For some time now, natural cure & herbal activists and some medical researchers believed in the premise that the herbal supplement, saw palmetto, contained anti-androgen properties and was effective in treating men with enlarged prostrates, or benign prostatic hyperplasia (BPH). Their logic also reasoned that if saw palmetto was effective against BPH, it might also be effective against male pattern baldness.
Since the discovery of finasteride (Proscar, Propecia) in the 1990s, researchers have understood that the overproduction of an androgenetic hormone in men called dihydrotestosterone (DHT) is responsible for not only enlarged prostrates but male pattern baldness as well, the cause of 95 percent of all hair loss in men.
Finasteride was found to terminate the production of DHT in men by blocking an enzyme called 5 Alpha Reductase. When 5 alpha-reductase combined itself with normal testosterone, it produced dihydrotestosterone, – the culprit behind BPH and male hair loss, also known as androgenetic alopecia.
What is saw palmetto?
Saw Palmetto (Serenoa repens or Sabal serrulatum), is an extract taken from the small fruit of the American Dwarf Palm Tree that inhabits the eastern coast of the United States. It was first discovered for medicinal purposes by the Seminole Indians of Florida.
However, the question is:
Does Saw Palmetto actually work for BPH and male pattern hair loss?
Well, some studies say yes, and the most recent large study says no, definitely not.
In a 2003 study review published in the Journal of the American Academy of Family Physicians, American Family Physician, clinical investigators went back and looked at all the studies done on Saw Palmetto up to that time.
“In a Cochrane Review, investigators conducted a meta-analysis of randomized controlled studies comparing saw palmetto with placebo or other drugs. … The review combined the results of 21 trials with durations of four to 48 weeks. The 21 studies included a total of 3,139 men with a mean age of 65 years (range: 40 to 88 years). …In the 13 studies that reported symptom scores, saw palmetto improved symptom scores, individual symptoms, and flow measures more than placebo. Patients and physicians were more likely to report improvement in symptoms with saw palmetto treatment than with placebo. In the12 studies that reported nocturia results (excessive urination at night), saw palmetto reduced nocturia by 25 percent compared with placebo.” (1).
So the logic for many years is that the anecdotal evidence reports that saw palmetto is an effective treatment for BPH (and subsequently, hair loss).
Not so fast says the National Institute of Health’s – National Center for Complimentary and Alternative Medicine. Their 2006 study published in the New England Journal of Medicine, concedes that in the past, several “…small studies suggest t that saw palmetto may be effective for treating BPH symptoms.”
But their own 2006 study conducted on 225 men with moderate to severe BPH “…found no improvement with 320 mg saw palmetto daily for 1 year versus placebo.” (2)
NCCAM co-funded the study with the National Institute of Diabetes and Digestive and Kidney Diseases.
In Summary, NCCAM reported the following conclusions:
- There is not enough scientific evidence to support the use of saw palmetto for reducing the size of an enlarged prostate or for any other conditions.
- Saw palmetto does not appear to affect readings of prostate-specific antigen (PSA) levels. (2)
Taken together, the NEJM-published study seems to be as strong in its negative conclusions for saw palmetto and BPH as the Cochrane Review is in favor of Saw Palmetto published 3 years earlier. However, both studies do report that saw palmetto offers little in the way of side effects (minor stomach discomfort). Saw palmetto is a relatively low-cost natural supplement and those who want to believe in its anti-androgen, pro-BPH, or anti-hair loss properties, will not suffer financially or physically. However, if it doesn’t work for them, they may lose valuable time needed to regrow their hair with more accepted treatments such as minoxidil and/or finasteride.