| What is your opinion of Saw Palmetto for prostate health? Have there been any scientific studies demonstrating its effectiveness? What are the pros and cons? -----------------------------------------------------------------------------------------------------------------------
Dear BT, The use of phytotherapeutics of plant extracts for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia(BPH) varies throughout the world. In Europe the physicians often prescribe saw palmetto as a first line therapy and have seen some subjective improvements in their patients. In the US most physician will not advocate taking saw palmetto due to the fact that objective studies have not established a statistically significant improvement in the face of appropriate controlled studies. Therefore many patients are taking this medication believing their symptoms are improving secondary to the action of saw palmetto, when in reality this is simply the placebo effect.
The mechanism of action of saw palmetto is thought to be similar to that of Finasteride(Proscar) a 5 alpha reductase inhibitor. Studies have shown that Proscar does not work for most patients, only those with large glands. Therefore if saw palmetto worked by the same mechanism of action we should expect similar results.
Saw palmetto is derived from the American dwarf palm tree and has never been associated with harmful side effects. I would never recommend beginning this medication, however if a patient was having success with it and they did not mind paying for it out of pocket, I would not tell them to stop. I would simply reinforce their knowledge base and tell them that the reason for their improvement may have nothing to do with the saw palmetto.
In an effort to better evaluate the efficacy of saw palmetto, a prospective, open -lable study was undertaken to investigate the changes in voiding symptoms, urodynamic parameters, and PSA. This study was done by Glenn S. Gerber et al. and appeared in the June edition of Urology 51:1003-1007,1998.
The results showed a significant improvement in symptom scores at 2, 4, and 6 months. However, there was no objective data to support these findings. There was also no significant change in peak urinary flow rate, post void residual volume, bladder pressure while voiding or PSA.
The bottom line on this medication is that the appropriate double blinded placebo controlled studies need to be done in order to prove the efficacy of saw palmetto. Until these studies are performed the American community of physician will stick to their tested and approved medications such as Proscar and the alpha blockers: Flomax, Cardura, and Hytrin.
This information is provided is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
HFHS M.D.-AK
*keyword: Saw Palmetto
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