July 1, 2025 • 58 mins
This episode will be looking at another herb of the world: saw palmetto or Serenoa repens. This is a well known herb used for over 2,000 years and has a modern reputation for treating prostatic hyperplasia or enlarged prostate. As always, we will do our deep dive into this herb and look at its traditional uses, and its preparation, interactions, and cautions and see if the science supports its use. And, as usual, we will be adding something a little different…We are going to revisit artificial intelligence and see if it is any better at giving us good information on herbs. Each episode of the podcast will go into great depth about a single herb or formula. Besides covering the basics of herbology including category, and functions, we will explore the history, quality, science, pharmacology, evidence, and any potential interactions of each herb or formula. Please join us, it is going to be another interesting rocket ship into the exciting solar system of herbs as we look at saw palmetto or Serenoa repens!
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Episode Transcript
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Speaker 1 (00:00):
Verbs that Angelica Sperver Hi, and welcome to episode eighty
eight of Sperbs Herbs. Today we're going to be talking
about an incredibly popular herb. Uh some one of my
(00:21):
sources said it was the top five other sources top
ten herbs western herbs in the US and Europe, and
that is saw palmetto or seran noa repens, I believe
is how it's pronounced, and without further too, let's get
into what that means. So today's episode we'll be looking
at another herb of the world, saw palmetto or serranoah repins.
(00:44):
This is a well known herb used for over two
thousand years. So you know, when I wrote this blurb,
I did a quick search and I found some someone
that said it was used for over two thousand years,
and my research probably wouldn't disagree with it, but it
didn't quite get as they did. The whole episode wasn't
(01:05):
quite two thousand years. We'll talk about that as we
talked about the history of this herb, but it's certainly
been used for quite a long while and has a
modern reputation for treating prostatic hyperplasia or enlarged prostate. As always,
we will do our deep dive into this herb and
look at its traditional uses and its preparation, interactions and
(01:29):
cautions and see if the science supports its use. And
as usual, we will be adding something a little different today.
It's going to be super exciting. We are going to
revisit artificial intelligence and see if it is any better.
I've given us good information on herbs, so that's a
fun one. Combines all my favorite topics. It combines technology
(01:51):
and herbs and learning. So there we go. We're gonna
deep dive into artificial intelligence. Actually I don't know if
I deep type, but we're diving into it. It's going
to be another interesting rocket ship into the exciting solar
system of herbs.
Speaker 2 (02:07):
Please join us today. Before we get.
Speaker 1 (02:11):
Into that, I just wanted to just quickly tell you
I've been teaching for quite a while now on a
wide variety of topics. If you like this podcast, I
want to explore more of my courses. They are available
at www dot Integrative Medicinecouncil dot org. That's Integrative Medicine
Council Council dot org and include a ton of different topics,
(02:35):
including my Drug Herb series looking at drugs and how
they interact with herbs and vice versa. Several ethics and
safety courses, Chinese medical research, several treatment of condition courses
such as arthritis, neck and back pain, COVID and depression
and anxiety, and one of my favorite courses the Chinese
herbal First Aid Kit.
Speaker 2 (02:57):
And they're all at a reasonable cost.
Speaker 1 (02:59):
And you get an additional twenty percent off with the
code SH twenty off. That's sh as in sperbs herbs
SH twenty off off.
Speaker 2 (03:12):
Thank you.
Speaker 1 (03:14):
All right, So let's talk about artificial intelligence over a
year and a half ago in episode forty eight and
we're on eighty eight, so this is, you know, forty
episodes down the road. In episode for Ey, we did
an experiment during this podcast we looked at artificial intelligence
AI and whether it can be useful when researching herbs.
(03:36):
At that point, we used Valerian, a very popular Westerner herb,
as the subject. I concluded this is a quote from
what I said. I'm really impressed by what it can do.
The bottom line is, I think this could be a
very useful tool for clinicians in the future, but still
needs quite a bit of work before it gets there.
So here we are again a very common Western herb
(03:59):
some But the reason why I choose common Western nerves
is because a lot of the Chinese rbs are not
as well documented as the Western nerves, and of course
it was very common there should be lots of information
for AI to gather, so that's why I've been choosing
very common Western herbs as we go into this, and
there have been some major changes in AI since the
last time we did this, So let's run the experiment again.
Speaker 2 (04:22):
And not only did I last time.
Speaker 1 (04:25):
When I ran it, I only ran it on one
AI because there weren't a whole much of others readily available.
Bard I actually got which was the old version of
Google's Gemini Today's Gemini. I got the invitation for that,
I think the day of and I couldn't get into
it in order to do it. So it's been out
(04:46):
for a little while now, so let's let's see what
we're gonna do. So today is the last time I
asked chad GBT, which is probably the most well known
at this point, so I asked chat chat tp GBT
to do today's presentation. This is at least one or
two generations of chat GBT since last time where we
use chat GBT three. Today we'll be using the latest
(05:10):
version four. And the reason why I say one or
two generations, they came out with three point five and
that was a pretty big leap over three, so it
wasn't quite a new generation, but it was sort of
a half to those. It's one or two generations, maybe
one and a half generations since the last time we
did this. We're also going to use We will also
use Gemini, Google's AI and not use Copilot Microsoft's AI
(05:35):
because it's based on chatchpt. You know, I have a
friend who's been really looking into AI for lots of
different reasons, and he has a bit of a He
has a website he runs, so he has a bit
of a tech background and that, and he said co Pilot,
even though it runs on chat GBT, does kind of
have its own spin on chat CHPT. But I just
I didn't think we had a third one. The other one,
(05:57):
which we're going to talk about, is the one that
my friend really likes, which is Perplexity. So we're gonna
talk we're gonna use that one as well. So we're
going to test three different AIS today. We're the last
time we only top one, we only use one. So
here's what happened. I gave the prompt create a forty
five minute professional presentation on saw Palmetto HERB. That was
(06:19):
the prompt. So here is today's experiment. I will, with
tons of transparency, be using some of the lines from
these AI attempts.
Speaker 2 (06:26):
These will be.
Speaker 1 (06:27):
Taken from several different iterations of the prompt. By iterations
means you do a prompt, you see what you get,
you tell it how you want it to change, and
it changes it and that's eventually you get to something
that's useful. So let's see how this will play out.
So first one is saw Palmetto and Chat GPT. I
put in the prompt discussed into chat GPT four and
(06:49):
it put out an outline and at the end it said,
would you like to continue with creating slides or content
or for any specific section. So that's kind of cool
right off the bat. It kind of knows what you're
trying to do. And even though I didn't give it
to you in the first iteration, it's like, hey, just
tell us that that's what you want. So I prompted
it to please create the slides and an added content
(07:11):
to each slide, though not a ton of it. Ending
this iteration with the question, would you like me to
help with detailed content or provide references for any specific slide?
Speaker 2 (07:22):
I responded with.
Speaker 1 (07:23):
Yes, please add detailed content with references, and it came
up with a fourteen slide presentation with references which always
need to be confirmed due to AI hallucinations. I confirmed
all references that we found here, and we'll talk about
that in just a minute. So I'm going to go
through the slides given by chat Gibt here as they
(07:43):
are very interesting. You should be done relatively quickly. The
first slide is a title slide and the last is
a references slide that says add all the references on
the individual side sites. So they had all the references
to the bottom of each slide, and the last slide
basically said, well, okay, all those individual references put it
in this slafe. So it didn't do it, but it
said what you should do. So that leaves slides two
(08:05):
through thirteen. So slide two titled introduction to Salt Palmetto
and it actually had a heading main content. Salt palmetto
is a small palm tree found primarily in the southeastern US,
particularly in Florida. Native Americans, including the Seminole tribes, historically
used salt palmetto berries for a variety of ailments, especially
(08:26):
those related to the urinary and reproductive systems.
Speaker 2 (08:29):
The RB gained.
Speaker 1 (08:30):
Popularity in Western medicine and late nineteenth century for treating
urinary and prostate issues. Now I can tell you, after
having gone through and researching all this, that is all correct.
So what it says is actually really good. Here's the references.
So the first reference is from Morton and it was
written in nineteen seventy seven Major Medicinal Plants, Botany, Culture
(08:53):
and Uses, and it has the publishers Charles C. Thomas
pub Ltd. And my comment here is confirmed. This is
real but quite old. Nineteen seventy seven is basically almost
you know, fifty years ago. So that's that's a lot.
That's very old for reference for something like this, bud valid,
(09:16):
so we're good. The next one was from a niche
l in nineteen ninety nine and it is in Ancient
Herbal Plants in Ancient Egyptian Medicine by the University of
Texas Press.
Speaker 2 (09:29):
And I did find this book, but it.
Speaker 1 (09:31):
Was published in nineteen eighty nine, not nineteen ninety nine,
with a newer version in two thousand and six. I
did not find anywhere in nineteen ninety nine version. In
the two thousand and six version was not by the
University of Texas Press, So somehow I got the date wrong. Okay,
maybe passable, So that was slight two. Side three is
a botanical description. Sarah no repinns belongs to the are
(09:56):
Erica erica as arica family and is native to the
coastal plains of the southeastern United States. The plant has
distinctive fan shaped leaves and produces dark red berries that
contain the active medicinal compounds. Thrives in sandy soil and underbrush,
particularly in pine forests and coastal plains. So you know,
(10:20):
I didn't get too much into the growing of this,
and I'm not sure about pine forests. I did read
coastal plains. For the most part, this seems relatively appropriate.
Fan shaped leaves. You know, it's a palm, so it
has those palm shaped leaves. So I think this is
pretty accurate. And here are the references from Higginfeldt h
(10:41):
in two thousand and one botany and Phyto chemistry of
sapal meta sero repenns written in the journal Fital Medicine
on pages and it has the volume and the number
of the of the journal eighty five and the pages
three eighty five to threety seven. Here's what I found.
This article does not exist. I could not find it
(11:01):
with a direct Google search. And when I found the
journal and looked at the issue sited, there was no
article on saw Palmetto. Though all the info was correct, volume, issue,
page numbers, they were all there. It was in saw Palmetto,
so it doesn't exist. I looked it up. I've never
not found a paper sighted somewhere in a Google search,
(11:25):
and I don't think I used it, but it may
have also used Google scholar search. Never not found a
paper where I have all the information. So this is
the first time I've never found a thing and I
looked up specifically what it said.
Speaker 2 (11:38):
Not there at all.
Speaker 1 (11:41):
Made up hallucination, that's what they call it, an AI
hallucination when they make up content, which they tend to
do so bad bad side for active constituents. The primary
active compounds found in solutplemental barries are fatty acids, luric
acid olac oliac acid and kumprilic acid, photosterials betas citosterol,
(12:03):
campestorol and stigmasterol, and flavonoids known for their anti inflammatory
and antioxidant properties. Again, these are having looked at the constituencies,
are all correct and are pretty are absolutely you know
from my research is this is all true information. These
(12:24):
components are believed to work together to support prostate.
Speaker 2 (12:26):
Health and hormonal balance.
Speaker 1 (12:28):
Okay, and here's the reference Villa navarette are at all?
This is what it says two thousand and three Pharmacological
effects of Serahenoa, repens and fo terapia, which is phytotherapy.
And I think it's Spanish. It's actually a well known
it's a fairly well known journal in this field. Again,
it has the volumes in the in the issue numbers
(12:50):
and the page numbers. And again this article does not exist.
Did a Google search, looked up Feto Tapia.
Speaker 2 (12:58):
That's not one. That's gonna have a lot of other.
Speaker 1 (13:02):
Confusing journals and looked at these pages, looked at the
whole journal.
Speaker 2 (13:07):
This article was not in any of them. Made up.
Speaker 1 (13:12):
Slide five Traditional uses Native Americans consume the barriers for
urinary tract infections, reproductive health, and as a general tonic.
They believed saw palmetto to be rejuvenating or particularly particularly
for men's health, supporting vitality and strength. It was also
used in poultices to treat wounds in skin conditions and
(13:34):
the reference is Barrett B. At All nineteen ninety nine
saw Palmeto a Review of Use Pharmacology and Therapy Potential
in the Journal of Alternative and Complimentary Medicine. Again it
has the volume and issue numbers and page numbers for
seventy one to forty two, and well, this is a trend.
The article does not exist. So out of the five
(13:56):
articles that it has cited so far, three of them
do not exist.
Speaker 2 (14:01):
They're completely made up.
