What are the potential benefits of saw palmetto for prostate health. How does saw palmetto compare to conventional treatments for benign prostatic hyperplasia. What are the possible side effects of taking saw palmetto supplements. Is saw palmetto safe and effective for long-term use.

What is Saw Palmetto and How Does it Work?

Saw palmetto (Serenoa repens) is a plant native to the southeastern United States that has been used for centuries as a natural remedy for various health conditions. The extract derived from the berries of this plant has gained popularity as a potential treatment for benign prostatic hyperplasia (BPH) and other prostate-related issues.

The mechanism of action of saw palmetto is not fully understood, but it is believed to work through several pathways:

• Inhibition of 5-alpha-reductase enzyme, which converts testosterone to dihydrotestosterone (DHT)
• Anti-inflammatory effects
• Modulation of androgen receptors
• Interference with prostate cell proliferation

These proposed mechanisms suggest that saw palmetto may help alleviate symptoms associated with BPH and potentially slow the progression of prostate enlargement.

Potential Benefits of Saw Palmetto for Prostate Health

Research on saw palmetto has yielded mixed results, but some studies suggest potential benefits for prostate health:

Improvement in Lower Urinary Tract Symptoms (LUTS)

Several studies have reported that saw palmetto may help improve LUTS associated with BPH. These symptoms include:

• Frequent urination
• Urgency to urinate
• Weak urine stream
• Difficulty starting urination
• Nocturia (waking up at night to urinate)

A systematic review by Gerber and Fitzpatrick (2004) found that saw palmetto extract may be effective in improving urinary symptoms and flow measures in men with BPH.

Potential Reduction in Prostate Size

Some research suggests that saw palmetto may help reduce prostate size in men with BPH. A study by Di Silverio et al. (1992) reported that saw palmetto extract displayed antiestrogenic activity in prostatic tissue of BPH patients, which could contribute to a reduction in prostate volume.

Possible Alternative to Conventional BPH Treatments

Saw palmetto has been investigated as a potential alternative or complementary treatment to conventional BPH medications. A randomized study by Carraro et al. (1996) compared saw palmetto extract (Permixon) with finasteride, a common BPH medication, in 1,098 patients. The study found that both treatments improved symptoms, with saw palmetto having fewer side effects.

Comparing Saw Palmetto to Conventional BPH Treatments

How does saw palmetto stack up against conventional treatments for benign prostatic hyperplasia? Let’s examine the evidence:

Efficacy Comparison

The efficacy of saw palmetto compared to conventional BPH treatments has been a subject of debate. Some studies suggest comparable effectiveness, while others show mixed results:

• A study by Engelmann et al. (2006) found that a combination of saw palmetto and nettle root extract was as effective as tamsulosin, an alpha-blocker commonly used for BPH, in improving LUTS.
• However, a large-scale study by Bent et al. (2006) published in the New England Journal of Medicine found no significant difference between saw palmetto and placebo in improving BPH symptoms.

Side Effect Profile

One potential advantage of saw palmetto over conventional BPH treatments is its generally milder side effect profile:

• Saw palmetto is associated with fewer sexual side effects compared to finasteride and dutasteride, which are 5-alpha-reductase inhibitors used to treat BPH.
• Unlike alpha-blockers, saw palmetto is not known to cause dizziness or orthostatic hypotension.

However, it’s important to note that the long-term safety and efficacy of saw palmetto have not been as extensively studied as conventional medications.

Potential Side Effects and Safety Considerations of Saw Palmetto

While saw palmetto is generally considered safe for most people, it can cause side effects in some individuals. Understanding these potential side effects is crucial for anyone considering its use:

Common Side Effects

According to a systematic review by Agbabiaka et al. (2009), the most commonly reported side effects of saw palmetto include:

• Gastrointestinal disturbances (abdominal pain, nausea, vomiting, diarrhea)
• Headache
• Dizziness
• Fatigue
• Decreased libido

These side effects are generally mild and occur in a small percentage of users.

Rare but Serious Side Effects

While rare, some more serious side effects have been reported:

• Liver damage
• Pancreatitis
• Bleeding complications

It’s important to note that these serious side effects are extremely rare and may be associated with other factors or underlying conditions.

Drug Interactions

Saw palmetto may interact with certain medications, potentially affecting their efficacy or increasing the risk of side effects. Potential interactions include:

• Anticoagulants and antiplatelet drugs (e.g., warfarin, aspirin)
• Hormonal medications (e.g., estrogen, testosterone)
• 5-alpha-reductase inhibitors (e.g., finasteride, dutasteride)

Always consult with a healthcare provider before combining saw palmetto with other medications or supplements.

