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20-September-2008 09:29:07 - Saw palmetto extract Saw palmetto extract is an extract of the fruit of Serenoa repens. It is rich in fatty acids and phytosterols, and has shown promise in treating benign prostatic hyperplasia1. Native Americans used the fruit for food, but also in the treatment of a variety of urinary and reproductive system problems. The Mayans drank it as a tonic, and the Seminoles used the berries as an expectorant and antiseptic.2 The European colonists learned of the use of saw palmetto. It was used as a crude extract for at least 200 years for various conditions including asthenia weakness, recovery from major illness, and urogenital problems. For instance, the Eclectic physician H. W. Felter wrote of it, Saw palmetto is a nerve sedative, expectorant, and a nutritive tonic, acting kindly upon the digestive tract...Its most direct action appears to be upon the reproductive organs when undergoing waste of tissue...3 The Eclectics knew saw palmetto as more than a prostate herb. King's American Dispensatory, in 1898 claims: It is also an expectorant, and controls irritation of mucous tissues. It has proved useful in irritative cough, chronic bronchial coughs, whooping-cough, laryngitis, acute and chronic, acute catarrh, asthma, tubercular laryngitis, and in the cough of phthisis pulmonalis. Upon the digestive organs it acts kindly, improving the appetite, digestion, and assimilation. However, its most pronounced effects appear to be those exerted upon the urino-genital tracts of both male and female, and upon all the organs concerned in reproduction. It is said to enlarge wasted organs, as the breasts, ovaries, and testicles, while the paradoxical claim is also made that it reduces hypertrophy of the prostate. Possibly this may be explained by claiming that it tends toward the production of a normal condition, reducing parts when unhealthily enlarged, and increasing them when atrophied.4 In modern times, much research has been done on extract made from the fruits, which are highly enriched with fatty acids and phytosterols. This research has been the subject of a thorough meta-analysis published in the Journal of the American Medical Association and has been shown to be effective for the treatment of men with symptomatic benign prostatic hyperplasia enlargement of the prostate compared to placebo and the two major categories of drugs used for men with this condition.1 There are also small, positive clinical trials published on the use of saw palmetto extracts topically and internally for male-pattern baldnesscitation needed. In 2005, a long-term, placebo-controlled trial showed that a combination of saw palmetto fruit and nettle root extracts were effective in treating urinary tract symptoms in older men.5 However, in February 2006, a large, blinded placebo-controlled study published in the New England Journal of Medicine showed no reduction of symptoms from enlarged prostate by taking saw palmetto, as compared to placebo.6 Designers of the latest study questioned whether the differently-flavored placebos in previous studies were adequately blinded. Critics of the latest study questioned whether a sufficient dosage of active ingredients was given.7 An earlier single case study on saw palmetto concluded that searching for information on a herbal medicine using MEDLINE alone was insufficient, and expanded their search to alternative databases, including AGRICOLA, EMBASE, IBIS, and Cochrane, plus a manual search of unindexed herbal journals.8 Other research has shown that the herb works by multiple mechanisms, including inhibiting 5-alpha-reductase, interfering with dihydrotestosterone binding to the androgen receptor, by relaxing smooth muscle tissue similarly to alpha antagonist drugs, and possibly by acting as a phytoestrogen.910 Because the fruit is the part used and because a prolific quantity is produced by an adult saw palmetto plant, this herbal medicine is considered ecologically sustainable. Though in vitro studies suggest saw palmetto has properties that might make it useful against prostate cancer cells or to reduce prostatitis, clinical trials are lacking. David Winston RH AHG describes a variety of conditions where saw palmetto extract is useful for men and women, using both research and ethnobotanical uses. 11 Contraindications and side effects Though men taking saw palmetto may develop mild nausea, reduced libido, or erectile dysfunction, the rate of