As promised... here is some great info!
Medical Attributes of Serenoa repens - Saw palmetto
By Calandria Hiller
Wilkes University, Wilkes-Barre, PA
July, 1999
Serenoa repens, often called the "plant catheter" for its therapeutic uses in treating prostate disorders (Borcherding 1999), is a small shrubby palm tree found in the southeastern coastal United States (Foster 1996, D'epiro 1999), specifically South Carolina to Florida and also west to the Mississippi (Foster 1996). The leaves and the petiole are covered with saw-like teeth giving it its common name, saw palmetto. The tree produces berries that are sweet and nutritionally rich (Anon. 1999b). These berries were once used by native Americans to treat male genitourinary (D'epiro 1999) and reproductive (Borcherding 1999) disorders in the 1700s. The fleshy part of the berries contains starches, polysaccharides, sugars and other compounds (Foster 1996) that have medicinal value (Beduschi, et. 1998). They are safe when eaten in moderation (Anon. 1999b).
Since the 15th century, benign prostate hyperplasia (BPH) (Plosker et. al. 1996) has been treated by the use of plant extracts (Segars 1999). This disorder is characterized by an increase in the size of the prostate. The prostate, a doughnut-shaped gland found in all male mammals, is about the size of a walnut. It lies below the bladder, and surrounds the urethra. It secretes a thin, milky, alkaiine fluid, that lubricates the urethra to prevent infection and increases sperm motility. These secretions are extremely important for a successful fertilization of the egg (Murray 1998). Benign prostatic hyperplasia is a common medical condition (Wilt et. al. 1999) that occurs in men over the age of fifty (Foster 1996; Sahelian et. al. 1998) or sixty (LEF Magazine 1999). Estimates show that this problem affects over 50% of men in their lifetime (Murray 1998, LeValle 1997, Wilt et. al. 1999). Enlargement of the prostate, not associated with prostate cancer (Foster 1996, Wilt et. al. 1998, Miller 1996), presses against the urethra, the tube that carries urine from the bladder out of the body, and causes urination to become painful (Schardt et. al, 1996). Symptoms include frequent causes of excessive urination, nighttime awakenings (Sahelian et. al. 1998, Murray 1998), and difficulty in urinating (Wilt et. al. 1999, Segars, 1999).
BPH is thought to be caused by an increase in testosterone and conversion of its more active metabolite dihydrotestosterone (DHT) in the prostate (Miller 1996, Palin et. al. 1998). This is believed to be compounded by the presence of estrogen, which inhibits the elimination of DHT (LaValle 1997). DHT is the hormone thought to cause prostrate cells to multiply and then lead to an enlarged prostate (Borcherding, 1999). The disorder also increases an enzyme called 5-alpha-reductase that converts testosterone into dihydrotestosterone, a male sex hormone (Foster 1996). Fat deficiencies, zinc deficiency, and amino acid deficiencies may also contribute (Miller 1996).
Over 30 plant compounds have been used to treat BPH, but most attention has been given to the saw palmetto (Wilt et. al. 1999, Borcherding 1999, Murray, 1998; Beduschi et. al. 1998). The extract from the berries, sometimes called "sabal" (Foster 1996), has been known to reduce the symptoms of prostate enlargement (Anon. 1999a, Wilt et. al. 1998) and BPH (Segars 1999; Wilt et. al. 1998; Rodriguez 1998). It has also been known to aid the nervous, respiratory, and digestive systems. The plant is also helpful in overcoming glandular weakness and in regenerating sexual glands (Anon., 1999b). Women have used the herb to stimulate breast enlargement, lactation, and to treat ovarian and uterine irritability (Borcherding, 1998).
Serenoa repens functions in many ways. Extracts from the fruit inhibit conversion of testosterone to dihydrotestosterone (DHT) (LEF Magazine, 1999). It also prevents binding of DHT to androgen receptors in prostate cells. It blocks the effect of estrogen on prostate tissue, and it inhibits growth factors responsible for stimulation of prostate tissue (Miller 1996, LaValle 1997, Sahelian 1998, Borcherding 1999). The herb consists of 80 to 90 percent free fatty acids (LaValle 1997), sterols, a volatile oil, steroidal saponoin, tannins, and polysaccharides (Borcherding 1999). The n-hexane lipido-sterol extract from S. repens is a phototherapuetic agent that inhibits types 1 and 2 isoenzymes (Plosker et. al. 1996) of 5-alpha-reductase and competitive binding to androgen receptors in prostatic cells (Disilerio et. al. 1998; Silverio 1998; Palin et. al. 1998). It is also an anabolic in that it strengthens and builds body tissues (Borcherding, 1999).
A large study of 2,939 men with a mean age of 65 having symptoms of BPH was performed. The study included randomized controlled trials for an average duration of 9 weeks (Rodriguez 1998, Segars 1999). The participants were unaware if they received saw palmeno or a placebo. The results of the men who took the herb were 28% improvement in urinary tract systems, 25% improvement in nocturia or nighttime awakenings to relieve the bladder, 24% improvement in peak erectile dysfunction, and 43% improvement in residual urine volume (Rodriguez 1998, D'epiro 1999). For residual urine levels under 50 ml the success of supplementation is usually excellent; for levels between 50 and 100ml, the results are usually good (Murray 1998). The findings establish that extracts from saw palmetto reduce symptoms of BPH (Segars, 1999) in 90% of men within the first four to six weeks (Murray 1998, Sahelian 1998). These improvements were also shown with a similar herb finasteride except for erectile dysfunction (D'epiro 1999). Murray (1998) would rate the relative effectiveness ofthis herb as the best healer.
