Saw Palmetto and Prostate Supplements: Benefits, Forms, Dosing, and Side Effects

Table of Contents

• Current evidence position
• Key safety points
• Brad's videos on this topic
• Overview
• Forms and Bioavailability
• Evidence for Benefits
• Recommended Dosing
• Safety and Side Effects
• Drug Interactions
• Dietary Sources
• References

Current evidence position

Brad has not made a video on this topic; this is a summary of the evidence, not his view. For urinary symptoms from an enlarged prostate (benign prostatic hyperplasia, BPH), saw palmetto taken alone is probably not helpful: a 2023 Cochrane review of 27 trials found little to no benefit, and an NIH-funded trial found none even at up to three times the standard 320 mg/d extract dose ^{[1, 7, 15]}. Beta-sitosterol (a mixture of plant sterols) and pygeum improved symptoms and urine flow in older trials, but those trials were short and used products that were not standardized ^{[29, 32]}. Saw palmetto is usually well tolerated and does not appear to change PSA readings, but it may be unsafe in pregnancy or breastfeeding, and case reports link it to bleeding during surgery and to inflammation of the pancreas or liver ^{[1, 16, 48, 68, 70]}; for severe upper belly pain with vomiting, call your local emergency number (111 in NZ, 000 in Australia, 911 in the US, 999 in the UK). Selenium did not prevent prostate cancer in the SELECT trial, and men who took more than 100 mg/day of supplemental zinc had a higher risk of advanced prostate cancer ^{[36, 38]}.

Brad's videos on this topic

None yet.

1. Overview

Saw palmetto (Serenoa repens) grows as a small tree of 6 to 10 feet, native to the West Indies and the southeast coast of North America; its berries are used for health purposes ^[1]. It is promoted mainly for urinary symptoms from an enlarged prostate, and also for male pattern baldness and chronic prostatitis/chronic pelvic pain syndrome ^[1].

Other plant products sold for the prostate include beta-sitosterol, a plant sterol found in vegetable oils, wheat germ, nuts, seeds and avocado, which has its own trials in BPH ^{[29, 77]}. Pygeum bark (Prunus africana), stinging nettle root (Urtica dioica) and pumpkin seed have been tested too ^{[13, 32, 33]}.

BPH is a non-cancerous enlargement of the prostate that can cause obstructive and irritative lower urinary tract symptoms (LUTS) ^[7]. Trials measure these symptoms with the International Prostate Symptom Score (IPSS), which runs from 0 to 35, with higher scores meaning worse symptoms ^[7]. Medicines, minimally invasive procedures and surgery are all used; in the longer term, procedures and surgery improve symptoms and urine flow more than medicines do ^[6].

In human cells, a liposterolic saw palmetto extract inhibited 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT), and blocked androgen binding to its receptor ^[3]. In laboratory tests, an acidic fatty fraction of the extract also inhibited the cyclooxygenase and 5-lipoxygenase pathways that make inflammatory compounds ^[49].

Despite these laboratory findings, the clinical evidence for saw palmetto in BPH is mostly negative. A 2023 Cochrane review of 27 randomized controlled trials (4,656 participants) concluded that saw palmetto alone provides little to no benefit for these symptoms ^{[1, 7]}. The National Center for Complementary and Integrative Health (NCCIH) concludes that saw palmetto is "probably not helpful" for urinary symptoms from an enlarged prostate ^[1]. Two NIH-funded trials found no benefit over placebo, while some smaller trials have reported improvements ^{[1, 15, 17, 20]}.

This article covers saw palmetto, beta-sitosterol and other prostate supplements: their forms, trial doses, safety and drug interactions.

2. Forms and Bioavailability

Saw Palmetto Extract Forms

Saw palmetto supplements come as liquids, powders, dried berries and tinctures, and their fatty acid and plant sterol content differs widely between these forms ^[9].

Liposterolic (lipid) extracts are the most studied form. Permixon was used in the European PERMAL trial, and USPlus was used in the Winograd 2024 study ^{[19, 65]}.

CO2-extracted products are made with supercritical carbon dioxide; one such extract inhibited inflammatory enzyme pathways in laboratory tests ^[49].

Hexane-extracted products were analyzed separately in the 2023 Cochrane review, which found no difference in effect on BPH symptoms between hexane-extracted and other products ^[1].

