Serenoa repens,Sabal serrulata,Saw Palmetto Herb Extract Benefit.

Contents

• Saw Palmetto Botanical Info.
• Saw Palmetto Botanical Description.
• Life History and Saw Palmetto Population Biology.
• Saw Palmetto Physical Tolerances.
• Saw Palmetto Economic Importance.
• Standardization and Saw Palmetto Herb Extract Benefits?
• Saw Palmetto: Archeology and traditional uses.
• Saw Palmetto and Useful Phytochemicals.
• Structure of Fatty Acids and Steroids.
• Saw Palmetto: Famous function and application.
• Sex Hormone Problems and Saw Palmetto.
• BPH Management with Sawl Palmetto.
• Saw Palmetto Dosage and Functional Mechanism.
• Male Sexual Health and the Prostate Gland.
• Herbal Therapy for BPH:Classical Literature and Combinations.
• How Search engine think about Saw Palmetto and Fatty Acid.
• Research Update.
• Photo Gallery of Serenoa serrulata.

Herbal Therapy for BPH:Classical Literature and Combinations.:

Recent Research Update:

 Benign prostatic hyperplasia (BPH) is a common problem of aging for men. It has been proposed that the disorder has two phases, one that involves no clinical signs and the other that is manifested as disorders of urination from urinary tract obstruction by an enlarged prostate. In the first phase, there are microscopic changes within the prostate that may occur as early as the fourth decade of life and these may then be followed by macroscopic changes, namely enlargement of the prostate that typically begins during the fifth or sixth decade of life. However, clinical signs of the disorder occur only if the enlargement is substantial and becomes complicated by other disorders, such as prostatitis, or if the gland becomes hardened or deformed. The progression to clinical disease is most often seen after age 60. It is further suggested that while nearly all men will experience the microscopic changes in the prostate if they live long enough, only about half will experience prostate enlargement, and, of those, only about half will develop clinical symptoms. The question then arises: what causes the relatively common occurrence of prostate changes that lead to clinical disease?

 Epidemiological studies have demonstrated that many of the same risk factors associated with cardiovascular diseases apply as risk factors for BPH. These risk factors include obesity, hypertension, and diabetes. The diabetes connection is considered especially strong; the risk is non-insulin dependent diabetes mellitus (NIDDM), which often involves excessive insulin levels, a possible direct contributor to the growth of the prostate. As with cardiovascular disease, both exercise and moderate alcohol consumption appear to be protective for BPH. The influence of cigarette smoking on BPH has been unclear: some studies indicate a protective effect (there is a protective effect of smoking for ulcerative colitis that is well-established, so this result is not to be rejected out of hand), but other studies indicate a negative impact, at least for heavy smokers.

 Hormones affect the development and progression of BPH. Men with liver cirrhosis have a lower incidence of BPH than those who have normal liver function, probably because the liver damage reduces the metabolism of hormones to compounds that adversely influence BPH. Not all hormonal influences on BPH have been determined, but both sex hormones (estrogen, testosterone, prolactin) and insulin have been shown to have an effect thus far. In particular, it is thought that the conversion of testosterone to 5-alpha-dihydrotestosterone (DHT) may be a significant risk factor for BPH. The drug Finasteride suppresses DHT production by inhibiting the enzyme (5-alpha reductase) that converts testosterone to DHT, and this drug has been shown effective in reducing symptoms of BPH. DHT, produced in sebaceous glands, is also a contributor to male-pattern balding.

 It is not known whether herbal, nutritional, or drug treatments for cardiovascular disease would also have an impact on BPH. However, the alpha-adrenoceptor agonist drug (Doxazosin) used for treating hypertension also appears to have therapeutic value for BPH.


 Oriental Treatment:

 Chinese medical literature has been relatively silent on the problem of BPH. Disorders of urination have been noted since ancient times, classified as "lin" syndromes, which involve obstruction of urinary flow. In descriptions of the lin syndromes, most times the obstruction of urination is described as accompanied by symptoms that are not characteristic of BPH, such as blood in the urine or passing of stones or cloudy urine. Therefore, while BPH may have been experienced and treated as one of the lin syndromes, it is unclear whether any of the therapies were specific for BPH.

 Chinese clinical researchers have addressed the problem of prostate disorders, but usually include a broad range of problems-dominated by acute prostatitis-in the study group, for which differential diagnosis is applied. Typical therapeutic categories are: qi and blood stasis (obstructed circulation), damp-heat accumulation (swelling and fluid accumulation), and kidney deficiency syndrome (problems of aging; weak function of the kidneys). The formulas administered vary considerably, but most formulations for treating qi and blood stasis include vacarria (wangbuliuxing); virtually all formulations for treating damp-heat and urinary obstruction include plantago seed (cheqianzi). Kidney deficiency formulations (subdivided into yin and yang deficiency categories) for prostate disorders usually incorporate herbs for treating blood stasis and damp-heat as secondary components.

