By their 60s, most men simply can’t escape frank discussions with their doctors about the health and proper function of their prostate. This walnut-sized gland is located just below the bladder and encircles the urethra. It’s where the body stores urine, and it also plays a role during sexual climax.
With age, the normal changes that occur to the prostate can sometimes cause symptoms that range from annoying to debilitating. The most common age-related prostate issue is benign prostatic hyperplasia, or BPH. (It’s also referred to as benign enlargement of the prostate.)
The prostate goes through two main periods of growth. The first occurs during puberty. The second starts in the mid-20s and continues for the rest of a man’s life. While it’s not completely clear why this happens, one theory points to dihydrotestosterone (DHT), a testosterone-derived chemical needed by the prostate to grow. Even though men produce less testosterone as they age, they still make and accumulate high levels of DHT in the prostate, which promotes its continued growth.
The larger the prostate becomes, the harder it squeezes and “clamps” the urethra. This results in symptoms such as frequent or urgent need to urinate, difficulty starting or straining, weak urine stream, and incomplete voiding.
As I’ve mentioned in previous e-letters, I believe in utilizing the best of both traditional and complementary approaches to address difficult health issues.
Saw palmetto (Serenoa repens) is one of those natural prostate products with a great deal of research. It is an extract derived from the berry of the dwarf palm tree. It is thought to work by inhibiting the enzyme that converts testosterone to DHT. Less DHT is associated with slower prostate growth.
It takes a lot of solid, supportive research for me to consider and recommend either a traditional or natural product to address your precious health. When it comes to saw palmetto, I can say that I am impressed by both the animal and human studies that provide evidence that it can help with BPH symptoms.
A meta-analysis (an analysis of a collection of studies) published in the Journal of the American Medical Association examined the results of 18 studies involving 2,939 men with BPH. Compared to the placebo group, the men using saw palmetto experienced significant improvements in urinary tract symptoms.1
In another review of existing research, the authors noted that, “most of the published trials regarding Serenoa repens demonstrate a significant improvement of urinary status and a favorable safety profile.” They also wrote that, according to European Association of Urology guidelines, saw palmetto extract substantially reduces nocturia (waking in the middle of the night to urinate) compared to placebo.2
In addition, it appears that saw palmetto provides relief similar to that of prescription medication, without the side effects. One study compared three treatments: 320 mg of saw palmetto extract per day, prescription tamulosin (Flomax), and a combination of saw palmetto and tamulosin. None of the treatments were statistically different from each other with regard to urinary flow rate and decreases in prostate symptom scores. The researchers concluded that both saw palmetto extract and tamulosin were effective in addressing BPH symptoms.3
Additional research suggests that taking saw palmetto along with lycopene and the trace mineral selenium may be even more effective.
In an animal study, rats with enlarged prostates were given 14-days of placebo, saw palmetto, or a combination of saw palmetto, lycopene, and selenium. The combination therapy was superior to saw palmetto alone for decreasing prostate weight and hyperplasia.4
Another study found that this triple-combination has better anti-inflammatory activity than any one individual nutrient, and therefore greater potential for the management of BPH. 5
There is another important issue that is often seen in the natural products world.
With the growing popularity of saw palmetto came growing demand. And with that often comes unscrupulous retailers who sell inferior or, even worse, fake products.
Saw palmetto is indigenous to southern Florida. For an effective, high-quality product, the berries must be harvested when they are ripe and dark brown or black in color. Many lower quality products are made with green, unripe fruits that provide little of the active compounds. Other supplements use saw palmetto powder instead of extract. The fatty acid content in powder is typically low compared to the 85-95% fatty acid content in the extract. This is important because the fatty acids are proposed to be what makes the product effective. Additionally, many inferior saw palmetto products have been watered down with olive or palm oils.
To make sure you’re buying a quality product, buy only from a supplement manufacturer that properly checks raw materials using scientifically validated quality assurance testing on every batch. Also, for best results, be sure the label reads “extract” and not powder.
- Wilt TJ, et al. JAMA. 1998 Nov 11;280(18):1604-9.
- Geavlete P, et al. Ther Adv Urol. 2011 Aug;3(4):193-8.
- Hizli F, Uygur MC. Int Urol Nephrol. 2007;39(3):879-86.
- Altavilla D, et al. J Urol. 2011 Oct;186(4):1524-9.
- Minutoli L, et al. Curr Med Chem. 2013;20(10):1306-12.