The Polypharmacy Network

Polypharmacy Prevention
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What You Should Know About Saw Palmetto
By: Joanne Jansen PharmD and Anjanette Dymerski PharmD
Many people consider herbal supplements safe since they are natural. However, even natural things can be bad for you; for example, a bite from a black widow spider is natural and not good. Always discuss any new supplements with your doctor or pharmacist before taking them to make sure they do not interact with your medications or cause worsening of a disease you have.

It is important to remember that natural supplements and vitamins are not regulated by the Food and Drug Administration (FDA). This means that there may be ingredients in the products that are not listed. There is also no guarantee that the ingredients listed on the bottle are accurate.

Saw palmetto is often used for the treatment of mild benign prostatic hyperplasia (BPH). Some research has shown that saw palmetto works as well as finasteride (Proscar) and tamsulosin (Flomax) while other research showed no benefit. When it does work, it may take 1 – 2 months to do so. The prescription drugs tend to be much quicker than that. Although saw palmetto can be combined with the prescription drugs, the combination does not seem to work any better than the prescription drug alone.

The research that has shown any effect used an extract of the saw palmetto berry containing 80 – 90% free fatty acids. Lower amounts do not seem to show any benefit on BPH. Because the main ingredient of saw palmetto is a fatty acid, products that use water to extract it, such as teas, probably do not contain enough active ingredient to work.

Other things you should know about saw palmetto:
• Tell your doctor you are taking this drug before you have surgery. You may need to stop it two weeks before surgery to prevent bleeding problems.
• Tell your doctor or pharmacist you are taking this drug before you start any new medications.
• Some side effects of saw palmetto can be dizziness, headache, nausea, vomiting, and diarrhea.

More information available at the Natural Products Database of The Pharmacist’s Letter.