Powdered berry products contain the dried berry ground into powder. In a 2013 analysis of 20 commercial supplements, powders held significantly more total fatty acids than tinctures but significantly less than liquids ^[9].

Tinctures contained negligible fatty acids (46.3 mg/g) and phytosterols (0.10 mg/g) in the same analysis ^[9].

Standardization and What to Look For

Liquid saw palmetto supplements contained significantly more total fatty acids (908.5 mg/g) and total phytosterols (2.04 mg/g) than the other forms, and the authors suggested liquids for people who want the highest amounts of both ^[9]. Pointers to independent product testing, such as consumerlab.com or Labdoor, can help when choosing a brand.

Beta-Sitosterol Forms

Products sold as "beta-sitosterol" can contain a mixture of plant sterols. The Berges 1995 trial used 20 mg of beta-sitosterol, which contains a mixture of phytosterols, three times a day ^[26]. The Klippel 1997 trial used 130 mg of free beta-sitosterol daily, from a defined extract of phytosterols with beta-sitosterol as the main component ^[27].

A 1999 review of four trials found that, pooled, beta-sitosterol improved symptoms and urine flow, but the one trial using pure beta-sitosterol-beta-d-glucoside showed no improvement in urine flow ^[29].

Much higher amounts of plant sterols, about 2 g a day, lower LDL cholesterol; this is a different use from BPH ^[76].

Other Prostate Supplement Forms

Pygeum bark extracts were tested in 18 trials, but the preparations varied and the reviewers called for standardized products ^[32].

Pumpkin seed oil was taken at 320 mg/day in the Hong 2009 trial ^[12]. In the partially blinded GRANU trial (1,431 men), 5 g of pumpkin seed twice a day for 12 months gave more responders than placebo, a difference the authors called descriptively significant, while pumpkin seed extract capsules (500 mg twice a day) did not ^[13].

Stinging nettle root was tested as a dry extract of 459 mg in a one-year trial ^[33].

3. Evidence for Benefits

Benign Prostatic Hyperplasia (BPH) -- Saw Palmetto

Saw palmetto is the most studied prostate supplement, with dozens of randomized trials. The largest and best-designed trials show no benefit.

Cochrane Systematic Review (Franco et al., 2023): A review of 27 trials involving 4,656 men with BPH concluded that saw palmetto alone provides little to no benefit ^[7]. In trials at low risk of bias, it made little to no difference to symptoms (IPSS mean difference -0.90, 95% CI -1.74 to -0.07) or quality of life at 3 to 6 months ^[7]. The reviewers analyzed hexane-extracted and other products separately and found no difference between them ^{[1, 7]}.

CAMUS Trial (Barry et al., JAMA 2011): This North American trial of 369 men gave saw palmetto extract at 320 mg/d, then 640 mg and 960 mg a day, each for 24 weeks. Between baseline and 72 weeks it did not reduce symptoms more than placebo ^[15]. Saw palmetto did not affect serum PSA more than placebo, even at these high doses ^[16].

STEP Trial (Bent et al., NEJM 2006): A double-blind trial of 225 men over the age of 49 years, whose BPH symptoms were moderate to severe, gave them saw palmetto extract (160 mg twice a day) or placebo for one year. The groups did not differ significantly in AUA Symptom Index scores, maximal urinary flow rate, prostate size, quality of life or PSA, and side effects were as common in both ^[17].

PERMAL Study (Debruyne et al., 2002): In a double-blind trial of 704 men with BPH, Permixon 320 mg/day and tamsulosin 0.4 mg/day each lowered the IPSS by 4.4 points at 12 months, and the authors judged them equivalent ^[19]. Ejaculation disorders were more common with tamsulosin ^[19].

Ye et al., Urology 2019 (China): A double-blind trial of 354 men with BPH at 19 centres gave Serenoa repens extract 320 mg or placebo for 24 weeks ^[20]. The extract improved peak urine flow, IPSS and quality of life more than placebo, and adverse events were few in both groups ^[20].

Winograd et al., Can J Urol 2024: In a single-arm study of 46 men taking a USP-verified extract (USPlus) at 320 mg a day, IPSS and quality of life improved at 12 weeks compared with baseline, mainly in men with moderate symptoms ^[65]. Urine flow improved, mainly among men whose symptoms were mild ^[65]. With no placebo group, the study cannot show how much of this change came from the extract.

