large clinical trials yet, and patients are well-advised to be cautious. But since it is the only supplement that has any efficacy in an RCT, it is safe, and patients want to be able to feel they are in control by taking a supplement, it is the only supplement I'd recommend.
The results from the small study at UW must be an anomaly then regarding significantly lower T levels. Not a shocker considering the low enrollment but the difference between the treatment and placebo group was very consistent. But as you point out there is no evidence in any other human trials showing a decrease in T or DHT.
My point of the quote from the study I referenced was about the dosage not the mechanism of action. But I get your point.
There does seem to be significant evidence that at least in vitro, sulforaphane reduces DHT in a dose dependent manner but I now believe that there aren't any practically high enough dosages (so far) achieved in humans to reliably produce that effect. The DHT lowering possibility is becoming of more interest in the area of hair loss though.
"But based on the current evidence, it’s very possible that sulforaphane may lower DHT levels by activating the 3α-HSD enzyme in humans. How strong of an effect it has is yet to be determined. Based on the listed studies, it appears there is at least some effect."
I note this author of this semi-scientific article uses the term "very possible" and "some effect" - very wishy washy terms. I think there is a lot of author bias play here regarding searching for a new hair loss supplement.
Dr. Fahey is a nutritional biochemist in whose laboratory plants are being developed as chemoprotective agents. His current work at Johns Hopkins addresses the induction by phytochemicals, of detoxication enzymes in mammalian systems. This work draws on elements of natural product chemistry, enzymology, nutritional epidemiology and clinical research in order to develop nutritional strategies for cancer chemoprotection in humans. Most of these studies have dealt with the glucosinolates and isothiocyanates that are found primarily in cruciferous vegetables. His work led to the discovery that broccoli sprouts are an exceptionally rich source of inducers of the enzymes that detoxify carcinogens, and to the development of techniques for their detection and for assessing their metabolism in humans. The most recent development has been the determination that one of these inducers (sulforaphane), has potent antibiotic activity against Helicobacter pylori, a causative agent of peptic ulcer disease and stomach cancer.
I have none readily available but it is a recommendation I remember seeing from more than one source. I think it has something to so with cancer using glycolysis so insulin resistance and blood sugar levels play into that. But this would really be for another thread.
I did a10day prolong fast droped psa levels from 25 to 15 . but the mistake I made was not following up with intermitent fasting so next test about 1mo latter right back to 25. Even with a very strict diet. Right now I need calories it's cold , losing muscle , and don't want anymore weight loss.
I steam Brussels sprouts, kale, and broccoli. Add ground mustard seed, olive oil, and balsamic vinegar, and call it a day! Plenty of sulforaphane with these foods, I believe.
And why would anyone pay $30 tp $60/month for a supplement that is at best only part of what cruciferous vegetables offer, when they can simply have a cup of cabbage or broccoli with dinner a few times a week for a few pennies a serve?
I've been doing so for the past 2 years and I agree. Here is one tip I would like to pass on. When the sprouts are ready to be eaten (about a week after you've placed the seeds in water), if you heat up water up to 160 Fahrenheit and you put your sprouts in that water for 10 minutes before eating them, apparently their potency is increased several folds. I began following that approach a few months back. Can't say if it helps but since there was no harm in doing so...
You can mitigate the cost by growing and eating broccoli sprouts. They are simple to grow in a few days but are an acquired taste unless added to a salad or sandwich.
Best to just grow and eat radish and broc sprouts both high in sulforaphane. Best bang for the buck for my cancer is Artemisinin ( herb ) 1wk on -1wk off- repeat. For reducing glucose and maybe cancer I take bitter melon . As for my hornymones I take Vitex . Thanks for your post
Interesting studies but I found that the controlled randomized studies I looked at included men with a TET (testosterone) median near 4.0 ng/dL (range 1.91 - 7.0)...this is practically zero. With these men their PSA slope increase was reduced some 86%...this means that its not being done by reducing TET; impossible. There is another mechanism going on. I believe that Sulforaphane works in reducing the slope increase of PSA, meaning that it must be controlling the growth of PCa (prostate cancer). Here is the study that I followed and there are many more that replicate its findings.
I take supplements made in the UK which are Liposomine stabalized...these are reasonably priced. The original Sulforaphane supplements come from France and they are the best, but the price is triple. I have checked with a natural products chemists (my Brother) who makes supplements commercially and he confirms that Liposomal delivery is a proven way to get unstable molecules, like Sulforaphane, into capsules and keep the chemical active until its past your gastric juices...here is my other post.
Short and skinny; if you have PCa you need to 1) grow and drink via smoothie 100 grams of sprouts daily and 2) consider hitting the beast with a supplement each day to boot...the ONE-TWO punch. Rick
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