Saw Palmetto Overview

1) Conditions Studied

• Benign Prostatic Hyperplasia (BPH): A common condition in older men where the prostate is enlarged.
• Chronic Pelvic Pain Syndrome: A form of prostatitis with persistent pain in the pelvic area.
• Androgenic Alopecia: A type of hair loss commonly referred to as male or female pattern baldness.
• Urinary Symptoms: Including reduced urinary flow and frequent urination, especially at night.

2) Efficacy in Treating Conditions

Research has produced mixed results on the effectiveness of saw palmetto. While some studies suggest it may help to reduce symptoms of BPH and improve urinary flow, other studies have not found it to be more effective than a placebo. Evidence for its efficacy in treating other conditions, such as chronic pelvic pain syndrome and androgenic alopecia, is limited and inconclusive.

3) Health Benefits

• Potential to improve urinary symptoms related to BPH.
• May play a role in inhibiting the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT), a hormone linked to hair loss.
• Contains anti-inflammatory compounds that might help with chronic pelvic pain.

4) Downsides

Saw palmetto is generally considered safe when used as directed, but it may cause some side effects such as dizziness, headache, nausea, vomiting, constipation, and diarrhea. It can also interact with certain medications, including blood thinners and hormone therapies, and may not be suitable for everyone, especially pregnant or nursing women.

5) Genetic Variations

There is limited research on the relationship between saw palmetto and specific genetic variations. However, individuals with genetic variations affecting hormone levels or metabolism may experience different effects from saw palmetto. Always consult with a healthcare professional before starting any new supplement, especially if you have a known genetic condition that might interact with its use.

Research Summary on Saw Palmetto

Impact on Immune Function and Serum Levels

A study evaluating a supplement containing Saw Palmetto among other components found minimal influence on immune function in middle-aged men. While it increased serum levels of androstenedione and other androgens, it did not significantly alter lymphocyte proliferation or cytokine production.

Extraction Techniques and Bioactive Compounds

Different extraction techniques from Saw Palmetto (Serenoa repens) affect the bioactive compounds profile, which leads to variations in clinical efficacy among commercial products. Standard reference materials developed for saw palmetto will help ensure accuracy and consistency of dietary supplements.

Effect on Gene Expression in BPH Cells

Lipidosterolic extract of Serenoa repens (LSESr) showed to quickly affect gene expression related to proliferation, apoptosis, and inflammation in BPH cell lines, suggesting its efficacy as a treatment for BPH.

Adverse Effects of Saw Palmetto

A case report suggests Saw Palmetto may have caused acute pancreatitis and hepatitis in a patient, highlighting the importance of monitoring supplement intake.

Active Components and Receptor Binding

Studies identified oleic and lauric acids in Saw Palmetto extract as main active components responsible for binding to prostate and bladder receptors in rats, contributing to therapeutic effects against BPH.

Combination Treatments for AGA

A composition containing LSESr, carnitine, and thioctic acid showed potential as a treatment for androgenetic alopecia (AGA) by suppressing expression of inflammatory genes in hair follicle keratinocytes.

Risk-Benefit Profiles of Herbal Remedies

Saw Palmetto has shown efficacy in reducing symptoms of benign prostatic hyperplasia in short-term trials.

Enzyme Inhibition and Herbal Supplements

Research indicates that Saw Palmetto supplements have potential to interact with drugs metabolized by the CYP2C8 enzyme, suggesting possible drug interactions.

BYSH and HRPC

A pilot study suggests the herbal formula BYSH combined with Saw Palmetto may help patients with advanced hormone refractory prostate cancer (HRPC) by maintaining stable PSA levels, but further research is needed to confirm efficacy.

Drug-Herb Interactions

Herbal medicinals, including Saw Palmetto, can interact with prescription drugs, emphasizing the importance of screening for potential interactions.

Testosterone Metabolism in Prostate Cells

Saw Palmetto extract (LSESr) inhibited the formation of testosterone metabolites in prostate cells, suggesting the need for therapeutic agent selection based on testosterone metabolism differences in BPH treatment.

Effectiveness of Serenoa repens in BPH Treatment

A systematic review found that Serenoa repens did not improve urinary flow measures or prostate size in men with BPH-associated LUTS compared to placebo.

