Mechanism of action:
(1) stimulation of estrogenic receptors
(2) inhibition of progesterone receptors
(3) inhibition of 5-alpha reductase (anti-androgenic)
(4) inhibition of the binding of dihydrotestosterone to androgen receptors
Complications:
(1) cholestatic hepatitis
(2) pancreatitis
(3) cholecystitis
(4) coagulopathy
(5) erectile dysfunction
(6) cardiac conduction defect
I would imagine gynecomastia in males might also be a complication.
Diagnosis:
(1) history of exposure to Saw Palmetto
(2) onset of complication after the starting of Saw Palmetto exposure
(3) disappearance of condition after discontinuation of Saw Palmetto (may be delayed)
(4) no other explanation for complication
(5) reappearance on re-exposure to Saw Palmetto (rarely done because of the risks)
