S. repens is safe in its application .
We suggest that strong placebo effect , potentially influenced by positive patients ' expectation on S. repens , shapes both the clinical practice outcomes and the findings of clinical trials .
Hitherto , the totality of evidence continues to suggest that S. repens is a prudent therapeutic option as part of the naturopathic treatment for LUTS/BPH .
OBJECTIVES Benign prostatic hyperplasia ( BPH ) commonly affects men above 40 years old .
The progression of BPH is often accompanied with lower urinary tract symptoms ( LUTS ) that can significantly affect the quality of life of the patients .
Serenoa repens ( saw palmetto ) is a popular herbal remedy indicated for LUTS/BPH .
We review ed the current research on the efficacy of S. repens on LUTS/BPH as a monotherapy as well as combination therapies .
RESULTS The latest evidence , based largely on the Cochrane review , suggests that S. repens is not superior to placebo in treating LUTS/BPH as a monotherapy , even at double and triple doses .
Initial clinical trials on treatment of LUTS/BPH using S. repens with lycopene and selenium , as well as S. repens with Urtica Dioica , have shown positive results .
Treatment assignment guesses by study participants in a double-blind dose escalation clinical trial of saw palmetto.
OBJECTIVES This report assesses participant perception of treatment assignment in a r and omized , double-blind , placebo-controlled trial of saw palmetto for the treatment of benign prostatic hyperplasia ( BCM ) . DESIGN Participants r and omized to receive saw palmetto  were instructed to take one 320 mg gelcap daily for the first 24 weeks , two 320 mg gelcaps daily for the second 24 weeks , and three 320 mg gelcaps daily for the third 24 weeks . Study participants assigned to placebo were instructed to take the same number of matching placebo gelcaps in each time period . At 24 , 48 , and 72 weeks postr and omization , the American Urological Association Symptom Index ( AUA-SI ) was administered and participants were asked to guess their treatment assignment . SETTING S The study was conducted at 11 clinical centers in North America . PARTICIPANTS Study participants were men , 45 years and older , with moderate to low severe BPH symptoms , r and omized to saw palmetto ( N=151 ) or placebo ( N=155 ) . OUTCOME MEASURES Treatment arms were compared with respect to the distribution of participant guesses of treatment assignment . RESULTS For participants assigned to saw palmetto , 22.5 % , 24.7 % , and 29.8 % correctly thought they were taking saw palmetto , and 37.3 % , 40.0 % , and 44.4 % incorrectly thought they were on placebo at 24 , 48 , and 72 weeks , respectively . For placebo participants , 21.8 % , 27.4 % , and 25.2 % incorrectly thought they were on saw palmetto , and 41.6 % , 39.9 % , and 42.6 % correctly thought they were on placebo at 24 , 48 , and 72 weeks , respectively . The treatment arms did not vary with respect to the distributions of participants who guessed they were on saw palmetto ( p=0.823 ) or placebo ( p=0.893 ) . Participants who experienced an improvement in AUA-SI were 2.16 times more likely to think they were on saw palmetto . CONCLUSIONS Blinding of treatment assignment was successful in this study . Improvement in BPH-related symptoms was associated with the perception that participants were taking saw palmetto
S. repens is safe in its application .
We suggest that strong placebo effect , potentially influenced by positive patients ' expectation on S. repens , shapes both the clinical practice outcomes and the findings of clinical trials .
Hitherto , the totality of evidence continues to suggest that S. repens is a prudent therapeutic option as part of the naturopathic treatment for LUTS/BPH .
OBJECTIVES Benign prostatic hyperplasia ( BPH ) commonly affects men above 40 years old .
The progression of BPH is often accompanied with lower urinary tract symptoms ( LUTS ) that can significantly affect the quality of life of the patients .
Serenoa repens ( saw palmetto ) is a popular herbal remedy indicated for LUTS/BPH .
We review ed the current research on the efficacy of S. repens on LUTS/BPH as a monotherapy as well as combination therapies .
RESULTS The latest evidence , based largely on the Cochrane review , suggests that S. repens is not superior to placebo in treating LUTS/BPH as a monotherapy , even at double and triple doses .
Initial clinical trials on treatment of LUTS/BPH using S. repens with lycopene and selenium , as well as S. repens with Urtica Dioica , have shown positive results .