Saw palmetto fruit extracts designed to heal the prostate are a sensation in pharmacies. Unfortunately, they are ineffective.
When men reach a certain age, they suddenly eagerly reach for medicinal plant preparations. Extracts of pumpkin seeds, nettle root, rye pollen or African plum bark are very popular, especially when ailments related to prostatic hypertrophy begin. Products containing saw palmetto active substances are of particular interest. This palm grows in Florida and the southeastern part of the United States. The extract obtained from its fruit has become a world bestseller. It is estimated that the annual turnover from saw palmetto preparations is $ 700 million. With an upward trend.
Men whose benign prostatic hyperplasia leads to frequent urge to bladder, severe lower abdominal pain and leakage of urine in the final stage of voiding, however, could better invest their money than spend it on herbal preparations. A large-scale study in the Journal of the American Medical Association found that saw palmetto extracts did little to help.
“Amazingly, the study did not show the slightest tangible effect, even when we increased the dose of the herbal remedy,” says urologist Claus Roehrborn of the University of Texas in Dallas, who participated in the study. – We have been able to identify neither a beneficial nor a harmful effect. So these substances have nothing but a placebo effect.
A team of North American urologists examined 369 men suffering from prostate ailments. Half of the men in their 60s first received one saw palmetto extract tablet to be taken once a day, the other half received an identical-looking bogus preparation. After half a year, the dose was increased to two tablets a day, after a year even to three – this is three times the standard dosage. The number of placebo tablets that the other half of the men were taking also increased. Every twelve weeks and at the end of the study, an interview was made, in which the well-being, the severity of ailments and the quality of life were asked in detail.
The effects of taking palm extract turned out to be meager. Although men reported that they felt a slight improvement in urination and their quality of life increased, the second group of pills that took identical-looking and tasting pills without the active substance also experienced minimal improvement. The very feeling of being treated leads to this phenomenon. – It doesn’t make any difference. You can save a lot of money because the effects of these preparations are not much better than those of sugar lozenges, says Gerald Andriole, urologist at the Washington School of Medicine in St. Louis.
Saw palmetto products, which also contain other plant substances, are very popular in Germany. These generally available remedies have become the bestsellers in every pharmacy, although even before the publication of this study, there was no convincing evidence of their effectiveness. It is true that men in previous studies reported that they did not have to go to the toilet frequently at night while taking saw palmetto extract tablets. It has been speculated that fruit-derived plant hormones, oils and fatty acids inhibit inflammation and counteract edema, slowing down prostate growth and clearing the urinary tract. However, no evidence was found for this, and the more detailed the studies were, the less successful it was. The success of selling these drugs can be explained more by the stress and frustration of men who hope to alleviate suffering rather than wait for scientific evidence.
Men with an enlarged prostate with age face a huge dilemma. Drug treatment that stops the growth of the prostate gland can lead to dizziness, headache, and chronic fatigue. While surgery promises to be highly effective, there is a risk of complications such as bleeding or urinary incontinence.
Conventional methods offered by us can cause various unpleasant side effects, while even the highest dose of saw palmetto extract shows no undesirable results, says Harvard urologist Michael Berry, who led the study. – That’s why I don’t mind if the patient wants to take herbal preparations. However, I want to be sure that he understands that the effectiveness will not be greater than the placebo effect.
In principle, benign prostatic hyperplasia cannot be prevented. Half of all men in their 80s suffer from inconvenience, and among XNUMX-year-olds, almost everyone suffers from it. – You have to decide whether the patient needs treatment or not. If you stick to plant preparations, it will usually prevent real help, says Ulrich Wetterauer, head of urology at the University Clinic in Freiburg. Undoubtedly, using medications can increase the urine flow and reduce the pressure on the bladder, which delays the need for surgery.
Text: Werner Bartens
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