References:

1. Ingestion of a dietary supplement containing dehydroepiandrosterone (DHEA) and androstenedione has minimal effect on immune function in middle-aged men
2. Modern extraction techniques and their impact on the pharmacological profile of Serenoa repens extracts for the treatment of lower urinary tract symptoms
3. Development of saw palmetto (Serenoa repens) fruit and extract standard reference materials
4. Lipidosterolic extract of serenoa repens modulates the expression of inflammation related-genes in benign prostatic hyperplasia epithelial and stromal cells
5. Saw palmetto-induced pancreatitis
6. Isolation and pharmacological characterization of fatty acids from saw palmetto extract
7. Inhibition of inflammatory gene expression in keratinocytes using a composition containing carnitine, thioctic Acid and saw palmetto extract
8. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava
9. Inhibitory effect of six herbal extracts on CYP2C8 enzyme activity in human liver microsomes
10. Prospective trial of an herbal formula BYSH and Saw palmetto in patients with hormonal refractory prostate cancer: a pilot study
11. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions
12. Testosterone metabolism in primary cultures of human prostate epithelial cells and fibroblasts
13. Serenoa repens for benign prostatic hyperplasia
14. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia
15. Hexanic lipidosterolic extract of Serenoa repens inhibits the expression of two key inflammatory mediators, MCP-1/CCL2 and VCAM-1, in vitro
16. Serenoa repens (Permixon): a 5alpha-reductase types I and II inhibitor-new evidence in a coculture model of BPH
17. Acute liver damage due to Serenoa repens: a case report
18. Mechanisms of disease: the PI3K-Akt-PTEN signaling node--an intercept point for the control of angiogenesis in brain tumors
19. Effects of anabolic precursors on serum testosterone concentrations and adaptations to resistance training in young men
20. Pharmacologically relevant receptor binding characteristics and 5alpha-reductase inhibitory activity of free Fatty acids contained in saw palmetto extract
21. Effects of androstenedione-herbal supplementation on serum sex hormone concentrations in 30- to 59-year-old men
22. Inhibition of steroid 5 alpha-reductase by specific aliphatic unsaturated fatty acids
23. Evaluation of Resettin® on serum hormone levels in sedentary males
24. Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms
25. Endocrine and lipid responses to chronic androstenediol-herbal supplementation in 30 to 58 year old men
26. Comparison of finasteride (Proscar) and Serenoa repens (Permixon) in the inhibition of 5-alpha reductase in healthy male volunteers
27. Saw palmetto for benign prostatic hyperplasia
28. Inhibition of phosphatidylinositol 3-kinase/AKT signaling by NVP-BKM120 promotes ABT-737-induced toxicity in a caspase-dependent manner through mitochondrial dysfunction and DNA damage response in established and primary cultured glioblastoma cells
29. Observational database serenoa repens (DOSSER): overview, analysis and results. A multicentric SIUrO (Italian Society of Oncological Urology) project
30. 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
31. Muscarinic and alpha 1-adrenergic receptor binding characteristics of saw palmetto extract in rat lower urinary tract
32. Effect of Serenoa repens (Permixon®) on the expression of inflammation-related genes: analysis in primary cell cultures of human prostate carcinoma
33. Pharmacological effects of saw palmetto extract in the lower urinary tract
34. Hot flashes in a young girl: a wake-up call concerning Serenoa repens use in children
35. Hormonal regulation of prostate-specific antigen (PSA) glycoprotein in the human prostatic adenocarcinoma cell line, LNCaP
36. Serenoa repens as an Endocrine Disruptor in a 10-Year-Old Young Girl: A New Case Report
37. The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia
38. Inhibition of androgen metabolism and binding by a liposterolic extract of "Serenoa repens B" in human foreskin fibroblasts
39. The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride
40. Saw palmetto extracts potently and noncompetitively inhibit human alpha1-adrenoceptors in vitro
41. Comparison of tamsulosin plus serenoa repens with tamsulosin in the treatment of benign prostatic hyperplasia in Korean men: 1-year randomized open label study
42. Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japanese men with androgenetic alopecia
43. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study
44. A possible case of saw palmetto-induced pancreatitis
45. Immunohistochemical localization of types 1 and 2 5alpha-reductase in human scalp
46. Serenoa repens (saw palmetto): a systematic review of adverse events
47. Serenoa repens for benign prostatic hyperplasia
48. Structure-activity relationships of receptor binding of 1,4-dihydropyridine derivatives
49. Effect of saw palmetto extract on PI3K cell signaling transduction in human glioma
50. Phytotherapy for benign prostatic hyperplasia
51. Effects of the sabal serrulata extract IDS 89 and its subfractions on 5 alpha-reductase activity in human benign prostatic hyperplasia
52. Serenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial)
53. PC-SPES: herbal formulation for prostate cancer
54. Human prostatic steroid 5 alpha-reductase isoforms--a comparative study of selective inhibitors
55. The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group
56. Serenoa repens for benign prostatic hyperplasia
57. Serenoa repens (Permixon) inhibits the 5alpha-reductase activity of human prostate cancer cell lines without interfering with PSA expression

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