 It is possible that the microscopic changes in the prostate in the early development of the disease process are consistent with microcirculation changes that are normally treated with blood vitalizing herbs. Prostate enlargement is consistent with a damp-heat syndrome, since this syndrome is commonly associated with non-painful swelling in the lower abdomen. The final development of clinical symptoms of urination disorders corresponds closely with Chinese depictions of significant blood stasis and damp-heat coupled with weakening kidney qi. Thus, the three main diagnostic categories for prostate disorders described in the Chinese medical literature may have relevance to BPH in terms of its development over several decades, with a progression of each of the three syndromes. Based on such a scenario, the therapy for clinical BPH with Chinese herbs would involve a combination of treating kidney deficiency syndrome as a solution for the constitutional disorder associated with aging, along with blood vitalizing and damp-heat removing herbs as a treatment for the swollen prostate.

 In accordance with traditional Chinese medicine doctrine, each patient should be treated on the basis of his actual syndrome rather than by a set formula. For example, yin deficiency fire (treated by modification of Zhi Bai Dihuang Wan) or spleen and lung qi deficiency (treated by modification of Buzhong Yiqi Tang) could each be factors contributing to urinary disorders such as those seen with BPH. Nonetheless, most cases of BPH in essentially healthy men are likely to correspond to the disorder categories generalized above. Although the Chinese herb formulas appear to have the potential to increase testosterone levels (see Appendix 2), this change may not be sufficient to adversely affect BPH, especially if the herbs can also suppress conversion of testosterone to DHT, as suggested for Western herbs used in treating BPH.
 


 Western Herbal Remedy:

 The treatment of BPH became a medical issue during the same time that cardiovascular disease therapy came to the fore, mainly during the 1970s. In Germany, where herbal therapy (phytotherapy) was still pursued by the pharmaceutical industry, the use of herbs was investigated at the same time that other researchers pursued surgical and drug options.

 Dr. Hildebert Wagner, one of the leading proponents of phytotherapy (working at the Institute for Pharmaceutical Biology at the University of Munich), proposed investigation of the active components in Sabal serrulata for BPH in 1981. This herb, now referred to as Serenoa serrulata or, more commonly, as Serenoa repens, had been popular in the U.S. during the 19th century as a treatment for a variety of urino-genital disorders and had been mentioned as a treatment for prostate problems as early as 1899. The fruit of the plant, a small palm called saw palmetto (palmetto is Spanish for small palm; it has sharp, saw-like leaves) that is abundant in Florida, was used as a food for farm and ranch animals and as a medicine for humans. Research into the effects of Serenoa in Germany, and subsequently in many other European countries, appeared to confirm a positive action on BPH, so that this became the principal use of the herb. By 1995, saw palmetto had become one of the 10 most extensively-used Western herbs, with almost all of the commercial supplies going into products for BPH. The fruit is rich in sterols, which appear to be the primary active constituents. Although various proposals have been made as to how the sterols might affect BPH, the mechanism of action is still not clearly established. It is thought that the sterols may have, as one mechanism of action, the inhibition of DHT production.


 At the same time, other Western herbs were investigated, with most attention falling to pumpkin seeds (Cucurbita pepo), nettle root (Urtica dioica or Urtica urens), bee pollen (particularly that from the rye plant), African potato (tubers of Hypoxis rooperi), and the large high-altitude African tree Pygeum africanum, also known as Prunus africanum. In most cases, but particularly with pumpkin seeds and African potato, the main active components are understood to be the sterols, such as beta-sitosterol, which has been used as a therapeutic agent for BPH by itself. Triterpenoids in pygeum have also been proposed to be active components, potentially having the action of reducing prostate swelling.

 Among the Chinese herbs recommended for BPH, the iridoid glycosides may be the active components: these include aucubin from plantago seed, catalpol from rehmannia, and morroniside from cornus (an ingredient in the rehmannia formulas). Iridoids have not been found in the Western herbal therapies for BPH and represent a potential new area for future investigation. Iridoids are the recognized active constituents of the Western herb chaste tree berry, Vitex agnus costus, which has been shown to reduce prolactin levels in women; elevated prolactin may be a risk factor for prostate enlargement in men. Triterpenoids found in vaccaria and alisma (an ingredient in rehmannia formulas) could contribute to their therapeutic effects, in a manner similar to those suggested for pygeum.