Dosage and Administration of Saw Palmetto

Determining the appropriate dosage of saw palmetto is essential for maximizing its potential benefits while minimizing the risk of side effects. Here’s what you need to know about dosing and administration:

Recommended Dosage

The optimal dosage of saw palmetto can vary depending on the specific product and formulation. However, most studies have used doses within the following range:

• 160-320 mg of saw palmetto extract daily, often divided into two doses
• Some studies have used higher doses up to 960 mg per day

It’s important to follow the dosage instructions on the product label or as recommended by a healthcare provider.

Forms of Saw Palmetto

Saw palmetto is available in various forms, including:

• Capsules or tablets
• Liquid extracts
• Powdered berries
• Teas (although less common and potentially less effective)

The most commonly studied form is the liposterolic extract of saw palmetto berries, which is typically standardized to contain 85-95% fatty acids and sterols.

Duration of Use

The optimal duration of saw palmetto use is not well-established. Some studies have evaluated its use for periods ranging from 3 months to 2 years. Long-term safety and efficacy beyond this timeframe require further investigation.

Combining Saw Palmetto with Other Natural Remedies

Some research has explored the potential benefits of combining saw palmetto with other natural ingredients for prostate health. These combinations may offer synergistic effects:

Saw Palmetto and Nettle Root

A study by Engelmann et al. (2006) found that a combination of saw palmetto and nettle root extract was effective in improving lower urinary tract symptoms associated with BPH.

Saw Palmetto, Lycopene, and Selenium

Minutoli et al. (2013) proposed a triple therapeutic approach using saw palmetto, lycopene, and selenium for managing BPH. This combination may offer enhanced antioxidant and anti-inflammatory effects.

Saw Palmetto and Pumpkin Seed Oil

A study by Hong et al. (2009) investigated the effects of combining saw palmetto oil and pumpkin seed oil in Korean men with symptomatic BPH. The combination showed potential benefits in improving BPH symptoms.

While these combinations show promise, more research is needed to fully understand their efficacy and safety profiles.

Future Research and Ongoing Studies on Saw Palmetto

The field of saw palmetto research continues to evolve, with ongoing studies and areas of interest for future investigation:

Standardization and Quality Control

One challenge in saw palmetto research has been the variability in product quality and standardization. Future studies may focus on:

• Developing more consistent and standardized saw palmetto extracts
• Identifying the most active compounds and their optimal concentrations
• Improving methods for quality control and product testing

Long-term Safety and Efficacy

While some studies have evaluated saw palmetto use for up to two years, more research is needed on its long-term effects:

• Long-term safety studies to identify any potential risks associated with prolonged use
• Investigation of saw palmetto’s efficacy in preventing BPH progression over extended periods

Mechanism of Action

Further research is needed to elucidate the precise mechanisms by which saw palmetto exerts its effects on prostate health. This may involve:

• In-vitro studies to identify specific molecular targets
• Animal studies to better understand the pharmacokinetics and pharmacodynamics of saw palmetto compounds
• Advanced imaging techniques to visualize the effects of saw palmetto on prostate tissue

Combination Therapies

Building on existing research, future studies may explore:

• Optimal combinations of saw palmetto with other natural ingredients or conventional medications
• Personalized approaches to combination therapy based on individual patient characteristics

As research progresses, our understanding of saw palmetto’s potential benefits and limitations in prostate health management will continue to evolve, potentially leading to more effective and targeted uses of this natural remedy.

Saw palmetto Information | Mount Sinai

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Andriole GL, McCullum-Hill C, Sandhu GS, Crawford ED, Barry MJ, Cantor A. The effect of increasing doses of saw palmetto fruit extract on serum prostate specific antigen: analysis of the CAMUS randomized trial. J Urol. 2013;189(2):486-492.

Avins AL, Lee JY, Meyers CM, Barry MJ. Safety and toxicity of saw palmetto in the CAMUS trial. J Urol. 2013;189(4):1415-1420.

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Boyle P, Robertson C, Lowe F, Roehrborn C. Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU International. 2004;93(6):751-756.

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Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate. 1996;29(4):231-242.

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Di Silverio F, D’Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Uro. 1992;21:309-314.

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Engelmann U, Walther C, Bondarenko B, Funk P, Schläfke S. Efficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. A randomized, double-blind study versus tamsulosin. Arzneimittelforschung. 2006;56(3):222-229.

Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John’s Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Ann Intern Med. 2002;136(1):42-53.

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Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Saw palmetto (Serenoa repens) is a tree that grows up to 10 feet tall with thorn-shaped leaves arranged like a fan. Its ripe fruit is used to make medicine.

Saw palmetto seems to lower the amount of pressure on the tubes that carry urine in males. Saw palmetto also might prevent testosterone from being converted to a more potent form called dihydrotestosterone (DHT). Reduced levels of DHT might help prevent some types of hair loss.

