Saw Palmetto

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Saw palmetto, Any of several shrubby palms primarily of the southern U.S. and West Indies that have spiny-toothed petioles (leafstalks), specifically a typical palm (Serenoa repens) of the southeastern U.S., with a typically creeping stem. Saw palmettos make up part of the greenery found in the Florida Everglades. When undisturbed, they grow into terrific masses of foliage. The saw palmetto has actually just recently drawn attention as the source of a possible treatment for prostate cancer. [1]


Saw palmetto is utilized by natural health practitioners to treat a range of conditions in men and women, such as testicular inflammation, urinary system inflammation, coughs, and respiratory blockage. It is likewise used to enhance the thyroid gland, balance the metabolism, promote hunger, and aid food digestion. According to the American Dietetic Association, saw palmetto is among the most commonly utilized dietary supplements among Americans in between the ages of 50 and 76.

The majority of the evidence supporting these uses is anecdotal and has actually not been shown by controlled scientific trials. Nevertheless, there is much clinical documentation outlining the efficiency of the herb in treating irritable bladder and urinary issues in men with benign prostate hyperplasia (BPH), an enlargement of the prostate gland. BPH results in a swelling of the prostate gland that blocks the urethra. This causes unpleasant urination, minimized urine circulation, problem starting or stopping the circulation, dribbling after urination, and more frequent nighttime urination. Saw palmetto does not reduce prostate enhancement. Instead, it is believed to operate 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 associated with DHT production.

In addition to triggering pain and embarrassment, BPH can result in severe kidney issues if undiagnosed and left untreated. It is a typical issue in males over the age of 40. Quotes are that 50-60% of all men will establish BPH in their lifetimes. It is approximated that there are six million guys between the ages of 50-79 who have BPH severe sufficient to require some kind of therapy. Yet only half of them look for treatment from physicians. Health professionals in both the allopathic and natural medicine neighborhoods suggest annual prostate evaluations for males over the age of 50, and a yearly blood test that measures prostate particular antigen, a marker for prostate cancer.

Just recently, a number of medical trials have confirmed the effectiveness of saw palmetto in treating BPH. A number of these trials have actually shown saw palmetto works much better than the most commonly used prescription drug, Proscar. Saw palmetto is effective in almost 90% of patients after six weeks of use, while Proscar is effective in less than 50% of clients. In addition, Proscar may take up to 6 months to achieve its full result. Because Proscar obstructs the production of testosterone, it can cause impotence and breast enhancement. Likewise, saw palmetto is substantially more economical 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). Initially prescribed to deal with hypertension, Cardura and Hytrin can drop blood pressure, causing lightheadedness and fainting. Presently, saw palmetto is being examined by the U.S. Fda (FDA) for treatment of BPH. If authorized, it would end up being the first herbal item to be accredited by the agency as a treatment for a specific condition. Saw palmetto is likewise utilized as a treatment for prostate complaints and irritable bladder.

Because the 1960s, substantial medical studies of saw palmetto have been done in Europe. A 1998 review of 24 European trials included nearly 3,000 men, some taking saw palmetto, others taking Proscar, and a 3rd group taking a placebo. The men taking saw palmetto had a 28% improvement in urinary tract signs, a 24% improvement in peak urine circulation, and 43% enhancement in general urine flow. The results were almost equivalent to the group taking Proscar and superior to the men taking a placebo.

On the other hand, saw palmetto does not appear to be useful in dealing with prostatitis or chronic pelvic pain syndrome (CPPS) in males. A group of researchers at Columbia University reported in early 2004 that males provided saw palmetto for CP/CPPS revealed no appreciable enhancement at the end of a year-long trial.


Saw palmetto berries have actually been used in American folk medicine for several hundred years as an aphrodisiac and for dealing with prostate issues. Native Americans in the southeast United States have utilized saw palmetto considering that 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 much healthier and fatter than other livestock. Early American settlers noticed the very same results and used the juice from saw palmetto berries to put on weight, to improve general personality, as a sedative, and to promote reproductive health.

