Is saw palmetto the best herbal supplement for the treatment of prostate ailments?
How effective is saw palmetto in this regard as compared to placebo and other medications?
The above questions and more will be answered by this article which aims to give us a clear picture of the shortcomings of saw palmetto with regard to treating prostate ailments. Although saw palmetto possesses excellent medicinal capabilities on a general basis, we believe that this plant and its extracts have been over-hyped for reasons best known to its promoters. This unfair promotion may not be in the interest of the common good and we intend to shed light on both sides of the coin in order to stay fair.
Saw palmetto and its extracts have been used as alternative medicine options for treating a number of bodily ailments over the years. This herbal remedy, which is rich in phytosterols and fatty acids, has been very popular over the years, especially in its application for the treatment of benign prostatic hyperplasia. According to statistics for 2010, over 2 million men across the world use saw palmetto supplements for the treatment of prostate ailments, having grown steadily from its initial documented usage among a handful of Native Americans about 200 years ago.
However, a number of studies carried out by reputable research labs and medical centres have indicated that saw palmetto may not be as efficient as it is claimed to be with regard to its treatment of prostate ailments.
Historically, saw palmetto was renowned as a staple food item among the natives of the south-eastern region of the United States and some native lands in the West Indies. This fruit, which are physically like green-black berries gained much popularity and medicinal usage over time as the Mayans then used it a refreshing tonic, while some other native tribes utilized it as antiseptics and expectorants. It is on record that the Native Americans always had a stock of saw palmetto around the house for treating unexpected illnesses and body nourishment. According to H.W. Felter, he believes that this fruit can serve multiple functions as an expectorant, nutrition rich tonic and nerve soothing substance. He went on to state that “Its most direct action appears to be upon the reproductive organs when undergoing waste of tissue.” This is also the opinion shared by a number of medical practitioners over the years.
In the past decade, extracts of saw palmetto gained a reputation as the most utilized herbal mixture for treatment of benign prostatic hyperplasia, which is a very common ailment among older men. Reports of usage over the years documented by medical experts indicate that saw palmetto extracts seem to have the most pronounced effects on the urino-genital organs in adult males and females. Paradoxically, while it has shown some promise in the reduction of male over-sized prostate glands, there are also reports of females whom have used it for the enlargement of underdeveloped ovaries and breasts. Thus, extreme care must be exercised in the application of saw palmetto for prostate ailments, especially benign prostatic hyperplasia, as it possesses enlargement properties also.
In the last decade, several research reports and clinical studies with real people have indicated that saw palmetto is not a super remedy for benign prostatic hyperplasia as its promoters claim it to be. This is very much true in the clinical studies where saw palmetto extracts were compared side by side with placebo and a number of other drugs and supplements.
The very first of these reports to shed light on the shortcomings of saw palmetto is a study conducted in 2001 – ten years ago- across eleven clinics in the United States this study covered a total of 369 men who were not aware of the inclusion of other groups from different clinics and the results were published in the “Journal of the American Medical Association” (JAMA). According to these results, the group who took placebo fared better than those who too saw palmetto at the same dosage and time frames. For benign prostatic hyperplasia, treatment effectiveness is measured in the drop experienced on the “American Urological Assn. Symptom Index” (AUASI). The AUASI score for men in the saw palmetto group dropped by 2.2%, while those in the placebo group dropped by 2.99% which indicates better treatment.
Further analysis of this study published in the Los Angeles times revealed that “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.”
Another study which was published in the English Journal of Medicine in 2009 corroborates the results noted in the above JAMA study. This new study covered a total of 225 men who took a specified dosage of saw palmetto extracts for a period of one year. They were monitored alongside other men who took the same dosage of placebo for the same period. Results indicated that the first group was not better than the latter after a year.
The men sampled in this study were all over the age of 49 and had been diagnosed of moderate/severe symptoms related to BPH. Based on random sampling, the researchers from the University of California administered same dosage (160mg capsule twice per day) of saw palmetto and placebo to two groups of these men. At the end of twelve months, there were no significant differences for the primary and secondary result outcomes for these two groups.
Apart from the primary AUASI scores and reduction measure utilized above, saw palmetto still did not perform better than placebo in reducing secondary measures such as urinary bothers at night time, quality of sleep and “prostate-specific antigen” (PSA) level etc.
In the last five years, we have seen reports that consolidated results of several clinical trials related to saw palmetto for BPH treatment. The conclusion is that saw palmetto only delivered below to average improvements in BPH treatment for over 3,000 men over a period of about three decades. This clearly proves that saw palmetto is not as superb as it promoters declare. Rather, it is just an ok herbal supplement.
For the above reasons, a definite clinical function of saw palmetto is yet to be defined and documented by key medical associations. For instance, the major Urology associations in the United States and Europe have not included saw palmetto as part of their recommended drugs for the treatment of BPH.
Saw palmetto is not the all magical herbal remedy its promoters tend to make it look like as it has a number of side effects, though few. The most common of these are related to headaches, blood pressure, possible erectile dysfunction and constipation among others. However, the very serious ones to be wary of include hepatitis and pancreatitis, usually occuring at high doses.
But the biggest side effect is temporary impotence, as saw palmetto binds with the 5-AR enzyme which converts testosterone into DHT. While DHT is demonized as an agent for hair loss (in those who are genetically predisposed to it), it is also what gives you an erection, and muscular strength. Recent scientific studies demonstrate that DHT is only a problem under certain conditions.
Also, it must be noted that extra care is required when using saw palmetto. This herb associates with birth control medication, finasteride and blood thinners etc. and can result into unexpected illnesses when used together.