People commonly use saw palmetto for symptoms of an enlarged prostate called benign prostatic hypertrophy (BPH). But it doesn’t seem to improve this condition. Saw palmetto is also used to prevent complications from prostate surgery and for treating other prostate conditions, male-pattern baldness, sexual dysfunction, and many other purposes, but there is no good scientific evidence to support most of these uses.

Uses & Effectiveness ?

Possibly Effective for

• A type of prostate surgery (transurethral resection of the prostate or TURP). Taking 320 mg of saw palmetto by mouth daily for 2 months before prostate surgery can improve surgery outcomes.

Possibly Ineffective for

• Enlarged prostate (benign prostatic hyperplasia or BPH). Taking saw palmetto by mouth has little or no benefit for reducing BPH symptoms. Saw palmetto doesn’t seem to reduce the need to go to the bathroom at night or reduce painful urination.

There is interest in using saw palmetto for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Saw palmetto is likely safe when used for up to 3 years. Side effects are usually mild and might include dizziness, headache, nausea, and diarrhea.

When given rectally: Saw palmetto is possibly safe when used for up to 30 days. It’s unknown if it is safe to use for longer periods of time.

Special Precautions and Warnings

When taken by mouth: Saw palmetto is likely safe when used for up to 3 years. Side effects are usually mild and might include dizziness, headache, nausea, and diarrhea.

When given rectally: Saw palmetto is possibly safe when used for up to 30 days. It’s unknown if it is safe to use for longer periods of time. Pregnancy and breast-feeding: Saw palmetto is likely unsafe when taken by mouth during pregnancy or breast-feeding. It acts like a hormone, and this could be dangerous. Don’t use during pregnancy or breast-feeding.

Surgery: Saw palmetto might slow blood clotting. It might cause extra bleeding during and after surgery. Stop using saw palmetto at least 2 weeks before a scheduled surgery.

Interactions ?

Moderate Interaction

Be cautious with this combination

• Saw palmetto might slow blood clotting. Taking saw palmetto along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

• Some birth control pills contain estrogen. Saw palmetto might decrease the effects of estrogen in the body. Taking saw palmetto along with birth control pills might decrease their effects. If you take birth control pills along with saw palmetto, use an additional form of birth control such as a condom.

• Saw palmetto seems to decrease estrogen levels in the body. Taking saw palmetto along with estrogen pills might decrease their effects.

Dosing

Saw palmetto has most often been used by adults in doses of 320-960 mg by mouth daily for up to 3 years. It’s also been used in lotion. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

Description of SERENOA REPENS indications, dosages, contraindications of the active substance SERENOA REPENS

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Active substance AMERICAN Dwarf Palm* (SERENOA REPENS*)

• Pharmacological properties
• Indications AMERICAN Dwarf Palm *
• Application AMERICAN Dwarf Palm *
• Contraindications
• Side effects
• Special instructions
• Interactions
• Diagnosis
• Recommended alternatives
• Trade names

Medicinal preparations containing the active substance AMERICAN Dwarf Palm *

Prostaker

capsules 320 mg, no. 30

MEGA LIFESCIENCES

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Prostaplant

capsules 320 mg, no. 30

Alpen Pharma AG 9 0007

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American dwarf palm fruit extract is used to treat patients with benign prostatic hyperplasia. The clinical effect is due to antiandrogenic, antiproliferative, anti-inflammatory, decongestant, vasoprotective and antiestrogenic effects. The active substances of the extract affect the metabolism of testosterone in the prostate tissue, without affecting its level in blood plasma and the balance of the hypothalamic-pituitary system, therefore, they do not adversely affect libido and sexual potency. By inhibiting the 1st and 2nd isoenzymes of 5-α-reductase, it inhibits the conversion of testosterone into its active form – dihydrotestosterone (the main etiopathogenetic factor in benign prostatic hyperplasia), affects its metabolism, and also inhibits the fixation of dihydrotestosterone on cytoplasmic receptors, preventing the penetration of the hormone into the nucleus of the cell. As a result, protein synthesis decreases and the process of organ hyperplasia stops.

In addition, inhibiting phospholipase A ₂ inhibits the formation of arachidonic acid derivatives – leukotrienes and prostaglandins, which are mediators of inflammation; blocks binding to specific prolactin receptors, which promotes increased permeability and proliferation of the prostate epithelium. Providing a local anti-inflammatory and anti-edematous effect, reduces swelling of the body, reduces capillary permeability, improves tone and motility of the lower urinary tract. Inhibits translocation of androgen and estrogen receptors, inhibits fibroblast growth factor (b-FGF) and epidermal growth factor (EGF).

urinary disorders and inflammatory symptoms due to uncomplicated benign prostatic hyperplasia.

orally 320 mg/day in 1 or 2 divided doses. The duration of use is determined individually.

hypersensitivity to the extract.

rarely – nausea when taken on an empty stomach.