Overview

Saw palmetto is a tree. Its ripe fruit is used to make medicine.

Saw palmetto is most commonly used for decreasing symptoms of an enlarged prostate called benign prostatic hypertrophy (BPH), but some scientific evidence shows that it does not work. Saw palmetto is also used to prevent complications from prostate surgery and for treating certain types of prostate conditions.

Classification

Is a Form of:

Tree

Primary Functions:

Enlarged Prostate

Also Known As:

American Dwarf Palm Tree, Baies du Chou Palmiste

How Does It Work?

Saw palmetto doesn't shrink the overall size of the prostate, but it seems to shrink the inner lining that puts pressure on the tubes that carry urine. Saw palmetto also might prevent testosterone from being converted to a more potent form of testosterone called dihydrotestosterone (DHT). It is thought that some types of hair loss are caused by increased sensitivity of hair follicles to DHT. Reduced levels of DHT may help prevent these types of hair loss.

Uses

• Prostate surgery (transurethral resection of the prostate; TURP).Research shows that taking 320 mg of saw palmetto daily for 2 months before prostate surgery can reduce the time spent in surgery, blood loss, the development of problems during surgery, and the total time spent in the hospital. However, one small study found that taking 160 mg of saw palmetto per day for 5 weeks before surgery does not lower the risk of problems during surgery.

Recommended Dosing

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

• Prostate surgery (transurethral resection of the prostate, TURP): 320 mg of saw palmetto extract daily for 2 months before surgery.

Saw Palmetto Supplements Frequently Asked Questions

What are the side effects of taking saw palmetto?

Side effects are usually mild. Some people have reported dizziness, headache, nausea, vomiting, constipation, and diarrhea. Some people have reported that saw palmetto causes impotence. However, these side effects do not seem to occur any more often with saw palmetto than with a sugar pill.

What is saw palmetto supplement used for?

Currently, saw palmetto is used as a dietary supplement for urinary symptoms associated with an enlarged prostate gland (also called benign prostatic hyperplasia or BPH), as well as for chronic pelvic pain, decreased sex drive, migraine, hair loss, and other conditions.

What is the best saw palmetto supplement?

I experimented with Saw Palmetto as well as other herbal supplements for the prostate. Nature's Bounty 1000 mg liquid capsules were the best product I have found. I took 1 capsule per day for over 2 years with very good results.

Is saw palmetto safe?

Saw palmetto is generally considered safe and has been associated with very few side effects. Some of the most commonly reported side effects of saw palmetto in research studies include headache, dizziness, nausea, and constipation ( 23 ). Note that saw palmetto is not recommended for everyone

Does saw palmetto damage the liver?

Some people have reported that saw palmetto causes impotence. There is some concern that saw palmetto might cause liver or pancreas problems in some people. There have been two reports of liver damage and one report of pancreas damage in people who took saw palmetto.

Who should not take saw palmetto?

Note that saw palmetto is not recommended for everyone. For example, women who are pregnant or breastfeeding should avoid taking saw palmetto, as it may impact hormone levels (24).

What medications does saw palmetto interfere with?

Do not take saw palmetto without medical advice if you are using any of the following medications:

• birth control pills or hormone replacement therapy;
• medicine to prevent blood clots--clopidogrel, dalteparin, enoxaparin, rivaroxaban, warfarin, Coumadin, Jantoven, and others;

What are the long term side effects of saw palmetto?

Side Effects & Safety

Saw palmetto is LIKELY SAFE for most people when taken by mouth for up to three years. Side effects are usually mild. Some people have reported dizziness, headache, nausea, vomiting, constipation, and diarrhea. Some people have reported that saw palmetto causes impotence.

Is saw palmetto good for skin?

Essential fatty acids can help keep skin nourished and hydrated. They also help reduce skin irritation. The essential fatty acids in saw palmetto may make it beneficial for several skin types, including oily, acne-prone skin.

How long does it take for saw palmetto to work?

It may take 4 to 6 weeks for saw palmetto to have an effect. There are no food sources of saw palmetto.

What is the best way to take saw palmetto?

