Saw Palmetto and prostate health

Hello Everyone,

Quite possibly this question will be TMI, but here it goes, like everyone else in the world, am getting older. I’m in my mid 40’s and noticing with each passing year The “things that will never happen to me” are happening to me. I’ve started having to wear reading glasses, my wife says that I must be deaf as I listen to the TV too loud. Thankfully I haven’t been forgetting things or started wearing my pants pulled up to the middle of my chest, but I am sure it’s coming.

One thing that has recently started is signs of an enlarged prostate. I noticed a few months ago that while urinating the stream isn’t near as strong as it used to be. Also I have noticed a lot of “pulsing” While urinating, not quite stop and starting, but what seems like the precursor to it. So as the commercial says, “I don’t have a going problem, i have a growing problem”.

I mentioned this to my doctor during my last visit. Issues dealing with my prostate health are given extra scrutiny because i am on Testosterone Replacement Therapy (due to long term opioid use for chronic pain) and this increases my risk for prostate cancer. So, i do a PSA every six months. My doctor told me that my symptoms were an indication of an enlarged prostate, however He believed it was very early and prior to trying prescription medication wanted me to try Saw Palmetto for a while and see if things didn’t improve.

So, I went to the hippy, I mean health food/vitamin store and got some Saw Palmetto and I’m taking two capsules per day, 1000mg. The results have been amazing! After only a few days I noticed a marked improvement. After one week I no longer am getting a pulsing sensation while urinating and urine flow appears to be easier. So, the question us, is it really possible that the Saw Palmetto had worked this quickly or is it possible that I have somehow convinced my body to"heal"itself, almost a placebo type effect? It isn’t that I don’t think the Saw Palmetto Will work, it’s just i can’t believe how quickly i saw marked improvement. Is this stuff really that good and how does it work? Thanks!
*Disclaimer
Oh, I know you are not a doctor, but a few of you are. I am not looking for medical advice, rather information on Saw Palmetto and it’s effectiveness. I don’t mind personal advice if you feel the need.

Part of getting old is an obsession with how you pee. Does the saw palmetto cure that?

It’s another one of those alternative medicines where you hear anecdotal confirmation all the time, and the scientifically controlled studies show nothing better than the placebo effect.

Well, I have to say that is what I thought. However, things are better, even my wife says that my morning bladder relief doesn’t sound painful any longer. Apparently she could hear the pulsating of the stream as it hit the water in the bowl. She said it always sounded like I had to “try” to pee. Now it seems like it should be. I’m so confused.

Actually, this is not true. Saw Palmetto is not one of the “fake” alternative medicines, it actually may help some people. Saw Palmetto acts as a 5-Alpha Reductase inhibitor that inhibits the conversion of testosterone into dihydrotestosterone. The mechanism of action is pretty much the same as prescription products Finasteride (Proscar, Propecia) and Dutasteride (Avodart).

However, in obbn’s case, he might be having some placebo effects from it. In normal use of a 5-alpha reductase inhibitor, it takes a few weeks to a month to see results. If you really had results in “a few days” it might be partly due to the placebo effect.

Though, Saw Palmetto does work in most people, it isn’t as potent as the prescription options, it can be better tolerated, and could delay the need for a prescription treatment. However, if you have insurance, you could end up paying more for using Saw Palmetto OTC then you’ll pay in copays for an RX option.

Myciteis this paper from 2009.

So, what are the side-effects of this inhibited conversion of T to DHT? And since the OP is on TRT, would the Saw Palmetto counteract the effectiveness of those treatments?

Like a lot of drug effects/interactions, it sounds very “push me, pull you.”

I started having a slightly enlarged prostate around your age, and began taking saw palmetto. It seemed to work (even as a placebo) until last year, when I was 66. All of a sudden my urinary tract totally stopped. I went through hell for two days, hoping the problem would go away by itself. It didn’t. Finally I saw a urologist, and he prescribed two medications (Finasteride and Tamsulosin HCl). One of them worked immediately, and the other kicked in after a few months. I take them every day, and my urine stream is noticeably stronger than it’s ever been. According to the urologist, the saw palmetto may have worked or may have been a placebo. What’s important is that I was problem-free for over 20 years. Then I needed something stronger.

My urologist recommended saw palmetto along with the prescription stuff, so I take it, but I have to say that I don’t see any difference when I run out of it and don’t get around to the store for a few days. Or when I decide to double my dose to see if more is better, for that matter.

The independent Cochrane organization (known for quality comprehensive reviews of the research literature) has just published a review of saw palmetto for benign prostatic enlargement.

“The update of this review included 32 randomized controlled trials involving 5666 men…compared with placebo, Serenoa repens, at double and triple the usual dose, provides no improvement for nocturia, peak urine flow, and symptom scores for men with benign prostatic hyperplasia.”

Cochrane has done reviews showing that other plant-based supplements may help with urinary symptoms caused by enlarged prostates, so it’s not as if they are down on all herbal remedies.

http://www.sbwire.com/press-releases/super-beta-prostate/sbwire-166082.htm

That one word is all you need to know, folks.

Everything I’ve ever read says that saw palmetto pills are just a high priced placebo. Beer works better.

No, what I need to know is what is in it? Why can’t they list the ingredients?

Careful folks, we’re moving from a discussion of the facts, to a debate on the merits of herbal remedies for prostate issues. If ya want to continue the debate, create a thread over in the GD forum.

It’s homeopathic. It doesn’t have ingredients. It has the memory of ingredients!

It’s a debate based on facts that there’s no good evidence that herbal remedies do anything beneficial for prostates. Works in GQ for me.

<<shrug>>

Consumer Reports has a good article (.pdf) with the straight dope and suggestions. Notice the distinct lack of OTC and herbal recommendations.

[Moderator Note]

dstarfire, if you think a thread is in the wrong forum please report it rather than giving instructions to other posters.

Colibri
General Questions Moderator

With all due respect, you reply is over the top. Everything has ingredients. Not sure what “memory of ingredients” is. Care to explain?

He is commenting on the nature of homeopathic medicines. They are based on the idea that an active ingredient can be diluted to the point where only traces remain, or possibly none at all. They have no more curative power than the tap water they are made from.

It is difficult to be over the top when discussing homeopathic medicine.

I’ll venture to briefly explain for him…

  • He’s a medical doctor.

  • This is GQ @ The Straight Dope.

  • By suggesting that homeopathic “remedies” are bunk*, he’s just giving you the straight dope.

*(Other than the possible placebo effect.)

If you are unfamiliar with what “homeopathic” really means, searching this board or Google should be elucidating. (Wiki’s got all you’ll need, and more.)