Saw palmetto - Dr. Axe

Saw palmetto benefits have been known for a long time. In fact, the saw palmetto plant was used for medicine by the Native Americans of the Southeastern U.S., and in the early 20th century, men used the berries to treat urinary tract problems and increase sperm production — in addition to maintaining prostate health.

Today, saw palmetto supplements are some of the most commonly consumed supplements by men with prostate cancer and benign prostatic hyperplasia (BPH) thanks to the numerous saw palmetto benefits. In fact, in 2011, over $18 million in saw palmetto was sold in the U.S., ranking it third among herbal dietary supplements.

Saw palmetto benefits have the power to treat colds, coughs and sore throat, and this supplement works as a natural remedy for asthma, chronic bronchitis, chronic pelvic pain syndrome and migraine headaches.

It’s also used to increase urine flow, promote relaxation and enhance sexual drive.

What Is Saw Palmetto?

Saw palmetto extract is taken from the deep purple berries of the saw palmetto fan palm, which is known as Serenoa repens. It grows as a tree or shrub and has lush, green leaves that fan out from its thorn stem.

It can reach heights of 10 feet in warm climates, with leaf clusters that can reach two feet or more.

Other common names for saw palmetto include American dwarf palm tree and cabbage palm. The plant is native to the West Indies, and in the U.S., saw palmetto grows in the warm climates of the Southeast Coast, from South Carolina to throughout Florida.

Saw palmetto benefits have been known for centuries, and the plant has been used in traditional, eclectic and alternative medicine. Its active ingredients include fatty acids, plant sterols and flavonoids.

The berries also contain high molecular weight polysaccharides (sugars), which may reduce inflammation and strengthen the immune system — thus adding immune system booster to the list of saw palmetto benefits.

The most important factor about Serenoa repens is that it’s been shown to slow the production of the enzyme 5-alpha reductase, so taking it is a strong step to improve prostate health. This enzyme converts the male hormone testosterone into dihydrotestosterone (DHT) — a sex steroid and androgen hormone.

While DHT is important because it plays a role in male development, it also contributes to many common health issues in men, such as loss of libido, an enlarged prostate and hair loss. By taking Serenoa repens supplements or using the extract of this beneficial plant, you inhibit the production of this hormone and help avoid these issues that are seen in middle-aged and older males, including enlargement of the prostate and BPH symptoms.

Saw palmetto berries may also help relieve chronic pain and migraines and reserve hair loss, in addition to other saw palmetto benefits.

Benefits/Uses

1. Treats Benign Prostatic Hypertrophy (BPH)

The most common form of an enlarged prostate is benign prostatic hyperplasia. The prostate usually stays at about the same size or grows slowly in adults, as long as male hormones are present.

It’s when the prostate becomes enlarged that men begin experiencing symptoms from BPH and lower urinary tract issues.

The prostate gland can become inflamed or enlarged as men get older. The prostate then compresses the urethra, leading to difficulty with urination that results in bladder infections or bladder stones.

BPH can be caused by a variety of circumstances, including hormonal changes (such as excess estrogen), deteriorating blood vessels and a zinc deficiency.

The American Urological Association reports that by the age of 60, over 50 percent of men will have BPH, and by age 85, 90 percent of men will have this condition. To add to this, one-fourth of these men will develop moderate to severe lower urinary tract symptoms that will greatly affect their quality of life.

Research shows that saw palmetto inhibits testosterone from binding to and stimulating prostate cells, which reduces the multiplication of prostatic cells and prostatic enlargement.

Other treatments for BPH, alpha blockers and 5-alpha-reductase inhibitors, can cause sexual dysfunctions themselves — while saw palmetto is a natural supplement that doesn’t have a long list of side effects. That makes it one of the best sources to increase testosterone naturally and improve prostate health the natural way.

One 2012 study conducted in Switzerland analyzed 82 patients in an eight-week trial. The patients took one capsule of 320 milligrams of saw palmetto extract daily.

At the end of the treatment, the International Prostate Symptom Score was reduced from 14.4 ± 4.7 to 6.9 ± 5.2. Investigators’ and patients’ assessments confirmed the good efficacy, and treatment was very well-tolerated and accepted by the patients.

2. Reduces Risk of Prostate Cancer

A systematic literature review of 11 studies identified saw palmetto supplements as one of the five commonly used forms of alternative medicine by men with prostate cancer.

