Saw Palmetto: 32% decline in DHT levels, study | HairLossTalk Forums

Saw Palmetto: 32% decline in DHT levels, study

Discussion in 'New Research, Studies, and Technologies' started by michael barry, Sep 12, 2007.

  1. michael barry

    michael barry Senior Member

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    These guys took 106 mgs of saw palmetto three times a day, for a total of 318 mgs, which is about the normal hairloss dose of the stuff. They also took nettle, pumpkin seed extract, and some lemon extract.........................



    HerbalGram. 2001;53:22-24 American Botanical Council



    Reviewed: Marks LS, Hess DL, Dorey FJ, et al. Tissue effects of saw palmetto and finasteride: Use of biopsy cores for in situ quantification of prostatic androgens. Urology. 2001;57:999-1005.

    Summary: Using prostate tissue samples obtained by needle biopsy, researchers compared tissue levels of testosterone (T) and dihydrotestosterone (DHT) in men with symptomatic benign prostatic hyperplasia (BPH) taking finasteride, placebo, or a saw palmetto herbal blend (SPHB). Tissue samples were obtained from three groups of men participating in different clinical trials: (1) 15 men receiving finasteride (Proscar®) treatment (5 mg/day) for 3 months or longer versus 7 untreated controls; (2) 22 men undergoing prostate adenomectomy (surgical excision of the gland) to rule out cancer (n = 18) or transurethral resection (a surgical technique used to allow relief of prostatic obstruction of urine flow in men with BPH) for the relief of obstruction (n = 4); (3) 44 men receiving either the SPHB (n = 21) or placebo (n = 23) for six months. Serum levels of T and DHT were also measured for each patient. The SPHB used in the original clinical trial1 is a combination supplying 106 mg of saw palmetto (Serenoa repens [W. Bartram] Small, Arecaceae) extract, stinging nettle (Urtica dioica L. ssp. dioica, Urticaceae) root extract (80 mg), pumpkin (Curcubita pepo L., Curcurbitaceae) seed extract (160 mg), flavonoids extracted from lemon (Citrus x limon [L.] Osbeck, Rutaceae) (33 mg), and vitamin A (190 mg) per capsule (supplied by Nutrilite, of Buena Park, California). One capsule of the product was taken three times per day.

    A total of 244 prostate samples were analyzed - 40 from the prostate adenomectomy group, 44 from the finasteride study, and 160 from the SPHB trial. In men taking finasteride, prostate tissue levels of DHT were decreased significantly when compared to untreated men (p < 0.01). Conversely, prostate tissue levels of T were significantly increased - five to ten times - in those taking finasteride compared to untreated controls (p < 0.01). While serum (i.e., bloodstream) levels of T remained similar, serum levels of DHT were also significantly reduced in men taking finasteride compared to controls (p < 0.01).

    Men taking SPHB had a significant decrease in prostate tissue levels of DHT from baseline to 6 months of treatment (p = 0.005). However, this reduction was not statistically significant when compared to the placebo group. The 6-month decline in DHT for the SPHB group was 32%. In comparison, the finasteride effect on prostate tissue levels of DHT was an 80% reduction compared to untreated men. Treatment with SPHB led to no changes in prostate tissue levels of T or in serum levels of T or DHT. Of particular interest, serum levels of prostate-specific antigen (PSA) decreased by approximately 50% in men taking finasteride compared to no change in men taking SPHB.

    The authors of the study conclude that compared to finasteride, the SPHB-induced suppression of prostatic DHT levels is modest but significant enough to support the hypothesis that inhibition of the enzyme 5-alpha reductase (5-AR), which is responsible for the converstion of T to DHT, may be a mechanism for saw palmetto and the SPHB used in the study.

