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Saw Palmetto
Description:
Saw palmetto is a small, tough, spiny palm tree that grows in the southern US. This robust tree can live up to the hearty age of 700-years-old. Saw palmetto trees contain dark berries that have medicinal properties of particular interest to men.
A number of scientific studies have verified that saw palmetto can relieve some of the symptoms associated with prostate problems. One-third of men over the age of 50 have benign prostatic hyperplasia - an enlarged prostate – which can obstruct the urethra and cause frequent, and sometimes painful urination. Saw palmetto seems to alter hormones that cause prostrate cells to multiply. It may also reduce inflammation and swelling in the area. The saw palmetto herb has also been used to boost the immune system, treat urinary tract infections and may even have some effect on preventing prostate cancer.
Studies have shown that using saw palmetto may bring faster results than prescription prostate medications. Furthermore, fewer side effects including reduced libido and impotence may be experienced with the herb as compared to drug therapies.
Look for supplements that contain 85% to 95% fatty acids and sterols, the active therapeutic ingredients in saw palmetto.
Method of Action:
Saw Palmetto Berries Contain Plant Steroids
Dried saw palmetto berries contain high concentrations of free and bound sitosterols, including the very active beta-sitosterol. When injected under the skin of animals, they exhibited estrogenic activity. Although no comparison can be made between this route of administration and drinking a cup of saw palmetto tea or taking a couple of capsules, one might speculate that the presence of such high concentrations of sitosterols, together with other principles in the berry, forms the basis for biological activity in man. Needless to say, a great deal more research would be required to verify such a mechanism.
Toxicity Levels:
There is no known toxicity level of this herb.
Recommended Dietary Allowances:
For early-stage BPH, 160 mg per day of liposterolic saw palmetto herbal extract in capsules is taken two times per day. One trial suggested that 320 mg once per day may be equally effective.8 It may take four to six weeks to see results with BPH. If improvement is noted, the saw palmetto should be used continuously. It is important to work closely with a urologist to determine clinical improvement. Although it has not been tested for efficacy, saw palmetto is occasionally taken as a tea made with 5–6 grams of the powdered dried fruit. Ground, nonstandardized berry preparations (1–2 grams per day) and liquid extracts of whole herb at 5–6 ml per day are also sometimes used but have not been specifically tested.
Food Sources:
Saw palmetto (sometimes referred to as sabal in Europe) is a native of the southeast United States. The berries of the plant are used medicinally.
Side Effects & Interactions:
No significant side effects have been noted in clinical trials with saw palmetto extracts. However, in rare cases, saw palmetto can cause stomach problems,9 and one individual who was taking saw palmetto developed severe bleeding during surgery.10 According to some clinical trials, saw palmetto extract does not appear to interfere with accurate measuring of prostate-specific antigen (PSA)—a marker for prostate cancer.11 One test tube study found that saw palmetto did not prevent the release of PSA from prostate cells.12 Saw palmetto is most effective in managing symptoms of BPH but has not been shown to aggressively shrink the size of the prostate. BPH can only be diagnosed by a physician (preferably a urologist). Use of saw palmetto extract for BPH should only occur after a thorough workup and diagnosis by a doctor. There are no proven uses of saw palmetto for women.
There is one case report in which the use of saw palmetto was thought to be the cause of pancreatitis in a middle-aged man, although a cause-effect relationship was not conclusively proven.13
At the time of writing, there were no well-known drug interactions with saw palmetto.
References:
1. Di Silverio F, Monti S, Sciarra A, et al. Effects of long-term treatment with Serenoa repens (Permixon®) on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia. Prostate 1998;37:77–83.
2. Strauch G, Perles P, Vergult G, et al. Comparison of finasteride (Proscar®) and Serenoa repens (Permixon®) in the inhibition of 5-alpha reductase in healthy male volunteers. Eur Urol 1994;26:247–52.
3. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia. JAMA 1998;280:160–9.
4. Bach D, Ebeling L. Long-term drug treatment of benign prostatic hyperplasia—results of a prospective 3-year multicenter study using Sabal extract IDS 89. Phytomedicine 1996;3:105–11.
5. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: A randomized international study of 1,098 patients. Prostate 1996;29:231–40.
6. Metzker H, Kieser M, Hölscher U. Efficacy of a combined Sabal-Urtica preparation in the treatment of benign prostatic hyperplasia (BPH).Urologe [B] 1996;36:292–300.
7. Sökeland J, Albrecht J. A combination of Sabal and Urtica extracts versus finasteride in BPH (stage I and II according to Alken): a comparison of therapeutic efficacy in a one-year double-blind study. Urologe [A] 1997;36:327–33.
8. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publications, 1996, 167–72.
9. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 201.
10. Cheema P, El-Mefty O, Jazieh AR. Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature. J Intern Med 2001;250:167–9.
11. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: A randomized international study of 1,098 patients. Prostate 1996;29:231–40.
12. Bayne CW, Donnelly F, Ross M, Habib FK. Serenoa repens (Permixon): a 5alpha-reductase types I and II inhibitor—new evidence in a coculture model of BPH. Prostate 1999;40:232–41.
13. Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611–2.