Benign Prostatic Hyperplasia: Saw palmetto relieves prostate problem

'I take saw palmetto (Serenoa repens) daily, and will for the rest of my life.'

That quote comes from US HSI Panelist Dr Allan Spreen, who, like many men, uses the herb saw palmetto to address problems associated with benign prostatic hyperplasia (BPH); an enlargement of the prostate gland experienced by more than half of all middle-aged and older men.

BPH symptoms include weak urinary flow, frequent urination, painful urination, and difficulty in completely emptying the bladder. Besides being very annoying, these symptoms raise the risk of kidney stones, as well as infections of the bladder and kidney.

And that list of risks just got longer (and more worrying) with new research from the Mayo Clinic in Rochester, New York (US).

BHP   kidney link
BPH typically hampers urine flow. In the worst cases, impeded flow causes an accumulation of metabolic waste. This sets the stage for toxin build up that can eventually develop into chronic kidney disease; a condition that sharply increases the risk of kidney failure and even cardiovascular problems.

Previous studies that looked for a link between BPH and chronic kidney disease have been inconclusive, largely because most of those studies examined only subjects who had symptoms of one or both of these health problems. In this new study - reported in the June 2005 issue of Kidney International - Mayo researchers randomly recruited more than 470 middle-aged and elderly men from the general population.

Each subject underwent clinical evaluation that included a detailed questionnaire regarding urinary flow. Ultrasound exams measured prostate size and residual urine volume, while peak urinary flow rates were recorded by uroflometer.

Results showed that 'chronic kidney disease was associated with diminished peak urinary flow rate, moderate severe lower urinary tract symptoms and chronic urinary retention.'

In a Mayo Clinic press release, one of the study authors, Dr Steven J. Jacobsen, stated: 'We were surprised at how much kidney disease can be attributed to BPH.' Dr. Jacobsen hopes further research will determine if BPH treatments can reverse kidney disease development.

Five tips for men
There's no evidence that saw palmetto can 'cure' BPH. But a study published last year in the British Journal of Urology International demonstrated just how effective saw palmetto may be in relieving BPH symptoms.

Researchers from the University of Chicago reviewed the results of nearly 20 trials that tested a commercial extract of saw palmetto. The conclusions were overwhelmingly positive, with these general outcomes:

* Improved urine flow
* Reduction of urinary urgency and pain
* Improved emptying of the bladder
* Reduction in size of prostate gland after two years
* Significant improvement in quality of life

When I asked Dr. Spreen to share some general advice on saw palmetto supplementation, he offered these five guidelines:

1. It MUST be the 'standardised berry extract.' Nothing else counts, as you have no idea what you're getting.

2. The minimum dose for effect is 320 milligrams daily, and it takes from 2-3 months to be really effective for most. So, if urination trouble is acute enough that no urine can be passed, it becomes too late for the easy solution.

3. The extract should be mixed with a second herb (in my opinion) called Pygeum africanum; they tend to augment each other.

4. I don't know of any toxicity problem, but the agent is not to be considered the solution for prostate cancer (though I'd take it anyway, and I've read it may help).

5. A key point is that prostate enlargement is due to deficiencies of zinc, essential fatty acids, and probably 2 or 3 amino acids. Saw palmetto does not supply those, though it does shrink the gland, so a word to the wise would be to decrease the sugar and refined flour intake (they use up zinc), and supplement with those nutrients.

Any man who may be experiencing symptoms of BPH should talk with his doctor or health care professional before starting a daily saw palmetto regimen. Saw palmetto is available at health food shops.