la-dee-da
HairLossTalk.com, I don't know the answers to any of those questions, and I don't think anyone else does, either. This would be a good time to repeat what I posted on alt.baldspot a few years ago...it's the excerpt about saw palmetto from the article by Sawaya and Shapiro about unapproved male pattern baldness treatments. I put the especially relevant statement in bold:
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This is my fourth excerpt from "Alopecia: Unapproved Treatments
or Indications", by Drs. Marty Sawaya and Jerry Shapiro.
"Serenoa Repens / Saw Palmetto / Permixon"
"This is very commonly known by patients and clinicians as it is widely available in most nutritional food stores. Serenoa repens berries grow naturally, with the extract claiming to inhibit DHT production, mainly claimed for use in prostate problems. There have been no extensive studies, but because of the stated implications of affecting DHT, men are anxious to try this OTC remedy to see whether it promotes hair growth on the scalp.
"Studies that have been done have compared Permixon with finasteride in treatment of 1098 men with benign prostatic hypertrophy (BPH).Permixon improved symptoms of BPH but had no effect on androgen-dependent parameters such as DHT levels or 5a-R, indicating that its effects must be due to other yet undetermined pathways that do not involve DHT or 5a-R directly. Another study in 32 young men (aged 20 to 30 years) in a 1-week open trial looked at the effects of finasteride versus Permixon with regard to serum androgen levels; no effect on DHT levels were found in the Permixon-treated group, similar to the placebo group, whereas the finasteride group reduced DHT by 65%.
"Side effects noted in taking Serenoa repens in either commercial form of Permixon or Saw Palmetto have been gynecomastia in men, which indicates again that it does not act on DHT alone, but by other as yet unrevealed mechanisms. To be effective the extract of the berries must be taken, not the berries themselves. Another active ingredient, Pygeum africanum compound, is added to this extract and is thought to influence testosterone metabolism, although it is not clear how at this point. The product comes in capsule form with 2 to 6 capsules as the recommended daily dose in divided doses between meals. The cost can range from $12 to $40 per month."
Bryan