Use of Saw Palmetto in Benign Prostatic Hyperplasia

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Holistic and natural medicine dates far back in history, but has recently re-emerged as a very popular alternative to prescription medication. Many decide to use natural remedies, such as dietary supplements, to avoid the high cost and extensive list of unwanted side effects of prescription medications, but these alternatives are not always an effective equivalent. The Food and Drug Administration (FDA) does not regulate holistic medicine such as dietary supplements, which pose concerns about the content and efficacy of the active ingredient.5 It is very difficult to standardize herbal remedies because herbs are usually complex mixtures and the constituents responsible for the claimed effects are often unknown.2
Saw palmetto (Serenoa repens) is a widely used dietary supplement in the treatment of benign prostatic hyperplasia (BPH). BPH is a urological condition common in men over the age of 50, caused by the non-cancerous enlargement of the prostate gland.4 As the prostate enlarges it causes there to be pressure on the urethra, resulting in lower urinary tract symptoms.4 The most common symptom of BPH is difficult or painful urination.4 Saw palmetto has been used as an alternative to prescription medication to treat the symptoms of BPH since the early 1900s, and is still a top choice for the over-the-counter treatment of symptoms by patients today.6 The active ingredient of the saw palmetto plant is it’s ripe berries. Clinically evaluated products are standardized based on the content of fatty acid. Supplements usually contain 70 to 95 percent of free fatty acids and phytosterols. 3 Although researchers are not sure of the exact mechanism of action of saw palmetto, the dietary supplement is said to inhibit 5α-reductase isoenzymes...

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2. Natural Medicines Comprehensive Database. Saw palmetto. http://0-naturaldatabase.therapeuticresearch.com.millennium.midwestern.edu/nd/Search.aspx?cs=SCHOOLNOPL~SFS&s=ND&pt=100&id=971&ds=&name=SAW+PALMETTO&searchid=46224023 (2014 April 2014)

3. De Smet P. Drug therapy: Herbal remedies. N Engl J Med. 2002; 347(25): 2046-56

4. American Urological Association. Benign prostatic hyperplasia. http://www.auanet.org/education/guidelines/benign-prostatic-hyperplasia.cfm (2104 April 14)

5. Bressler R. Herb-drug interactions: Interactions between saw palmetto and prescription medication. Geriatrics. 2005; 60(November): 32-4

6. Ehrlich S. Saw palmetto.http://umm.edu/health/medical/altmed/herb/saw-palmetto (2014 April 14)

7. Agbabiaka T, Pittler M, Wider B, Ernst E. Serenoa repens (saw palmetto): A systematic review of adverse events. Drug Safety. 2004; 32(8): 637-47

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