Saw Palmetto


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Saw palmetto, Any of several shrubby palms mainly 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 creeping stem. Saw palmettos comprise part of the plants discovered in the Florida Everglades. When undisturbed, they become great masses of foliage. The saw palmetto has just recently drawn attention as the source of a possible treatment for prostate cancer. [1]


Saw palmetto is utilized by natural health practitioners to deal with a range of conditions in men and women, such as testicular swelling, urinary tract inflammation, coughs, and breathing congestion. It is also used to strengthen the thyroid gland, balance the metabolic process, promote cravings, and help digestion. According to the American Dietetic Association, saw palmetto is among the most commonly utilized dietary supplements among Americans in between the ages of 50 and 76.

Most of the evidence supporting these uses is anecdotal and has actually not been proven by regulated clinical trials. Nevertheless, there is much clinical documentation laying out the efficiency of the herb in dealing with irritable bladder and urinary problems in men with benign prostate hyperplasia (BPH), an enhancement of the prostate gland. BPH results in a swelling of the prostate gland that obstructs the urethra. This causes unpleasant urination, reduced urine flow, trouble starting or stopping the flow, dribbling after urination, and more regular nighttime urination. Saw palmetto does not decrease prostate augmentation. Instead, it is thought to work in a variety of methods. First, it inhibits the conversion of testosterone into dihydrotestosterone (DHT). BPH is believed to be caused by a boost in testosterone to DHT. Second of all, saw palmetto is thought to interfere with the production of estrogen and progesterone, hormones related to DHT production.

In addition to causing pain and embarrassment, BPH can cause serious kidney issues if undiagnosed and left untreated. It is a typical issue in guys over the age of 40. Quotes are that 50-60% of all guys will establish BPH in their life times. It is estimated that there are six million guys in between the ages of 50-79 who have BPH major sufficient to require some type of therapy. Yet only half of them seek treatment from physicians. Health practitioners in both the allopathic and natural medicine communities advise yearly prostate assessments for males over the age of 50, and a yearly blood test that measures prostate specific antigen, a marker for prostate cancer.

Recently, a number of scientific trials have validated the efficiency of saw palmetto in dealing with BPH. Many of these trials have shown saw palmetto works much better than the most commonly utilized prescription drug, Proscar. Saw palmetto is effective in almost 90% of clients after six weeks of use, while Proscar is effective in less than 50% of patients. In addition, Proscar may use up to six months to achieve its complete impact. Since Proscar blocks the production of testosterone, it can cause impotence and breast enlargement. Also, saw palmetto is significantly less expensive 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 high blood pressure, causing lightheadedness and fainting. Currently, saw palmetto is being evaluated by the U.S. Fda (FDA) for treatment of BPH. If approved, it would become the first organic item to be licensed by the company as a treatment for a particular condition. Saw palmetto is likewise used as a treatment for prostate grievances and irritable bladder.

Since the 1960s, comprehensive scientific studies of saw palmetto have actually been carried out in Europe. A 1998 review of 24 European trials involved almost 3,000 men, some taking saw palmetto, others taking Proscar, and a 3rd group taking a placebo. The men taking saw palmetto had a 28% improvement in urinary system signs, a 24% enhancement in peak urine circulation, and 43% improvement in total urine flow. The outcomes were almost comparable to the group taking Proscar and superior to the men taking a placebo.

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


Saw palmetto berries have been used in American herbal remedies for several hundred years as an aphrodisiac and for treating prostate issues. Native Americans in the southeast United States have utilized saw palmetto considering that the 1700s to treat male urinary problems. In the 1800s, medical botanist John Lloyd kept in mind that animals that ate saw palmetto appeared healthier and fatter than other livestock. Early American inhabitants saw the very same effects and utilized the juice from saw palmetto berries to gain weight, to improve basic personality, as a sedative, and to promote reproductive health.

In the United States, the medical uses of saw palmetto were first documented in 1879 by Dr. J. B. Read, a physician in Savannah, Georgia, who released a paper on the medical advantages of the herb in the April 1879 problem of American Journal of Pharmacy. He discovered the herb beneficial in dealing with a wide range of conditions. “By its strange soothing power on the mucous membrane it causes sleep, eliminates the most troublesome coughs, promotes expectoration, improves digestion, and increases fat, flesh and strength. Its sedative and diuretic residential or commercial properties are impressive,” Read wrote. “Considering the great and varied power of the saw palmetto as a restorative agent, it seems strange that it ought to have so long left the notice of the medical occupation.”

