Saw Palmetto: Health Benefits And Uses

Saw palmetto is a low-growing palm with dark berries, native to the warmer climates of the southeastern U.S. It’s known for its potential effects on the reproductive and urinary systems.

Extracts from the berries of the saw palmetto plant are commonly used in dietary supplements. “[Saw palmetto] gained popularity in recent years due to its potential health benefits, particularly in the realm of men’s health,” says Glen Nagel, a naturopathic doctor, clinical herbalist and dean of botanical medicine at the National University of Natural Medicine. “It has an oily black berry that’s harvested when ripe and used in herbal medicine. It’s a source of free fatty acids, triglycerides, phytosterols (mainly beta sitosterol, a plant-based compound similar in structure to cholesterol), flavonoids and polysaccharides,” he continues. These active ingredients may be responsible for the benefits associated with saw palmetto extracts.

The American Urological Association says that while many men use supplements and nutraceuticals like saw palmetto in an attempt to alleviate symptoms associated with enlarged prostate, available research is flawed and can’t confirm these potential health benefits. Still, some research, as well as experts, suggest saw palmetto may offer health and wellness benefits for men.

For instance, research suggests saw palmetto may help improve symptoms of benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland that causes urinary concerns.

“Studies show that saw palmetto can reduce urinary symptoms, such as
frequent urination, nocturia (waking up at night to urinate), weak urine flow and
incomplete bladder emptying,” says Dr. Nagel. “[Researchers believe it] works by inhibiting the production of an enzyme that contributes to prostate growth.”

While the herb’s exact mechanisms are not fully understood, researchers and herbalists believe saw palmetto may also help inhibit the conversion of testosterone to dihydrotestosterone (DHT), a hormone associated with hair loss. “[Saw palmetto] has been shown to be a weak inhibitor of 5 alpha reductase, the enzyme that converts testosterone to DHT,” says Dr. Nagel. “[However], there’s less research about the use of saw palmetto for treating hair loss.”

“DHT is naturally higher in individuals assigned as male at birth,” says Alicia McCubbins, a naturopathic doctor based in Vancouver, Washington. “It’s helpful for development and puberty but doesn’t play a significant role in adulthood. [However], high levels of DHT can lead to prostate enlargement, prostate cancer and androgenic alopecia (male pattern hair loss),” she continues.

Make sure to consult with a health care provider before incorporating saw palmetto into your wellness regimen to ensure this supplement supports your unique health goals.

Saw palmetto may help regulate testosterone levels, particularly when testosterone and/or DHT are high in people with polycystic ovarian syndrome (PCOS), says Dr. McCubbins. “[PCOS symptoms] can be seen clinically with hirsutism (excess hair growth) or acne along the jawline, chest or back,” she continues.

A 2022 study in Frontiers in Pharmacology examined the effects of herbal remedies, such as saw palmetto, in women with PCOS, noting some benefits when saw palmetto and other herbs were combined with a PCOS-friendly diet and exercise plan^[1]Zeng LH, Rana S, Hussain L, et al. Polycystic Ovary Syndrome: A Disorder of Reproductive Age, Its Pathogenesis, and a Discussion on the Emerging Role of Herbal Remedies. Front Pharmacol. 2022;13:874914. .

Saw palmetto may also help prevent hair loss in women. A 2022 study in the Journal of Clinical and Aesthetic Dermatology examined the potential benefits of saw palmetto extract on alopecia in men and women, noting a 35% increase in hair density after three months^[2]Ring C, Heitmiller K, Correia E, Gabriel Z, Saedi N. Nutraceuticals for Androgenetic Alopecia. J Clin Aesthet Dermatol. 2022;15(3):26-29. .  Additional clinical high-quality clinical trials are needed to fully support this benefit.

Saw palmetto is often found in capsule or pill form, but it can also be made into a tea or tincture. “Saw palmetto is one of the worse-tasting herbs, so it’s best to take it in a capsule or pill form,” advises Dr. Nagel. Dr McCubbins agrees, saying she typically doesn’t prescribe saw palmetto tea or tincture because of its strong flavor.

Saw Palmetto Dosage

As research into saw palmetto is limited, there’s no standard clinically effective dose. Dr. McCubbins suggests a daily dosage of 330 milligrams of saw palmetto extract (from the plant’s berries) in capsule or tablet form depending on an individual’s symptoms and health goals. She notes that she often prescribes formulas with additional synergistic herbs tailored to the particular condition and individual to help treat the whole person.

Individuals interested in taking saw palmetto can discuss dosing information with a health care provider knowledgeable about the herb.

“When it comes to safety, saw palmetto is generally well tolerated by most individuals when used appropriately. However, it’s important to consult with a health care professional before incorporating it into your routine, especially if you have any pre-existing medical conditions or are taking medications,” says Dr. Nagel.

“[Saw palmetto] isn’t believed to interfere with prostate-specific antigen (PSA) readings, a screening tool for prostate cancer. Patients are advised to get [a] clinical assessment if they have concerns about enlarged prostate, as self-medicating with saw palmetto doesn’t replace workups for BPH or prostate cancer,” adds Dr. McCubbins.

While saw palmetto is generally considered safe when taken as directed, some potential risks and contraindications associated with saw palmetto, according to Dr. Nagel, include:

• Allergic reactions. In rare cases, individuals may experience allergic reactions to saw palmetto.
• Interaction with hormonal medications. Saw palmetto may interact with certain hormonal medications, such as oral contraceptives or hormone replacement therapy.
• Pregnancy and breastfeeding. Due to limited research on its effects during pregnancy and breastfeeding, people who are pregnant or breastfeeding should avoid taking saw palmetto.

Saw palmetto is well tolerated by most users, though it may cause mild side effects, including digestive symptoms or headache, according to the National Center for Complementary and Integrative Health (NCCIH).

A health care provider can help an individual determine whether saw palmetto is appropriate for them based on their unique health history and needs.

Dr. McCubbins advises shopping from physician-grade supplement companies for saw palmetto supplements. These companies are likely to be committed to third-party laboratory testing, have a research team on staff and follow current good manufacturing practices (CGMPs -regulated by the Food and Drug Association), assessing contents of supplements to ensure they’re the most therapeutic forms provided in safe doses. “Capsules may be higher-quality options than tablets, as they don’t generally contain the binders and fillers needed for tablet production”, she adds.

“I also raise caution with third-party distributors (like Amazon) where quality and actual content isn’t [always] overseen [depending on the brand]. I’ve had many instances of patients receiving a product that was not actually what they ordered,” says Dr. McCubbins.