Saw Palmetto

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Saw palmetto, Any of a number of shrubby palms mainly of the southern U.S. and West Indies that have spiny-toothed petioles (leafstalks), especially 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 turn into excellent masses of foliage. The saw palmetto has actually recently drawn attention as the source of a possible treatment for prostate cancer. [1]


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

The majority of the proof supporting these uses is anecdotal and has actually not been proven by controlled medical trials. However, there is much scientific documents laying out the efficiency of the herb in treating irritable bladder and urinary problems in males 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, difficulty starting or stopping the circulation, dribbling after urination, and more frequent nighttime urination. Saw palmetto does not reduce prostate enhancement. Rather, it is believed to work in a variety of ways. Initially, it prevents 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 believed to disrupt the production of estrogen and progesterone, hormonal agents related to DHT production.

In addition to triggering discomfort and humiliation, BPH can lead to severe kidney problems if undiagnosed and left untreated. It is a typical problem in males over the age of 40. Quotes are that 50-60% of all men will develop BPH in their lifetimes. It is approximated that there are six million males between the ages of 50-79 who have BPH severe sufficient to require some type of treatment. Yet only half of them look for treatment from physicians. Health practitioners in both the allopathic and natural medicine communities advise annual prostate examinations for males over the age of 50, and a yearly blood test that determines prostate specific antigen, a marker for prostate cancer.

Recently, a number of clinical trials have actually validated the effectiveness of saw palmetto in treating BPH. A lot of these trials have actually shown saw palmetto works much better than the most typically utilized prescription drug, Proscar. Saw palmetto works in almost 90% of patients after six weeks of use, while Proscar works in less than 50% of patients. In addition, Proscar may use up to six months to attain its full effect. Considering that Proscar blocks the production of testosterone, it can trigger impotence and breast enlargement. Likewise, saw palmetto is substantially cheaper 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 deal with BPH are Cardura (doxazosin), Hytrin (terazosin), and Flomax (tamsulosin hydrochloride). Originally recommended to deal with hypertension, Cardura and Hytrin can drop high blood pressure, causing lightheadedness and fainting. Presently, saw palmetto is being assessed by the U.S. Food and Drug Administration (FDA) for treatment of BPH. If approved, it would become the first organic product to be licensed by the firm as a treatment for a particular condition. Saw palmetto is likewise utilized as a treatment for prostate problems and irritable bladder.

Because the 1960s, substantial medical research studies of saw palmetto have actually been carried out in Europe. A 1998 review of 24 European trials included almost 3,000 males, some taking saw palmetto, others taking Proscar, and a third group taking a placebo. The men taking saw palmetto had a 28% improvement in urinary tract signs, a 24% enhancement in peak urine circulation, and 43% improvement in total urine flow. The outcomes were nearly comparable 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 discomfort syndrome (CPPS) in men. A group of researchers at Columbia University reported in early 2004 that men provided saw palmetto for CP/CPPS showed 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 a century as an aphrodisiac and for treating prostate issues. Native Americans in the southeast United States have actually used saw palmetto since the 1700s to deal with 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 animals. Early American inhabitants observed the exact same impacts and utilized the juice from saw palmetto berries to gain weight, to improve general disposition, as a sedative, and to promote reproductive health.

In the United States, the medicinal 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 medicinal advantages of the herb in the April 1879 issue of American Journal of Drug Store. He discovered the herb helpful in treating a wide range of conditions. “By its peculiar relaxing power on the mucous membrane it causes sleep, eases the most problematic coughs, promotes expectoration, enhances digestion, and increases fat, flesh and strength. Its sedative and diuretic properties are exceptional,” Read wrote. “Thinking about the excellent and diversified power of the saw palmetto as a therapeutic representative, it seems unusual that it ought to have so long escaped the notification of the medical profession.”