Combination with Alpha-Blockers: The evidence on adding saw palmetto to an alpha-blocker is mixed. In 186 Italian men followed for at least 12 months, silodosin plus a hexane extract of saw palmetto gave lower IPSS scores than silodosin alone, and younger age and more severe symptoms predicted a meaningful response (Boeri et al., Sci Rep 2017) ^[21]. In a small Turkish study of three 20-man groups, adding saw palmetto (320 mg a day) to tamsulosin (0.4 mg a day) gave no extra benefit (Hizli et al., Int Urol Nephrol 2007) ^[22].

Pre-surgical use: In 75 men having transurethral resection of the prostate (TURP), saw palmetto 160 mg/day for 5 weeks before surgery did not reduce blood loss compared with no treatment (Tuncel et al., Scand J Urol Nephrol 2009) ^[23].

Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A 2022 review of five studies found no significant benefit of saw palmetto for chronic prostatitis/chronic pelvic pain syndrome ^{[1, 24]}.

Summary for BPH: The largest and best-designed trials do not support saw palmetto alone for BPH symptoms, though some smaller trials report improvement ^{[7, 15, 17, 20]}.

Benign Prostatic Hyperplasia (BPH) -- Beta-Sitosterol

A 1999 systematic review of four trials (519 men) found that beta-sitosterol improved urinary symptom scores and flow measures compared with placebo, with a weighted mean difference of -4.9 IPSS points (95% CI -6.3 to -3.5) in the two trials that reported the IPSS ^[29].

Berges et al., Lancet 1995: A German trial in 200 men used 20 mg of beta-sitosterol three times a day for 6 months. The IPSS fell by 7.4 points with beta-sitosterol and 2.1 points with placebo, and peak urine flow rose ^[26].

Klippel et al., Br J Urol 1997: A German trial in 177 men used 130 mg of free beta-sitosterol daily for 6 months and improved the IPSS by 5.4 points more than placebo ^[27].

Berges et al., Br J Urol 2000 (follow-up): At 18 months, men who kept taking beta-sitosterol had stable results, while men who stopped had slightly worse symptom scores ^[28]. The authors called for further trials before concluding that it works ^[28].

Mechanism: Beta-sitosterol did not shrink the prostate in these trials ^{[26, 29]}.

Wilt et al., Cochrane 1999: The same review noted that the trials were short and used products that were not standardized, so long-term effectiveness and safety are unknown ^[29].

BPH -- Pumpkin Seed Oil

Hong et al., Nutr Res Pract 2009 (Korea): In a 12-month trial of 47 BPH patients (average age of 53.3 years), 320 mg/day of pumpkin seed oil reduced the IPSS within 3 months compared with baseline, and peak urine flow improved by 6 months ^[12]. Prostate volume did not change ^[12].

Nishimura et al., J Tradit Complement Med 2014: In 45 people with overactive bladder, 10 g of pumpkin seed oil a day for 12 weeks lowered overactive bladder symptom scores; there was no placebo group ^[30].

Vahlensieck et al., Urol Int 2015: In the GRANU trial, 1,431 men with BPH symptoms took pumpkin seed (5 g twice a day), pumpkin seed extract (500 mg twice a day) or placebo for 12 months ^[13]. The extract did not differ from placebo, while 58.5% responded to pumpkin seed against 47.3% to placebo; the authors said a confirmatory study is needed ^[13].

BPH -- Pygeum Bark

Ishani et al., Am J Med 2000: A review of 18 trials (1,562 men) found that pygeum modestly improved urinary symptoms and flow; nocturia fell by 19% ^[32]. The trials were short, with a mean of 64 days ^[32].

BPH -- Stinging Nettle Root

In a one-year German trial of 246 men, 459 mg of dry stinging nettle root extract lowered the IPSS from 18.7 to 13.0, a statistically significant difference from placebo (18.5 to 13.8), with no significant difference in peak urine flow (Schneider & Rubben, Urologe A 2004) ^[33].

Prostate Cancer Prevention

A 2020 review of randomized trials, including saw palmetto and selenium, found the evidence inadequate to recommend most dietary supplements for lowering PSA in men with or at risk of prostate cancer ^[63]. In 2,207 men treated with radiation for prostate cancer, the 10% who used men's health supplements had no difference in cancer control, cancer-specific survival or toxicity over a median 46 months; their better overall survival weakened after adjustment for lifestyle and other conditions (Zaorsky et al., Am J Clin Nutr 2016) ^[35].