A pungent tea made from saw palmetto berries was commonly utilized in the early 1900s to treat prostate enhancement and urinary tract infections. It was also utilized in males to increase sperm production and sex drive, although these usages are marked down today. One of the very first released medical recommendations that saw palmetto worked in dealing with prostate problems appeared in the 1926 edition of United States Dispensatory. In the late 1920s, using medicinal plants, consisting of saw palmetto, began to decrease in the United States, while at the same time, it was on the rise in Europe.


The National Institute on Aging advises that people taking saw palmetto need to obtain it just from reliable sources. In addition, individuals should utilize just standardized extracts that contain 85-95% fatty acids and sterols. Dosages differ depending upon the type of saw palmetto utilized. A typical dose is 320 mg daily of standardized extract (1-2 g) daily of ground dried entire berries. It may use up to 4 weeks of use prior to advantageous effects are seen. In late 1999, the web-based independent customer organization checked 27 leading brand names of saw palmetto for fat and sterol material. Ten of the brand names included less than the minimum suggested level of 85% fatty acids and sterols. [2]

Pharmacology of Saw Palmetto

Saw Palmetto is widely used as a remedy for urinary dysfunction due to an enlarged prostate (benign prostatic hyperplasia (BPH)) and can be used 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 commonly used as a restorative solution for urinary dysfunction due to an enlarged 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 ladies (hirsutism), acne, inflammatory skin condition (seborrhea) and eczema.

Systems of Action

Saw Palmetto extracts inhibit 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 females is also connected to this enzyme. An excess in the activity of 5- reductase has been revealed to be responsible for enlarged 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 greater affinity for 5 DHT than testosterone. Once the ligand has actually engaged with its cognate receptor, the receptor-ligand complex enters the nucleus and controls gene expression.

Historical Use of Saw Palmetto

Saw Palmetto (Serenoa repens) is used in several forms of conventional medicine. Native people of Florida such as the Seminoles relied on saw palmetto berries for food, and the Mayans consumed it as a tonic; however, Europeans frequently discovered the taste of the berries objectionable.

Historically, Saw Palmetto was taken with nettle root and pumpkin seeds. Thus, some modern-day formulas consist of these components. Native American medicine men likewise reputedly kept a medicine bag of Saw Palmetto around to make antiseptic and a tonic, and to deal with a wide range of conditions, including impotence, swelling and infertility, and as an expectorant.

Saw Palmetto has historically been utilized to treat infertility in ladies and underdeveloped breasts. It has likewise been utilized to increase lactation, mitigate agonizing menstruation cycles, and reduce the size of a bigger prostate. It has actually even been used as a cravings stimulant.

A crude extract of Saw Palmetto was utilized for a minimum of 200 years for numerous conditions consisting of asthenia (weak point), healing from a significant illness, and urogenital problems.

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

Throughout the late 19th century interest in Saw Palmetto developed when its positive effect on livestock was observed. This interest increased when its helpful results on the genitourinary system were kept in mind. 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 formally consisted of in the United States Pharmacopeia in 1906 and 1916, and in the National Formulary from 1926 to 1950. Nevertheless, after the World War II era, the use of Saw Palmetto as a medication decreased in the United States.

Despite this decrease in the US, use of Saw Palmetto as a medicinal herb continued in Europe. Presently, the use of herbal alternatives for the treatment of benign prostatic hyperplasia (BPH) is extremely common there. This is most common in Germany, whereas numerous as 95% of clients are first treated with a herbal treatment. Treatment with natural remedies has provided a more favorable ratio between therapeutic advantages and adverse responses. In Germany, a standard has been set such that Saw Palmetto extract need to include 85-95% fats and sterols (utilized as biomarkers and believed to be the active components). It is this lipophilic extract that has actually been utilized throughout Europe and upon which most of Saw Palmetto research has 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 lots of “male-oriented” disorders such as impotence, loss of hair, male pattern baldness, enlargement of the prostate, BPH and even sexual dysfunctions and poor sex drive.

Early research study indicated that the extract is well-tolerated and suggested “mild to moderate enhancement in urinary signs and circulation measures.” Later trials of higher methodological quality indicated no distinction from placebo. Questions of sufficient blinding and delivery 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 shown.

Other propositions for mechanisms of action consist of interfering with dihydrotestosterone binding to the androgen receptor, relaxing smooth muscle tissue likewise to alpha antagonist drugs, and serving as a phytoestrogen.

