Saw palmetto is an extract from the ripe berries of the American dwarf palm, has been widely used as a therapeutic remedy for urinary dysfunction due to benign prostatic hyperplasia (BPH) in Europe. Numerous mechanisms of action have been proposed for SPE, including the inhibition of 5α-reductase. Today, α1-adrenoceptor antagonists and muscarinic cholinoceptor antagonists are commonly used in the treatment of men with voiding symptoms secondary to BPH. The improvement of voiding symptoms in patients taking SPE may arise from its binding to pharmacologically relevant receptors in the lower urinary tract, such as α1-adrenoceptors, muscarinic cholinoceptors, 1,4-dihyropyridine receptors, and vanilloid receptors.
Uses / Health Benefits of Saw Palmetto
- Anti-inflammatory effects – Inflammation was frequently observed in hormonally induced hypertrophied prostates of dogs and in a study of human BPH. Mahakali et al concluded that the development of hyperplasia preceded inflammatory infiltration. An anti-inflammatory effect was indicated as one of the mechanisms of action of SPE. In fact, it is plausible that SPE affects several inflammatory mediators. SPE showed anti-inflammatory and anti-edematous effects in vivo. The production of 5-lipoxygenase metabolites was inhibited by SPE at a concentration of 5 μg/mL35. Breu et al34 demonstrated that acid lipophilic compounds of SPE inhibited the biosynthesis of cyclooxygenase and 5-lipoxygenase metabolites with the same intensity as SPE.
- Anti-proliferative effects – Maintenance of a constant number of cells is one of the basic functions of homeostasis. In the normal adult prostate, the delicate balance between apoptosis and proliferation is well regulated and these indices are low. In contrast, in a prostate with BPH this equilibrium may not be maintained 40. Kyprianou et al37 showed a statistically significant elevation in TGF-β, a negative growth factor able to induce apoptosis under physiological conditions, in the epithelial cells of BPH tissue compared with the normal prostate and a statistically significant increase in the intensity of immunoreactivity for bcl-2 and the number of positive epithelial cells in BPH specimens relative to normal prostate.
Anti-androgenic effects – The development and growth of the prostate gland depend on androgen stimulation. DHT is one of several factors regulating this development and growth and is converted from testosterone by 5α-reductase. This enzyme has two isoforms (5α-reductase 1 and 2). The respective roles of these 5α-reductases in BPH development have not yet been elucidated26. SPE inhibited both isozymes in a noncompetitive manner whereas finasteride inhibited only 5α-reductase 2 in a competitive manner25. Among the many components of SPE, lauric acid and linoleic acid showed inhibition of both isozymes, oleic acid was active only against 5α-reductase 1 and myristic acid was active only against 5α-reductase 2. However, palmitic acid, stearic acid, esterified fatty acids, sterols, and alcohols were inactive against both30.
Prostate surgery (transurethral resection of the prostate; TURP) – Research shows that taking 320 mg of saw palmetto daily for 2 months before prostate surgery can reduce the time spent in surgery, blood loss, the development of problems during surgery, and the total time spent in the hospital. However, one small study found that taking 160 mg of saw palmetto per day for 5 weeks before surgery does not lower the risk of problems during surgery.
Enlarged prostate (benign prostatic hyperplasia; BPH) – The effect of saw palmetto on prostate symptoms is conflicting. However, higher quality and more reliable research seem to indicate that saw palmetto has little or no benefit for reducing symptoms such as going to the bathroom at night or painful urination in men with BPH. Any benefit is modest at best. Also, saw palmetto does not seem to work as quickly or enhance the effects of certain drugs used to treat BPH.
Male and female pattern baldness (androgenic alopecia) – The effects of saw palmetto in people with male and female pattern baldness are conflicting. Some research shows that taking saw palmetto and beta-sitosterol by mouth improves the amount and quality of hair in men with male pattern baldness. However, taking saw palmetto by mouth does not appear to improve hair growth as well as the drug finasteride. Early research suggests that applying saw palmetto to the scalp may increase hair density in men and women who are balding. However, higher quality research is needed to confirm these results.
Underactive bladder (hypotonic bladder) – The underactive bladder is a condition in which the bladder can hold unusually large amounts of urine but does not empty completely upon urination. Early research suggests that taking 90-120 drops of a combination of echinacea and saw palmetto for 77 days improves the amount of urine the bladder can hold and the amount left in the bladder after urination in women with the underactive bladder.
- Prostate cancer – Taking saw palmetto doesn’t seem to be linked with a reduced risk of prostate cancer. Also, taking saw palmetto during radiation for early prostate cancer doesn’t seem to improve lower urinary tract symptoms. These symptoms are common in men undergoing radiation for prostate cancer.
- Prostate swelling and chronic pelvic pain syndrome – Some early research shows that saw palmetto can improve symptoms in men with prostate swelling not caused by an infection. Other early research suggests that taking saw palmetto along with the drug prulifloxacin reduces pain and urinary symptoms better than taking prulifloxacin alone in men with prostate swelling caused by an infection. However, taking the combination doesn’t appear to treat the infection or improve sexual function.
- Protection against Hair Loss – Saw palmetto extracts and supplements aid as hair loss remedies because they keep testosterone levels balanced in the male body. The conversion of testosterone by 5-alpha-reductase in the hair follicles causes male pattern baldness (androgenetic alopecia). By inhibiting the action of this enzyme, saw palmetto may lessen hair loss and stimulate hair growth. Saw palmetto extract also contributes to hair regrowth.
- Treats Impotence – Saw palmetto extract has long been known as a herbal treatment for impotence. It can boost sexual performance and increase virility.
- Urinary Frequency – Saw palmetto supports the urological system in men who have benign prostatic hyperplasia. It also helps to cure urinary dysfunction and overactive bladder. Saw palmetto is also advantageous to treat weakening urinary organs in elderly people or women after menopause because it strengthens the urinary organs and has been recommended as a natural remedy for kidney stones.
- Increases Muscle Mass – Saw palmetto can positively impact on testosterone in the body and thus, is responsible for muscle mass increase.
- Boosts Immunity – Saw palmetto have been known to generally enhance the immune system, particularly for mild conditions such as colds, coughs, and sore throats. Headaches and migraine sufferers have also benefitted from the use of saw palmetto. It works as an anti-inflammatory agent and reduces pain and discomfort.
In baldness and prostate enlargement.
To help build and strengthen tissue and increase metabolism.
As a diuretic which improves urinary flow.
As an expectorant to relieve chronic bronchitis, asthma and chest congestion.
In thyroid disorders.
To stimulate appetite, digestion, and absorption of nutrients.
In polycystic ovary syndrome.
The dosage of Saw Palmetto
Prostate surgery (transurethral resection of the prostate, TURP)
- 320 mg of saw palmetto extract daily for 2 months before surgery.