SAW PALMETTO
The saw palmetto is a low, scrubby palm that grows in the coastal plain of Florida and other southeastern states. Its fan-shaped leaves have sharp, saw-toothed edges that give the plant its name. Dense clumps of saw palmetto can form an impenetrable thicket. The abundant, 2–cm long berries are harvested from the wild in the fall and are dried for medicinal use. They also serve as a source of nutrition for deer, bears, and wild pigs.
What is Saw Palmetto used for?
Traditional/Ethnobotanical uses
Native tribes of Florida relied on saw palmetto berries for food; however, Europeans often found the taste of the berries objectionable. While native medicinal use of saw palmetto is not recorded, it was introduced into Western medical practice in the 1870s and was a favorite of Eclectic medical practitioners for prostate and other urologic conditions. Saw palmetto berries were official in the US Pharmacopeia in 1906 and 1916, and in the National Formulary from 1926 to 1950. While use in the US declined after that time, saw palmetto has long been a staple phytomedicine in Europe.
Prostate/Urinary effects
Recent interest has been rekindled, and saw palmetto currently is ranked in the top 10 herbal products in the US. It is used primarily for its activity in benign prostatic hyperplasia (BPH). Saw palmetto is used to treat symptoms of benign prostatic hyperplasia, including reduction of urinary frequency, increase of urinary flow, and decrease of nocturia (nighttime urination). Saw palmetto may delay the need for prostate surgery. Although the mechanism of action of saw palmetto is not completely understood, clinical trials in BPH have shown convincing evidence of moderate efficacy. One clinical study of saw palmetto vs the drug finasteride found equivalent efficacy and less side effects for saw palmetto. Likewise, another study of BPH patients found clear superiority of saw palmetto to placebo in reduction of BPH symptoms. Clinical studies show good promise.
What is the dosage of Saw Palmetto?
The crude saw palmetto berries usually are administered at 1 to 2 g/day. However, lipophilic extracts standardized to 85% to 95% fatty acids in soft native extract or 25% fatty acids in a dry extract are more common. Some of the brand name products include Permixon (Pierre Fabre Medicament), Prostaserene (Indena) SCF extract, Prostagutt (WS 1473, Schwabe), Remigeron (Schaper & Brummer), IDS 89 (Strathmann AG), Quanterra Prostate (Warner Lambert), and LG 166/S (Lab. Guidotti). Typical doses of standardized extracts range from 100 to 400 mg given twice daily for benign prostatic hypertrophy.
Contraindications
Contraindications have not yet been identified.
Pregnancy/nursing
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Interactions
Increased anticoagulant effect of warfarin has been reported during concurrent ingestion of saw palmetto. However, there was a more likely explanation for the interaction. Until more data are available, patients taking warfarin should consult their health care provider before taking saw palmetto or other herbal products.
Side Effects
Saw palmetto is generally well tolerated, with occasional reports of adverse GI effects. Do not use during pregnancy. Because of well-documented anti-androgen and anti-estrogenic activity, avoid taking with any hormone therapy, including oral contraceptive and hormone replacement therapy.
Toxicities
Research reveals little or no information regarding toxicology with the use of saw palmetto.
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