Evidence supporting the use of: Saw palmetto
For the health condition: Benign Prostate Hyperplasia

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Saw palmetto (Serenoa repens) is a plant whose berries have been traditionally used by Native Americans for urinary and reproductive health, particularly in men. Its modern popularity centers on its use as an herbal remedy for Benign Prostatic Hyperplasia (BPH), a non-cancerous enlargement of the prostate gland that can cause urinary symptoms in older men. The mechanism is thought to involve inhibition of 5-alpha-reductase, an enzyme that converts testosterone to dihydrotestosterone (DHT), which is implicated in prostate growth.

Scientific studies on saw palmetto have yielded mixed results. Early small trials and some meta-analyses suggested modest benefit for urinary symptoms associated with BPH. However, larger, more rigorous randomized controlled trials, such as the 2011 STEP study published in JAMA, found that saw palmetto was no more effective than placebo in reducing BPH symptoms, even at higher doses. Systematic reviews and guidelines, including those from the American Urological Association, generally conclude that saw palmetto is not significantly better than placebo for BPH symptom relief.

In summary, while scientific study of saw palmetto for BPH exists, and it is widely used for this purpose, the overall quality of evidence supporting significant benefit is low to moderate, leading to a rating of 2 out of 5. The use of saw palmetto for BPH is justified by both historical tradition and scientific inquiry, but robust clinical efficacy has not been consistently demonstrated.

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