Serenoa repens                                      

Common name: Saw Palmetto

Family: Arecaceae/Palmae

Part used: Berries

Constituents: 

•      Fixed Oils (free fatty acids: capric, caprylic, caproic, lauric, palmitic, and oleic acids)
•      Phytosterols (B-sitosterol)
•      Carbohydrates & Mucilage
•      Flavonoids
•      Tannins
•      Carotenes

Medicinal Actions: 

•      Alterative
•      Anti-inflammatory
•      Antispasmodic
•      Diuretic
•      Reproductive Tonic

Medical uses: 

• The Eclectics used it for respiratory and genitourinary complaints, especially to reduce catarrh and mucus membrane irritation (e.g. cystitis, bronchitis and prostatitis),  atrophy of reproductive organs & tissues (e.g. breast, ovaries and testes) and for Benign Prostatic Hypertrophy (BPH). It was described as the “old man’s friend”, and as “a remedy for prostatic irritation and relaxation of tissue (rather) than for a hypertrophied prostate.” It was also used for inflamed gonads in the male or female and as an aphrodisiac.
• Specific use for disorders of the prostate such as acute and chronic prostatitis and benign prostatic hyperplasia (especially milder cases not requiring surgery).
• A review of 18 randomized trials in patients with BPH lasting 4 to 48 weeks were assessed. Compared with placebo was shown to improve urinary symptoms and flow measures comparable with finasteride and was associated with fewer adverse events.
• Also been shown to be an effective topical preparation in male pattern baldness (androgenic alopecia), and to regenerate hair growth in animal models.

Pharmacology:

•  Liposterolic (fat soluble) constituents such as sterols & fatty acids appear most responsible for therapeutic effects. Mechanism of action in treatment of BPH has been thought to result from inhibition (via blocking 5-alpha reductase) in the intraprostatic conversion of testosterone to dihydrotestosterone (DHT) and inhibition of its intracellular binding and transport. However, more recent research has suggested additional mechanisms of action, including anti-estrogenic and receptor site-binding effects.
• Additional pharmacological in animals include spasmolytic, anti-estrogenic activity, and anti-inflammatory activity.

Pharmacy: 

•      Liposterolic extract (8-10:1): 160 mg, BID. (standardized to 85-95% fatty acids &           sterols)
•      Dried Berries: 2-4 g, QD.
•      Tincture: (1:2, 60-90%), 2-4 ml, QD.

Toxicity:

•    May cause stomach upset (rare).
•    Ensure continually monitoring of PSA levels and prostate size even if symptoms of BPH are improving with use.

Contraindications: None known.

Interactions:

•    Anti-platelet and anti-coagulant drugs may potentiate effects (theoretical).

References:

• Find a complete list of references for this monograph as well as images and a review of its evidence based applications in Dr. Marciano’s Herbal Textbook.