Common side effects of saw palmetto include bad breath, stomach upset, diarrhea, nausea, vomiting, headache, dizziness, and fatigue. In rare cases, saw palmetto has been known to cause erectile dysfunction, loss of sex drive, and abnormally enlarged breasts in males.
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Saw palmetto (Serenoa repens or Sabal serrulata) is a plant belonging to the palm tree family native to the southeastern United States. Historically, the Glades culture and the Seminole tribes in southern Florida used the fruit of saw palmetto to treat particular urinary tract and reproductive conditions. The extract of the saw palmetto fruit contains phytosterols and flavonoids, which block the effect of androgens (natural sex steroid hormones). A test tube study suggested palmetto relieved lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH), also known as an enlarged prostate. The way it did this was by blocking the effects of androgens and by blocking inflammation. Popularly used for prostate enlargement, saw palmetto is also used for hair loss and chronic pelvic pain.
This article discusses the potential uses of saw palmetto, the possible side effects, and the risks of this popular supplement.
Dietary supplements are not regulated like drugs in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. When possible, choose a supplement tested by a trusted third party, such as USP, ConsumerLabs, or NSF. However, even if supplements are third-party tested, that doesn’t mean they are safe for all or effective in general. Therefore, talk to your healthcare provider about any supplements you plan to take and check in about potential interactions with other supplements or medications.
Active ingredient(s) : Phytosterols, flavonoids
: Phytosterols, flavonoids Alternate name(s) : Serenoa repens, American dwarf palm tree, cabbage palm, saw palmetto fruit, saw palmetto extract
: Serenoa repens, American dwarf palm tree, cabbage palm, saw palmetto fruit, saw palmetto extract Legal status : Over-the-counter herbal supplement (United States)
: For lower urinary tract symptoms associated with BPH, the standard dose used in clinical trials is 320 milligrams (mg) per day (160 milligrams (mg) soft capsule twice daily by mouth). Safety considerations: Hormone-sensitive cancer, pregnancy, breastfeeding, prescription drugs (ex., hormone-containing drugs, blood thinners). Stomach discomfort.
Uses of Saw Palmetto
Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
Saw palmetto is perhaps best known for its use in treating prostate problems. This includes benign prostatic hyperplasia (an enlarged prostate) and prostatitis (prostate inflammation),
There's limited evidence to support these claims.
Symptoms of Enlarged Prostate
One of the most common uses of saw palmetto is the treatment of BPH, also known as an enlarged prostate. Benign prostatic hyperplasia is not considered a severe health issue, but it can cause significant symptoms, such as the increased need to urinate and urinary leakage. It can also increase the risk of urinary tract infections.
In a 24-week study of 354 people designated male at birth aged 50 to 70 years with lower urinary tract symptoms (LUTS) associated with BPH, the ingestion of Serenoa repens extract improved such urinary symptoms compared to placebo.
This finding contrasted with previous results from a systematic review that reported that Serenoa repens showed no improvement of urinary symptoms in people designated male at birth with BPH compared to placebo.
A meta-analysis (a collection of studies) evaluating four randomized, double-blind, controlled trials involving 1,080 people with BPH reported Serenoa repens taken daily for six months appeared to improve urinary flow, similar to the effect of Flomax (tamsulosin) (although there was no improvement in prostate size - unlike the case with tamsulosin).
Further research is needed.
Hair Loss
Lab studies have shown that saw palmetto can block the action of 5-alpha-reductase, an enzyme that converts testosterone to a hormone called dihydrotestosterone (a more potent form of testosterone). Dihydrotestosterone appears to play a role in developing androgenetic alopecia (AGA), more commonly known as male-pattern hair loss or baldness.
Although topical Rogaine (minoxidil) and oral finasteride are two FDA-approved drugs used to treat male-pattern baldness, their unfavorable side effect profile may make supplements, such as saw palmetto, seem like an attractive option.
A two-year study consisting of 100 people designated male at birth aged between 20 and 40 years of age with mild to moderate AGA showed that taking Serenoa repens 320 milligrams (mg) per day by mouth helped stabilize hair loss. Still, only at the top of the head, finasteride 1 milligram (mg) per day by mouth was more effective because it also functioned well in the frontal region (forelock or central forelock) of the hair. Furthermore, the study suggested that Serenoa repens could be an alternative for people with mild to moderate AGA who cannot use finasteride or other topical therapies. However, more studies will be needed to confirm the efficacy of Serenoa repens and its mechanism.
