Saw Palmetto
The leading natural remedy for prostate health and BPH symptoms
Also known as: Serenoa repens • Sabal serrulata • American Dwarf Palm
Overview
Saw Palmetto (Serenoa repens) is a small palm tree native to the southeastern United States whose berries have been used medicinally by Native Americans for centuries. Today, it is one of the most commonly used herbal supplements for men's health, particularly for benign prostatic hyperplasia (BPH) — the non-cancerous enlargement of the prostate that affects over 50% of men over age 50. Saw palmetto's primary mechanism involves inhibiting 5-alpha-reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT). DHT is the primary driver of prostate enlargement and male pattern hair loss. The berry extract also has anti-inflammatory and anti-androgenic properties. While clinical evidence is mixed (with some large trials showing no benefit), many meta-analyses and clinical guidelines still support its use, particularly for mild-to-moderate BPH symptoms.
Key Benefits
BPH Symptom Relief
Multiple meta-analyses show saw palmetto improves urinary symptoms of BPH including frequent urination, weak stream, nighttime urination (nocturia), and incomplete bladder emptying. Effects are comparable to finasteride for mild-moderate symptoms.
5-Alpha-Reductase Inhibition
Saw palmetto inhibits both type I and type II 5-alpha-reductase enzymes, reducing conversion of testosterone to DHT. Unlike prescription 5-alpha-reductase inhibitors, it does not significantly affect PSA levels, which is important for prostate cancer screening.
Anti-Inflammatory Effects
The fatty acids and phytosterols in saw palmetto reduce inflammation in prostate tissue by inhibiting cyclooxygenase and 5-lipoxygenase pathways. This helps reduce prostate swelling and associated urinary symptoms.
Hair Loss Support
Due to its DHT-blocking properties, saw palmetto has been studied for androgenetic alopecia (male pattern baldness). A small study showed 60% improvement in hair quality, though evidence is limited compared to finasteride.
Dosage & How to Take
320mg of liposterolic extract (85-95% fatty acids) once daily
| Purpose | Dose | Notes |
|---|---|---|
| BPH symptoms | 320mg once daily | Allow 4-6 weeks for noticeable improvement |
| Prostate maintenance | 160-320mg daily | Lower dose for prevention |
| Hair loss | 320mg daily | Limited evidence; may take 6+ months |
| Combined with other prostate herbs | 320mg daily | Often combined with pygeum, nettle root, beta-sitosterol |
Best Time to Take
Once daily with a meal containing some fat (fat-soluble extract)
With or Without Food
Take with a fat-containing meal for optimal absorption
Forms & Bioavailability
| Form | Absorption | Best For | Notes |
|---|---|---|---|
| Liposterolic Extract (85-95% fatty acids) | High | BPH treatment | The clinically studied form — most effective |
| CO2 Supercritical Extract | High | Premium quality | Clean extraction preserves active compounds |
| Dried Berry Powder | Low | Mild support | Much lower concentration of active fatty acids |
| Tincture | Moderate | Convenience | Fatty acids don't extract well in alcohol |
Side Effects & Safety
Common
- Mild GI upset
- Headache
- Dizziness
Rare
- Decreased libido (uncommon, unlike prescription alternatives)
- Breast tenderness
Contraindications
- Hormone-sensitive conditions
- Pregnancy (anti-androgenic effects)
- Children
Interactions
Additive 5-alpha-reductase inhibition
Theoretical antiplatelet effect — limited evidence
Anti-androgenic effects may theoretically interact
Scientific Research
Cochrane Review of Saw Palmetto for BPH
Meta-analysis showed improvement in urinary symptom scores and peak urine flow vs placebo
STEP Trial (Negative)
Large NIH trial of 320mg/day showed no improvement over placebo for BPH — but extract quality was questioned
Hair Loss Pilot Study
60% of men showed improvement in hair quality after 5 months of 200mg saw palmetto + 50mg beta-sitosterol
Food Sources
Frequently Asked Questions
Medical Disclaimer
This content is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before starting any supplement regimen, especially if you have pre-existing health conditions or are taking medications. The statements on this page have not been evaluated by the Food and Drug Administration.