ses of Saw Palmetto
Saw palmetto is used to treat symptoms of benign prostatic
hyperplasia, including reduction of urinary frequency, increase of
urinary flow, and decrease of nocturia. Saw palmetto may delay the need
for prostate surgery. However, the mechanism of action is unknown.
Saw Palmetto Dosing
The crude saw palmetto berries are usually 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. Brand-name products include Permixon , Prostaserene ,
Prostagutt , Remigeron , Quanterra Prostate , and LG 166/S . Typical
dosages of standardized extracts range from 100 to 400 mg given twice
daily for benign prostatic hypertrophy.
Contraindications
Contraindications have not been identified.
Pregnancy/Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid use.
Saw Palmetto Interactions
Increased anticoagulant effect of warfarin has been reported during
concurrent ingestion of saw palmetto. However, there was a more likely
alternative explanation for the interaction. Until more data are
available, patients taking warfarin should consult their health care
provider before taking saw palmetto or other alternative medicine
products.
Saw Palmetto Adverse Reactions
Saw palmetto is generally well tolerated, with occasional reports of
adverse GI effects. Because of well-documented antiandrogen and
antiestrogenic activity, avoid taking with any hormone therapy,
including oral contraceptive and hormone replacement therapy.
Toxicology
Research reveals little or no information regarding toxicology with the use of saw palmetto.
Botany
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 in the fall and are dried for medicinal use. They
also serve as a source of nutrition for deer, bears, and wild pigs.
1
History
Native tribes of Florida relied on saw palmetto berries for food;
however, Europeans often found the taste of the berries objectionable.
1
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 officially included in the US
Pharmacopeia in 1906 and 1916, and in the National Formulary from 1926
to 1950. While use in the United States declined after that time, saw
palmetto has long been a staple phytomedicine in Europe. Interest in the
plant has been rekindled, and saw palmetto is ranked among the top 10
herbal products in the United States, primarily for its activity in
benign prostatic hyperplasia (BPH).
2
Chemistry
Saw palmetto berries contain large quantities of beta-sitosterol and other plant sterols,
3 as well as free and esterified fatty acids.
4
Most standardized commercial preparations are liposterolic extracts
containing nonpolar constituents (eg, fatty acids and sterols) produced
either by conventional hexane extraction or by supercritical carbon
dioxide extraction. The fatty acid components have been quantitated by
gas chromatography
5 and supercritical fluid chromatography,
6
while the alcohols and sterols have been analyzed by thin-layer
chromatography and electrospray mass spectrometry of ferrocenyl
derivatives.
7 An acidic polysaccharide with anti-inflammatory activity has been isolated from saw palmetto fruit.
8 ,
9
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