Selenium and Prostate Cancer: In SELECT, a trial of 35,533 men, selenium (200 μg/d), vitamin E or both did not prevent prostate cancer ^[36]. There was a statistically nonsignificant increase in type 2 diabetes in the selenium group ^[36]. In men already diagnosed with prostate cancer, selenium supplements of 140 μg/day or more were linked to a 2.60-fold greater risk of prostate cancer death (95% CI 1.44 to 4.70) ^[67].

Zinc and Prostate Cancer: In a Greek case-control study, men with higher dietary zinc had a higher risk of BPH (Lagiou et al., Urology 1999) ^[37]. In 46,974 US men, supplemental zinc up to 100 mg/day was not linked to prostate cancer, but more than 100 mg/day was linked to advanced prostate cancer (relative risk 2.29, 95% CI 1.06 to 4.95), as was taking zinc for 10 or more years (relative risk 2.37, 95% CI 1.42 to 3.95) (Leitzmann et al., J Natl Cancer Inst 2003) ^[38].

Androgenetic Alopecia (Hair Loss)

Because saw palmetto inhibits 5-alpha reductase in laboratory studies, it has been tested for androgenetic alopecia (male- and female-pattern baldness) ^{[3, 43]}.

Sudeep et al., Clin Cosmet Investig Dermatol 2023: A four-arm trial in 80 men and women aged 18-50 years with mild-to-moderate androgenetic alopecia tested 400 mg capsules of a saw palmetto oil (VISPO, 2-3% beta-sitosterol) or a topical 20% formulation (5 mL), each against placebo, for 16 weeks ^[39]. Hair fall dropped by up to 29% (oral) and 22.19% (topical) from baseline, and hair density rose by 5.17% and 7.61% ^[39]. The anagen/telogen ratio did not change significantly ^[39].

Rossi et al., Int J Immunopathol Pharmacol 2012: In a two-year open-label study of 100 men with mild to moderate androgenetic alopecia, 38% of those taking saw palmetto (320 mg/day) had more hair growth, compared with 68% of those taking finasteride (1 mg/day) ^[40]. There was no placebo group. Saw palmetto worked mainly at the vertex, while finasteride worked at both the front and the vertex ^[40].

Prager et al., J Alt Comp Med 2002: In a small placebo-controlled pilot trial of saw palmetto extract plus beta-sitosterol, 6 of 10 men on the active formula were rated as improved ^[41].

Pumpkin seed oil for hair loss (Cho et al., 2014): In a placebo-controlled trial of 76 men, pumpkin seed oil at 400 mg a day for 24 weeks raised mean hair count by 40%, compared with 10% on placebo ^[42].

Network meta-analysis and emerging research: A 2025 network meta-analysis of 19 trials (1,658 patients) found that saw palmetto extract gave higher blinded doctor-assessed hair regeneration scores than placebo ^[66]. A 2020 systematic review of five trials and two cohort studies reported 60% improvement in overall hair quality, 27% improvement in total hair count, increased hair density in 83.3% of patients, and stabilized disease in 52% with various saw palmetto products (100-320 mg), while noting that high-quality data are lacking ^[43].

Summary for hair loss: Saw palmetto may give modest benefit for androgenetic alopecia, mainly at the vertex, but it was less effective than finasteride in a head-to-head study ^[40]. A 2024 expert review still names topical minoxidil and oral finasteride as the preferred treatments ^[64]. NCCIH judges the evidence on saw palmetto for male-pattern hair loss too limited to allow conclusions ^[1].

Other Investigated Conditions

Chronic pelvic pain syndrome / chronic prostatitis: In a one-year randomized open-label trial in 64 men, saw palmetto gave no lasting improvement, while finasteride improved symptoms (Kaplan et al., J Urol 2004) ^[44].

Libido and sexual function: A 2021 meta-analysis found no statistically significant difference in sexual function between saw palmetto and placebo ^[46].

Other traditional uses: NCCIH finds too little evidence to judge saw palmetto for uses other than BPH ^[1].

Beta-Sitosterol for Cholesterol Lowering

At about 2 g a day, plant sterols reduce cholesterol absorption in the gut and lower LDL cholesterol by between 8 and 10% ^[76]. This is a separate use from BPH, at a much higher dose.