In a 24-week study of 50 people designated male at birth aged between 20 and 50 years with mild to moderate hair loss, the daily topical application of 3.3 milliliters (mL) of concentrated serum-containing Serenoa repens to the thinning areas on the scalp for the first four weeks and two milliliters of lotion-containing Serenoa repens to the whole scalp throughout the study period resulted in a significant increase in hair count at the 12th week.
Notably, the positive gains declined in the 24th week, most likely due to the termination of a more concentrated Serenoa repens-containing serum after only four weeks. It is important to note that the study was limited in that it did not have a control group and that the length of the study (duration) was only 24 weeks. Additionally, the serum and lotion used in the study contained saw palmetto, green tea extract, peony root extract, piroctone-olamine, and oligopeptides. The effect of saw palmetto alone is unclear.
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Emerging research investigated the use of saw palmetto in people with chronic pelvic pain syndrome (CPPS). Chronic pelvic pain syndrome is defined as pain in the pelvic area (the area below the belly button and between the hips) that lasts over six months and is severe enough to limit functioning. Chronic prostatitis/chronic pelvic pain syndrome, or CP/CPPS, is a syndrome defined by chronic pelvic pain often associated with lower urinary tract symptoms (LUTS). Moreover, the National Institute of Health (NIH) defines CP/CPPS as a syndrome without an infection.
In a multicenter, randomized, double-blind, placebo-controlled trial of 221 people designated male at birth between 18 and 50 years old with CP/CPPS, the intake of Serenoa repens 160 milligrams (mg) soft capsule by mouth twice daily for 12 weeks showed significant improvement on pain relief and urinary symptoms compared with the placebo group. The study was limited because it did not distinguish between people with or without inflammatory CP/CPPS.
Although one study in a meta-analysis (collection of studies) showed that Serenoa repens was more effective than a placebo in treating CP/CPPS, other studies showed inconsistent results. Further relevant studies are needed to confirm the result.
Other Uses
In addition to the potential health benefits listed above, other traditional and unproven uses of saw palmetto include the following:
Colds and coughs
Sore throat
Asthma
Chronic bronchitis
Migraine headache
Fluid retention (used as a diuretic)
Relaxation (used as a sedative)
What Are the Side Effects of Saw Palmetto?
Despite its therapeutic potential, saw palmetto may have potential side effects. Let’s discuss the possible common and severe side effects.
Common Side Effects
Common side effects include but may not be limited to the following:
Severe Side Effects
No severe side effects were reported in studies evaluating the efficacy and safety of Serenoa repens in people with LUTS/BPH and CP/CPPS.
Stop taking saw palmetto if you experience an allergic reaction such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
Precautions
Precautions should be taken when considering use of saw palmetto in the following groups:
Hormone-sensitive cancer : Saw palmetto can theoretically influence sex hormone levels, including estrogen and testosterone. Because of this, people with hormone-sensitive cancers (including breast and prostate cancer) should consult their oncologist before using saw palmetto. Some people designated male at birth have also reported erectile dysfunction, breast tenderness, gynecomastia (breast enlargement), and a loss of libido (sex drive) while taking saw palmetto.
: Saw palmetto can theoretically influence sex hormone levels, including estrogen and testosterone. Because of this, people with hormone-sensitive cancers (including breast and prostate cancer) should consult their oncologist before using saw palmetto. Some people designated male at birth have also reported erectile dysfunction, breast tenderness, gynecomastia (breast enlargement), and a loss of libido (sex drive) while taking saw palmetto. Pregnancy or breastfeeding : Saw palmetto may be unsafe to use when pregnant or breastfeeding. Please do not start saw palmetto without first consulting with your healthcare provider.
: Saw palmetto may be unsafe to use when pregnant or breastfeeding. Please do not start saw palmetto without first consulting with your healthcare provider. Children: Because the safety of saw palmetto has primarily been studied in people designated male at birth with BPH, little is known about its safety in children.
Dosage: How Much Saw Palmetto Should I Take?
Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.
The standard dose used in clinical trials studying the efficacy of saw palmetto in BPH, male-pattern baldness, and CP/CPPS is 320 milligrams (mg) soft capsule by mouth daily.
Please speak to your healthcare provider before using supplements for medical reasons, as there may be situations in which they pose more harm than good.
Verywell / Anastasia Tretiak
What Happens If I Take Too Much Saw Palmetto?
A trial conducted in 369 people designated male at birth taking saw palmetto extract in an escalating manner at doses of 320, 640, and 960 milligrams (mg) at 6-month intervals over 18 months showed no evidence of toxicity. Furthermore, no differences were observed between the groups in serious or non-serious adverse events.
However, as a general rule, never take more than the recommended dose on the product label.
Interactions
Saw palmetto supplements typically contain extracts of the fruit of the plant. You can purchase saw palmetto supplements online and in many natural food stores, drugstores, and stores specializing in herbal products.
