Although it is native to the United States, saw palmetto, like other
alternative medicines, first became popular in Europe, where herbal
remedies are big sellers.
In many European countries, a number of prescription and
over-the-counter remedies for prostate enlargement contain saw
palmetto extract. In Germany, for example, saw palmetto is an
approved drug often recommended by physicians. This is because using
saw palmetto to treat an enlarged prostate can be quite effective.
Now saw palmetto is also very popular in the United States.
Saw Palmetto Studies
In Belgium, researchers gave saw palmetto extract to 505 men with
benign prostate disease. At the end of the trial, the researchers
concluded that saw palmetto had aided urinary flow, reduced residual
urinary volume and prostate size, and otherwise improved the
patients' quality of life. Saw palmetto, moreover, began to produce
results within 45 days. Finasteride, on the other hand, can take six
months to a year to work, if indeed it works at all.
Nutrition and Prostate Health
After 90 days of saw palmetto treatment, 88 percent of patients and
their physicians said they considered the therapy to be effective.
Said the Belgian researchers: "The extract of saw palmetto appears
to be an effective and well-tolerated pharmacologic agent in
treating urinary problems accompanying benign prostate hypertrophy."
In a two-year study conducted in Germany, 88 men with mild BPH were
randomly assigned saw palmetto or placebo (dummy pill). By the end
of the study, the men taking saw palmetto were much less likely to
have had their symptoms worsen compared to those men who were on the
placebo.
But not all the studies of saw palmetto have been as encouraging. In
one double-blind trial, 110 patients took either a placebo or an
extract of saw palmetto for one month. The patients who received saw
palmetto showed statistical improvement, but not enough for the
researchers to conclude that saw palmetto was an effective
treatment.
A very large trial published in the New England Journal of Medicine
in 2006 found no effect for saw palmetto compared to placebo.
However, the men in this study had significantly more severe BPH
symptoms than in previous studies. This research seemed to confirm
that saw palmetto is best for mild-to-moderate BPH symptoms and is
unlikely to help in more serious cases.
How Saw Palmetto Works
According to the late pharmacognosist Varro E. Tyler, Ph.D., former
professor emeritus at Purdue University School of Pharmacy in
Indiana, an extract from saw palmetto berries appears to counteract
the effects of certain male sex hormones, called androgens, that may
cause prostate enlargement. He said it also has an anti-inflammatory
activity.
Just how saw palmetto achieves results remains unclear. Studies in
mice have shown that an extract of saw palmetto berries inhibits the
enzyme 5-alpha-reductase. That's the chemical, you'll recall, that
spurs production of DHT, which causes prostate tissue growth.
Saw palmetto extract also appears to inhibit DHT from binding to
cell receptor sites. This increases the breakdown of DHT and
encourages its excretion. Other studies show saw palmetto can relax
the prostate tissue by blocking the same receptors as alpha-blockers
like tamsulosin.
Other research suggests saw palmetto appears to reduce the effects
of excess estrogen. In a subsequent human trial, 80 percent of men
with benign prostate enlargement reported significant improvement in
symptoms after using saw palmetto extract.
How Does Saw Palmetto Compare?
Medications used to treat BPH typically cost twice as much (or more)
as saw palmetto. Prices vary from region to region, but as far back
as 1993, the U.S. Office of Alternative Medicine concluded that
$2.78 billion per year could be saved by using saw palmetto more
widely. The savings would certainly be much more today.
Treatment Options for an Enlarged Prostate
Nonetheless, it's unlikely that you'll see saw palmetto as a
federally approved drug any time soon. In 1990, a company called
Enzymatic Therapy petitioned the FDA to have saw palmetto approved
for treatment of BPH. The federal agency rejected the application.
FDA officials said they recognized results of clinical trials that
showed "statistically significant" improvements in men who took the
herbal extract. But the FDA concluded that such data was not
"clinically significant."
What Should You Take?
So where does that leave you if you're suffering from symptoms of
prostate enlargement? The first thing to do is to see your doctor to
rule out other conditions, including prostate cancer. Then the two
of you can determine whether it would be in your best interest to
try prescription medications, saw palmetto extract, or a combination
to treat your enlarged prostate.
When purchasing saw palmetto, be sure to buy an extract standardized
to contain 85 to 95 percent fatty acids and sterols. Berries alone,
although cheaper than the extract, would have to be taken in much
greater amounts to achieve beneficial effects. Only standardized
fatty acid sterols have been studied for their ability to shrink
prostatic tissue.
As discussed in this article, there are many steps you can take on
your own to ease the symptoms of an enlarged prostate. But remember
to see your doctor regularly don't let an enlarged prostate go
untreated.
Source
