Saw Palmetto: Benefits, Dosage, Contraindications

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Sabal or saw palmetto is a tree native to the Caribbean and the southeastern coast of North America (from South Carolina to Louisiana). It reaches a height of 2 to 3 meters and is characterized by its fan-shaped spine-like leaves. The brown oval-shaped berries are used in therapeutics. Its extracts must be standardized to contain at least 11% fatty acids. The fruit contains a fatty oil with triacylglycerols, free fatty acids (linoleic, linolenic, palmitic, lauric, oleic acids), sterols (beta-sitosterol), polysaccharides, and flavonoids. Saw palmetto was traditionally used in medicine to treat various urogenital disorders, as well as fertility and impotence problems in men. It was nicknamed "the old man's friend" due to its benefits for men's health, particularly in older men. Its action is primarily anti-androgenic. Saw palmetto is most often used to reduce symptoms of benign prostatic hyperplasia.

Other name(s) 

Saw palmetto, Sabal

Scientific name(s)

Serenoa repens

Family or group: 

Plants

Active ingredients:

Linoleic acid

Alpha-linolenic acid

Beta-sitosterol


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Hair Loss
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Preliminary clinical research shows that a combination of 200 mg of saw palmetto extract and 50 mg of beta-sitosterol taken twice daily improves subjective scores of hair quantity and quality in men with androgenetic alopecia. However, other clinical research indicates that taking 320 mg of saw palmetto extract per day for 24 months is less effective than taking 1 mg of finasteride per day in improving hair growth in men with androgenetic alopecia. Some early clinical research shows that saw palmetto lotion applied twice daily for 50 weeks improves hair density by 27% in men and women with androgenetic alopecia. However, it is not clear whether saw palmetto provided a statistically significant improvement compared to a placebo.

Posologie

posologieTopical, oral: fruit

posologie200 - 320 mg

duration2 - years


Synergies


Benign Prostatic Hyperplasia
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There are numerous clinical studies on this topic, with smaller and shorter ones noting some slight to moderate improvements in urinary symptoms such as frequent urination, painful urination, urgency, and perineal heaviness. Some studies also show that saw palmetto reduces nocturia (the need to urinate at night), improves urinary flow, and reduces residual urine volume in patients with benign prostatic hyperplasia. However, larger and longer trials have noted no effect. The most recent Cochrane meta-analysis also reports no effect. Research results remain inconsistent. This may be due to different study methodologies, patient populations, symptom measurement methods, and saw palmetto products used in studies. Most clinical studies, including those yielding positive and negative results, have used liposterolic extracts of saw palmetto berries containing about 80% to 90% free fatty acids.

Posologie

posologieOral: fruit

posologie320 - 320 mg


Prostatitis
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Saw palmetto may improve symptoms of prostatitis compared to no treatment in patients suffering from non-bacterial prostatitis. Other preliminary clinical evidence suggests that taking a daily saw palmetto extract for eight weeks, in addition to prulifloxacin 600 mg per day for 15 days, reduces pain and urinary symptoms more significantly than prulifloxacin alone in patients with bacterial prostatitis. However, other preliminary clinical research suggests that oral saw palmetto 325 mg taken for a year does not significantly improve non-bacterial prostatitis and chronic pelvic pain syndrome compared to treatment with finasteride 5 mg. Interestingly, preliminary clinical research shows that taking a complex based on saw palmetto, selenium, and lycopene for 8 weeks significantly improves symptoms and peak flow in patients suffering from chronic prostatitis and/or chronic pelvic pain syndrome compared to pre-treatment. However, these effects were less significant in patients treated with saw palmetto alone, indicating that saw palmetto might not be the sole active component of this combination.

Posologie

posologieOral administration: fruit

posologie160 - 320 mg


Synergies


Properties


Anti-androgenic

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Saw palmetto has anti-androgenic, antiproliferative, and anti-inflammatory properties that are believed to improve symptoms of benign prostatic hyperplasia (BPH). Monitoring of 5-alpha-reductase and dihydrotestosterone (DHT) is crucial as they play a significant role in certain health conditions. 5-alpha-reductase is an enzyme that converts testosterone into DHT, a more potent form of testosterone. High levels of DHT are associated with issues like benign prostatic hyperplasia (BPH) and androgenetic alopecia. Saw palmetto appears to non-competitively inhibit types 1 and 2 of 5-alpha-reductase and prevent the conversion of testosterone into DHT in vitro, which may help limit prostate growth. However, levels of 5-alpha-reductase in prostate tissue and serum testosterone, DHT, and PSA are not significantly reduced by saw palmetto in vivo. Inhibition of 5-alpha-reductase and prevention of testosterone conversion to DHT may also contribute to saw palmetto's activity in androgenetic alopecia. It's suggested that this condition involves increased follicular sensitivity to DHT, reducing their growth phase and size.

Usages associés

Hair loss, Benign prostatic hyperplasia

Anticancer

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In laboratory studies, saw palmetto extract (Serenoa repens) has shown potential to fight cancer. It appears to inhibit an enzyme (urokinase-type plasminogen activator) linked to the spread of cancer cells in urological cancers. Furthermore, saw palmetto has demonstrated inhibitory effects on the growth and/or induction of cell death in several types of cancer cells, including various prostate, breast, kidney, bladder, colon, and lung cancers. These effects vary depending on the dose of the extract used.


Anti-inflammatory

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Inflammatory mediators seem to contribute to the etiology of BPH. In men with benign prostatic hyperplasia (BPH), a saw palmetto extract appears to decrease tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta, which are markers of inflammation in prostate tissue. Laboratory results suggest saw palmetto inhibits lipoxygenase and cyclooxygenase (COX), which are involved in inflammation. Additionally, animal research suggests saw palmetto inhibits the accumulation of mast cells in the prostate.

Usages associés

Prostatitis

Hormonal metabolism

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Some animal research outcomes suggest that saw palmetto fruit extract has estrogenic activity due to its relatively high concentration of beta-sitosterol. However, human research outcomes suggest that the extract displays anti-estrogenic activity in prostate tissue of men with benign prostatic hyperplasia.


Safety dosage

Adult from 18 years: 160 mg - 320 mg

Long-term use is possible. If symptoms persist while using saw palmetto, a doctor or qualified health professional should be consulted. Symptoms: fever, spasms or blood in urine, painful urination, or urinary retention.


Interactions

Médicaments

Warfarin: weak interaction

A few cases of suspected interactions with warfarin have been reported. Increased INR values were described. If you are taking an anticoagulant medication such as warfarin (Coumadin), your prothrombin time test results will be expressed as an international normalized ratio (INR).

Oral contraceptives: moderate interaction

Saw palmetto might have anti-estrogenic effects. Its use may interfere with contraceptive medications.


Precautions

Child up to 18 years: avoid

Avoid due to lack of data.

Hepatic insufficiency: avoid

In cases of liver disorders, saw palmetto is not recommended.


Contraindications

Pregnant woman: prohibited

Saw palmetto has hormonal activity.

Breastfeeding woman: prohibited

Saw palmetto has hormonal activity.