High doses of saw palmetto don't impact serum PSA

(HealthDay)—Compared with placebo, saw palmetto, even at a dose as high as 960 mg, does not affect serum prostate-specific antigen (PSA) levels in men with lower urinary tract symptoms, according to research published in the February issue of The Journal of Urology.

Gerald L. Andriole, M.D., of the Washington University School of Medicine in St. Louis, and colleagues conducted the randomized, placebo-controlled Complementary and Alternative Medicine for Urologic Symptoms trial involving 369 men over the age of 45 with lower urinary tract symptoms. Participants were randomized to placebo or escalating doses of saw palmetto (320, 640, and 960 mg for 24 weeks each). Serum PSA levels were assessed at baseline, 24, 48, and 72 weeks.

The researchers found that, during the study, similar changes in PSA were observed, with a mean change of 0.16 ± 1.08 ng/mL and 0.23 ± 0.83 ng/mL in the placebo and saw palmetto groups, respectively (P = 0.50). When the groups were stratified by baseline PSA there was no differential effect on serum PSA between the treatment arms.

"The results of this study are clinically relevant to men's health. While convincing data have established the lack of therapeutic benefit of saw palmetto in alleviating lower urinary tract symptoms, many men continue to take this medication," the authors write. "By definitively establishing the lack of an effect on PSA by saw palmetto, even at supra-standard doses, our study confirms that clinicians need not adjust serum PSA in men taking this herbal supplement who opt to undergo such testing for prostate cancer early detection."

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