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Should saw palmetto be taken with or without food?

How should the supplement be taken? The fatty acids in Saw Palmetto are free fatty acids and as such are very acidic. If you ingest a lot of it, it could cause some stomach upset so it's recommended that it be taken with food.

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Saw Palmetto and prostate health

The good stuff is in the berries

Saw Palmetto is derived from the Serenoa repens, a low growing palm tree native to the the south-east region of the United States, particularly the Florida peninsula. The berries of the Saw Palmetto contain fatty acids, plant sterols and flavonoids and it's where we get Saw Palmetto Extract from. It is available as liquid extracts, tablets, capsules, and as a tea.

Traditionally used as a herbal medicine

Saw Palmetto has been around for a considerable amount of time and it has been traditionally used as a herbal medicine - American Indians used the fruit for food and to treat a variety of urinary and reproductive system problems. The Mayans drank it as a tonic, and the Seminoles (an indigenous tribe of Florida) used the berries as an antiseptic.

Now known as a treatment for an enlarged prostate

Nowadays Saw Palmetto is most well known as a treatment for an enlarged prostate. The prostate is a very important organ - it two purposes as both a muscle and a sex gland as part of the reproductive system. It is both a muscle and a gland and is located just below the bladder. A vital part of the prostate system is the urethra, a tube that carries urine and sperm out of the body. One of the prostate's main functions is to nourish semen, the fluid that keeps sperm healthy for fertilisation. A healthy prostate also has a built-in immune function. In a young man, the prostate is typically walnut-sized but it can balloon to about the size of an egg as a normal part of ageing. As the urinary tract runs right through the middle of the prostate, when the it starts growing or swelling it compresses the urethra and in doing so impedes the flow of urine. An enlarged prostate is also known as benign prostatic hyperplasia (BPH). Symptoms may include:

Needing to urinate frequently

Difficulty starting urination

Stopping and starting while urinating

Urinating frequently at night (nocturia)

Dribbling after urination ends

Being unable to empty your bladder

Blood in the urine (BPH can cause small blood vessels to burst)

Recurrent urinary tract infections (UTIs)

BPH is extremely common - symptoms usually develop around the age of 50 and by the age of 60 most men have some degree of BPH. At the age of 85, men have a 90% chance of having urination problems caused by BPH.

How does it work?

Research to date hasn't identified exactly how Saw Palmetto improves BPH, however a review of conventional drugs typically prescribed for enlarged prostate might help us understand to an extent.

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The primary types of drugs prescribed for BPH (or enlarged prostate) fall into the following two groups:

Alpha-blockers

5-alpha-reductase inhibitors

Alpha-blockers relax smooth muscles, such as your bladder and prostate thereby helping to improve urine flow. 5-alpha-reductase inhibitors, includes drugs like Avodart and Proscar. The prostate gland contains an enzyme called 5 alpha-reductase, which converts the male hormone testosterone to dihydrotestosterone (DHT). It's the pooling of DHT in the prostate that causes it to become enlarged. This type of drug inhibits 5 alpha-reductase, thereby blocking the conversion of testosterone to DHT and as a result may help to actually shrink the prostate. Saw Palmetto appears to work like Avodart and Proscar which prevent testosterone from being converted into dihydrotestosterone in the body. Some studies have shown Saw Palmetto to be as effective as Proscar - in fact a European study showed that half of German urologists preferred Saw Palmetto over pharmaceuticals for treatment of BPH. ​Interestingly one of the first prostate drugs on the US market was actually Saw Palmetto, released by Eli Lilly Company back in the early 1870s.

Other nutrients may heighten the benefits of the Saw Palmetto

More recent research suggests that certain nutrients may heighten the benefits of the Saw Palmetto - one of them is organic pumpkin seed oil is well known for its 5-alpha-reductase inhibition. The other nutrient that works well with Saw Palmetto is lycopene, and there's a growing body of evidence indicating that lycopene is beneficial for prostate health. Lycopene is a potent antioxidant – a super carotenoid – the activity of which has been suggested to be more powerful than that of other carotenoids, such as beta-carotene. Animal studies have shown that of all the carotenoids, lycopene is the one that accumulates in the prostate of male animals, and this is the case for humans too.

How should the supplement be taken?

The fatty acids in Saw Palmetto are free fatty acids and as such are very acidic. If you ingest a lot of it, it could cause some stomach upset so it's recommended that it be taken with food. Another reason it should not be taken on an empty stomach is due to that fact that it's a fat soluble supplement, so it will not absorb well without a little bit of fat.

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