Saw Palmetto

Saw palmetto, Any of a number of shrubby palms primarily of the southern U.S. and West Indies that have spiny-toothed petioles (leafstalks), specifically a common palm (Serenoa repens) of the southeastern U.S., with an usually sneaking stem. Saw palmettos comprise part of the greenery found in the Florida Everglades. When undisturbed, they grow into terrific masses of foliage. The saw palmetto has actually just recently drawn attention as the source of a possible treatment for prostate cancer. [1]


Saw palmetto is utilized by natural health professionals to treat a variety of ailments in males and females, such as testicular inflammation, urinary tract inflammation, coughs, and respiratory congestion. It is also used to reinforce the thyroid gland, balance the metabolic process, promote appetite, and help digestion. According to the American Dietetic Association, saw palmetto is one of the most commonly utilized dietary supplements amongst Americans between the ages of 50 and 76.

The majority of the proof supporting these uses is anecdotal and has not been shown by regulated medical trials. Nevertheless, there is much clinical documents outlining the effectiveness of the herb in treating irritable bladder and urinary issues in men with benign prostate hyperplasia (BPH), an augmentation of the prostate gland. BPH results in a swelling of the prostate gland that blocks the urethra. This triggers painful urination, minimized urine flow, trouble beginning or stopping the circulation, dribbling after urination, and more frequent nighttime urination. Saw palmetto does not lower prostate enlargement. Instead, it is believed to work in a variety of methods. Initially, it prevents the conversion of testosterone into dihydrotestosterone (DHT). BPH is believed to be triggered by an increase in testosterone to DHT. Secondly, saw palmetto is thought to disrupt the production of estrogen and progesterone, hormones connected with DHT production.

In addition to causing discomfort and shame, BPH can lead to serious kidney problems if undiagnosed and left neglected. It is a typical problem in men over the age of 40. Price quotes are that 50-60% of all men will establish BPH in their lifetimes. It is estimated that there are six million guys in between the ages of 50-79 who have BPH serious sufficient to require some kind of therapy. Yet only half of them seek treatment from doctors. Health professionals in both the allopathic and natural medicine neighborhoods recommend annual prostate examinations for men over the age of 50, and an annual blood test that determines prostate specific antigen, a marker for prostate cancer.

Just recently, a number of medical trials have validated the effectiveness of saw palmetto in treating BPH. A lot of these trials have shown saw palmetto works much better than the most commonly used prescription drug, Proscar. Saw palmetto works in almost 90% of clients after 6 weeks of use, while Proscar works in less than 50% of patients. In addition, Proscar may take up to six months to achieve its complete effect. Because Proscar obstructs the production of testosterone, it can trigger impotence and breast augmentation. Also, saw palmetto is considerably less costly than Proscar. A one-month supply of saw palmetto costs $12-25, while a one month supply of Proscar costs $65-75. Other prescription substance abuse to treat BPH are Cardura (doxazosin), Hytrin (terazosin), and Flomax (tamsulosin hydrochloride). Initially prescribed to treat high blood pressure, Cardura and Hytrin can drop blood pressure, causing lightheadedness and fainting. Presently, saw palmetto is being examined by the U.S. Food and Drug Administration (FDA) for treatment of BPH. If approved, it would end up being the very first natural product to be certified by the agency as a treatment for a specific condition. Saw palmetto is also utilized as a treatment for prostate grievances and irritable bladder.

Considering that the 1960s, extensive scientific studies of saw palmetto have been carried out in Europe. A 1998 evaluation of 24 European trials included nearly 3,000 men, some taking saw palmetto, others taking Proscar, and a third group taking a placebo. The men taking saw palmetto had a 28% enhancement in urinary tract symptoms, a 24% improvement in peak urine circulation, and 43% enhancement in total urine flow. The outcomes were almost similar to the group taking Proscar and superior to the men taking a placebo.

On the other hand, saw palmetto does not seem beneficial in dealing with prostatitis or chronic pelvic pain syndrome (CPPS) in men. A group of scientists at Columbia University reported in early 2004 that males offered saw palmetto for CP/CPPS revealed no appreciable enhancement at the end of a year-long trial.


