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Saw palmetto is an herbal product used in the treatment of symptoms related to benign prostatic hyperplasia. The active component is found in the fruit of the American dwarf palm tree. Studies have demonstrated the effectiveness of saw palmetto in reducing symptoms associated with benign prostatic hyperplasia. Saw palmetto appears to have efficacy similar to that of medications like finasteride, but it is better tolerated and less expensive. There are no known drug interactions with saw palmetto, and reported side effects are minor and rare. No data on its long-term usage are available. The herbal product also has been used to treat chronic prostatitis, but currently there is no evidence of its efficacy.
Saw palmetto, also known as Serenoa repens or Sabal serrulatum, is an herb that is most commonly used to treat problems related to benign prostatic hyperplasia (BPH). The medicinal element of saw palmetto is taken from the partially dried ripe fruit of the American dwarf palm tree, which is indigenous to the coastal regions of the southern United States, from the Carolinas and Florida to California.
BPH is a nearly universal result of the aging process in men. As the prostate gland enlarges, it can cause both obstructive and irritative symptoms; however, the size of the prostate gland is not predictive of the symptoms that patients experience.
Saw palmetto is widely used in other countries; for example, it is used in 50 percent of treatments for BPH in Italy and in 90 percent of such treatments in Germany.1 The active part of the plant is the sterols and free fatty acids found in the berry. The particular solvent used in the extraction process affects the resulting formulation of the product. The most widely studied form of saw palmetto is Permixon, which uses the solvent hexane; other formulations have used ethanol, methanol, and liquid carbon dioxide as solvents. Historically, saw palmetto was administered with nettle root and pumpkin seeds, and some modern formulations include these elements.
It is unclear which components are the most active, and the mechanism of action is not fully understood. Some of the mechanisms proposed include anti-inflammatory activity,2 blocked conversion of testosterone to dihydrotestosterone (DHT),3,4 and prostate epithelial involution similar to effects noted with the use of finasteride (Proscar).5
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