 Today, products for BPH remain one of the primary commercial successes in the field of herbal medicine. The herbs are sold either individually or in combination products with 2 or 3 of the ingredients. The two most commonly-used substances, both as single herbs or in combination products, are saw palmetto and pygeum. The National Institutes of Health (NIH) have taken note of this and proposed to fund a large study of saw palmetto and pygeum (see Appendix 3). The usual amount of saw palmetto provided in clinical studies is 320-480 mg of extract per day, in two divided doses. The usual amount of pygeum extract used in clinical trials is 100-200 mg/day. Treatment time is from 45 to 90 days to obtain significant improvement in symptoms; treatment time of 6 months has been reported to have a lasting effect for at least 18 months. Adverse effects of the herb therapies for BPH have not been reported.
 


 Combinations for treatment Index:

 Appendix 1. Rehmannia Eight Formula and Its contents:

 Rehmannia Eight Formula is presented with some variations among the Chinese texts. The following is a representative formulation that can be used as a starting point for discussion of the ingredients and their effects:

 Rehmannia(shudi) 24%,Cornus(wuzhuyu) 16%,Dioscorea(shanyao) 16%,Alisma(zexie) 12%,Hoelen(fuling) 12%,Moutan(mudanpi) 12%,Aconite(fuzi) 4%,Cinnamon(guizhi) 4%

 The lead ingredient is cooked rehmannia, which is described in the Chinese tradition as a nutritive agent, alleviating dryness and promoting the functions of the liver and kidney systems (see Appendix 2 for further details). The remaining herbs of the formula can be understood as supporting the function of rehmannia. The small amounts of processed aconite and either cinnamon bark (rougui) or cinnamon twig (guizhi) serve as the hallmark of this particular rehmannia formula, one of numerous rehmannia-based combinations relied upon by Chinese doctors.

 The characteristics of rehmannia, for which the processed form (shudi) is used here, are: rich and moist quality, sweet taste, and warming nature. Rehmannia would be too thick and rich to offer as a single herb: it is said to have a "cloying" quality (being very sweet and moist). Therefore, the herb is combined with others that can balance and harmonize its actions.

 In particular, three of the herbs in this formula help to balance the rich, moist quality of rehmannia: alisma, hoelen, and dioscorea. These herbs:

 promote the function of the digestive system (thus helping it handle the rich tonic, which is otherwise somewhat difficult to digest, like a rich dessert);

 get rid of any excess moisture that may already be present (which, when combined with the moist rehmannia, would make an uncomfortable condition of fullness and tiredness); and

 assist the functions of the kidney system in a manner that compliments the tonic effect of rehmannia, namely by promoting its draining action (aiding elimination via urination).

 Chinese doctors point to the role of alisma in dissolving greasiness, which is useful in countering the thick, moist quality of rehmannia; additionally, it removes (via urination) turbid materials that accumulate in the body. Dioscorea also helps the body to eliminate excess moisture, especially from the digestive tract (where diarrhea can occur if the moisture accumulates). Hoelen is depicted as absorbing moisture, like a sponge, from places of accumulation, to deposit it where it is needed (e.g., to areas that are dry or areas that will lead to its elimination).


 The book Commonly Used Chinese Herb Formulas with Illustrations gives a listing of the Kanpo applications for Rehmannia Eight Formula as follows:

 1.Nephritis (nephrosclerosis, nephrolithiasis, nephrotuberculosis), pyelitis (nephroatrophy), albuminuria, and edema.
 2.Cystitis, cystolithiasis, cystotuberculosis, senile cystoatrophy, prostatomegaly, dysuria, urinary incontinence, and nocturia.
 3.Diabetes and urinary incontinence.
 4.Cerebral hemorrhage, arteriosclerosis, hypertension, and hypotension.
 5.Neurasthenia, amnesia, nocturnal emission, uncontrolled emission, impotence, and inappropriate erection of the penis.
 6.Lumbago, sciatica, deformed vertebra, numbness of the legs, and beriberi.
 7.Cataract, glaucoma, decrease of eyesight, and keratitis.
 8.Eczema, tinea, senile itching, vaginal itching, dry skin, and urticaria.
 9.Chronic gonorrhea, rectoptosis, climacteric disturbance and related disorders.

 The first three groups of indications are related to urinary system disorders (diabetes is included as a cause of frequent urination). In the original text presentations (Shanghan Lun and Jingui Yaolue), the principal applications of the formula were for syndromes that included urination disorders. The underlying causes of these urinary disorders were described in terms understood many centuries ago; today, it is believed that various diseases of the kidney, bladder, and prostate are responsible for most of the changes in urination.

 For the most part, the other indications given for the formula (items 4-9) are more recent applications (developed during the past 50 years). Some of these indications can be predicted on the basis of the herb ingredients and Chinese medical theories. For example, the kidney system is said to control sexual function and influence the lower back and legs (e.g., symptoms of impotence, low back pain, sciatica, and knee swelling would often be interpreted as arising from dysfunction of the kidney system), thus helping to explain most of the items listed in 5 and 6. Disorders that typically arise as part of the aging process, such as the cardiovascular diseases (item 4), the eye disorders (item 7), and the dry skin problems (item 8), are addressed, according to Chinese doctrine, by nourishing the kidney and liver, as accomplished by the rehmannia-based formulas.


