Treating Lower Urinary Tract Symptoms with Saw Palmetto

Summary and Comment |
October 6, 2011

Treating Lower Urinary Tract Symptoms with Saw Palmetto

  1. Thomas L. Schwenk, MD

Even at three times the usual dose, it was no better than placebo.

  1. Thomas L. Schwenk, MD

Older men often use an extract of fruit from the saw palmetto tree as an alternative treatment for lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia. Various hormonal, inflammatory, and cellular mechanisms of action have been proposed. However, benefits found in earlier studies and meta-analyses have been countered by negative findings in more recent trials. To assess the value of much-higher-than-usual saw palmetto doses, 369 men were randomized to daily placebo or saw palmetto (320 mg, with escalations to 640 mg at 24 weeks and to 960 mg at 48 weeks). The men (age, ≥45; mean age, 61) had moderately impaired urinary flow and a range of standardized LUTS scores.

In an intent-to-treat analysis of the 306 men who completed the 72-week trial, both groups had similar small improvements in mean symptom scores, but saw palmetto conferred no benefit over placebo on symptom scores or on any secondary outcomes. Adverse effects were similar in both groups, except that — for unclear reasons — significantly more saw palmetto recipients than placebo recipients experienced physical injury or trauma (24 vs. 10).

Comment

In the most-recent studies, the usual dosage of saw palmetto (320 mg daily) provided no benefit, and, in this trial, no benefit accrued when the usual dose was tripled. No basis exists for recommending saw palmetto for patients with LUTS.

Citation(s):

Reader Comments (2)

Clinton M. Blumer

Which type of saw palmetto was used?

Competing interests: None declared

C. Mallory Blumer

This is one research result. Many other research projects have proven the contrary.

Competing interests: None declared

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