Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
New York, NY
January 4 , 2000
Extracts of berries from saw palmetto, a dwarf palm found growing mainly in southern Florida, have been popular in Europe for some years for the relief of benign prostatic hyperplasia (BPH), or an enlarged prostate. Demand for saw palmetto is also increasing in the U.S., along with the overall popularity of herbal remedies. According to the National Kidney Foundation, BPH affects more than half of men over 60 and as many as 80 percent of men aged 80 or older, causing symptoms like:
- a weak stream of urine
- feeling unable to empty the bladder completely
- trouble starting to urinate
- needing to urinate more often or having an urgent need to urinate
- getting up often at night to urinate
- stopping and starting of the urine stream.
Recent clinical trials indicate that saw palmetto extract can significantly improve quality of life for men with BPH. Several trials of long-term use of saw palmetto extract suggest that its benefits compare favorably with those of finasteride, one of the drugs most widely used by physicians in the U.S. for treating BPH. Patients using saw palmetto showed significant improvement in symptoms. In another recent multi-center study, prostate tissue biopsied before and after treatment showed clear-cut evidence that saw palmetto extract actually reduced the size of enlarged prostate epithelial tissue.
While these studies suggest a possible role for saw palmetto in the treatment of BPH, experts recommend that men with BPH speak to their doctors before taking the extract. Many patients do not reveal their use of herbal remedies to their physicians, and concerns have been raised that men may be self-treating BPH without adequate medical supervision or screening for more serious conditions, including prostate cancer.
Like other nutritional supplements, herbal remedies are not reviewed by the U.S. Food and Drug Administration for effectiveness, purity or safety. Patients wishing to use saw palmetto extracts are advised to obtain them from reputable providers in standardized doses containing 85 to 95 percent sterols and lipids. Few side effects have been reported for these extracts, with stomach upsets being the main one. This can be minimized by taking saw palmetto with food. Teas made from saw palmetto berries are not likely to be effective because the active ingredients do not dissolve in water.
To rule out prostate cancer, all patients with BPH should have regular tests for PSA (prostate specific antigen) and an annual digital rectal examination. For more information about benign prostatic hyperplasia or prostate cancer, contact the National Kidney Foundation at (800) 622-9010.