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Saw Palmetto
Aka: Saw Palmetto, Serenoa repens, Sabal serrulata
- Indications (Purported benefits)
- Benign Prostatic Hyperplasia (BPH)
- Efficacy
- Initial studies suggested benefit
- Saw Palmetto equaled Finasteride for improved urine flow (but not Prostate volume)
- Appeared effective for mild to moderate urinary obstructive symptoms
- Wilt (1998) JAMA 280:1604 [PubMed]
- Carraro (1996) Prostate 29:231 [PubMed]
- However, later studies found no benefit
- Placebo-controlled study found no benefit
- Bent (2006) N Engl J Med 354: 557-66 [PubMed]
- Large metaanalysis found no benefit
- Did not reduce Nocturia, Peak Urine Flow, Prostate size or AUA Symptom Index for BPH
- Tacklind (2012) Cochrane Database Syst Rev (12): CD001423 [PubMed]
- Dosing (extracts are not standardized)
- Saw Palmetto 160 mg PO bid or 320 mg PO qd
- Background
- Saw Palmetto
- Scientific names: Serenoa repens, Sabal serrulata
- Dwarf palm tree grows in southeast U.S.
- Active ingredient: Sitosterols
- Extract compositions are not standardized
- Some preparations contain almost no active ingredient
- Feifer (2002) J Urol 168:150-4 [PubMed]
- Pharmacokinetics: Saw Palmetto berry
- In vitro activity
- Anti-androgen
- Anti-Estrogen
- Anti-Inflammatory
- Inhibits Testosterone-5a-reductase (High dose)
- Less Testosterone to Dihydrotestosterone conversion
- Inhibits binding of androgen to receptor (High dose)
- In vivo activity
- No anti-androgen effects demonstrable in rats
- No decreased dihydrotestosterone in men after 7 days
- References
- Rhodes (1993) Prostate 22:43 [PubMed]
- Adverse Effects (Incidence <3%)
- Headache
- Gastrointestinal upset
- Hypertension
- Impotence
- Decreased libido
-
Drug Interactions
- No significant Drug Interactions
- References
- Asher (2017) Am Fam Physician 96(2): 101-7 [PubMed]
- Gordon (2003) Am Fam Physician 67(6):1281-3 [PubMed]
- Marks (2000) J Urol 163:1451-6 [PubMed]