A pungent tea made from saw palmetto berries was typically utilized in the early 1900s to treat prostate enlargement and urinary system infections. It was also used in men to increase sperm production and libido, although these usages are discounted today. Among the first published medical suggestions that saw palmetto worked in dealing with prostate problems appeared in the 1926 edition of United States Dispensatory. In the late 1920s, the use of medical plants, including saw palmetto, started 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 people taking saw palmetto should acquire it only from credible sources. In addition, people must use only standardized extracts which contain 85-95% fats and sterols. Does differ depending upon the kind of saw palmetto utilized. A normal dose is 320 mg each day of standardized extract (1-2 g) each day of ground dried whole berries. It might take up to 4 weeks of use prior to advantageous results are seen. In late 1999, the web-based independent consumer company checked 27 leading brand names of saw palmetto for fatty acid and sterol content. Ten of the brands consisted of less than the minimum suggested level of 85% fats and sterols. [2]

Pharmacology of Saw Palmetto

Saw Palmetto is commonly used as a treatment for urinary dysfunction due to an enlarged prostate (benign prostatic hyperplasia (BPH)) and can be used for male pattern baldness, acne, excess hair in ladies and eczema

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

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

Mechanisms 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 similar etiology. Bigger prostate or benign prostatic hyperplasia (BPH) and male pattern baldness are both related to the enzyme 5- reductase. Hirsutism in women is likewise related to this enzyme. An excess in the activity of 5- reductase has actually been shown to be responsible for enlarged prostate and male pattern baldness, in addition to hirsutism in ladies.

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. As soon as the ligand has actually engaged with its cognate receptor, the receptor-ligand complex gets in the nucleus and controls gene expression.

Historical Use of Saw Palmetto

Saw Palmetto (Serenoa repens) is used in several forms of traditional medicine. Native tribes of Florida such as the Seminoles relied 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. Hence, some contemporary formulas consist of these elements. Native American medicine men likewise reputedly kept a medication bag of Saw Palmetto around to make antiseptic and a tonic, and to deal with a wide array of conditions, consisting of impotence, swelling and infertility, and as an expectorant.

Saw Palmetto has actually traditionally been utilized to treat infertility in females and underdeveloped breasts. It has likewise been utilized to increase lactation, alleviate painful menstruation cycles, and decrease the size of an enlarged prostate. It has actually even been used as a hunger stimulant.

A crude extract of Saw Palmetto was used for at least 200 years for various conditions including asthenia (weakness), recovery from a major health problem, and urogenital problems.

Medicinal use of Saw Palmetto was presented into Western medical practice in the 1870s and was a favorite of diverse physicians for prostate and other urologic conditions. For instance, the diverse medicine practitioner H. W. Felter composed of it, “Saw Palmetto is a nerve sedative, expectorant, and a nutritious tonic, acting kindly upon the gastrointestinal system … Its most direct action seems upon the reproductive organs when going through waste of tissue …”

Throughout the late 19th century interest in Saw Palmetto developed when its positive result on livestock was observed. This interest increased when its useful impacts on the genitourinary system were noted. At this time Saw Palmetto was utilized as a treatment for enlarged prostate, cystitis, gonorrhea, and inflammation of the mucous membranes.

Saw Palmetto berries were formally consisted of in the US Pharmacopeia in 1906 and 1916, and in the National Formulary from 1926 to 1950. Nevertheless, after the World War II age, using Saw Palmetto as a medication lessened in the United States.

Regardless of this decline 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 typical there. This is most prevalent in Germany, whereas lots of as 95% of patients are first treated with an organic treatment. Treatment with natural remedies has provided a more beneficial ratio between healing benefits and unfavorable responses. In Germany, a standard has been set such that Saw Palmetto extract need to contain 85-95% fatty acids and sterols (used as biomarkers and thought 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 study has been performed.

In the last few years, the United States has actually seen a revival of interest in using Saw Palmetto extract for the treatment of numerous “male-oriented” conditions such as impotence, loss of hair, male pattern baldness, enlargement 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 enhancement in urinary symptoms and circulation measures.” Later trials of higher methodological quality suggested no distinction from placebo. Questions of adequate blinding and shipment of any active components remain.

Inhibition of both types of 5-alpha-reductase with no reduction in cellular capacity to secrete prostate-specific antigen is shown.

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

Limited in vitro and animal model studies recommend possible anti-tumor activity and capacity for use in the treatment of cancer. However, these outcomes have not been corroborated with human trials.