In the United States, the medical uses of saw palmetto were first documented in 1879 by Dr. J. B. Read, a doctor in Savannah, Georgia, who released a paper on the medical advantages of the herb in the April 1879 concern of American Journal of Pharmacy. He found the herb helpful in dealing with a large range of conditions. “By its peculiar relaxing power on the mucous membrane it causes sleep, alleviates the most troublesome coughs, promotes expectoration, enhances food digestion, and increases fat, flesh and strength. Its sedative and diuretic residential or commercial properties are exceptional,” Read composed. “Considering the great and diversified power of the saw palmetto as a restorative agent, it appears strange that it must have so long left the notice of the medical occupation.”

A pungent tea made from saw palmetto berries was typically used in the early 1900s to treat prostate augmentation and urinary system infections. It was also utilized in males to increase sperm production and sex drive, although these uses are discounted today. Among the very first released medical suggestions that saw palmetto was effective in dealing with prostate issues appeared in the 1926 edition of United States Dispensatory. In the late 1920s, the use of medicinal plants, including saw palmetto, started to decrease in the United States, while at the same time, it was on the rise in Europe.


The National Institute on Aging recommends that people taking saw palmetto must obtain it only from respectable sources. In addition, people must utilize just standardized extracts that contain 85-95% fats and sterols. Does vary depending upon the kind of saw palmetto utilized. A typical dose is 320 mg each day of standardized extract (1-2 g) per day of ground dried entire berries. It may take up to 4 weeks of use before beneficial results are seen. In late 1999, the web-based independent customer organization evaluated 27 leading brands of saw palmetto for fat and sterol material. 10 of the brand names consisted of less than the minimum recommended level of 85% fats and sterols. [2]

Pharmacology of Saw Palmetto

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

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

Based upon mechanisms of action, Saw Palmetto extracts can likewise be utilized for male pattern baldness (alopecia), excess hair in ladies (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 two typically associated male physiological events 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 ladies is also associated with this enzyme. An excess in the activity of 5- reductase has actually been revealed to be responsible for bigger prostate and male pattern baldness, along with hirsutism in females.

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 higher affinity for 5 DHT than testosterone. When the ligand has actually interacted with its cognate receptor, the receptor-ligand complex goes into the nucleus and manages gene expression.

Historic Use of Saw Palmetto

Saw Palmetto (Serenoa repens) is used in several forms of conventional medication. Native people of Florida such as the Seminoles depended on saw palmetto berries for food, and the Mayans drank it as a tonic; however, Europeans frequently found the taste of the berries objectionable.

Historically, Saw Palmetto was taken with nettle root and pumpkin seeds. Thus, some contemporary solutions consist of these components. Native American medicine men likewise reputedly kept a medication bag of Saw Palmetto around to make antibacterial and a tonic, and to deal with a wide variety of conditions, including impotence, inflammation and infertility, and as an expectorant.

Saw Palmetto has historically been used to deal with infertility in females and underdeveloped breasts. It has likewise been used to increase lactation, mitigate painful menstruation cycles, and minimize the size of an enlarged prostate. It has even been utilized as an appetite stimulant.

A crude extract of Saw Palmetto was utilized for a minimum of 200 years for different conditions consisting of asthenia (weakness), recovery from a major health problem, and urogenital issues.

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 example, the diverse medication professional H. W. Felter wrote of it, “Saw Palmetto is a nerve sedative, expectorant, and a nutritive tonic, acting kindly upon the gastrointestinal system … Its most direct action seems upon the reproductive organs when going through waste of tissue …”

During the late 19th century interest in Saw Palmetto established when its favorable result on livestock was observed. This interest increased when its useful impacts on the genitourinary tract were kept in mind. At this time Saw Palmetto was used as a treatment for bigger prostate, cystitis, gonorrhea, and inflammation of the mucous membranes.

Saw Palmetto berries were formally included in the United States 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 diminished in the United States.

Despite this decrease in the United States, use of Saw Palmetto as a medical herb continued in Europe. Presently, making use of herbal options for the treatment of benign prostatic hyperplasia (BPH) is extremely common there. This is most widespread in Germany, whereas many as 95% of clients are first treated with an organic treatment. Treatment with natural remedies has actually offered a more beneficial ratio between therapeutic benefits and unfavorable responses. In Germany, a standard has been set such that Saw Palmetto extract must include 85-95% fats and sterols (utilized as biomarkers and believed to be the active components). It is this lipophilic extract that has been utilized throughout Europe and upon which most of Saw Palmetto research study has been carried out.