Speaker 1 (14:03):
One had the wrong date, which, okay, you might if
that was the only thing wrong, you might give a
pass on, but it's not. And one was super old,
super old and so just not good.
Speaker 2 (14:18):
And I called it.
Speaker 1 (14:19):
That's it, calling it chat cheapt seems to have fairly
accurate information. Actually I'd say really accurate information.
Speaker 2 (14:26):
It was it made up a really good thing.
Speaker 1 (14:30):
It was a little short for me, you know, for this,
you know, because I have I don't know, I have
probably thirty or forty slides that are quite way more
detailed than chat chept. But okay, the information was relevant.
It was there out of thin air, so it's really cool.
So was able to put together a useful presentation. But
too many of its references are fake or wrong, and
(14:52):
therefore the information cannot be relied upon, and it completely
fails the test. I'm sorry, references are everything so done,
This was not not good chat chat gpt is not
a good source for herbal knowledge. We'll have to test
it again in another year or two and see where
it's at at that point. But until chat gpt starts
getting its references correct, it's just it's not a viable option.
(15:16):
And of course I extend that out. I mean this
is not a I mean herb. Herbalism in general is
I think a little bit more obscure than other things.
But if it can't get this right, what else can it?
Speaker 2 (15:24):
Does it get right or wrong? So not liking it?
Speaker 1 (15:29):
Okay, So let's look at salpal Metto and Gemini. So
Gemini is Google's version of AI. Again, I put the
prompt create a forty five minute professional presentation on saltpal Meto,
herb into Google's Gemini, and again it created a good,
if a little short, and relevant outline of a of
a presentation. I then asked it to please create this
(15:52):
presentation with references, to which you responded with a short
but decent presentation with seemingly useful information with references. However,
when you looked at the references, they were all placeholders
that said, in brackets insert citation for dot dot dot ellipses,
whatever the topic was. In other words, there were zero references.
(16:15):
And this constitutes another complete fail. If you don't tell
me what you're getting the information from, I can't trust
the information period. If I can't confirm your information, it
doesn't exist. So Gemini is another utter failure based simply
because it couldn't do any references at all. So I'm
I'm getting a pattern here thinking okay, we're not there.
Speaker 2 (16:37):
I can't do it. So I did do this Subplemento
and perplexity.
Speaker 1 (16:42):
I did the same exercise for another AI that one
of my friends prefers, and that's perplexity dot ai. That's
how that's the www that you put in perplexity dot ai.
So p E r p l e x I T
Y dot ai should be period. As with others, the
initial answer was an outline of presentation, and I then
(17:05):
asked for detailed content with references. Well, I would say
it might be a fifteen minute presentation rather than a
forty five minute one. I do this a lot, so
I can pretty much judge how long a presentation is
going to be. It was pretty good with individual references
that link to the source websites. Two of the eight
sources were scientific papers, while the others were websites that
(17:26):
were appropriate and relevant, like WebMD and healthline. Except for
the reference to Amazon for dosing, it actually had when
you it had what was cool about the references they
had the pages? You click on it and we go
to that page. So it was really just an Amazon
page with products of salt palmetto, and that's what it
was using for it. It's dosing, which.
Speaker 2 (17:47):
I guess isn't wrong. I just wouldn't use.
Speaker 1 (17:50):
That ever as a reference, so I didn't go into
as much death depth as I would have wanted. However,
Perplexity was definitely the best of the AI discussed here,
at least as far as herbs are concerned. It had references,
it wasn't bad. The information wasn't bad overall.
Speaker 2 (18:09):
I liked it.
Speaker 1 (18:10):
And if you guys want transcripts, I copied and pasted
everything I did here, just send me an email. I'm
happy to send do the transcript of everything I did
and what the responses were and all that, so you
can kind of see what everything was. But for my money,
if I were to ask a question of an Ai,
it would be perplexity about herbs, and even then I
would I would definitely look at it with a fine
(18:32):
tooth comb to see if I trusted.
Speaker 2 (18:35):
It or not. But at least there was one that
wasn't half bad, so we'll check it again another year
or two.
Speaker 1 (18:41):
Not bad though, okay. And with that on Ai and
sal palmetto and herbs, let's get into our thing that
was interesting. I think we're getting there, and maybe a
perplexity is mostly there, but none were as professionally relevant
as I would like. So let's get into our normal
in depth approach to or herbs. So we're talking about Seronia,
(19:03):
so Sroona, I can't even say this, So Santa Noah
repins salt palmetto and it comes from the family, as
was mentioned in one of those slides. Ericassier eric Adi
Cassier and the species of Sarah Noah repins in parentheses W.
Bartram and then Small after that.
Speaker 2 (19:25):
So remember the W.
Speaker 1 (19:26):
Bartram and the Small actually refer to biologists. This this
technically means that the biologist Bartram W. Bartram was the
first to codify this species, and then it was revised
by the biologists Small, And that's what that all means.
The medicinal part is the fruit. Other names for this
(19:48):
rather than salt palmetto are American dwarf palm tree, cabbage palm, jews,
jong sable fruits, cerelata, So that was that's the Latin
staple cerulata, So it's no longer the correct name, but
it is an older name for this. For this plant
the shrub palmetto, salt palmetto berry, sarah Nooa cereulate, Brahia cereulata,
(20:15):
and Carifa repens. So there's a bunch of potential Latin
names for this, but the correct one is sarah Noa repens.
So let's talk about the area. Eric Osier family, the
Erka see I keep wanting to say it, so I
get it better. The Erikasier family constitutes perennial flowering monocots,
(20:37):
or plants with fibrous root systems. The plants of this
family are all palms. There are approximately one hundred and
eighty one genera in two thy six hundred species, with
one exception. They are known by their fronds, large evergreen,
compound leaves. The fruits are usually single seeded drup. This
(20:59):
family includes many historically useful plants and products still important today,
including date palms, coconuts, ivory nuts, carnuba, wax from Brazilian palms, ratans,
palm oil, hearts of palm asai, and several palms used
to create alcoholic beverages. They kind of went into a
(21:21):
little detail, and I thought it was a little bit
more than we needed to know. So history of this so,
according to Foster, who had a really nice overview paper
on excuse me, Salt Palmetto, native groups throughout Salt Palmetto's
range consumed the fruit as a staple food. In fifteen
(21:44):
seventy five, Spanish explorer Hernando de Escalante Fontaneeda, who was
around fifteen thirty who lived from fifteen thirty six to
fifteen seventy five, was the first known European to record
the use of the bear as food by indigenous groups
in Florida at the time of first European contact and
(22:06):
what is now Florida in fifteen thirteen. The now extinct
Glade Indians of southern Florida, including the Colusa, the Tequesta,
may Emi, Miaimi, Jega or Jobe, and ais Ais, consumed
salt palmetto fruits to mukua I'm sorry, I'm butchering these
(22:30):
these terms. The Timucua and Appalachi ate fresh berries. The
Alabama Creek, Mikosuki, and Seminole also consumed the fruits. The
Choctaw dried the fruits for winter consumption. This is supported
by another paper. Salt palmetto was one of the most
(22:52):
important foods for Florida's pre Colombian non horticultural peoples and
later Creek immigrants.
Speaker 2 (23:00):
Among the older Seminole.
Speaker 1 (23:01):
Population, the fruit is still consumed in moderate quantities, and
a sweeten traditional drink called Chiopi soft key is made
from the juice. Sal palmetto was largely unknown by the
European and American medical communities until the second half of
the nineteenth century. Foster continues to discuss the first inkling
(23:26):
of medical uses in eighteen oh six bondanist and physician
John L. E. W. Chicut Chicut she Cut, who lived
from seventeen seventy to eighteen thirty six, and his Flora
Carolinius carolina ensis, recommended a cautious approach to consuming the
(23:46):
fruits and had it hinted at medicinal activity, which may
have been the result of microbial contamination, given that the
alleged purgative effect is not reported elsewhere. This is a
quote from that book. Hope of this fruit is of
an uncommon sweet taste, but it's possessed of such a
purgative quality. The strangers are sure to pay dear for
(24:07):
the knowledge obtained from one experiment. They are so tempting
and pleasant that few can refrain from tasting, and one
or two of them produces a copious evacuation and are
very apt to occasional gripings or grippings. You know, it's
an old word, and I think we pronounce it grippings
these days, it's spelled gripings. I am of the opinion
(24:29):
a valuable medicine might be prepared from this fruit.
Speaker 2 (24:34):
Grippings.
Speaker 1 (24:34):
Gripings means cramps basically okijun cramps. The first medicinal uses
of salt palmeto are similarly elucidated by Foster. The use
of salt palmetto as food sparked observations on its medicinal use.
Quoting a letter recard from doctor George Wallace of Daytona, Florida,
recalling use in the eighteen fifties, excerpted excerpt I can't
(25:00):
even say it an excerpt excerpted in an article on
the evolution of the salt pametto in the June eighth,
nineteen hundred issue of the Virginia Medical Semi Monthly. J. C.
Speaker 2 (25:12):
Lhardy, m d.
Speaker 1 (25:13):
Of Savannah, Georgia wrote, Indigenous groups and enslaved Africans ate
the berries ravenously with us. The taste is an acquired one.
At first it is almost repulsive, but generally, after a
few days one becomes passionately fond of it. It takes
the place of food, is slightly stimulating, and the indigenous
(25:34):
groups and enslaved Africans all say that it is an
excitant to the organs of generation and a splendid tonic
and builder up when convalescing from fevers or other wasting diseases.
So that's probably the first mentioned. Like we said in
the second half of the eighteen hundreds, one of the
(25:54):
first mentions of salt palmetto as medicine.
Speaker 2 (25:58):
Other uses.
Speaker 1 (26:00):
Saw palmetto is a hearty, if slowly reproducing plant and
has had many uses historically and in modern times, including
as food, fiber, oil, medicine, wax, and roof thatch, among
other economic products. In the late nineteenth century, a market
emerged for use of salt palmetto vegetative material for the
(26:21):
tanning industry. Indigenous groups were seen to bruise the stems,
then boil them in water and use the liquid to.
Speaker 2 (26:29):
Tan hides traditional uses.
Speaker 1 (26:34):
So the PDR for Herbal Medicines UH says it was
approved by commission e for irroble bladder and prostate complaints.
We've talked about commissioning in the past. Commissioning was something
done in the I think it was in the eighties
in Europe, and basically at that point, if a herb
wasn't approved by commissioning, I don't think you could sell
it in Europe. So commissioning was approved, you know, was
(26:57):
important and they looked at all the evidence and decided
which ones did something, which ones didn't do it, so
being approved by commissioning basically says there's some evidence to
show that it does support these sort of things, though
as we find out, it may not be you know,
as strong evidences as we may have thought with commissioning,
But Commissioning approved it for eral, bladder and prostate complaints.
(27:20):
Unproven uses including folk medicine sall plemtos used for inflammation
of the urinary tract, bladder, testicles, and mammary glands. It
has been used for nocturnal and usis that is, bedwetting,
persistent cough exima, and improvement of libido. WebMD You're still
under traditional uses. Web md says the serve can be
(27:44):
used for people used for people commonly use.
Speaker 2 (27:48):
Oh, that is bad grammar, that's choose up.
Speaker 1 (27:51):
So people commonly use saw palmetto for symptoms of an
enlarged prostate called benign prostatic HI purchase you're a BPH.
Saw palmental is also used to prevent complications from prostate
surgery and for treating other prostate conditions, mal pattern baldness,
sexual dysfunction.
Speaker 2 (28:09):
And many other purposes.
Speaker 1 (28:13):
Drugs dot Com says Salplemento has been used to treat
symptoms of enlarged prostate benign PROSTATICI purchafy or BPH, such
as the increased nighttime urination or decreased urinary flow. Other
uses not proven with research have included treating sore throat, cough,
cold symptoms asthma, bronchitis, migraine, headache, mal pattern, baldness, chronic
(28:35):
pelvic pain and prostate swelling, bladder problems, prostate cancer, and
other conditions. Mount Sinai ads it may help with benign
prostatic hi perchafy, prostate cancer, promote urination and inflammation. Doesn't
promote inflammation, it would help inflammation, so USPS monograph. We't
(28:59):
talk about USPN seconds, so USP's monographs says. Salt palmetto
has been used in males to tone and strengthen the
reproductive system and specifically for symptoms of prostatic enlargement, and
women has been used occasionally to reduce savarian enlargement and
increase the size of small undeveloped memory glands and both sexes.
