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Does Saw Palmetto Work For Prostate Health?

palmetto_300Saw palmetto has long been used for various aspects of prostate and urinary health such as urinary symptoms associated with an enlarged prostate, and the pain and inflammation from prostatitis. Saw palmetto (from the American dwarf palm tree) contains fatty acids and sterols and also works best when combined with other prostate supplements.

Enlarged Prostate (BPH) And Saw Palmetto Health Benefits

Saw palmetto is used throughout the United States and Europe for promoting the health of men with an enlarged prostate (BPH). The beta-sitosterol in saw palmetto works by reducing levels of DHT (dihydrotestosterone) and inhibiting the activity of the 5-alpha-reductase and receptor sites on cell membranes. This prevents the cells from absorbing DHT, which is associated with BPH.

Studies on saw palmetto show that it works best for BPH symptoms when it is used in combination with stinging nettle root extract, quercetin and curcumin. In fact, the reason some studies of saw palmetto for management of BPH have not yielded good results is because they failed to use saw palmetto in combination with other selected supplements. For example, an updated review in the Cochrane Library (May 2012) evaluated 17 randomized controlled trials (with 2,008 participants) and compared 320 mg per day of saw palmetto with a placebo. The reviewers found that saw palmetto alone was no better than placebo in improving lower urinary tract symptoms (LUTS).

On the other hand, a 2011 study evaluated the long-term efficacy of treatment with a saw palmetto extract in men who had LUTS (urinary tract symptoms) associated with BPH. They treated 120 patients with mild or moderate LUTS daily for two years with one capsule of 320 mg ethanolic extract of saw palmetto. At the end of the two-year treatment period, the men showed a statistically significant improvement in their International Prostate Symptom Scores (5.5 points), quality of life, Qmax (urinary flow), International Index of Erectile Function (IIEF; 6.4 points) and reduction in residual urinary volume. Their prostate volume had declined from a mean of 39.8 mL at baseline to 36 mL at two years. The study’s authors concluded that treatment with 320 mg of ethanolic saw palmetto extract long-term is effective in reducing urinary obstruction, improving LUTS, improving quality of life, and that it has a positive impact on sexual function (illustrated by the statistically significant increase in the IIEF).

BPH Surgery

Not only is saw palmetto helpful for BPH but a study shows that is also helpful to take it before BPH surgery (prostate surgery). When compared with patients who did not take saw palmetto, the patients who took 320 mg of saw palmetto every day for two months prior to prostatectomy or transurethral resection of the prostate had fewer complications after surgery, no complications during surgery, no need for transfusion, shorter catheterization and shorter hospital stays than the non-treated group.

Prostatitis And Saw Palmetto

Prostatitis is a common prostate condition that refers to swelling and inflammation of the prostate gland. It can cause painful urination, pain in the groin and flulike symptoms. Saw Palmetto can help alleviate symptoms of prostatitis. A March 2010 study evaluated over 100 patients and found that saw palmetto helped patients with pain and discomfort.

Another study split prostatitis patients into two groups. One group took antibiotics while the other group took antibiotics with a saw palmetto supplement containing curcumin, and quercetin. Nearly 90 percent of the patients who received the supplement had all their symptoms go away after one month compared to 27 percent of the group that received only an antibiotic. None of the supplement group experienced a recurrence of prostatitis in the following six months, but those who did not receive the supplement suffered recurring problems.

Saw palmetto has been compared to the medication Flomax (tamsulosin) for men suffering with chronic prostatitis. In one study, researchers randomly assigned 157 chronic prostatitis sufferers to take either 160 mg saw palmetto twice a day or 0.4 mg Flomax for six weeks. At the end of the study period, men in both groups experienced similar improvements in their Chronic Prostatitis Symptom Index (CPSI) scores, although men who took saw palmetto had a greater decline in their pain scores. Besides being better at relieving pain, saw palmetto does not cause the negative sexual side effects that are associated with Flomax.

How To Take Saw Palmetto

Saw palmetto is best absorbed in supplement form, and it is often used as an ingredient in supplements that are designed for men’s health. It is usually taken at a dose of 320 mg per day, and it is most effective when taken with quercetin, stinging nettle, and curcumin. For example, the prostate supplement Prost-P10x contains 640 mg of saw palmetto, along with other natural ingredients. While saw palmetto is available as a tea, some of the active ingredients are not water soluble, so supplements are recommended. Side effects of saw palmetto may include some back pain and headache.

References:

Anceschi R et al. Serenoa repens (Permixon) reduces intra- and postoperative complications of surgical treatments of benign prostatic hyperplasia. Minerva Urol Nefrol 2010 Sep; 62(3): 219-23

Cai T et al. Serenoa repens associated with Urtica dioica (ProstaMEV) and curcumin and quercitin (FlogMEV) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomized study. Int J Antimicrob Agents 2009 Jun; 33(6): 549-53

Kravchick SG et al at the 27th Annual European Association of Urology Congress, February 24-28, 2012, Paris, France.

Mantovani F. Serenoa repens in benign prostatic hypertrophy: analysis of 2 Italian studies. Minerva Urol Nefrol 2010 Dec; 62(4): 335-40

Sinescu I et al. Long-term efficacy of serenoa repens treatment in patients with mild and moderate symptomatic benign prostatic hyperplasia. Urol Int 2011; 86(3): 284-49

Tacklind J et al. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev 2009 Apr 15; (2): CD001423.

Dr. Geo Espinosa

is the Director of the Integrative Urology Center at New York University Langone Medical Center and the Chief Science Officer at Prostate Research Labs. Before joining NYU, Dr. Espinosa was a clinician, researcher and director of clinical trials at the Center for Holistic Urology at Columbia University Medical Center. He is a licensed naturopathic doctor, licensed acupuncturist, a Certified Nutrition Specialist and a Registered Herbalist. Dr. Espinosa is an author of the naturopathic entry in 1000 Cures for 200 Ailments (Harper Collins, March, 2007) and “Prostate Cancer — Nutrients that may slow its progression,” Food and Nutrients in Disease Management (Maryland: Cadmus Publishing, 2009). Dr. Espinosa also serves on the editorial board of the Natural Medicine Journal. Dr Geo is a frequent speaker at universities, medical schools and conferences on Integrative Health, nutrition and natural treatments for prostate disease. Read more on Dr. Geo.

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