If you choose to buy this or any supplement, the National Institutes of Health recommends reading the Supplement Facts label. It contains valuable information every consumer should know, including the amount of active and inactive ingredients per serving (including fillers and binders you may be allergic to).
Opt for supplements certified by U.S. Pharmacopeia (USP), ConsumerLab, or NSF International. Certification does not guarantee the product's safety or effectiveness but provides assurance that the product was manufactured correctly, contains the ingredients listed on the product label, and does not contain harmful contaminants.
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It is essential to carefully read a supplement's ingredient list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.
How to Store Saw Palmetto
Store saw palmetto supplements in a cool and dry place, away from direct sunlight. Discard as indicated on the packaging.
Similar Supplements
The following are supplements that may share similar effects as saw palmetto:
An experimental model showed that the combination of saw palmetto, selenium, and lycopene is more effective than saw palmetto alone in reducing the prostate inflammatory response. However, the effects of saw palmetto alone are unclear. And it needs to be clarified if this translates to a real-life setting.
Frequently Asked Questions What are the side effects of saw palmetto? The most common side effect reported in clinical studies is mild stomach discomfort. A meta-analysis (a collection of studies) showed that the saw palmetto group had a lower incidence of sexual dysfunction than a group using tamsulosin. No severe side effects were noted in clinical studies evaluating the safety of saw palmetto.
Does saw palmetto affect my prostate-specific antigen (PSA) level? Prostate-specific antigen, or PSA, is a protein produced by healthy and cancerous cells. An elevated level of PSA in the blood is often associated with an increased risk for prostate cancer, although PSA level can be affected by other non-cancerous conditions. Several studies indicated that saw palmetto supplementation failed to cause changes to PSA concentrations when compared with placebo, finasteride, or tamsulosin. Moreover, the National Center for Complementary and Integrative Health states that saw palmetto does not appear to affect readings of PSA levels, even when taken in higher-than-usual amounts.
Can people designated female at birth take saw palmetto? Saw palmetto has predominantly been used by people designated male at birth. However, a study found that saw palmetto extract 320 milligrams (mg) capsule taken by mouth once daily for 12 weeks reduced the symptoms of daytime and nighttime urinary frequency in people designated female at birth. Of note, people who are pregnant, breastfeeding, or taking hormone-containing drugs should likely avoid taking saw palmetto.
Saw palmetto supplements typically contain extracts of the plant's fruit. You can purchase saw palmetto supplements online and in many natural food stores, drugstores, and stores specializing in herbal products.
If you choose to buy this or any supplement, read the supplement facts label, as it contains valuable information, including the amount of active and inactive ingredients per serving (including fillers and binders you may be allergic to).
Opt for supplements certified by U.S. Pharmacopeia (USP), ConsumerLab, or NSF International. Certification does not guarantee the product's safety or effectiveness but provides assurance that the product was manufactured correctly, contains the ingredients listed on the product label, and does not contain harmful contaminants.
Saw Palmetto Supplements
Saw palmetto is available as a capsule, soft gel, liquid extract, tincture, powder, dried berry, and tea.
The extract obtained from the berries of saw palmetto is rich in fatty acids, which are believed to be responsible for the inhibition of 5-alpha-reductase.
Since fatty acids are insoluble in water, it would follow that consuming saw palmetto in a tea form may not be as effective. Moreover, it has been found that liquid saw palmetto supplements contain the highest concentrations of fatty acid and phytosterol, followed by powder, dried berry, and tincture supplements. Such findings suggest that the liquid form (that is, the content in gel capsules) of saw palmetto may be the best choice if you want to take a saw palmetto supplement with the highest concentrations of bioactive components or active ingredients.
Saw palmetto is also included in topical (on the skin) serums for hair loss. However, such products have often been combined with other ingredients, such as pumpkin seed oil and rosemary essential oil. The effects of saw palmetto alone are unclear.
Summary
Saw palmetto is a plant belonging to the palm tree family. Its fruit extract has popularly been studied with some evidence showing the role of saw palmetto in improving symptoms associated with enlarged prostate, reducing hair loss, and improving symptoms of CP/CPPS.
In general, saw palmetto supplements are well tolerated but may cause stomach discomfort in some people. Saw palmetto should not be used in children, during pregnancy or breastfeeding, or in those with hormone-sensitive cancers. It should also be avoided if you take hormone replacement therapy, birth control pills, or blood thinners.
Fluxactive Complete is conveniently packed with over 14 essential prostate powerhouse herbs, vitamins and grade A nutrients which work synergistically to help you support a healthy prostate faster
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