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What Is Saw Palmetto?
The berries of a fan palm, Serenoa repens, aka: Sabal serrulata.
Saw Palmetto Gives Prostate Relief!
50 to 60% of men will experience benign prostatic hyperplasia (BPH), the swelling of the prostate gland. The prostate gland surrounds the urethra--imagine a rubber washer (prostate) with a straw (urethra) strung through it, and you have the basic setup. As the prostate gland swells and pinches closed the urethra, problems begin to emerge: painful urination, decreased flow, difficulty stopping or starting flow, nocturnal urination, etc.--these are clearly unpleasant and undesirable symptoms.
Hormonal changes that take place as men age are responsible for BPH and an understanding of these changes and how they effect the prostate gland will help to explain why Saw Palmetto is so effective at relieving BPH. As men age levels of testosterone decrease, but levels of some other hormones actually increase. The hormones that increase are FSH, LH, estrogen, and prolactin. One other culprit, an enzyme called 5-alpha-reductase, which converts testosterone to dihydrotestosterone (DHT) is increased as well. Though levels of testosterone drop, the testosterone that is present begins to concentrate in the prostate gland--inefficient removal of the testosterone combined with increasing levels of 5-alpha-reductase results in inordinately high levels of DHT, a much more potent hormone than its precursor. This in turn causes the prostate gland to swell. Estrogen seems to inhibit the removal of DHT, complicating the situation further and prolactin is known to be an aggravating factor as well.
Saw Palmetto has a track record in reducing the severity of BPH in mild to moderate cases that is better than finasteride, the most commonly prescribed medication for BPH in the US. Why? Finasteride is a specific 5-alpha-reductase inhibitor. While Saw Palmetto is not nearly as strong a 5-alpha-reductase inhibitor as finasteride, its multiplicity of actions makes it more effective than finasteride in mild to moderate BPH - this seems to be typical of herbal medicines. Saw Palmetto shrinks the prostate with at least 10 different mechanisms:1
inhibition of 5-alpha-reductase
inhibition of DHT binding to androgen receptors
slowing of nuclear and cystol androgen receptors
inhibition of 17beta-hydroxysteroid dehydrogenase
anti-estrogenic activity
reduction of growth-factor-induced prostatic growth
reduction of prolactin-induced prostatic growth
general anti-inflammatory activity
spasmolytic effect on smooth muscle
general reduction of edema
In Germany and Austria, Saw Palmetto is a first-line treatment for BPH, where it is far out-prescribed over finasteride. Saw Palmetto is MUCH cheaper than finasteride and has no side effects.
Saw Palmetto References & Research
McPartland, JM, Treating benign prostatic hyperplasia with saw palmetto: a literature review and an N=1 clinical trial. J Am Osteopath Assoc. 1999. In press.
Boccafoschi & Annoscia "Comparison of Serenoa repens Extract with Placebo by Controlled Clinical Trial in Patients with Prostatic Adenomatosis", Urologia 50 (1983): 1257-68.
Braeckman, "The Extract of Serenoa repens in the Treatment of Benign Prostatic Hyperplasia: A Multicenter Open Study", Curr Ther Res 55 (1994): 776-85.
Champlault, Patel & Bonnard, "A Double-Blind Trial of an Extract of the Plant Serenoa repens in Benign Prostatic Hyperplasia", Br J Clin Pharmacol 18 (1984): 461-2.
Cirillo-Marucco, Pagliarulo & Tritto, et. al., "Extract of Serenoa repens (Permixon) in the Early Treatment of Prostatic Hypertrophy", Urologia 5 (1983): 1269-77.
Emili, Lo Cigno & Petrone, "Clinical Trial of a New Drug for Treating Hypertrohy of the Prostate (Permixon)", Urologia 50 (1983): 1042-8.
Tasca, Barulli, & Cavazzana, et. el., "Treatment of Obstructive Symptomatology Caused by Prostatic Adenoma with an Extract of Serenoa repens: Double-Blind Clinical Study vs. Placebo", Minerva Urol Nefrol 37 (1985): 87-91.
Tripodi, Giancaspro & Pascarella, et. al., "Treatment of Prostatic Hypertrophy with Serenoa repens Extract", Med Praxis 4 (1983): 41-6.
Wilt, T. J., A. Ishani, et al. (1998). "Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review [published erratum appears in JAMA 1999 Feb 10;281(6):515]." JAMA 280(18): 1604-9.
