Prostate “Saw Palmetto for Enlarged Prostate: Friend or Foe?”

Editorial by David Mulvain

A study recently published in the Journal of the American Medical Association (JAMA) reported that use of the herb, saw palmetto, did not improve the symptoms of benign prostate hypertrophy (BPH), the medical term for enlarged prostate gland. These results conflict with the many studies on this topic that have found that saw palmetto is as beneficial as drugs for BPH, is safer and has fewer side effects.  This is important, because over half of men over 60 have some prostate enlargement.  By age 70, 90% of men will have prostate enlargement.  Most, but not all, will have symptoms and seek treatment.  Saw palmetto is the most commonly used herb for BPH in the U.S., and the first choice of treatment in several European countries.

The medical theory is that both BPH, and prostate cancer are caused by dihydrotestosterone (DHT).  DHT is 10 times more active than testosterone. In healthy young men, 80% of testosterone is converted to DHT. The drugs that are used to treat BPH; Proscar, Flowmax and Avodart block the conversion of testosterone to DHT.  In other words, we are supposed to believe that DHT is a young man’s friend, but becomes his foe as he ages.  This does not make sense. It is older men with low levels of testosterone, not younger men with high levels that develop BPH.

The most important contributor to symptom improvement with saw palmetto is that it relaxes the smooth muscles surrounding the urethra in the bladder neck and prostate gland, which reduces resistance to urine flow without reducing the prostate size.  However, saw palmetto also has the same action as the drugs; it blocks the conversion of testosterone to DHT, but is weaker, which accounts for its safety.

The accepted recommendation for saw palmetto is 160mg twice a day of a standardized concentration of the fatty acids extracted from the berries.  The study in question used 3 times that much, 960 mg a day.  That is enough to seriously reduce DHT levels.  If whoever designed the study would have referred to a biochemical textbook, they would have learned that, like the testes, the prostate gland, requires DHT to maintain its size and function.  That much saw palmetto would be expected to drop testosterone levels low enough to shrink both the testes and prostate, and interfere with their proper function.  That could easily account for the poor results of this study.

A large body of research and years of saw palmetto use have proven it safe and usually beneficial for the treatment of BPH when used as recommended. This JAMA study demonstrates a reckless lack of knowledge about herbology and biochemistry.

The theory about DHT causing BPH and prostate cancer is based on 60-year-old research, and is not supported by newer research.  As men age, or put on extra fat, more testosterone is converted to estrogen, and less to DHT.  Higher estrogen levels may contribute to BPH, but the real culprit for BPH and prostate cancer is man-made chemicals that have powerful estrogenic effects.  Medically lowering DHT with drugs to treat prostate cancer may explain why a disproportionately large number of men develop very fast progressing cancer.  DHT is protective.  Their life expectancy is reduced to 18 to 22 months.  Compare that to the new medical recommendation for prostate cancer, “watch and wait”.  Most men with prostate cancer will live to a ripe old age with no treatment.  The most advanced practitioners are using bio-identical hormone replacement therapy and herbs or drugs that lower estrogen levels to prevent and treat BPH, and in some cases, prostate cancer.


Health Library Topics
aches acid reflux acid stomach acne add add/adhd adhd age spots aging aids allergies alopecia als alzheimer's disease anemia aneurysm anti-aging anxiety arrhythmia arthritis asthma athletes foot atrial fibrillation attitude autism back pain baker's cyst balance bedwetting bipolar blocked artery blood pressure body builder bone bone density bone spurs bowel brain wellness bronchitis bulging discs burns burping bursitis c-diff cancer candida canker sore carpal tunnel cataracts celiac disease cellulite cerebral palsy cervical dysplasia chemotherapy children cholestasis cholesterol chronic fatigue cleft palate cold and flu cold sores colic colitis colon concentration congestive heart failure constipation copd craving carbs crohn's disease cystic fibrosis dave dehydration dementia dental depression developmentally delayed diabetes diarrhea diverticulitis dizziness down syndrome dry skin ear infection eczema editorial emphysema endometriosis energy enlarged prostate epilepsy epstein-barr esophagitis eye eyesight fatigue fever fibroid tumor fibromyalgia flu fluid retention food poisoning fracture frozen shoulder ganglion cyst gastric bypass gestational diabetes get clean glaucoma gout graves' disease hair headache healing heart heart-cardiac arrest heart-coronary artery disease heart attack heartburn hepatitis high blood pressure hip HIV hives hot flashes hyperactivity hypertension hyperthyroidism hypoglycemia hypothyroidism immunity immunizations incontinence infertility inflammation insomnia intestinal irritable bowel jet lag joint pain kidney knee learning leukemia lichen planus lichen sclerosus lightheaded liver enzymes lou gehrig's lung lupus lyme lymph macular memory meniere's disease menopause menstrual mental mental focus metabolism migraine molluscum multiple sclerosis muscle mycosis fungoidis nerve damage neuropathy nightmares nosebleeds numbness nutriferon obsessive compulsive disorder odd osgood schlatter's disease osteoarthritis osteopenia osteoporosis pain parkinsons peridontal disease pets ph phlebitis plantar faciitis pleva pms pneumonia poison ivy poison oak polio polycystic pregnancy prost prostate psoriasis pulmonary hypertention rapid heart beat recovery renal failure respiratory restless legs rheumatoid arthritis rosacea rotator runny nose sarcoidosis scar sciatica scleroderma seizures shingles sick sids sinus sjogren's skin sleep smoking sore nails sore throat spider sports nutrition stomach stomach pain stress stretch marks stroke stuttering stye surgery surgery-recovery swimmer's ear swollen glands tachycardia teething tendonitis tennis elbow thyroid toenail fungus torn rotator cuff tourette tremor tremors tumor turner syndrome ulcer ulcerative Colitis uterine fibroids varicose veins virus vision vitamin D vivix warts water retention weight wellness west nile wounds yeast infection & skin rash
Password Reset
Please enter your e-mail address. You will receive a new password via e-mail.