Saw palmetto berries have actually been used in American folk medicine for a number of hundred years as an aphrodisiac and for dealing with prostate issues. Native Americans in the southeast United States have used saw palmetto because the 1700s to deal with male urinary problems. In the 1800s, medical botanist John Lloyd kept in mind that animals that consumed saw palmetto appeared much healthier and fatter than other animals. Early American settlers observed the same effects and used the juice from saw palmetto berries to gain weight, to enhance general personality, as a sedative, and to promote reproductive health.

In the United States, the medical uses of saw palmetto were first recorded in 1879 by Dr. J. B. Read, a doctor in Savannah, Georgia, who released a paper on the medicinal advantages of the herb in the April 1879 issue of American Journal of Drug Store. He discovered the herb useful in dealing with a vast array of conditions. “By its strange relaxing power on the mucous membrane it induces sleep, relieves the most troublesome coughs, promotes expectoration, enhances digestion, and increases fat, flesh and strength. Its sedative and diuretic properties are impressive,” Read wrote. “Thinking about the excellent and diversified power of the saw palmetto as a restorative agent, it appears unusual that it ought to have so long got away the notice of the medical profession.”

A pungent tea made from saw palmetto berries was commonly used in the early 1900s to treat prostate augmentation and urinary system infections. It was also utilized in males to increase sperm production and sex drive, although these uses are marked down today. One of the very first published medical suggestions that saw palmetto worked in treating prostate problems appeared in the 1926 edition of United States Dispensatory. In the late 1920s, using medicinal plants, including saw palmetto, began to decline in the United States, while at the same time, it was on the increase in Europe.


The National Institute on Aging recommends that individuals taking saw palmetto ought to acquire it just from credible sources. In addition, individuals need to utilize only standardized extracts that contain 85-95% fatty acids and sterols. Does differ depending upon the type of saw palmetto used. A typical dosage is 320 mg each day of standardized extract (1-2 g) per day of ground dried whole berries. It may take up to four weeks of use before useful impacts are seen. In late 1999, the web-based independent customer company evaluated 27 leading brand names of saw palmetto for fatty acid and sterol material. 10 of the brand names contained less than the minimum suggested level of 85% fatty acids and sterols. [2]

Pharmacology of Saw Palmetto

Saw Palmetto is extensively used as a treatment for urinary dysfunction due to a bigger prostate (benign prostatic hyperplasia (BPH)) and can be utilized for male pattern baldness, acne, excess hair in females and eczema

Saw palmetto extracts of the ripe berries of the American dwarf palm (Serenoa repens), are extensively used as a healing remedy for urinary dysfunction due to a bigger prostate or benign prostatic hyperplasia (BPH) in the US and more so in Europe.

Based on systems of action, Saw Palmetto extracts can likewise be utilized for male pattern baldness (alopecia), excess hair in women (hirsutism), acne, inflammatory skin condition (seborrhea) and eczema.

Mechanisms of Action

Saw Palmetto extracts hinder 5α-reductase, which is an enzyme responsible for conversion of testosterone to dihydrotestosterone. Inhibition of such conversion preserves prostate health.

There are 2 typically associated male physiological occasions that have a comparable etiology. Bigger prostate or benign prostatic hyperplasia (BPH) and male pattern baldness are both related to the enzyme 5- reductase. Hirsutism in women is also connected to this enzyme. An excess in the activity of 5- reductase has actually been shown to be responsible for bigger prostate and male pattern baldness, as well as hirsutism in females.

5- Reductase catalyzes the conversion of testosterone to 5 dihydrotestosterone (5 DHT). 5 DHT is a physiological ligand for an intracellular androgen receptor. The intracellular receptor has a higher affinity for 5 DHT than testosterone. Once the ligand has engaged with its cognate receptor, the receptor-ligand complex enters the nucleus and manages gene expression.

Historic Use of Saw Palmetto

Saw Palmetto (Serenoa repens) is utilized in several types of traditional medication. Native tribes of Florida such as the Seminoles depended on saw palmetto berries for food, and the Mayans drank it as a tonic; nevertheless, Europeans often found the taste of the berries objectionable.

