Saw palmetto (Serenoa repens, Sabal serrulata) is a very popular herb in both North America and Europe. For decades, saw palmetto has been used by many Europeans to treat symptoms of prostatic hypertrophy (enlarged prostate or BPH). In the USA, saw palmetto is quickly gaining fame for BPH partly because it is safe and has much fewer side effects compared to the conventional drugs. However, all consumers should understand that saw palmetto is not a replacement for traditional medical therapy for prostate hypertrophy but a complimentary therapy The use of saw palmetto can be traced back to the Mayan culture that used extracts of the plant as a tonic and an antiseptic. Even the berries of the plant were widely consumed to relieve cough and fever.
At the moment saw palmetto is an accepted licensed product in many European countries but in North America it is classified as a health supplement. Its use in America is empirical and one does not need a prescription.
There is some evidence that saw palmetto does inhibit enzymes that make the hormone, testosterone, and there are other reports which indicate that the herb may also have a direct action of androgen receptors.
So what should one use saw palmetto for?
Many clinical trials have shown that saw palmetto can improve symptoms of benign prostate hypertrophy. While the herb does not decrease size of the prostate gland it does relieve night time urination, improves urine flow and relieves irritation while voiding. Individuals who take saw palmetto for BPH claim that it has much fewer side effects that the conventional drugs. While saw palmetto may not be better than some of the newer drugs like cardura or hytrin, it is much superior to placebo (sugar pill).
Many men take saw palmetto for hair loss and the results are conflicting. In general, saw palmetto does grow on a few strands of hair here and there and that is about it. For those expecting a full head of hair, you are in for a major disappointment; hair once gone, usually never comes back.
There is little clinical evidence that saw palmettos can cure or prevent prostate cancer. The herbal formula PC SPEC which contains saw palmetto has been found to be toxic and the FDA has banned its sale in North America. Other conditions where manufacturers claim saw palmetto works but there is little clinical evidence include chronic pelvic pain, urinary incontinence, or prostatitis.
The dose of saw palmetto is about 1-2 g of dried powder. There are also solutions, tinctures and whole berries available for sale and the dose is quite variable. There are even tea formulas prepared from berries but these formulas do not work well. There is not enough data to recommend saw palmetto for use in children.
In general, saw palmetto is safe but has been associated with rare cases of allergies. Other common side effects of saw palmetto include stomach cramps, nausea, vomiting, bad breath and constipation. Experts recommend taking saw palmetto with food to avoid the nausea. The lipidosterolic extract is felt to be safe and has much fewer side effects. Other rare side effects of saw palmetto include yellow discoloration of skin and liver damage. Since saw palmetto can enhance bleeding, people undergoing surgery or dental work should stop this herb at least 7-12 days before the procedure.
Some men do report breast tenderness, decreased libido and testicular discomfort after taking saw palmetto for a long time. Because of safety concerns the product PC SPES is no longer available in North America Saw palmetto is not recommended for women.
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