    Comments/Opinions: Directed by Leonard Marks, M.D., head of the Urological Sciences Research Foundation, this is the first American study to explore potential mechanisms of action for saw palmetto. While a meta-analysis of clinical trials published in the Journal of the American Medical Association in 1998 concluded that saw palmetto preparations are safe and effective in treating many of the symptoms associated with BPH,2 there has been little consensus on the how saw palmetto achieves this clinical effect.

    DHT is the major androgenic hormone in the prostate and is needed throughout life for the growth and maintenance of the gland. It is derived from T and this conversion is catalyzed by 5-AR. As excessive accumulation of DHT is thought to be a potential contributor to the development of BPH in middle age and older males, drugs that inhibit 5-AR (i.e. finasteride) have been developed to treat BPH. Some herbal experts and European researchers have suggested that this action may partially explain how saw palmetto works.

    In vitro and animal studies have suggested an antiandrogenic action for the liposterolic extract of saw palmetto.3 In vitro studies have shown inhibition of the enzymes 5-AR and 3-ketosteroid reductase as well as inhibition of the binding of DHT to prostate cells.4,5 In addition, in vitro as well as in vivo research has found that saw palmetto extract inhibits the production of basic fibroblast growth factor and epidermal growth factor.6,7 In addition to DHT, these growth factors are also thought to contribute to BPH.

    There have been conflicting results regarding the ability of saw palmetto extracts to inhibit 5-AR - particularly when compared to finasteride. One in vitro study found minimal 5-AR inhibition when compared directly to finasteride.8 However, one study showed that at the therapeutic dose of 320 mg/day, saw palmetto extract does inhibit 5-AR, 9 and other studies have shown inhibition of both type I and type II isoenzymes of 5-AR.10,11 One in vitro study found that inhibition of 5-AR was limited to only prostate cells and not cells from other parts of the body.12 Unlike other 5-AR inhibitors, saw palmetto has not shown inhibition of prostate-specific antigen (PSA) secretion, even after stimulation with testosterone in vitro.13 As noted below, PSA is a serum marker used to detect possible prostate cancer. Inhibition of PSA secretion may, in some cases, block early detection of prostate cancer. One in vivo study found that decreased levels of DHT were significant only in the periurethral area.7 This may suggest a more localized effect for the extract and may partly explain why in clinical trials administration of saw palmetto extracts have not resulted in significant reduction in prostate size. In fact, the current study found no reduction in prostate size for men taking SPHB while those taking finasteride had a 20% reduction.

    While the study by Dr. Marks and colleagues suggests that inhibition of 5-AR (likely far more modest than that noted for finasteride) may partially explain the modest reduction in DHT levels noted for men taking the SPHB product, further studies are needed to confirm the earlier European studies noted above.

    Finally, the results of this study may be viewed critically as the product used contains not only saw palmetto but also nettle root and pumpkin seed oil, two other products sometimes used for the symptomatic treatment of BPH and both approved by the German Commission E for this use (albeit with much less clinical evidence than saw palmetto).14 Interestingly, an earlier Italian study using a monopreparation of saw palmetto (Permixon®, Pierre Fabre, Paris) found a 50% reduction in prostate tissue levels of DHT in men with BPH taking 320 mg of the extract per day.7 The daily dosage of saw palmetto extract used in the current study equals that used in the Italian study. Could some ingredient in the combination product counter some of the effect of saw palmetto? This could only be answered with a comparison study of the two products.

    Practice Implications: The results of this study confirm that a saw palmetto herbal combination product does reduce prostate tissue levels of DHT- an effect that may partially explain the clinical effectiveness of saw palmetto for the treatment of mild to moderate BPH. Further studies are needed to determine the degree to which saw palmetto inhibits 5-AR, the likely explanation for the effect noted in this study. Perhaps most notable to the healthcare professional is the lack of effect on PSA levels noted in the study. An important serum marker for prostate cancer, the findings of this study confirm the lack of effect for saw palmetto on PSA noted in earlier clinical trials.15-17

    While the liposterolic extract of saw palmetto at a daily dosage of 320 mg appears to be a safe and effective alternative to finasteride, future clinical trials should compare the herbal extract to the class of BPH drugs known as alpha-blockers (e.g. Cardura®, Flomax®, and Hytrin®) which are far more commonly prescribed than finasteride.
    -Donald J. Brown, N.D.