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

The Cochrane Database review (2009) concludes that “The evidence suggests that Serenoa repens offers mild to moderate improvement in urinary signs and circulation measures. Serenoa repens produced comparable enhancement in urinary signs and flow compared to finasteride and is related to fewer unfavorable treatment events.” [3]

Saw Palmetto Benefits/Uses

1. Treats Benign Prostatic Hypertrophy (BPH)

The most common type of a bigger prostate is benign prostatic hyperplasia. The prostate normally stays at about the exact same size or grows gradually in grownups, as long as male hormones exist.

It’s when the prostate becomes enlarged that males start experiencing signs from BPH and lower urinary tract issues.

The prostate gland can end up being irritated or bigger as guys grow older. The prostate then compresses the urethra, leading to difficulty with urination that results in bladder infections or bladder stones.

BPH can be brought on by a variety of scenarios, including hormonal changes (such as excess estrogen), degrading capillary and a zinc shortage.

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

Research reveals that saw palmetto prevents testosterone from binding to and stimulating prostate cells, which lowers the multiplication 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 negative effects. That makes it among the very best sources to increase testosterone naturally and improve prostate health the natural method.

One 2012 research study performed 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 Score was decreased from 14.4 ± 4.7 to 6.9 ± 5.2. Investigators’ and patients’ evaluations confirmed the good effectiveness, and treatment was very well-tolerated and accepted by the patients.

2. Reduces Threat of Prostate Cancer

A systematic literature review of 11 studies identified saw palmetto supplements as one of the 5 commonly used types of alternative medicine by males with prostate cancer.

Serenoa repens supplements work as 5-alpha reductase inhibitors– suggesting they decrease the conversion of testosterone to DHT by obstructing the enzyme and preventing its formation. According to research study, DHT is responsible for prostate augmentation, which may be a reason for 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) found that men taking either drug were less most likely to develop prostate cancer after several years than males getting an inactive placebo. The problem depends on the side effects of these medications– they can cause sexual negative effects, such as lowered libido and impotence.

Saw palmetto, on the other hand, can also prevent DHT and assist with urinary problems from BPH, such as problem urinating and dripping urine– plus it controls your testosterone levels, assists with sex drive and works as a natural treatment for impotence.

Research studies have likewise found that saw palmetto prevents the development of prostatic cancer cells and may ruin unsafe cells. A study conducted at the Department of Biochemistry and Molecular Biology at the Peking University Health Science Center in Beijing found that saw palmetto caused growth arrest of prostate cancer LNCaP, DU145 and PC3 cells and down-regulated DHT, the hormonal agent that leads to prostate enlargement.

Another interesting note about saw palmetto is the research study that has been done to determine its result on post-surgery healing time. Prostate surgery (called transurethral resection of the prostate or TURP) can require a prolonged recovery duration, but research study reveals that taking 320 milligrams of saw palmetto daily for 2 months prior to prostate surgical treatment can reduce the time spent in surgical treatment.

It likewise assists with blood loss, the development of issues throughout surgery and the overall time spent in the health center.

3. Helps with Hair Loss

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

The cause of hair loss is due to the hair roots’ sensitivity to DHT, which is a male androgen hormonal agent that causes roots to shrink, resulting in a shorter life expectancy and reduction of hair production.

Generally, after a hair falls out, another hair begins to grow from this exact same follicle– however if DHT is high, hair growth reduces. Saw palmetto benefits have the power to stop the conversion of testosterone into DHT, making it advantageous for hair development.

Although the viewpoints about saw palmetto as an efficient hair growth agent are blended, specifically when it pertains to using saw palmetto for women, there are studies that suggest its use as useful.

One study carried out at the Clinical Research and Development Network in Colorado checked 34 guys and 28 women, aged 18– 48 years, who topically used saw palmetto extract in lotion and hair shampoo base for three months. The results 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 method for both men and women.

A 2020 evaluation of proof published in the Cochrane database, PubMed and Google Scholar discovered that Serenoa repens extract led to enhancement in total hair quality, total hair count and hair density amongst alopecia clients. Reports also show that saw palmetto was well-tolerated and not related to serious unfavorable events.

4. Maintains Testosterone Levels

Because saw palmetto prevents the conversion of testosterone into DHT, the body maintains regular levels of testosterone. This aids with weight loss, strength management, pain action, loss of hair and libido.

Today, low testosterone in males is rapidly growing, and this results in persistent fatigue, a stunt in libido and a decreased sense of well-being.

