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Research published in the Feb. 9, 2006 New England Journal of Medicine found that the popular dietary supplement saw palmetto was no more effective than an inactive placebo in treating the symptoms of an enlarged prostate gland. The National Institute of Diabetes and Digestive and Kidney Diseases and the National Center for Complementary and Alternative Medicine funded the research in part. Both groups are part of the National Institutes of Health.
Symptoms of an enlarged prostate gland include:
- Slowed or delayed start of the urinary stream
- Weak urine stream
- Dribbling after urinating
- Straining to urinate
- Strong and sudden urge to urinate
- Incomplete emptying of your bladder
- Needing to urinate two or more times per night
- Urinary retention (complete inability to urinate)
- Incontinence
- Pain with urination or bloody urine (these may indicate infection)
The research used the “gold standard” double blind, randomized method, the best way to detect if saw palmetto actually has any effect on the symptoms of an enlarged prostate gland. The researchers randomly assigned 225 men over the age of 49 who had moderate to severe symptoms of an enlarged prostate, technically called benign prostatic hyperplasia, or BPH for short. The 112 men assigned to the saw palmetto group received one year of treatment with 160 milligrams of saw palmetto extract twice daily. The other 113 men received an identical looking placebo twice daily for one year.
The researchers conclusion was short and to the point:
“. . . saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia.”
Saw palmetto is used by an estimated two million men in the U.S. for the treatment of BPH and is commonly recommended as an alternative to drugs approved by the Food and Drug Administration (FDA) for the disorder.
In an editorial that accompanied the publication of the saw palmetto study, the authors noted that the approval of prescription drugs by the FDA is based on rigorous scientific evidence and has served the public well by establishing clear methods and criteria for determining the safety and efficacy of drugs. Without the same oversight for herbal products such as saw palmetto, the public risks self-medication with substances that are potentially ineffective, toxic, or both. The lack of regulatory oversight also prevents health professionals from appropriately informing and advising patients about these products.
The editorial also questioned how patients can be better guided with respect to the issues surrounding the use of herbal supplements. The authors believe that herbal supplements should be studied the same way as drugs and approved by the FDA only if there is evidence of safety and effectiveness.
We agree.
Until there is adequate research on dietary supplements, it is the responsibility of all health care providers to inform their patients to protect them from the inherent risks of unproven therapies.
What You Can Do
You should not use saw palmetto to control the symptoms of an enlarged prostate gland. It is not effective.
If you have the symptoms of an enlarge prostate gland listed in this article, consult a physician, not the local health food store.