Saw palmetto can be taken in many forms. Little research exists on effective dosages when the saw palmetto berries are eaten whole or steeped to make a tea. When taken as a dried supplement or an oily liquid extraction, saw palmetto appears most effective in daily dosages of 160–320 mg

Does saw palmetto increase estrogen?

Saw palmetto seems to decrease estrogen levels in the body. Taking saw palmetto along with estrogen pills might decrease the effectiveness of estrogen pills. Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.

Does saw palmetto stop hair loss?

Research on whether saw palmetto works to treat hair loss is limited but promising. An extract of saw palmetto berries may block 5-alpha-reductase, an enzyme that converts testosterone to DHT. Researchers hope it can slow or stop hair loss too.

Does saw palmetto raise blood pressure?

Several of these supplements can increase blood pressure and heart rate, including caffeine, chondroitin, dong quai, ephedra, ginkgo, ginseng, glucosamine, goldenseal, jimson weed, licorice, saw palmetto, St. John's wort, and yohimbe.

Is it safe to take saw palmetto long term?

Potential side effects

Saw palmetto is generally considered safe and has been associated with very few side effects. Some of the most commonly reported side effects of saw palmetto in research studies include headache, dizziness, nausea, and constipation ( 23 ). Note that saw palmetto is not recommended for everyone.

How much saw palmetto should I take daily?

Summary Saw palmetto appears most effective when taken in daily doses of 160–320 mg. However, more studies — particularly in women — are needed.

Does saw palmetto lower testosterone?

May help regulate testosterone levels. Saw palmetto is often used by men looking to boost testosterone levels naturally. Another study in 40 men observed that treatment with saw palmetto decreased levels of DHT by 32% after 6 months, suggesting that saw palmetto was effective at maintaining testosterone levels ( 21 ).

Does saw palmetto really work?

Although DHT plays a vital role in the development of the prostate, it can also lead to prostate issues such as BPH. Many people believe that taking saw palmetto will reduce their BPH symptoms by blocking DHT production. However, there is a lack of evidence to confirm that saw palmetto benefits prostate health.

Is too much saw palmetto bad for you?

Saw palmetto is LIKELY SAFE for most people when taken by mouth for up to three years. Side effects are usually mild. Some people have reported dizziness, headache, nausea, vomiting, constipation, and diarrhea. Some people have reported that saw palmetto causes impotence.

