Saw palmetto extract is an extract of the fruit of the saw palmetto. It’s promoted as a treatment for benign prostatic hyperplasia, but there’s no clinical evidence that it’s effective for this purpose.

Saw palmetto extract is usually marketed as a dietary supplement meant to improve symptoms of benign prostatic hyperplasia (BPH)–also referred to as prostate gland enlargement–that is a frequent illness during aging in men. An enlarged prostate may cause increased frequency or urgency of urination, difficulty initiating urination, weak urine stream or a stream that stops and starts, dribbling at the end of urination, and inability to fully empty the bladder.
Saw palmetto extract has been studied in clinical trials as a potential treatment for those who have prostate cancer and for men with lower urinary tract symptoms related to BPH. As of 2020[update], there is insufficient scientific evidence that saw palmetto extract is effective for treating prostate cancer or BPH and its symptoms.

One 2016 review of clinical trials using a standardized extract of saw palmetto (known as Permixon) found that the extract was secure and could be effective for relieving BPH-induced urinary symptoms compared against a placebo.

Saw palmetto was used in folk medicine to treat coughs or other ailments.

The use of saw palmetto extract isn’t recommended in children under 12 years old since it may influence the metabolism of androgen and estrogen hormones.

Saw palmetto extract shouldn’t be used during pregnancy. The effects of saw palmetto extract on androgen and estrogen metabolism could possibly impair fetal genital development. Saw palmetto extract should also be avoided during breastfeeding because of lack of accessible information.

In a case report, a patient taking saw palmetto extract had increased bleeding time during operation. Bleeding time returned to normal after stopping taking the herb. 1 clinical trial pre-treated prostate surgery patients with saw palmetto for five weeks before the operation, since there was evidence from earlier literature which such pre-treatment reduced operative bleeding. The trial reported no improvement compared to placebo. As a general rule surgeons should ask patients to stop dietary supplements before scheduled surgery.

Saw palmetto extract has extensive interactions with other drugs. It may decrease the efficacy of estrogen products by lowering estrogen levels in the body through its antiestrogenic effects. It may interfere with the use of birth control pills that contain estrogen as an active ingredient. Because of this, it’s suggested that an additional form of birth control, like a condom, be used to avoid pregnancy in patients taking birth control pills with saw palmetto extract. Additionally, saw palmetto extract may also interfere with hormone replacement therapy by decreasing the efficacy of estrogen pills. The combination of saw palmetto extract with estrogen products should be used with caution.

When used together with an anticoagulant or antiplatelet medication, saw palmetto extract may increase the chance of bleeding by boosting the anticoagulation or antiplatelet effects. A few examples of anticoagulant and antiplatelet drugs include aspirin, clopidogrel, nonsteroidal anti inflammatory drugs (NSAIDs), and warfarin.

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