Saw Palmetto

Serenoa Repens

Historically, the American Indians used saw palmetto berries in the treatment of genitor-urinary tract and prostate disorders. It was also used to increase testicular function, relieve mucous membrane irritation, help mammary gland disorders and atrophy, and as a tonic to support the body nutritionally. Saw palmetto is also known for its effects on reducing congestive catarrhal conditions of the respiratory system. The saw palmetto berries contain an abundance of nutritional and pharmacological agents including; carotenoids, lipases, tannins, sugars, and fatty acids such as caprylic acid, palmitic acid, oleic acid, and beta-sitosterol.

PROSTATE SUPPORT - Saw palmetto has been found to beneficial in cases of mild to moderate Benign Prostatic Hyperplasia (BPH), a common disorder affecting 50-60 percent of men between 40 and 59 years of age. The positive effects attributed to saw palmetto are mainly due to its ability to inhibit 5-alpha reductase, this enzyme is responsible for the conversion of testosterone to dihydrotestosterone (DHT). Inhibitors of 5-alpha-reductase, such as the drug Proscar, block the conversion of T to DHT and have been found to reduce the size of the prostate and lead to an increase in peak urinary flow rate and a reduction in obstructive symptoms. A 2002 study from the Cochrane Database demonstrated that Serenoa repens produced similar improvement in urinary symptoms and flow compared to finasteride and is associated with fewer adverse treatment events.
Benign Prostatic Hyperplasia - is a slow, progressive enlargement of the fibro-muscular and epithelial structures within the prostate gland. Symptoms can be due to obstruction or irritation or both. Many factors are thought to be involved in the development of this condition including; sex hormones, growth factors, insulin, and prolactin. Irritation and associated spasm of smooth muscle tissue, inflammation and oedema may also contribute to the development of symptoms.
ANTI-SEPTIC - The volatile oil found in saw palmetto exerts a considerable anti-septic action on the urinary tract.
MALE PATTERN BALDNESS - or ANDROGENETIC ALOPECIA is characterized by the structural miniaturization of androgen-sensitive hair follicles in susceptible individuals and is anatomically defined within a given pattern of the scalp. A recent controlled study examining the effects of saw palmetto on 5AR inhibition showed a highly positive response to treatment using saw palmetto.
ANTI-OESTROGENIC - Saw palmetto may also be of benefit in conditions of androgen excess in women, such as hirsutism and polycystic ovarian disease (PCOS).
ANTI-INFLAMMATORY - Saw palmetto would appear to reduce prostatic inflammatory processes by inhibiting the pro-inflammatory metabolites of arachidonic acid -
ANTI-CATARRHAL - Historical use suggests that saw palmetto acts to reduce congestive catarrhal conditions of the respiratory system.

Dosage

One to three capsules daily. Positive results in BPH studies suggest 160mg of the lipo-sterolic extract twice daily. Numerous studies on saw palmetto have shown it to be effective in nearly 90 percent of patients, usually in a period of 4 to 6 weeks. No restriction on duration of use.

Potential applications

Mild to moderate BPH, prostatitis, and urinary infections. Conditions of androgen excess e.g. PCOS, male pattern baldness. Respiratory congestion and irritation. Tones the male reproductive system. Studies suggest that saw palmetto is cytotoxic towards cancer cells within the prostate.

Known contraindications

No significant side effects have been noted in clinical trials with saw palmetto extracts. However, in rare cases, saw palmetto can cause stomach problems. 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. No adverse effects in regards to pregnancy and lactation although physician guidance recommended.

Interactions

At the time of writing, there were no well-known drug interactions with saw palmetto.

Use in conjunction with

Benign Prostatic Hyperplasia - Pumpkin seed oil, Rhodiola, zinc complex, multi-phytonutrient complex.
Diet and lifestyle - regular aerobic exercise, stress management, adequate sleep, antioxidant rich diet, low saturated / hydrogenated fats, regular meals, keep hydrated (1.5 litres water). A high protein (40% protein) appears to inhibit 5AR. May help reduce insulin response.

Note

Saw palmetto has a history of use as an aphrodisiac.

REFERENCES

Simon Mills & Kerry Bone. Principles and Practice of Phytotherapy. Modern Herbal Medicine. 2000.
PDR for Herbal Medicines. Second Edition. 2000
Michael Murray. The Healing Power of Herbs. 2nd Edition. 1995.
David Hoffman. The New Holistic Herbal. 1990.
Melvyn R. Werbach & Michael T. Murray. Botanical Influences on Illness. A source book of clinical research. 1994
Wilt T, Ishani A, Mac Donald R. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2002;(3):CD001423.
Gordon AE, Shaughnessy AF. Saw palmetto for prostate disorders. Am Fam Physician. 2003 Mar 15;67(6):1281-3.
Pytel YA, Vinarov A, Lopatkin N, Sivkov A, Gorilovsky L, Raynaud JP. Long-term clinical and biologic effects of the lipidosterolic extract of Serenoa repens in patients with symptomatic benign prostatic hyperplasia. Adv Ther. 2002 Nov-Dec;19(6):297-306.
Prager N, Bickett K, French N, Marcovici G. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med. 2002 Apr;8(2):143-52.

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