A food-derived seed preparation whose plant sterols act on the same pathway as prostate and hair-loss drugs, but far more weakly. The clearest signal is pattern hair loss, with modest regrowth over six months. Urinary findings conflict: ground whole seed outperformed placebo, the concentrated extract did not. Digestive upset is common; seed allergy, though uncommon, is the serious concern. (Full Review)
| Marker | Target | Why |
|---|---|---|
| International Prostate Symptom Score | 0–7 points; fall of ≥3 defines response | Primary endpoint in every urinary trial |
| Overactive Bladder Symptom Score | ≤2 points | Tracks urgency and leakage when not prostate-driven |
| Post-void residual urine volume | <50 mL | Separates symptom relief from resolved obstruction |
| Maximum urinary flow rate | >15 mL/s | Objective obstruction measure symptom scores miss |
| Prostate-specific antigen | <1.0 ng/mL under age 60; annual rise <0.35 ng/mL/year | Detects prostate pathology that symptom relief could mask |
| High-density lipoprotein cholesterol | >60 mg/dL (>1.55 mmol/L) | The one lipid fraction that moved in the trials |
| Home blood pressure | <120/75 mmHg | Captures the small hypotensive and additive drug effect |
| Serum total testosterone | 500–800 ng/dL | Confirms no androgen suppression, as trials indicate |
| Scalp hair density by trichoscopy | No established target; track change from own baseline | The only objective, non-observer-rated hair endpoint |
Cadence: Symptom questionnaire at 4 and 8 weeks, formal reassessment at 12 weeks, then every 6 months; lipids and blood pressure at 12 weeks, then annually; hair photographs at 12 and 24 weeks.