Saw Palmetto (Serenoa repens) is a tree of the Arecaceae family indigenous to the West Indies and North America. The ripe fruit, which is used in herbal medicine both orally and topically, is rich in flavonoids, polysaccharides and fatty acids. Saw Palmetto has traditionally been used to treat benign prostatic hyperplasia (BPH). The Eclectic also used the berry to treat respiratory issues, as well as enlargement of the uterus, inflamed gonads, and atrophy of the breast and ovaries. Saw Palmetto has anti-inflammatory properties; it is an androgen antagonist and endocrine agent. Topically, Saw Palmetto is used to treat male pattern hair loss and scalp issues (Bone & Mills, 2013).

Studies on the use of lipidosterolic extract of Saw Palmetto (LESP) to treat BPH have been contradictory. Some have shown positive effects of LESP on urinary flow and nocturia (Champault, G. et al., 1984), while other studies have shown no positive effects at all (Bent et al., 2006). I must admit that the differences in outcome of the many studies reviewed was shocking to me. I have been using Saw Palmetto in my practice with positive results for over a decade, and I believe that this herbal medicine has spared my father from prostate laser surgery. I can only attribute such varied results to each participants’ unique biochemical makeup and to different preparations/extracts of the berry used during the various trials. Other questions that arise when clinical trials yield such a disparity in results also concern other lifestyle factors: do the participants smoke? Do the participants consume a diet high in processed, pro-inflammatory foods? I was not able to find data on lifestyle factors.

In addition to LESP activity on the androgen hormones testosterone and DHT, studies in the animal model show that LESP may reduce also prolactin. While most of the research is in the treatment of male disorders, this mechanism of action may have applications in the treatment of PCOS (Grant & Ramasamy, 2012).

In vitro and in vivo studies have also analyzed results produced using various saw palmetto extracts on prostate cancer cells. Despite some positive results in transgenic mice with prostate cancer showing reduced PSA and reduced tumor grade (Wadsworth et al., 2007), at this time researchers do not believe that the use of saw palmetto can prevent the development of prostate cancer.

References

Bent, S., Kane, C., Shinohara, K., Neuhaus, J., Hudes, E. S., Goldberg, H., & Avins, A. L. (2006). Saw palmetto for benign prostatic hyperplasia. The New England journal of medicine, 354(6), 557–566. https://doi.org/10.1056/NEJMoa053085

Champault, G., Patel, J. C., & Bonnard, A. M. (1984). A double-blind trial of an extract of the plant Serenoa repens in benign prostatic hyperplasia. British journal of clinical pharmacology, 18(3), 461–462. https://doi.org/10.1111/j.1365-2125.1984.tb02491.x

Grant, P., & Ramasamy, S. (2012). An update on plant derived anti-androgens. International journal of endocrinology and metabolism, 10(2), 497–502. https://doi.org/10.5812/ijem.3644

Wadsworth, T. L., Worstell, T. R., Greenberg, N. M., & Roselli, C. E. (2007). Effects of dietary saw palmetto on the prostate of transgenic adenocarcinoma of the mouse prostate model (TRAMP). The Prostate, 67(6), 661–673. https://doi.org/10.1002/pros.20552