Saw Palmetto: Medical Uses Saw palmetto is used for benign prostatic hyperplasia (BPH), stages I and II. Historical Uses Saw palmetto berries were used by Native Americans for food and for medicinal effects. Traditional use has been as a tonic for men. Growth Saw palmetto is a short palm tree with sharp leaves that flourishes in the southern United States. Berries appear at the end of the summer months, and they turn a purplish black color. Saw palmetto is difficult to cultivate. Part Used • Fruit (berries) Major Chemical Compounds • Free fatty acids • Sitosterols Saw Palmetto: Clinical Uses Saw palmetto is used for benign prostatic hyperplasia (BPH), stages I and II. Mechanism of Action Saw palmetto inhibits the conversion of testosterone to dihydrotestosterone (as does finasteride [Proscar], a drug prescribed for treating BPH). It also speeds the breakdown and elimination of other hormones that are responsible for prostate enlargement. It reduces inflammation and fluid accumulation by a nonhormonal mechanism that does not affect serum prostate-specific antigen (PSA) levels, thereby limiting the risk that treatment could mask the development of prostate cancer. Saw palmetto also has androgenic Read more […]
Archive for category Saw Palmetto'
(Saw Palmetto) Saw palmetto, Serenoa repens, also known as the American dwarf palm tree, grows wild in the southern states of the USA especially in Florida and Georgia. It is an evergreen shrub, grows up to 3 metres tall and has fan-shaped leaves. The plant was used as a food by the Native American populations in Florida and even today is still used as a food by Seminole people; a sweetened traditional drink ‘shiope sofkee’ is made from its juice. Although saw palmetto has been used for a variety of medicinal purposes by Native Americans, it is now almost exclusively used to treat benign prostatic hyperplasia. It is easily the most commonly used herbal preparation for this condition worldwide and in some European countries it is regarded as the first-line treatment for this condition and is considerably cheaper than conventional drugs. It is the fruit of the plant that is used in modern dietary supplements and herbal medicines. It is consumed as a dried ground fruit or as an extract of the lipid fraction where the pharmacological activity is thought to be found. Teas made from saw palmetto are consumed, but as the active ingredients are believed to be lipid soluble these will contain little of these ingredients. Read more […]
Serenoa repens (Bartram) J.K. Small (Arecaceae) Synonym(s) and related species American dwarf palm, Sabal, Serenoa. Brahea serrulata H.Wendl., Sabal serrulata (Michx.) Schult f., Sabal serrulatum Schult f., Serenoa serrulata (Michx.) Hook. f. ex B.D. Jacks. Pharmacopoeias Powdered Saw Palmetto (US Ph 32); Saw Palmetto (US Ph 32); Saw Palmetto Capsules (US Ph 32); Saw Palmetto Fruit (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents The fruit of saw palmetto contains about 25% fatty acids (extracts are often standardised to a minimum of 11% total fatty acids) consisting of capric, caprylic, lauric, palmitic, oleic, linoleic and linolenic acids in the form of fixed oils. Sterols including campesterol, stig masterol and beta-sitosterol are also present, as are long-chain alcohols, carotenoids, various polysaccharides and some flavonoids, including rutin, isoquercetin and kaempferol. Use and indications The main contemporary use of saw palmetto fruit is to treat the urological symptoms of benign prostatic hyperplasia. It has also been used as a diuretic, a sedative, an endocrine agent, an antiseptic and for treating disorders involving the sex hormones. Pharmacokinetics Saw Read more […]
