Saw palmetto plant supplement recommended by international urology panel for mild-to-moderate prostate issues

The Journal of Current Medical Research and Opinion published a systematic review of the saw palmetto plant’s efficacy for prostate healing …

As men get older, they have an increased risk of benign prostatic hyperplasia (BPH), also known as prostate gland enlargement. This population also tends to experience more lower urinary tract symptoms (LUTS) later in life, some of which include an urge to urinate more frequently, a slow urine stream, and increased urination at night. While research has repeatedly associated the saw palmetto plant (Serenoa repens) with prostate health improvements, urologists around the world have traditionally been unable to agree on whether this supplement should be recommended for the treatment of these types of concerns.

That is, until now.

New urology consensus statements

On June 21, 2022, the journal Uro published an article indicating that a panel of international urology experts has agreed that saw palmetto should be considered when treating male patients with mild-to-moderate cases of BPH and LUTS versus engaging in watchful waiting.

This agreement was provided in the form of seven consensus statements and serves to resolve the guidance differences that have previously existed between the American Urological Association (AUA) and the European Association of Urology (EAU).

Before these consensuses were reached, the AUA held the position that studies involving the saw palmetto plant for LUTS have provided mixed results. Thus, this organization could not provide a positive recommendation for its use. The EAU felt the opposite, citing that there was adequate research-based support for the use of saw palmetto in males with LUTS.

These different positions have affected how much saw palmetto is governed by regulatory agencies in various areas of the world, further impacting what extracts are used. They’ve also created confusion about whether male patients could benefit from this treatment approach.

The saw palmetto plant, hexane, and prostate health

A 2019 article published in Food Science and Biotechnology confirms that confusion on this topic exists, in part, due to a lack of standardization in saw palmetto formulas used. However, when hexane extraction is utilized, the results are more consistent.

This type of extraction has been a point of contention between the AUA and EAU in years past. While Europe has approved a drug containing saw palmetto extract for the treatment of LUTS, this drug is not available in the United States, allegedly due to concerns over some hexane being left in the medication after extraction.

The article outlining the consensus agreements shares that, when European standards are used, prescribed dosages of the saw palmetto plant-containing drug appear to be safe, even though it does contain some hexane. Yet, because the U.S. Food and Drug Administration considers saw palmetto a food additive, this organization cannot guarantee its safety in food sources since exposure to hexane is variable and, in large doses, could lead to toxicity.

This different categorization of saw palmetto — either as a drug that can be regulated or food that cannot be regulated — is believed to be a contributing factor to this prostate drug not being available in the U.S.

Scientifically-supported benefits

On June 24, 2022, the Journal of Current Medical Research and Opinion published a systematic review of saw palmetto’s efficacy for prostate health. In it, the authors indicate that this herbal plant provides many valuable uses, some of which include:

• treatment of an enlarged prostate
• treatment for urinary tract infections
• reduced inflammation
• increased sexual desire
• improved fertility
• hair loss prevention
• preservation of prostate health

Several theories exist about saw palmetto’s mechanisms of action. One is that when prostate cells take in saw palmetto’s free fatty acids, it disrupts the processes by which inflammatory cells grow and die, ultimately improving prostate health.

Usage and safety

A 2021 evidential review in Uro indicates that many studies assessing the impact of saw palmetto as a LUTS treatment have involved subjects taking 320 milligrams of this substance per day. It adds that this dosage amount has remained consistent since 1983, which is when the first article was published on this topic.

At the same time, until some sort of standardization is achieved on these extracts, it is recommended that practitioners educate patients about how to select high-quality products that adhere to industry-recognized dosage and composition standards. This can help them choose a supplement with higher safety and efficacy profiles.

For more information on the benefits of saw palmetto click here.