The article “Saw Palmetto Won’t Ease Enlarged Prostate” follows.

Saw Palmetto Won’t Ease Enlarged Prostate: The headline of this article appears to make one conclude that saw palmetto is ineffective for enlarged prostate. It is important that in interpreting this headline to understand the study on which it is based. A study was done on 225 men at the University of California on the benefits of saw palmetto in treating BPH (benign prostatic hyperplasia). The conclusion that saw palmetto does not help in prostate health is flawed on five accounts:

1. This study is only one study that goes directly against previous studies that proved saw palmetto worked. In fact, a met analysis (a study of studies) evaluated 18 clinical trials and a second met analysis on over 21 studies involving 3,000 men showed that saw palmetto was beneficial. So… the California study based on 225 men concluded that saw palmetto did not work while previous studies involving over 3,000 men concluded that it did.

2. All previous studies, with positive conclusions on the safety and efficacy of saw palmetto in treating symptoms of BPH, were for men with mild to moderate symptoms. The California study was done on men with advanced cases of severe prostate enlargement. It should be noted that men with severe prostate enlargement don’t respond to drug therapy, and in fact, the recommended course of treatment is not drugs, but rather surgery.

3. Dr. Stephen Bent, a leading researcher in the California study, concluded by saying this study was not definitive. He recommends for men getting a benefit from saw palmetto “I think it is worth continuing.”

4. Dr. Crom, a medical doctor and a consultant to the manufacturing company that provided the saw palmetto for this study reports that he has been taking saw palmetto for more than 5 years. Five years ago he was up 2-3 times per night to pass his urine and now after taking saw palmetto he sleeps through the night uninterrupted. It should be noted that the saw palmetto used in this study was an excellent brand.

5. The side effects of drugs to treat the prostate include dizziness and sexual dysfunction. The side effects of saw palmetto are rare but occasionally are reported to be mild indigestion. In this study an interesting fact was that some men were given a placebo and others were given saw palmetto; while a few of the people on the saw palmetto had mild indigestion, the placebo group had twice as many side effects. This suggests that the people in the study had other pre-existing medical conditions and other health problems in addition to advanced enlarged prostate.

It is important to note that headlines sell newspapers and magazines and do not tell the true entire story. A second point is to note the difference between the mechanism of action between a drug and an herb. Drugs generally go in and take charge of the body and do the work the body is failing to do. On the other hand vitamins and herbs offer a much more supportive role in the body allowing the body to continue to do its job, but assist it to a healthier level of functioning.

In conclusion, all of the studies show that saw palmetto is a safe, well-tolerated efficacious herb that relieves the symptoms of mild to moderate prostate enlargement. This recent study out of the University of California is no cause to stop taking saw palmetto.

A final note is that since saw palmetto has been clearly demonstrated to work on just a portion of the prostate it is preferable to take saw palmetto in conjunction with other herbs such as pygeum and nettle which address other areas of the prostate. Other nutrients essential for the prostate include vitamin E and zinc. Please note that all of these are found in Men’s Formula. However in Prostate Formula these nutrients are found in much higher concentrations and deliver a much more therapeutic benefit. Therefore, for men over 35 concerned about maintaining good prostate health, Men’s Formula along with Daily Extra is sufficient. Men with prostate symptoms will do better with Daily Extra and Prostate Formula.

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Saw Palmetto Won’t Ease Enlarged Prostate

WEDNESDAY, Feb. 8 (HealthDay News) — Millions of older American men use the herbal supplement saw palmetto to treat an enlarged prostate, but a new study concludes the product doesn’t work.

A few smaller studies had suggested the extract might be of limited benefit to men with enlarged prostate, clinically known as benign prostatic hyperplasia (BPH).

However, this controlled, blinded study of 225 men found that, “over a 12-month period, saw palmetto was no better than placebo in changing symptoms for this condition,” said lead researcher Dr. Stephen Bent, an assistant professor of medicine at the University of California, San Francisco.

