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Product Review:
Saw Palmetto

Background:  Saw palmetto dietary supplements are primarily used in the U.S. to improve urinary flow and reduce the frequency and urgency of urination in men with prostate enlargement (benign prostatic hyperplasia, or BPH). Saw palmetto has also been used to treat bladder inflammation (cystitis), chronic bronchitis, laryngitis, and asthma-associated nasal inflammation, among other conditions. Saw palmetto is actually a type of palm tree, also known as the dwarf palm. Its primary medicinal value lies in the oily compounds found in its berries.
Most dietary supplements are composed of an extract from the berries, although crushed berry products are also available.
Saw palmetto is believed to inhibit the actions of testosterone on the prostate that cause prostate enlargement and interference with urinary flow. Among the main constituents of saw palmetto are fatty acids and sterols. The fatty acids are purported to be responsible for testosterone-inhibiting effects within the prostate. The mechanism of action of the sterols is not well understood, although they are present in other herbs (such as Pygeum bark, stinging nettle root, and pumpkin seed extract) used in treating prostate conditions. At least 85% of the weight of clinical quality saw palmetto products are expected to be attributable to specific fatty acids and sterols.
Currently, saw palmetto and other dietary supplements are not considered drugs in the U.S. and are not required to be tested for quality by any governmental or independent agency prior to sale. As part of its mission to independently evaluate health, wellness and nutrition products, ConsumerLab.com purchased and tested saw palmetto dietary supplements sold in the U.S.
Testing & Results:  ConsumerLab.com purchased 27 leading brands of saw palmetto in November and December 1999, in order to determine whether they possessed the minimum amounts of specific fatty acids and sterols commonly found in saw palmetto products used in published clinical trials.  Five saw palmetto products were immediately eliminated from testing as their labels claimed that they had been standardized to levels of fatty acids that were below 85%. These products claimed to be standardized to 20-25%, 40%, 45%, 80%, and 80%, respectively. A sixth product was eliminated as it had incomplete labeling to determine the amount of saw palmetto per serving.
Among the 21 remaining products that were tested, four were found not to contain the minimum amounts of specific fatty acids and/or sterols commonly found in saw palmetto products used in published clinical trials.
Among these four, all had low fatty acid levels. In addition, one of these four had low sterol levels and another had no detectable level of saw palmetto sterols. Among the 17 products that passed, most contained additional oils that were generally identified as being part of a "prostate formula." These combinations may or may not have additional benefit, as they have generally not been clinically tested. Two passing products appeared to contain exclusively the saw palmetto extract similar to that used in most clinical trials.
Examples of some of the products that passed review are:
(Info in order of Product Name, Labeled Concentration of Saw Palmetto Per Pill, and Manufacturer or Distributor)
ProstaPro, Saw Palmetto Berry Extract, Standardized Extract, 160 mg/softgel capsule,  PhytoPharmica
Super Saw Palmetto, 160 mg/softgel capsule,  Enzymatic Therapy
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