Updated: Oct 16, 2021
Herb Research Foundation, Boulder, CO, USA. | Oct 15, 2021
The latest research on saw palmetto further supports its use as the option of first choice for men with benign prostatic hyperplasia (BPH, or prostate enlargement). The study was the first American study to evaluate an herbal formula for the treatment of BPH, and provided some intriguing clues about the mechanism of its action (Marks, et al., 2000). Europeans already favor the natural approach for treating this common condition in mature men. In Italy, herbal remedies are used five times as often as synthetic drugs, and in Germany, more than 90 percent of men and their physicians choose natural remedies over synthetics for treating BPH.
The recent American study was a small, controlled, six-month clinical trial that tested a proprietary blend of saw palmetto extract (Serenoa repens [Bartram] Small, Arecaceae), nettle root extract (Urtica dioica L., Urticaceae), and pumpkin seed oil (Cucurbita pepo L., Cucurbitaceae) against placebo in 44 men aged 45 to 80. (All three of these herbs are approved by the German Commission E for treatment of BPH symptoms.) The test formula, which also contained lemon bioflavonoid extract and vitamin A, was manufactured by the Nutrilite division of Amway.
According to the results, those taking the herbal remedy experienced improvements in clinical symptoms of prostate enlargement, but the improvements were not statistically significant, possibly because of the small number of subjects. However, the results demonstrated something else that has never before been documented for saw palmetto combinations. In the group taking the saw palmetto formula, the researchers observed changes at the cellular level that may cast some light on the way saw palmetto works. The epithelium (lining) of the prostate contracted, and showed a larger number of atrophied (non-growing) cells than seen in the placebo group. While the total prostate volume (size) did not change, the epithelial contraction and the increase in atrophied cells both suggest that the saw palmetto combination slowed the growth of prostate tissue.
Blood tests and tissue analysis confirmed that the herbal remedy did not affect levels of hormones or of PSA (prostate specific antigen), a marker used to test for prostate cancer. The absence of effects on PSA or dihydrotestosterone levels - which have been noted in other studies as well - show that saw palmetto does not work by the same mechanism as the synthetic pharmaceutical drugs such as finasteride. The effect is not hormonal, which accounts for the absence of the negative side effects that are common with synthetic drugs, including loss of libido and sexual function. Synthetic prostate drugs have strong effects on hormone levels because they inhibit an enzyme (5-alpha-reductase) that regulates male sex hormones.
The authors concluded, "Saw palmetto herbal blend for symptomatic BPH resulted in the contraction of prostatic epithelial tissues, apparently via a nonhormonal mechanism. Serum PSA was unchanged. The effect on symptom score and urinary flow was mild but statistically significant in large studies. Thus, saw palmetto herbal blend appears to be a reasonable alternative for men with early, uncomplicated prostatism. No major side effects were observed." In addition, they noted, "…the saw palmetto option deserves consideration as first line intervention in men with symptomatic and uncomplicated BPH." - Rob McCaleb, HRF
[Marks LS, Partin AW, Epstein JI, Tyler VE, Simon I, Macairan ML, Chan TL, Dorey FJ, Garris JB, Veltri RW, Santos PBC, Stonebrook KA, deKernion JB. Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. J Urol 2000; 163(5): 1451-1456.]
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