His team’s research, published in the Feb. 9 issue of the New England Journal of Medicine, is “the most thorough and well-controlled study of the effect of saw palmetto on men with BPH that’s ever been done,” added Dr. Ronald A. Morton, director of urologic oncology at the Cancer Institute of New Jersey.

Morton, who co-authored a related editorial on the findings, said, “Obviously, for anyone who holds saw palmetto in high regard, these results are a little bit disappointing.”

Still, both experts agreed there’s no evidence that the herb — an extract of a seed from a scrub palm that grows naturally in the southeastern United States — poses any long-term safety hazard to users.

“So, if people are taking this and feel like they are getting some benefit, I think it’s worth continuing,” Bent said.

He noted that the science on the efficacy of saw palmetto for BPH has been ambiguous, with some studies suggesting a benefit and others finding it to be of no help at all.

“Those studies were of short duration, however, or they didn’t use what is now the standard measure of symptoms,” Bent said. “They also didn’t report on what we call the ‘adequacy of blinding’ — we never knew in these prior studies whether patients in the placebo group knew they were on placebo or not.”

His team sought to redress a lot of those issues, taking special care to ensure proper blinding and using a pool of patients large enough to gain sufficient statistical power.

They also went to great lengths to choose a top-notch product — in this case, a brand of saw palmetto capsules marketed in the United States by Rexall-Sundown Co. “We had an external advisory committee from the National Center for Complementary and Alternative Medicine, experts in the field, who evaluated a number of different extracts,” Bent said. “They felt this was the best one.”

Rexall-Sundown did not respond to requests for comment.

In the trial, the researchers tracked the symptoms of 225 men over the age of 49 with moderate-to-severe BPH. Half of the men took 160 milligrams of saw palmetto twice daily, while the other half took an inactive placebo.

At the one-year mark, the researchers found no difference between the two groups in terms of symptom scores, urine flow rates, prostate size, quality of life, or blood levels of prostate-specific antigen (PSA), a marker for enlarged prostate.

Morton agreed with Bent that saw palmetto is probably safe for users. But he questioned whether too many men plagued by enlarged prostate are using this ineffective remedy in lieu of conventional drugs whose efficacy has long been supported by clinical research.

“There are two medications that we commonly use for men with BPH,” said Morton, who is also chief of the division of urology at Robert Wood Johnson Medical School at the University of Medicine and Dentistry of New Jersey. “One includes drugs called alpha blockers, and the other group is 5-alpha-reductase inhibitors. Alpha blockers cause a relaxation of the prostate that makes it easier for a man to urinate. And 5-alpha-reductase inhibitors shrink the prostate.”

Either of these medications might be more effective than over-the-counter saw palmetto, Morton said.

He held out the possibility that formulations other than the Rexall-Sundown brand used in the study might still be of benefit to some users. “I do believe, though, that the investigators went to great lengths to ensure the purity of the compound that they were testing,” he said.

In a statement, Andrew Shao, vice president of the Council for Responsible Nutrition, a supplements industry trade group, called the findings “puzzling, given that more than 20 studies have shown promising findings for saw palmetto in alleviating symptoms commonly associated with prostate problems.”

He agreed the study was “well-designed,” but blamed its negative findings on the researchers’ focus on patients with moderate-to-severe BPH. According to Shao, the bulk of the positive literature on saw palmetto involves men with milder symptoms.

“The exclusion of those patients with mild symptoms from the study may have reduced [its] ability to detect the benefits we’ve seen in other trials,” he said.

A much bigger issue, according to Bent and Morton, is the lack of regulation and oversight of herbals and other alternative medicines, which are not tested or checked for quality by the U.S. Food and Drug Administration in the same way that conventional drugs are.

“There are millions and millions of men out there who take saw palmetto,” Morton said. “And if you review the literature on saw palmetto, it’s really all over the map. Quite frankly, I’m not certain that the FDA would approve it — I’m pretty certain they would not. But it’s simply not held to the same standard.”

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