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saw.jpg (4828 byte)It is an extract derived by the homonym plant, a small aboriginal palm of the south east of America . From 400 years it is used against enuresis, atrophy of the testicles, inflammation of the prostate, mild aphrodisiac for men. Women have used its berries to treat sterility, painful menstruations and problems of lactation.

It is used as medicine to fight the enlarged prostate and it  has shown to be effective in numerous studies.

Some studies have shown instead that it is enough useful against androgenetic baldness and someone has had good results.

Unfortunately studies were not enough to demonstrate utility in the androgenetic baldness.

In fact some studies are available for enlarged prostate but not many and precise for androgenetic alopecia baldness.

It has anti androgens effects if it is assumed for systemic street, in fact it would stop the alpha reduttasi of the testosterone, the citosilic receptor of the DHT (around 50%), as well as the citosilic receptor of the estrogens.

It has anti inflammatory action. The inflammation is common in the zones involved in the androgenetic alopecia.

One of its component is beta-sitosterine.

It contains an oil with different fat acids, capryc acid, lauryc, oleyc, palmityc and them foreign etilicis, fitosteroli what beta-sitosterolo, cicloartenolo, stigmasterolo, lupeolo, lupenone, 24-metil-cicloartenolo, other oils, resins and tannini.

The fatty acids in saw palmetto also discourage the actions of inflammatory substances that otherwise contribute to BPH.

The dosage is usually 160 mgs in the morning and 160 mgs in the evening.

It is important that the extract is at least 85-95% standardized.

Saw Palmetto is based on a great deal of scientific research which firmly establishes the link that many natural agents have on combating the effects of dihydrotestosterone (DHT) in the treatment of benign prostatic hypertrophy (BPH). Saw palmetto in tablet form can also be used as a non-drug alternative of benign prostatic hypertrophy, the swelling of the prostate in middle-aged men.


The prostate is a gland located beneath the urinary bladder in men.  It is responsible of the production of fluids involved in reproduction. When men urinate, the urine stored in the bladder travel through a conduit, called urethra, before it can exit out of penis. The urethra passes through the prostate after exiting the bladder. This is because the urethra is also responsible of the carriage of the reproductive fluids produced in the prostate. As a consequence of its location, an enlarged prostate can contribute to urinary flow obstruction as well as to bladder dysfunction by "squeezing" on the urethra. A symptom associated to an enlarged prostate is a frequent urination, increased urination at night, dribbling, a weak urinary stream, urgency, and incomplete emptying of the bladder. It can also result in the inability to urinate.

The medical term for an enlarged prostate, not related to cancer, is benign prostatic hypertrophy. This condition is thought, in part, from exposure to specific androgens, such as dihydrotestosterone.

Men after a certain age develop in this condition. Note that individuals born with a deficiency in 5 alpha-reductase, the enzyme that produces dihydrotestosterone, suffer neither hair loss nor prostatic disease. Individuals who lack this enzyme are unable to produce the more potent form of testosterone, dihydrotestosterone. Dihydrotestosterone (DHT) is required for the development of both androgenic alopecia (male/female pattern hair loss) and prostatic disease.


There are two basic treatment options for an enlarged prostate gland or benign prostatic hypertrophy. These include medical (drugs) and surgical therapy. When men with benign prostatic hypertrophy, a condition that many physicians believe to be caused by excess dihydrotestosterone, were treated with oral or systemic finasteride (the generic name Propecia and Proscar), their enlarged prostate glands became smaller. Unfortunately, this study also demonstrated that a small percentage of the patients (less than 6%) receiving this drug also suffered from sexually related side effects such as decreased sex drive and impotence. Surgical therapy can also lead to sexually related side effects.

Recently, medical literature has provided increased support for the use of naturally occurring nutrients that prevent the progressive enlargement of the prostate gland (BPH). Some of these nutrients have even been demonstrated to reduce the incidence of prostate cancer! These nutrients that combat the detrimental effects of DHT in the prostate can be utilized to combat the effects of DHT in hair loss. The following discussion outlines multiple DHT fighting agents.

