Saw palmetto, known scientifically as Serenoa repens, has been shown to be an effective treatment for BPH symptoms.
However, several recent studies have found that this herb does not live up to its reputation. A 2013 study published in The Journal of the American Medical Association (JAMA) found that saw palmetto did not offer any benefits over placebo in treating lower urinary tract symptoms in men with BPH.
Likewise, a Cochrane systematic review found that saw palmetto did not significantly improve urinary symptoms associated with BPH and was no more effective than placebo.
Saw Palmetto May Treat Symptoms of BPH
BPH is a prostate condition affecting men over 40. It is not a serious health problem, but it does lead to urinary symptoms such as a slow or weak urine stream and difficult urination (e.g., stopping and starting, dribbling after urinating). The National Institutes of Health reports that more than 50 percent of men between ages 60 and 80 experience BPH-related urinary symptoms.
The term benign prostatic hyperplasia refers to an enlarged prostate gland—not cancerous growths or life-threatening conditions. However, in some cases, BPH can cause other problems such as bladder infections.
In addition to lifestyle changes (such as diet and exercise), doctors may recommend medications like finasteride (Proscar) or dutasteride (Avodart) to treat symptoms of BPH. A study published in May 2014 in BJU International found that saw palmetto extract taken at high doses was no more effective than placebo at reducing urinary symptoms related to BPH when compared with finasteride or dutasteride.
However, several small studies have suggested modest benefits of saw palmetto for treating these same symptoms.
Saw Palmetto May Help with Urinary Symptoms Related to Benign Prostatic Hyperplasia
A review of studies in 2005 found that saw palmetto was not more effective than placebo for treatment of urinary symptoms related to benign prostatic hyperplasia.
It did find that high doses of saw palmetto may reduce testosterone levels, which may be a disadvantage if you are hoping to maintain normal testosterone levels.
The largest study available evaluated 1,393 men with mild to moderate symptoms and compared a high dose (320 mg) daily of saw palmetto extract versus placebo.
Although several small studies have suggested modest benefits of saw palmetto for treating symptoms of BPH, a large study evaluating high doses of saw palmetto and a Cochrane review found that saw palmetto was not more effective than placebo for treatment of urinary symptoms related to BPH.
In addition, saw palmetto does not appear to improve quality of life or sexual function. If you do decide to try saw palmetto for your BPH symptoms, make sure it is from a reputable source and at 320 mg per day or higher. There are no known side effects from taking 320 mg per day or higher of saw palmetto extract.
If You Decide To Try Saw Palmetto: Make sure it is from a reputable source and at 320 mg per day or higher. There are no known side effects from taking 320 mg per day or higher of saw palmetto extract.
A Cochrane Review Found That Saw Palmetto Was No Better Than Placebo for Treating Symptoms of Benign Prostatic Hyperplasia
If you have BPH, there are two drugs that your doctor might prescribe to reduce your symptoms. One of them (finasteride) decreases levels of DHT in your body, which shrinks swollen prostate tissue.
The other drug, finasteride, and Dutasteride, prevents new hair from growing in your prostate area. However, researchers found that saw palmetto was no better than placebo at treating symptoms of benign prostatic hyperplasia.
It’s possible that saw palmetto may be helpful for men with milder cases of BPH, but a recent Cochrane review suggests it is not effective enough to recommend as a treatment option. Researchers found that it only reduced urinary symptoms by 0.2 points on a scale measuring the quality of life; they also noted that adverse effects were common with saw palmetto use.
For example, 20% of people taking saw palmetto experienced gastrointestinal side effects like nausea or diarrhea. Other side effects included headache, dizziness, tiredness, and trouble sleeping.
According to a Cochrane review, saw palmetto was no better than placebo at reducing urinary symptoms related to benign prostatic hyperplasia. That being said, some small studies have suggested that saw palmetto may help reduce symptoms of BPH in men who are not taking finasteride.
For example, one study found that men who took 160 milligrams of saw palmetto extract twice daily had significantly lower International Prostate Symptom Scores when compared to men taking a placebo.
Saw Palmetto Does Not Work Better Than Placebo in Treating Symptoms Related to Benign Prostatic Hyperplasia (BPH)
According to recent research, men who suffer from urinary symptoms related to benign prostatic hyperplasia (BPH) may find relief from a popular herbal supplement.
That said, results of recent studies suggest that saw palmetto supplements are not more effective than placebo in treating such symptoms.
