Serenoa creeping - saw palmetto
Synonyms: saw palmetto, saw palmetto, saw palmetto

Characteristics: Serenoa creeper (Serenoa repens) is a low-growing palm tree found on the coasts of Florida and other southeastern states. Its dense growths can form an impenetrable thicket. The plant has a characteristic creeping trunk and fan-shaped leaves that have sharp serrated edges. The sweet-smelling fruits (stones) are dark brown to black. The fruits are harvested and dried in autumn for medicinal use, or serve as a source of nutrition for deer, bears, and wild boar. Serenoa was introduced into Western medical practice in the 1870s and was recommended for the treatment of urological diseases and the prostate. Interest in it has flared up like never before, so it ranks among the most widely used plants worldwide. Uses in traditional medicine also includes baldness, increased appetite, increased metabolism, thyroid disorders, asthma and polycystic ovary syndrome.

Part used: fruits

Ingredients: The fruits mainly contain free fatty acids (oleic, lauric, myristic, palmitic, linoleic, linolenic acid) and their ethyl esters, as well as phytosterols (beta-sitosterol, stigmasterol) and long-chain alcohols. In addition, flavonoids and polysaccharides were identified. Fatty acids help improve nerve signaling and reduce inflammation, phytosterols block the effects of androgens (male hormones), and flavonoids have anti-inflammatory and antioxidant properties.

Dietary supplements: Serenoa fruit extract is processed into capsules, soft capsules, powder or remains in the form of liquid extracts. There are also oil-based serums that are applied directly to the hair.

Effect: Serenoa is among the best researched alternative or complementary treatments for benign prostatic hyperplasia (BPH). Its active ingredients are believed to improve symptoms of BPH, including nocturia (nocturnal urination), frequent urination, decreased urine flow, incomplete bladder emptying, and urge to urinate. The substances contained show an antiandrogenic effect due to inhibition of the 5α-reductase enzyme and inhibition of the binding of dihydrotestosterone (DHT) to androgen receptors, as well as an anti-inflammatory and antiproliferative (anti-growth) effect. Binding to pharmacologically significant receptors in the lower urinary tract is also described. Through this action, serenoa contributes to the normalization of the functions of the prostate, urinary system, and reproductive system. Its effect was also tested in the therapy of androgenic alopecia, i.e. hair loss caused by an excessive reaction to androgens, especially DHT. Androgenic alopecia can also affect women and is a characteristic feature of the hormonal disorder polycystic ovary syndrome (PCOS). By suppressing androgens, serenoa is seen as a cheap and attractive alternative to prescription hair loss drugs (minoxidil and oral finasteride).

Recommended daily dose: Not established. Serenoa fruits are usually given at a dose of 1‒2 g/day; however, lipophilic extracts standardized to 25% fatty acids in dry extract are more common. A standardized extract of 320 mg/day is commonly used in clinical trials.

Adverse Effects: Results of clinical trials rate serenoa products as well tolerated, with occasional reports of gastrointestinal adverse effects (nausea, diarrhea) and headaches.

Interactions: Serenoa exhibits antiplatelet activity that may increase the risk of bleeding when used concurrently with anticoagulants (blood thinners).

Pregnancy: Information on safety and efficacy in pregnancy is lacking. Since effects on the metabolism of androgens and estrogens have been found and there is no reason for its use in pregnancy, serenoa should not be used.

Breastfeeding: Information on safety and efficacy during breastfeeding is lacking. Use is not recommended.

Warning: Use in children under 12 years of age is not recommended due to possible effects on androgen and estrogen metabolism. There is a case report of hot flashes in an 11-year-old girl using serena for hair loss. Patients with hormone-sensitive cancers, such as breast and prostate cancer, should consult with their oncologist before using serenoa.

Note: The prostate-specific antigen (PSA) test is a blood test that can help identify prostate problems, including BPH and prostate cancer. Serenoa has no effect on PSA levels when tested.