(29:21):
Has been used as a general tonic for genito urinary problems,
to increase sexual vigor and as a diuretic. That paper
continues to say the Native Americans of the Southeast regions
considered saltple metal useful as a nutritional tonic, a use
to which the high oil content and the nuts and
flesh of the fruits probably contributed. As a diuretic, a sedative,
(29:44):
and an aphrodisiac. The steam from cooking fruits was inhaled
is still the usp monograph.
Speaker 2 (29:53):
The steam from cooking.
Speaker 1 (29:54):
Fruits was inhaled for use in bronchitis and to relieve
irritated mucous membranes. As an expectorant, Salpometa was largely unknown
by the European and American medical communities until the second
half of the nineteenth century. The plant was first considered
a nutritive tonic and a useful remedy for relieving local
irritations of the mucous membranes of the respiratory, digestive, and
(30:18):
reproductive tracts. Over time, it became widely used for the
relief of urinary difficulty and pain in men with benign
prostatic hyperplasia. Benefit was attributed to an ability to increase
bladder tone and reduce urinary urgency, allowing bitter contraction and
(30:39):
expulsion of urine with reduced pain. Salpometo also was used
for certain eurogenital disorders in women, including our varying and enlargement,
dysminery or pain fulmencies, and for stimulating mammary gland secretion.
Salpometa was also frequently used to relieve chronic bronchial coughs
(31:00):
and learningitis. So that's not a use that you hear
a lot about, you know, when just going through saltplemento.
But there are some respiratory uses, some lung uses of
the sort of. Okay, I mentioned the USP, So let's
talk about the USP, because you know, this is actually
a really important So I think I just have a
slider to have one slide on this.
Speaker 2 (31:22):
So we're going to talk.
Speaker 1 (31:23):
About USP stands for United States Pharmacopeia, and we're using
a source from the United States Pharmacopea USP, and I
wanted to take a quick break in our presentation today
to briefly introduce the USP.
Speaker 2 (31:34):
The USP was.
Speaker 1 (31:35):
Started in eighteen twenty and is a nonprofit, non governmental
organization that publishes a pharmacopeia with quality standards for the
United States. If these standards are met, drugs and dietary
supplements may use the designation's USP or NF for national
formulary on the products. So when you see a USP,
(31:57):
you know often you'll see a little USP in a
bottle that means it's up to these standards. The US
Food and Drug Administration, the FDA, uses the standards for
individual constituents as the basis for determining whether or not
an ingredient has been adulterated.
Speaker 2 (32:12):
So while it's non.
Speaker 1 (32:14):
Governmental and there's no laws backing this up, the FDA
does use it as a reference and the FDA can
use it to enforce certain laws as well. So the
USP is actually very important in the US, and they
and they definitely have a lot of scientists and they
have annual conventions where they talk about all these things
and they look at all these quality standards. So it's
(32:36):
a it's a big deal. So that monograph was actually
a really good source of information.
Speaker 2 (32:41):
For US today on salt palmetto.
Speaker 1 (32:45):
Okay, let's talk about dosage and preparation of this herb.
According to the PDR for herbal medicines, dosage should be
a daily dose should be a daily dose of one
to two grams of the rug or three hundred and
twenty milligrams of the lipophilic extract and then it says
hexan or ethanol ninety percent v slash V, which is
(33:08):
volume to volume. So that's it, and we'll see typical
doses are three hundred and twenty milligrams a day, often
in divided back next one dro This is from still
from the PDR for verbal medicines. Dosage is used in
studies demonstrated efficacy at one hundred and sixty.
Speaker 2 (33:25):
Milligrams given twice daily or three hundred and twenty milligrams
given one Dailey. There you go.
Speaker 1 (33:30):
Web MD says APPA metal has most often been used
by adults and doses of three hundred and twenty to
nine hundred and sixty milligrams to my mouth daily for
up to three years. Now, I gotta say that's the
one source I've seen that goes as high as this.
Most of the sources are saying one sixty to three twenty,
so nine to sixty seems like a lot.
Speaker 2 (33:50):
And here's the USP monograph.
Speaker 1 (33:52):
They say traditional preparation for traditional preparations as a t
one to two grams per day as a decoction, bring
to boil one cup of water and one third the
total daily dose of saltpalmetal, fruits and simmer gently for
five minutes. Drink one cup three times daily. As this
is a hydrophilic extract process, it contains few lipophilic components,
(34:15):
and that's important, especially since we think the lipophilic components
are actually the the the active ingredients. So I would
not recommend it decoction with this, but it is, it
is done. The next thing is still the USP monograph
liquid extract A one to one herb to extract ratio
or HR is you should have point six to one
(34:37):
point five millilaters three times daily as a tincture eighty
percent alcohol fresh fruit and one to two herb to
extract ratio dry fruit. One to five herb to extract
ratio one to The dosage is one to two millilators
three to four times daily. So you know, some of
(34:59):
the the sources actually say that this is probably better
taken as a liquid form and TENSUREFORMX that's where a
lot of the active ingredients are, rather than in.
Speaker 2 (35:09):
Pill form, which is how most of it is done.
Speaker 1 (35:12):
So kind of take that as you will for clinical
trial preferences. Again, we're still in the USP monograph clinical
trial preparations. Liposterolic extractor l SP three hundred and twenty
milligrams orally once daallarer one hundred and sixty milligrams twice
daily in liquid or solid form, with an approximate ten
to one herb to extract ratio HR.
Speaker 2 (35:35):
I love this about the USP.
Speaker 1 (35:36):
It's all about these extract ratios and it's one of
the issues I have when other people try to dose.
They don't give you the extract ratios. They're incredibly important.
So this is really good information. So approximately ten to
one herb to extract ratio standardized to seventy to ninety
five percent free fatty acids has been studied for symptomatic
treatment of benign pross chiperchapse stage one and two. Consumer
(36:01):
lab dot com which I love as a resource. If
you want some really good direct information, that's it. It
is behind to pay, well, you do have to pay
for it. It's the one subscription I paid for without hesitation,
so I use it constantly. One of the things I
love about Consumer Lab and we're not gonna get into
it at all, but they test the products, like with
with Saalpa Meto. I think they test like maybe with
(36:24):
combination products, maybe eight or ten different combination you know,
brands of saftple meto test them for contaminants, to test
them for. It has what it says it has and
gives you a recommendation based on price and what it
has in there.
Speaker 2 (36:38):
It's great if you want.
Speaker 1 (36:39):
To know not just what it should do, what it does,
and how it does it and all that, but also
which specific products you should buy. I love consumer lab
dot com can praise them enough. So consumer lab dot
Com says a typical dose three hundred twenty milligrams per
day of extract standardized to eighty five to ninety five
percent fatty acid, so it pretty much falls at USP.
(37:00):
Another book that we're going to refer a couple times
here is The Energetics of Western Herbs, a Materia Medica
integrating Western and Oriental herbal medicine traditions.
Speaker 2 (37:10):
This one is volume one.
Speaker 1 (37:12):
That says by Holmes that says this herb should be
used at the following doses in decoction four to eight grams,
which remember earlier we said one to two grams, but you're.
Speaker 2 (37:24):
Supposed to take it three times a day, so that's
in the ballpark.
Speaker 1 (37:26):
I think tincture one to three milliars at one to
two strength and forty five percent alcohol. Holmes notes that
it can also be used as a pository for prostate
conditions and as a syrup for treating dry irritated conditions
of the upper and lower respiratory mucosa.
Speaker 2 (37:44):
So that they really he really goes into the lung.
Aspects of this.
Speaker 1 (37:51):
Quality, it was difficult to find anything on what makes
good quality soft palmetto. However, heavy metal contamination, especially arsenic
lead and cabin is a concern. In consumer lab dot
COM's testing of eight products containing salt palmeta, none showed contamination.
That's good because I've seen them do reviews and almost
all of them show contamination. So the fact that none
(38:14):
show contaminations, it means we have a pretty healthy supply.
One of those eight did not get approved due to
too few fatty acids in the product, but nothing else
inherently wrong.
Speaker 2 (38:25):
With the product, which is good. So it's about Chinese
medical actions of this herb. A source.
Speaker 1 (38:35):
Says this herb is.
Speaker 2 (38:36):
Julie Zong or jujong in Chinese, so.
Speaker 1 (38:40):
There is a Chinese name for it, though I tried
to look that up in any of my Chinese herbal
texts and they weren't there. So you know, even though
that's a name, I don't know how prevalent that is.
The source from the White Rabbit Institute of Healing goes
on to say, salt palmetta is slightly sweet, pungent, astringent,
dry and warm, and enters the kidney and lung, which
(39:03):
makes sense. We're talking about, you know, prostate and sexual health.
The kidneys are often involved that and we saw a
lot of lung functions, so mixed sense that those would
be the two big channels here. His actions are boosts
jing tinafies, kidney chi. Both of those could be you know,
(39:23):
considered to be useful for bph as well as potentially
for libidos.
Speaker 2 (39:28):
So those are that makes sense.
Speaker 1 (39:29):
Booshing tanaphies kidney chi, reduces inflammation, and then it has
a colon, explaining these three functions of boost sexual drive,
swollen and flamed reproductive organs, infertility, ovaridis or inflammation of
the ovarrays, impotence, sterility, improved energy and weight gain. And
then's other set of actions is it expels phlegm and
(39:51):
supports lung chi and again a colon and coughs, flues bronchitis, wheezing,
asthma and gtars, so guitars are are I can never.
Speaker 2 (40:01):
Remember what a guitar is, so I used to have
it up here. But it's to do with the lungs.
It's an old term.
Speaker 1 (40:09):
Another sourt of Chinese nutrition, dot Org says it is sweet, sour, warm,
and enters the spleen, bladder, kidney, and liver, so not
exactly the same. It doesn't have lung and it adds
in bladder, which makes a bit of sense. I don't
know about spain liver, but okay, the slain makes sense
a little bit too.
Speaker 2 (40:28):
It describes its actions.
Speaker 1 (40:29):
As in terms of Chinese medicine, salt palmetto is known
for its ability to tanify chi and tonify young. It
also helps resolve cold and resolve phlegm, so that's its functions.
And then there's that book that we talked about, the
Energetics of Westernerrbs of Materimatic Integrate Western Oriental Herbal Medicine Traditions.
Holmes says saftplemetto is somewhat sweet, astringent, pungent, which is
(40:55):
another word for spicy, aromatic, and warm. And there's the kidney, liver, spleen,
and lungs, so it kind of has all the same
as the Chinese nutrition dot org but adds in that
lung again. So he has four groupings of functions. So
the first grouping there's a lot here. He puts a
lot in these groupings, so hang with the Grouping number
(41:16):
one toonifies reproductive chy, regulates menstruation and relieves impotence and frigidity,
strengthens and nourishes the reproductive organs, increases hormones, and promotes
sexual organ development, conception.
Speaker 2 (41:29):
And lactation.
Speaker 1 (41:31):
Grouping number two tonifies urinary CHI. Harmonizes urination, relieves the
irritation and the end incontinence, strengthens the bladder and prostate,
and reduces swelling and inflammation. Grouping three tonifies the digestive chy,
promotes absorption and improves weight. Grouping four moistens the lungs,
(41:53):
promotes expectoration and relieves coughing, dispels wind heat dryness, reduces inflammation,
soothes the throat and opens the voice, and stimulates immunity.
So those are some different perspectives on chiness medical actions
with my own opinion thrown in there. Comparisons and combinations, well,
(42:15):
generally there weren't any direct comparisons or combinations for this
herb in our literature searches. Consumer labs dot com mentioned
the similar functions of beta cetosterol and tested combinations of both.
Speaker 2 (42:26):
And remember this does include.
Speaker 1 (42:27):
Some beta cytosterol, which is actually a very important herbal constituent,
and so they do. Actually there are combination products of
selpa metal and beta cytosterol. So I think you know
it's an interesting combination here contents so Evans, which is
(42:48):
a book I'm pharma Cognitcy says fatty acids constitute an
important feature of the drug, referring to the CRB the principle.