A case study reported in the American Journal of Medicine examined a 52-year-old male who was experiencing erectile dysfunction, low sex drive and fatigue. He took no medications and was otherwise healthy.

The study recommends that his metabolic status enhanced considerably by increasing his testosterone counts. After three months, he already felt more energized, and his sexual function improved.

5. Supports Urological System

Saw palmetto benefits the urological system in males who have benign prostatic hyperplasia. This takes place because of an interaction with the receptors in the lower urinary tract that can cause urinary dysfunction and overactive bladder.

Serenoa repens is likewise suggested to deal with compromising urinary organs in elderly people or ladies after menopause due to the fact that it reinforces the urinary organs and has been suggested as a natural treatment for kidney stones.

The Journal of American Medical Association launched a 1998 evaluation stating that saw palmetto is effective in enhancing urological symptoms and urine flow. For the review, 18 randomized trials with nearly 3,000 male individuals were examined.

In general, 28 percent of the men taking saw palmetto showed fewer urinary system symptoms, 24 percent showed improvement in peak urine circulation and total urine flow enhanced for 43 percent of the participants.

The outcomes were comparable to the group taking Proscar– a prescribed medication– and they were a lot more promising than the men taking a placebo.

Another randomized, double-blind, placebo-controlled trial done at the University of Chicago Pritzker School of Medication included 85 males who arbitrarily received either saw palmetto or a placebo for six months. The outcomes show that saw palmetto usage leads to a considerable enhancement in urinary signs in guys with lower urinary tract symptoms compared to placebo.

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

How to Take

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

Supplements of saw palmetto tends to be in the series of 160-320 mg, taken once daily, of a product which is 80-90% liposterolic substances by weight. While it is not verified if saw palmetto requires to be taken with food due to the fat soluble nature of this portion it is encouraged. [5]

Offered Kinds

Saw palmetto can be acquired as dried berries, powdered pills, tablets, liquid casts, and liposterolic extracts. The product label need to suggest that contents are standardized and consist of 85% to 95% fatty acids and sterols. Check out labels carefully, and purchase only from reliable business. [6]

Possible Negative Effects

Saw palmetto is usually well tolerated however may trigger side effects in some people, especially when overused.

These consist of:

  • Foul breath
  • Irregularity
  • Diarrhea
  • Lightheadedness
  • Tiredness
  • Headache
  • Nausea or throwing up
  • Stomach upset

Saw palmetto can theoretically affect sex hormone levels, including estrogen and testosterone. Because of this, people with hormone-sensitive cancers (including breast cancer and prostate cancer) should talk to their oncologist prior to using saw palmetto.

Some men have actually also reported impotence, breast tenderness, gynecomastia (breast enlargement), and a loss of sex drive (libido) while taking saw palmetto.

Individuals on blood slimmers such as Coumadin (warfarin) and Plavix (clopidogrel) ought to prevent saw palmetto as it may increase the threat of bleeding. For this very same reason, saw palmetto ought to be stopped at least two weeks prior to or after surgery.

Kids and pregnant females ought to not use saw palmetto due to the lack of security research. [7]

What do we understand about safety?

Saw palmetto is well endured by most users. It may trigger moderate negative effects, consisting of gastrointestinal symptoms or headache.

Saw palmetto does not appear to affect readings of prostate-specific antigen (PSA) levels, even when taken in higher-than-usual amounts. PSA is a protein produced by the prostate gland. PSA levels have actually been used to screen for prostate cancer and are also utilized to monitor clients who have actually been identified with prostate cancer.

Saw palmetto has not been revealed to engage with medications.

Details on the safety of saw palmetto comes primarily from studies of its usage for BPH in men. Little is known about the security or adverse effects of saw palmetto when used for other conditions, particularly in ladies or kids.

Saw palmetto might be hazardous for use during pregnancy or while breastfeeding. [8]

Unique Preventative Measures and Warnings

Pregnancy and breast-feeding: Saw palmetto is most likely unsafe when taken by mouth during pregnancy or breast-feeding. It acts like a hormone, and this could be harmful. Don’t use during pregnancy or breast-feeding.

Surgical treatment: Saw palmetto may slow blood clotting. It may trigger extra bleeding during and after surgery. Stop utilizing saw palmetto at least 2 weeks before an arranged surgical treatment. [9]


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

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

Although undetermined, present proof does not undermine the experience of individuals who have actually discovered saw palmetto valuable. Taken correctly, it might deserve attempting as a complementary treatment. [10]


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