Hundreds of studies with thousands of patients have shown how the herbal cure saw palmetto works for an enlarged prostate, a.k.a. benign prostatic hyperplasia (BPH). Evidence is always important to consider before you reach for a natural supplement, so here we go with a look at some proof.
Researchers reviewed the best data available in the world literature on the effectiveness and safety of saw palmetto in the respected “Cochrane Review.” This review looked at the results of 21 trials that lasted four to 48 weeks conducted in more than 3,100 men aged 65 years (on average). These men had moderate BPH symptoms.
In these 13 studies, saw palmetto improved individual symptoms and flow measures more than placebo. Both the patients and physicians were more likely to report improvements in symptoms with saw palmetto treatment than with placebo treatment. In 12 studies, saw palmetto reduced the frequency or nighttime urination to 25%, as compared with placebo. Similar results were reported in another review as well.
The efficacy of saw palmetto on BPH symptoms was found to be comparable to or even better than conventional drugs but, in terms of safety, saw palmetto was better tolerated than the drugs finasteride and tamsulosin.
Saw palmetto did not reduce the size of prostate or prostate-specific antigen (PSA) levels as much as the drug finasteride. PSA levels are known markers for cancer. Adding saw palmetto to an alpha-blocker drug such as tamsulosin did not relieve the BPH symptoms any better than the alpha-blocker drug alone. Thus, it would seem you could try to replace the drug with the natural remedy.
However, you need to discuss this with your doctor before discontinuing your medication.
There seems to be a lag time to see an effect from saw palmetto, as in conventional drugs treatment. So, you might have to give the herb one to two months before you see noticeable improvements. Most clinical studies used a “liposterolic extract” of saw palmetto berry with 80%-90% fatty acids, a formulation similar to most commercial brands. Make sure yourself that any saw palmetto supplement you find offers this mix. Read my previous articles on this series here: