Saw Palmetto Herbal Tincture
Saw palmetto grows in the southern United States.
Common Names–Saw Palmetto, American dwarf palm tree, cabbage palm
Latin Names–Serenoa repens, Sabal serrulata
What It Is Used For
* Saw palmetto is used mainly for urinary symptoms associated with an enlarged prostate gland (also called benign prostatic hyperplasia, or BPH).
* Saw palmetto is also used for other conditions, including chronic pelvic pain, bladder disorders, decreased sex drive, hair loss, and hormone imbalances.
How It Is Used
The ripe fruit of saw palmetto is used in several forms, including ground and dried fruit or whole berries. It is available as a liquid extract, tablets, capsules, and as an infusion or a tea.
What the Science Says
* Several small studies suggest that saw palmetto may be effective for treating BPH symptoms.
* In 2006, a large study of 225 men with moderate-to-severe BPH found no improvement with 320 mg saw palmetto daily for 1 year versus placebo. NCCAM cofunded the study with the National Institute of Diabetes and Digestive and Kidney Diseases.
* There is not enough scientific evidence to support the use of saw palmetto for reducing the size of an enlarged prostate or for any other conditions.
* Saw palmetto does not appear to affect readings of prostate-specific antigen (PSA) levels. PSA is protein produced by cells in the prostate. The PSA test is used to screen for prostate cancer and to monitor patients who have had prostate cancer.
Side Effects and Cautions
* Saw palmetto may cause mild side effects, including stomach discomfort.
* Some men using saw palmetto have reported side effects such as tender breasts and a decline in sexual desire.
* Tell your health care providers about any herb or dietary supplement you are using, including saw palmetto. This helps to ensure safe and coordinated care.
Saw palmetto. Natural Medicines Comprehensive Database Web site. Accessed March 30, 2006.
Saw palmetto (Serenoa repens [Bartran] Small). Natural Standard Database Web site. Accessed March 30, 2006.
Saw palmetto (Serenoa repens) In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New York, NY: Marcel Dekker; 2005;635-644.
De Smet PA. Herbal remedies. New England Journal of Medicine. 2002;347(25):2046-2056.
National Cancer Institute. The Prostate-Specific Antigen (PSA) Test: Questions and Answers. National Cancer Institute Web site. Accessed at
http://www.cancer.gov/cancertopics/factsheet/Detection/PSA on March 30, 2006.
Saw palmetto berry. In: Blumenthal, M, Goldberg, A, Brinckman, J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:335-340.
Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. New England Journal of Medicine. 2006;354(6):557-566.
Saw Palmetto berries (Serenoa serrulata or S. repens)
Currently Saw Palmetto is principally associated with the treatment of BPH but also has a generally supportive effect on the whole male reproductive system. Manin active ingredients are found in it s lipid content: free fatty acids (including lauric, myristic and loeic acids), together with triglycerides, diglycerides and monoglyycerides, phytosterols (mainly beta sitosterol) and fatty alcohols. Also contains flavonoids and polysaccharides.
A very active lipase during ripening and drying of the fruit causes splitting of the triglycerides into free fatty acids. This gives the berries their characteristic rancid odour and taste which according to Mills and Bone (2000:524), may account for the occasional digestive upsets, reported from Serenoa usage.
Actions: inhibition of 5-alpha-reductase. This enzyme is responsible for converting testosterone into its more potent form: DHT. It is also thought to inhibit DHT from binding to the prostate androgen receptors. This inhibitory effect on 5-alpha-reductase is 5,600-40,000 times weaker than that produces by the drug Finasteride. The Serenoa extract is normally given in doses 100 times greater than those used with Finasteride, meaning clinical potency is actually only approximately 60 times weaker (Mills and Bone 2000:534-5).
Inhibition of oestrogen and prolactin. Animal studies have demonstrated serenoa’s sitosterol glycosides as having oestrogenic effects, but a more recent study has reversed this view, and it is now thought Serenoa actually inhibits oestrogen. There is some evidence that Serenoa also inhibits prolactin, another hormone connected with prostate growth stimulation (Bone 1998:17).
Spasmolytic activity. A study on rat bladder, aorta and uterus, demonstrated that a liposterolic extract of Serenoa resulted in spasmolytic activity. According to Bone (1988:16) this and other trials have indicated this action results from ‘alpha-adrenoceptor and calcium blocking activities’.
Anti-oedematous and anti-inflammatory actions have been demonstrated through research trials, with the latter action being shown to result from inhibition of cyclo-oxgenase and 5-lipoxygenase (Mills and Bone 2000:526).
Serenoa was previously thought to only relieve the signs and symptoms of BPH, but recent research indicates it can also reduce the size of prostate epithelial tissue (Overmyer 2000:1).
Numerous clinical trials have been conducted on the efficacy and safety of Serenoa. The general consensus of these trials is that Serenoa impr9ves urological symptoms and flow measures and is comparable to finasteride in effectiveness, but produces fewer adverse effects.
Side effects. No contraindications, cautions or known adverse drug interactions are given by the German Commission E. the only side effect noted, was that in rare cases mild gastrointestinal upsets had been reported (Blumenthal et al 2000:338).
The standardised extract used fro 3 months or more is associated with inhibited libido in male patients, whereas it has been noted that this adverse effect is not found when the tincture of Serenoa is used.