4. Recommended Dosing

Saw Palmetto

Standard BPH dose: The standard trial dose is 320 mg/d of extract, often split into 160 mg doses twice a day ^{[15, 17]}. Large trials found no benefit at this dose ^{[7, 17]}.

Higher doses: The CAMUS trial tested 320 mg, 640 mg and 960 mg a day; none worked better than placebo ^{[15, 16]}.

Safety at these doses: No clearly attributable adverse effects were found over the 72 weeks of the CAMUS trial ^[15].

Beta-Sitosterol

BPH dose: The two main positive trials used 20 mg three times a day and 130 mg of free beta-sitosterol daily ^{[26, 27]}.

Cholesterol-lowering dose: About 2 g a day of plant sterols lowers LDL cholesterol ^[76].

Pygeum Bark

The 18 trials pooled in the main review used varied pygeum preparations and lasted a mean of 64 days (range 30 to 122), so they do not set one standard dose ^[32].

Pumpkin Seed

Pumpkin seed oil: the Hong 2009 trial used 320 mg/day ^[12].

Pumpkin seeds: 5 g twice a day in the GRANU trial ^[13].

Stinging Nettle Root

Dose: 459 mg of dry root extract (Bazoton uno) in the one-year Schneider 2004 trial ^[33].

Selenium

The SELECT trial found that selenium (200 μg/d) did not prevent prostate cancer ^[36], and in men with prostate cancer, 140 μg/day or more was linked to higher prostate cancer death ^[67].

Zinc

Higher dietary zinc was linked to BPH in one study ^[37], and more than 100 mg/day of supplemental zinc, or use for 10 or more years, was linked to advanced prostate cancer ^[38]. The evidence does not support zinc for prostate health.

5. Safety and Side Effects

Saw Palmetto Safety Profile

Saw palmetto is well tolerated and has been used safely in research studies for up to 3 years; adverse effects are mild and infrequent and may include digestive symptoms, dizziness and headache ^[1]. In the Cochrane review it probably made little to no difference to adverse events compared with placebo (risk ratio 1.01, 95% CI 0.77 to 1.31) ^[7].

One-year safety data: In the STEP trial, side effects were as common with saw palmetto as with placebo over one year ^[17].

Long-term safety: A 2009 systematic review of 40 articles found adverse events mild and similar to placebo, most often abdominal pain, diarrhoea, nausea, fatigue, headache, decreased libido and rhinitis ^[51].

Adverse event reports (Crescioli et al., Phytother Res 2023): In 1,810 reports of suspected adverse reactions worldwide, serious reactions were more likely with dietary supplements, with products containing more than four active compounds (OR 4.38, 95% CI 3.21 to 5.99), and with saw palmetto use for more than 14 days (OR 1.89) ^[47].

Bleeding risk: A man taking saw palmetto had severe bleeding during surgery; his prolonged bleeding time returned to normal within days of stopping the herb (Cheema et al., J Intern Med 2001) ^[48]. A man who took saw palmetto before hernia surgery later developed a large retroperitoneal hematoma ^[71]. In laboratory tests an acidic fatty fraction of the extract inhibited cyclooxygenase (Breu et al., Arzneimittel-forschung 1992) ^[49]. A 2015 review lists saw palmetto among supplements with reported bleeding risks and recommends stopping herbal medicines about 2 weeks before planned surgery ^[72].

Hepatic and pancreatic effects: Case reports link saw palmetto to inflammation of the liver or pancreas that improved after stopping it or with treatment. In one man, hepatitis and pancreatitis cleared when he stopped saw palmetto and returned twice when he restarted it (Jibrin et al., South Med J 2006) ^[68]. Another man developed acute pancreatitis while taking saw palmetto and recovered in hospital ^[69]. A 2026 case report describes cholestatic liver injury attributed to saw palmetto, though the man had also taken other drugs ^[70]. LiverTox, an NIH resource, says saw palmetto has been implicated in rare cases of clinically apparent liver injury, but its specific role remains uncertain ^[79]. See a doctor promptly for yellow skin or eyes or pale stools. For severe upper belly pain with vomiting, call your local emergency number (111 in NZ, 000 in Australia, 911 in the US, 999 in the UK).

