Saw Palmetto (Serenoa repens)

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 […]

Serenoa Repens

(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 […]

Sex Herbs

The following herbs are used to improve sexual function: • Anise imitates the female hormone estrogen, increasing sexual intensity and satisfaction • Epimedium, a Chinese herb, has a testosterone-like substance and enhances a woman’s sexual desire • Fenugreek augments breast size and is used to elevate sex drive • Fennel prolongs orgasm, allowing men to enjoy sex for a longer period of time • Guarana seed tea has aphrodisiac effect • Quebracho (in South America) and Sheng Jing (in China) are used in male infertility and erectile dysfunction (impotence) Erectile dysfunction (ED) is a condition defined by the inability to attain or maintain penile erection sufficient for satisfactory sexual intercourse. In 1995, it was estimated that approximately 152 million men worldwide suffered from erectile dysfunction, with projections for 2025 growing to a prevalence of 322 million affected men. In the past, erectile dysfunction was believed to be caused by nonspecific psychological causes; however, in the past two decades, the majority of cases have been attributed to an organic etiology. Although erectile dysfunction patients can have a number of medical conditions, organic erectile dysfunction Read more […]

ANTIANDROGENS

ANTIANDROGENS (androgen antagonists) are a class of drugs that are hormone antagonists. Some drugs act directly to prevent the actions of the male sex hormone, testosterone, at receptors on its target tissues (e.g. cyproterone). Others act indirectly by preventing the formation of androgens by inhibiting the enzyme 5α-reductase (e.g. flutamide). Finally, some agents act indirectly by inhibiting the release of androgens (e.g. buserelin). Cyproterone is used in high doses as an ANTICANCER AGENT for cancer of the prostate gland. It is also used in relatively moderate doses, for the treatment of precocious puberty in males, and for hypersexuality or sexual deviation in men (in whom the drug causes a condition of reversible sterility through a reduction in the production of sperm and a decrease in libido). It works by being a derivative of progesterone with weak progestogenic activity. Thus it is a partial agonist at androgen receptors, competing with dihydrotestosterone for receptors in androgen-sensitive target tissues. By an effect on the hypothalamus it decreases the synthesis of gonadotrophins. It can also be used (orally at low dose, and in a preparation containing oestrogen) to treat acne, and excess body hair Read more […]

Saw palmetto: Practice Points – Patient Counselling. FAQ

• 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 […]

Saw palmetto: Adverse Reactions. Significant Interactions. Pregnancy Use

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 […]

Saw palmetto: Clinical Use. Dosage

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 […]

Saw palmetto: Background. Actions

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 […]

Stinging Nettle: Toxicity. Adverse Reactions

Insufficient reliable evidence is available. Adverse Reactions One report states that gastrointestinal discomfort, allergic reactions, urticaria, pruritus, oedema and decreased urine volume are possible. Clinical studies in BPH with herbal combinations containing nettle have found only 0.72% to 3.7% experience mild adverse effects. URTICARIA DUE TO STINGING NETTLE A frequent cause of contact urticaria is skin exposure to the stinging nettle. The urticaria is accompanied by a stinging sensation lasting longer than 12 hours. Part of the immediate reaction to nettle stings is due to histamine introduced by the nettle. It has also been found that both hair and plant extracts of nettle contain high levels of leukotrienes B4 and C4, besides histamine, which add to the irritant effects. Significant Interactions Controlled studies are not available; therefore, interactions are based on evidence of activity and are largely theoretical and speculative. DIURETIC MEDICINES Potentiated effects are theoretically possible observe — patients taking this combination. ANTIHYPERTENSIVE MEDICINES Additive effects are theoretically possible observe— patients taking this combination. FINASTERIDE Additive effects are theoretically Read more […]

Stinging Nettle: Clinical Use. Dosage

Different parts of the nettle herb have been used for different indications. Most evidence comes from traditional usage as nettle has not been significantly investigated under controlled conditions as a stand-alone treatment. ARTHRITIC CONDITIONS Traditionally, nettle herb and leaf have been used to treat painful joint diseases, and scientific investigation now shows there is a demonstrable benefit with its use. One randomised, double-blind crossover study involving 27 patients with OA pain at the base of the thumb or index finger compared topical applications of stinging nettle leaf with placebo, used daily for 1 week. After a 5-week washout period, treatments were then reversed. Nettle application used for 1 week showed reduction in pain and disability and produced significantly superior results to placebo. An open study of 17 patients reporting beneficial effects with the nettle sting of U. dioica showed that a transient urticarial rash can be associated with topical use. It is suspected that a counterirritant effect is chiefly responsible. In a multicentre study of 152 subjects with degenerative rheumatic conditions, 1.54 g dried nettle herb extract produced a subjective improvement in 70% of cases after Read more […]