Saw palmetto is a native plant of North America, and it is still primarily grown in the United States.
The saw palmetto tree grows only about 2 to 4 feet high, with fan-shaped serrated leaves and abundant berries. Native Americans used these berries for the treatment of various urinary problems in men, as well as for women with breast disorders. European and American physicians took up saw palmetto as a treatment for benign prostatic hyperplasia (BPH). In the 1960s, French researchers discovered that by concentrating the oils of saw palmetto berry they could maximize the herb's effectiveness.
Saw palmetto contains many biologically active chemicals. Unfortunately, we don't know which ones are the most important. We also don't really know how saw palmetto works; it appears to interact with various sex hormones, but it also has many other complex actions that could affect the prostate.
Saw palmetto oil is an accepted medical treatment for benign prostatic hyperplasia (BPH)
Typical symptoms of BPH include difficulty starting urination, weak urinary stream, frequent urination, dribbling after urination, and waking up several times at night to urinate. Most, thought not all, research suggests that saw palmetto can markedly improve all these symptoms. Benefits require approximately 4 to 6 weeks of treatment to develop. It appears that about two-thirds of men respond reasonably well.
Furthermore, while the prostate tends to continue to grow when left untreated,
Research tells us that saw palmetto is equally effective for reducing BPH symptoms as Proscar, and it has one meaningful advantage: It leaves PSA (prostate-specific antigen) levels unchanged. Cancer raises PSA levels, and lab tests that measure PSA are used to screen for prostate cancer. Proscar lowers PSA measurements, and therefore, its use may have the unintended effect of masking prostate cancer. Saw palmetto won't do this. On the other hand, Proscar has been shown to reduce the need for surgery, unlike saw palmetto or any of the other drugs used for BPH.
Saw palmetto also appears to be equally effective as another class of standard drugs known as alpha blockers, but may cause fewer side effects.
Note : Before self-treating with saw palmetto, be sure to get a proper medical evaluation to rule out prostate cancer.
Saw palmetto is also widely used to treat
Saw palmetto is sometimes recommended as a treatment for hair loss, but there is no evidence at all that it is effective for this purpose.
The scientific evidence for the effectiveness of saw palmetto in treating prostate enlargement is reasonably convincing, but not completely consistent.
At least 10
studies involving a total of about 900 people have compared the benefits of saw palmetto against
A double-blind study followed 1,098 men who received either saw palmetto or the drug Proscar over a period of 6 months.
A 52-week, double-blind study of 811 men compared saw palmetto to a standard drug in another class: the alpha-blocker tamsulosin.
A study involving 435 men found that the benefits of saw palmetto endure for at least 3 years.
A 48-week, double-blind trial of 543 men with early BPH compared combined saw palmetto and
Finally, a 6-month, double-blind, placebo-controlled trial of 44 men given a saw palmetto herbal blend (containing, in addition, nettle root and pumpkin seed oil) found shrinkage in prostate tissue.
The standard dosage of saw palmetto for the treatment of BPH is 160 mg twice a day of an extract standardized to contain 85% to 95% fatty acids and sterols. A single daily dose of 320 mg may be just as effective for this condition. 21,22
Saw palmetto is thought to be essentially nontoxic. 24
There are at least two case reports in which use of saw palmetto was linked to liver inflammation;
Finally, there is one report of saw palmetto apparently causing excessive bleeding during surgery.
Saw palmetto has no known drug interactions. Safety for pregnant or nursing women, or those with severe kidney or liver disease, has not been established.
8. Tasca A, Barulli M, Cavazzana A, et al. Treatment of obstructive symptomatology caused by prostatic adenoma using an extract of Serenoa repens . Double-blind clinical study vs. placebo [in Italian]. Minerva Urol Nefrol . 1985;37:87-91.
11. Descotes JL, Rambeaud JJ, Deschaseaux P, et al. Placebo-controlled evaluation of the efficacy and tolerability of Permixon in benign prostatic hyperplasia after exclusion of placebo responders. Clin Drug Invest . 1995;9:291-297.
14. 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;29:231-240.
15. Debruyne F, Koch G, Boyle P, et al. Comparison of a phytotherapeutic agent (Permixon) with an alpha-blocker (Tamsulosin) in the treatment of benign prostatic hyperplasia: a one-year randomized international study. Eur Urol. 2002;41:497-507.
21. Braeckman J, Bruhwyler J, Vandekerckhove K, et al. Efficacy and safety of the extract of Serenoa repens in the treatment of benign prostatic hyperplasia: therapeutic equivalence between twice and once daily dosage forms. Phytother Res. 1997;11:558-563.
22. Stepanov VN, Siniakova LA, Sarrazin B, et al. Efficacy and tolerability of the lipidosterolic extract of Serenoarepens (Permixon) in benign prostatic hyperplasia: a double-blind comparison of two dosage regimens. Adv Ther . 1999;16:231-241.
27. Giannakopoulos X, Baltogiannis D, Giannakis D, et al. The lipidosterolic extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a comparison of two dosage regimens. Adv Ther . 2002;19:285-296.
31. Lopatkin N, Sivkov A, Walther C, et al. Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms-a placebo-controlled, double-blind, multicenter trial. World J Urol . 2005 Jun 1. [Epub ahead of print]
Last reviewed April 2009 by EBSCO CAM Review Board
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