Erectile dysfunction: Decreased libido is among the most often reported adverse events ^[51]. A 2022 phytovigilance report examined erectile dysfunction attributed to saw palmetto (Gallo et al., Br J Clin Pharmacol 2022) ^[52]. In a 2021 meta-analysis, sexual function did not differ significantly between saw palmetto and placebo ^[46].

PSA levels: Saw palmetto does not appear to affect PSA readings, even at higher-than-usual doses ^{[1, 16]}.

Hormonal effects: Saw palmetto may be unsafe during pregnancy or while breastfeeding ^[1]. If you take prescription medicines, check with your doctor or pharmacist before starting ^[1].

Beta-Sitosterol Safety Profile

In the 1999 review, withdrawal rates were 7.8% with beta-sitosterol and 8.0% with placebo, but long-term safety is unknown ^[29].

Long-term safety at higher intakes: Plant sterol intakes of 2 g a day have not been linked to adverse health effects in long-term human studies ^[76].

Contraindication, sitosterolemia: Sitosterolemia is a rare inherited disorder in which the body absorbs too much plant sterol; treatment includes limiting plant sterols in the diet, so beta-sitosterol supplements are not for people who have it ^[77].

Nutrient absorption: In a meta-analysis of randomized trials at an average of 2.5 g a day, plant sterols and stanols lowered blood beta-carotene by 16.3% and alpha-carotene by 14.4%, though levels stayed within normal ranges ^[75].

Bleeding risk: In laboratory and mouse studies, beta-sitosterol inhibited thrombin, an enzyme in blood clotting, and had anticoagulant activity when given by mouth (Gogoi et al., J Nat Prod 2018) ^[53]. Whether this affects bleeding in people is unknown.

Adverse event reports: A 2023 review of FDA adverse event reports from 2004 to 2021 named beta-sitosterol among the supplements with the most reports ^[54].

Stinging Nettle Safety

A man developed breast enlargement (gynecomastia) for which nettle tea was the only cause found (Sahin et al., N Z Med J 2007) ^[34].

6. Drug Interactions

Saw Palmetto Drug Interactions

Anticoagulants and antiplatelet agents: A 2014 review lists saw palmetto among the herbs in case reports of severe adverse effects, such as bleeding, in people also taking warfarin ^[73]. A 2013 overview of systematic reviews noted moderately severe interactions for saw palmetto, and across the herbs it covered, antiplatelet agents and anticoagulants were the drugs that interacted most often ^[78]. Two earlier systematic reviews found no reported drug interactions with saw palmetto ^{[51, 74]}. If you take warfarin or another blood thinner, check with your doctor first.

Hormonal medications: If you take prescription medicines, check with your doctor or pharmacist before starting ^[1].

Alpha-blockers: Adding saw palmetto to silodosin or tamsulosin has been studied for benefit, not for interactions ^{[21, 22]}.

Pre-surgical considerations: Stop saw palmetto about 2 weeks before planned surgery, because of the reported bleeding cases ^{[48, 71, 72]}.

Beta-Sitosterol Drug Interactions

Anticoagulant drugs: Beta-sitosterol showed anticoagulant activity in laboratory and mouse studies ^[53]; whether it interacts with blood thinners in people is unknown. If you take a blood thinner, check with your doctor first.

Cholesterol-lowering medications: At 2 g a day, the LDL-lowering effect of plant sterols adds to that of statins ^[76].

Stinging Nettle Interactions

If you take prescription medicines, check with your doctor or pharmacist before starting ^[1].

Supplement-Supplement Interactions

Bleeding risks have also been reported for garlic, ginkgo, ginseng, green tea, St John's wort and fish oil, so taking them with saw palmetto before surgery calls for the same caution ^[72].

7. Dietary Sources

Saw palmetto's compounds come from the berries of Serenoa repens, which are not a normal food.

Beta-sitosterol and other plant sterols are found in many foods. Dietary sources include:

These foods are listed in a review of sitosterolemia as rich in plant sterols ^[77].

Pumpkin seeds: In the partially blinded GRANU trial, 5 g of pumpkin seed twice a day gave more responders than placebo, a difference the authors called descriptively significant, and they asked for confirmation ^[13].

Zinc-rich foods: Higher dietary zinc was linked to BPH in one Greek study ^[37], and high-dose zinc supplements to advanced prostate cancer ^[38], so neither supports extra zinc for the prostate.