 In the book, Kampo Treatment for Climacteric Disorders (22), Rehmannia Eight Formula is described as one for "conditions marked by degenerative changes and decline in functions, commonly associated with aging..." As a major indication, "limpness or pain in the lumbar region or knees" is cited, along with sensitivity to cold, abnormal urination, and a variety of symptoms such as impairment of vision or hearing, decline in mental abilities, dry itchy skin, and shortness of breath. The authors claim that the formula "can be more effective than conventional drug therapy in controlling and preventing complications of diabetes, such as peripheral neuropathy, nephropathy, and retinopathy." While the focus of their book is on climacteric syndrome (menopause), they also mention the "male menopause" conditions of impotence, prostatitis, and prostate hypertrophy as additional applications of the formula.

 In the book 100 Famous and Effective Prescriptions of Ancient and Modern Times (23), which depicts the practices in mainland China, Rehmannia Eight Formula is said to have the following indications:

 Insufficiency of kidney yang marked by lumbago, lassitude of the feet, cold feelings in the lower part of the body, cramping sensation in the lower abdomen, difficulty in urination or plenty of urination, impotence, pale and thick tongue proper, weak and fine pulse, as well as cough due to phlegm retention, diabetes, edema, chronic diarrhea...etc.

 For modern indications, the book relates a list somewhat similar in nature, though shorter, than that given by Kanpo practitioners: chronic nephritis, hypertension, diabetes, prostatic hyperplasia, postpartum retention of urine, pulmonary emphysema, neurosis, menopausal syndrome, and senile cataract. The book goes on to mention two clinical trials of the formula, one for treatment of cataract and the other for dysuria (due to prostatic hyperplasia); both are claimed to show positive results.
 


 Appendix 2. Rehmannia Phytochemicals:

 The main active constituents of rehmannia are iridoid glycosides. These are monoterpenes that have a glucose molecule attached. Catalpol was the first of these isolated from rehmannia (in 1969), and is the one present in largest amounts. There are more than a dozen iridoids that have been isolated from rehmannia, but the others are present in relatively minor quantities. In a study of several samples of rehmannia, it was found that catalpol makes up about 3-11% of the undried root content (depending on the growing conditions), with considerably less (about 1-2%) in the dried root: the drying process evidently destroys this component, converting it into another compound that may or may not be active.

 The pharmacological action of catalpol and the other iridoids is not fully established, but it appears that their main function is to stimulate production of adrenal cortical hormones. These hormones have anti-inflammatory action (explaining the claimed benefits of rehmannia for asthma, skin diseases, and arthritis) and are involved in the production of sex hormones (explaining the claimed benefit of treating menopause, impotence, and other signs of hormone deficiency). It is possible that anti-inflammatory effects could explain its early use in mending injuries, and the androgens that the adrenal gland might yield could increase muscle mass. The adrenal steroids may then serve as precursors to production of sex hormones. Rehmannia Eight Formula was tested in aged rats. It was shown to increase estradiol level of the serum in female rats and to raise serum testosterone in male rats.

 One of the iridoid glycosides that is found in small amounts in rehmannia and scrophularia is aucubin. It is very similar to catalpol and is also an active ingredient of the rarely used herb Acuba japonica, a close relative of cornus (which contains secoiridoid glycosides) that is used in many rehmannia formulas; aucubin is also present in the more commonly used plantago seed. Both aucubin and geniposide have been shown to have liver-protective actions.

 Appendix 3. Alternative Therapies for Benign Prostate Symptoms-Clinical Trials Consortium:

 The Division of Kidney, Urologic and Hematologic Diseases (DKUHD) of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Center for Complementary and Alternative Medicine (NCCAM), and the Office of Dietary Supplements (ODS) invite cooperative agreement grant applications to establish a research consortium to conduct a randomized controlled clinical trial of Serenoa repens (saw palmetto) and Pygeum africanum in men with benign prostatic hyperplasia (BPH). The plan is to spend $29 million over the next seven years.


 As the population ages the number of men with lower urinary tract symptoms indicative of BPH is expected to increase substantially. The segment of the United States population that utilizes alternative and complementary approaches to disease prevention and management is also increasing rapidly, including the use of phytotherapy to control the symptoms of BPH. The most common phytotherapeutic agent is Serenoa repens or saw palmetto. Pygeum africanum is also frequently used in this country for the same purpose. Little is known, however, about the long-term effects of these agents on the lower urinary tract symptoms experienced by men with BPH since rigorously conducted clinical trials for these agents have not been conducted.