Clinical Studies

• ^ a b Prager N1, et al. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med. (2002)
• ^ a b Anderson ML1. Evaluation of Resettin® on serum hormone levels in sedentary males. J Int Soc Sports Nutr. (2014)
• ^ a b c Morgia G1, et al. Serenoa repens, lycopene and selenium versus tamsulosin for the treatment of LUTS/BPH. An Italian multicenter double-blinded randomized study between single or combination therapy (PROCOMB trial). Prostate. (2014)
• ^ Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Ann Intern Med. (2002)
• ^ a b c d e De Monte C, et al. Modern extraction techniques and their impact on the pharmacological profile of Serenoa repens extracts for the treatment of lower urinary tract symptoms. BMC Urol. (2014)
• ^ a b c d e f g h i j k l m n o p q r s t u Schantz MM1, et al. Development of saw palmetto (Serenoa repens) fruit and extract standard reference materials. Anal Bioanal Chem. (2008)
• ^ a b c d e f Weisser H1, et al. Effects of the sabal serrulata extract IDS 89 and its subfractions on 5 alpha-reductase activity in human benign prostatic hyperplasia. Prostate. (1996)
• ^ a b c d e f g h i j k l m n o Abe M, et al. Isolation and pharmacological characterization of fatty acids from saw palmetto extract. Anal Sci. (2009)
• ^ Abe M, et al. Pharmacologically relevant receptor binding characteristics and 5alpha-reductase inhibitory activity of free Fatty acids contained in saw palmetto extract. Biol Pharm Bull. (2009)
• ^ a b c d e f g h i Habib FK1, et al. Serenoa repens (Permixon) inhibits the 5alpha-reductase activity of human prostate cancer cell lines without interfering with PSA expression. Int J Cancer. (2005)
• ^ a b Goepel M1, et al. Saw palmetto extracts potently and noncompetitively inhibit human alpha1-adrenoceptors in vitro. Prostate. (1999)
• ^ a b c d e f g Suzuki M1, et al. Muscarinic and alpha 1-adrenergic receptor binding characteristics of saw palmetto extract in rat lower urinary tract. Urology. (2007)
• ^ Takahashi D, et al. Structure-activity relationships of receptor binding of 1,4-dihydropyridine derivatives. Biol Pharm Bull. (2008)
• ^ a b c Suzuki M1, et al. Pharmacological effects of saw palmetto extract in the lower urinary tract. Acta Pharmacol Sin. (2009)
• ^ a b Strauch G1, et al. Comparison of finasteride (Proscar) and Serenoa repens (Permixon) in the inhibition of 5-alpha reductase in healthy male volunteers. Eur Urol. (1994)
• ^ Albassam AA1, Mohamed ME, Frye RF. Inhibitory effect of six herbal extracts on CYP2C8 enzyme activity in human liver microsomes. Xenobiotica. (2014)
• ^ Chittur S1, Parr B, Marcovici G. Inhibition of inflammatory gene expression in keratinocytes using a composition containing carnitine, thioctic Acid and saw palmetto extract. Evid Based Complement Alternat Med. (2011)
• ^ Latil A1, et al. Hexanic lipidosterolic extract of Serenoa repens inhibits the expression of two key inflammatory mediators, MCP-1/CCL2 and VCAM-1, in vitro. BJU Int. (2012)
• ^ Sirab N1, et al. Lipidosterolic extract of serenoa repens modulates the expression of inflammation related-genes in benign prostatic hyperplasia epithelial and stromal cells. Int J Mol Sci. (2013)
• ^ Iehlé C1, et al. Human prostatic steroid 5 alpha-reductase isoforms--a comparative study of selective inhibitors. J Steroid Biochem Mol Biol. (1995)
• ^ Liang T1, Liao S. Inhibition of steroid 5 alpha-reductase by specific aliphatic unsaturated fatty acids. Biochem J. (1992)
• ^ a b c Bayne CW1, et al. Serenoa repens (Permixon): a 5alpha-reductase types I and II inhibitor-new evidence in a coculture model of BPH. Prostate. (1999)
• ^ Délos S1, et al. Testosterone metabolism in primary cultures of human prostate epithelial cells and fibroblasts. J Steroid Biochem Mol Biol. (1995)
• ^ Sultan C, et al. Inhibition of androgen metabolism and binding by a liposterolic extract of "Serenoa repens B" in human foreskin fibroblasts. J Steroid Biochem. (1984)
• ^ Brown GA1, et al. Effects of anabolic precursors on serum testosterone concentrations and adaptations to resistance training in young men. Int J Sport Nutr Exerc Metab. (2000)
• ^ Brown GA1, et al. Endocrine and lipid responses to chronic androstenediol-herbal supplementation in 30 to 58 year old men. J Am Coll Nutr. (2001)
• ^ Kohut ML1, et al. Ingestion of a dietary supplement containing dehydroepiandrosterone (DHEA) and androstenedione has minimal effect on immune function in middle-aged men. J Am Coll Nutr. (2003)
• ^ Brown GA1, et al. Effects of androstenedione-herbal supplementation on serum sex hormone concentrations in 30- to 59-year-old men. Int J Vitam Nutr Res. (2001)
