[Scotti]

2 more for the against:

Reading both of those articles, they both seem to me come back and contradict the findings of the studies. I'd be especially leery of ANY study conducted by an interested party (as was the case in the first article).

From the first article...

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.

From the second article...

There is one very serious flaw with both of these studies though, one which in my opinion should have precluded their being funded or published in such prestigious journals. Both used only a placebo control. In light of the existence of two classes of medications that are approved by regulatory agencies for treatment of BPH symptoms and are therefore supposedly effective for that condition, why not have a control group taking some kind of active medication?