Saw Palmetto

Palmier nain, Serenoa repens, Sabal Fructus

Efficacy

  • Indications with possible efficacy:
    Benign prostatic hyperplasia (popular use)
  • Indications with possible, but poorly documented efficacy:
    Alopecia
  • Indications with no proof of efficacy:
    Antiseptic
    Aphrodisiac
    Inflammation of the genitourinary tract
    Mild diuretic
    Prostate cancer
    Testicular atrophy
    To increase breast size
    To increase sexual vigor

Security

  • Risk of Drug Interactions: Low
  • Adverse Effects: Rare

Description

Part of the plant used: fruits

Saw palmetto is widely found in the United-States, from the Carolinas to Texas. This small palm tree is 1,8 to 3 meters tall. Its fan-like top is 60 to 120 cm tall and is made of long, dentate leafs. The applicable part of saw palmetto is the fruit.

The saw palmetto berry contains polysaccharides, fixed oils, volatile oil, steroids, including b-sitosterol. Saw palmetto is thought to reduce the symptoms of benign prostatic hyperplasia (by inhibition of dihydroxytestosterone binding at the androgen receptors and inhibition of 5-a-reductase activity on testosterone, thus preventing the conversion of testosterone to dihydrotestosterone). Anti-inflammatory properties also appear to be involved.

The product is available in capsules containing dried berries or lipophilic extracts containing 80 to 95% fatty acids and sterols.

Direction of use

  • Benign prostatic hyperplasia:
    It reduces the need to urinate at night, decreases the volume of residual urine and increases urine flow. Benefits were reported within 4 to 8 weeks of starting treatment.
    Used doses: 1 to 2 grams of dried berry or 320 mg (in 1 or 2 doses) daily of lipophilic extract containing 80% to 90% of fatty acids.
  • Alopecia:
    Amount and quality of hair could improve in men showing androgenetic alopecia.
    Used doses: 200 mg 2 times a day in combination with 50 mg of beta-sitosterol.

There is insufficient reliable information to conclude that saw palmetto is effective in any other indication.

Precautions

  • Side effects
    Saw palmetto is not associated with any specific toxicity. Rarely, it causes headaches and gastrointestinal problems.
  • Interactions
    Because saw palmetto appears to have hormonal properties (antiandrogen and estrogen), it may, in theory, interfere with hormonal drugs (oral contraceptives, hormone replacement therapy, etc.). Before taking saw palmetto, check with your pharmacist to make sure that there are no interactions with your regular medication.
  • Pregnancy and lactation
    Because saw palmetto appears to have hormonal properties, it should never be used during pregnancy or breast-feeding.

Clinical notes

  • Saw palmetto is a very popular natural remedy. Its medicinal properties in the treatment of benign prostatic hyperplasia are well established. However, always consult your physician before using this product.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plant contents vary naturally from plant to plant - just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

References

  1. Blumethal M et al. The Complete German Commission E monographs, 1998
  2. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2010
  3. Lininger S. et Al. The Natural Pharmacy, Prima Health, 1998
  4. Barnes J. et Al. Herbal Medicines, 2nd edition, Pharmaceutical Press, 2002
  5. Pierce Andrea, Practical Guide to Natural Medicines, 1999
  6. Alan Low "Benign prostatic hyperplasia: a review", Pharmacy Practice, September 2000
  7. Passeportsanté.net. Palmier nain. www.passeportsante.net
  8. Taylor J. CE: Phytomedicinals: Uses, precautions, and drug interactions. Drug Topics 2003;1:79
  9. Rotblatt M. et Ziment I. Evidence-Based Herbal Medicine, Hanley & Belfus, 2002
  10. Gordon AE et Shaughnessy AF. Saw Palmetto for Prostate Disorders. American Family Physician, March 15, 2003
  11. Natural Therapeutics Pocket Guide, 2000-2001
  12. The Review of Natural Products, 6th Edition, 2010
  13. Health Canada, Natural Products Database

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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.

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