Saw palmetto is also known as Serenoa repens, Sabal serrulata American dwarf palm tree and cabbage palm. It is the fruit of a small palm tree which grows in the southeastern US. Saw palmetto extract is the primary active ingredient in many natural hair loss remedies, including Advecia, Avacor, Procerin, Provillus, Revivogen and Scalp Med. Saw palmetto has been used extensively to treat BPH. It is rich in fatty acids and phytosterols and is believed to be able to block dihydrotestosterone (DHT). Research findings regarding saw palmetto are conflicting. There are papers that have reported that saw palmetto is beneficial in treating BPH. However, there are also research studies that claim that saw palmetto may not have any effect on the plasma concentration of DHT or the prostate gland itself. Saw palmetto has never been clinically evaluated as a hair loss treatment, and its efficacy and mechanism of action remain unknown. In addition, saw palmetto can have side effects and should be used with caution.

Saw palmetto dosage

The recommended dose is a 160mg capsule taken twice each day, but the ingredients need to be made from the berry extract and not the dried berries themselves.

For enlarged prostate (benign prostatic hypertrophy), a dose of 320 mg daily, in one dose or two divided doses (80% to 90% liposterolic content), has been used in numerous studies. Traditional dosages include: 1 to 2 gm of ground, dried, or whole berries daily; 2 to 4 ml of tincture (1:4) three times daily; 1 to 2 milliliters fluid extract of berry pulp (1:1) three times daily; or tea (2 teaspoons of dried berry with 24 ounces of water, simmered slowly until liquid is reduced by half) taken as 4 ounces three times daily. Teas prepared from saw palmetto berries are potentially not as effective because the active ingredients may not dissolve in water.

Not enough information is available to recommend the use of saw palmetto in children.

Side effects of saw palmetto

Few allergic reactions to saw palmetto have been reported.

Saw palmetto may cause mild side effects, including stomach discomfort. Some male users of saw palmetto have reported tender breasts and a decline in sexual desire. Few severe side effects related to saw palmetto have been reported in the scientific literature. The most common side effects involve the stomach and intestines, and include stomach pain, nausea, vomiting, bad breath, constipation, and diarrhea. Stomach upset caused by saw palmetto may be reduced by taking it with food. A small number of reports describe ulcers or liver damage and yellowing of the skin (jaundice), but the role of saw palmetto is not clear in these cases. Similarly, reports of headache, dizziness, insomnia, depression, breathing difficulties, muscle pain, high blood pressure, chest pain, abnormal heart rhythm, and heart disease have been reported, but are not clearly caused by saw palmetto. Patients with health conditions involving the stomach, liver, heart, lungs, or are scheduled for surgery should use caution in taking saw palmetto.

Saw palmetto may have effects on the body’s response to the sex hormones estrogen and testosterone, but no specific effect has been well documented in humans. Men or women taking hormonal medications (such as finasteride/Proscar®/Propecia® or birth control pills) or who have hormone-sensitive conditions should use caution. In theory, PSA (prostate specific antigen) levels may be artificially lowered by saw palmetto. Potentially there could be a delay in diagnosis of prostate cancer or alteration of PSA levels during treatment or monitoring in men with known prostate cancer.

Because of possible hormonal activity, saw palmetto extract is not recommended for women who are pregnant or breastfeeding.

Research on saw palmetto

Several clinical trials indicate that saw palmetto may be effective for treating BPH symptoms such as nighttime urination, urinary flow, and overall quality of life, although it may not greatly reduce the size of the prostate. In 2006, a study involving 225 men with BPH demonstrated no improvement in symptoms at a daily dose of 320 mg saw palmetto for 1 year. Considered overall, there is not enough scientific evidence to convincingly support the use of saw palmetto for treating BPH.

Currently there is not enough scientific evidence to recommend the product PC-SPES® (which contains saw palmetto) for the treatment of prostate cancer. PC-SPES® also contains seven other herbs (Chrysanthemum morifolium, Glycyrrhiza glabra, Ganoderma lucidum, Isatis indigotica, Panax pseudo-ginseng, Rabdosia rubescens and Scutellaria baicalensis). The U.S. Food and Drug Administration (FDA) has issued a warning not to use PC-SPES® because it contains the anticoagulant chemical warfarin and may cause bleeding.

Health benefits of saw palmetto

Saw palmetto is used as a remedy for urinary symptoms associated with an enlarged prostate gland (benign prostatic hyperplasia, or BPH). Saw palmetto is also used for other conditions, including chronic pelvic pain, bladder disorders, decreased sex drive, hair loss and hormone imbalances.

The ripe fruit of saw palmetto can be taken in several forms, including ground and dried fruit or whole berries. It is available as a liquid extract, tablets, capsules and as an infusion or a tea.