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Johns Hopkins Health Alert

Saw Palmetto for BPE Symptoms: What the Latest Research Shows Us

Comments (4)

A number of herbal remedies are marketed to men with benign prostatic enlargement (BPE, also known as benign prostatic hyperplasia or BPH). By far the most popular of these plant-based treatments are saw palmetto supplements, which contain extract derived from a species of dwarf palm tree that grows in the southeastern United States.

The popularity of saw palmetto stems, in part, from a 2002 study examining the benefits of saw palmetto. The results appeared to be encouraging: Pooled evidence from 21 studies suggested that men taking saw palmetto supplements reduced their number of nighttime trips to the bathroom and reported fewer overall symptoms. But there were certain weaknesses with some of these studies. For example, many trials involved relatively small groups of men or were quite brief, some lasting as little as a month. In some cases, researchers used flawed or inadequate scoring systems when asking men to rate their urinary symptoms.

As findings from more -- and better -- research were reported, the news about saw palmetto began to look less promising. First, a 2006 study of 225 men with moderate to severe BPE published in the New England Journal of Medicine -- then the largest trial of its kind ever conducted -- found that saw palmetto had no effect on lower urinary tract symptoms.

An even larger 2011 study offered more bad news. Investigators recruited nearly 400 middle aged and older men (average age, 61) with BPE symptoms ranging from mild to severe to take saw palmetto supplements or placebo pills for 72 weeks. After 24 weeks, and again after 48 weeks, the men receiving saw palmetto increased their dose. By the end of the study, which was published in the Journal of the American Medical Association (JAMA), men in the saw palmetto group were receiving three times the normal daily dose of this herb, yet researchers found no evidence that saw palmetto improved the men's BPE symptoms.

Most recently, a scientific review published in mid-2012 seems to leave little doubt about the effectiveness of saw palmetto for urinary problems. The researchers examined 17 high quality clinical trials and found that saw palmetto worked no better than placebo pills for the treatment of BPE.

What if you use -- or want to try -- saw palmetto? In spite of substantial scientific evidence that saw palmetto is not effective for BPE symptoms, a number of men report that it works for them. Some experts believe that it may simply be the placebo effect at work; however, if it helps alleviate your symptoms, there's likely no harm in continuing.

Posted in Enlarged Prostate on May 21, 2013


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


I have used a super-grade saw palmetto supplement for approximately two months and it works in two ways: it cuts down the number of trips to the bathroom fairly consistently and, most importaly for me, it stops post-urinal drip.

I don't think it has any effect on erectile efficiency.

The company I order the product from makes a claim for improvement for only 70% (not all).

The studies that informed the John Hopkins article did not specify which product was used. Most saw palmetto is useless.

In addition, I can't help but wonder if the AMA and pharmaceutical companies had anything to do with the report on supplements.

My own physician thought it was a good idea to try a superior brand.

Posted by: blyfox | May 24, 2013 2:29 AM

Post by blyfox: addendum

The product I take is OptiProstate XTS (saw palmetto with pumpkin-seed oil). It is high-grade and concentrated enough that only one 320mg capsule a day is recommended.

One capsule-aid that I forgot to include (actually the most important): the product significantly increases the flow-rate of urine.

The prescription "remedies" produced by pharmacies, even if they work, all have appreciably deleterious side-effects of one sort or another with which I would not want to take chances. I'd rather have my prostate removed than risk the prescribed medication.

Again, I reiterate: my primary physician recommends saw palmetto.

Health capsules of any kind should be careful chosen, to be sure, but there is a definite and mindless prejudice against them in the medical profession -- apparently including those at John Hopkins; and I expect that responses to my comments will not be included in any space, including, as stated, in this one.

Posted by: blyfox | May 25, 2013 1:37 AM

I've been taking 320 mg of saw palmetto for twenty years.The only one that works is the product made from the berry.The junk ground up from the plant isn't worth a dime.Like one of the other post I also use the one with pumpkin seed oil.I was getting up as many as four times a night and now sometimes i get up once.I was having bph (or enlarged prostate about every two months )and my internal medicine doctor recomended I try this type of saw palmetto,I can promise you that if I miss a couple of doses,I have problems.I am not recomending any certain herb company,but I've tried serveral different companies and the only one that works for me is Swansons Product.Its a little pricey,but compared to the good it does,I will never be without it as long as I can afford it.Forgot to mention,My uroligist also recommed this he admitted taking it himself.

Posted by: shoeman | May 25, 2013 8:26 AM

Dear Shoeman:

Thanks for the information: I was going to try to go off my saw palmetto periodically -- now I won't try that. Why don't you check out the Stop Aging Now product -- it also uses only the berry and no other part of the plant; the pumpkin seed oil is merely there for the purpose of aiding absorbtion. Their accompanyhing information makes a lot of sense. Of course, the best thing to do, all things considered, is stick with what works.

You might find a price differential worth examining.

Sorry for my typos: I neither read nor write well on a computer.

Posted by: blyfox | May 26, 2013 12:22 AM

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