Saw Palmetto (Serenoa repens)
Saw palmetto is the perfect example of an herb that has been pigeonholed in people’s minds by scientific research. Most people think of these berries from a small palm tree as remedies for the prostate—and they are—but they are also much more than this.
Native to North America, saw palmetto was used for indigestion, respiratory infections, snake bites, insect bites, skin ulcers by the indigenous people of Florida, and other areas where it grows. It was even used for food; a nutritious flour was made from the ground berries. It was also considered a valuable remedy to counteract some of the effects of aging, including wasting (weight loss), lung weakness and urinary problems.
Settlers first considered this palm a nuisance plant and cleared it from the land. However, they noticed that their animals would lean over the fences to get at the black fruit. Then they noticed that these animals were healthier than the ones who did not eat the berries. This prompted farmers to gather the plant and feed it to their animals, and then eat it themselves.
Nicknamed “the plant catheter,” the herb is given to strengthen the bladder. Infusions have been used as a diuretic to improve urine flow and to treat both irritable bladders and enlarged prostate glands. Herbalists often prescribe saw palmetto for reduced or absent sex drive, impotence and frigidity, too.
Saw Palmetto and BPH For at least 150 years, both European and American physicians considered saw palmetto a valuable remedy for benign prostatic hyperplasia (BPH). Medical doctors used the berries as a urogenital tonic for both men and women. It was dropped from the US National Formulary in 1950, as conventional physicians were not convinced of its effectiveness. (It was reinstated in 1998). Its popularity continued in Europe and regained its status as a valuable remedy in the 1960s. At that time, French researchers discovered that by concentrating the oils of saw palmetto berry, they could maximize the herb’s effectiveness. They also isolated specific compounds and found that these compounds have demonstrable effects on the prostate gland.
Today, saw palmetto is an accepted medical treatment for BPH in New Zealand, France, Germany, Austria, Italy, Spain and other European countries. It is also increasing in popularity in the United States. BPH affects the quality of life for a quarter of men over the age of 40 and 90% of men in their 80s. Symptoms include difficulty starting urination, weak urinary stream, frequent urination, dribbling after urination, and waking up several times at night to urinate. (BPH is not a form of prostate cancer, that is a different problem).
Even today, the exact cause of BPH is unknown, as is saw palmetto’s complete mechanism of action. As with all medicinal plants, the benefits are due to a combination of compounds working together, not just a single “active” ingredient. Research and experience suggest that saw palmetto has antispasmodic activity, affects hormonal activity and has anti-inflammatory and diuretic properties.
Saw palmetto appears to have a balancing effect on male sex hormones. It not only helps BPH, it also helps to preserve male potency, while tonifying and revitalizing the organs of the urogenital system. It appears that urinary symptoms due to mild to moderate prostate enlargement respond more readily to saw palmetto than symptoms due to severe enlargement.
Action of Saw Palmetto on the Prostate
Research and clinical studies suggest that extracts of saw palmetto help reduce BPH and prostatitis by inhibiting the conversion of testosterone to dihydrotestosterone (DHT). DHT is five times more potent than testosterone and is believed to be responsible for prostate enlargement. It appears to overstimulate growth of prostate tissue. By inhibiting the conversion of testosterone to DHT, saw palmetto inhibits this growth of prostate tissue.
Another mechanism is that the herb has an anti-estrogenic action in prostate tissue. Apparently, it inhibits both androgen and estrogen receptor activity which, again, prevents over stimulation of prostate tissue. It is interesting to note that the prostate and uterus are embryologically analogous tissue and that as men age, testosterone levels drop and estrogen levels rise.
A number of double blind studies comparing saw palmetto and the drug Proscar, found both to be equally effective at shrinking the prostate. Proscar lowered PSA levels (prostate-specific antigen), whereas saw palmetto leaves PSA levels unchanged. Cancer raises PSA levels, and lab tests that measure PSA are used to screen for prostate cancer. Lower PSA measurements may have the unintended effect of masking prostate cancer. Saw palmetto won’t do this. Other side effects of Proscar include decreased sexual function. Saw palmetto causes no significant side effects, improves sexual function, but still improves urinary flow rate and reduces other symptoms of BPH.
Saw palmetto is also good for prostatitis (inflammation of the prostate) and prostate infection. It is anti-inflammatory and in cases of prostate infection, stimulates urination, causing the infectious microorganisms to be flushed out.
Saw palmetto is fat-soluble, so it is best taken with meals. Regular use over 4 to 6 weeks can help decrease frequency of urination, especially during the night, by reducing inflammation of the bladder and by allowing the bladder to empty more completely. Before self-treating with saw palmetto, be sure to get a proper medical evaluation to rule out prostate cancer. Saw palmetto is going to be of little help if the problem is prostate cancer.
Saw palmetto can be even more effective when combined with other herbs for the prostate. It is an ingredient in Men’s Formula (for prostatitis and BPH), DHEA-M (a blend for enhancing men’s testosterone levels), X-A (for impotence, erectile dysfunction and loss of sexual desire in men or women), Men’s X-Action (another blend for impotence, erectile dysfunction and loss of desire more specifically targeted to men).
Other Uses for Saw Palmetto
However, as we have indicated, saw palmetto is more than just a prostate remedy. When it was introduced into Western medical practice, it was used for many other purposes. Saw palmetto is a digestive tonic. It enhances digestion and assimilation of nutrients. It is an excellent food for elderly men and women who are losing weight and having trouble digesting their food. This makes a great remedy for wasting diseases, debility and failure to thrive.
There is some evidence that saw palmetto can enhance breast size in women which makes it a popular ingredient in herbal formulas for increasing the bust line in women, such as Breast Enhance. The problem is that it does this by enhancing overall metabolism and can result in modest overall weight gain, not just increase in breast size.
Saw palmetto was also traditionally used as a remedy for the lungs. It relieves irritation of the mucus membranes and has been used for pertussis, laryngitis, coughs, tuberculosis, bronchitis and asthma. It is also an immune system tonic making it beneficial for people who catch colds easily.
Because saw palmetto is a non-irritating diuretic, it is also useful for inflammatory conditions of the urinary passages. Combined with other herbs, it can be helpful for painful, burning urination, urinary tract infections and interstitial cystitis. It is best used in combination with other remedies for these conditions.
Because it reduces excess androgens in women, saw palmetto can be useful for polycystic ovaries and ovarian pain in women. It can reduce the pelvic congestion that causes menstrual pain in some women, too.
Saw palmetto has been used as a food, so it is a very safe herb for long term use. However, because of its potential hormonal effects, pregnant women should avoid saw palmetto. Breast-feeding women should also avoid saw palmetto as it inhibits prolactin and may interfere with nursing.
Saw Palmetto by Ray Sahelian
Saw palmetto by EBSCO CAM Publishing
Prostate by J.C. Carraro, et al.
Herbal Supplements and Therapy by Merrily A. Kuhn and David Winston
The Comprehensive Guide to Nature’s Sunshine Products by Tree of Light
The Encyclopedia of Medicinal Plants by Andrew Chevallier