 In order to determine the effect of Serenoa repens and Pygeum africanum on the clinical progression of BPH the NIDDK and the NCCAM plan to establish a clinical trial consortium to conduct a large simple placebo-controlled clinical trial of these two agents comparing saw palmetto to placebo, and Pygeum to placebo. A secondary analysis will include head-to-head comparison of the two phytotherapy agents. The collaborative research group will consist of Clinical Evaluation and Treatment Centers (CETCs) to design and conduct the clinical trial and a single Data Coordinating Center (DCC) to collect, store, and analyze data generated by the CETCs.

 More than one-half of the men 50 years of age or older have lower urinary tract symptoms associated with the development of benign prostatic hyperplasia (BPH). The condition accounts for at least 1.7 million office visits per year in the United States with estimated health care costs exceeding $4 billion a year. In addition, these symptoms have been shown to have a significant negative impact on patient-reported quality of life and psychological well-being. The use of alternative therapeutic agents to relieve the symptoms of BPH is increasing very rapidly. In 1996 extracts of the saw palmetto berry was the 9th most common herbal remedy sold in the U.S increasing to the 5th most common in 1997. It is anticipated that the use of alternative therapies for BPH will continue to increase substantially as the U.S. male population continues to age.


 Despite the widespread use of phytotherapy for BPH in the United States, most physicians are reluctant to either discuss or recommend their use since only a modest number of published reports have appeared in the peer-reviewed medical literature about their efficacy. Moreover, very few have met rigorous standards for reporting the results of clinical trials. Nonetheless, the available literature supports the hypothesis that these compounds may have some beneficial effects on BPH symptoms. This is supported by a recent meta-analysis that suggests that Saw palmetto improves urinary flow-rate and nocturia in men with symptoms of BPH. However, there are no statistically significant reports of rigorously conducted clinical trials on the long-term effects (both beneficial and adverse) and on patient-reported outcomes.

 The objective is to determine if Serenoa repens and Pygeum africanum prevent the clinical progression of BPH, as defined by the development of one of the following: acute urinary retention, renal insufficiency (due to BPH), recurrent urinary tract infections, incontinence, or an increase in the American Urological Association (AUA) symptom score index of four or more points. This definition of the clinical progression of BPH is identical to that used in a soon-to-be-completed clinical trial supported by the NIDDK, the Medical Therapy of Prostatic Symptoms (MTOPS) Trial. Results from the MTOPS Trial, in particular the event rate among the placebo group, will be made available to investigators participating in this consortium to assist in refinement of the trial design. The investigators participating in this consortium will design and conduct a large simple clinical trial. It is envisioned that the clinical trial will require a total of approximately 3,100 men with BPH who will be randomized over a two-year period. The clinical trial will be double-masked and placebo controlled. It is expected that each CETC will recruit and follow-up 300 men for the duration of the trial. Men will be followed for a minimum of four (4) years and a maximum of six (6) years post-randomization. Innovative methods will be required to implement this clinical trial including recruitment of a large number of men with symptoms of BPH, use of multiple strategies to promote long-term adherence to these agents, maintenance of high rates for clinic visits, and complete ascertainment of endpoints


 Appendix 3. Classical Combinations Plus:

 Saw Palmetto (Serenoa Repens 35-45% fatty acids) 160 mg
 Small Flover Willow (Epilobium Parviflorum organic) 150 mg
 Stinging Nettle (Urtica Dioica 5% amino acids , 1.97% sitosterol 120 mg
 Juniper Berries (Juniperus Communis) 110 mg
 Cornsilk (Zea Mays) 100 mg
 Buchu Leaves 60 mg
 Pygeum Africanum (5% Beta-sitosterol) 50 mg

 Saw palmetto extract (SPE) should now be considered a treatment option for men with symptomatic BPH, absent complications of the disorder. SPE is extremely safe; it is likely to exert positive effects; many patients want it; and more potent remedies, i.e., drugs or surgery, are generally not required in most BPH cases. A recent meta-analysis of SPE trials from Europe (where nearly all previous studies originated) was published in a recent issue of the Journal of the American Medical Association concluding that SPE improves urinary flow and decreases prostate symptoms in men with BPH.

 Non-malignant hypertrophy of the prostate affects slightly more than half of all men between the ages of 40 and 60. For these men, urination is more difficult; they experience incomplete emptying of the bladder during urination, and painful and more frequent urination at night. Infection, incontinence and urinary bleeding usually follow. Scientists associate this disease with an excess of testosterone in the form of dihydrotestosterone (DHT). Testosterone is transformed in to DHT by 5-alpha-reductase (5-AR), which increases in men as they grow older. Though extremely common, this disease can be prevented or treated if caught in time.