    References
     
  2. michael barry

    michael barry Senior Member

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    My remark:


    I wonder if taking 400 or so mgs in the morning and 400 at night would increase the serum levels of DHT down to around 70% or so? There is some indication that palmetto inhibits both type one and type two alpha five reductase, and frankly inhibition of type one isn't all that desirable in my opinion. There might be unfortunate sides to taking 700-800 mgs of the stuff though.


    It DID show some alpha five suppression in that study though. 32% and there were alot of test subjects in this study, not a mere 10 guys or some such.
     
  3. frailstar

    frailstar Established Member

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    Interesting, in doing my own research on different cultures with the best hair, I decided that getting your omegas in seemed the most important. That's when I decided that the best thing to eat for a vegan to get balanced omegas would be to eat pumpkin seeds.
     
  4. CCS

    CCS Senior Member

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    they took all that stuff and only reduced DHT 32%. Finasteride reduces the right kind of 5ar to reduce serum DHT 70%, and follicle DHT 80-90%. finasteride doses that reduce DHT less than 50% don't even slow down hair loss.
     
  5. RaginDemon

    RaginDemon Senior Member

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    If your hair follicles have weak resistence against DHT (genetic, illness) that 10% DHT thats not blocked by finasteride will still cause a lot of trouble.
     
  6. michael barry

    michael barry Senior Member

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    CCS,

    I was openly questioning whether higher amounts of SP would have a suppressive effect on DHT.

    The fatty acids that happen to occur in their free form are, of course, what should inhibit alpha five reductase therein SP, but they probably dont actually make up that much of the stuff. If someone took for instance, 400 mgs in the morn and 400 at night...................it would be interesting to see just how low their serum levels of DHT were.

    It may be as good as finas with higher doses, but then again it may not. We will never know unless someone tests this.



    If some nosy guy took some "STANDARDIZED" SP extract for a few weeks, and then got his DHT levels checked vs. his previous levels.................we could probably find out. However, even if SP worked as well as finas.........................as cheap as finas can be obtained online now in the form of generic proscar, Im not too sure it would really be a bit addition to the hairloss arsenal these days.
     
  7. mulder

    mulder Established Member

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    Herbalgram journal?? Why wouldn't they publish this study in something more reputable if it had more scientific merit?
     
  8. antonio666

    antonio666 Senior Member

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    there is no way that finasteride reduces follicle DHT anywhere near 90%,avodart only reduces 55% scalp DHT and probably a lot less follicl DHT.

    if finasteride reduced follicle DHT by 90% then it would completley cure balding nearly
     
  9. Bryan

    Bryan Senior Member
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    Why do you believe that?

    Do you think follicle means the same thing as scalp? :)

    Evidently not quite. For one thing, other androgens are probably involved in balding, too.
     
  10. abcdefg

    abcdefg Senior Member

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    Ive always suspected this to be true. My head stopped itching when i took 320 mg of saw palmetto and I guess I know why. Im not sure it was the type 1 enzyme or type 2 enzyme being inhibited but I think propecia might make my itchy head go away
     
  11. mogadon

    mogadon Established Member

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    does saw palmetto cause the same sexual sides as finasteride , anyone ?
     
  12. mulder

    mulder Established Member

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    Some claim it's actually an aphrodisiac. Since it theoretically is capable of blocking more androgen related sites than finasteride I would expect it to have more sexual sides...who knows.
     
  13. CCS

    CCS Senior Member

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    some say they get gyno from it. I'm happy with finasteride, though I guess some guys on here genuinely have side effects. I doubt most of the stuff I hear though.
     
