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Saw palmetto

Improves symptoms of enlarged prostate

Young men don't want to think about it. Older men don't want to talk about it. But the reality is that more than half of all men over age 50 will experience the discomfort of an enlarged prostate gland.

In the not-too-distant past men sometimes relied on remedies made from saw palmetto berries for relief. These days there are more treatment options available — usually prescription drugs or surgery — but a man can still seek relief from saw palmetto. The only difference these days is that the herb increasingly has the blessing of modern medical science.

What exactly is this prostate unpleasantness that so many men have to deal with? The prostate is a tiny gland located at the base of a man's bladder. It completely encircles the urethra-the narrow tube through which urine exits the body. When the gland enlarges as a man ages, it sometimes blocks the urethra, creating a frequent, urgent need to urinate, a weak or interrupted flow and difficulty emptying the bladder.

Berries versus Blockage

Saw palmetto is a palm that grows throughout the southeastern United States, and its therapeutic value lies in its dark red berries. The herb's active ingredient is unknown. But studies done in Europe show that an extract from the berries appears to counteract the effects of androgens, male sex hormones that may cause prostate enlargement, says Varro E. Tyler, Ph.D., professor of pharmacognosy at Purdue University School of Pharmacy in West Lafayette, Indiana, and author of The Honest Herbal. In Europe, Dr. Tyler notes, medications based on saw palmetto are routinely prescribed for enlarged prostate.

Saw palmetto products are available in this country, although they are not labeled for use in treating an enlarged prostate. That's because the Food and Drug Administration (FDA) has banned marketing saw palmetto medications for this problem, claiming there is too little proof that they work. The FDA evidently "overlooked" the European research when it made that ruling, notes Dr. Tyler.

But the FDA did not ban saw palmetto here; it simply restricted marketing claims. In fact, some American health practitioners and herbalists recommend the herb highly.

"I recommend saw palmetto berry extract for men with enlarged prostate glands," says Alan R. Gaby, M.D., a Baltimore physician who practices nutritional and natural medicine and is president of the American Holistic Medical Association. "Studies have shown that it can improve urinary flow rates and reduce symptoms like urinary hesitancy and weak flow. In many cases, it works as well or better than the prescription drug — and it's cheaper and safer."

Putting the herb to work

Just because some herbalists believe saw palmetto works doesn't mean you should use it on your own. Dr. Gaby and other herb experts caution against self-medicating for an enlarged prostate.

Seeking medical care for prostate symptoms can be a lifesaver, points out Dr. Gaby. "Taking this or any herb does not eliminate the need for older men to get a routine checkup for prostate cancer," he says. Alert your doctor if you take any saw palmetto product, he warns, because the herb may change the results of blood tests that are used to detect prostate cancer. It's also inadvisable to take saw palmetto products plus prescription medication for an enlarged prostate, he adds. They could interact.

Finally, the form in which you take the herb is important, says Dr. Tyler. An oil-based extract was used in the scientific studies. "A water-based saw palmetto preparation, such as a tea, would give little or no benefit," says Dr. Tyler.

If you want to take saw palmetto, use an extract prepared by a reputable herbal medicine company and follow dosage directions on the package. The commonly recommended dose is 320 milligrams of oil-based extract daily. And make sure you discuss it with your doctor.

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