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Herbs & Supplements

Saw Palmetto
Other Names: Cabbage Palm, Fan Palm, Sabal, Sabal serrulata, Scrub Palm, Serenoa, Serenoa repens

References

Adams LS, Seeram NP, Hardy ML, Carpenter C, Heber D. Analysis of the interactions of botanical extract combinations against the viability of prostate cancer cell lines. Evidence Based Complementary and Alternative Medicine. 2006;3(1):117-124.

Al-Shukri SH, Deschaseaux P, Kuzmin IV, Amdiy RR. Early urodynamic effects of the lipido-sterolic extract of Serenoa repens (Permixon(R)) in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. Prostate Cancer and Prostatic Diseases. 2000;3(3):195-199.

Anon: Saw Palmetto. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. June 2000.

Avins AL, Bent S. Saw palmetto and lower urinary tract symptoms: what is the latest evidence? Current Urology Reports. 2006 Jul;7(4):260-265.

Awad AB, Fink CS. Phytosterols as anticancer dietary components: evidence and mechanism of action. Journal of Nutrition. 2000;130(9):2127-2130.

Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. New England Journal of Medicine. 2006;354(6):557-566.

Boon H, Westlake K, Stewart M, et al. Use of complementary/alternative medicine by men diagnosed with prostate cancer: prevalence and characteristics. Urology. 2003;62(5):849-853.

Boyle P, Robertson C, Lowe F, Roehrborn C. Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia. BJU International. 2004;93(6):751-756.

Boyle P, Robertson C, Lowe F, Roehrborn C. Meta-analysis of clinical trials of permixon in the treatment of symptomatic benign prostatic hyperplasia. Urology. 2000;55(4):533-539.

Bressler R. Herb-drug interactions. Interactions between saw palmetto and prescription medications. Geriatrics. 2005;60(11):32, 34.

Cao N, Haynes JM, Ventura S. Saw palmetto is an indirectly acting sympathomimetic in the rat-isolated prostate gland. Prostate. 2006;66(2):115-123.

Capodice JL, Bemis DL, Buttyan R, Kaplan SA, Katz AE. Complementary and alternative medicine for chronic prostatitis/chronic pelvic pain syndrome. Evidence Based Complementary and Alternative Medicine. 2005;2(4):495-501.

Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate. 1996;29(4):231-242.

Carrington ME, Gottfried T, Mullahey JJ. Pollination biology of saw palmetto (Serenoa repens) in southwestern Florida. Palms. 2003;47(2).

Comhaire F, Mahmoud A. Preventing diseases of the prostate in the elderly using hormones and nutriceuticals [sic]. Aging Male. 2004;7(2):155-169.

Debruyne F, Boyle P, Calais Da Silva F, et al. Evaluation of the clinical benefit of permixon and tamsulosin in severe BPH patients-PERMAL study subset analysis. European Urology. 2004;45(6):773-780.

Debruyne F, Koch G, Boyle P, et al. Comparison of a phytotherapeutic agent (Permixon) with an alpha-blocker (Tamsulosin) in the treatment of benign prostatic hyperplasia: a 1-year randomized international study. European Urology. 2002;41(5):497-507.

Di Silverio F, D'Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. European Urology. 1992;21(4):309-314.

Djavan B. Lower urinary tract symptoms/benign prostatic hyperplasia: fast control of the patient's quality of life. Urology. 2003 Sep;62(3 Suppl 1):6-14.

Djavan B, Fong YK, Chaudry A, et al. Progression delay in men with mild symptoms of bladder outlet obstruction: a comparative study of phytotherapy and watchful waiting. World Journal of Urology. 2005;23(4):253-256.

Dull P, Reagan RW Jr, Bahnson RR. Managing benign prostatic hyperplasia. American Family Physician. 2002;66(1):77-84 and 87-88.

Eng J, Ramsum D, Verhoef M, Guns E, Davison J, Gallagher R. A population-based survey of complementary and alternative medicine use in men recently diagnosed with prostate cancer. Integrated Cancer Therapy. 2003;2(3):212-216.

Engelmann U, Walther C, Bondarenko B, Funk P, Schlafke S. Efficacy and safety of a combination of sabal and urtica extract in lower urinary tract symptoms. A randomized, double-blind study versus tamsulosin. Arzneimittelforschung. 2006;56(3):222-229.

Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Annals of Internal Medicine. 2002;136(1):42-53.