In recent years, the United States has seen a renewal of interest in using Saw Palmetto extract for the treatment of numerous “male-oriented” disorders such as impotence, hair loss, male pattern baldness, enhancement of the prostate, BPH and even sexual dysfunctions and poor libido.

Early research showed that the extract is well-tolerated and suggested “moderate to moderate enhancement in urinary signs and circulation steps.” Later trials of higher methodological quality suggested no difference from placebo. Questions of adequate blinding and shipment of any active components stay.

Inhibition of both kinds of 5-alpha-reductase without any decrease in cellular capability to produce prostate-specific antigen is suggested.

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

Limited in vitro and animal design research studies recommend possible anti-tumor activity and potential for use in the treatment of cancer. Nevertheless, these results have not been corroborated with human trials.

The Cochrane Database evaluation (2009) concludes that “The evidence recommends that Serenoa repens provides moderate to moderate improvement in urinary signs and flow measures. Serenoa repens produced comparable enhancement in urinary symptoms and circulation compared to finasteride and is connected with less unfavorable treatment events.” [3]

Saw Palmetto Benefits/Uses

1. Deals With Benign Prostatic Hypertrophy (BPH)

The most typical type of a bigger prostate is benign prostatic hyperplasia. The prostate usually remains at about the exact same size or grows slowly in grownups, as long as male hormonal agents exist.

It’s when the prostate ends up being enlarged that men begin experiencing signs from BPH and lower urinary tract problems.

The prostate gland can become irritated or enlarged as men age. The prostate then compresses the urethra, causing problem with urination that leads to bladder infections or bladder stones.

BPH can be caused by a range of scenarios, consisting of hormonal modifications (such as excess estrogen), degrading capillary 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 males will have this condition. To contribute to this, one-fourth of these men will establish moderate to serious lower urinary tract symptoms that will considerably impact their lifestyle.

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

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

One 2012 study conducted in Switzerland examined 82 clients in an eight-week trial. The clients took one pill 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’ evaluations confirmed the excellent efficacy, and treatment was extremely well-tolerated and accepted by the clients.

2. Lowers Danger of Prostate Cancer

An organized literature review of 11 studies identified saw palmetto supplements as one of the five typically used forms of natural medicine by guys with prostate cancer.

Serenoa repens supplements work as 5-alpha reductase inhibitors– meaning they slow down the conversion of testosterone to DHT by obstructing the enzyme and preventing its development. According to research study, DHT is responsible for prostate enhancement, which may be a reason for prostate cancer.

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

Saw palmetto, on the other hand, can likewise prevent DHT and assist with urinary problems from BPH, such as difficulty urinating and dripping urine– plus it controls your testosterone levels, helps with libido and works as a natural remedy for impotence.

Studies have likewise found that saw palmetto prevents the development of prostatic cancer cells and might destroy dangerous 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 development arrest of prostate cancer LNCaP, DU145 and PC3 cells and down-regulated DHT, the hormonal agent that results in prostate enhancement.

Another fascinating note about saw palmetto is the research study that has been done to determine its impact on post-surgery recovery time. Prostate surgical treatment (referred to as transurethral resection of the prostate or TURP) can need a prolonged recovery period, but research shows that taking 320 milligrams of saw palmetto daily for 2 months prior to prostate surgery can reduce the time spent in surgery.

It also assists with blood loss, the development of issues during surgical treatment and the total time spent in the health center.

3. Helps with Hair Loss

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

The cause of hair loss is because of the hair follicles’ level of sensitivity to DHT, which is a male androgen hormone that triggers hair follicles to diminish, resulting in a shorter life span and decrease of hair production.

Typically, after a hair falls out, another hair starts to grow from this very same roots– but if DHT is high, hair development reduces. Saw palmetto benefits have the power to stop the conversion of testosterone into DHT, making it advantageous for hair growth.

Although the viewpoints about saw palmetto as a reliable hair growth agent are blended, especially when it pertains to using saw palmetto for women, there are studies that suggest its usage as helpful.

One research study performed at the Medical Research and Development Network in Colorado evaluated 34 guys and 28 women, aged 18– 48 years, who topically applied saw palmetto extract in cream and shampoo base for 3 months. The results found that 35 percent of the individuals had an increase in hair density.