 Willow-herb (Epilobium parviflorum), one of the fetish plants of the celebrated Maria Treben, has provided the traditional treatment for prostate problems. This plant is also an ingredient in the famous elixir, Swedish bitters. Recent research, notably at the Universite de Lausanne, maintains that willow herb has anti-inflammatory properties and an inhibitory effect on the enzymes that transform testosterone into DHT. It is therefore a tonic for the prostate.

 Epilobium parviflorum is a plant used in Central Europe for the treatment of prostate disorders. Research has shown it to inhibit the conversion of testosterone to dihydrotestosterone (DHT) by activity of 5-alpha-reductase and aromatase((the group of enzymes that catalyze the conversion of testosterone to estradiol) ), two enzymes which are involved in the development of benign prostatic hyperplasia (BPH). The main polyphenols responsible for the inhibition of the these enzymes have been identified as oenothein A and oenothein B, which have been identified in Epilobium parviflorum plant extracts. Epilobium fatty acids contents also inhibits the production and release of prostaglandin D2 and of prostaglandin E2.

 Actions: antiadenomic, anti-androgenic, anticancer, antiedemic, antiestrogenic, anti-inflammatory, antiprostadenomic (inhibitts prostate cancer), antiprostatitic, antitumor, bactericide, inhibits formation of dihydrotestosterone (DHT), liver protectant, prostate cancer preventative, reproductive alterative, uterosedative
 Traditional use: benign prostatic hypertrophy (BPH), epididymitis, gynecomastia, nocturia, orchialgia, orchitis, painful menstruation, prostatitis, impotence, sex hormone disorders, testicular atrophy, urinary tract infection


 Pygeum Africanum:

 While saw palmetto extract is the far better known herbal medication to reduce the size of an enlarged prostate, pygeum may in many cases be superior for the treatment of the condition. Pygeum is an evergreen tree found in the higher elevations of central and southern Africa. Its bark, once used as a tea for relief of urinary disorders, has been found to contain not one, but three types of compounds that relieve the symptoms of prostate enlargement BHP (benign prostatic hyperplasia).

 Pygeum contains three groups of active components: Phytosterols such as beta-sitosterol; pentacyclic triterpenoids, such as ursolic and oleanic acids; and ferulic esters of fatty alcohols, particularly the ferulic esters of docosanol and tetra-cosanol. The phytosterols constituents, beta-sitosterol and beta-sitosterone , particularly beta-sitosterol are found in numerous plants and are anti-inflammatory, inhibiting the synthesis of prostaglandins. Beta-sitosterol, the most important of the three, interferes with the formation of prostaglandins that cause inflammation and swelling in the prostate. Beta-sitosterol has been shown to be useful in cases of BPH by helping to reduce the normally elevated levels of prostaglandins in these patients. The elimination of the excess blood and vasal congestion helps reduce the size of prostate adenomas. The pentacyclic triter-penoids (urosolic, oleanic and crataegolic acids), also help inhibit inflammation by blocking enzymatic activity. They are effective anti-edema agents and also help increase the integrity of small veins and capillaries. The third active group, the ferulic esters (n-docosanol and tetracosanol), long-chain fatty acids, act by inhibiting the absorption and metabolism of cholesterol and combat enlargement by reducing levels of prolactin, a hormone which promotes uptake of growth-promoting testosterone in the prostate. Both prolactin and cholesterol increases binding sites for DHT in the prostate. BPH and other cases of enlarged prostates are characterized by containing abnormally high levels of cholesterol. Pygeum also inhibits protein kinase C-induced proliferation of prostate cells


 European scientists were so impressed with reports of pygeum's actions that they began laboratory investigations into the active constituents in the bark. This led to the development of the modern lipophilic (fat soluble) extract used today.

 Pygeum africanum extract is available in many countries, including those in central and eastern Europe, for the treatment of mild to moderate BPH. Its efficacy and acceptability have been demonstrated in numerous open and placebo-controlled studies in large populations. The present open three-centre efficacy and safety study was conducted according to common protocol at urology clinics in the Czech and Slovak Republics and in Poland, in order to confirm the therapeutic profile of Pygeum africanum in conditions of daily practice, using International Prostate Symptom Score (IPSS) and flowmetry assessments. The changes in subjective scores, IPSS and QoL (quality of life) after the two-month treatment period were highly statistically significant with mean improvements of 40% and 31%, respectively. Nocturnal frequency was reduced by 32% and the mean reduction was again highly statistically significant. Mean maximum urinary flow, average urinary flow and urine volume were also statistically significantly improved, but the modest improvement in post-voiding volume did not reach statistical significance. The improvements, which exceeded those observed with placebo in earlier studies, were maintained after one month without treatment indicating an interesting persistence of clinically useful activity. Prostatic volume and quality of sexual life remained unchanged throughout. No treatment-related adverse effects were observed. In conclusion, under conditions of daily practice, Pygeum africanum extract induces significant improvement in IPSS and uroflowmetry parameters. These positive effects are accompanied by a very satisfactory safety profile with the overall result of a substantial improvement in QoL.

