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Saw Palmetto: Benefits, Uses, Side Effects, and Essential Information

Saw palmetto has caught the attention of many people searching for natural supplements to address concerns with prostate issues and hair loss. It has also gained notoriety for a number of women's health issues such as polycystic ovary syndrome and bladder problems. But, what is saw palmetto? The small palm tree, native to the southeastern United States, has a long and interesting history of traditional uses in folk medicine. As its popularity rises in the modern world, it’s important to look into the science behind saw palmetto benefits.

In this article, we’ll take an unbiased look into the health claims surrounding this supplement. We’ll explore the potential benefits of saw palmetto for women and men, dive into the latest research, and discover if saw palmetto lives up to the hype.

What is saw palmetto?

Saw palmetto, also scientifically known as Serenoa repens, is a low-growing type of palm tree whose berries have been used in traditional herbal medicine for several hundred years. It was commonly given as a herbal remedy to address reproductive organ issues in both men and women.

Saw palmetto source and active components

The saw palmetto berries are the part of the tree that is used in herbal preparations and supplements. The active components in saw palmetto extracts include fatty acids, plant sterols, and flavonoids, which are all thought to contribute to its reported potential benefits.

It’s important to note that the concentrations of the active components can vary widely depending on the type of supplement and the extraction method. For example, saw palmetto tea may have fewer fatty acids than a saw palmetto oil preparation.

How saw palmetto works

As with any supplement or herbal extraction, it’s important to ask the question: what does saw palmetto do? Although not fully understood, it's thought that the medicinal effects of saw palmetto are delivered through multiple different mechanisms.

Firstly, the phytosterols present in the plant may inhibit enzyme activity, which reduces the conversion of testosterone to dihydrotestosterone (DHT).

DHT is involved in prostate enlargement, so potentially reducing DHT with saw palmetto supplements may contribute to a healthy prostate. However, there is not enough scientific research that establishes a firm relationship between saw palmetto and prostate health.

Secondly, the flavonoids in saw palmetto are thought to have antioxidant and anti-inflammatory properties.

The antioxidant molecules fight free radicals, which can cause cellular harm if their levels get too high in the body. Flavonoids, which are present in many fruits, vegetables, and herbs, have also been extensively studied for their ability to fight inflammation. A 2022 review of the current research presented the exact mechanisms are yet to be studied, but flavonoids can reduce the enzymes responsible for inflammation.

The fatty acids found in saw palmetto, including caprylic, lauric, palmitic, stearic, oleic, and linolenic may also help reduce inflammation. However, it would be beneficial to conduct more high-quality research on the concentrations and effectiveness of the fatty acids specific to saw palmetto.

Saw palmetto benefits

The benefits of saw palmetto are contested, and it’s worth noting that there is contradictory research. Advocates suggest you can use saw palmetto for sex drive, hair loss, prostate health, and as a supplement for polycystic ovary syndrome (PCOS). However, before deciding if it might be the right supplement for you, let’s look at the scientific research behind saw palmetto benefits for men and women.

Saw palmetto for prostate health

The prostate is a small gland found between the bladder and the penis. It’s approximately the size and shape of a walnut and produces a thick fluid that is mixed with sperm to produce semen. It can often get bigger as you age and lead to complications such as prostate enlargement and inflammation.

Saw palmetto is probably best known for its use in alternative and complementary medicine for the management of symptoms linked to benign prostatic hyperplasia (BPH), the medical term for an enlarged prostate. Symptoms of BPH include:

  • Swollen prostate
  • Bladder dysfunction
  • Incontinence
  • Decreased urine flow
  • Dribbling after urination
  • Straining to urinate

In one study of 354 patients with BPH, saw palmetto supplementation given over 24 weeks was shown to improve the storage of urine symptoms and voiding symptoms (normal stream during urination) associated with the condition when compared with the placebo group.

In another double-blind, placebo-controlled study, participants were given either phytosterol-enriched saw palmetto oil, conventional saw palmetto oil, or a placebo. The researchers found that those who had taken the enriched oil had significant improvements in BPH symptoms compared to the placebo and conventional saw palmetto oil group. While this study shows promise for the use of saw palmetto oil in the treatment of BPH symptoms, it’s important to take into account the fact that it was the enriched oil that showed the greatest efficacy.

Despite the research offering somewhat promising results, an overview of 27 studies published in the Cochrane can be summed up with the following quote:

Serenoa repens alone results in little to no difference in urinary tract symptoms or quality of life compared to placebo at three to six months.