Free acids are olaic, loric, meristic, and palmitic acids, with
lesser amounts of caproic, caprillic, capric, steric, stearic, steric, linolaic,
(43:10):
and linolinic acids. Other constituents include flabinoids such as rutin, isocars, citron,
and others, phytosterols including cytosterol, its, glucosides and esters, and stigmasterol,
immunostimuli and polysacharides involving glactose, rabinose, mannose, ramnose, glucuronic acid
(43:32):
and others caratenoids and volatile oil.
Speaker 2 (43:39):
So those are the contents. Let's talk about the science.
Is there science behind this?
Speaker 1 (43:43):
There have been many studies looking at the use of
salva meto in lower urinary tract symptoms due to benign
prostacic enlargement.
Speaker 2 (43:51):
The results have been mixed overall.
Speaker 1 (43:54):
A recent Cochrane Database review looked at twenty seven studies
involving four thousand, six hundred more than fifty six participants
and concluded serenoa repins alone provides little to no benefits
for men with lower urinary tract symptoms due to benign
prostatic enlargement. There's more uncertainty about the role of sereno
repins in combination with other phyto therapeutic agents. So if
(44:20):
you're not familiar with the Cochrane Database, it is great.
It is a fantastic resource. They have very strict protocols
as to what gets into the Coctrine Database for systematic reviews.
It is considered fairly high level information, relatively high on
the evidence based medical system. So what it says is
(44:42):
usually really strong evidence, and this is basically saying it
doesn't do it.
Speaker 2 (44:46):
So I am.
Speaker 1 (44:47):
You know, before I did this, I was thinking if
someone came up to me with BPH, you know, and
of course go okay, well, salt promtos is thought to
really help this. After doing this, I'm like, no, I
don't know if salt prometa really does it. See, now
here's the problem, though. We haven't looked at all these studies.
And I can tell you one of the faults of
these studies is they will look at any studies that
(45:08):
have this that look at sarah these two things, the
salpametto and the benign prostatic hyperchafy. What it doesn't do
is assess dosagyen, and to me, dosage is key. So
there are twenty seven studies. I don't know if those
were all properly dosed or not. I think they probably
were because the dosting seems to be pretty standardized, but
(45:30):
I haven't looked at those twenty seven studies, so I
don't know. So overall, I would say this probably isn't
looking good for benign prostatic hi perchafye. But that doesn't
mean we should take this without reading it more in
depth and looking at it a little bit more closely.
Retrospective study. So retrospective study is not considered one of
the stronger strongest studies. We usually like to use prospective studies,
(45:54):
so we constructive study to examine what we want to do.
Retrospective studies looking at old records and then and coming
up with information from that. I reprotective retrospective studies are
really useful. For one thing, You can usually get a
lot of numbers from retrospective studies and they can really
be helpful in figuring out how and when and what
(46:15):
you might want to design a prospective study for. But
in and of itself, it is decent clinical evidence, but
not really strong clinical evidence. So a retrospective study looking
at twenty three hundred and one men undergoing radiation therapy
for prostate cancers showed no difference in outcomes in those
patients taking mental health supplements including salt palmetto and those
(46:38):
who are not. So in other words, it didn't help
with radiation therapy. So according to Cooperman, which is from
Consumer Labs, he's the doctor that runs that, there have
been some small manufacturer conducted studies looking at the use
of salt palmetto for androgenic alopecia. That's mel pattern baldness,
and other small studies that showed some hair growth in
(46:58):
these patients were not statistically significant, and we're not as
effective as pharmaceutical intervention. So basically this is interesting. It
does potentially produce some hair growth, just not in a
lot of people, you know, a lot.
Speaker 2 (47:12):
Fewer people than would be with often. It was compared
with finasteride, which is.
Speaker 1 (47:19):
A drug that helps promote It's not rogaine, it's the
other one does help promote hair growth, and it I
think fanastride worked in like eighty percent and this worked
in like forty percent, so a lot fewer people and
not as strongly as the finastride, So it.
Speaker 2 (47:36):
Had some effect it looks like but not strong. But
they're small, so we're not sure.
Speaker 1 (47:42):
Krupman also says there's no evidence for salt palmto's used
for bladder inflammation or sostitis, chronic bronchitis, laryngitis, and asthma
associated nasal inflammation. The USP monograph, though Older, says saw
palmetto may have in hit ambition of five alpha reductase activity,
(48:02):
alpha one adreenergic blocking activity, anti androgenic and anti estrogenic activity,
anti inflammatory activity, and anti spasmodic activity.
Speaker 2 (48:13):
So you know those all mean certains.
Speaker 1 (48:16):
So the five alpha reductase activity, alpha one, adrenergic blocking,
those are pharmacological activities. It can block androgenic activity, which
is male hormones as anti estrogenic activity, so it can
block estrogenic estrogen hormones. Frankly, I don't like things messing
with hormones and this is doing a bit of that.
So potentially, potentially. The PDR for herbal Medicines also says
(48:43):
Salpa metal has anti androgenic and anti estrogenic and anti
inflammatory effects as well.
Speaker 2 (48:53):
It's talk about Drugger of interactions.
Speaker 1 (48:55):
There are quite a few suggestions of the Drugger interactions
between Salpa meto and various drugs, though none appear to
have any clinical evidence. Warfron is frequently mentioned as a
potential interaction, though there's no clear evidence supporting this, and
Warfarn kind of gets this rap like, if there's any
hint then it might affect the blood, then it's going
to affect warf Warfin is very sensitive drugs. That's relatively
(49:19):
valid thing, but there's no evidence to really say that.
It does add that you will see a lot of
warnings like this should probably not be taken with blood
to any medications like warfrin, but there's no evidence. Then
the other the argument to that is, well, it doesn't
need evidence. It seems like a likely thing, and we
don't want to put our patients at risk, so we're
(49:40):
saying it.
Speaker 2 (49:41):
Okay, Yeah, I think.
Speaker 1 (49:44):
With as much use of warfron as much use of
salt plameta, especially in that population though where that can
overlap quite a bit, I would effect some evidence of interaction.
So anyways, another common concern is the combination of salt
pamtal and oral contraceptives, So again this appears speculative. Well,
there have been a small number of in vitro studies,
(50:05):
so in vitro means in glass studies showing potential cycachlonopy
for fifty interactions or CYP interactions. This is one of
the few herbs where clinical trials have shown no CYP
one A two, two six, two E one or three
A four interactions. So what we're saying here, so, first
of all, cychachroone P for fifty is one of those
risk factors for drug rib interactions, So we're concerned if
(50:28):
an herb effects cychrolonopy for fifty.
Speaker 2 (50:31):
It is at much higher.
Speaker 1 (50:33):
Risk for a drug rib interaction because it can effect
the use of tychcrolonepy for fifty by drugs. And so
this one when done in vitro, and is why I
don't like in vitro studies. It said, Okay, yeah, there's
a few interactions happening with tychcroonprey for fifty. But just
because that does that in a test tube, it doesn't
mean by test to I just mean broader, just not
(50:57):
in animals or in humans in viva. Well, so it
doesn't mean it's going to do it in humans. This
one they've done clinical trials. They had twenty healthy people
in this one trial and there's another one here as well,
and they actually gave them things that to see if
it affected these particular twenty subtypes of psycroone P fifty
(51:19):
two two, six, two, one three or four, three or
four is the big one that we're worried about. Forty
sixty percent of drugs will utilize that, and it found
that there was no interactions with that at all. So
who cares what it does in glass in vitro, in humans?
In clinical trials it does not. It clearly does not
have any interactions that's useful. So no real Drugger interactions
(51:42):
here that we've seen so far, so let's continue our
conversation of literatures. Did not find any mention of peak
lycoprotein interactions, which is another target for Drugger of interactions.
And the American Rbal Products Association's Botanical Safety Handbook puts
this herb in interaction Class A herbs for which no
clinical relevant interactions are expected, and I agree with that
(52:03):
with my research, this does not seem a high risk
for a drug or interaction. That doesn't mean there aren't concerns.
Let's talk about some of those concerns. According to the
PDR for Herbal Medicines, patients with hormone dependent cancers should
observe caution, speak to a physician. A physician regarding the
use of salt palmto because of its anti estrogenic, estrogenic
(52:24):
and anti androgenic effects, so you know, maybe they also
suggest the use of salt plemental with pregnancy and breast
feeding is not recommended due to its potential hormonal effects.
The USP monograph says clinical studies indicate that subplemento is
well tolerated by most patients, with the primary reported side
(52:44):
effects being mild gastro intestinal complaints such as an augea
and diarrhea. Salt palmeto has not been reported to be
toxic in humans or animals. Web Md says salt palmetto
is likely safe when used for up to three years.
Side effects are usually mild and might include dizziness, headache,
naugen and diarrhea. Salt palmetto is likely unsafe when taken
(53:07):
by mouth during pregnancy or breastfeeding. It acts like horomone
and this could be dangerous. Don't use during pregnancy or breastfeeding.
Salt palmtal might slow blood clotting again speculative, it might
cause extra bleeding during and after surgery. Stop using saltal
metal at least two weeks before a scheduled surgery. I'll
be honest with the most surgeons, especially in a big surgery,
(53:29):
you're gonna say stop everything two weeks before, so I
would stop it. Paper looking and liver toxicity from salt
palmetto concludes. Hippatotoxicity from salt palmetto is very rare and
cases have been self limiting.
Speaker 2 (53:44):
Upon stopping the.
Speaker 1 (53:45):
Herbal there have been no instances leading to fatalities, liver transplantation,
chronic hepatitis or vanishing bile duct syndrome, and the American
Herbal Products Associations Botanical Safety Hammock puts the serve in
safety class one herbs that can be safely consumed when
used appropriately. A systematic review of selplemental adverse effects concluded
(54:11):
adverse effects associated with the use of s repins are
mild and similar similar to those with placebo. The most
frequently reported adverse events are abdominal pain, diarrhea, nausea, fatigue, headache,
decreased libido, and rhinitis. More serious adverse effects, such as
death and cerebral hemorrhage are reported in isolated case reports
(54:31):
and data from spontaneous reporting schemes, but causality is questionable.
No drug interactions were reported. Currently available data suggests that
s repens is well tolerated by most users is not
associated with serious adverse effects. The majority of adverse effects
are mild, infrequent, and reversible, and include abdominal pain, diarrhea,
(54:53):
nausea and fatigue, headache, decreased libido, and rhinitis, which is
just everything I just read. Those are all the cautions.
So in summary, we started a discussion to day with
a look at the current state of artificial intelligence for
examining and assessing herbs and the evidence supporting their use,
and we found for the most part of it failed
(55:15):
except with perplexity. From there, we did our deep dive
into salplemento or Serenoa repens, one of the most commonly
used Western herbs and used primarily for benign prostatic I
purchase fee. Though the evidence doesn't support this use, has
a long history of use and appears to be quite safe.
So you know, based on its safety profile, if someone
(55:36):
wanted to take this, I wouldn't object to it necessarily,
but I would also explain that it probably won't help overall,
another interesting nerve that doesn't quite live up to the hype,
at least until there are more studies. That's the thing
about science. It's a step wise process. So right now
it doesn't look like it's very effective. Maybe there's bigger
and better and stronger studies and it turns out it
(55:57):
is very effective.
Speaker 2 (55:58):
You never know.
Speaker 1 (55:59):
I've seen it out and looking at this stuff for decades.
Speaker 2 (56:02):
Now it happens.
Speaker 1 (56:05):
In our next episode, we will be exploring another interesting
Chinese herb chiang huo or no top tier g Rihizoma
sutis or no top tier gem root or rhizome. This
herb is in the Chinese medical subcategory of warm acrid
herbs that release the exterior under the category of release
the exterior herbs. It is helpful for certain types of
(56:28):
colds and especially for alleviating pain and unblocking painful obstructions
in many conditions, such as some types of arthritis, and
as usual, we will be exploring something a little different.
Please join us for this intriguing episode. See you in
two weeks. Thank you very much for listening. If you
(56:50):
like this podcast podcast, please do us a huge favorite
give us a five star rating in your favorite podcast app.
We really appreciate it, and we thank you ahead of
time for even thinking about doing it. And remember you
can get continuing education units and National Certification Commission of
Acupunction Oriental Medicine Professional Development activities at www dot Integrativemedicine
(57:12):
Council dot org whether that's Council c O U, n
c I L dot org. And don't forget that twenty
percent off with the code s H two zero off.
You can always get in touch with me at doctor
Greg at sperbserbs dot com.
Speaker 2 (57:25):
That's s p e r B s h E r
b s dot com, or.
