* Please Note: This information is based partly on Traditional Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
Description
Name
The botanical name for the dwarf palm or saw palmetto, is Serenoa repens (Arecaceae). A related variety, containing the same active ingredients, is called Sabal serrulata. Extracts of Serenoa repens are sold in Europe under various brand names (LESS®, Permixon, Sereprostat). In German, it is Sabalfrüchte.
Source
The active ingredient comes from an oil extracted from berries at the tops of trees. Saw palmetto is a palm that grows mainly along the southern Atlantic coast of the United States. There are large commercial plantations in Florida, many near Cape Canaveral. A closely related palm grows in southern Europe and in northern Africa. The berries contains small amounts of a volatile oil rich in fatty acids (caproic, caprylic, capric, lauric, palmitic, and oleic acids). In addition, the berries contain beta-sitosterol and ferulic acid. In Europe, products sold to treat prostate enlargement contain at least 85 percent purified oils.
History
For many years the berries were used as a diuretic and as a treatment for the symptoms of urinary tract infections. They were not very effective, and by 1950 Serenoa had been dropped from the National Formulary. Even though physicians lost interest in the plant, claims that it could cause women's breasts to grow have been circulating for years. Strangely enough, the claims may contain an element of truth (see below). It is also claimed, without very much evidence, that Serenoa is an aphrodisiac. The results of modern laboratory studies suggest that the opposite may be the case.
Traditional Claims
Diuretic.
Commission E Recommendations
Saw Palmetto is used to treat diminished urination associated with BPH Stages 1 and 2, and prostate adenoma.
Proven Effects
More than half of men age 50 and older experience some symptoms related to enlargement of the prostate gland!
Serenoa has two separate and apparently unrelated effects on the cells of the prostate that reduce symptoms by making the gland smaller; Serona is an anti-inflammatory but it also blocks a key enzyme that promotes prostate gland enlargement. The prostate gland wraps around the urethra. Hormonal changes associated with aging cause the gland to enlarge. Enlargement, in itself, would not be that great a problem, but the gland is surrounded by a tight shell. As the individual cells grow, they run up against the tight covering, and pressure within the gland increases. The urethra gets compressed, and the result is well known to many middle-aged men: frequency, urgency, difficulty in starting to urinate, and the feeling that the bladder is not really being emptied.
Until recently, the problem could only be solved by surgery. But in the early 1990s, effective medications became available. The first, called Finasteride (Proscar™) works by blocking an enzyme that converts testosterone to dihydrotestosterone (DHT). DHT, it turns out, is the hormone that makes the individual cells grow too much. Blocking DHT prevents the growth and allows the prostate to return to normal size. The problem with this approach is that it may take a year to see any results. Evidence suggests that Serenoa blocks DHT in much the same fashion as Proscar™.
Other studies have shown that Serenoa has anti-inflammatory effects, at least within the prostate, and that could help reduce prostate size as well. The anti-inflammatory effect may explain why many men report improvements in far less time than 12 months. In controlled studies, a dose of 160 mg twice a day significantly reduced symptoms and caused minimal side effects. Results were nearly as good as those achieved with the new generation of prostate drugs (called alpha 1-blockers, Cardura, Flomax, and Hytrin are the best known).
Using the herbal approach may result in some substantial cost savings. Drugs like Cardura cost more than a dollar a tablet, and must be taken for life. Costs for Proscara are even higher, well over $2 per day. The diuretic effects of Serenoa, if any, have never been tested in a clinical trial.
References
Gerber GS, Zagaja GP, Bales GT, Chodak GW, Contreras BA. Saw palmetto (Serenoa repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Urology 1998;51(6):1003-7.
Herbal supplements. Is saw palmetto good for the prostate? Harv Health Lett 1998;23(7):6.
Monograph: Serenoa repens. Altern Med Rev 1998;3(3):227-9.
Powers JE. That pesky prostate and the saw palmetto. S D J Med 1997;50(12):453-4.
Van Berkel GJ, Quirke JM, Tigani RA, Dilley AS, Covey TR. Derivatization for electrospray ionization mass spectrometry. 3. Electrochemically ionizable derivatives. Anal Chem 1998; 70(8):1544-54.
Dosage
Commission E recommends 1 to 2 grams a day of the dried berries or 320 milligrams per day of the extract. Most of the controlled trials done in Europe utilized the 320 milligram per day dose.
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Directions
Take 1 capsule, 3 times daily, with meals.
Cautions
Concerns
The same researchers who found that Serenoa blocked the conversion to DHT, also found that Serenoa interfered with the actions of testosterone. Blocking testosterone is not a good thing in general, and could be a very bad thing, especially for the libido. Instead of being an aphrodisiac, saw palmetto could be an anti-aphrodisiac! Actually, the situation is even worse. Beta-sitosterol, which is also present in the oil from the berries, behaves like a very weak female sex hormone (estrogen). That may explain the claims of some women who say that taking the extract made their breasts grow. In theory, they may be correct.
Warnings
Extracts of saw palmetto appear to be very safe products. Reports of toxicity are limited to the occasional stomach upset. The real cause for concern has nothing to do with the herb, but with the disease it is being used to treat. Cancer of the prostate can mimic the symptoms of benign prostatic hypertrophy (BPH). Only a physician can determine whether it is BPH causing the symptoms or some other disorder. A simple examination and blood test (for PSA, "prostate specific antigen") is all that is required. Once the possibility of cancer has been ruled out, the choice of treatment should be up to the patient.
Drug Testing
There are no reports suggesting that any of the components of the standardized oil could crossreact or cause a false positive in a workplace testing program.
Additional Information
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These statements have not been evaluated by the Food and Drug Administration (FDA). Products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor. The essence of the current American rule on Traditional Uses is, as stated by FTC, "Claims based on historical or traditional use should be substantiated by confirming scientific evidence, or should be presented in such a way that consumers understand that the sole basis for the claim is a history of use of the product for a particular purpose."