It has been for a long time the most commonly recognized and discussed herb concerning the prostate. Before the begin of the discussion, I highly recommend to read the book entitled "Saw Palmetto Nature's Prostate Healer" by Ray Sahelian, M.D. This is a marvelous book that talks about the prostate and says how saw palmetto and other natural nutrients can prevent prostate disease.

Saw palmetto is a plant (dwarf palm tree) native of the United States.  It has been used first in the 1800s. Early literature concerning saw palmetto described it as relieving symptoms ranging from prostate enlargement in men to gynecological problems in women such as menstrual discomfort. It has even been described as a potential aphrodisiac.   Saw palmetto contains hundreds of different substances. Saw palmetto is usually distributed as a crushed berry or an extract. Most of the substances are effective in treating benign prostatic enlargement and are found in the extract form. The extract form has been demonstrated to be more potent than the dried berry form. For these reasons, if you decide to use saw palmetto, try to use the extract form.

There are a multitude of articles in the medical literature describing the efficacy of saw palmetto in the treatment of benign prostatic hypertrophy.  One of the most recent and prestigious articles entitled "Saw Palmetto Extracts for the Treatment of Benign Prostatic Hyperplasia: a Systematic Review" by Timothy J. Wilt, MD, MPH et al. appeared in The Journal of the American Medical Association on November 11, 1998. The study clearly demonstrated that the use of saw palmetto improved urinary tract symptoms associated with benign prostatic hypertrophy. It also demonstrated that saw palmetto provided similar improvement in urinary tract symptoms when compared to drugs such as finasteride. It also had fewer side effects.  Although the mean study duration (the period of time that participants were using saw palmetto) was 9 weeks, participants were noticing positive results in 4 weeks. The following discussion might get a little technical, but it's for the benefit of anyone who's interested in details. If you're not, past the technical parts.   A total of 18 randomized controlled trials involving 2939 men who met inclusion criteria were analyzed. Treatment allocation concealment was adequate in 9 studies (I.e., they were single-blind tests), whereas 16 studies were double-blinded. The average duration of the study was 9 weeks.

Compared men within the placebo control group, with men treated with the SP extract S. repens (saw palmetto) a measurable improvement in urinary tract symptoms has been sawn. The weighted average difference for patients treated with S. repens was -1.41 points with a 95% confidence interval of L2.52, -0.301, compared to the control group's weighted-mean difference of -0.76 with a 95% confidence interval of [-1.22, -0.32]. This represents a relative weighted mean difference of 46% (Here, a lower weighted-mean difference correlates with improved urinary tract function).  The patients themselves provided a self-improvement rating in urinary tract symptoms that were highly correlated with their quantitative evaluations.   Compared with men receiving finasteride, men treated with S. repens showed similar improvements in urinary tract scores.

 The main advantage of treatment of BPH with S. repens over finasteride was apparent in the decreased incidence of adverse side effects. For example, 4.9% of patients treated with finasteride reported erectile dysfunction compared with 1.1% of patients treated with S. repens. These percentages are based on the Neyman-Pearson binary hypothesis test with power function parameter P set to P<0.001. That is, the probability of a Type-II error was fixed at 0.999. (Here a Type-II error refers to the probability of accepting the null hypothesis H_0 (no urinary tract improvement) when the alternative hypothesis H_1 (urinary tract improvement) is actually true. The significance level for all randomized trials was set at 0.05, thus indicating a probability of 0.05 of rejecting H_0 when H_1 is true.   