Speaker 1 (57:30):
On our website www dot sperbserbs dot com. And as
usual I have a good long bibliography.
Speaker 2 (57:42):
Thank you very much, spurs Or. The preceding was presented
by doctor Greg Spermer. We would like to thank Janelle.
Speaker 1 (57:50):
For all our support and everybody else who contributed to
this program.
Speaker 2 (57:55):
Rogercamble
Verbs that Angelica Sperver Hi, and welcome to episode eighty
eight of Sperbs Herbs. Today we're going to be talking
about an incredibly popular herb. Uh some one of my
(00:21):
sources said it was the top five other sources top
ten herbs western herbs in the US and Europe, and
that is saw palmetto or seran noa repens, I believe
is how it's pronounced, and without further too, let's get
into what that means. So today's episode we'll be looking
at another herb of the world, saw palmetto or serranoah repins.
(00:44):
This is a well known herb used for over two
thousand years. So you know, when I wrote this blurb,
I did a quick search and I found some someone
that said it was used for over two thousand years,
and my research probably wouldn't disagree with it, but it
didn't quite get as they did. The whole episode wasn't
(01:05):
quite two thousand years. We'll talk about that as we
talked about the history of this herb, but it's certainly
been used for quite a long while and has a
modern reputation for treating prostatic hyperplasia or enlarged prostate. As always,
we will do our deep dive into this herb and
look at its traditional uses and its preparation, interactions and
(01:29):
cautions and see if the science supports its use. And
as usual, we will be adding something a little different today.
It's going to be super exciting. We are going to
revisit artificial intelligence and see if it is any better.
I've given us good information on herbs, so that's a
fun one. Combines all my favorite topics. It combines technology
(01:51):
and herbs and learning. So there we go. We're gonna
deep dive into artificial intelligence. Actually I don't know if
I deep type, but we're diving into it. It's going
to be another interesting rocket ship into the exciting solar
system of herbs.
Speaker 2 (02:07):
Please join us today. Before we get.
Speaker 1 (02:11):
Into that, I just wanted to just quickly tell you
I've been teaching for quite a while now on a
wide variety of topics. If you like this podcast, I
want to explore more of my courses. They are available
at www dot Integrative Medicinecouncil dot org. That's Integrative Medicine
Council Council dot org and include a ton of different topics,
(02:35):
including my Drug Herb series looking at drugs and how
they interact with herbs and vice versa. Several ethics and
safety courses, Chinese medical research, several treatment of condition courses
such as arthritis, neck and back pain, COVID and depression
and anxiety, and one of my favorite courses the Chinese
herbal First Aid Kit.
Speaker 2 (02:57):
And they're all at a reasonable cost.
Speaker 1 (02:59):
And you get an additional twenty percent off with the
code SH twenty off. That's sh as in sperbs herbs
SH twenty off off.
Speaker 2 (03:12):
Thank you.
Speaker 1 (03:14):
All right, So let's talk about artificial intelligence over a
year and a half ago in episode forty eight and
we're on eighty eight, so this is, you know, forty
episodes down the road. In episode for Ey, we did
an experiment during this podcast we looked at artificial intelligence
AI and whether it can be useful when researching herbs.
(03:36):
At that point, we used Valerian, a very popular Westerner herb,
as the subject. I concluded this is a quote from
what I said. I'm really impressed by what it can do.
The bottom line is, I think this could be a
very useful tool for clinicians in the future, but still
needs quite a bit of work before it gets there.
So here we are again a very common Western herb
(03:59):
some But the reason why I choose common Western nerves
is because a lot of the Chinese rbs are not
as well documented as the Western nerves, and of course
it was very common there should be lots of information
for AI to gather, so that's why I've been choosing
very common Western herbs as we go into this, and
there have been some major changes in AI since the
last time we did this, So let's run the experiment again.
Speaker 2 (04:22):
And not only did I last time.
Speaker 1 (04:25):
When I ran it, I only ran it on one
AI because there weren't a whole much of others readily available.
Bard I actually got which was the old version of
Google's Gemini Today's Gemini. I got the invitation for that,
I think the day of and I couldn't get into
it in order to do it. So it's been out
(04:46):
for a little while now, so let's let's see what
we're gonna do. So today is the last time I
asked chad GBT, which is probably the most well known
at this point, so I asked chat chat tp GBT
to do today's presentation. This is at least one or
two generations of chat GBT since last time where we
use chat GBT three. Today we'll be using the latest
(05:10):
version four. And the reason why I say one or
two generations, they came out with three point five and
that was a pretty big leap over three, so it
wasn't quite a new generation, but it was sort of
a half to those. It's one or two generations, maybe
one and a half generations since the last time we
did this. We're also going to use We will also
use Gemini, Google's AI and not use Copilot Microsoft's AI
(05:35):
because it's based on chatchpt. You know, I have a
friend who's been really looking into AI for lots of
different reasons, and he has a bit of a He
has a website he runs, so he has a bit
of a tech background and that, and he said co Pilot,
even though it runs on chat GBT, does kind of
have its own spin on chat CHPT. But I just
I didn't think we had a third one. The other one,
(05:57):
which we're going to talk about, is the one that
my friend really likes, which is Perplexity. So we're gonna
talk we're gonna use that one as well. So we're
going to test three different AIS today. We're the last
time we only top one, we only use one. So
here's what happened. I gave the prompt create a forty
five minute professional presentation on saw Palmetto HERB. That was
(06:19):
the prompt. So here is today's experiment. I will, with
tons of transparency, be using some of the lines from
these AI attempts.
Speaker 2 (06:26):
These will be.
Speaker 1 (06:27):
Taken from several different iterations of the prompt. By iterations
means you do a prompt, you see what you get,
you tell it how you want it to change, and
it changes it and that's eventually you get to something
that's useful. So let's see how this will play out.
So first one is saw Palmetto and Chat GPT. I
put in the prompt discussed into chat GPT four and
(06:49):
it put out an outline and at the end it said,
would you like to continue with creating slides or content
or for any specific section. So that's kind of cool
right off the bat. It kind of knows what you're
trying to do. And even though I didn't give it
to you in the first iteration, it's like, hey, just
tell us that that's what you want. So I prompted
it to please create the slides and an added content
(07:11):
to each slide, though not a ton of it. Ending
this iteration with the question, would you like me to
help with detailed content or provide references for any specific slide?
Speaker 2 (07:22):
I responded with.
Speaker 1 (07:23):
Yes, please add detailed content with references, and it came
up with a fourteen slide presentation with references which always
need to be confirmed due to AI hallucinations. I confirmed
all references that we found here, and we'll talk about
that in just a minute. So I'm going to go
through the slides given by chat Gibt here as they
(07:43):
are very interesting. You should be done relatively quickly. The
first slide is a title slide and the last is
a references slide that says add all the references on
the individual side sites. So they had all the references
to the bottom of each slide, and the last slide
basically said, well, okay, all those individual references put it
in this slafe. So it didn't do it, but it
said what you should do. So that leaves slides two
(08:05):
through thirteen. So slide two titled introduction to Salt Palmetto
and it actually had a heading main content. Salt palmetto
is a small palm tree found primarily in the southeastern US,
particularly in Florida. Native Americans, including the Seminole tribes, historically
used salt palmetto berries for a variety of ailments, especially
(08:26):
those related to the urinary and reproductive systems.
Speaker 2 (08:29):
The RB gained.
Speaker 1 (08:30):
Popularity in Western medicine and late nineteenth century for treating
urinary and prostate issues. Now I can tell you, after
having gone through and researching all this, that is all correct.
So what it says is actually really good. Here's the references.
So the first reference is from Morton and it was
written in nineteen seventy seven Major Medicinal Plants, Botany, Culture
(08:53):
and Uses, and it has the publishers Charles C. Thomas
pub Ltd. And my comment here is confirmed. This is
real but quite old. Nineteen seventy seven is basically almost
you know, fifty years ago. So that's that's a lot.
That's very old for reference for something like this, bud valid,
(09:16):
so we're good. The next one was from a niche
l in nineteen ninety nine and it is in Ancient
Herbal Plants in Ancient Egyptian Medicine by the University of
Texas Press.
Speaker 2 (09:29):
And I did find this book, but it.
Speaker 1 (09:31):
Was published in nineteen eighty nine, not nineteen ninety nine,
with a newer version in two thousand and six. I
did not find anywhere in nineteen ninety nine version. In
the two thousand and six version was not by the
University of Texas Press, So somehow I got the date wrong. Okay,
maybe passable, So that was slight two. Side three is
a botanical description. Sarah no repinns belongs to the are
(09:56):
Erica erica as arica family and is native to the
coastal plains of the southeastern United States. The plant has
distinctive fan shaped leaves and produces dark red berries that
contain the active medicinal compounds. Thrives in sandy soil and underbrush,
particularly in pine forests and coastal plains. So you know,
(10:20):
I didn't get too much into the growing of this,
and I'm not sure about pine forests. I did read
coastal plains. For the most part, this seems relatively appropriate.
Fan shaped leaves. You know, it's a palm, so it
has those palm shaped leaves. So I think this is
pretty accurate. And here are the references from Higginfeldt h
(10:41):
in two thousand and one botany and Phyto chemistry of
sapal meta sero repenns written in the journal Fital Medicine
on pages and it has the volume and the number
of the of the journal eighty five and the pages
three eighty five to threety seven. Here's what I found.
This article does not exist. I could not find it
(11:01):
with a direct Google search. And when I found the
journal and looked at the issue sited, there was no
article on saw Palmetto. Though all the info was correct, volume, issue,
page numbers, they were all there. It was in saw Palmetto,
so it doesn't exist. I looked it up. I've never
not found a paper sighted somewhere in a Google search,
(11:25):
and I don't think I used it, but it may
have also used Google scholar search. Never not found a
paper where I have all the information. So this is
the first time I've never found a thing and I
looked up specifically what it said.
Speaker 2 (11:38):
Not there at all.
Speaker 1 (11:41):
Made up hallucination, that's what they call it, an AI
hallucination when they make up content, which they tend to
do so bad bad side for active constituents. The primary
active compounds found in solutplemental barries are fatty acids, luric
acid olac oliac acid and kumprilic acid, photosterials betas citosterol,
(12:03):
campestorol and stigmasterol, and flavonoids known for their anti inflammatory
and antioxidant properties. Again, these are having looked at the constituencies,
are all correct and are pretty are absolutely you know
from my research is this is all true information. These
(12:24):
components are believed to work together to support prostate.
Speaker 2 (12:26):
Health and hormonal balance.
Speaker 1 (12:28):
Okay, and here's the reference Villa navarette are at all?
This is what it says two thousand and three Pharmacological
effects of Serahenoa, repens and fo terapia, which is phytotherapy.
And I think it's Spanish. It's actually a well known
it's a fairly well known journal in this field. Again,
it has the volumes in the in the issue numbers
(12:50):
and the page numbers. And again this article does not exist.
Did a Google search, looked up Feto Tapia.
Speaker 2 (12:58):
That's not one. That's gonna have a lot of other.
Speaker 1 (13:02):
Confusing journals and looked at these pages, looked at the
whole journal.
Speaker 2 (13:07):
This article was not in any of them. Made up.
Speaker 1 (13:12):
Slide five Traditional uses Native Americans consume the barriers for
urinary tract infections, reproductive health, and as a general tonic.
They believed saw palmetto to be rejuvenating or particularly particularly
for men's health, supporting vitality and strength. It was also
used in poultices to treat wounds in skin conditions and
(13:34):
the reference is Barrett B. At All nineteen ninety nine
saw Palmeto a Review of Use Pharmacology and Therapy Potential
in the Journal of Alternative and Complimentary Medicine. Again it
has the volume and issue numbers and page numbers for
seventy one to forty two, and well, this is a trend.
The article does not exist. So out of the five
(13:56):
articles that it has cited so far, three of them
do not exist.
Speaker 2 (14:01):
They're completely made up.
Speaker 1 (14:03):
One had the wrong date, which, okay, you might if
that was the only thing wrong, you might give a
pass on, but it's not. And one was super old,
super old and so just not good.
Speaker 2 (14:18):
And I called it.
Speaker 1 (14:19):
That's it, calling it chat cheapt seems to have fairly
accurate information. Actually I'd say really accurate information.
Speaker 2 (14:26):
It was it made up a really good thing.