Historically, Saw Palmetto was taken with nettle root and pumpkin seeds. Therefore, some contemporary solutions include these elements. Native American medicine men likewise reputedly kept a medicine bag of Saw Palmetto around to make antibacterial and a tonic, and to treat a variety of conditions, consisting of impotence, inflammation and infertility, and as an expectorant.

Saw Palmetto has actually historically been utilized to treat infertility in females and underdeveloped breasts. It has actually also been utilized to increase lactation, mitigate painful menstruation cycles, and lower the size of a bigger prostate. It has even been utilized as a hunger stimulant.

An unrefined extract of Saw Palmetto was utilized for a minimum of 200 years for different conditions including asthenia (weak point), healing from a significant illness, and urogenital problems.

Medicinal use of Saw Palmetto was presented into Western medical practice in the 1870s and was a favorite of diverse medical practitioners for prostate and other urologic conditions. For example, the eclectic medication professional H. W. Felter wrote of it, “Saw Palmetto is a nerve sedative, expectorant, and a nutritious tonic, acting kindly upon the digestive tract … Its most direct action appears to be upon the reproductive organs when undergoing waste of tissue …”

Throughout the late 19th century interest in Saw Palmetto established when its favorable effect on animals was observed. This interest increased when its beneficial effects on the genitourinary tract were noted. At this time Saw Palmetto was utilized as a treatment for enlarged prostate, cystitis, gonorrhea, and irritation of the mucous membranes.

Saw Palmetto berries were officially included in the United States Pharmacopeia in 1906 and 1916, and in the National Formulary from 1926 to 1950. Nevertheless, after the World War II period, using Saw Palmetto as a medication lessened in the United States.

Regardless of this decrease in the United States, use of Saw Palmetto as a medical herb continued in Europe. Presently, making use of herbal alternatives for the treatment of benign prostatic hyperplasia (BPH) is very common there. This is most prevalent in Germany, whereas numerous as 95% of clients are first treated with a natural treatment. Treatment with organic treatments has provided a more favorable ratio between restorative advantages and unfavorable reactions. In Germany, a requirement has actually been set such that Saw Palmetto extract need to consist of 85-95% fatty acids and sterols (used as biomarkers and thought to be the active ingredients). It is this lipophilic extract that has actually been utilized throughout Europe and upon which most of Saw Palmetto research has actually been carried out.

In the last few years, the United States has seen a renewal of interest in using Saw Palmetto extract for the treatment of numerous “male-oriented” disorders such as impotence, hair loss, male pattern baldness, enhancement of the prostate, BPH and even sexual dysfunctions and bad libido.

Early research suggested that the extract is well-tolerated and recommended “moderate to moderate improvement in urinary symptoms and circulation measures.” Later trials of greater methodological quality showed no distinction from placebo. Questions of adequate blinding and shipment of any active components remain.

Inhibition of both types of 5-alpha-reductase without any reduction in cellular capability to produce prostate-specific antigen is suggested.

Other propositions for mechanisms of action consist of hindering dihydrotestosterone binding to the androgen receptor, unwinding smooth muscle tissue similarly to alpha villain drugs, and serving as a phytoestrogen.

Restricted in vitro and animal design research studies suggest possible anti-tumor activity and potential for usage in the treatment of cancer. However, these outcomes have not been validated with human trials.

The Cochrane Database evaluation (2009) concludes that “The proof suggests that Serenoa repens supplies moderate to moderate enhancement in urinary signs and circulation steps. Serenoa repens produced comparable enhancement in urinary symptoms and flow compared to finasteride and is connected with fewer adverse treatment events.” [3]

Saw Palmetto Benefits/Uses

1. Treats Benign Prostatic Hypertrophy (BPH)

The most typical kind of a bigger prostate is benign prostatic hyperplasia. The prostate usually stays at about the very same size or grows slowly in adults, as long as male hormonal agents are present.

It’s when the prostate becomes bigger that men begin experiencing symptoms from BPH and lower urinary system concerns.

The prostate gland can end up being swollen or bigger as guys grow older. The prostate then compresses the urethra, leading to problem with urination that leads to bladder infections or bladder stones.

BPH can be brought on by a range of circumstances, including hormone changes (such as excess estrogen), deteriorating capillary and a zinc shortage.

