Saw Palmetto

Effects and Benefits

Core Identification

Common Names:
- Saw Palmetto
- Sabal
- American Dwarf Palm
- Cabbage Palm

Latin Name: Serenoa repens (syn. Serenoa serrulata, Sabal serrulata)

Category: Herb

Uses

Traditional Uses

• Prostate and urinary health - Native American and early American medicine (pre-1950s)
• Sexual vigor and reproductive tonic - Traditional Western herbalism
• Chronic respiratory conditions - Traditional Western herbalism (bronchial coughs, laryngitis)
• Women's hormonal support - Traditional use for enlarged ovaries and undeveloped mammary glands

Modern Uses

• Benign Prostatic Hyperplasia (BPH) - Reducing urinary symptoms associated with prostate enlargement | Research quality: Conflicting
• Key findings: Early European clinical trials and meta-analyses showed improvements in urinary symptoms and flow rates. However, two rigorous US government-funded trials (STEP and CAMUS) found no benefit over placebo at doses up to 960mg daily over 72 weeks

• Source citations: Barrett - Handbook of Clinically Tested Herbal Remedies; Moyad - The Supplement Handbook; German Commission E

• Hair Loss - Preliminary use for androgenic alopecia | Research quality: Preliminary

• Key findings: Some practitioners recommend 320-960mg daily for early-stage hair loss due to potential DHT-blocking effects
• Source citations: Moyad - The Supplement Handbook

Active Compounds

Primary Active Ingredients:
- Fatty acids (85-95% in liposterolic extract) - Primarily as triglycerides; may inhibit 5-alpha-reductase enzyme
- β-Sitosterol (0.1-0.3%) - Phytosterol with potential anti-inflammatory and anti-androgenic properties
- Fatty alcohols - Contribute to overall lipid profile
- Flavonoids - Present in ethanol extracts; antioxidant activity

Dosage Information

Standard Dosage:
- Form: Liposterolic extract (LESP) capsule
- Amount: 320 mg per day
- Frequency: Once daily or 160 mg twice daily

Therapeutic Dosage:
- Form: Liposterolic extract
- Amount: 320-960 mg per day
- Purpose: BPH symptoms (though efficacy is disputed)
- Duration: Minimum 1-3 months to assess response

Alternative Forms:
- Liquid extract (1:2): 2.0-4.5 ml per day
- Tincture (1:5, 80% alcohol): 1-2 ml, 3-4 times daily
- Dried berries: 1-2 g per day
- Tea: One cup three times daily (decoction of berries)

Maximum Safe Dosage:
- Daily maximum: Studies have used up to 960 mg without significant adverse effects
- Warning threshold: No established upper limit; higher doses did not show increased efficacy

Bioavailability Notes:
- Liposterolic extract (LESP) is most studied form, using hexane or supercritical CO2 extraction
- Fat-soluble compounds best absorbed with food
- 8:1 to 10:1 concentrate of original dried berries

How to Take It

Timing:
- Take with meals to improve absorption and reduce GI upset
- Morning or evening dosing equally effective
- Consistent daily use required for any potential effect

Synergies - What It Works Well With

Complementary Supplements:
1. Stinging Nettle Root - Combined use studied for BPH; may provide equivalent results to finasteride with better tolerability
2. Pumpkin Seed Oil - Traditional combination for prostate support
3. Pygeum Bark - Combined use for urinary symptoms; addresses complementary mechanisms

Avoidance - What NOT to Combine With

Supplement Interactions:
1. Other Hormone-Modulating Herbs - Potential additive effects on hormonal pathways

Drug Interactions:
1. Anticoagulants/Antiplatelet drugs - One case report of bleeding during surgery; use caution | Potential consequence: Increased bleeding risk | Severity level: Moderate
2. Finasteride/Dutasteride (5-alpha-reductase inhibitors) - Potential additive effects | Potential consequence: Unknown combined effect | Severity level: Mild
3. Hormone Therapies - Possible endocrine effects | Potential consequence: Altered hormonal balance | Severity level: Mild

Food Interactions:
- No significant food interactions reported

Safety Information

Contraindications:
- Not recommended during pregnancy or breastfeeding (insufficient safety data)
- Use caution before surgery (discontinue 2 weeks prior due to potential bleeding concerns)

Side Effects:
- Mild gastrointestinal disturbances (rare): nausea, stomach upset, diarrhea
- Generally very well tolerated in clinical trials
- One isolated case report of hemorrhage during surgery

Long-Term Use:
- Studies up to 3 years have shown continued good tolerability
- 98% of participants in long-term studies rated tolerability as good or very good
- No cycling required
- Regular monitoring of prostate symptoms recommended if using for BPH

Special Precautions:
- Does not affect PSA levels (unlike finasteride)
- Should not replace proper medical evaluation for urinary symptoms
- Symptoms of BPH require proper diagnosis to rule out prostate cancer

Primary Uses At-a-Glance

Primary: Urinary symptoms associated with BPH, prostate health support

Secondary: Hair loss prevention, general male reproductive tonic, hormonal support

Sources

Local Library:
- Barrett, Marilyn - The Handbook of Clinically Tested Herbal Remedies Vol 1 & 2
- Bone, Kerry - A Clinical Guide to Blending Liquid Herbs
- Balch, Phyllis - Prescription for Herbal Healing
- WRCHM - Western Materia Medica I
- Moyad, Mark - The Supplement Handbook
- Brewer, Sarah - TDT Encyclopedia of Vitamins
- Lust, John - The Natural Remedy Bible
- Grogan, Barbara Brownell - Healing Herbs Handbook
- Pursell, J.J. - The Herbal Apothecary

General Knowledge:
- German Commission E Monographs
- United States Pharmacopoeia (USP)