Speaker 1 (14:30):
It was a little short for me, you know, for this,
you know, because I have I don't know, I have
probably thirty or forty slides that are quite way more
detailed than chat chept. But okay, the information was relevant.
It was there out of thin air, so it's really cool.
So was able to put together a useful presentation. But
too many of its references are fake or wrong, and
(14:52):
therefore the information cannot be relied upon, and it completely
fails the test. I'm sorry, references are everything so done,
This was not not good chat chat gpt is not
a good source for herbal knowledge. We'll have to test
it again in another year or two and see where
it's at at that point. But until chat gpt starts
getting its references correct, it's just it's not a viable option.
(15:16):
And of course I extend that out. I mean this
is not a I mean herb. Herbalism in general is
I think a little bit more obscure than other things.
But if it can't get this right, what else can it?
Speaker 2 (15:24):
Does it get right or wrong? So not liking it?
Speaker 1 (15:29):
Okay, So let's look at salpal Metto and Gemini. So
Gemini is Google's version of AI. Again, I put the
prompt create a forty five minute professional presentation on saltpal Meto,
herb into Google's Gemini, and again it created a good,
if a little short, and relevant outline of a of
a presentation. I then asked it to please create this
(15:52):
presentation with references, to which you responded with a short
but decent presentation with seemingly useful information with references. However,
when you looked at the references, they were all placeholders
that said, in brackets insert citation for dot dot dot ellipses,
whatever the topic was. In other words, there were zero references.
(16:15):
And this constitutes another complete fail. If you don't tell
me what you're getting the information from, I can't trust
the information period. If I can't confirm your information, it
doesn't exist. So Gemini is another utter failure based simply
because it couldn't do any references at all. So I'm
I'm getting a pattern here thinking okay, we're not there.
Speaker 2 (16:37):
I can't do it. So I did do this Subplemento
and perplexity.
Speaker 1 (16:42):
I did the same exercise for another AI that one
of my friends prefers, and that's perplexity dot ai. That's
how that's the www that you put in perplexity dot ai.
So p E r p l e x I T
Y dot ai should be period. As with others, the
initial answer was an outline of presentation, and I then
(17:05):
asked for detailed content with references. Well, I would say
it might be a fifteen minute presentation rather than a
forty five minute one. I do this a lot, so
I can pretty much judge how long a presentation is
going to be. It was pretty good with individual references
that link to the source websites. Two of the eight
sources were scientific papers, while the others were websites that
(17:26):
were appropriate and relevant, like WebMD and healthline. Except for
the reference to Amazon for dosing, it actually had when
you it had what was cool about the references they
had the pages? You click on it and we go
to that page. So it was really just an Amazon
page with products of salt palmetto, and that's what it
was using for it. It's dosing, which.
Speaker 2 (17:47):
I guess isn't wrong. I just wouldn't use.
Speaker 1 (17:50):
That ever as a reference, so I didn't go into
as much death depth as I would have wanted. However,
Perplexity was definitely the best of the AI discussed here,
at least as far as herbs are concerned. It had references,
it wasn't bad. The information wasn't bad overall.
Speaker 2 (18:09):
I liked it.
Speaker 1 (18:10):
And if you guys want transcripts, I copied and pasted
everything I did here, just send me an email. I'm
happy to send do the transcript of everything I did
and what the responses were and all that, so you
can kind of see what everything was. But for my money,
if I were to ask a question of an Ai,
it would be perplexity about herbs, and even then I
would I would definitely look at it with a fine
(18:32):
tooth comb to see if I trusted.
Speaker 2 (18:35):
It or not. But at least there was one that
wasn't half bad, so we'll check it again another year
or two.
Speaker 1 (18:41):
Not bad though, okay. And with that on Ai and
sal palmetto and herbs, let's get into our thing that
was interesting. I think we're getting there, and maybe a
perplexity is mostly there, but none were as professionally relevant
as I would like. So let's get into our normal
in depth approach to or herbs. So we're talking about Seronia,
(19:03):
so Sroona, I can't even say this, So Santa Noah
repins salt palmetto and it comes from the family, as
was mentioned in one of those slides. Ericassier eric Adi
Cassier and the species of Sarah Noah repins in parentheses W.
Bartram and then Small after that.
Speaker 2 (19:25):
So remember the W.
Speaker 1 (19:26):
Bartram and the Small actually refer to biologists. This this
technically means that the biologist Bartram W. Bartram was the
first to codify this species, and then it was revised
by the biologists Small, And that's what that all means.
The medicinal part is the fruit. Other names for this
(19:48):
rather than salt palmetto are American dwarf palm tree, cabbage palm, jews,
jong sable fruits, cerelata, So that was that's the Latin
staple cerulata, So it's no longer the correct name, but
it is an older name for this. For this plant
the shrub palmetto, salt palmetto berry, sarah Nooa cereulate, Brahia cereulata,
(20:15):
and Carifa repens. So there's a bunch of potential Latin
names for this, but the correct one is sarah Noa repens.
So let's talk about the area. Eric Osier family, the
Erka see I keep wanting to say it, so I
get it better. The Erikasier family constitutes perennial flowering monocots,
(20:37):
or plants with fibrous root systems. The plants of this
family are all palms. There are approximately one hundred and
eighty one genera in two thy six hundred species, with
one exception. They are known by their fronds, large evergreen,
compound leaves. The fruits are usually single seeded drup. This
(20:59):
family includes many historically useful plants and products still important today,
including date palms, coconuts, ivory nuts, carnuba, wax from Brazilian palms, ratans,
palm oil, hearts of palm asai, and several palms used
to create alcoholic beverages. They kind of went into a
(21:21):
little detail, and I thought it was a little bit
more than we needed to know. So history of this so,
according to Foster, who had a really nice overview paper
on excuse me, Salt Palmetto, native groups throughout Salt Palmetto's
range consumed the fruit as a staple food. In fifteen
(21:44):
seventy five, Spanish explorer Hernando de Escalante Fontaneeda, who was
around fifteen thirty who lived from fifteen thirty six to
fifteen seventy five, was the first known European to record
the use of the bear as food by indigenous groups
in Florida at the time of first European contact and
(22:06):
what is now Florida in fifteen thirteen. The now extinct
Glade Indians of southern Florida, including the Colusa, the Tequesta,
may Emi, Miaimi, Jega or Jobe, and ais Ais, consumed
salt palmetto fruits to mukua I'm sorry, I'm butchering these
(22:30):
these terms. The Timucua and Appalachi ate fresh berries. The
Alabama Creek, Mikosuki, and Seminole also consumed the fruits. The
Choctaw dried the fruits for winter consumption. This is supported
by another paper. Salt palmetto was one of the most
(22:52):
important foods for Florida's pre Colombian non horticultural peoples and
later Creek immigrants.
Speaker 2 (23:00):
Among the older Seminole.
Speaker 1 (23:01):
Population, the fruit is still consumed in moderate quantities, and
a sweeten traditional drink called Chiopi soft key is made
from the juice. Sal palmetto was largely unknown by the
European and American medical communities until the second half of
the nineteenth century. Foster continues to discuss the first inkling
(23:26):
of medical uses in eighteen oh six bondanist and physician
John L. E. W. Chicut Chicut she Cut, who lived
from seventeen seventy to eighteen thirty six, and his Flora
Carolinius carolina ensis, recommended a cautious approach to consuming the
(23:46):
fruits and had it hinted at medicinal activity, which may
have been the result of microbial contamination, given that the
alleged purgative effect is not reported elsewhere. This is a
quote from that book. Hope of this fruit is of
an uncommon sweet taste, but it's possessed of such a
purgative quality. The strangers are sure to pay dear for
(24:07):
the knowledge obtained from one experiment. They are so tempting
and pleasant that few can refrain from tasting, and one
or two of them produces a copious evacuation and are
very apt to occasional gripings or grippings. You know, it's
an old word, and I think we pronounce it grippings
these days, it's spelled gripings. I am of the opinion
(24:29):
a valuable medicine might be prepared from this fruit.
Speaker 2 (24:34):
Grippings.
Speaker 1 (24:34):
Gripings means cramps basically okijun cramps. The first medicinal uses
of salt palmeto are similarly elucidated by Foster. The use
of salt palmetto as food sparked observations on its medicinal use.
Quoting a letter recard from doctor George Wallace of Daytona, Florida,
recalling use in the eighteen fifties, excerpted excerpt I can't
(25:00):
even say it an excerpt excerpted in an article on
the evolution of the salt pametto in the June eighth,
nineteen hundred issue of the Virginia Medical Semi Monthly. J. C.
Speaker 2 (25:12):
Lhardy, m d.
Speaker 1 (25:13):
Of Savannah, Georgia wrote, Indigenous groups and enslaved Africans ate
the berries ravenously with us. The taste is an acquired one.
At first it is almost repulsive, but generally, after a
few days one becomes passionately fond of it. It takes
the place of food, is slightly stimulating, and the indigenous
(25:34):
groups and enslaved Africans all say that it is an
excitant to the organs of generation and a splendid tonic
and builder up when convalescing from fevers or other wasting diseases.
So that's probably the first mentioned. Like we said in
the second half of the eighteen hundreds, one of the
(25:54):
first mentions of salt palmetto as medicine.
Speaker 2 (25:58):
Other uses.
Speaker 1 (26:00):
Saw palmetto is a hearty, if slowly reproducing plant and
has had many uses historically and in modern times, including
as food, fiber, oil, medicine, wax, and roof thatch, among
other economic products. In the late nineteenth century, a market
emerged for use of salt palmetto vegetative material for the
(26:21):
tanning industry. Indigenous groups were seen to bruise the stems,
then boil them in water and use the liquid to.
Speaker 2 (26:29):
Tan hides traditional uses.
Speaker 1 (26:34):
So the PDR for Herbal Medicines UH says it was
approved by commission e for irroble bladder and prostate complaints.
We've talked about commissioning in the past. Commissioning was something
done in the I think it was in the eighties
in Europe, and basically at that point, if a herb
wasn't approved by commissioning, I don't think you could sell
it in Europe. So commissioning was approved, you know, was
(26:57):
important and they looked at all the evidence and decided
which ones did something, which ones didn't do it, so
being approved by commissioning basically says there's some evidence to
show that it does support these sort of things, though
as we find out, it may not be you know,
as strong evidences as we may have thought with commissioning,
But Commissioning approved it for eral, bladder and prostate complaints.
(27:20):
Unproven uses including folk medicine sall plemtos used for inflammation
of the urinary tract, bladder, testicles, and mammary glands. It
has been used for nocturnal and usis that is, bedwetting,
persistent cough exima, and improvement of libido. WebMD You're still
under traditional uses. Web md says the serve can be
(27:44):
used for people used for people commonly use.
Speaker 2 (27:48):
Oh, that is bad grammar, that's choose up.
Speaker 1 (27:51):
So people commonly use saw palmetto for symptoms of an
enlarged prostate called benign prostatic HI purchase you're a BPH.
Saw palmental is also used to prevent complications from prostate
surgery and for treating other prostate conditions, mal pattern baldness,
sexual dysfunction.
Speaker 2 (28:09):
And many other purposes.
Speaker 1 (28:13):
Drugs dot Com says Salplemento has been used to treat
symptoms of enlarged prostate benign PROSTATICI purchafy or BPH, such
as the increased nighttime urination or decreased urinary flow. Other
uses not proven with research have included treating sore throat, cough,
cold symptoms asthma, bronchitis, migraine, headache, mal pattern, baldness, chronic
(28:35):
pelvic pain and prostate swelling, bladder problems, prostate cancer, and
other conditions. Mount Sinai ads it may help with benign
prostatic hi perchafy, prostate cancer, promote urination and inflammation. Doesn't
promote inflammation, it would help inflammation, so USPS monograph. We't
(28:59):
talk about USPN seconds, so USP's monographs says. Salt palmetto
has been used in males to tone and strengthen the
reproductive system and specifically for symptoms of prostatic enlargement, and
women has been used occasionally to reduce savarian enlargement and
increase the size of small undeveloped memory glands and both sexes.
(29:21):
Has been used as a general tonic for genito urinary problems,
to increase sexual vigor and as a diuretic. That paper
continues to say the Native Americans of the Southeast regions
considered saltple metal useful as a nutritional tonic, a use
to which the high oil content and the nuts and
flesh of the fruits probably contributed. As a diuretic, a sedative,
(29:44):
and an aphrodisiac. The steam from cooking fruits was inhaled
is still the usp monograph.
