Saw Palmetto Health Article

Definition

Saw palmetto is an extract derived from the deep purple berries of the saw palmetto fan palm (Serenoa repens), a plant indigenous to the coastal regions of the southern United States and southern California. There is an estimated one million acres of wild saw palmetto palms in Florida, where the bulk of commercial saw palmetto is grown.

Purpose

Saw palmetto is used by natural health practitioners to treat a variety of ailments in men and women, such as testicular inflammation, urinary tract inflammation, coughs, and respiratory congestion. It is also used to strengthen the thyroid gland, balance the metabolism, stimulate appetite, and aid digestion. Most of the evidence supporting these uses is anecdotal and has not been proven by controlled clinical trials. However, there is much scientific documentation outlining the effectiveness of the herb in treating irritable bladder and urinary problems in men with benign prostate hyperplasia (BPH), an enlargement of the prostate gland. BPH results in a swelling of the prostate gland that obstructs the urethra. This causes painful urination, reduced urine flow, difficulty starting or stopping the flow, dribbling after urination, and more frequent nighttime urination. Saw palmetto does not reduce prostate enlargement. Instead, it is thought to work in a variety of ways. First, it inhibits the conversion of testosterone into dihydrotestosterone (DHT). BPH is thought to be caused by an increase in testosterone to DHT. Secondly, saw palmetto is believed to interfere with the production of estrogen and progesterone, hormones associated with DHT production.

In addition to causing pain and embarrassment, BPH can lead to serious kidney problems if undiagnosed and left untreated. It is a common problem in men over the age of 40. Estimates are that 50-60% of all men will develop BPH in their lifetimes. It is estimated that there are six million men between the ages of 50–79 who have BPH serious enough to require some type of therapy. Yet only half of them seek treatment from physicians. Health practitioners in both the allopathic and natural medicine communities recommend annual prostate exams for men over the age of 50, and an annual blood test that measures prostate specific antigen, a marker for prostate cancer.

Recently, a number of clinical trials have confirmed the effectiveness of saw palmetto in treating BPH. Many of these trials have shown saw palmetto works better than the most commonly used prescription drug, Proscar. Saw palmetto is effective in nearly 90% of patients after six weeks of use, while Proscar is effective in less than 50% of patients. In addition, Proscar may take up to six months to achieve its full effect. Since Proscar blocks the production of testosterone, it can cause impotence and breast enlargement. Also, saw palmetto is significantly less expensive than Proscar. A one month supply of saw palmetto costs $12–25, while a one month supply of Proscar costs $65–75. Other prescription drugs used to treat BPH are Cardura (doxazosin), Hytrin (terazosin), and Flomax (tamsulosin hydrochloride). Originally prescribed to treat hypertension, Cardura and Hytrin can drop blood pressure, causing light-headedness and fainting. Presently, saw palmetto is being evaluated by the U.S. Food and Drug Administration (FDA) for treatment of BPH. If approved, it would become the first herbal product to be licensed by the agency as a treatment for a specific condition. Saw palmetto is also used as a treatment for prostate complaints and irritable bladder.

Since the 1960s, extensive clinical studies of saw palmetto have been done in Europe. A 1998 review of 24 European trials involved nearly 3,000 men, some taking saw palmetto, others taking Proscar, and a third group taking a placebo. The men taking saw palmetto had a 28% improvement in urinary tract symptoms, a 24% improvement in peak urine flow, and 43% improvement in overall urine flow. The results were nearly comparable to the group taking Proscar and superior to the men taking a placebo.

Uses in women

There is very little documentation or scientific research into saw palmetto use in women. However, several studies in the 1990s show that the BPH drug Proscar can be effective in stopping unwanted facial and body hair growth, and in treating thinning hair in women. It works by blocking the action of an enzyme called 5-alpha reductase. Anecdotal reports suggest that saw palmetto may be as effective as Proscar in treating unwanted hair growth and thinning hair, and in preventing some types of acne. It has also been used to treat urinary tract inflammation and help relieve the symptoms of menstruation. There are claims it can be used to enlarge breasts, but these claims have not been scientifically tested.