Juan VA Franco et al. Cochrane Database of Systematic Reviews, June 2023

Whether or not saw palmetto truly has an effect on prostate health is debated. The evidence for its use in treating BPH is lacking and would benefit from more high-quality studies.

Saw palmetto for hair loss

Hair loss is incredibly common and often happens due to hormonal imbalances. Saw palmetto has been touted as a potential solution for those with androgenic alopecia, also known as male or female pattern baldness. But does saw palmetto for hair loss actually work?

It’s thought that the compounds in saw palmetto inhibit an enzyme called 5-alpha-reductase. By reducing the activity of this enzyme, the conversion of testosterone to dihydrotestosterone (DHT) is also reduced, as mentioned previously. DHT is a molecule that influences hair loss and is also responsible for prostate enlargement.

One review of the research looked at five randomized clinical trials and two prospective cohort studies in which both topical saw palmetto and oral supplements were administered to patients with androgenetic alopecia. The review uncovered some promising results:

  • A 60% improvement in overall hair quality
  • An increase in hair density for 83.3% of patients
  • A 27% improvement in total hair count

Although researchers and advocates of saw palmetto might hope that by inhibiting the activity of DHT saw palmetto may help prevent hair follicle miniaturization (hair thinning) and promote hair growth, the science is still limited in scope. More robust and high-quality research is certainly needed to establish firm conclusions.

Despite the lack of conclusive research, many brands offer saw palmetto shampoo and hair oils that claim to address issues with hair loss.

Saw palmetto for women's health

While saw palmetto is more often associated with men's health, it may also hold promise for women, particularly in conditions like polycystic ovary syndrome (PCOS) and hirsutism (excessive hair growth in certain areas e.g. face).

Saw palmetto may help maintain healthy hormonal balance in women by influencing estrogen and testosterone levels. With PCOS, hormonal imbalance triggers a range of symptoms, including:

  • Irregular and painful periods
  • Too much androgen hormone, which can lead to acne and hirsutism
  • Enlarged and cystic ovaries

In a scientific discussion on the uses of herbal remedies to treat symptoms of PCOS, published in Frontiers in Pharmacology, researchers noted that saw palmetto may help treat hirsutism because of its anti-androgenic activity. It is thought to provide this function by inhibiting the 5-alpha-reductase enzyme, reducing DHT levels, which is implicated in PCOS. The potential hormone-modulating effect of the extract may alleviate symptoms like hirsutism and may help restore regular periods.

Many herbal and alternative supplements for PCOS contain saw palmetto; however, you should always consult with a doctor before starting any new supplemental protocol.

There is little to no research into the direct activity of saw palmetto supplements being used solely for the improvement of PCOS and its associated symptoms. To be able to make any firm assertions as to its efficacy as an alternative to approved drug therapies, more high-quality studies are needed.

Other potential saw palmetto benefits

Research into the potential benefits of saw palmetto is still ongoing. There are a few studies that offer interesting insights, pointing to a potential role in immune support, urinary health, and even skincare.

Saw palmetto for urinary health

Lower urinary tract symptoms affect millions of women globally and cause issues with frequent or urgent urination, nocturia (nighttime urination), and bladder capacity. One study supplemented 76 older women in Japan with 320 mg of saw palmetto daily for 12 weeks. After the study period, those given the saw palmetto reported less urgency and frequency in urination than the control group.

Saw palmetto for skin

Skincare is a thriving industry and many products contain plant extracts that promise to reverse or delay the signs of aging. Saw palmetto has been added to topical skin treatments and advocates say that it helps to control blemishes, nourishes the skin with fatty acids, and supports the overall texture and appearance of the skin. While these claims may sound highly appealing, supporting research is lacking.

Saw palmetto for immunity

There have been some anecdotal reports that taking saw palmetto supplements may be beneficial for the immune system. Advocates say that the extract helps with mild colds, coughs and sore throats. The anti-inflammatory and antioxidant properties of the plant could potentially be responsible for these effects. However, robust and high-quality studies are needed to fully understand its efficacy in these areas.

When it comes to the immune system, supplements shouldn't replace the need for a healthy diet. Many different foods have been well-studied for their ability to help build immunity from the inside out.

How to use saw palmetto

There are lots of options when it comes to finding the best way to use saw palmetto. The way you choose to incorporate it into your health and wellness regime will depend on your personal preferences, health goals, and the recommendations of your healthcare practitioner.

