II. Indications (Purported benefits)

III. Efficacy

  1. Initial studies suggested benefit
    1. Saw Palmetto equaled Finasteride for improved urine flow (but not Prostate volume)
    2. Appeared effective for mild to moderate urinary obstructive symptoms
    3. Wilt (1998) JAMA 280:1604 [PubMed]
    4. Carraro (1996) Prostate 29:231 [PubMed]
  2. However, later studies found no benefit
    1. Placebo-controlled study found no benefit
      1. Bent (2006) N Engl J Med 354: 557-66 [PubMed]
    2. Large metaanalysis found no benefit
      1. Did not reduce Nocturia, Peak Urine Flow, Prostate size or AUA Symptom Index for BPH
      2. Tacklind (2012) Cochrane Database Syst Rev (12): CD001423 [PubMed]

IV. Dosing (extracts are not standardized)

  1. Saw Palmetto 160 mg PO bid or 320 mg PO qd

V. Background

  1. Saw Palmetto
    1. Scientific names: Serenoa repens, Sabal serrulata
    2. Dwarf palm tree grows in southeast U.S.
  2. Active ingredient: Sitosterols
  3. Extract compositions are not standardized
    1. Some preparations contain almost no active ingredient
    2. Feifer (2002) J Urol 168:150-4 [PubMed]

VI. Pharmacokinetics: Saw Palmetto berry

  1. In vitro activity
    1. Anti-androgen
    2. Anti-Estrogen
    3. Anti-Inflammatory
    4. Inhibits Testosterone-5a-reductase (High dose)
      1. Less Testosterone to Dihydrotestosterone conversion
    5. Inhibits binding of androgen to receptor (High dose)
  2. In vivo activity
    1. No anti-androgen effects demonstrable in rats
    2. No decreased dihydrotestosterone in men after 7 days
  3. References
    1. Rhodes (1993) Prostate 22:43 [PubMed]

VII. Adverse Effects (Incidence <3%)

  1. Headache
  2. Gastrointestinal upset
  3. Hypertension
  4. Impotence
  5. Decreased libido

VIII. Drug Interactions

  1. No significant Drug Interactions

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Ontology: Sabal serrulata (C0697222)

Definition (NCI) A small hardy fan palm, endemic to coastal plains from South Carolina to southeastern Louisiana including the Florida peninsula, whose stem usually remains below ground or runs just along the surface. In some cases, it develops an erect or arching trunk that may lift the whorl of leaves 2-8 ft (0.6-2.4 m) above ground. The palmate leaves are 2-3 ft (0.6-0.9 m) across and green or bluish green. The cluster of leaves gets about 4-6 ft (1.2-1.8 m) high with a similar spread. In the wild, saw palmetto often grows in clumps 20 ft (6 m) or more in diameter. Drugs extracted from its berries have been used to treat, prostrate swelling, bladder infections and urinary tract infections.
Definition (NCI_NCI-GLOSS) A shrub that is a member of the palm tree family. An extract made from the berries of this shrub has been studied in the treatment of certain urinary and prostate disorders. The scientific name is Serenoa repens.
Definition (CSP) saw palmetto is the common name for Serenoa repens; an extract made from the berries of this shrub is used to treat and strengthen the male reproductive system; particularly beneficial for enlargement of the prostate gland.
Definition (ALT) Saw palmetto.
Concepts Plant (T002)
MSH D028024
English Saw Palmetto, serrulata, Sabal, serrulata, Serenoa, serrulatas, Serenoa, repens, Serenoa, Sabal serrulatas, Serenoa repen, serrulatas, Sabal, repen, Serenoa, Serenoa serrulatas, serenoa serrulata, sabal serrulata, serenoa repen, palmetto saw, saw palmetto, Sabal serrulata, Serenoa repens (W.Bartram) Small, Serenoa serrulata, Corypha repens, Chamaerops serrulata, SERENOA REPENS WHOLE, serenoa repens, Serenoa repens, Serenoa serrulata / saw palmetto, serenoa serrulata/saw palmet
French Serenoa repens, Serenoa serrulata, Sabal serrulata, Palmier nain
Norwegian Palmetto, Serenoapalme, Serenoa repens, Serenoa serrulata, Sabal serrulata, Sagpalme, Dvergpalme