• ^ a b c Bertaccini A1, et al. Observational database serenoa repens (DOSSER): overview, analysis and results. A multicentric SIUrO (Italian Society of Oncological Urology) project. Arch Ital Urol Androl. (2012)
• ^ Jane EP1, et al. Inhibition of phosphatidylinositol 3-kinase/AKT signaling by NVP-BKM120 promotes ABT-737-induced toxicity in a caspase-dependent manner through mitochondrial dysfunction and DNA damage response in established and primary cultured glioblastoma cells. J Pharmacol Exp Ther. (2014)
• ^ Castellino RC1, Durden DL. Mechanisms of disease: the PI3K-Akt-PTEN signaling node--an intercept point for the control of angiogenesis in brain tumors. Nat Clin Pract Neurol. (2007)
• ^ Yang Y1, et al. Effect of saw palmetto extract on PI3K cell signaling transduction in human glioma. Exp Ther Med. (2014)
• ^ a b Silvestri I1, et al. Effect of Serenoa repens (Permixon®) on the expression of inflammation-related genes: analysis in primary cell cultures of human prostate carcinoma. J Inflamm (Lond). (2013)
• ^ Marks LS1, et al. PC-SPES: herbal formulation for prostate cancer. Urology. (2002)
• ^ a b Ng AC, Cheng KF, Leung PC1. Prospective Trial of an Herbal Formula BYSH and Saw Palmetto in Patients with Hormonal Refractory Prostate Cancer: A Pilot Study. Recent Pat Inflamm Allergy Drug Discov. (2014)
• ^ Bayne EK1, et al. Immunohistochemical localization of types 1 and 2 5alpha-reductase in human scalp. Br J Dermatol. (1999)
• ^ Boersma IH, et al. The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia. Indian J Dermatol Venereol Leprol. (2014)
• ^ Sato A1, Takeda A. Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japanese men with androgenetic alopecia. J Dermatol. (2012)
• ^ Gubelin Harcha W1, et al. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia. J Am Acad Dermatol. (2014)
• ^ Olsen EA1, et al. The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride. J Am Acad Dermatol. (2006)
• ^ Rossi A, et al. Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol. (2012)
• ^ Lepor H, et al. The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group. N Engl J Med. (1996)
• ^ Montgomery BT1, et al. Hormonal regulation of prostate-specific antigen (PSA) glycoprotein in the human prostatic adenocarcinoma cell line, LNCaP. Prostate. (1992)
• ^ Wilt TJ, et al. Phytotherapy for benign prostatic hyperplasia. Public Health Nutr. (2000)
• ^ Champault G, Patel JC, Bonnard AM. A double-blind trial of an extract of the plant Serenoa repens in benign prostatic hyperplasia. Br J Clin Pharmacol. (1984)
• ^ Ryu YW1, et al. Comparison of Tamsulosin Plus Serenoa Repens with Tamsulosin in the Treatment of Benign Prostatic Hyperplasia in Korean Men: 1-Year Randomized Open Label Study. Urol Int. (2015)
• ^ a b Tacklind J1, et al. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. (2009)
• ^ Wilt T1, Ishani A, Mac Donald R. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. (2002)
• ^ Gerber GS1, et al. Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms. Urology. (2001)
• ^ Bent S1, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med. (2006)
• ^ Tacklind J, et al. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev. (2012)
• ^ Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. (1998)
• ^ Agbabiaka TB, et al. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf. (2009)
• ^ Jibrin I, et al. Saw palmetto-induced pancreatitis. South Med J. (2006)
• ^ Wargo KA, Allman E, Ibrahim F. A possible case of saw palmetto-induced pancreatitis. South Med J. (2010)
• ^ Lapi F, et al. Acute liver damage due to Serenoa repens: a case report. Br J Clin Pharmacol. (2010)
• ^ Miroddi M1, et al. Hot flashes in a young girl: a wake-up call concerning Serenoa repens use in children. Pediatrics. (2012)
• ^ a b Morabito P, et al. Serenoa repens as an Endocrine Disruptor in a 10-Year-Old Young Girl: A New Case Report. Pharmacology. (2015)
• MacDonald R, et al. Serenoa repens monotherapy for benign prostatic hyperplasia (BPH): an updated Cochrane systematic review. BJU Int. (2012)
• Willetts KE, et al. Serenoa repens extract for benign prostate hyperplasia: a randomized controlled trial. BJU Int. (2003)
• Hizli F, Uygur MC. A prospective study of the efficacy of Serenoa repens, tamsulosin, and Serenoa repens plus tamsulosin treatment for patients with benign prostate hyperplasia. Int Urol Nephrol. (2007)
• Suter A, et al. Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation? Results from a pilot trial. Phytother Res. (2013)
• Andriole GL, et al. The effect of increasing doses of saw palmetto fruit extract on serum prostate specific antigen: analysis of the CAMUS randomized trial. J Urol. (2013)
• Barry MJ, et al. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA. (2011)