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 Saw Palmetto  
The following is one in an ongoing series of columns entitled Natural Medicine Research by . View all columns in series

Saw palmetto is best taken with meals since it is fat-soluble. Most of the time, the recommended dosage is one pill twice a day. However, a higher dosage of 320 mg taken once a day is also an option.

Q. For which conditions is saw palmetto useful?
A. The best known use of saw palmetto is for the treatment of prostate enlargement. However, there's a possibility that substances in saw palmetto could have an influence on a variety of body tissues. They may even have anti-tumor potential. I'll review the research discussing these influences in a later chapter.

It appears that urinary symptoms due to mild to moderate prostate enlargement respond more readily to saw palmetto than symptoms due to severe enlargement (Ebbinghaus, 1995).

Q. How does saw palmetto work?
A. Unfortunately, many herbal and natural medicines have had far less research money devoted to them than they deserve. SP is no exception. Consequently, we don't know all the answers to the exact mechanisms of how the different compounds within SP work. However, there have been enough studies to give us some clues. Some of most likely mechanisms include the reduction in the amount of dihydrotestosterone (DHT) in prostate tissue, inhibition of binding of DHT to androgen receptors in prostate cells, and the anti-estrogenic action in prostate tissue. I will discuss the studies supporting or refuting these claims in greater detail in a later chapter. Unlike a particular medicine, such as Proscar, which has one active ingredient, saw palmetto has a number of different compounds within it. Thus, you can see why it would be complicated to evaluate all the possible interactions that these compounds have on a variety of tissues within our bodies. Furthermore, it is possible that a single compound within saw palmetto may not have much of an influence on its own although its combination with the other compounds would have a synergistic effect. The more I learn about the human body, the more I realize how complicated it is. Early in my medical career I often unquestioningly accepted the results of studies done in a laboratory or on animals and was quick to use this information to generalize to humans. I now know otherwise. In order to understand truly how a medicine works, it has to be studied directly on humans. Although laboratory and animal studies can give us important information, they are never a replacement for thorough human evaluations. Another complicating factor is that modern medicine does not advance solely on the basis of seeking the most efficient therapy for human diseases. There are significant economic factors that influence the funding of studies, the subsequent interpretation of the results, and especially the dissemination of this information. Many of the studies done with saw palmetto were financed either by companies who market this extract, such as Pierre Fabre Medicament, or by pharmaceutical companies, such as Merck, who have developed competing drugs that treat prostate enlargement. Merck has the drug Proscar. Not surprisingly, the results of studies obtained by Merck scientists on the method of action of saw palmetto are often in marked disagreement with the results obtained by scientists working under the auspices of saw palmetto-selling companies. Full details are provided later.

Q. Is there info available re taking saw palmetto along with perscription meds such as high blood pressure meds?
A. As far as we know, saw palmetto does not interfere to any clinical degree with other medicines.

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 About The Author
Ray Sahelian, M.D., is a popular and respected physician who has been seen on numerous television programs including NBC Today, Dateline NBC, and CNN, and quoted by countless major magazines such as Newsweek He......moreRay Sahelian MD
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