Saw palmetto extract
Encyclopedia
Saw palmetto extract is an extract of the fruit of Serenoa repens. It is rich in fatty acid
s and phytosterol
s. It has been used in traditional
, eclectic
, and alternative medicine
for a variety of indications, most notably benign prostatic hyperplasia
.
. Native Americans
used the fruit for food and in the treatment of a variety of urinary
and reproductive system
problems. The Mayans
drank it as a tonic, and the Seminole
s used the berries as an expectorant and antiseptic
.
The taste of saw palmetto fruit is reported to be repugnant. A book by Susan Hales (1898) describes the saw palmetto fruit as a staple food item for the Seminole Indians. The aboriginal American medicine man also kept a medicine bag of saw palmetto around to treat illness and to nourish the body. Other historical uses have included the treatment of infertility in women, treatment of underdeveloped breasts, increased lactation, painful menstruation cycles, reduce prostate, appetite stimulant, and as a tonic.
practitioner 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..."
King's American Dispensatory (1898) describes the extract as:
, a common condition in older men. Early research indicated that the extract is well-tolerated and suggested "mild to moderate improvement in urinary symptoms and flow measures". Later trials of higher methodological quality indicated no difference from placebo. Questions of adequate blinding and delivery of any active ingredients remain.
Inhibition of both forms of 5-alpha-reductase with no reduction in cellular capacity to secrete prostate-specific antigen is indicated.
Other proposals for mechanisms of action include interfering with dihydrotestosterone
binding to the androgen receptor, relaxing smooth muscle tissue similarly to alpha antagonist drugs, and acting as a phytoestrogen.
Limited in vitro and animal model studies suggest possible anti-tumor activity and potential for use in the treatment of cancer
. These results have not been substantiated with human trials
.
Saw palmetto extract has been suggested as a potential treatment for male pattern baldness.
The latest Cochrane Database review. (2009) concludes that "The evidence suggests that Serenoa repens provides mild to moderate improvement in urinary symptoms and flow measures. Serenoa repens produced similar improvement in urinary symptoms and flow compared to finasteride
and is associated with fewer adverse treatment events. "
A 2001 study published in JAMA (The Journal of the American Medical Association
) found that saw palmetto fruit extract failed to reduce urinary tract symptoms more than placebo. The double-blind study was conducted at eleven North American clinics and included 369 men. Men in the experimental group experienced a 2.20 point drop in their American Urological Assn. Symptom Index (AUASI) score. However, men in the placebo group saw a 2.99 point drop. The Los Angeles Times
reports, “42.6% of the men in the extract group saw their AUASI scores fall by at least three points; 44.2% of the men in the placebo group saw the same degree of benefit.” The study was funded by several offices within the NIH, including the National Center for Complementary and Alternative Medicine.”
Beta-sitosterol, one chemical present in saw palmetto extract, 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.
As with other herbal preparations, precise chemical constituents may vary by manufacturer and batch.
Contraindications include pregnancy, lactation due to antiandrogenic and estrogenic activity.
Fatty acid
In chemistry, especially biochemistry, a fatty acid is a carboxylic acid with a long unbranched aliphatic tail , which is either saturated or unsaturated. Most naturally occurring fatty acids have a chain of an even number of carbon atoms, from 4 to 28. Fatty acids are usually derived from...
s and phytosterol
Phytosterol
Phytosterols, which encompass plant sterols and stanols, are steroid compounds similar to cholesterol which occur in plants and vary only in carbon side chains and/or presence or absence of a double bond. Stanols are saturated sterols, having no double bonds in the sterol ring structure. More than...
s. It has been used in traditional
Traditional medicine
Traditional medicine comprises unscientific knowledge systems that developed over generations within various societies before the era of modern medicine...
, eclectic
Eclectic medicine
Eclectic medicine was a branch of American medicine which made use of botanical remedies along with other substances and physical therapy practices, popular in the latter half of the 19th and first half of the 20th centuries....
, and alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....
for a variety of indications, most notably benign prostatic hyperplasia
Benign prostatic hyperplasia
Benign prostatic hyperplasia also known as benign prostatic hypertrophy , benign enlargement of the prostate , and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate....
.
Traditional medicine
Saw palmetto is used in several forms of traditional medicineTraditional medicine
Traditional medicine comprises unscientific knowledge systems that developed over generations within various societies before the era of modern medicine...
