Johns Hopkins Health Alert
Saw Palmetto for BPE Symptoms: What the Latest Research Shows Us
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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