The Cochrane Database evaluation (2009) concludes that “The proof recommends that Serenoa repens offers mild to moderate enhancement in urinary symptoms and circulation steps. Serenoa repens produced comparable enhancement in urinary signs and circulation compared to finasteride and is connected with fewer negative 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 normally remains at about the same size or grows gradually in grownups, as long as male hormonal agents are present.

It’s when the prostate ends up being enlarged that men start experiencing signs from BPH and lower urinary system issues.

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

BPH can be caused by a variety of situations, consisting of hormone modifications (such as excess estrogen), degrading blood vessels and a zinc deficiency.

The American Urological Association reports that by the age of 60, over 50 percent of males 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 establish moderate to severe lower urinary tract signs that will greatly impact their quality of life.

Research study shows that saw palmetto inhibits testosterone from binding to and stimulating prostate cells, which decreases the multiplication of prostatic cells and prostatic augmentation.

Other treatments for BPH, alpha blockers and 5-alpha-reductase inhibitors, can trigger sexual dysfunctions themselves– while saw palmetto is a natural supplement that doesn’t have a long list of negative effects. That makes it among the very best sources to increase testosterone naturally and enhance prostate health the natural method.

One 2012 research study performed in Switzerland analyzed 82 clients in an eight-week trial. The clients took one capsule of 320 milligrams of saw palmetto extract daily.

At the end of the treatment, the International Prostate Sign Rating was reduced from 14.4 ± 4.7 to 6.9 ± 5.2. Investigators’ and clients’ assessments validated the great efficacy, and treatment was extremely well-tolerated and accepted by the patients.

2. Minimizes Danger of Prostate Cancer

A systematic literature review of 11 studies recognized saw palmetto supplements as one of the five typically secondhand types of alternative medicine by men with prostate cancer.

Serenoa repens supplements work as 5-alpha reductase inhibitors– implying they decrease the conversion of testosterone to DHT by blocking the enzyme and preventing its development. According to research study, DHT is accountable for prostate enlargement, which may be a reason for prostate cancer.

The science is still uncertain on this matter, however studies on two 5-alpha reductase inhibitor prescriptions, Finasteride (Proscar) and Dutasteride (Avodart) discovered that males taking either drug were less most likely to establish prostate cancer after a number of years than males getting a non-active placebo. The issue depends on the negative effects of these medications– they can cause sexual negative effects, such as decreased sexual desire and impotence.

Saw palmetto, on the other hand, can likewise hinder DHT and assist with urinary issues from BPH, such as trouble urinating and dripping urine– plus it manages your testosterone levels, helps with sex drive and works as a natural solution for impotence.

Studies have also found that saw palmetto prevents the development of prostatic cancer cells and may damage hazardous cells. A study performed at the Department of Biochemistry and Molecular Biology at the Peking University Health Science Center in Beijing discovered that saw palmetto induced growth arrest of prostate cancer LNCaP, DU145 and PC3 cells and down-regulated DHT, the hormonal agent that leads to prostate augmentation.

Another interesting note about saw palmetto is the research study that has actually been done to measure its result on post-surgery recovery time. Prostate surgical treatment (known as transurethral resection of the prostate or TURP) can need a prolonged healing period, however research study reveals that taking 320 milligrams of saw palmetto daily for 2 months before prostate surgical treatment can lower the time invested in surgical treatment.

It likewise aids with blood loss, the advancement of problems throughout surgery and the total time invested in the health center.

3. Helps with Loss Of Hair

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

The cause of loss of hair is due to the hair follicles’ level of sensitivity to DHT, which is a male androgen hormonal agent that causes roots to shrink, leading to a shorter life span and decline of hair production.

Normally, after a hair falls out, another hair begins to grow from this exact 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 useful for hair development.

Although the viewpoints about saw palmetto as an effective hair development representative are mixed, particularly when it pertains to utilizing saw palmetto for ladies, there are research studies that show its use as helpful.

One research study performed at the Clinical Research and Development Network in Colorado tested 34 males and 28 women, aged 18– 48 years, who topically used saw palmetto extract in cream and hair shampoo base for 3 months. The outcomes discovered that 35 percent of the individuals had a boost in hair density.

