Alternative medicine becomes a more obsolete term every month. American researchers are continuing to dig for answers about the effectiveness of so-called alternative therapies such as acupuncture (which has been long studied in Asian cultures) and herbs (documented extensively during the 1900s in Europe, especially Britain and Germany).
One of December’s examples comes from University of Chicago researcher Dr. Glenn Gerber. He published a study in the peer-reviewed Journal of Urology that showed saw palmetto extract (from the plant’s berries) can improve urinary symptoms such as an enlarged prostate or urinary-tract infection. The men in the study, ages 45 to 80, reported relief during a six-month period.
“The study provides the best evidence to date that saw palmetto can have a beneficial effect,” said Gerber, a urologist with a university-based practice.
“The findings give us more information to tell our patients. We can say it appears saw palmetto is a safe, well-tolerated substance that produces short-term improvement of urinary symptoms.”
The 85 men in the study were scored at two-, four- and six-month intervals for such symptoms as how often you get up at night to urinate, if you urinate more frequently than every two hours, feeling an urgency to find a bathroom, stopping and starting during urinary flow, rating the stream flow and difficulty urinating. Gerber and his colleagues used the standard scoring system developed by the American Urological Association that rates men from 0 to a worst-case 35.
Participants taking the saw palmetto in 160-milligram doses twice daily significantly improved their scores (down to 12.3 from 16.7) compared with the placebo group, whose scores also decreased. In a related measurement, neither group showed any improved or changed sexual function.
Gerber said the placebo effect of the study is positive in itself. He reasoned that men with urinary symptoms face little downside for trying saw palmetto as part of their remedy.
Lifestyle changes can help, such as limiting fluid intake later in the day and drinking less alcohol and caffeinated beverages (both are diuretics that pull fluid from the body).
“It’s a subjective thing to determine if your symptoms are better,” he said. “There is no lab test or X-ray. Saw palmetto has virtually no side effects, so it can help and not hurt.”
But Gerber quickly added two provisos.
One is that any man with urinary symptoms shouldn’t rely on saw palmetto alone to address any problems. “The biggest take-home message for men who might have symptoms such as getting up too much at night is not to self-medicate,” Gerber said. “You need to see a doctor to rule out cancer, urinary infection or damage to the kidneys.”
Although saw palmetto shows promise for lessening urinary symptoms and discomfort, there is no research indicating it actually shrinks an enlarged prostate that causes the condition known as BPH, or benign prostatic hypertrophy.
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More than half of men in their 60s have BPH, and it is estimated that as many as 90 percent of men in their 70s and 80s are affected. Difficulty urinating is a common symptom, along with urgency during sleep.
What’s more, there is no evidence that saw palmetto is effective to treat or prevent prostate cancer. Men need to determine their condition before turning to saw palmetto.
The second proviso focuses on the quality of saw palmetto supplements, which cost about $20 to $35 per month for the recommended dose.
Like all herbal remedies sold in the United States, it is not highly regulated. The potency can vary widely among products. Gerber said the Internet site www.consumerlab.com recently conducted a test of 27 saw palmetto products. Ten of the products did not contain the active ingredient of saw palmetto extract in the labeled amount.
That figures to be disturbing news to American men, who spend $140 million on saw palmetto preparations each year, making it one of the 10 best-selling herbs in the country.
The consumerlab.com site charges a fee for more specific information, but Gerber said it could be worth the price for any man with urinary symptoms.
Even men 50 and older without symptoms shouldn’t feel complacent about urinary health. Gerber said men should get regular checkups for prostate health, especially cancer.
“Women are more accustomed to getting annual exams [for reproductive health] because they see gynecologists,” Gerber said. “Many men had their last physical when they went out for high school sports. It’s a smart idea to change that pattern.”