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

Research study shows that saw palmetto prevents testosterone from binding to and promoting prostate cells, which lowers the reproduction of prostatic cells and prostatic augmentation.

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

One 2012 research study carried out in Switzerland examined 82 clients in an eight-week trial. The patients took one pill of 320 milligrams of saw palmetto extract daily.

At the end of the treatment, the International Prostate Sign Rating was lowered from 14.4 ± 4.7 to 6.9 ± 5.2. Detectives’ and patients’ evaluations validated the great effectiveness, and treatment was extremely well-tolerated and accepted by the clients.

2. Lowers Danger of Prostate Cancer

An organized literature review of 11 research studies identified saw palmetto supplements as one of the 5 frequently pre-owned types of natural medicine by men with prostate cancer.

Serenoa repens supplements work as 5-alpha reductase inhibitors– indicating they decrease the conversion of testosterone to DHT by obstructing the enzyme and avoiding its formation. According to research, DHT is accountable for prostate augmentation, which might be a cause of prostate cancer.

The science is still unclear on this matter, however research studies on 2 5-alpha reductase inhibitor prescriptions, Finasteride (Proscar) and Dutasteride (Avodart) discovered that males taking either drug were less likely to develop prostate cancer after several years than males getting an inactive placebo. The problem lies in the adverse effects of these medications– they can trigger sexual side effects, such as lowered sexual desire and impotence.

Saw palmetto, on the other hand, can likewise prevent DHT and aid with urinary problems from BPH, such as trouble urinating and leaking urine– plus it manages your testosterone levels, assists with libido and works as a natural solution for impotence.

Research studies have actually likewise found that saw palmetto inhibits the development of prostatic cancer cells and may ruin harmful cells. A research 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 enhancement.

Another fascinating note about saw palmetto is the research that has been done to determine its impact on post-surgery healing time. Prostate surgery (known as transurethral resection of the prostate or TURP) can need a prolonged recovery period, but research study shows that taking 320 milligrams of saw palmetto daily for two months prior to prostate surgery can lower the time invested in surgery.

It also assists with blood loss, the advancement of problems throughout surgical treatment and the total time spent in the healthcare facility.

3. Aids With Hair Loss

Saw palmetto extracts and supplements work as hair loss treatments since they keep testosterone levels balanced. As guys age, the testosterone hormone is diminished, and the hormonal agent called 5α-Dihydrotestosterone (DHT) increases.

The cause of loss of hair is because of the hair roots’ level of sensitivity to DHT, which is a male androgen hormone that triggers follicles to shrink, leading to a shorter life expectancy and reduction of hair production.

Usually, after a hair falls out, another hair starts to grow from this same roots– however if DHT is high, hair growth reduces. Saw palmetto benefits have the power to stop the conversion of testosterone into DHT, making it helpful for hair growth.

Although the opinions about saw palmetto as a reliable hair development representative are combined, particularly when it concerns utilizing saw palmetto for females, there are research studies that show its use as beneficial.

One research study performed at the Medical Research and Development Network in Colorado checked 34 men and 28 females, aged 18– 48 years, who topically applied saw palmetto extract in lotion and shampoo base for 3 months. The outcomes discovered that 35 percent of the individuals had a boost in hair density.

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

A 2020 evaluation of proof released in the Cochrane database, PubMed and Google Scholar found that Serenoa repens extract led to improvement in general hair quality, overall hair count and hair density among alopecia patients. Reports likewise show that saw palmetto was well-tolerated and not connected with major negative events.

4. Keeps Testosterone Levels

Due to the fact that saw palmetto prevents the conversion of testosterone into DHT, the body maintains regular levels of testosterone. This aids with weight-loss, strength management, discomfort response, loss of hair and libido.

Today, low testosterone in males is quickly growing, and this leads to chronic tiredness, a stunt in sex drive and a reduced sense of wellness.

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

The study suggests that his metabolic status enhanced dramatically by increasing his testosterone counts. After 3 months, he currently felt more stimulated, and his sexual function enhanced.

5. Supports Urological System

Saw palmetto benefits the urological system in guys 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 suggested to deal with deteriorating urinary organs in senior individuals or women after menopause since it reinforces the urinary organs and has been suggested as a natural remedy for kidney stones.

