Saw Palmetto

Evidence from over 35 clinical trials supports the use of standardized saw palmetto extracts for the treatment of lower urinary symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Treatment with the extract increases peak urine flow, and decreases nocturia, without increasing serum PSA levels. Patients should contact their physician prior to self-medicating with saw palmetto to obtain a diagnosis of BPH, and to rule out urinary tract infections or prostate cancer. The recommended dose of a standardized saw palmetto extract (standardized to contain 70–95% free fatty acids, esters and sterols) is 320 mg per day, either 160 mg twice daily or 320 mg in a single dose. Treatment for 1–3 months may be required before the therapeutic effects are apparent. No drug interactions have been reported, and adverse reactions are limited to gastrointestinal disturbances such as nausea and diarrhea. There are no clinical data to justify the use of saw palmetto extracts in either women or children. In addition, due to possible estrogen and androgen antagonism by saw palmetto extract, adminis- tration during pregnancy, nursing or to young children is contraindicated.