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Saw Palmetto

Best studied for: Enlarged prostate (BPH); Frequent nighttime urination; Hair thinning in men. Best known for easing urinary symptoms in men.

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What is saw palmetto? Saw Palmetto (Serenoa repens) is a plant that grows in the southeastern United States, and its berries have been used for medicinal purposes for centuries. It is commonly used to treat symptoms of an enlarged prostate and for conditions affecting the urinary tract. How does it work? The exact mechanism by which saw palmetto works for medicinal purposes is not completely understood. However, it is believed to work by reducing the production of dihydrotestosterone (DHT), which is a hormone that can cause prostate growth. Additionally, saw palmetto may also have anti-inflammatory and antioxidant effects. What are the active ingredients that are important for its medicinal properties? The active ingredients in saw palmetto that are important for its medicinal properties include fatty acids and phytosterols. What forms does it come in? Saw palmetto is available in a variety of forms, including capsules, tablets, tinctures, and extracts. When was it first used for medicinal purposes? The first use of saw palmetto for medicinal purposes dates back to the indigenous people of the southeastern United States, who used the berries for various conditions. However, its use as a treatment for symptoms of an enlarged prostate became more widespread in the 20th century.

Helps

What does Saw Palmetto help with? Saw palmetto is a small palm tree from the southeast United States. Native American healers used its berries for urinary and male health. Today the berry extract is sold as a capsule or soft gel. An enlarged prostate (BPH) making it hard to pee Good evidence — several human trials; this is the most studied use in our file. In these trials, many men reported better flow and fewer symptoms. The change came over a few months of daily use, not days. Our file does not record the size or dose of each trial, so we do not state them. Evidence grade B · Traditional tier T2 Waking up at night to pee Good evidence — several trials of a standardised berry extract. Waking two or more times a night to pee is called nocturia. In several trials, men taking a standardised extract made fewer night trips. The file does not record how many men took part, or at what dose. Evidence grade B · Traditional tier T2 A weak or slow urine stream Early evidence — clinical studies of men, with sizes and doses not on file. An enlarged prostate presses on the urethra and narrows it. In these studies, men reported better peak flow after steady use. In lab work, the extract eased swelling and relaxed muscle a little. Evidence grade C · Traditional tier T2 Male-pattern hair loss Early evidence — early, small human studies. Male-pattern baldness is driven by DHT, a strong form of testosterone. In lab studies, saw palmetto slowed the enzyme that makes DHT. Early human studies point to slower loss, and slightly thicker hair at the crown in some men. Evidence grade C · Traditional tier T2 Long-term prostate swelling (prostatitis) Long traditional use · not yet tested in trials — user reports and lab work; no clear human trial on file. Some men with pelvic pain and burning have reported relief with regular use. In lab work, the extract lowered the activity of swelling-related compounds in prostate tissue. Our file holds no trial size or dose for this use. Evidence grade D · Traditional tier T2 Pelvic pain in men Long traditional use · not yet tested in trials — limited, mixed results in men with chronic pelvic pain. Some men with chronic pelvic pain reported less discomfort. The reports came from care that mixed saw palmetto with other steps. So we cannot say how much came from the berry alone. Evidence grade D · Traditional tier T2 Sudden urges to pee, or a bladder that feels full again right away Long traditional use · not yet tested in trials — no human study on file for this use by itself. Some men on saw palmetto for BPH report fewer urges and fewer daytime trips. But our file holds no trial that tested urgency on its own. The proposed action is on hormones and on bladder muscle tone. Evidence grade insufficient · Traditional tier T2 High DHT levels Long traditional use · not yet tested in trials — lab studies of the enzyme only. In lab studies, saw palmetto slowed 5-alpha reductase. That enzyme turns testosterone into DHT. Our file holds no human trial that measured DHT levels before and after. Evidence grade insufficient · Traditional tier T2 Hormone balance as men age Long traditional use · not yet tested in trials — practitioner use and tradition, with no human trial on file. Some practitioners use it when DHT-linked signs show up with normal testosterone. Those signs include prostate growth and thinning hair. Our file records no human trial of hormone ratios, so this rests on practice alone. Evidence grade insufficient · Traditional tier T2 What Saw Palmetto has not been shown to do It has not been shown to raise testosterone or build muscle; the work on file points to little change in overall testosterone. It has not been shown to prevent or treat prostate cancer; our file holds no human study on cancer at all. It has not been shown to regrow a full head of hair; the best reports were modest gains at the crown. It has not been shown to shrink an enlarged prostate back to normal size; the gains men reported were in symptoms