 A study by Swiss researchers R. Hartmann et al. demonstrate that extracts of pygeum (Pygeum africanum Kalkman, Rosaceae) and nettle root (Urtica dioica L., Urticaceae) partially blocked the action of two enzymes involved in the body's production of dihydrotestosterone and estrogen. The in vitro (laboratory) study showed that both pygeum and nettle root extracts were effective in inhibiting these two enzymes (5alpha-reductase and aromatase) and that a combination of the two plant extracts was significantly more effective than either extract individually in blocking aromatase activity.


 Stinging nettle (Urtica dioic) and the bark of Pygeum Africanum both have anti- inflammatory and decongestant (anti-edema) properties.

 Nettle root extract was effective only at high concentrations, while pygeum extract showed "a much higher efficacy" at lower doses. The combination of the two extracts was as effective as pygeum against 5 a-reductase and significantly more effective than either against aromatase. This study supports the use of combinations of these two ingredients in the treatment of BPH. This is especially important because pygeum bark is both expensive and limited in supply, while nettle roots are easily produced on a large scale.

 Stinging nettle root contains both acid and neutral polysaccharides (2 glucans, 2 glucogalacturonans, and 1 arabinogalactan); sterols (0.2-1% 3-b-sitosterol, 0.05-0.2% sitosterol-3-b-D-glucoside); 0.1-0.2% lectin U. dioica agglutinin or UDA composed of six isolectins; coumarin (approximately 0.002-0.01% scopoletin); phenolic acids, phenylpropanoid aldehydes, and alcohols; lignans (neo-olivil and derivatives); fatty acids; tannins; and monoterpenes and triterpenes (Bruneton, 1995; ESCOP, 1997; Leung and Foster, 1996; List and H"rhammer, 1979; Newall et al., 1996; Wichtl and Bisset, 1994).

 Stinging nettle root reported increased urinary volume, increased maximum urinary flow, and reduced residual urine activities. Note: This preparation relieves the symptoms of an enlarged prostate without reducing the enlargement. Please consult a physician at regular intervals.

 The British Herbal Pharmacopoeia reported prostatic action (BHP, 1996). Preliminary clinical observations of men after long-term treatment with an alcoholic extract of nettle root reported improvement of bladder outlet obstruction symptoms and decrease in post-voiding residual urine (Bruneton, 1995). A study of BPH patients treated with a nettle root alcoholic fluidextract reported a 66% decrease in residual urine; another study reported a reduction of nocturnal micturition frequency in patients over 60 years of age after six months of treatment with a nettle root alcoholic tincture at 5 ml daily (ESCOP, 1997; Leung and Foster, 1996). The active substances responsible for these actions are unknown, which makes quality control and chemical or biological standardization of extracts difficult (Bruneton, 1995; Wichtl and Bisset, 1994).


 Uses:Stinging nettle root approved the internal use for difficulty in urination in benign prostatic hyperplasia stages 1 and 2.

 ESCOP indicates its use for symptomatic treatment of micturition disorders [nocturia (excessive nighttime urination), pollakisuria (frequent urination), dysuria (painful urination), or urine retention] in BPH stages 1 and 2 (ESCOP, 1997). The French Herbal Remedies Notice to Applicants for Marketing Authorization allows two uses of nettle root: as an adjunctive treatment for the bladder outlet obstruction symptoms of prostatic origin, and to enhance the renal elimination of water (Bruneton, 1995). It is used as a diuretic for conditions of dropsy and also for early stages of prostatitis. In African medicine it is used to treat diarrhea and as an anthelmintic to expel intestinal worms (List and H"rhammer, 1979).

 Corn Silk:  As a soothing diuretic, Corn Silk is helpful in any irritation of the urinary system. It is used for renal problems in children and as a urinary demulcent combined with other herbs in the treatment of cystitis, urethritis, prostatitis and the like. Ellingwood suggests Corn Silk in the following conditions: catarrhalcystitis, lithaemia(stones), bladder irritation, gonorrhoea, all catarrhal conditions of the urinary passages, dropsies due to heart disease, edema.

 Constituents : Saponins, Allantoin, Sterols, especially [[beta]]-sitosterol and stigmasterol, the alkaloid hordenine, Vitamins C and K, cryptoxanthin, anthocyanins, plant acids.