. Native Americans
Indigenous peoples of the Americas
The indigenous peoples of the Americas are the pre-Columbian inhabitants of North and South America, their descendants and other ethnic groups who are identified with those peoples. Indigenous peoples are known in Canada as Aboriginal peoples, and in the United States as Native Americans...
used the fruit for food and in the treatment of a variety of urinary
Urinary system
The urinary system is the organ system that produces, stores, and eliminates urine. In humans it includes two kidneys, two ureters, the bladder and the urethra.-Kidney:...
and reproductive system
Reproductive system
The reproductive system or genital system is a system of organs within an organism which work together for the purpose of reproduction. Many non-living substances such as fluids, hormones, and pheromones are also important accessories to the reproductive system. Unlike most organ systems, the sexes...
problems. The Mayans
Maya civilization
The Maya is a Mesoamerican civilization, noted for the only known fully developed written language of the pre-Columbian Americas, as well as for its art, architecture, and mathematical and astronomical systems. Initially established during the Pre-Classic period The Maya is a Mesoamerican...
drank it as a tonic, and the Seminole
Seminole
The Seminole are a Native American people originally of Florida, who now reside primarily in that state and Oklahoma. The Seminole nation emerged in a process of ethnogenesis out of groups of Native Americans, most significantly Creeks from what is now Georgia and Alabama, who settled in Florida in...
s used the berries as an expectorant and antiseptic
Antiseptic
Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction...
.
The taste of saw palmetto fruit is reported to be repugnant. A book by Susan Hales (1898) describes the saw palmetto fruit as a staple food item for the Seminole Indians. The aboriginal American medicine man also kept a medicine bag of saw palmetto around to treat illness and to nourish the body. Other historical uses have included the treatment of infertility in women, treatment of underdeveloped breasts, increased lactation, painful menstruation cycles, reduce prostate, appetite stimulant, and as a tonic.
Eclectic medicine
The crude extract was used for at least 200 years for various conditions including asthenia (weakness), recovery from major illness, and urogenital problems. For instance, the eclectic medicineEclectic medicine
Eclectic medicine was a branch of American medicine which made use of botanical remedies along with other substances and physical therapy practices, popular in the latter half of the 19th and first half of the 20th centuries....
practitioner 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..."
King's American Dispensatory (1898) describes the extract as:
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 catarrhCatarrhCatarrh is a disorder of inflammation of the mucous membranes in one of the airways or cavities of the body. It can result in a thick exudate of mucus and white blood cells caused by the swelling of the mucous membranes in the head in response to an infection...
, asthma, tubercular laryngitis, and in the cough of phthisis pulmonalisTuberculosisTuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. 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.
Alternative medicine
Saw palmetto extract is the most popular herbal preparation taken for benign prostatic hyperplasiaBenign prostatic hyperplasia
Benign prostatic hyperplasia also known as benign prostatic hypertrophy , benign enlargement of the prostate , and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate....
, a common condition in older men. Early research indicated that the extract is well-tolerated and suggested "mild to moderate improvement in urinary symptoms and flow measures". Later trials of higher methodological quality indicated no difference from placebo. Questions of adequate blinding and delivery of any active ingredients remain.
Inhibition of both forms of 5-alpha-reductase with no reduction in cellular capacity to secrete prostate-specific antigen is indicated.
Other proposals for mechanisms of action include interfering with dihydrotestosterone
Dihydrotestosterone
Dihydrotestosterone is an androgen or male sex hormone. The enzyme 5α-reductase synthesises DHT in the prostate, testes, hair follicles, and adrenal glands...
binding to the androgen receptor, relaxing smooth muscle tissue similarly to alpha antagonist drugs, and acting as a phytoestrogen.
Limited in vitro and animal model studies suggest possible anti-tumor activity and potential for use in the treatment of cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
. These results have not been substantiated with human trials
Clinical trial
Clinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...
.
Saw palmetto extract has been suggested as a potential treatment for male pattern baldness.
The latest Cochrane Database review. (2009) concludes that "The evidence suggests that Serenoa repens provides mild to moderate improvement in urinary symptoms and flow measures. Serenoa repens produced similar improvement in urinary symptoms and flow compared to finasteride
Finasteride
Finasteride is a synthetic antiandrogen that inhibits type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone...
and is associated with fewer adverse treatment events. "
A 2001 study published in JAMA (The Journal of the American Medical Association
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...
) found that saw palmetto fruit extract failed to reduce urinary tract symptoms more than placebo. The double-blind study was conducted at eleven North American clinics and included 369 men. Men in the experimental group experienced a 2.20 point drop in their American Urological Assn. Symptom Index (AUASI) score. However, men in the placebo group saw a 2.99 point drop. The Los Angeles Times
Los Angeles Times
The Los Angeles Times is a daily newspaper published in Los Angeles, California, since 1881. It was the second-largest metropolitan newspaper in circulation in the United States in 2008 and the fourth most widely distributed newspaper in the country....
reports, “42.6% of the men in the extract group saw their AUASI scores fall by at least three points; 44.2% of the men in the placebo group saw the same degree of benefit.” The study was funded by several offices within the NIH, including the National Center for Complementary and Alternative Medicine.”
Contraindications and side effects
Few side effects or allergic reactions are associated with saw palmetto extract use. The most common side effects are gastrointestinal, some of which may be reduced by taking the extract with food. Use may increase the risk of bleeding or affect sex hormones, and concurrent use of other drugs with similar action should be avoided.Beta-sitosterol, one chemical present in saw palmetto extract, 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.
As with other herbal preparations, precise chemical constituents may vary by manufacturer and batch.
Contraindications include pregnancy, lactation due to antiandrogenic and estrogenic activity.
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