Fagelman E, Lowe FC. Herbal medications in the treatment of benign prostatic hyperplasia (BPH). Urology Clinics of North America. 2002 ;29(1):23-29 and vii.

Gerber GS. Phytotherapy for benign prostatic hyperplasia. Current Urology and Reproduction. 2002;3(4):285-291.

Gerber GS, Fitzpatrick JM. The role of a lipido-sterolic extract of Serenoa repens in the management of lower urinary tract symptoms associated with benign prostatic hyperplasia. BJU International. 2004;94(3):338-344.

Gerber GS, Zagaja GP, Bales GT, Chodak GW, Contreras BA. Saw palmetto (Serenoa repens) in men with lower urinary tract symptoms: effects on urodynamic parameters and voiding symptoms. Urology. 1998;51(6):1003-1007.

Giannakopoulos X, Baltogiannis D, Giannakis D, Tasos et al. The lipidosterolic extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a comparison of two dosage regimens. Advanced Therapy. 2002;19(6):285-296.

Gilman EF. Serenoa repens. University of Florida Cooperative Extension Service Fact Sheet FPS-547. October 1999. Available at: http://hort.ifas.ufl.edu/shrubs/SERREPA.PDF. Accessed September 15, 2004.

Gordon AE, Shaughnessy AF. Saw palmetto for prostate disorders. American Family Physician. 2003;67(6):1281-1283.

Habib FK, Wyllie MG. Not all brands are created equal: a comparison of selected components of different brands of Serenoa repens extract. Prostate Cancer and Prostatic Diseases. Published online in advance of publication. August 3, 2004. Abstract available at: http://www.nature.com/cgi-taf/dynapage.taf?file=/pcan/journal/vaop/ncurrent/abs/4500746a.html. Accessed August 13, 2004.

Hill B, Kyprianou N. Effect of permixon on human prostate cell growth: Lack of apoptotic action. Prostate. 2004;61(1):73-80.

Hizli F, Uygur MC. A prospective study of the efficacy of Serenoa repens, Tamsulosin, and Serenoa repens plus Tamsulosin treatment for patients with benign prostate hyperplasia. International Urology and Nephrology. 2007; 39(3):879-886.

Hutchison A, Farmer R, Verhamme K, Berges R, Navarrete RV. The Efficacy of Drugs for the Treatment of LUTS/BPH, A Study in 6 European Countries. European Urology. Epublished ahead of print June 27, 2006.

Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. Southern Medical Journal. 2006;99(6):611-612.

Kaplan SA, Volpe MA, Te AE. A prospective, 1-year trial using saw palmetto versus finasteride in the treatment of category III prostatitis/chronic pelvic pain syndrome. Journal of Urology. 2004;171(1):284-288.

Lopatkin N, Sivkov A, Walther C, et al. Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms--a placebo-controlled, double-blind, multicenter trial. World Journal of Urology. 2005;23(2):139-146.

Mar C, Bent S. An evidence-based review of the 10 most commonly used herbs. Western Journal of Medicine. 1999;171(3):168-171.

Markowitz JS, Donovan JL, Devane CL, et al. Multiple doses of saw palmetto (Serenoa repens) did not alter cytochrome P450 2D6 and 3A4 activity in normal volunteers. Clinical Pharmacology and Therapeutics. 2003;74(6):536-542.

Marks L, Partin AW, Epstein JI, et al. Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia. Journal of Urology. 2000;163(5):1451-1456.

McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Product Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press; 1997.

National Center for Complementary and Alternative Medicine. National Institutes of Health. U.S. Department of Health and Human Services. Recall of PC SPES and SPES dietary supplements. [press release]. Updated June 18, 2002. Available at: http://nccam.nih.gov/health/alerts/spes Accessed February 13, 2003.

National Kidney and Urologic Diseases Information Clearinghouse. National Institute of Diabetes and Digestive and Kidney Diseases. National Institutes of Health. U.S. Department of Health and Human Services. Prostate enlargement: benign prostatic hyperplasia. NIH Publication No. 02-3012. June 2002. Available at: http://www.niddk.nih.gov/health/urolog/pubs/prostate/#common Accessed February 12, 2003.

Natural Medicines Comprehensive Database, Online Edition. Pharmacist's Letter/Prescriber's Letter. Stockton CA: Therapeutic Research Facility, 2006. Available at: http://www.pharmacistsletter.com/(S(ulqz3s45omt3ag55um4kj345))/home.aspx?li=1&st=1&cs=&s=ND.