such problems is clinically and statistically far less common than in men taking drugs to treat BPH symptoms, based on the JAMA meta-analysis cited above. There are no known drug interactions. It should generally be avoided in pregnancy and lactation and in small children due to lack of experience and knowledge in these populations and because of the purely theoretical risk of hormonal interference. It has not been proven that Saw palmetto causes a reduction of libido or erectile dysfunction. In fact saw Palmetto is used also as a light aphrodisiac; Saw palmetto reduces the DHT in the blood in a different way than Finasteride which could cause reduced libido. It is common to find in herbal drugs as a cure for sexual problems, such as reduced libido or erectile disfunction, a small dose of saw palmetto extract associated with ginseng or other plants that contain L-arginine Emanuel Gargiulo While saw palmetto is generally considered safe, one of its primary active ingredients, beta-sitosterol, is chemically similar to cholesterol. High levels of sitosterol concentrations in blood have been correlated with increased severity of heart disease in men who have previously suffered from heart attacks.12 As with other nutrients and herbs, various people may have different responses based on their chemical and biological make up. References ^ a b Wilt TJ et al 1998. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 280: 1604-1609. doi:10.1001/jama.280.18.1604. ^ Saw palmetto. Mayo Clinic. Retrieved on 2008-04-17. ^ Felter's complete text ^ King's American Dispensatory 1898 ^ Lopatkin N et al 2005. Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms-a placebo-controlled, double-blind, multicenter trial. World Journal of Urology 23 2: 139-146. doi:10.1007/s00345-005-0501-9. ^ Bent S et al 2006. Saw Palmetto for Benign Prostatic Hyperplasia. NEJM 354: 557-566. doi:10.1056/NEJMoa053085. ^ Allison Aubrey. Morning ion: Study Casts Doubt on Saw Palmetto as Prostate Remedy Audio recording. National Public Radio. ^ McPartland JM, Pruitt PL. 2000. Benign prostatic hyperplasia treated with saw palmetto: a literature search and an experimental case study. JAOA 100 2: 89-96. ^ Di Silverio F et. al 1998. Effects of long-term treatment with Serenoa repens Permixon on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia. Prostate 37 2: 77-83. doi:10.1002/SICI1097-00451998100137:277::AID-PROS33.0.CO;2-I. ^ Plosker GL, Brogden RN 1996. Serenoa repens Permixon. A review of its pharmacology and therapeutic efficacy in benign prostatic hyperplasia. Drugs Aging 9 5: 379-95. ^ David Winston 1999. Saw Palmetto for Men Women: Herbal Healing for the Prostate, Urinary Tract, Immune System and More Medicinal Herb Guide. Storey Publishing, LLC. ISBN 978-1580172066. ^ Assmann G, et. al 2006. Plasma sitosterol elevations are associated with an increased incidence of coronary events in men: results of a nested case-control analysis of the Prospective Cardiovascular Munster PROCAM study. Nutr Metab Cardiovasc Dis 16 1: 13-21. doi:10.1016/j.numecd.2005.04.001. External links Guide to Supplements-Saw Palmetto-Berkeley Wellness Letter Saw Palmetto for Prostate Disorders-American Academy of Family Physicians Complementary and Alternative Therapies For Cancer Patients Saw Palmetto-University of California at San Diego Medical Center v d e Urologicals G04 Acidifiers Ammonium chloride, Calcium chloride Urinary antispasmodics primarily antimuscarinics Darifenacin, Emepronium, Fesoterodine, Flavoxate, Imidafenacin, Meladrazine, Oxybutynin, Propiverine, Solifenacin, Terodiline, Tolterodine, Trospium For erectile dysfunction prostaglandins Alprostadil PDE5 inhibitors Avanafil - Sildenafil - Tadalafil - Udenafil - Vardenafil alpha blockers Moxisylyte - Phentolamine - Yohimbine others Apomorphine - Papaverine Other urologicals Acetohydroxamic acid, Collagen, Dimethyl sulfoxide, Magnesium hydroxide, Pentosan polysulfate, Phenazopyridine, Phenyl salicylate, Succinimide For BPH 5α-reductase inhibitors Dutasteride, Finasteride Alpha blockers Alfuzosin, Doxazosin, Silodosin, Tamsulosin, Terazosin Herbals Pygeum africanum, Serenoa repens Retrieved from http://en..org/wiki/Saw_palmetto_extract Categories: Dietary supplements | Medicinal plantsHidden categories: All articles with statements | Articles with statements since April 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page This page was last modified on 13 August 2008, at 02
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