Serenoa repens supplements work as 5-alpha reductase inhibitors — meaning they slow down the conversion of testosterone to DHT by blocking the enzyme and preventing its formation. According to research, DHT is responsible for prostate enlargement, which may be a cause of prostate cancer.

The science is still unclear on this matter, but studies on two 5-alpha reductase inhibitor prescriptions, Finasteride (Proscar) and Dutasteride (Avodart) found that men taking either drug were less likely to develop prostate cancer after several years than men getting an inactive placebo. The problem lies in the side effects of these medications — they can cause sexual side effects, such as lowered sexual desire and impotence.

Saw palmetto, on the other hand, can also inhibit DHT and help with urinary problems from BPH, such as trouble urinating and leaking urine — plus it regulates your testosterone levels, helps with libido and works as a natural remedy for impotence.

Studies have also found that saw palmetto inhibits the growth of prostatic cancer cells and may destroy dangerous cells. A study conducted at the Department of Biochemistry and Molecular Biology at the Peking University Health Science Center in Beijing found that saw palmetto induced growth arrest of prostate cancer LNCaP, DU145 and PC3 cells and down-regulated DHT, the hormone that leads to prostate enlargement.

Another interesting note about saw palmetto is the research that has been done to measure its effect on post-surgery recovery time. Prostate surgery (known as transurethral resection of the prostate or TURP) can require a lengthy recovery period, but research shows that taking 320 milligrams of saw palmetto daily for two months before prostate surgery can reduce the time spent in surgery.

It also helps with blood loss, the development of problems during surgery and the total time spent in the hospital.

3. Helps with Hair Loss

Saw palmetto extracts and supplements work as hair loss remedies because they keep testosterone levels balanced. As men age, the testosterone hormone is diminished, and the hormone called 5α-Dihydrotestosterone (DHT) increases.

The cause of hair loss is due to the hair follicles’ sensitivity to DHT, which is a male androgen hormone that causes follicles to shrink, resulting in a shorter life span and decrease of hair production.

Normally, after a hair falls out, another hair starts to grow from this same follicle — but if DHT is high, hair growth decreases. Saw palmetto benefits have the power to stop the conversion of testosterone into DHT, making it beneficial for hair growth.

Although the opinions about saw palmetto as an effective hair growth agent are mixed, especially when it comes to using saw palmetto for women, there are studies that indicate its use as beneficial.

One study conducted at the Clinical Research and Development Network in Colorado tested 34 men and 28 women, aged 18–48 years, who topically applied saw palmetto extract in lotion and shampoo base for three months. The results found that 35 percent of the participants had an increase in hair density.

This suggests that saw palmetto for hair loss may work as a natural approach for both men and women.

A 2020 review of evidence published in the Cochrane database, PubMed and Google Scholar found that Serenoa repens extract resulted in improvement in overall hair quality, total hair count and hair density among alopecia patients. Reports also show that saw palmetto was well-tolerated and not associated with serious adverse events.

Saw palmetto benefits - Dr. Axe

4. Retains Testosterone Levels

Because saw palmetto inhibits the conversion of testosterone into DHT, the body retains normal levels of testosterone. This helps with weight loss, strength management, pain response, hair loss and sex drive.

Today, low testosterone in males is rapidly growing, and this results in chronic fatigue, a stunt in libido and a decreased sense of well-being.

A case study reported in the American Journal of Medicine analyzed a 52-year-old man who was experiencing erectile dysfunction, low libido and fatigue. He took no medications and was otherwise healthy.

The study suggests that his metabolic status improved dramatically by increasing his testosterone counts. After three months, he already felt more energized, and his sexual function improved.

5. Supports Urological System

Saw palmetto benefits the urological system in men who have benign prostatic hyperplasia. This occurs because of an interaction with the receptors in the lower urinary tract that can lead to urinary dysfunction and overactive bladder.

Serenoa repens is also recommended to treat weakening urinary organs in elderly people or women after menopause because it strengthens the urinary organs and has been recommended as a natural remedy for kidney stones.

The Journal of American Medical Association released a 1998 review stating that saw palmetto is effective in improving urological symptoms and urine flow. For the review, 18 randomized trials with almost 3,000 male participants were analyzed.

