Question

BPH and Enlarged Prostate Gland

1. Would you recommend patients use saw palmetto for prostate overgrowth in lieu of the prescription options? Why or why not?
2. Since the risk of falls is so low for men taking the prescription options, would you mention it to a patient?
3. Some health care providers don't recommend prostate exams routinely. Instead, they recommend prostate exams when men have symptoms. This is the case even for men over 50. What is your opinion? Which side of the argument do you agree with most? Why?

Answer 1

◾️Saw palmetto, a herbal extract taken by more than two million US men for relief from the symptoms of benign prostatic hyperplasia, showed no benefit over placebo, a study has found.

◾️Saw palmetto (Serenoa repens) is a palm that grows in the Southern coastal regions of the United States. It is about 2 to 4 feet high. Its leaves are fan-shaped and sharp, and it makes a lot of berries.

Some small studies have shown saw palmetto might help you with BPH symptoms in several ways. Among them:

You may need to get up less often at night to pee.
It can improve your flow when you go.
It can ease painful urination.
In case people taking saw palmetto for other reasons than BPH. Some of them include:

Low sex drive
Hair loss
Low sperm count
Migraines
Ongoing pelvic pain
So far, studies have shown limited results for saw palmetto helping with these other types of problems.

The best-studied, most commonly used supplements to treat BPH are:

Beta-sitosterol.
Pygeum.
Rye grass.
Saw palmetto.
Physicians at UC San Diego Health are now offering prostate artery embolization (PAE) as a new treatment option for men with benign prostatic hyperplasia (BPH), or an enlarged prostate. The minimally invasive procedure is an alternative to surgery, with no hospital stay, little operative pain and lower cost.

◾️The safest medication for enlarged prostate

Alpha blockers for BPH

alfuzosin (Uroxatral)
doxazosin (Cardura)
silodosin (Rapaflo)
tamsulosin (Flomax)
terazosin (Hytrin)
Side effects of saw palmetto

dizziness.
headache.
nausea.
vomiting.
constipation.
diarrhea.
They can shrink the prostate by around a quarter after 6 to 12 months of treatment. They may shrink the prostate even more if taken for longer. 5-alpha-reductase inhibitors usually take at least six months to work fully, but they are effective at improving symptoms in the long term.

Saw palmetto is well tolerated by most users. It may cause mild side effects, including digestive symptoms or headache.
Saw palmetto does not appear to affect readings of prostate-specific antigen (PSA) levels, even when taken in higher-than-usual amounts. PSA is a protein produced by the prostate gland. PSA levels have been used to screen for prostate cancer and are also used to monitor patients who have been diagnosed with prostate cancer.
Saw palmetto has not been shown to interact with medications.
Information on the safety of saw palmetto comes primarily from studies of its use for BPH in men. Little is known about the safety or side effects of saw palmetto when used for other conditions, especially in women or children.
Saw palmetto may be unsafe for use during pregnancy or while breastfeeding.
For BPH, studies have used a daily intake of 320 milligrams of saw palmetto split into two doses. The doses will be different in other forms, such as tinctures (a liquid preparation). Get advice from your doctor.
Keep in Mind

Urinary tract symptoms can have several causes, including conditions such as prostate cancer that need prompt treatment. If you’re having problems with urination, it’s important to tell your health care provider.
Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.
Above conditions based i agree the argument of prescription option and also i mentioned it to patient about there conditions and risks.

Key References

Agbabiaka TB, Pittler MH, Wider B, et al. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Safety. 2009;32(8):637-647.
Andriole GL, McCullum-Hill C, Sandhu GS, et al. The effect of increasing doses of saw palmetto fruit extract on serum prostate specific antigen: analysis of the CAMUS randomized trial. Journal of Urology. 2013;189(2):486-492.
Avins AL, Lee JY, Meyers CM, et al. Safety and toxicity of saw palmetto in the CAMUS trial. Journal of Urology. 2013;189(4):1415-1420.
Barry MJ, Meleth S, Lee JY, et al. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA. 2011;306(12):1344-1351.