The saw palmetto plant, scientifically known as Serenoa repens, is a small, shrub-like palm native to the southeastern United States, particularly Florida and other coastal regions. The ripe, dark berries have a long history of use in traditional medicine, employed by Native American tribes like the Seminole for food and to treat various urological issues. Modern scientific interest focuses almost exclusively on the concentrated lipophilic extracts derived from the fruit. These extracts are widely consumed as a dietary supplement, primarily due to their effects on men’s health.
Primary Use in Managing Prostate Health
The most recognized and studied application of saw palmetto berry extract is addressing the urinary symptoms associated with Benign Prostatic Hyperplasia (BPH). BPH is a non-cancerous enlargement of the prostate gland that commonly affects aging men, causing lower urinary tract symptoms. These symptoms include a frequent need to urinate, especially at night (nocturia), a weak or slow urinary stream, and the sensation of incomplete bladder emptying.
Many individuals turn to saw palmetto as an alternative to prescription medications to alleviate these discomforts. Early clinical trials suggested the extract could lead to improvements in urinary flow and overall symptom scores. However, larger, high-quality studies have presented mixed results, with some finding little difference between saw palmetto extract and a placebo in reducing BPH symptoms.
Despite the conflicting scientific evidence, saw palmetto remains one of the most popular herbal remedies globally for prostate-related urinary problems. Variability in study outcomes may stem from differences in the quality and standardization of the specific extract used in various trials. Nonetheless, the management of BPH symptoms continues to be the primary reason for the supplement’s widespread use.
How Saw Palmetto Works
The therapeutic effects of saw palmetto are attributed to its interaction with specific hormonal pathways. The extract contains a complex mixture of fatty acids and plant sterols that interfere with the enzyme 5-alpha reductase. This enzyme converts the hormone testosterone into its more potent form, Dihydrotestosterone (DHT).
By partially inhibiting 5-alpha reductase, saw palmetto may decrease the local concentration of DHT within prostate tissue. Since DHT is a potent stimulator of prostate cell growth, reducing its levels is a proposed mechanism for slowing prostate enlargement. This mechanism is similar to that of some prescription medications used to treat BPH.
The extract is also believed to possess anti-inflammatory properties. Chronic inflammation within the prostate is a factor in BPH progression, and saw palmetto components may help reduce this localized tissue irritation. Other proposed actions include promoting the programmed death of prostate cells, known as apoptosis, which could contribute to a reduction in prostate size.
Other Reported Uses
The DHT-blocking property that focuses saw palmetto on prostate health also suggests its use for managing androgenic alopecia, commonly known as male-pattern baldness. Androgenic alopecia is characterized by the shrinkage of hair follicles due to DHT action, and saw palmetto is marketed as a natural inhibitor of this process. While some preliminary studies indicate that both oral and topical preparations may help increase hair count, the evidence supporting this application is generally considered weaker compared to prescription treatments.
Historically, the berries were used as a tonic for general urinary tract support, addressing issues like urinary incontinence and frequency. Traditional uses also extended to hormonal balance, including mitigating painful menstruation or supporting lactation. However, there is limited modern research to substantiate these broad traditional applications, and the primary focus remains on prostate and hair health.
Dosage, Forms, and Safety
For optimal effect, saw palmetto is typically consumed as a lipophilic (fat-soluble) extract rather than the whole dried berry or a simple tea, since the active components are fatty acids and sterols. Effective products are standardized to contain a high percentage of these compounds, often between 80% and 95% total fatty acids and sterols. The most commonly studied dosage for BPH symptoms is 320 milligrams per day, often taken in two divided doses.
Saw palmetto is generally considered safe for most people when used for up to three years, with side effects typically being mild and infrequent. The most common adverse reactions reported are minor gastrointestinal upset, headache, or dizziness. The extract has the potential to interact with certain medications, primarily those that affect blood clotting, such as anti-coagulants.
Due to its influence on hormonal pathways, individuals with hormone-sensitive conditions or those taking hormonal therapies should exercise caution. Because saw palmetto may increase the risk of bleeding, it is recommended that use be discontinued at least two weeks before any scheduled surgical procedure. Anyone considering taking saw palmetto, especially those with existing health conditions or who are taking other medications, should first consult a healthcare professional.