Prostasol: a risk for blood clots?

A report has just been published regarding two recent cases of venous thromboembolism in men self-medicating with “Dr. Donsbach’s Prostasol.” Patients who are using or who are considering using this product should be aware of this possibility, as should their physicians. Any patient who is taking this product as a complementary or alternative medicine would be wise to discuss this with his doctor.

About 25 to 33 percent of patients diagnosed with prostate cancer report that they use complementary and alternative medicines. Many of these patients take a supplement called “Dr. Donsbach’s Prostasol.” According to Clement and Bubley, two patients with prostate cancer who were taking Dr. Donsbach’s Prostasol developed venous thromboembolic events while taking this supplement, in the absence of other obvious risk factors.

Their publication reviews the two cases and the time-line for the development of the venous thromboembolic events and use of Dr. Donsbach’s Prostasol. They compare Prostasol with PC-SPES, a similar supplement that was associated with thrombosis and was ultimately taken off the market because of patient safety concerns.

Prostasol contains phytoestrogens that could result in the suppression of testosterone and the predisposition to thrombosis. Both the patients under discussion had suppression of their testosterone to castrate levels with an associated decrease in PSA levels at the time of their thrombotic event.

According to Clement and Bubley, “These cases are suggestive of an association between Prostasol use and venous thromboembolic events. Physicians should be aware of the use of this agent in their patients, although it is not known whether it would be appropriate to prescribe prophylactic low-dose warfarin therapy.”

7 Responses

  1. A prior Danish report advises that analysis of Prostasol determined the presence of diethystilbestrol (DES) and prohibits its distribution.

    Proponents of Prostasol argue that Nattokinase accompanying Prostasol will protect against deep-vein thrombosis (DVT), yet, if such protection is necessary, the manufacturers of Prostasol are encouraging its use as a herbal treatment and not acknowledging the presence of DES and not cautioning against the possibility of DVT.

    Personally, I would avoid the use of Prostasol and certainly not recommend patients consider adding this product to their treatment considerations.

  2. I have been managing my PCa since diagnosis in March 1996 with complementary medicine, and after a spike in my PSA I commenced Prostasol intake and in May 2008 my PSA dropped to 0.8 ng/ml from a January 2008 level of 15.9 ng/ml. On August 21, 2008 I suffered a mini-stroke with 4 days in a Sydney hospital. They ran other tests (my PSA was then 4.2 ng/ml) and also found a perforation between the left and right ventricles. On December 1, 2008 an amplatzer implant operation successfully sealed the “hole.”

    My unresolved question is, “Was this clot formed by the heart defect or the Prostasol?” My PSA level is now back to 8.3 percent. Will Nattokinase supplements with 100 mg aspirin daily together with Prostasol be a smart or dumb option? Regards, John R.

  3. Dear John:

    I doubt if anyone can actually answer your unresolved question in a definitive manner. However, given the known association between Prostasol therapy and blood clots in men using this product, I think one has to make the decision that Prostasol was likely to be either the cause or a contributing factor thereto, and that restarting Prostasol, regardless of any other form of adjuvant therapy, is simply a dangerous clinical strategy for you. We also believe that this is an occasion when you need to ask your “new found” cardiologist this question and listen to his/her advice. Cardiac arrest is much more likely to kill you than prostate cancer! In case (s)he hasn’t previously come across the study referred to in the original report above, I suggest you give your cardiologist a copy of the abstract!

  4. Hi. While Prostasol will undoubtedly increase the risk of venous thromboembolic disease, a stroke or mini-stroke is either an arterial blockage or a bleed that occurs on the arterial side — which is quite different from a venous problem. I am not aware that there is any evidence that Prostasol is associated with this issue. The hole in the heart may be more relevant. You could check with your cardiologist whether the incidence of CVA or strokes was altered in females taking estrogen supplementation since there are large studies on estrogen supplementation and that would be the closest you could get. Whatever you do, an aspirin a day sounds like a good thing.

  5. John R.:

    Have your serum “fibrinogen” level checked via a blood test. Fibrinogen is a fibrous material in the blood (like a gauze pad) and is often elevated by prostate cancer. Excess fibrinogen can cause clots, strokes, and even rapid atheroscerosis (in my case). It has been referred to as “sticky blood disorder.” … Healthy fibrinogen levels should be 150-300 mg/dL (not 400). Fibrinogen levels can be controlled with bromelain (>2400 GDU) and tumeric 2x per day. It has been suggested that cancer cells may use fibrinogen to travel through the body.

  6. I have taken PC-SPES and Prostasol for 10 years from l999 to 2009 without apparent problems. I had RP in l994 with follow-up radiation. Cancer had escaped the glad but hadn’t reached the lymph nodes. Considered early advanced with a Gleason score of 8.

    I have maintained a zero PSA reading ever since. However, after reading that Prostasol invites blood clots, I switched to 6-month shots of Eligard (leupprolide acetate) on the advice of my primary. I have so far had two 6-month shots and am about to get my third. My PSA still at zero, but my insurance (Medicare/Tricare) may balk at the obscene price — $4580 the first time, $3400 something the second.

    If so, I may go back to Prostasol. What concerns me is that the stuff is made in Mexico, and that the people promoting it like Dr. Donsbach and Chad Larson have rap sheets. Also, Pure Health Solutions claim it isn’t made anymore but other websites offer it — Seacoast, for instance. Also, I have a 3/09 form letter from Donsbach disclaiming responsibility for the product.

    I take blood pressure medicine but have never had a stroke or heart attack and am in good shape for an 81-year-old. But it seems to me I’m left swinging in the wind about the product’s integrity. I await comments/suggestions.

    John W. Otis

  7. I just managed a patient with DVT that occurred 2 weeks after he started using Prostasol. No other risk factors for DVT were identified in the preliminary work-up. [Editorial addendum: DVT = deep vein thrombosis]

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