The Journal of American Medical Association released a 1998 review mentioning that saw palmetto works in improving urological signs and urine circulation. For the review, 18 randomized trials with almost 3,000 male participants were examined.

Overall, 28 percent of the men taking saw palmetto revealed less urinary system symptoms, 24 percent showed improvement in peak urine circulation and total urine circulation enhanced for 43 percent of the individuals.

The outcomes were comparable to the group taking Proscar– a recommended medication– and they were a lot more appealing 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 males who randomly got either saw palmetto or a placebo for six months. The results indicate that saw palmetto use results in a considerable improvement in urinary symptoms in males with lower urinary system symptoms compared with placebo.

This study reveals that saw palmetto can be an effective natural home remedy for UTI. [4]

How to Take

While the active compound(s) are not yet known, it is understood that they exist in what is referred to as the ‘liposterolic’ fraction of the fruits. If using saw palmetto pick an item that discloses the percentage of the supplement which is this fraction.

Supplements of saw palmetto tends to be in the variety of 160-320 mg, taken once daily, of an item which is 80-90% liposterolic compounds by weight. While it is not confirmed if saw palmetto needs to be taken with food due to the fat soluble nature of this fraction it is advised. [5]

Offered Forms

Saw palmetto can be purchased as dried berries, powdered pills, tablets, liquid casts, and liposterolic extracts. The item label ought to show that contents are standardized and contain 85% to 95% fatty acids and sterols. Read labels carefully, and purchase just from credible business. [6]

Possible Negative Effects

Saw palmetto is usually well endured however might trigger negative effects in some individuals, particularly when overused.

These consist of:

  • Bad breath
  • Irregularity
  • Diarrhea
  • Dizziness
  • Tiredness
  • Headache
  • Queasiness or vomiting
  • Stomach upset

Saw palmetto can theoretically affect sex hormonal agent levels, consisting of estrogen and testosterone. Because of this, individuals with hormone-sensitive cancers (including breast cancer and prostate cancer) ought to speak with their oncologist before using saw palmetto.

Some guys have also reported impotence, breast inflammation, gynecomastia (breast enhancement), and a loss of sex drive (libido) while taking saw palmetto.

Individuals on blood slimmers such as Coumadin (warfarin) and Plavix (clopidogrel) must avoid saw palmetto as it may increase the threat of bleeding. For this exact same factor, saw palmetto ought to be stopped a minimum of two weeks before or after surgical treatment.

Kids and pregnant women ought to not utilize saw palmetto due to the absence of safety research. [7]

What do we know about security?

Saw palmetto is well endured by most users. It may trigger moderate side effects, including digestive signs or headache.

Saw palmetto does not appear to impact readings of prostate-specific antigen (PSA) levels, even when taken in higher-than-usual quantities. PSA is a protein produced by the prostate gland. PSA levels have actually been utilized to screen for prostate cancer and are likewise utilized to keep track of patients who have been identified with prostate cancer.

Saw palmetto has actually not been shown to engage with medications.

Details on the safety of saw palmetto comes primarily from research studies of its usage for BPH in males. Little is understood about the security or negative effects of saw palmetto when utilized for other conditions, particularly in ladies or kids.

Saw palmetto may be risky for use during pregnancy or while breastfeeding. [8]

Special Safety Measures and Warnings

Pregnancy and breast-feeding: Saw palmetto is likely unsafe when taken by mouth during pregnancy or breast-feeding. It acts like a hormonal agent, and this could be unsafe. Do not use during pregnancy or breast-feeding.

Surgery: Saw palmetto may slow blood clot. It may trigger extra bleeding throughout and after surgery. Stop utilizing saw palmetto a minimum of 2 weeks prior to an arranged surgery. [9]


More research is required to conclude whether saw palmetto is an effective treatment for prostate-related conditions.

While there is some proof to support the truth that saw palmetto might have a favorable effect, its prospective negative effects have actually not been well studied.

Although inconclusive, current proof does not undermine the experience of individuals who have actually discovered saw palmetto helpful. Taken properly, it might be worth attempting as a complementary treatment. [10]


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