Saw Palmetto for Enlarged Prostate: What’s the Latest?

Maybe your doctor just diagnosed you
with benign prostatic hyperplasia (aka BPH, an enlarged prostate). Perhaps
you’ve had BPH for a while, or you’re wondering whether it’s in your future.
After all, it affects 70 percent of men in the US ages 60 to 69 and 80 percent
of those 70 years or older. What are your treatment options? If you want a
natural approach, you might consider saw palmetto for enlarged prostate.

Why saw palmetto for enlarged prostate?

If you search for information on
natural ways to treat an enlarged prostate, saw palmetto often comes up. A
number of research studies have shown that the herb can be especially helpful
in managing symptoms associated with BPH. Those symptoms, often referred to as
LUTS (lower urinary tract symptoms), include urinary urgency, urinary
frequency, dribbling, painful urination, frequent nighttime urination, and the
annoying start-and-stop urination.

Take this new study on LUTS and BPH, for example, which was published in March 2019 in Urology. In this multicenter, double-blind, placebo-controlled study, 354 men were given either 320 mg saw palmetto (159 men) or a placebo (169) daily for 24 weeks. The investigators evaluated changes in the International Prostate Symptom Score and peak urinary flow as well as other LUTS factors, total prostate-specific antigen (PSA) levels, quality of life score, and sexual function.

How did the men in the saw palmetto
group do? Compared with those who received placebo, they experienced

  • Significant improvement in peak urinary flow, IPSS scores,
    LUTS symptoms, quality of life, and sexual function scores.
  • One or more adverse events occurred in 2 men in the placebo
    group and 3 in the saw palmetto group
  • Overall, the authors stated that the herbal supplement was
    “effective, safe, well-tolerated, and clinically and statistically superior to
    placebo.”

What should I know about saw palmetto for enlarged prostate?

The saw palmetto berries contain
more than 100 compounds, which include fatty acids, long-chain alcohol, and
phytosterols, including beta-sitosterol, stigmasterol, and others.
Beta-sitosterol is the phytosterol most often mentioned when talking about an
enlarged prostate, because it can attach itself to the prostate and has anti-inflammatory
properties. As beta-sitosterol reduces swelling and inflammation, men can
experience relief from the symptoms associated with LUTS.

More specifically, beta-sitosterol
inhibits the activity of an enzyme called 5-alpha-reductase. This enzyme is
responsible for converting testosterone into 5-alpha dihydrotestosterone (DHT),
a hormone that promotes the growth of the prostate. That makes beta-sitosterol
a substance that inhibits the activity of DHT and thus helpful in the
management of an enlarged prostate.

If you choose to take a saw palmetto
supplement, be sure you are getting a pure product that is providing all the
ingredients stated on the label, especially when it comes to beta-sitosterol.
In a 2018 study, the authors attempted to verity the actual amount of
phytosterols in supplements that contained saw palmetto. They used a technique
called gas-chromatography, which is commonly used for this purpose.

They discovered a wide variation in
the amount of phytosterols in the supplements they studied, which included both
those that had saw palmetto as the sole ingredient as well as combination
products. Therefore, it’s best to choose a product from a highly reliable
source when choosing supplements that contain saw palmetto if you want to reap the
benefits of this herb.

As an added bonus, beta-sitosterol
also has been associated with lowering bad cholesterol (LDL) without having an
impact on good cholesterol (HDL). The phytosterol also may help enhance immune
system function, normalize blood sugar (glucose) levels, and help in the fight
against prostate cancer.

The bottom line

There seems to be a place for use of
saw palmetto for enlarged prostate and the LUTS that accompany it. Look for
high-quality supplements with certified amounts of beta-sitosterol.

Sources

Giammarioli S et al. Phytosterols in
supplements containing Serenoa repens: an example of variability of active
principles in commercial plant based products. Natural Product Research 2018 Oct 8:1-5

Kurzweil R, Grossman T. 6 proven
health benefits of beta-sitosterol. Transcend

Parsons JK. Benign prostatic
hyperplasia and male lower urinary tract symptoms: epidemiology and risk
factors. Current Bladder
Dysfunction Reports
2010 Sep 7

Saper RB. Clinical use of saw
palmetto. Up To Date 2019 Apr

WebMD. Beta-sitosterol.

Ye Z et al. Efficacy and safety of
Serenoa repens extract among patients with benign prostatic hyperplasia in
China: a multicenter, randomized, double-blind, placebo-controlled trial. Urology 2019 Mar 14

by Mens Health Editor

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