Saw Palmetto: Herbal Medications, What Works

Dr. Kenneth R. Pelletier - The Best Alternative Medicine

Corporate Health Improvement Program (C H I P)

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Saw Palmetto: Herbal Medications, What Works

Saw palmetto (Serenoa repens) berry is the most widely used botanical preparation for prostate problems. Saw palmetto is native to the West Indies and the southeastern United States. Native Americans used saw palmetto berries to treat genitourinary problems. In the early part of this century, saw palmetto berry tea was commonly recommended by medical professionals for benign prostatic hypertrophy (BPH).

Although a number of controlled clinical studies have verified the use of saw palmetto preparations as a safe and effective treatment for relieving the symptoms associated with BPH, results overall have been somewhat variable. Claims that the herb reduces prostate enlargement, or helps prevent the onset of prostate cancer, are not well documented.

A twenty-eight-day study of 110 BPH patients by Champault and associates found that saw palmetto was able to reduce painful urination, nighttime urination, and residual urine in the bladder, with significant improvement in flow rate.

In a trial in Belgium, 505 patients with mild to moderate BPH symptoms were treated with an oral saw palmetto preparation. At the end of three months, the 305 patients who were available for evaluation showed a significant decrease in prostate symptom scores.

A critical review by Lowe and Ku, however, argued that no clear mechanism of action has been proposed for BPH, that there is conflicting evidence in some areas, and that some trials were of poor quality.

Saw palmetto extract has been compared with finasteride (Proscarå), a commonly used synthetic pharmaceutical for the treatment of BPH. In a six-month RCT of 1,098 men, prostate symptom scores showed equivalent decreases with both treatments, but saw palmetto use resulted in fewer complaints of impotence and reduced libido.

Most recently, in the special CAM issue of the Journal of the American Medical Association in November of 1998, researchers at the Minneapolis Veteran Affairs Medical Center reported another positive study on the effectiveness of saw palmetto. This study also found that saw palmetto was as effective as the drug Proscar in relieving symptoms and increasing urine flow with fewer side effects than the commonly prescribed drug.

Biochemical and anatomical evidence is lacking to support claims that saw palmetto actually reduces enlarged prostate size. While some research suggests it may help to prevent prostate cancer, more research in this area is needed. In the United States, the FDA currently prohibits the sale of over-the-counter products for treating BPH, arguing that none have been proven efficacious, and that their use may cause delays in seeking medical attention. Under proper medical supervision, lipophilic saw palmetto extract, sold as a dietary supplement, may afford a low-cost and nontoxic alternative to conventional pharmaceutica

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From THE BEST ALTERNATIVE MEDICINE: WHAT WORKS? WHAT DOES NOT? by Dr. Kenneth R. Pelletier.

Reprinted by permission of Simon & Schuster, Inc., New York, New York.

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