Plants for a Future Database. Serenoa repens. No date given. Available at: http://www.ibiblio.org/pfaf/cgi-bin/arr_html?Serenoa_repens. Accessed August 13, 2004.

Plosker GL, Brogden RN. Serenoa repens (Permixon). A review of its pharmacology and therapeutic efficacy in benign prostatic hyperplasia. Drugs and Aging. 1996;9(5):379-395.

Prager N, Bickett K, French N, Marcovici G. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. Journal of Alternative and Complementary Medicine. 2002;8(2):143-152.

Prototype monograph on saw palmetto. Institute of Medicine and National Research Council of the National Academies. 2004. Available at: http://www.iom.edu/Object.File/Master/19/564/Introduction%20and%20Saw%20Palmetto%20Prototype%20Monograph.v2.pdf. Accessed: September 9, 2007.

Pytel YA, Vinarov A, Lopatkin N, Sivkov A, Gorilovsky L, Raynaud JP. Long-term clinical and biologic effects of the lipidosterolic extract of Serenoa repens in patients with symptomatic benign prostatic hyperplasia. Advanced Therapy. 2002;19(6):297-306.

Reece Smith H, Memon A, Smart CJ, Dewbury K. The value of permixon in benign prostatic hypertrophy. British Journal of Urology. 1986;58:36-40.

Schleich S, Papaioannou M, Baniahmad A, Matusch R. Extracts from Pygeum africanum and Other Ethnobotanical Species with Antiandrogenic Activity. Planta Medica. 2006;72(9):807-813.

Singh YN, Devkota AK, Sneeden DC, Singh KK, Halaweish F. Hepatotoxicity potential of Saw Palmetto (Serenoa repens) in rats. Phytomedicine. 2007;14(2-3):204-208.

Stepanov VN, Siniakova LA, Sarrazin B, Raynaud JP. Efficacy and tolerability of the lipidosterolic extract of Serenoa repens (Permixon) in benign prostatic hyperplasia: a double-blind comparison of two dosage regimens. Advances in Therapeutics. 1999;16:231-241.

Talpur N, Echard B, Bagchi D, Bagchi M, Preuss HG. Comparison of Saw Palmetto (extract and whole berry) and Cernitin on prostate growth in rats. Molecular and Cellular Biochemistry. 2003;250(1-2):21-26.

Taylor M, Coleman E. Saw palmetto. Health Care Reality Check. No Date Given. Available at: http://www.hcrc.org/faqs/sawpalm.html Accessed February 12, 2003.

U.S. Forest Service. U.S. Department of Agriculture. Serenoa repens (Bartr.) Small PALMAE. No Date Given. Available at: http://www.fs.fed.us/global/iitf/pdf/Serenoa%20repens.pdf Accessed February 5, 2003.

Vela Navarrete R, Garcia Cardoso JV, Barat A, Manzarbeitia F, Lopez Farre A BPH and inflammation: pharmacological effects of Permixon on histological and molecular inflammatory markers. Results of a double blind pilot clinical assay. European Urology. 2003;44(5):549-555.

Wadsworth TL, Carroll JM, Mallinson RA, Roberts CT Jr, Roselli CE. Saw palmetto extract suppresses insulin-like growth factor-I signaling and induces stress-activated protein kinase/c-Jun N-terminal kinase phosphorylation in human prostate epithelial cells. Endocrinology. 2004;145(7):3205-3214.

Willetts KE, Clements MS, Champion S, Ehsman S, Eden JA. Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial. BJU International. 2003;92(3):267-270.

Wilt T, Ishani A, Stark G, Mac Donald R. Serenoa repens for benign prostatic hyperplasia (Cochrane Review Update). In: The Cochrane Library, Issue 3, 2002. Oxford: Update Software.

Wilt TJ, Ishani A, Rutks I, MacDonald R. Phytotherapy for benign prostatic hyperplasia. Public Health and Nutrition. 2000:3(4A):459-472.

Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. Journal of the American Medical Association. 1998;280:1604-1609.

Yale SH, Glurich I. Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9. Journal of Alternative and Complementary Medicine. 2005;11(3):433-439.

Zlotta AR, Teillac P, Raynaud JP, Schulman CC. Evaluation of male sexual function in patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) treated with a phytotherapeutic agent (Permixon), tamsulosin or finasteride. European Urology. 2005;48(2):269-276.

Last Revised September 9, 2007

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Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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