Saw Palmetto

Men, as most women can attest, tend to be rather stubborn and not admit when something is wrong. This is true whether it's persistent knee pain that results from using too much weight on the leg extension machine or, in my case, refusing to stop and ask for directions when I was trying to drive home from Boston, a few years ago. While some may rationalize this as the way men's brains are wired, our inability to ask for help when we need it can make things worse, especially when a simple answer is probably readily available. Take, for instance, the delicate issue of the prostate. Many men in their 40s have probably encountered the humbling experience in which their doctor dons a latex glove, pokes his/her finger you-know-where and performs a rectal exam. One of the reasons physicians do this is to check for an enlargement of the prostate gland, a small, walnut-sized organ that manufactures a portion of the fluid that is found in semen. A common occurrence as men grow older is that the prostate gets bigger, a problem technically called benign prostate hyperplasia or BPH for short. BPH is unfortunately an issue that most men will experience at some point in their lives. For example, some estimate that by age sixty, 50 percent of men will have some degree of BPH. This number jumps to a whopping 90 percent of men who are 85 years old! Several medical options are available for the man who has an enlarged prostate. In addition to these, some men may experience relief with an herb called saw palmetto. Saw palmetto is a small palm tree that that grows in California, South Carolina and Florida. While traditionally used for a number of conditions, the most popular use of saw palmetto is in the treatment of enlarged prostate glands.

How Does Saw Palmetto Work?

As was mentioned above, as men grow older, the prostate gland enlarges, producing a condition called BPH. Because the prostate gland encircles the urethra, the tube through which urine flows from the body, an enlargement of the prostate can result in a cutting off of the urine stream, resulting in a difficulty emptying the bladder and frequent urination. The cause of BPH is not fully understood but one of the most widely held theories states it may be due in part to levels of a hormone called dihydrotestosterone (DHT). DHT is actually a form of the hormone, testosterone. Evidence suggests that saw palmetto works by inhibiting the enzyme (5 alpha-reductase) that converts testosterone into DHT. Thus, by limiting the buildup of DHT, saw palmetto might reduce the symptoms of benign prostate hyperplasia.

Several well-done studies of the last several years have found that saw palmetto is effective for alleviating symptoms such as painful and frequent urination that are associated with BPH. Saw palmetto appears to work by slowing the growth of the prostate but it does not appear to shrink prostate size. Research shows that saw palmetto is most effective for men who suffer from mild BPH symptoms. While the ingredients responsible for saw palmetto's effects are not well identified, some experts feel those ingredients reside in the fruit of the plant. Thus, supplements should be derived from saw palmetto fruit and not other parts of the plant.

Studies finding positive effects on BHP symptoms have generally used 1-2 grams of saw palmetto berries a day or 160 mg of saw palmetto extract twice per day. While supplements may combine saw palmetto with other ingredients, it's important to remember that it is saw palmetto that has the most evidence. Whether or not other ingredients boost the effectiveness of saw palmetto is unknown. Also, don't be discouraged if improvements do not occur overnight. Studies find that saw palmetto may take up to 8 weeks before improvements in BPH are noticed. Currently, it is unknown if using saw palmetto can prevent BPH from occurring in the first place.

Can Saw Palmetto Reduce Prostate Cancer?

Unfortunately prostate cancer does not have the press agent that breast cancer does, so it is not mentioned as much in the media but that does not mitigate its devastating effects. Prostate cancer is the second leading cause of death in American men resulting in over 30,000 deaths each year. Men, armed with this information sometimes opt to use supplements such as saw palmetto to help reduce the risk of getting prostate cancer. Currently however, there is little proof that saw palmetto is effective for this reason. A better option in this case might be selenium where low dietary levels of this mineral have been linked to reduced prostate cancer risk. Lycopene, a phytonutrient found in tomatoes, is also sometimes advocated to reduce prostate cancer risk however I should mention that the evidence for eating tomatoes and tomato-products is stronger than for lycopene supplements.

Saw palmetto does not appear to alter prostate specific antigen (PSA) levels, a commonly used test for prostate cancer. For men at risk of prostate cancer, saw palmetto can't hurt and might help especially when combined with other important lifestyle changes such as eating less saturated fat and exercising more. This is sage advice given that small changes like eating better and getting more exercise also tend to make big impacts on reducing other diseases as well.

Side Effects

Saw palmetto is generally considered safe with few problems. Side effects that are sometimes mentioned are generally mild and include stomach upset, nausea and headache—very common stuff that pops up in most drug and dietary supplement research. There is some speculation that saw palmetto may lengthen bleeding time if you are cut. Thus, saw palmetto (like all supplements) should be discounted prior to surgery. People using blood thinner medications should consult their physician before using saw palmetto.

Saw palmetto may prove to be a simple, natural way to obtain relief for the millions of men who experience symptoms from enlarged prostate glands. Before using saw palmetto it is highly recommended that men see their doctor first because symptoms resembling benign prostate hyperplasia may also be caused by other, more serious issues such as prostate cancer.

About the author: Joe Cannon, MS, CSCS, is an exercise physiologist, personal trainer, writer and health educator. He is the author of Nutritional Supplements: What Works and Why. A Comprehensive Review from A to Zinc and Nutrition Essentials, a Guidebook for the Fitness Professional. For more information visit his official website www.Joe-Cannon.com or drop Joe an email directly at JoeCannon@rcn.com