Saw palmetto is a palm plant found in the southeastern United States. Its berries contain beneficial compounds used for centuries to support prostate health. It is commonly used as an herbal remedy for symptoms associated with an enlarged prostate, such as urinary issues.
The prostate is a small gland located near the bladder in men, this gland is responsible for maintaining healthy sperm. Saw palmetto is most commonly used for reducing symptoms of an enlarged prostate in a condition known as benign prostatic hypertrophy (BPH).
Saw palmetto has not been seen to shrink the overall size of the prostate, however it seems to work by shrinking the inner lining that puts pressure on where urine is carried [i] [ii]. The herb is also associated with other benefits, including decreased inflammation and improved urinary function.
There is some research in test tube studies surrounding saw palmetto and prostate cancer. According to one test-tube study, saw palmetto berry extract was able to decrease the growth of prostate cancer cells [iii]. Another test-tube study showed that saw palmetto blocked the spread and growth of prostate cancer cells by deactivating specific receptors involved in cancer development [iv]. That said, further high-quality research is needed to evaluate how saw palmetto may affect prostate health in humans.
Urinary tract symptoms are common among older men and include incontinence or difficulty urinating. One 12-week study in 92 men showed that taking two capsules daily of a supplement containing saw palmetto, was seen to improve urinary tract symptoms associated with BPH [v]. Similarly, a study of men given palmetto twice daily reduced lower urinary tract symptoms, increased urine flow, and improved overall quality of life after 6 months. This study was performed on 85 men over the age of 45 [vi].
Saw palmetto is often used by men seeking to boost testosterone levels naturally. Testosterone is an important hormone, not only in the reproductive system but also for regulating body composition, libido, mood, and cognition [vii]. Saw palmetto also might prevent testosterone from being converted to a more potent form called dihydrotestosterone (DHT). A study in 40 men observed that application of saw palmetto decreased levels of DHT by 32% after 6 months, suggesting that saw palmetto was effective at maintaining testosterone levels [viii].
It is thought that some types of hair loss are caused by increased sensitivity of hair follicles to DHT. Reduced levels of DHT may help prevent these types of hair loss. Other causes of hair loss include factors such as: genetics, certain medical conditions, hormonal changes, and the use of medications, such as stimulants and blood thinners [ix].
Early research shows that applying saw palmetto to the scalp may increase hair growth. Also, a combination of saw palmetto and beta-sitosterol taken by mouth may improve the amount and quality of scalp hair production in men with male pattern baldness [x] [xi].
In one particular study, saw palmetto was seen to be effective in improving hair growth in 60% of men with male pattern baldness between the ages of 23 and 64 [xii]. Another study in 62 adults showed that applying saw palmetto topically for 3 months increased hair density by 35% [xiii].
Saw palmetto contains the antioxidants epicatechin and methyl gallate. These compounds elicit antioxidant action in the body, preventing damage to cells, decreasing inflammation, and protecting against chronic disease. This action has also been linked to potential benefits in terms of prostate health. For example, one study observed that giving saw palmetto extract to mice with enlarged prostate glands decreased swelling and several markers of inflammation, including interleukin 6 (IL-6) [xiv]. Similar results on BPH have been seen in other mice studies [xv].
Oestrogen medications: Saw palmetto seems to decrease estrogen levels in the body. Taking saw palmetto along with synthetic oestrogen pills might decrease the effectiveness of oestrogen medication.
Anticoagulant / Antiplatelet drugs: Saw palmetto might slow blood clotting. Taking saw palmetto along with medications that also slow clotting might increase the chances of bruising and bleeding.
Pregnancy and breast-feeding: Saw palmetto is not safe when taken by mouth during pregnancy or breast-feeding. Due to its hormone-altering effects this herb could present dangers in pregnancy. Use is not recommended during pregnancy or breast-feeding.
Surgery: Saw palmetto might slow blood clotting. It is recommended to stop using saw palmetto at least 2 weeks before a scheduled surgery.
[i] Debruyne, F. Boyle, P. Calais, da Silva, Gillenwater, J. G.et al. (2004) ‘Evaluation of the clinical benefit of Permixon and tamsulosin in severe BPH patients--PERMAL study subset analysis'. Progrès en Urologie. 14(3):326-331.
[ii] Di Silverio, F. Sciarra, A. D’Eramo, G. et al. (1997) ‘Zonal distribution of androgens and epidermal growth factor (EGF) in human BPH tissue: responsiveness to flutamide, finasteride, and Serenoa repens administration’. BJU International. 80(Suppl 2):214.
[iii] Goldmann, W. Sharma, A.L. & Currier, S.J. (2001) ‘Saw palmetto berry extract inhibits cell growth and Cox-2 expression in prostatic cancer cells’. Cell Biology International. 25(11):1117-24.
[iv] Yang, Y. Ikezoe, T. Zheng, Z. et al. (2007) ‘Saw Palmetto induces growth arrest and apoptosis of androgen-dependent prostate cancer LNCaP cells via inactivation of STAT 3 and androgen receptor signaling’. International Journal of Oncology.31(3):593-600.
[v] Shi, R. Xie, Q. Gang, X. et al. (2008) ‘Effect of saw palmetto soft gel capsule on lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized trial in Shanghai, China.’ The Journal of Urology.179(2):610-5.
[vi] Gerber, G.S. Kuznetsov, D. Johnson, B.C. et al. (2001) ‘Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms’. Urology. 58(6):960-4; discussion 964-5.
[vii] Bain, J. (2007). ‘The many faces of testosterone’. Clinical interventions in ageing, 2(4), 567–576.
[viii] Marks, L.S. Hess, D.L. Dorey, F.J. et al. (2001) ‘Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens’. Urology. 57(5):999-1005.
[ix] Phillips, T.G. Slomiany, W.P. & Allison, R. (2017) ‘Hair Loss: Common Causes and Treatment’. American Family Physician. 15;96(6):371-378.
[x] Sinclair, R. D. Mallari, R. S. & Tate, B. (2002) ‘Sensitization to saw palmetto and minoxidil in separate topical extemporaneous treatments for androgenetic alopecia’. Australasian Journal of Dermatology. 43(4):311-312.
[xi] Prager, N. Bickett, K. French, N. et al. (2002) ‘A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia’.Journal of Alternative and Complementary Medicine 8:143-52.
[xii] Prager, N. Bickett, K. French, N. et al. (2002) ‘A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia’. Journal of Alternative and Complementary Medicine. 8(2):143-52.
[xiii] Murugusundram, S. (2009). ‘Serenoa Repens: Does It have Any Role in the Management of Androgenetic Alopecia?’. Journal of cutaneous and aesthetic surgery, 2(1), 31–32.
[xiv] Bernichtein, S. Pigat, N. Camparo, P. et al. (2015) ‘Anti-inflammatory properties of Lipidosterolic extract of Serenoa repens (Permixon®) in a mouse model of prostate hyperplasia’. Prostate. 75(7):706-22.
[xv] Colado-Velázquez, J. III, Mailloux-Salinas, P. Medina-Contreras, J. et al. (2015) ‘Effect of Serenoa Repens on Oxidative Stress, Inflammatory and Growth Factors in Obese Wistar Rats with Benign Prostatic Hyperplasia’. Phytotherapy Research. 29(10):1525-31.
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