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NMU – 230 Saw palmetto in the Prevention and Treatment of Prostate Enlargement

Nutrition/Natural Medicine Update No 230

(February 8, 2022)

with Dr. James Meschino


Topic: Saw palmetto in the Prevention and Treatment of Prostate Enlargement

Source: Food Science Biotechnology Journal (2019)

As reported in the 2019 review article in the journal Food, Science Biotechnology, nearly all men develop signs and symptoms of prostate enlargement by age 80.  But does it have to be that way? More and more studies are showing that the prostate gland is very much influenced by dietary and lifestyle factors, in addition to the aging process itself. Studies are showing that there are lifestyle practices that can help prevent prostate enlargement, reverse prostate enlargement, and protect the prostate from other undesirable outcomes. How does all this work? As men age, prostate cells typically convert more testosterone into dihydrotestosterone (DHT), which causes prostate cells to divide at a faster rate. This increases the number of prostate cells, and hence, the size of the prostate gland increases. An enlarged prostate (known as Benign Prostatic Hyperplasia BPH) puts pressure on the urethra, inhibiting normal urination. So, typical symptoms of an enlarged prostate include a weaker urine stream, difficulty initiating urination, and incomplete voiding of the bladder, leading to more frequent bathroom visits. Over the years many studies have shown that the natural agent Saw palmetto, can reverse many cases of mild to moderate prostate enlargement problems. In fact, the use of Saw palmetto as a medical treatment for prostate enlargement is very common in various European countries. The 2019 review of saw palmetto and prostate enlargement highlighted three important mechanisms through which Saw palmetto has been shown to prevent and treat benign prostatic hyperplasia (BPH).

These include:

1. Blocking the conversion of testosterone into the more harmful DHT. Fatty acids and sterols in Saw palmetto inhibit the enzyme (5- alpha-reductase) that converts testosterone into DHT. By blocking DHT build-up, it helps prevent the prostate cells from dividing too quickly and leading to  prostate enlargement, and this effect has been shown to help reverse mild to moderate BPH problems in various human clinical studies.

2. Induces programmed cell death of human prostate cancer cells. Experimentally, some constituents in Saw palmetto have been shown to cause human prostate cancer cells to commit suicide (apoptosis), which may imply that Saw palmetto can also help to prevent prostate cancer from developing to some degree.

3. Anti-inflammatory effects. Saw palmetto is also shown to produce anti-inflammatory effects on the prostate gland, which has also been identified as a means to help prevent and treat prostate enlargement problems.

In my view, because men over the age of 40 tend to increase concentrations of DHT in their prostate glands, it makes sense to be proactive and help the body keep this dangerous hormone in check. Eating soy foods on a regular basis is one way to do this, as soybeans contain isoflavones, which are also shown to block the conversion of testosterone into DHT in prostate cells. But taking a supplement that contains the standardized grade of Saw palmetto, along with other synergistic natural agents that support prostate health makes good sense to me. I personally like a supplement product that combines the following prostate support nutrients:

  • Saw palmetto extract
  • Beta-sitosterol
  • Pygeum africanum
  • Soy Extract
  • Stinging Nettle

I recommend this combination to all my male patients who are over the age of 40. Each of these nutrients has shown benefit in clinical studies in men with BPH. But I think that preventing prostate enlargement in the first place should be a priority for all men, and the fact that some of these natural agents also show promising anti-cancer effects in prostate research studies makes this strategy even more compelling in my view. I have included the 2019 review article reference on Saw palmetto and benign prostatic hyperplasia in the text below. I think this is a very important topic to be aware of for all men over the age of 40.


Kwon Y. Use of saw palmetto (Serena repens) extract for benign prostatic hyperplasia. Food Sci Biotechnol. 2019; 28(6): 1599-1606


Eat Smart, Live Well, Look Great,

Dr. Meschino

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