Saw PalmettoLacey Fishman

March 3, 2008

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http://www.herbs2000.com/images/herbs_saw_palmetto.jpg

The Miracle Plant!

• All-natural alternative to Viagra!• Reduces prostate size and alleviates all

symptoms of BPH!• Makes critical phytonutrients available to

the prostate gland!• Reverses hair loss!• Stops unwanted hair growth!• Increases breast size in women!

REALLY?!?!?!

Taxonomy [16]

Kingdom – PlantaePhylum – MagnoliaphytaClass – LilopsidaOrder – ArecalesFamily – Arecacea Genus – SerenoaSpecies – Serenoa repens L.

http://plants.usda.gov/java/profile?symbol=SERE2&photoID=sere2_003_avp.tif

http://plants.usda.gov/java/profile?symbol=SERE2&photoID=sere2_004_avp.tif

Botanical description [8,16]

• Perennial shrub• S-L-O-W growth…only .01 inches per

YEAR• Best suited to warm, moist climates• Yellow-green leaves with white flowers

and black seeds• Native to South Carolina, Georgia,

Alabama, Florida, Mississippi, Louisiana and Texas

Traditional Uses [4]• Alcoholism• Respiratory infections• Appetite stimulant• Bronchitis• Dysentery• Kidney disease• Whooping cough• Headaches• Rheumatism• Hemorrhoids• Stomach ache• Anti-inflammatory

• Breast atrophy• Ovarian atrophy• Alopecia• Sexual stimulant• Sperm production• Prostate enlargement• Testicular atrophy• Hormone regulation• Infertility• Incontinence• Urinary tract infections• Diuretic

Benign Prostatic Hyperplasia

• Non-cancerous enlargement of the prostate glad [15]

• Pressure on urethra from enlarged prostate causes symptoms [15]– Frequent, difficult urination– Incomplete emptying, leading to chronic

urinary tract infections– If left untreated, chronic urine retention can

lead to renal failure

How does it help?

• Exact method of action not known– One suggested cause of BPH is increase in

androgens, especially dihydrotestosterone; may interfere with conversion of testosterone to dihydrotestosterone and block the androgen binding sites [2]

• Has been experimentally shown to discourage cell growth and encourage death of abnormal cells (apoptosis) [14]

Possible Actions

• Defends prostate from androgens, including dihydrotestosterone [4]– Inhibition of 5-alpha reductase– Action on alpha adrenergic receptors

• Anti-inflammatory [4]– Reduce swelling of prostate gland

• Interference with growth factors [4]– Prevent abnormal growth of prostate gland

What’s in it?

• The active ingredient is not known, but several are hypothesized– Acylglycerides [11]

• 1-monolaurin• 1-monomyrstin

– Phytosterols [13]• Campesterol• Sigmasterol• Beta-Sitosterol

http://chemfinder.cambridgesoft.com/result.asp

Dosage

• Many different recommendations [2,4,17] – 320 mg of liposterolic extract ~ 1g berries– If taking dried, powdered saw palmetto:

• 1350-2250 mg• 540 mg• 320 mg

– In addition to powders and extracts, can also be brewed into a tea

• 3-5 cups of tea daily

Side Effects [4,5,7,12]

• Constipation• Diarrhea• Nausea• Breast swelling and tenderness• Decreased libido• All side effects supposed to be “mild,

infrequent, and readily reversible”

Contraindications

• Should not be used by alcoholics, as it can induce cholestatic hepatitis or acute pancreatitis. [6]

Adulterants

• Unripe Saw Palmetto berries [3]– Mature berries are harvested in the fall, at the

end of the growing season– Immature berries sometimes harvested and

sold before the main harvest of berries is ripe– Concentrations of possible active ingredients

has not been quantified in unripe berries; ripe and unripe berries have different chemical compositions and unripe berries may not be medicinally useful

How well does it work?

• According to the National Center for Complementary and Alternative Medicine:– “Several small studies suggest that saw

palmetto may be effective for treating BPH symptoms.” [7]

– “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.” [7]

How well does it work?