 Buchu (Barosma betulina):

 The standard Buchus of commerce are obtained from three species: Barosma betulina, known as 'shorts'; B. crenulata, known 'ovals' and 'shortbroads,' and B. serratifolia, known as 'longs.' The leaves of the firstnamed are most valued and constitute the foliea buchu of the British Pharmacopoeia. The Hottentots use several species, all under the common name of 'Bucku.' The leaves have a rue-like smell, and are used by the natives to perfume their bodies. Buchu leaves are collected while the plant is flowering and fruiting, and are then dried and exported from Cape Town. The bulk of the Buchu exported to London from South Africa eventually finds its way to America, where it is used in certain proprietary medicines.

 The principal constituents of Buchu leaves are volatile oil and mucilage (volatile oil: diosphenol (=buchu camphor), pulegone, (+) and (-) isopulegone, 8-mercapto-p-menthan-3-one, responsible for the black currant type odour; 8-acetylthiomenthone, piperitone epoxide (+)-menthone, (-)-isomenthone, p-cymol, limonene, terpineol, flavonoids: rutin, diosmin, hesperidin, quercitin and derivatives miscellaneous: vitamins of the B group) tannin and mucilage., also diosphenol, which has antiseptic properties, and is considered by some to be the most important constituent of Buchu its absence from the variety known as 'Long Buchu' has led to the exclusion of the latter leaves from the British Pharmacopoeia.


 The Cape Government exercises strict control over the gathering of Buchu leaves and has lately made the terms and conditions more onerous, in order to prevent the wholesale destruction of the wild plants, no person being permitted to pick or buy Buchu without a licence. Cultivation experiments with Buchu have been made from time to time by private persons, and during the war experiments were conducted at the National Botanic Gardens, Kirstenbosch (near Cape Town), the result of which (given in the South African Journal of Industries, 1919, 2, 748) indicate that, under suitable conditions, the commercial cultivation of Buchu should prove a success, B. betulina, the most valuable kind, being the species alone to be grown. The plant is particularly adapted to dry conditions, and may be cultivated on sunny hillsides where other crops will not succeed.

 Buchu has long been known at the Cape as a stimulant tonic and remedy for stomachic troubles, where it is infused in Brandy and known as Buchu Brandy. Its use was learnt from the Hottentots. It was introdueed into official medicine in Great Britain in 1821 as a remedy for cystitis urethritis, nephritis and catarrh of the bladder.

 Buchu may be used in any infection of the genito-urinary system, such as cystitis, urethritis and prostatitis. Its healing and soothing properties indicate its use together with other relevant remedies in many conditions of this system, especially useful where dysuria is part of the symptom picture. The oil content may be too irritating for people with a history of major kidney disease. Ellingwood says that " it acts directly upon the urinary apparatus, stimulating the kidneys . . . by its tonic and restorative influence. It relieves irritation of the bladder and urethra, and is valuable in catarrh of the bladder, pyelitis and gonorrhoea."


 Jupiter (Juniperus communis) and Indian corn stigma (zea mays) are excellent diuretics and help prevent inflammation of the gallbladder.

 Juniper Berries make an excellent antiseptic in conditions such as cystitis. The essential oil present is quite stimulating to the kidney nephrons and so this herb should be avoided in kidney disease. The bitter action aids digestion and eases flatulent colic. It is used in rheumatism and arthritis. Externally, is eases pain in the joints or muscles.

 Constituents :

 Volatile oil, containing mainly myrcene, sabinene andx-pinene, with 4-cineole, p-cymene, camphene, limonene, [[beta]]-pinene, terpin-4--ol, y-terpinene, x-thujene.

 Condensed tannins; (+)-afzelechin, (-)-epiafzelechin, (+)-catechin, (-)-epicatechin, (+)-gallocatechin and (+)-epigallocatechin l, 4-dimethyl-3-cyclohexen-l-yl, methyl ketone

 Diterpene acids; myreocommunic, communic, sandaracopimaric, isopimaric, torulosic acids and other diterpenes such as geijerone. Miscellaneous; sugars, resin, vitamin C.

 But without question, the ingredient that makes the leading contribution to our formula for prostate protection is extract of palmetto leaf or saw palmetto (Serenoa repens). In recent years, it has been extraordinarily popular in Europe and North America in the treatment and prevention of prostate problems. Researchers have discovered that this plant blocks 5-AR activity, thereby lowering production of DHT, which causes hypertrophy of the prostate. European studies have shown that in the treatment of non-malignant hypertrophy of the prostate, palmetto leaves are just as efficient as conventional synthetic drugs, though they do not have any undesirable secondary effects.

Reference:

• Serenoa repens,Sabal serrulata,Saw Palmetto Herb Extract Benefit.

This article written and edited via herbalist of MDidea Extracts Professional. They run a range of online descriptions about this herb,including general information related and summarized updating discoveries from findings of professional scientisits this field related.Describe style aimed to form a useful detecting literature space where the intertwined threshold and related questions raise out and visualize themselves.

♣ last edit date:08th,Oct.2010.