-reductase and antagonistic effects at androgen receptors. Clinical trials of saw palmetto in benign prostatic hyperplasia (BPH) have been mixed. Some have shown improvement in urologic function and in urinary flow. Others, including a recent well-controlled, double-blind 1-yr study in moderate to severe BPH, have shown no significant effects on symptoms or objective measures.

Toxicity and Drug Interactions

Abdominal pain with gastrointestinal distress, decreased libido, headache, and hypertension occur; overall incidence was less than 3%. Saw palmetto has no effect on the prostate-specific antigen (PSA) marker.

Skill Keeper: Drugs from Plant Sources

Many conventional drugs, strictly regulated by governmental agencies such as the FDA, originated from plant sources. How many of these compounds can you identify? The Skill Keeper Answer appears at the end of the chapter.

Purified Nutritional Substances

Coenzyme Q10

Nature

Coenzyme Q10, also known as ubiquinone, is a benzoquinone that serves as a cofactor in the mitochondrial electron transport chain and, in its reduced form of ubiquinol, serves as an important antioxidant. After ingestion, the reduced form predominates in the circulation.

Pharmacology

Coenzyme Q10 may have a small degree of efficacy in reducing systolic and diastolic blood pressure and in treating coronary artery disease and chronic stable angina, but it does not appear to be useful as adjunctive therapy of heart failure. Coenzyme Q10 may have some efficacy in reducing muscle pain in patients with statin-related myopathy.

Toxicity

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