This Cochrane review examined data from five randomized controlled trials with a total of 991 participants.
The researchers found no significant difference between those taking saw palmetto and those taking placebo in terms of symptom improvement or quality-of-life measures at 12 weeks or 24 weeks after treatment began.
In addition, they found no significant differences between groups when comparing treatment effects on peak urine flow rate and maximum urinary flow rate over time.
However, it should be noted that two of these studies were funded by saw palmetto manufacturers; three were funded by noncommercial sources. Further research into saw palmetto’s effectiveness for treating BPH symptoms is needed before strong conclusions can be drawn about its efficacy.
Side Effects of Saw Palmetto Can Be Worse Than Your Original Problem
A recent report shows that men who take saw palmetto to alleviate their urinary symptoms linked to an enlarged prostate may end up worse off than when they started.
A study published in Prostate Cancer and Prostatic Diseases examined a large population of men using saw palmetto, who had reported side effects such as headaches, anxiety, and difficulty sleeping.
The researchers found that these negative side effects of saw palmetto were most pronounced in patients who had been taking it for more than three months.
In addition, some patients stopped taking saw palmetto because of its unpleasant side effects. If you’re considering trying saw palmetto for your BPH symptoms, be sure to talk with your doctor about potential side effects before you begin treatment.
It’s also important to note that certain medications can make saw palmetto less effective or even dangerous; if you are currently on other medications or have any questions about how they might interact with saw palmetto, be sure to consult your doctor before beginning treatment.
How Do We Know if Saw Palmetto Works?
It’s important to note that many of these studies were quite small, and not all of them compared saw palmetto directly to other types of treatments.
The largest trial – published in JAMA – included only 202 men, which makes it hard to definitively say that saw palmetto does or doesn’t work for BPH. A large Cochrane review found that there was insufficient evidence to conclude whether saw palmetto worked.
One of the ways researchers has tried to figure out whether saw palmetto works is by measuring PSA levels. It’s known that saw palmetto may lower PSA levels, but it isn’t clear whether a lowered PSA level actually has any clinical benefit.
In theory, if you have prostate cancer and saw palmetto lowers your PSA level, then it would be harder to find out if you had prostate cancer or not.
To try to get around these issues, one study compared men taking saw palmetto with men taking finasteride (Proscar). Finasteride is a drug commonly used to treat BPH symptoms; it blocks an enzyme called 5-alpha reductase that causes testosterone to convert into dihydrotestosterone (DHT), which can cause enlargement of the prostate.
The study found no difference in symptoms between those two groups at 12 weeks – but also no difference in PSA levels either.
If you're thinking about taking saw palmetto, talk with your doctor first before starting a new supplement regimen.
Although saw palmetto seems to be a popular choice among those with symptoms of BPH, studies show that it’s not effective for long-term symptom relief. While your doctor might still recommend saw palmetto if other non-drug treatment options haven’t worked, do some research on your own before taking any supplements to make sure they can actually help you.
Other natural remedies may work better than saw palmetto if you are looking at home remedies instead of clinical trials
Cinnamon and nettle root appear to be effective in treating symptoms of BPH, according to a 2011 study in Urology. Although cinnamon has been traditionally used for treating diabetes, blood sugar levels were not decreased with consumption of 1 to 2 grams of cinnamon a day.
Cinnamon also appears to have antioxidant properties that may help prevent cancer. A 1998 study published in Cancer Letters found that 2 grams per day were associated with reducing markers of inflammation. Researchers have yet to determine if there are any other health benefits or side effects associated with consuming cinnamon at these doses.
A single randomized controlled trial showed combination therapy of saw palmetto plus lycopene, selenium, and tamsulosin was more effective than single therapies alone.
A 2014 randomized trial of 225 men with lower urinary tract symptoms and BPH examined the efficacy and tolerability of combination therapy between saw palmetto, lycopene, and selenium plus tamsulosin versus single therapies.
The findings suggest that combination therapy of saw palmetto, lycopene, selenium, and tamsulosin is more effective than single therapies in improving the International Prostate Symptom Score and increasing the maximum urinary flow rate.
It was noted that after 6 months of treatment, the combination therapy significantly improved symptom scores compared with a single therapy, and from 6 to 12 months, combination therapy demonstrated significant improvement in urine flow rate compared to tamsulosin alone.
There were no reported treatment-related adverse events associated with combination therapy.
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