Some key points worth mentioning regarding these results are in order here. First, since all the statistical studies are based on classical (or frequentist) methods, all inferences derived therefrom are inherently indirect. That is, no direct claims can regard the probabilities of improved urinary tract function. Rather, one can only infer the probabilities that the treatment did not fail. This is by no means a fallacy on the part of the researchers or on the methods of data acquisition, but is an inherent aspect of frequentist analysis. To emphasize this point further, consider the value of the mean-weighted difference for patients treated with S. repens. The reported value was -1.41. Note that this is not a true statistical estimate of this parameter. Rather, it is a measured value that has a 95% probability of being contained in the random interval [2.52, -0.30]. If one desidered to make direct inferences from the data, non-classical statistical analyses such as those based on Bayesian decision theory should be employed [3]. Another point concerns the sensitivities of the tests. Since the studies did not report the standard errors of the differences between the means S. repens and control, the authors assessed the sensitivity of the tests by analyzing data for 3 different values of correlation coefficients, namely (0.25, 0.50, 0.75). The work then reported "no significant statistical difference in outcomes according to the three correlation coefficients." As a result, the correlation coefficient was arbitrarily set to 0.50. One could certainly argue that this is somewhat ad-hoc approach. To be more precise and more objective, the correlation coefficient could have (and should have) been estimated by a standard technique such as the method of maximum likelihood [4] or via another point estimator such as the Bayesian minimum mean square error (MMSE) estimator, or the Bayesian maximum a-posteriori (MAP) estimator. This would certainly have altered the calculated relative weighted mean difference from its reported value of 46%, but to what degree is unknown. Note that the relative weighted mean difference of 46% was not actually reported in the JAMA article but rather was calculated by the current authors based on the results in.  

Putting these technicalities aside however, it is still clear that there was an improvement in patients given S. repens over the placebo-control group, and, moreover, the improved urinary tract function paralleled that was displayed by patients on finasteride.   This study clearly demonstrated that the use of saw palmetto improved urinary tract symptoms associated with BPH, and that its effects were in concert with the improvements achieved through the use of finasteride. It also showed that saw palmetto administration produced a lower incidence of adverse side effects compared to finasteride.

The mean duration of the study encompassed 9 weeks of saw palmetto administration; however, many participants were reporting positive results in 4 weeks.  Both saw palmetto and finasteride were found to be effective in the treatment of benign prostatic hypertrophy (BPH). This study clearly establishes the role of saw palmetto in combating the effects of DHT.

***Note that saw palmetto was compared to 5 mg of finasteride in this study and that Propecia is only 1 mg of finasteride. ***

Side effects experienced with saw palmetto are infrequent. One study conducted over a three-year period of time with 315 patients demonstrated that no significant side effects were demonstrated in 98% of the patient population [6]. The most common side effects experienced with saw palmetto include nausea and mild headaches.    Since saw palmetto is fat soluble, it is better to take it with meals. It usually takes about from one to two hours to be absorbed.


Pygeum Africanum is an evergreen tree indigenous to Africa. It is extracted from its bark and have been documented to improve urinary tract symptoms associated with benign prostatic hypertrophy [1]. 

Another study showed that in addition to improving symptoms associated with BPH, this herb also
improved sexual behavior in men [2]. Although its exact mechanism is unknown, many researchers speculate that it may work by inhibiting growth factors responsible for the increase in prostate size. Another theory is that this herb may have anti-inflammatory properties within the prostate gland itself.

Products with Saw Palmetto to topical use  : Folligen, Nisim Hair Stimulating Extract, Revivogen.

Products with Saw Palmetto to oral use: Antiandrogenic complex by Spencer Forrest, Bio-Organics Saw Palmetto Complex, Proguard (also with Pygeum Africanum), Prostaguard.

Scientific studies
Comparison of finasteride (Proscar), a 5 alpha reductase inhibitor, and various commercial plant extracts in in vitro and in vivo 5 alpha reductase inhibition
Testosterone metabolism in primary cultures of human prostate epithelial cells and fibroblasts
Human prostatic steroid 5 alpha-reductase isoforms—a comparative study of selective inhibitors
Saw palmetta VS Proscar
Growth suppression of hamster flank organs by topical application of gamma-linolenic and other fatty acid inhibitors of 5alpha-reductase
Androgen action: molecular mechanism and medical application
Inhibition of steroid 5 alpha-reductase by specific aliphatic unsaturated fatty acids
Androgen action: molecular mechanism and medical application
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