• Substantial scientific evidence has shown that saw palmetto is an effective treatment for stages 1 and 2 of BPH in cases where the diagnosis of cancer is negative. It is as effective as finasteride and alpha-adrenoreceptor antagonist drugs such as tamsulosin and alfuzosin, although prazosin may be slightly more effective. • Typically, symptom reduction is experienced within 1-2 months’ treatment, which is well tolerated, and associated with fewer side effects than finasteride and tamsulosin. • The herb does not affect PSA levels therefore PSA test results will be unaffected. • If symptoms worsen, blood is detected in the urine or acute urinary retention occurs, seek professional advice. Answers to Patients’ Frequently Asked Questions What will this herb do for me? Saw palmetto has been investigated in numerous scientific studies and shown to reduce symptoms of enlarged prostate with few side-effects. There is also some early research suggesting it may be useful in some forms of hair loss and prostatitis. When will it start to work? Symptom relief for enlarged prostate is generally experienced within 4-8 weeks. Are there any safety issues? Saw palmetto is well tolerated; however, Read more […]
The herb is generally well tolerated, with only non-specific symptoms reported, such as gastrointestinal upset, constipation, nausea, abdominal pain and diarrhea. These minor complaints are generally resolved by taking the herb in association with meals. One large clinical study identified headache and rhinitis as the most common side-effects associated with use. Significant Interactions No controlled studies are available and theoretical interactions are difficult to predict, due to the poorly understood nature of the herb’s mechanism of action. FINASTERIDE (AND OTHER 5-ALPHA REDUCTASE INHIBITOR AGENTS) Additive effect theoretically possible — potential beneficial effect, although the clinical significance is unknown. ANDROGENIC DRUGS Theoretically, saw palmetto may reduce effectiveness of therapeutic androgens such as testosterone— observe patient for lack of drug effect. Contraindications and Precautions If symptoms of BPH worsen, blood is detected in the urine, or acute urinary retention occurs, professional reassessment is required. Pregnancy Use Use of saw palmetto during pregnancy is contraindicated due to the herb’s hormonal effects. In clinical practice, it is not used in pregnancy. Read more […]
The most studied saw palmetto preparation is a commercial product known as Permixon (Pierre Fabre Medicament, Castres, France), which is a liposterolic extract consisting of 80% free (e.g. 94 g/100 g extract) and 7% esterified fatty acids, as well as small amounts of sterols (beta-sitosterol, campesterol, stigmasterol, cycloartenol), and a minimum percentage of polyprenic compounds, arabinose, glucose, galactose, uronic acid, and flavonoids. BENIGN PROSTATIC HYPERTROPHY Saw palmetto extracts are extremely popular in Europe where herbal preparations represent approximately one-third of total sales of all therapeutic agents sold for the treatment of BPH. Substantial evidence suggests that saw palmetto is an effective treatment for stages 1 and 2 of BPH. A 2002 Cochrane review assessing the results from 21 randomised trials involving 3139 men concluded that saw palmetto improves urinary scores, symptoms and urinary flow measures compared with placebo, with effects on symptoms scores and peak urine flow similar to the pharmaceutical drug finasteride. Additionally, its use is associated with fewer adverse effects compared with finasteride and typically, symptomatic relief is reported more quickly. In 2004, an updated Read more […]
Common Name Serenoa or saw palmetto Other Names American dwarf palm tree, cabbage palm, dwarf palmetto, fan palm, sabal fructus, sabal, serenoa Botanical Name / Family Sabal serrulata, Serenoa repens (family Arecaceae or Palmaceae) Plant Part Used Dried ripe fruit Chemical Components An ethanol extract of the berry contains free fatty acids rich in shorter chain-length fatty acids, such as capric, caprylic, lauric and myristic acid. Palmitic, stearic, oleic, linoleic and linolenic acid are also present in the extract. There are also lesser amounts of phytosterols (such as beta-sitosterol, stigmasterol, ampesterol, and cycloartenol), aliphatic alcohols and polyprenic compounds. The lipophilic extract is used medicinally. Historical Note Saw palmetto was used traditionally as a treatment for urogenital irritations, impotence and male infertility, among other conditions, and was described by the American Eclectic physicians as the ‘old man’s friend’. Between 1906 and 1917 saw palmetto was listed in the US Pharmacopoeia and between 1926 and 1950 it was in the National Formulary as a treatment for urogenital ailments; however, it fell out of favour for several decades as pharmaceutical medicines came to the Read more […]