This suggests that saw palmetto for loss of hair may work as a natural approach for both males and females.

A 2020 review of evidence released in the Cochrane database, PubMed and Google Scholar found that Serenoa repens extract led to enhancement in total hair quality, total hair count and hair density among alopecia clients. Reports also reveal that saw palmetto was well-tolerated and not associated with major negative occasions.

4. Maintains Testosterone Levels

Due to the fact that saw palmetto inhibits the conversion of testosterone into DHT, the body retains regular levels of testosterone. This aids with weight reduction, strength management, discomfort action, hair loss and sex drive.

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

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

The research study suggests that his metabolic status enhanced significantly by increasing his testosterone counts. After 3 months, he already felt more energized, and his sexual function enhanced.

5. Supports Urological System

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

Serenoa repens is also suggested to deal with deteriorating urinary organs in senior people or women after menopause due to the fact that it strengthens the urinary organs and has been advised as a natural treatment for kidney stones.

The Journal of American Medical Association released a 1998 evaluation mentioning that saw palmetto is effective in enhancing urological symptoms and urine circulation. For the review, 18 randomized trials with practically 3,000 male participants were analyzed.

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

The results were comparable to the group taking Proscar– a prescribed medication– and they were much 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 included 85 males who arbitrarily got either saw palmetto or a placebo for six months. The results indicate that saw palmetto use results in a significant improvement in urinary symptoms in guys with lower urinary tract signs compared with placebo.

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

How to Take

While the active substance(s) are not yet understood, it is understood that they exist in what is called the ‘liposterolic’ fraction of the fruits. If utilizing saw palmetto pick an item that divulges the percentage of the supplement which is this portion.

Supplementation of saw palmetto tends to be in the range of 160-320 mg, taken daily, of a product which is 80-90% liposterolic compounds by weight. While it is not validated if saw palmetto requires to be taken with food due to the fat soluble nature of this portion it is advised. [5]

Offered Forms

Saw palmetto can be bought as dried berries, powdered capsules, tablets, liquid tinctures, and liposterolic extracts. The item label should suggest that contents are standardized and consist of 85% to 95% fatty acids and sterols. Read labels carefully, and purchase just from respectable companies. [6]

Possible Negative Effects

Saw palmetto is typically well endured however might trigger side effects in some individuals, particularly when excessive used.

These include:

  • Bad breath
  • Constipation
  • Diarrhea
  • Lightheadedness
  • Tiredness
  • Headache
  • Queasiness or vomiting
  • Stomach upset

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

Some men have likewise reported erectile dysfunction, breast inflammation, gynecomastia (breast enhancement), and a loss of sex drive (libido) while taking saw palmetto.

People on blood thinners such as Coumadin (warfarin) and Plavix (clopidogrel) ought to prevent saw palmetto as it might increase the danger of bleeding. For this very same reason, saw palmetto needs to be stopped at least two weeks prior to or after surgical treatment.

Kids and pregnant females should not utilize saw palmetto due to the absence of security research. [7]

What do we understand about security?

Saw palmetto is well tolerated by many users. It may trigger mild negative effects, consisting of digestion signs or headache.

Saw palmetto does not appear to affect 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 evaluate for prostate cancer and are likewise utilized to monitor clients who have actually been identified with prostate cancer.

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

Info on the security of saw palmetto comes mainly 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, especially in women or kids.

Saw palmetto may be hazardous for usage during pregnancy or while breastfeeding. [8]

Special Precautions and Cautions

Pregnancy and breast-feeding: Saw palmetto is likely risky when taken by mouth during pregnancy or breast-feeding. It imitates a hormone, and this could be hazardous. Do not use during pregnancy or breast-feeding.

Surgical treatment: Saw palmetto might slow blood clotting. It might cause additional bleeding throughout and after surgery. Stop using saw palmetto a minimum of 2 weeks prior to a scheduled surgery. [9]


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

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

Although inconclusive, present proof does not undermine the experience of people who have discovered saw palmetto handy. Taken properly, it might be worth trying as a complementary treatment. [10]


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