Dosage and forms

Saw palmetto supplements come in many forms, from tinctures to teas. The table below offers some insight into the types you can find along with the typical saw palmetto dosage recommendations according to product specifications.

Capsules/softgels/tabletsInternal application, ingested160–320 mg taken with meals
Tea Internal application, ingested1 teaspoon stirred into hot water
Tincture Internal application, ingested1–2 ml taken up to three times daily in a glass of water or as prescribed by a herbal practitioner
Oil/serumExternal application, applied to skinMassage a few drops directly into the affected area or use as part of a regular skin and haircare regimen

While most of the studies on saw palmetto supplements gave participants between 160 mg and 320 mg per day, there is no standardized or official recommended dose. Always follow product-specific recommendations and consult with a healthcare professional.

When to take saw palmetto

So how do you know when to take saw palmetto, morning or night? There are a few factors to consider.

  1. Personal preferences. Some people prefer to take their supplements in the morning after breakfast, and others after dinner.
  2. Practitioner recommendations. If your healthcare practitioner has given you the guidance to take your supplement at a particular time, you should follow it.
  3. Type of supplement. Your timing may be dictated by the form of saw palmetto you use. For example, if you are using a topical application, it might be best done after a morning shower, or right before bed.
  4. Adverse effects prevention. It’s generally advised to take saw palmetto with meals to minimize the risk of an upset stomach.

Ultimately, there aren’t any official recommendations for timings. However, consistency is key if you want to achieve optimal results.

Saw palmetto side effects and safety considerations

As with any botanical remedy, there may be side effects and safety considerations to be aware of.

In general, saw palmetto is well tolerated in most individuals. However, mild saw palmetto side effects such as stomach aches and headaches have been observed. In rare cases, allergic reactions or gastrointestinal issues could arise. If you don’t feel right after taking saw palmetto, then you should seek medical attention right away.

Who should not take saw palmetto?

Information on the safety of saw palmetto comes primarily from studies of its use for benign prostatic hyperplasia in men. Very little is known about the safety and side effects of the extract when used for other conditions, especially in women and children. Children should not take saw palmetto.

You should not take saw palmetto if you are:

  • Pregnant
  • Nursing

You should seek advice from a medical professional if you are:

  • On oral contraception or hormone replacement
  • On blood thinners such as Warfarin or Apixaban
  • Have liver disease, pancreas disorder, or any other health conditions

Drug interactions

It’s vital to ensure that there aren’t any saw palmetto interactions that could affect other medications you may be taking. If you have any underlying conditions or are taking any other supplements or medications, it’s recommended to seek medical advice before trying saw palmetto or any other botanical remedy.

Saw palmetto vs. pygeum

Pygeum is another natural botanical that has been used traditionally to enhance prostate health. Also known as African plum extract, it’s derived from the bark of the African cherry tree.

Let’s explore pygeum vs. saw palmetto, taking a deeper look at the pros and cons of both these powerful plants.

Pygeum pros and cons

Saw palmetto pros and cons

When comparing saw palmetto and pygeum, both have demonstrated potential for their use in prostate health. However, as with any supplement, individual responses may vary widely, and it’s best to choose based on your own personal preferences, specific health goals, and the recommendations of your healthcare practitioner.

Combining saw palmetto with other supplements

Saw palmetto is often combined with other supplements into capsules and marketed for use to address different issues. For example, a saw palmetto blend for women’s lower urinary tract symptoms (LUTS) may contain extracts of ashwagandha, cranberry, and pumpkin seeds.

Different providers claim that the blends act in a synergistic way, with each ingredient enhancing the effects of the other. These claims are not backed by robust scientific research and would benefit from dedicated studies.

Before taking any blends, or combining your supplements, make sure to check in with a medical professional to check their safety and efficacy.

Final thoughts on saw palmetto

Saw palmetto is a versatile botanical with promising benefits for various health conditions, including prostate issues, hair loss, and hormonal imbalances in men and women. As there aren’t any official guidelines or research studies about how much saw palmetto is too much, always use it responsibly and follow the recommended doses. If you have any existing healthcare concerns or are taking medications, it’s best to consult with a healthcare professional before supplementing with saw palmetto.

While the current research into saw palmetto is encouraging, with more high-quality studies, its role in supporting overall health and well-being may become more defined.


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