title: Effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia.
abstract: OBJECTIVE
  We tested the effects of a saw palmetto herbal blend in men with symptomatic benign prostatic hyperplasia (BPH) via a randomized, placebo controlled trial.
  
  
  METHODS
  We randomized 44 men 45 to 80 years old with symptomatic BPH into a trial of a saw palmetto herbal blend versus placebo. End points included routine clinical measures (symptom score, uroflowmetry and post-void residual urine volume), blood chemistry studies (prostate specific antigen, sex hormones and multiphasic analysis), prostate volumetrics by magnetic resonance imaging, and prostate biopsy for zonal tissue morphometry and semiquantitative histology studies.
  
  
  RESULTS
  Saw palmetto herbal blend and placebo groups had improved clinical parameters with a slight advantage in the saw palmetto group (not statistically significant). Neither prostate specific antigen nor prostate volume changed from baseline. Prostate epithelial contraction was noted, especially in the transition zone, where percent epithelium decreased from 17.8% at baseline to 10.7% after 6 months of saw palmetto herbal blend (p <0.01). Histological studies showed that the percent of atrophic glands increased from 25. 2% to 40.9% after treatment with saw palmetto herbal blend (p <0.01). The mechanism of action appeared to be nonhormonal but it was not identified by tissue studies of apoptosis, cellular proliferation, angiogenesis, growth factors or androgen receptor expression. We noted no adverse effects of saw palmetto herbal blend. When the study was no longer blinded, 41 men elected to continue therapy in an open label extension.
  
  
  CONCLUSIONS
  Saw palmetto herbal blend appears to be a safe, highly desirable option for men with moderately symptomatic BPH. The secondary outcome measures of clinical effect in our study were only slightly better for saw palmetto herbal blend than placebo (not statistically significant). However, saw palmetto herbal blend therapy was associated with epithelial contraction, especially in the transition zone (p <0.01), indicating a possible mechanism of action underlying the clinical significance detected in other studies.
authors.affiliation: Department of Urology, University of California Los Angeles School of Medicine, Los Angeles, CA, USA.
authors.forename: L S
authors.initials: LS
authors.lastname: Marks
authors.forename: A W
authors.initials: AW
authors.lastname: Partin
authors.forename: J I
authors.initials: JI
authors.lastname: Epstein
authors.forename: V E
authors.initials: VE
authors.lastname: Tyler
authors.forename: I
authors.initials: I
authors.lastname: Simon
authors.forename: M L
authors.initials: ML
authors.lastname: Macairan
authors.forename: T L
authors.initials: TL
authors.lastname: Chan
authors.forename: F J
authors.initials: FJ
authors.lastname: Dorey
authors.forename: J B
authors.initials: JB
authors.lastname: Garris
authors.forename: R W
authors.initials: RW
authors.lastname: Veltri
authors.forename: P B
authors.initials: PB
authors.lastname: Santos
authors.forename: K A
authors.initials: KA
authors.lastname: Stonebrook
authors.forename: J B
authors.initials: JB
authors.lastname: deKernion
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000627:therapeutic use*; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000473:pathology; D028024:Serenoa
chemical_list: D000726:Androgen Antagonists; D010936:Plant Extracts; C040972:saw palmetto extract