Speaker 2 (29:53):
The steam from cooking.
Speaker 1 (29:54):
Fruits was inhaled for use in bronchitis and to relieve
irritated mucous membranes. As an expectorant, Salpometa was largely unknown
by the European and American medical communities until the second
half of the nineteenth century. The plant was first considered
a nutritive tonic and a useful remedy for relieving local
irritations of the mucous membranes of the respiratory, digestive, and
(30:18):
reproductive tracts. Over time, it became widely used for the
relief of urinary difficulty and pain in men with benign
prostatic hyperplasia. Benefit was attributed to an ability to increase
bladder tone and reduce urinary urgency, allowing bitter contraction and
(30:39):
expulsion of urine with reduced pain. Salpometo also was used
for certain eurogenital disorders in women, including our varying and enlargement,
dysminery or pain fulmencies, and for stimulating mammary gland secretion.
Salpometa was also frequently used to relieve chronic bronchial coughs
(31:00):
and learningitis. So that's not a use that you hear
a lot about, you know, when just going through saltplemento.
But there are some respiratory uses, some lung uses of
the sort of. Okay, I mentioned the USP, So let's
talk about the USP, because you know, this is actually
a really important So I think I just have a
slider to have one slide on this.
Speaker 2 (31:22):
So we're going to talk.
Speaker 1 (31:23):
About USP stands for United States Pharmacopeia, and we're using
a source from the United States Pharmacopea USP, and I
wanted to take a quick break in our presentation today
to briefly introduce the USP.
Speaker 2 (31:34):
The USP was.
Speaker 1 (31:35):
Started in eighteen twenty and is a nonprofit, non governmental
organization that publishes a pharmacopeia with quality standards for the
United States. If these standards are met, drugs and dietary
supplements may use the designation's USP or NF for national
formulary on the products. So when you see a USP,
(31:57):
you know often you'll see a little USP in a
bottle that means it's up to these standards. The US
Food and Drug Administration, the FDA, uses the standards for
individual constituents as the basis for determining whether or not
an ingredient has been adulterated.
Speaker 2 (32:12):
So while it's non.
Speaker 1 (32:14):
Governmental and there's no laws backing this up, the FDA
does use it as a reference and the FDA can
use it to enforce certain laws as well. So the
USP is actually very important in the US, and they
and they definitely have a lot of scientists and they
have annual conventions where they talk about all these things
and they look at all these quality standards. So it's
(32:36):
a it's a big deal. So that monograph was actually
a really good source of information.
Speaker 2 (32:41):
For US today on salt palmetto.
Speaker 1 (32:45):
Okay, let's talk about dosage and preparation of this herb.
According to the PDR for herbal medicines, dosage should be
a daily dose should be a daily dose of one
to two grams of the rug or three hundred and
twenty milligrams of the lipophilic extract and then it says
hexan or ethanol ninety percent v slash V, which is
(33:08):
volume to volume. So that's it, and we'll see typical
doses are three hundred and twenty milligrams a day, often
in divided back next one dro This is from still
from the PDR for verbal medicines. Dosage is used in
studies demonstrated efficacy at one hundred and sixty.
Speaker 2 (33:25):
Milligrams given twice daily or three hundred and twenty milligrams
given one Dailey. There you go.
Speaker 1 (33:30):
Web MD says APPA metal has most often been used
by adults and doses of three hundred and twenty to
nine hundred and sixty milligrams to my mouth daily for
up to three years. Now, I gotta say that's the
one source I've seen that goes as high as this.
Most of the sources are saying one sixty to three twenty,
so nine to sixty seems like a lot.
Speaker 2 (33:50):
And here's the USP monograph.
Speaker 1 (33:52):
They say traditional preparation for traditional preparations as a t
one to two grams per day as a decoction, bring
to boil one cup of water and one third the
total daily dose of saltpalmetal, fruits and simmer gently for
five minutes. Drink one cup three times daily. As this
is a hydrophilic extract process, it contains few lipophilic components,
(34:15):
and that's important, especially since we think the lipophilic components
are actually the the the active ingredients. So I would
not recommend it decoction with this, but it is, it
is done. The next thing is still the USP monograph
liquid extract A one to one herb to extract ratio
or HR is you should have point six to one
(34:37):
point five millilaters three times daily as a tincture eighty
percent alcohol fresh fruit and one to two herb to
extract ratio dry fruit. One to five herb to extract
ratio one to The dosage is one to two millilators
three to four times daily. So you know, some of
(34:59):
the the sources actually say that this is probably better
taken as a liquid form and TENSUREFORMX that's where a
lot of the active ingredients are, rather than in.
Speaker 2 (35:09):
Pill form, which is how most of it is done.
Speaker 1 (35:12):
So kind of take that as you will for clinical
trial preferences. Again, we're still in the USP monograph clinical
trial preparations. Liposterolic extractor l SP three hundred and twenty
milligrams orally once daallarer one hundred and sixty milligrams twice
daily in liquid or solid form, with an approximate ten
to one herb to extract ratio HR.
Speaker 2 (35:35):
I love this about the USP.
Speaker 1 (35:36):
It's all about these extract ratios and it's one of
the issues I have when other people try to dose.
They don't give you the extract ratios. They're incredibly important.
So this is really good information. So approximately ten to
one herb to extract ratio standardized to seventy to ninety
five percent free fatty acids has been studied for symptomatic
treatment of benign pross chiperchapse stage one and two. Consumer
(36:01):
lab dot com which I love as a resource. If
you want some really good direct information, that's it. It
is behind to pay, well, you do have to pay
for it. It's the one subscription I paid for without hesitation,
so I use it constantly. One of the things I
love about Consumer Lab and we're not gonna get into
it at all, but they test the products, like with
with Saalpa Meto. I think they test like maybe with
(36:24):
combination products, maybe eight or ten different combination you know,
brands of saftple meto test them for contaminants, to test
them for. It has what it says it has and
gives you a recommendation based on price and what it
has in there.
Speaker 2 (36:38):
It's great if you want.
Speaker 1 (36:39):
To know not just what it should do, what it does,
and how it does it and all that, but also
which specific products you should buy. I love consumer lab
dot com can praise them enough. So consumer lab dot
Com says a typical dose three hundred twenty milligrams per
day of extract standardized to eighty five to ninety five
percent fatty acid, so it pretty much falls at USP.
(37:00):
Another book that we're going to refer a couple times
here is The Energetics of Western Herbs, a Materia Medica
integrating Western and Oriental herbal medicine traditions.
Speaker 2 (37:10):
This one is volume one.
Speaker 1 (37:12):
That says by Holmes that says this herb should be
used at the following doses in decoction four to eight grams,
which remember earlier we said one to two grams, but you're.
Speaker 2 (37:24):
Supposed to take it three times a day, so that's
in the ballpark.
Speaker 1 (37:26):
I think tincture one to three milliars at one to
two strength and forty five percent alcohol. Holmes notes that
it can also be used as a pository for prostate
conditions and as a syrup for treating dry irritated conditions
of the upper and lower respiratory mucosa.
Speaker 2 (37:44):
So that they really he really goes into the lung.
Aspects of this.
Speaker 1 (37:51):
Quality, it was difficult to find anything on what makes
good quality soft palmetto. However, heavy metal contamination, especially arsenic
lead and cabin is a concern. In consumer lab dot
COM's testing of eight products containing salt palmeta, none showed contamination.
That's good because I've seen them do reviews and almost
all of them show contamination. So the fact that none
(38:14):
show contaminations, it means we have a pretty healthy supply.
One of those eight did not get approved due to
too few fatty acids in the product, but nothing else
inherently wrong.
Speaker 2 (38:25):
With the product, which is good. So it's about Chinese
medical actions of this herb. A source.
Speaker 1 (38:35):
Says this herb is.
Speaker 2 (38:36):
Julie Zong or jujong in Chinese, so.
Speaker 1 (38:40):
There is a Chinese name for it, though I tried
to look that up in any of my Chinese herbal
texts and they weren't there. So you know, even though
that's a name, I don't know how prevalent that is.
The source from the White Rabbit Institute of Healing goes
on to say, salt palmetta is slightly sweet, pungent, astringent,
dry and warm, and enters the kidney and lung, which
(39:03):
makes sense. We're talking about, you know, prostate and sexual health.
The kidneys are often involved that and we saw a
lot of lung functions, so mixed sense that those would
be the two big channels here. His actions are boosts
jing tinafies, kidney chi. Both of those could be you know,
(39:23):
considered to be useful for bph as well as potentially
for libidos.
Speaker 2 (39:28):
So those are that makes sense.
Speaker 1 (39:29):
Booshing tanaphies kidney chi, reduces inflammation, and then it has
a colon, explaining these three functions of boost sexual drive,
swollen and flamed reproductive organs, infertility, ovaridis or inflammation of
the ovarrays, impotence, sterility, improved energy and weight gain. And
then's other set of actions is it expels phlegm and
(39:51):
supports lung chi and again a colon and coughs, flues bronchitis, wheezing,
asthma and gtars, so guitars are are I can never.
Speaker 2 (40:01):
Remember what a guitar is, so I used to have
it up here. But it's to do with the lungs.
It's an old term.
Speaker 1 (40:09):
Another sourt of Chinese nutrition, dot Org says it is sweet, sour, warm,
and enters the spleen, bladder, kidney, and liver, so not
exactly the same. It doesn't have lung and it adds
in bladder, which makes a bit of sense. I don't
know about spain liver, but okay, the slain makes sense
a little bit too.
Speaker 2 (40:28):
It describes its actions.
Speaker 1 (40:29):
As in terms of Chinese medicine, salt palmetto is known
for its ability to tanify chi and tonify young. It
also helps resolve cold and resolve phlegm, so that's its functions.
And then there's that book that we talked about, the
Energetics of Westernerrbs of Materimatic Integrate Western Oriental Herbal Medicine Traditions.
Holmes says saftplemetto is somewhat sweet, astringent, pungent, which is
(40:55):
another word for spicy, aromatic, and warm. And there's the kidney, liver, spleen,
and lungs, so it kind of has all the same
as the Chinese nutrition dot org but adds in that
lung again. So he has four groupings of functions. So
the first grouping there's a lot here. He puts a
lot in these groupings, so hang with the Grouping number
(41:16):
one toonifies reproductive chy, regulates menstruation and relieves impotence and frigidity,
strengthens and nourishes the reproductive organs, increases hormones, and promotes
sexual organ development, conception.
Speaker 2 (41:29):
And lactation.
Speaker 1 (41:31):
Grouping number two tonifies urinary CHI. Harmonizes urination, relieves the
irritation and the end incontinence, strengthens the bladder and prostate,
and reduces swelling and inflammation. Grouping three tonifies the digestive chy,
promotes absorption and improves weight. Grouping four moistens the lungs,
(41:53):
promotes expectoration and relieves coughing, dispels wind heat dryness, reduces inflammation,
soothes the throat and opens the voice, and stimulates immunity.
So those are some different perspectives on chiness medical actions
with my own opinion thrown in there. Comparisons and combinations, well,
(42:15):
generally there weren't any direct comparisons or combinations for this
herb in our literature searches. Consumer labs dot com mentioned
the similar functions of beta cetosterol and tested combinations of both.
Speaker 2 (42:26):
And remember this does include.
Speaker 1 (42:27):
Some beta cytosterol, which is actually a very important herbal constituent,
and so they do. Actually there are combination products of
selpa metal and beta cytosterol. So I think you know
it's an interesting combination here contents so Evans, which is
(42:48):
a book I'm pharma Cognitcy says fatty acids constitute an
important feature of the drug, referring to the CRB the principle.
Free acids are olaic, loric, meristic, and palmitic acids, with
lesser amounts of caproic, caprillic, capric, steric, stearic, steric, linolaic,
(43:10):
and linolinic acids. Other constituents include flabinoids such as rutin, isocars, citron,
and others, phytosterols including cytosterol, its, glucosides and esters, and stigmasterol,
immunostimuli and polysacharides involving glactose, rabinose, mannose, ramnose, glucuronic acid
(43:32):
and others caratenoids and volatile oil.
Speaker 2 (43:39):
So those are the contents. Let's talk about the science.
Is there science behind this?
