Saw palmetto, or Serenoa repens, is a low-growing palm tree found along the southern Atlantic and Gulf coasts of the United States. Extracts of saw palmetto berries are widely used to treat a condition called benign prostatic hyperplasia, or BPH, in men. According to a May 2008 "American Family Physician" review, 20 percent of 40-year-old men and 90 percent of 70-year-old men suffer from BPH. BPH can occasionally cause bloody urine, or hematuria, and at least one case of hematuria has been attributed to the use of saw palmetto.
BPH
Often considered a normal consequence of aging, benign prostatic hyperplasia is characterized by enlargement of your prostate gland, a doughnut-shaped organ at the base of your bladder and surrounds your urethra, which is the tube that drains urine from your bladder. Compression of your urethra and bladder by an enlarging prostate leads to urinary urgency, a slow stream, urinary dribbling and incomplete bladder emptying. Although the American Urological Association does not recommend its use, saw palmetto compares favorably to some prescription drugs for improving BPH symptoms.
Hematuria
Hematuria is a general term used to describe varying amounts of blood in your urine. Microscopic hematuria --- blood that cannot be detected with the human eye --- can stem from numerous causes, ranging from the harmless, such as BPH or strenuous exercise, to life-threatening, such as cancer. Gross hematuria --- blood you can see when you urinate --- often indicates more serious problems, such as cancer of the bladder, prostate or kidney. Dr. Peter Choyke at the National Cancer Institute in Bethesda, Maryland, states that all cases of hematuria require a thorough medical evaluation.
Increased Bleeding
In 2009, physicians at the Puerto Rico Health Science Center in San Juan, Puerto Rico, described the case of a man who developed blood clotting abnormalities while taking saw palmetto for BPH. His increased tendency to bleed resulted in hematuria, and the ensuing medical evaluation implicated saw palmetto as the cause of the clotting abnormality. Another case, reported in the August 2001 issue of "Journal of Internal Medicine," involved a man who, during surgery for a brain tumor, developed life-threatening bleeding as a result of taking saw palmetto for BPH.
Considerations
Saw palmetto is a widely used alternative remedy for benign prostatic hyperplasia, a common condition in older men. Saw palmetto can interfere with blood clotting, and its use has been associated with hematuria. However, hematuria can arise from many causes, some of which can be life-threatening. If you are taking saw palmetto for BPH and you have developed hematuria, see your physician immediately. Even if your hematuria resolves when you stop using saw palmetto, your doctor may recommend a thorough evaluation to rule out more serious problems.
References
- "American Family Physician"; Diagnosis and Management of Benign Prostatic Hyperplasia; J.L. Edwards; May 2008
- "Boletín de la Asociación Médica de Puerto Rico"; Coagulopathy Induced by Saw Palmetto: A Case Report; S. Villanueva, J. González; Jul-Sep 2009
- "American Family Physician"; Radiologic Evaluation of Hematuria: Guidelines from the American College of Radiology's Appropriateness Criteria; P.L. Choyke; August 2008
- "Journal of Internal Medicine"; Intraoperative Haemorrhage Associated with the Use of Extract of Saw Palmetto Herb: A Case Report and Review of Literature; P. Cheema, et al.; August 2001
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