Another clinical trial involving 110 men for 28 days was performed with saw palmetto and a placebo. The results showed that it especially reduced the urination frequency inhibited by individuals having BPH by 45%. Also the pain of urination was relieved in the treatment group. No side effects were noted, except for a rare stomach upset (Foster 1996).
In 1990, the FDA banned saw palmetto as a therapeutic agent in the US (D'epiro 1999). The medicinal herb of choice had been finasteride. It provides all the same treatments as saw palmetto. Now the FDA plans to approve saw palnetto for treatment against benign prostate hyperplasia (D'epiro 1999). Sahelian (1998) showed that men who received saw palmeno were twice as likely to have improved urinary symptoms without the frequent erectile dysfunction of finasteride (Rodriguez 1998, Sahelian 1998). The dosage of this herb is 160 mg and no major side effects have been found (LaValle 1997, Levy 1998), except for some minor gastrointestinal problems (Plosker 1996). The herb is preferred because it is a fraction of the cost of finasteride (Wilt et. al 1999). Many men self-prescribe therapies for prostrate disorders (Beduschi et. al. 1998, Murray 1998) because this herb is readily available without a prescription. LaValle (1997), a pharmacist, stresses that patients should not do this, but instead should see their physician.
LITERATURE CITED
Anon. 1997. Placebo helps prostate problems long-term. NCAHF Newsletter 20:2.
Anon, 1999a. Saw palmetto for benign prostatic hyperplasia. Medical letter on Drugs and Therapeutics 41:18
Anon. 1999b. Herbs now for healthy living. Glandular system: Saw palmetto.
http://www.herbsnow.com/sawpalmetto.htm
Beduschi, R., Beduschi, M.C.; and Oesterling, J. E. 1998. Nonprescription altemative therapies for BPH. Geriatrics. 53:37.
Borcherding, Mer, and Mark. 1999. Saw Palmetto - facts and information. Symmetry products with saw palmeno; male balance.
http://www/go-symmetry.com/saw-palmetto.htm
D'epiro, N.W. 1999. Saw Palmetto and the Prostate. Patient Care 33:29.
Di Silverio, F., Monti S., Sciarra A., Varasano P.A., Martini C., Lanzara S., D'Eramo G., DiNicola S., Toscano V. 1998. Effects of long term treatment with Serenoa repens on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia. Prostate 37:77-83.
Foster, S.. 1996. Saw palmetto: herbal prevention for common male health concems. 58:54.
http://www.follicle.com/treatments_palmetto_article.html.
LaValle, J. B. 1997. Men's prostate health: a variety of key nutrients may play a role in prevention. Drug Store News 19:14.
LEF Magazine. 1999. Prostate Enlargement... What men should do.
http://www.leg.org/magazine/mag99/feb99-products.html
Levy, S. 1998. Can saw palmetto be used to benign prostatic hyperplasia? Drug Topics 142:53.
McKinney, D.E. 1999. Saw Palmetto for Benign Prostatic Hyperpiasia. JAMA. The Journal of the American Medical Association 281:1699.
Miller, A.L. 1996. Benign prostatic hyperplasia: nutritional and botanical therapeutic options. Alternative Medicine Review 1:18-25.
Murray, M.T. 1998. Saw palmetto is tops for men's health. Better Nutrition 16:12
Palin M.F., Faguy M., LeHoux J.G., Pelletier G. 1998. Inhibitory effects of Serenoa repens on the kinetics of pig prostatic microsomal 5-alpha-reductase activity. Endocrine 1:65-69.
Plosker G.L. and Brogden R.N. 1996. Serenoa repens. A review of its pharmacology and therapeutic efficacy in benign prostatic hyperplasia. Drugs Aging 9:379-395.
Rodriguez, R. 1998. Saw palmetto extracts for treatment of BPH. Impotence & Male Health Weekly Plus.
Sahelian, R. 1998. Saw palmetto herb effective for enlarged prostate. New JAMA article.
http://www.raysahelian.com/saw.html.
Schardt, D. and Schmidt, S. 1996. "P" is for prostate. Nutrition Action Healthletter 23:8.
Segars, L.W. 1999. Saw Palmetto extracts for Benign Prostatic Hyperplasia. Journal of Family Practice. 48:88.
Wilt, T. J., Ishani A., Stark G., MacDonald J.L., and Mulrow C. 1998. Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia. JAMA. The Journal of the American Medical Association. 280:1602.
Wilt, T. J., A. Ishani, & G Stark. 1999. Saw palmetto for benign prostatic hyperplasia. Nutrition Research Newsletter 18:1.
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This paper was developed as part of the BIO 368 - Medical Botany course offered at Wilkes University during the summer of 1999. Course instructor was Kenneth M. Klemow, Ph.D. (
[email protected]). The information contained herein is based on published sources, and is made available for academic purposes only. No warrantees, expressed or implied, are made about the medical usefulness or dangers associated with the plant species in question.
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This page posted and maintained by Kenneth M. Klemow, Ph.D., Biology Department, Wilkes University, Wilkes-Barre, PA 18766. (570) 408-4758,
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