Speaker 1 (43:43):
There have been many studies looking at the use of
salva meto in lower urinary tract symptoms due to benign
prostacic enlargement.
Speaker 2 (43:51):
The results have been mixed overall.
Speaker 1 (43:54):
A recent Cochrane Database review looked at twenty seven studies
involving four thousand, six hundred more than fifty six participants
and concluded serenoa repins alone provides little to no benefits
for men with lower urinary tract symptoms due to benign
prostatic enlargement. There's more uncertainty about the role of sereno
repins in combination with other phyto therapeutic agents. So if
(44:20):
you're not familiar with the Cochrane Database, it is great.
It is a fantastic resource. They have very strict protocols
as to what gets into the Coctrine Database for systematic reviews.
It is considered fairly high level information, relatively high on
the evidence based medical system. So what it says is
(44:42):
usually really strong evidence, and this is basically saying it
doesn't do it.
Speaker 2 (44:46):
So I am.
Speaker 1 (44:47):
You know, before I did this, I was thinking if
someone came up to me with BPH, you know, and
of course go okay, well, salt promtos is thought to
really help this. After doing this, I'm like, no, I
don't know if salt prometa really does it. See, now
here's the problem, though. We haven't looked at all these studies.
And I can tell you one of the faults of
these studies is they will look at any studies that
(45:08):
have this that look at sarah these two things, the
salpametto and the benign prostatic hyperchafy. What it doesn't do
is assess dosagyen, and to me, dosage is key. So
there are twenty seven studies. I don't know if those
were all properly dosed or not. I think they probably
were because the dosting seems to be pretty standardized, but
(45:30):
I haven't looked at those twenty seven studies, so I
don't know. So overall, I would say this probably isn't
looking good for benign prostatic hi perchafye. But that doesn't
mean we should take this without reading it more in
depth and looking at it a little bit more closely.
Retrospective study. So retrospective study is not considered one of
the stronger strongest studies. We usually like to use prospective studies,
(45:54):
so we constructive study to examine what we want to do.
Retrospective studies looking at old records and then and coming
up with information from that. I reprotective retrospective studies are
really useful. For one thing, You can usually get a
lot of numbers from retrospective studies and they can really
be helpful in figuring out how and when and what
(46:15):
you might want to design a prospective study for. But
in and of itself, it is decent clinical evidence, but
not really strong clinical evidence. So a retrospective study looking
at twenty three hundred and one men undergoing radiation therapy
for prostate cancers showed no difference in outcomes in those
patients taking mental health supplements including salt palmetto and those
(46:38):
who are not. So in other words, it didn't help
with radiation therapy. So according to Cooperman, which is from
Consumer Labs, he's the doctor that runs that, there have
been some small manufacturer conducted studies looking at the use
of salt palmetto for androgenic alopecia. That's mel pattern baldness,
and other small studies that showed some hair growth in
(46:58):
these patients were not statistically significant, and we're not as
effective as pharmaceutical intervention. So basically this is interesting. It
does potentially produce some hair growth, just not in a
lot of people, you know, a lot.
Speaker 2 (47:12):
Fewer people than would be with often. It was compared
with finasteride, which is.
Speaker 1 (47:19):
A drug that helps promote It's not rogaine, it's the
other one does help promote hair growth, and it I
think fanastride worked in like eighty percent and this worked
in like forty percent, so a lot fewer people and
not as strongly as the finastride, So it.
Speaker 2 (47:36):
Had some effect it looks like but not strong. But
they're small, so we're not sure.
Speaker 1 (47:42):
Krupman also says there's no evidence for salt palmto's used
for bladder inflammation or sostitis, chronic bronchitis, laryngitis, and asthma
associated nasal inflammation. The USP monograph, though Older, says saw
palmetto may have in hit ambition of five alpha reductase activity,
(48:02):
alpha one adreenergic blocking activity, anti androgenic and anti estrogenic activity,
anti inflammatory activity, and anti spasmodic activity.
Speaker 2 (48:13):
So you know those all mean certains.
Speaker 1 (48:16):
So the five alpha reductase activity, alpha one, adrenergic blocking,
those are pharmacological activities. It can block androgenic activity, which
is male hormones as anti estrogenic activity, so it can
block estrogenic estrogen hormones. Frankly, I don't like things messing
with hormones and this is doing a bit of that.
So potentially, potentially. The PDR for herbal Medicines also says
(48:43):
Salpa metal has anti androgenic and anti estrogenic and anti
inflammatory effects as well.
Speaker 2 (48:53):
It's talk about Drugger of interactions.
Speaker 1 (48:55):
There are quite a few suggestions of the Drugger interactions
between Salpa meto and various drugs, though none appear to
have any clinical evidence. Warfron is frequently mentioned as a
potential interaction, though there's no clear evidence supporting this, and
Warfarn kind of gets this rap like, if there's any
hint then it might affect the blood, then it's going
to affect warf Warfin is very sensitive drugs. That's relatively
(49:19):
valid thing, but there's no evidence to really say that.
It does add that you will see a lot of
warnings like this should probably not be taken with blood
to any medications like warfrin, but there's no evidence. Then
the other the argument to that is, well, it doesn't
need evidence. It seems like a likely thing, and we
don't want to put our patients at risk, so we're
(49:40):
saying it.
Speaker 2 (49:41):
Okay, Yeah, I think.
Speaker 1 (49:44):
With as much use of warfron as much use of
salt plameta, especially in that population though where that can
overlap quite a bit, I would effect some evidence of interaction.
So anyways, another common concern is the combination of salt
pamtal and oral contraceptives, So again this appears speculative. Well,
there have been a small number of in vitro studies,
(50:05):
so in vitro means in glass studies showing potential cycachlonopy
for fifty interactions or CYP interactions. This is one of
the few herbs where clinical trials have shown no CYP
one A two, two six, two E one or three
A four interactions. So what we're saying here, so, first
of all, cychachroone P for fifty is one of those
risk factors for drug rib interactions, So we're concerned if
(50:28):
an herb effects cychrolonopy for fifty.
Speaker 2 (50:31):
It is at much higher.
Speaker 1 (50:33):
Risk for a drug rib interaction because it can effect
the use of tychcrolonepy for fifty by drugs. And so
this one when done in vitro, and is why I
don't like in vitro studies. It said, Okay, yeah, there's
a few interactions happening with tychcroonprey for fifty. But just
because that does that in a test tube, it doesn't
mean by test to I just mean broader, just not
(50:57):
in animals or in humans in viva. Well, so it
doesn't mean it's going to do it in humans. This
one they've done clinical trials. They had twenty healthy people
in this one trial and there's another one here as well,
and they actually gave them things that to see if
it affected these particular twenty subtypes of psycroone P fifty
(51:19):
two two, six, two, one three or four, three or
four is the big one that we're worried about. Forty
sixty percent of drugs will utilize that, and it found
that there was no interactions with that at all. So
who cares what it does in glass in vitro, in humans?
In clinical trials it does not. It clearly does not
have any interactions that's useful. So no real Drugger interactions
(51:42):
here that we've seen so far, so let's continue our
conversation of literatures. Did not find any mention of peak
lycoprotein interactions, which is another target for Drugger of interactions.
And the American Rbal Products Association's Botanical Safety Handbook puts
this herb in interaction Class A herbs for which no
clinical relevant interactions are expected, and I agree with that
(52:03):
with my research, this does not seem a high risk
for a drug or interaction. That doesn't mean there aren't concerns.
Let's talk about some of those concerns. According to the
PDR for Herbal Medicines, patients with hormone dependent cancers should
observe caution, speak to a physician. A physician regarding the
use of salt palmto because of its anti estrogenic, estrogenic
(52:24):
and anti androgenic effects, so you know, maybe they also
suggest the use of salt plemental with pregnancy and breast
feeding is not recommended due to its potential hormonal effects.
The USP monograph says clinical studies indicate that subplemento is
well tolerated by most patients, with the primary reported side
(52:44):
effects being mild gastro intestinal complaints such as an augea
and diarrhea. Salt palmeto has not been reported to be
toxic in humans or animals. Web Md says salt palmetto
is likely safe when used for up to three years.
Side effects are usually mild and might include dizziness, headache,
naugen and diarrhea. Salt palmetto is likely unsafe when taken
(53:07):
by mouth during pregnancy or breastfeeding. It acts like horomone
and this could be dangerous. Don't use during pregnancy or breastfeeding.
Salt palmtal might slow blood clotting again speculative, it might
cause extra bleeding during and after surgery. Stop using saltal
metal at least two weeks before a scheduled surgery. I'll
be honest with the most surgeons, especially in a big surgery,
(53:29):
you're gonna say stop everything two weeks before, so I
would stop it. Paper looking and liver toxicity from salt
palmetto concludes. Hippatotoxicity from salt palmetto is very rare and
cases have been self limiting.
Speaker 2 (53:44):
Upon stopping the.
Speaker 1 (53:45):
Herbal there have been no instances leading to fatalities, liver transplantation,
chronic hepatitis or vanishing bile duct syndrome, and the American
Herbal Products Associations Botanical Safety Hammock puts the serve in
safety class one herbs that can be safely consumed when
used appropriately. A systematic review of selplemental adverse effects concluded
(54:11):
adverse effects associated with the use of s repins are
mild and similar similar to those with placebo. The most
frequently reported adverse events are abdominal pain, diarrhea, nausea, fatigue, headache,
decreased libido, and rhinitis. More serious adverse effects, such as
death and cerebral hemorrhage are reported in isolated case reports
(54:31):
and data from spontaneous reporting schemes, but causality is questionable.
No drug interactions were reported. Currently available data suggests that
s repens is well tolerated by most users is not
associated with serious adverse effects. The majority of adverse effects
are mild, infrequent, and reversible, and include abdominal pain, diarrhea,
(54:53):
nausea and fatigue, headache, decreased libido, and rhinitis, which is
just everything I just read. Those are all the cautions.
So in summary, we started a discussion to day with
a look at the current state of artificial intelligence for
examining and assessing herbs and the evidence supporting their use,
and we found for the most part of it failed
(55:15):
except with perplexity. From there, we did our deep dive
into salplemento or Serenoa repens, one of the most commonly
used Western herbs and used primarily for benign prostatic I
purchase fee. Though the evidence doesn't support this use, has
a long history of use and appears to be quite safe.
So you know, based on its safety profile, if someone
(55:36):
wanted to take this, I wouldn't object to it necessarily,
but I would also explain that it probably won't help overall,
another interesting nerve that doesn't quite live up to the hype,
at least until there are more studies. That's the thing
about science. It's a step wise process. So right now
it doesn't look like it's very effective. Maybe there's bigger
and better and stronger studies and it turns out it
(55:57):
is very effective.
Speaker 2 (55:58):
You never know.
Speaker 1 (55:59):
I've seen it out and looking at this stuff for decades.
Speaker 2 (56:02):
Now it happens.
Speaker 1 (56:05):
In our next episode, we will be exploring another interesting
Chinese herb chiang huo or no top tier g Rihizoma
sutis or no top tier gem root or rhizome. This
herb is in the Chinese medical subcategory of warm acrid
herbs that release the exterior under the category of release
the exterior herbs. It is helpful for certain types of
(56:28):
colds and especially for alleviating pain and unblocking painful obstructions
in many conditions, such as some types of arthritis, and
as usual, we will be exploring something a little different.
Please join us for this intriguing episode. See you in
two weeks. Thank you very much for listening. If you
(56:50):
like this podcast podcast, please do us a huge favorite
give us a five star rating in your favorite podcast app.
We really appreciate it, and we thank you ahead of
time for even thinking about doing it. And remember you
can get continuing education units and National Certification Commission of
Acupunction Oriental Medicine Professional Development activities at www dot Integrativemedicine
(57:12):
Council dot org whether that's Council c O U, n
c I L dot org. And don't forget that twenty
percent off with the code s H two zero off.
You can always get in touch with me at doctor
Greg at sperbserbs dot com.
Speaker 2 (57:25):
That's s p e r B s h E r
b s dot com, or.
Speaker 1 (57:30):
On our website www dot sperbserbs dot com. And as
usual I have a good long bibliography.
Speaker 2 (57:42):
Thank you very much, spurs Or. The preceding was presented
by doctor Greg Spermer. We would like to thank Janelle.
Speaker 1 (57:50):
For all our support and everybody else who contributed to
this program.
Speaker 2 (57:55):
Rogercamble
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