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Saw Palmetto (Serenoa repens)Male Reproductive

Saw Palmetto (Serenoa repens)

Overview

Saw palmetto (Serenoa repens), also known as Sabal serrulata, is a small, slow-growing palm (to about 20 ft / 6 m) bearing fan-like fronds and white flowers that develop into dark purple to black berries. Historically used by Native Americans as a tonic, saw palmetto has become renowned for supporting prostate health and urinary function.

Traditional uses & properties

Prostate Tonic: The berries help reduce symptoms of benign prostatic hyperplasia (BPH) by supporting urinary flow and reducing gland inflammation. Mild Diuretic & Anti-Inflammatory: Aids urine flow, alleviates pelvic congestion, and can help with mild fluid retention. Digestive Tonic: At low doses, occasionally used for appetite stimulation and mild digestive support. Anabolic Agent: Promotes tissue building and weight gain, especially beneficial in convalescence.

Preparations & dosage

DECOCTION

1 teaspoon in 8 ounces, decoct for 15 minutes, steep for 30 minutes; 2–3 cups daily

GLYCERITE

Dried berries (1:8); 0.1–10 ml (0.5–2 tsp.) 2–4 times daily

TINCTURE

Dried berries (1:5, 50% alcohol); 2–5 ml (0.4–1 tsp.) 3 times daily

CAPSULE

1,000–2,000 mg, 3 times daily; standardized extracts (85%–95% fatty acids and sterols); 1–2 times daily for a total dose of 320 mg

Safety & precautions

Pregnancy, Nursing, Hormone-Sensitive Cancers: Avoid due to hormonal effects. Medication Interactions: Consult a health provider if using other drugs for hormonal balance, bleeding disorders, or blood pressure issues.

Drug & food interactions

Caffeine

In a randomised study, 12 healthy subjects were given saw palmetto 160 mg twice daily for 28 days, with a single 100-mg dose of caffeine at the end of treatment with saw palmetto. The pharmacokinetics of caffeine were unchanged by saw palmetto.

Chlorzoxazone

Saw palmetto does not appear to affect the pharmacokinetics of chlorzoxazone. In a study in 12 healthy subjects the metabolism of a single 250-mg Saw palmetto 345 S dose of chlorzoxazone was not affected by saw palmetto 160 mg twice daily for 28 days

Dextromethorphan

Saw palmetto does not appear to affect the metabolism of dextromethorphan. In a study in 12 healthy subjects, saw palmetto 320mg daily for 16 days did not affect the metabolism of a single 30-mg dose of dextromethorphan given on day 14.

Food

No interactions found.

Text

There may be an increased response to anticoagulant treatment in patients who also take saw palmetto. Saw palmetto does not appear to have a clinically relevant effect on the majority of cytochrome P450 isoenzymes and no other interactions with saw palmetto have been found.

Anticoagulants

The INR of one patient taking warfarin modestly increased after he took Curbicin (saw palmetto, cucurbita and vitamin E). This product has also been associated with an increased INR in a patient not taking anticoagulants. Excessive bleeding during surgery has been reported in another patient who had been taking saw palmetto. A 61-year-old man taking warfarin and simvastatin, with a stable INR of around 2.4, had an increase in his INR to 3.4 within 6 days of starting to take 5 tablets of Curbicin daily.Within a week of stopping the Curbicin, his INR had fallen to its previous value. Another elderly man who was not taking any anticoagulants and was taking 3 tablets of Curbicin daily was found to have an INR of 2.1 (normal 0.9 to 1.2). His INR decreased (to between 1.3 and 1.4) when he was given vitamin K, but did not normalise until a week after the Curbicin was stopped. Curbicin is a herbal remedy used for micturition problems, and contains extracts from the fruit of saw palmetto and the seed of Cucurbita pepo.1 In addition, saw palmetto has been attributed to excessive bleeding in a 53-year-old man undergoing a surgical procedure to remove a brain tumour. An estimated 2 litres of blood were lost during surgery and bleeding time did not return to normal for 5 days. The patient denied taking NSAIDs pre-operatively but admitted to taking saw palmetto for benign prostate hypertrophy.

Herbal medicines

No interactions found.

Benzodiazepines

No pharmacokinetic interaction appears to occur between saw palmetto and alprazolam or midazolam. In a study in 12 healthy subjects, saw palmetto 320mg daily for 16 days did not affect the pharmacokinetics of a single 2-mg dose of alprazolam given on day 14.1 In another study in 12 healthy subjects saw palmetto 160mg twice daily for 28 days did not affect the metabolism of a single 8-mg dose of midazolam.

Habitat

Native to the southeastern U.S., typically along Atlantic and Gulf coastal plains, saw palmetto thrives in sandy, well-drained areas. The ripe berries are collected in autumn.

Traditionally used for

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