Saw palmetto (Serenoa repens) might rightfully be considered a man’s herb, because most of the research and discussion about this medicinal plant has focused on men’s health issues, including enlarged prostate (benign prostatic hyperplasia, BPH), lower urinary tract symptoms (usually associated with BPH), and male pattern baldness. Yet despite the growing number of published studies regarding saw palmetto and men’s maladies and the supplements available to manage them, there is still some disagreement among experts about the effectiveness of this popular herbal remedy.
Fortunately, scientists have been busy attempting to close the knowledge gap regarding saw palmetto and men’s health issues. Before we take a look at those most recent attempts and their findings, let’s take a brief look at saw palmetto itself.
What Is Saw Palmetto?
Saw palmetto, also known as the American dwarf palm tree, is a palm-like plant with spiny leaves found primarily in the Southeastern United States. Its dark red-black berries are rich in four major substances:
- Phytosterols: including beta-sitosterol (among the most studied of the phytosterols), campesterol and stigmasterol. Phytosterols are chemically similar to cholesterol, but they actually have cholesterol-busting properties.
- Fatty acids: including oleic acid, myristic acid and palmitic acid.
- Free fatty alcohols: fatty acids attached to an alcohol molecule.
- Monoglycerides: a type of fatty acid attached to glycerol molecules.
To make saw palmetto supplements, the berries are partially dried and treated with a solvent to break them down, eventually resulting in liquid extracts or capsules.
A growing number of men are turning to saw palmetto for men’s health conditions. One reason is that saw palmetto has been shown to reduce levels of the hormone dihydrotestosterone (DHT) in prostate tissue. DHT plays a major role in the development of an enlarged prostate. Saw palmetto also has demonstrated abilities to inhibit the activity of insulin-like growth factor (IGF-1), another substance known to cause an enlarged prostate.
Along with saw palmetto’s effect on prostate enlargement is its impact on lower urinary tract symptoms that accompany BPH. A number of studies have shown that saw palmetto is an effective remedy for relieving lower urinary tract symptoms as well as symptoms associated with chronic, prostatitis, a condition characterized by inflammation of the prostate.
Turning away from the prostate for a moment, saw palmetto may also help prevent or slow progression of male pattern baldness. That benefit also is associated with the herb’s ability to reduce DHT levels.
Studies Of Saw Palmetto
So, what do the researchers have to say about the ability of saw palmetto to improve men’s health? Here are some recent findings.
- An Italian study (June 2012) conducted by a large team at Villa Tiberia Clinic reported on the use of saw palmetto in men with either an enlarged prostate or chronic prostatitis. Nearly 600 men were enrolled in the multicenter study and treated for six months with saw palmetto. All the men completed standard questionnaires concerning lower urinary tract symptoms and sexual function both before and after the treatment period. Saw palmetto use resulted in “statistically significant improvement” in scores “not only in an improvement in urinary symptoms but also in an overall improvement in patients’ quality of life.” 
- At the University of London, a study (April 2012) evaluated the use of saw palmetto (320 mg daily) in 82 men with an enlarged prostate in an open multicenter clinical pilot format. At the end of the eight-week study, the men improved significantly on sexual function, prostate symptoms and quality of life scores, and the supplement was well tolerated. The authors also noted that “this was the first trial with saw palmetto to show improvement in BPH symptoms and SDys [sexual dysfunctions] as well.” 
- An interesting study from the University of Messina (October 2011) reported on the use of saw palmetto along with two other natural supplements associated with prostate health: selenium and lycopene. It appears that saw palmetto, when taken along with the antioxidants selenium and lycopene, is more effective at reducing the weight and size of an enlarged prostate gland than use of saw palmetto alone. 
- Worried about hair loss? A Colorado pilot study explored the use of a saw palmetto extract and beta-sitosterol in men with mild to moderate male pattern baldness. Investigators in the double-blind study reported that “60% of (6/10) study subjects dosed with the active study formulation were rated as improved at the final visit.”
Not every study has reported positive results regarding the effect of saw palmetto on men’s health. For example:
- The authors of a Cochrane systematic review evaluated 17 randomized, controlled studies involving more than 2,000 individuals. Overall, reviewers found that saw palmetto was no better than placebo in reducing lower urinary tract symptoms, even when doses of the herbal remedy were doubled and tripled. Saw palmetto was not associated with any significant side effects.
- In a Journal of the American Medical Association article, a double-blind, multicenter, placebo-controlled trial involving 369 men explored the use of 320 mg per day or more of saw palmetto versus placebo on lower urinary tract symptoms. Overall, the reviewers did not see a significant difference in urinary tract symptoms when compared with placebo. 
Could saw palmetto help you? The only way to know is to try it. Although some users of saw palmetto have reported side effects such as constipation, diarrhea, dizziness, headache, nausea and vomiting, they occur just as often as they do when men take a placebo.  Be sure to consult your healthcare provider before taking saw palmetto supplements or starting any supplement program.
 Multicenter study on the efficacy and tolerability of an extract of Serenoa repens in patients with chronic benign prostate conditions associated with inflammation. http://www.ncbi.nlm.nih.gov/pubmed/22908779
 A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. http://www.ncbi.nlm.nih.gov/pubmed/12006122
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