• According to Chemist & Druggist Magazine:– “S. repens significantly improves urologic

symptoms and flow measures compared with placebo.”[4]

– “Numerous uncontrolled trials…essentially corroborate the clinical effectiveness and safety in this condition.”[4]

How well does it work?

• According to Science News Magazine [10]:– “In the Feb. 9 New England Journal of

Medicine, scientists report that 112 men with BPH who took two capsules of saw palmetto extract daily for a year still had symptoms similar to those reported by 113 men with BPH who took inert capsules.”

– “Saw Palmetto flunks prostate exam.”

How well does it work?

• We don’t really know!– Studies show varied results; some say that it

is markedly more effective than other treatments, some say that it is no more effective than a placebo.

• Could be due to variations in length of clinical trials, variations in amount of saw palmetto given in each trial, and variations in purity/contents of herbal supplement

Bibliography1. Beta sitosterol. (2008). Retrieved February 27, 2008 from

<<http://chemfinder.cambridgesoft.com/result.asp>>2. Brown, G., Vukovich, M., Martini, E., Kohut, M., Franke, W., Jackson, D., & King,

D. (Sept 2001). Effects of androstenedione-herbal supplementation on serum sex hormone concentrations in 30- to 59-year-old men. International Journal for Vitamin and Nutrition Research. 71(5), p. 293-301.

3. Cavaliere, C. (Jan 2008). Drought Reduces 2007 Saw Palmetto Harvest. Herbalgram. 77(1). p.56-57

4. Ernst, Edzard. (Feb 2003). Nature’s healer: saw palmetto. Chemist & Druggist, p. 21-22

5. Helmer, J. (June 2006). Saw Palmetto: Find out how this dwarf plant may help stop prostate enlargement. Better Nutrition. p.12

6. Jibrin, I., Erinle, A., Saidi, A., & Aliyu, Z. (2006, June). Saw Palmetto-induced Pancreatitis. Southern Medical Journal, 99(6), 611-612. Retrieved February 28, 2008, from Academic Search Premier database.

Bibliography7. (May 2006). Saw palmetto; drug overview. Pamphlet by: National Center for

Complementary and Alternative Medicine, p.18. Ohr, L. (Jan 2003). Botanically speaking. Food Technology. v 57(1), p. 65-67, 89. 9. The Saw Palmetto Harvesting Company. (2008). Retrieved February 10, 2008

from <<http://www.sawpalmetto.com/>>10. Seppa, N. (2006, February 25). Saw palmetto flunks prostate exam. Science

News, 169(8), 126-126. Retrieved February 27, 2008, from Academic Search Premier database.

11. Shimada, H., Tyler, V., & McLaughlin, J. (Apr 1997). Biologically active acylglycerides from the berries of saw-palmetto (Serenoa repens). Journal of Natural Products. 60(4), p. 417-418

12. Sikov, Lopatkin et al. (Jan 2008). Clinical Trial Follow-up Evaluates Safety and Effectiveness of Saw Palmetto and Stinging Nettle Extracts in Men with BPH. Herbalgram. 77(1), p. 31

Bibliography13. Sorenson, W., & Sullivan, D. (2007 May-June). Determination of Campesterol,

Stigmasterol, and Beta-Sitosterol in Saw Palmetto Raw Materials and Dietary Supplements by Gas Chromatography: Collaborative Study. Journal of AOAC International. 90(3), p. 670-678.

14. Tanner, G.(July 1996). Saw-palmetto: an Ecologically and Economically Important Native Palm. IFAS Extension. p.1-4.

15. Thorpe, A. (April 2003). Benign Prostatic Hyperplasia. The Lancet. 9366(361). p. 1359-1352

16. USDA, NRCS. 2002. The PLANTS Database, Version 3.5 (http://plants.usda.gov). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.

17. The Whole Truth: Prostate 5LX.(2008). Retrieved February 10, 2008 from<<http://www.newchapter.com/products/prostate-5lx>>