Saw Palmetto

Quick Facts

  • What it is: A small palm tree native to the southeastern United States whose berry extract has been used for centuries to support male urinary and hormonal health.
  • Main uses: Best known for easing urinary symptoms in men with an enlarged prostate and supporting healthy testosterone balance.
  • Best for: Enlarged prostate (BPH), Frequent nighttime urination, Hair thinning in men
  • Active ingredients: Beta-sitosterol, Free fatty acids (lauric, oleic, myristic), Phytosterols, Polysaccharides, Flavonoids
  • Forms: Softgel capsule, Liposterolic extract, Liquid extract, Tincture, Whole berry powder, Tea (less potent)
  • Time to effect: 4 to 8 weeks for noticeable urinary symptom improvement; up to 6 months for fuller effect
  • Side effects: Generally very well tolerated — mild digestive upset is the most common complaint, and rare cases of headache or dizziness have been reported.
  • Pregnancy & breastfeeding: Avoid in pregnancy and while breastfeeding.

Educational information, not medical advice — ask your doctor or midwife.

What is saw palmetto?

Saw Palmetto (Serenoa repens) is a plant that grows in the southeastern United States, and its berries have been used for medicinal purposes for centuries. It is commonly used to treat symptoms of an enlarged prostate and for conditions affecting the urinary tract.

How does it work?

The exact mechanism by which saw palmetto works for medicinal purposes is not completely understood. However, it is believed to work by reducing the production of dihydrotestosterone (DHT), which is a hormone that can cause prostate growth. Additionally, saw palmetto may also have anti-inflammatory and antioxidant effects.

What are the active ingredients that are important for its medicinal properties?

The active ingredients in saw palmetto that are important for its medicinal properties include fatty acids and phytosterols.

What forms does it come in?

Saw palmetto is available in a variety of forms, including capsules, tablets, tinctures, and extracts.

When was it first used for medicinal purposes?

The first use of saw palmetto for medicinal purposes dates back to the indigenous people of the southeastern United States, who used the berries for various conditions. However, its use as a treatment for symptoms of an enlarged prostate became more widespread in the 20th century.

Who should avoid Saw Palmetto?

  • Do not take saw palmetto if you are pregnant or trying to get pregnant, since it acts on hormones.
  • Do not take it while breastfeeding.
  • Do not give saw palmetto to children.
  • Do not mix it with blood thinners like warfarin (a drug that stops clots).
  • Do not add it to daily aspirin without asking your doctor first.
  • Do not take it if you have a bleeding disorder or bruise very easily.
  • Stop taking it at least two weeks before any surgery or dental surgery.
  • Do not take it on an empty stomach, as this can upset your gut.
  • Do not take more than 320 mg a day of the standard extract.
  • Do not use it in place of a prostate check-up with your doctor.
  • Do not have a PSA blood test without telling your doctor you take saw palmetto.
  • Stop taking it if your skin or eyes turn yellow, and call your doctor.

When should you see a doctor?

Call your doctor the same day if you see blood in your urine. Do the same if you cannot pee at all, or if you have pain in your belly with a fever. Bleeding that will not stop, or new heavy bruising, also needs a call that day.

Stop the supplement and see a doctor within a day if your skin or eyes look yellow. Dark urine or ongoing sickness in your stomach can point to liver trouble. Headache, dizziness or breast tenderness that lasts more than two weeks is worth a call too.

Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.

Remedies related to Saw Palmetto

African PotatoBeta-SitosterolBulbineGoshajinkigan ModifiedNettle LeafNettle RootPumpkin Seeds (Pepitas)Pygeum AfricanumRoghan KaduStinging NettleVaruna (Crataeva nurvala)Willow Herb (Epilobium)

People take Saw Palmetto when they say

Everyday descriptions of the problems this remedy is recommended for.

Conditions where Saw Palmetto is recommended

Each grade below is for that condition specifically, not for Saw Palmetto in general.

Natural options for Prostate Health, ranked by evidence

The 2 options with the best evidence for Prostate Health, each with its grade and who should avoid it. One email.

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