  14. lazarus

    lazarus Member

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    That 32% reduction refers to DHT levels in prostate tissue samples, not serum DHT levels.

    The study showed that finasteride lowered DHT levels in both the prostate tissue samples and the serum level of DHT was "significantly reduced". On the other hand, "Treatment with SPHB led to no changes in prostate tissue levels of T or in serum levels of T or DHT."

    Actually, that 32% decline is stated as not being significantly different than the placebo group. This study does nothing to promote saw palmetto as an effective treatment for the prostate, never mind hair loss.
     
  15. antonio666

    antonio666 Senior Member

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    bryan ,follicle DHT is the most important factor and you think that finasteride would possibly block 90% follicle DHT,i don't think so if that were the case avodart woukld be the cure for hair loss
     
  16. michael barry

    michael barry Senior Member

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    lazarus wrote:



    That is a good point, and a weird one when you think about it. I wouldn't have even posted the study had I noticed that. When I saw the 32% and knew it was taken internally, I just assumed that it would have inhibited that much serum DHT also.

    What a strange phenomena. How in the world could the fatty acids in palmetto inhbit prostate alpha five, but not the other alpha five enzymes throughout the body when taken internally.......................................and the sample size of men was of quite a few men, so it can't be a fluke.

    Oh well, the SP was a nice thought. Scratch it off the list for hair..............
     
  17. michael barry

    michael barry Senior Member

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    lazarus wrote:



    That is a good point, and a weird one when you think about it. I wouldn't have even posted the study had I noticed that. When I saw the 32% and knew it was taken internally, I just assumed that it would have inhibited that much serum DHT also.

    What a strange phenomena. How in the world could the fatty acids in palmetto inhbit prostate alpha five, but not the other alpha five enzymes throughout the body when taken internally.......................................and the sample size of men was of quite a few men, so it can't be a fluke.

    Oh well, the SP was a nice thought. Scratch it off the list for hair..............
     
  18. michael barry

    michael barry Senior Member

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    I didn't notice that when I skimmed the article, the 32% reduction figure catching my attention.


    If I had, I wouldn't have even bothered posting it.



    What a strange thing that is, the fatty acids inhibiting alpha five, but only the alpha five in the prostate. It would almost lead one to believe their msut be some fundamental difference in prostate and other alpha five enzymes in the body, but then again finasteride blocks them both.


    Oh well, ..........................bummer for the SP.
     
  19. GhostInTheShell

    GhostInTheShell Established Member

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    So its best to take saw palmetto orally...or topically? i am going to add it in.
     
  20. abcdefg

    abcdefg Senior Member

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    I dont know. For me it was weird. I tried saw palmetto after much debate and it made my head really numb the itch i always had amazingly went away and so did the feeling in my private parts. It was very weird then gradually the itch slowly came back. I quit because it was a little weird and now placebo effect is very powerful its possible i imagined this but I really dont think i did. I had a weird thing happen to me that i dont want to get into but it proved to me saw palmetto definately effected my prostate and my head itch went away almost completely like it got numb. I started saw palmetto again after like 3 or 4 months but saw palmetto never had the same effect after using it for the first time. Science doesnt seem to agree with me and I cant say I understand any of it but thats what it did to me. whatever saw palmetto does it effected my prostate, and it also did something to my scalp. Somehow whether it be dht or something the prostate and hair are linked together somehow i now know that through my own experience.

    Oh yeah it also slowed my hairloss like the white flaky stuff and the shedding decreased noticeably when that happened but it went back after maybe 4 months or so even using saw palmetto kind of like the effect wore off. It has me thinking I should try propecia and i went to a derm and got a prescription for finasteride just not brave enough to use it based on this. One thing doesnt really mean another in the body like you might logically want to think

    I havent use any real treatment since. Of course now my head itches even using nizoral and countless shampoos like I did before. Saw palmetto is the only thing i ever used that made my itch go away almost completely. I still dont know if i imagined it or what.
     

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