Saw Palmetto

Serenoa repens, commonly known as saw palmetto, is a low-growing palm tree that is native to the United States. Its berries were used as both food and medicine by the Seminole people of what is today Florida before European settlers arrived. In the early 1900s it was listed in the official United States Pharmacopoeia, and today an extract of the berries is recommended throughout Europe and even prescribed by doctors there. Although in traditional folk medicine it was used for conditions as varied as stomach ache and bronchitis and as a nutritive tonic, modern use and research of saw palmetto is almost exclusively focused on prostate health.[1]

Saw Palmetto and BPH

Saw palmetto has mostly been studied for use in men suffering from Benign Prostatic Hyperlasia, or BPH, a condition that affects nearly 75% of men over the age of 50.[2] BPH occurs when the prostate gland swells and squeezes the urethra. When this happens, the urethra, the path of urine from the bladder to the outside world, is constricted, and symptoms such as difficulty urinating, dribbling after urination, incomplete emptying of the bladder and increased nighttime urination occur. Although any man experiencing these symptoms should see a doctor to rule out more serious problems such as prostate cancer, BPH is non-cancerous and more of a nuisance since it is rarely life-threatening.

As a male reproductive tonic, saw palmetto has earned a reputation as a first line of defense against BPH. Most studies have shown that saw palmetto improves the symptoms of mild to moderate BPH and may be especially good for nighttime urination issues.[3],[4] Exactly how saw palmetto exerts its beneficial effects is still not completely understood. Most researchers and herbalists believe that it is the naturally occurring fatty acids in the berries that are the active constituents. These fatty acids may mildly reduce the action of 5 alpha-reductase, an enzyme that converts testosterone to DHT, the hormone that stimulates cell growth of prostate tissues. Other possible actions of saw palmetto include modulating inflammation and normalizing steroid hormones, such as progesterone and estrogen, in the prostate.[5],[6]

Using Saw Palmetto

Most clinical studies on saw palmetto berries have used an extract standardized[*] to 85-95% fatty acids in a dosage of 160 milligrams twice daily or 320 milligrams total each day. The use of saw palmetto does not interfere with prostate cancer screening, so continued monitoring is possible while taking the herb. It is not generally recommended for those with severe BPH. Reported side effects of saw palmetto are rare, with the most common being mild gastrointestinal disturbances when taken on an empty stomach.[7] As always, caution should be used when starting any new herb, nutrient, or medication, especially if you are already taking other supplements or medications.


References

[*]Because the quality and potency of an herb is dependent on variables in season, soil, weather,  growing location and post-harvest handling, some companies choose to standardize their herbal products in an attempt to deliver a consistent product every time. Standardization in botanical extracts refers to delivering a consistent, measurable amount of a recognized plant constituent, often one believed to be an active ingredient.

[1] WHO Monographs of Selected Medicinal Plants. World Health Organization. Available at: http://apps.who.int/medicinedocs/pdf/s4927e/s4927e.pdf

[2] n.a. The saw palmetto controversy. The Star Online. April 23, 2006. Available at: http://www.thestar.com.my/story.aspx/?file=%2f2006%2f4%2f23%2fhealth%2f14016867&sec=health

[3] Blumenthal M. The ABC Clinical Guide to Herbs. New York, NY: Thieme; 2003.

[4] Grant P, Ramasamy S. An Update on Plant Derived Anti-Androgens. Int J Endocrinol Metab. 2012;10(2):497-502.

[5] Brown DJ. Herbal Prescriptions for Health & Healing. Twin Lakes, WI: Lotus Press; 2000.

[6] Buhner SH. The Natural Testosterone Plan for Sexual Health and Energy. Rochester, VT: Healing Arts Press; 2007.

[7] Blumenthal M. The ABC Clinical Guide to Herbs. New York, NY: Thieme; 2003.