The berries of a fan palm, Serenoa repens, aka: Sabal serrulata.
Saw Palmetto Gives Prostate Relief!
50 to 60% of men will experience benign prostatic hyperplasia (BPH), the swelling of the prostate gland. The prostate gland surrounds the urethra--imagine a rubber washer (prostate) with a straw (urethra) strung through it, and you have the basic setup. As the prostate gland swells and pinches closed the urethra, problems begin to emerge: painful urination, decreased flow, difficulty stopping or starting flow, nocturnal urination, etc.--these are clearly unpleasant and undesirable symptoms.
Hormonal changes that take place as men age are responsible for BPH and an understanding of these changes and how they effect the prostate gland will help to explain why Saw Palmetto is so effective at relieving BPH. As men age levels of testosterone decrease, but levels of some other hormones actually increase. The hormones that increase are FSH, LH, estrogen, and prolactin. One other culprit, an enzyme called 5-alpha-reductase, which converts testosterone to dihydrotestosterone (DHT) is increased as well. Though levels of testosterone drop, the testosterone that is present begins to concentrate in the prostate gland--inefficient removal of the testosterone combined with increasing levels of 5-alpha-reductase results in inordinately high levels of DHT, a much more potent hormone than its precursor. This in turn causes the prostate gland to swell. Estrogen seems to inhibit the removal of DHT, complicating the situation further and prolactin is known to be an aggravating factor as well.
Saw Palmetto has a track record in reducing the severity of BPH in mild to moderate cases that is better than finasteride, the most commonly prescribed medication for BPH in the US. Why? Finasteride is a specific 5-alpha-reductase inhibitor. While Saw Palmetto is not nearly as strong a 5-alpha-reductase inhibitor as finasteride, its multiplicity of actions makes it more effective than finasteride in mild to moderate BPH - this seems to be typical of herbal medicines. Saw Palmetto shrinks the prostate with at least 10 different mechanisms:1
inhibition of 5-alpha-reductase
inhibition of DHT binding to androgen receptors
slowing of nuclear and cystol androgen receptors
inhibition of 17beta-hydroxysteroid dehydrogenase
anti-estrogenic activity
reduction of growth-factor-induced prostatic growth
reduction of prolactin-induced prostatic growth
general anti-inflammatory activity
spasmolytic effect on smooth muscle
general reduction of edema
In Germany and Austria, Saw Palmetto is a first-line treatment for BPH, where it is far out-prescribed over finasteride. Saw Palmetto is MUCH cheaper than finasteride and has no side effects.
Saw Palmetto References & Research
McPartland, JM, Treating benign prostatic hyperplasia with saw palmetto: a literature review and an N=1 clinical trial. J Am Osteopath Assoc. 1999. In press.
Boccafoschi & Annoscia "Comparison of Serenoa repens Extract with Placebo by Controlled Clinical Trial in Patients with Prostatic Adenomatosis", Urologia 50 (1983): 1257-68.
Braeckman, "The Extract of Serenoa repens in the Treatment of Benign Prostatic Hyperplasia: A Multicenter Open Study", Curr Ther Res 55 (1994): 776-85.
Champlault, Patel & Bonnard, "A Double-Blind Trial of an Extract of the Plant Serenoa repens in Benign Prostatic Hyperplasia", Br J Clin Pharmacol 18 (1984): 461-2.
Cirillo-Marucco, Pagliarulo & Tritto, et. al., "Extract of Serenoa repens (Permixon) in the Early Treatment of Prostatic Hypertrophy", Urologia 5 (1983): 1269-77.
Emili, Lo Cigno & Petrone, "Clinical Trial of a New Drug for Treating Hypertrohy of the Prostate (Permixon)", Urologia 50 (1983): 1042-8.
Tasca, Barulli, & Cavazzana, et. el., "Treatment of Obstructive Symptomatology Caused by Prostatic Adenoma with an Extract of Serenoa repens: Double-Blind Clinical Study vs. Placebo", Minerva Urol Nefrol 37 (1985): 87-91.
Tripodi, Giancaspro & Pascarella, et. al., "Treatment of Prostatic Hypertrophy with Serenoa repens Extract", Med Praxis 4 (1983): 41-6.
Wilt, T. J., A. Ishani, et al. (1998). "Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review [published erratum appears in JAMA 1999 Feb 10;281(6):515]." JAMA 280(18): 1604-9.

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