The standardized extract of Saw Palmetto, (Permixon), has been extensively used for the prevention and treatment of hair loss since it first widely appeared on the European market some 17 years ago.
Its reported efficacy has gotten mixed reviews. Many have claimed to have gotten moderate to significant results, while others maintain it is completely useless.
There is only one study in the medical literature evaluating its effects on hairloss, and this study showed a positive result over a 6 month period. What is problematic about this study though is that one (not all) of the authors noted has a commercial interest in an oral, Saw Palmetto based, hair loss treatment product. This in itself may not necessarily negate the results.
Another study, sponsored by Merck, the manufacturer of both Proscar and Propecia, evaluated the ability of Saw Palmetto to improve BPH (prostate enlargement) symptoms and lower serum levels of DHT (dihydrotestosterone) compared to finasteride(Proscar/Propecia).
Not surprisingly, Saw Palmetto came out the big loser, as it showed no effect whatsoever on BPH symptoms and no effect on serum DHT levels, while finasteride dropped DHT by 65%.
This one study by Merck was unfortunately enough to cause many to abandon its usage.
Despite this negative result in a company sponsored study, subsequent studies showed Saw Palmetto to be at least as effective, and often superior to finasteride in its ability to mitigate the symptoms of BPH.
So what gives??
The significant part of the answer lies in one of its identified mechanisms of action. There is a common and erroneous perception that Saw Palmetto and Propecia work the same way.
Saw Palmetto, unlike finasteride (Proscar/Propecia), does not function as a 5 alpha reductase inhibitor that results in lower serum DHT (at least according to Merck). It works instead by reducing the uptake of DHT at the receptor sites by a factor of 40%.
Another erroneous perception is that Saw Palmetto somehow only inhibits androgen binding in Prostatic tissue, and somehow leaves other sites in the body unaffected. The following study shows a reduction of DHT in all tissue specimens evaluated.
Acta Obstet Gynecol Scand. 1988;67(5):397-9.
The effect of Permixon on androgen receptors.
el-Sheikh MM, Dakkak MR, Saddique A.
Department of Obstetrics and Gynaecology, King Khalid University Hospital, Riyadh, Saudi Arabia.
Permixon, the liposterolic extract of the plant Serenoa Repens is a recently introduced drug for the treatment of benign prostatic hyperplasia. The effect of Permixon on dihydrotestosterone and testosterone binding by eleven different tissue specimens was tested. The drug reduced the mean uptake of both hormones by 40.9% and 41.9% respectively in all tissue specimens. Since hirsutism and virilism are among other gynecological problems caused either by excessive androgen stimulation or excess endorgan response, we suggest that Permixon could be a useful treatment in such conditions and recommend further investigations of the possible therapeutic values of the drug in gynecological practice.
These findings would seem consistent with the many anecdotal claims made by female bodybuilders that Saw Palmetto reliably prevents the hair thinning and body hair growth (hirsutism) often induced by certain anabolic steroids.
So what does all this mean for hair loss treatment??
It would appear to indicate that Saw Palmetto is likely very useful as a hair loss intervention, however its ascertainable effects on hair, like any mild anti-androgen, take a long time (often 1 year or more) to manifest.
Not unlike Proscar , when it first came to market in ’92, many have tried Saw Palmetto for a few months, didn’t see visible results, and concluded it didn’t work. When Proscar(5X more finasteride than Propecia) was being experimented in the early years, prior to its FDA approval for hair loss, the consensus was that it useless, and a big disappointment. The reason for this was that the results for most were subtle and virtually undetectable for the first 6-9 months anyway.
As we all know, Proscar (5mg finasteride) went on to become FDA approved for hair loss at a 1mg dose,(Propecia) in ’98, a full 6 years after it came out.
I was personally fortunate enough(at least for my hair) to have stayed on both Saw Palmetto and a tablet of Proscar since ’92. In 2004 I dropped Proscar for prophylactic health reasons (having to do with elevated estrogen levels) and have since been on a Saw Palmetto/Pygeum/Nettle /Cernitin/Beta Sitosterol combo (amongst a plethora of other compounds) with no apparent detriment to my hair.
The fact is that anti-androgens by themselves are slow acting and very gradually produce subtle at best cosmetic results, and are generally far more useful for hairloss prevention and attenuation than they are for regrowth.
As such, Saw Palmetto, if continually used, will likely give results equivocal to Propecia, and due to its unique mechanisms of action, can be combined with Propecia and other treatments for an additive effect.
FEATURED TREATMENT COMPOUND:
NATURAL PROSTATE FORMULA – An advanced herbal DHT, aromatase, and estrogen blocking formula. This formula utilizes the CO2 extraction method on Saw Palmetto as opposed to the regular hexane extraction, yielding a pure more potent compound that has been shown to be more effective at inhibiting DHT recepror binding than regular Saw Palmetto Extract, (52%, as opposed to 40%). More importantly though, this formula contains a methanolic nettle root extract that is active in inhibiting estrogen binding to sex hormone binding globulin (SHBG).What does this have to do with hair loss??Through this binding activity researchers have shown in several tissue samples, including prostate and hair follicles, that estrogen is “capable of activating path ways normally considered androgen responsive.” It has been established in recent research that certain estrogen blockers grow hair, but the mechanism of action has not been fully understood.Most researchers now concede that DHT is not the sole hormonal trigger of hair loss.SHBG increases with age and with the presence of bound estrogen, can act like an additional androgen receptor. Aromatase inhibitors have been studied closely and have shown promise in generating hair growth (Dr. Sheffield).In addition to inhibiting the binding of SHBG, at least six constituents of the methanolic extract of nettle root inhibit aromatase reducing the conversion of androgens to estrogens. In all studies involving affects on SHBG and aromatase inhibition, the methanolic extracts and not the ethanolic extracts were shown to be effective.The ethanolic extracts were shown, in fact, to be inactive. The Natural Prostate Formula uses methanolic extracts of stinging nettle root, in addition to a more advanced extract of Saw Palmetto, and Pygeum Extract (a mild 5-alpha-reductase inhibitor, and anti-inflammatory). Beta Sitosterol, Pygeum, and Cernitin, all which down regulate androgen receptor activity, along with Boron, Lycopene, and Rosemary extract have been added. This synergestic formula is much more comprehensive than Saw Palmetto and will provide many a side effect free option of dealing with multiple hormonal facets involved with hair loss, not just DHT. Directions: Take two softgels, one in the a.m., one in the p.m.