Overall, 28 percent of the men taking saw palmetto showed fewer urinary tract symptoms, 24 percent showed improvement in peak urine flow and overall urine flow improved for 43 percent of the participants.

The results were comparable to the group taking Proscar — a prescribed medication — and they were much more promising than the men taking a placebo.

Another randomized, double-blind, placebo-controlled trial done at the University of Chicago Pritzker School of Medicine involved 85 men who randomly received either saw palmetto or a placebo for six months. The results indicate that saw palmetto use leads to a significant improvement in urinary symptoms in men with lower urinary tract symptoms compared with placebo.

This study shows that saw palmetto can be an effective home remedy for UTI.

Forms/Dosage

You can purchase dried saw palmetto berries in some health food and vitamin stores. You may see the scientific name Serenoa repens saw palmetto on the label.

You can find dried berries that have been pulverized to powder and made into capsules, tablets, tinctures, teas or extracts as well.

Saw palmetto capsules are sold in most health food or convenient stores with a vitamin section. The price for a bottle of saw palmetto capsules range from $10 to $15.

The product label should indicate that contents are standardized and contain 85 percent to 95 percent fatty acids and sterols, so be sure to read the label before you make a purchase.

Recommended Dosage

  • The general daily saw palmetto dosage ranges from 160–320 milligrams. This depends on your health condition, and it should be decided with the guidance of your health care provider.
  • When using saw palmetto to treat BPH, the recommended dose is starting with 320 milligrams daily for four months. Some doctors may recommend a higher dosage of 320 milligrams three times a day and then dropping down to 320 milligrams once a day after a four-month treatment period.
  • For treating early stages of BPH, take 160 milligrams twice a day.
  • For future prostate surgery (called transurethral resection of the prostate), take 320 milligrams daily for two months before scheduled surgery.
  • For the treatment of bald spots, take 200 milligrams twice daily, combined with 50 milligrams of beta-sitosterol twice daily.
  • You can drink saw palmetto tea, but keep in mind that the fatty acids, its most active ingredients, are not soluble in water and won’t be as effective as capsules.

Risks, Side Effects and Interactions

A systematic review done in 2009 measured the adverse side effects of saw palmetto when used for the treatment of lower urinary tract infections and BPH. After reviewing a number of randomized trials, evidence suggests that adverse events associated with the use of saw palmetto are mild and similar to those with the placebo.

The most frequently reported saw palmetto side effects are abdominal pain, diarrhea, nausea, fatigue, headache, decreased libido and rhinitis.

Saw palmetto may not be safe to use during pregnancy or when breastfeeding. It acts like a hormone, and this could be dangerous to the pregnancy, so be sure to consult your doctor before use.

Some birth control pills contain estrogen, and saw palmetto might decrease the effects of estrogen in the body. Taking saw palmetto along with birth control pills might decrease the effectiveness of birth control pills.

Serenoa repens may also decrease estrogen levels in the body, so taking saw palmetto along with estrogen pills might decrease the effectiveness of the estrogen pills and affect your hormonal balance.

Saw palmetto might slow blood clotting, so taking saw palmetto along with medications that also slow clotting might increase the chances of bruising and bleeding. Some medications that slow blood clotting include:

  • aspirin
  • clopidogrel (Plavix)
  • diclofenac (Voltaren, Cataflam, others)
  • ibuprofen (Advil, Motrin, others)
  • naproxen (Anaprox, Naprosyn, others)
  • dalteparin (Fragmin)
  • enoxaparin (Lovenox)
  • heparin
  • warfarin (Coumadin)
  • and others

If you’ve never taken saw palmetto before, it’s wise to discuss your intentions with your health care professional in order to pinpoint an appropriate dosage and to rule out possible interactions.

Conclusion

  • Serenoa repens extracts are taken from the berries of the saw palmetto fan palm.
  • Saw palmetto benefits are best known for the ability to slow the production of the enzyme 5-alpha reductase, which promotes prostate health. Research suggests that saw palmetto benefits could be used to treat benign prostatic hypertrophy (BPH) and reduce the risk of prostate cancer.
  • Other saw palmetto benefits include preventing hair loss, maintaining normal testosterone levels and supporting urological function.
  • The general recommended saw palmetto dosage is between 160–320 milligrams daily.
  • Before using saw palmetto, consult your health care professional to decide on the appropriate dosage and rule out any potential pharmaceutical interactions.

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