This recommends that saw palmetto for loss of hair may work as a natural method for both men and women.

A 2020 evaluation of proof published in the Cochrane database, PubMed and Google Scholar found that Serenoa repens extract resulted in enhancement in overall hair quality, overall hair count and hair density amongst alopecia clients. Reports likewise show that saw palmetto was well-tolerated and not related to serious negative events.

4. Retains Testosterone Levels

Due to the fact that saw palmetto prevents the conversion of testosterone into DHT, the body maintains normal levels of testosterone. This assists with weight reduction, strength management, discomfort action, hair loss and sex drive.

Today, low testosterone in males is rapidly growing, and this results in chronic tiredness, a stunt in sex drive and a reduced sense of wellness.

A case study reported in the American Journal of Medication evaluated a 52-year-old guy who was experiencing impotence, low sex drive and fatigue. He took no medications and was otherwise healthy.

The study recommends that his metabolic status improved considerably by increasing his testosterone counts. After 3 months, he currently felt more stimulated, and his sexual function enhanced.

5. Supports Urological System

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

Serenoa repens is also advised to deal with compromising urinary organs in senior individuals or women after menopause because it enhances the urinary organs and has actually been advised as a natural treatment for kidney stones.

The Journal of American Medical Association launched a 1998 evaluation stating that saw palmetto is effective in improving urological signs and urine circulation. For the evaluation, 18 randomized trials with almost 3,000 male participants were analyzed.

Overall, 28 percent of the men taking saw palmetto revealed fewer urinary system symptoms, 24 percent showed improvement in peak urine flow and overall urine flow enhanced for 43 percent of the participants.

The outcomes were comparable to the group taking Proscar– a prescribed medication– and they were far 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 involved 85 men who randomly received either saw palmetto or a placebo for 6 months. The outcomes indicate that saw palmetto use causes a substantial enhancement in urinary symptoms in guys with lower urinary system signs compared to placebo.

This study reveals that saw palmetto can be an effective 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 known as the ‘liposterolic’ fraction of the fruits. If using saw palmetto pick a product that reveals the portion of the supplement which is this fraction.

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

Available Forms

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

Possible Side Effects

Saw palmetto is normally well endured however might trigger adverse effects in some people, especially when excessive used.

These include:

  • Foul breath
  • Irregularity
  • Diarrhea
  • Dizziness
  • Tiredness
  • Headache
  • Nausea or vomiting
  • Indigestion

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

Some men have actually also reported impotence, breast tenderness, gynecomastia (breast augmentation), and a loss of libido (libido) while taking saw palmetto.

People on blood slimmers such as Coumadin (warfarin) and Plavix (clopidogrel) ought to prevent saw palmetto as it might increase the risk of bleeding. For this exact same reason, saw palmetto needs to be stopped a minimum of 2 weeks prior to or after surgery.

Children and pregnant women should not utilize saw palmetto due to the absence of safety research. [7]

What do we understand about safety?

Saw palmetto is well tolerated by many users. It may cause moderate adverse effects, including digestion symptoms 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 also used to monitor clients who have actually been diagnosed with prostate cancer.

Saw palmetto has not been revealed to engage with medications.

Info on the safety of saw palmetto comes mainly from studies of its use for BPH in males. Little is learnt about the safety or side effects of saw palmetto when used for other conditions, particularly in females or kids.

Saw palmetto might be unsafe for usage during pregnancy or while breastfeeding. [8]

Unique Safety Measures and Cautions

Pregnancy and breast-feeding: Saw palmetto is likely unsafe when taken by mouth during pregnancy or breast-feeding. It imitates a hormonal agent, and this could be harmful. Do not utilize during pregnancy or breast-feeding.

Surgery: Saw palmetto might slow blood clot. It might trigger extra bleeding during and after surgery. Stop using saw palmetto a minimum of 2 weeks before a set up surgery. [9]


More research study is needed to conclude whether saw palmetto is an efficient treatment for prostate-related conditions.

While there is some proof to support the fact that saw palmetto might have a positive effect, its potential negative effects have actually not been well studied.

Although inconclusive, present evidence does not weaken the experience of people who have found saw palmetto helpful. Taken correctly, it might be worth attempting as a complementary treatment. [10]


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