Saw Palmetto

Saw palmetto is a popular ingredient in dietary supplements formulated to promote male genitourinary health – which includes the urinary tract and genital tract of the reproductive system – specifically focusing on supporting healthy prostate gland function. During the natural aging process, many men experience health issues affecting their prostate gland. Herbal supplements of saw palmetto contain bioactive compounds that may promote prostate health. Read this article to learn more about saw palmetto’s potential health benefits on male reproductive function and healthy aging.

What is Saw Palmetto, and How Does It Work?


Saw palmetto (Serenoa repens), also known as the American dwarf palm tree, or cabbage palm, is a fan palm that grows as a tree or shrub throughout warm climates in the southern United States from South Carolina to throughout Florida. It can grow up to 10 feet high, with leaf clusters that can reach 2 feet wide. It has a creeping, horizontal growth pattern. Its saw-toothed leaves fan out from thorny stems. The plant has white flowers with yellow berrylike fruit (sometimes referred to as a “saw palmetto berry,” although it is a single seed drupe) that turns brownish black when ripe and is dried for medicinal use. The extract from this “berry” is often used in herbal remedies and dietary supplements. Herbalists recommend saw palmetto to support overall healthy aging, for hair loss, upper respiratory issues, urine flow (as a diuretic), relaxation (as a sedative), libido (as an aphrodisiac), and most commonly – to support healthy function of the male prostate gland. (1, 2, 3)

What is the Prostate Gland, and How Does It Work?


The prostate is a walnut-sized gland that is an important part of the male reproductive system. It is located below the bladder and in front of the rectum, surrounding part of the urethra. The main function of the prostate gland is to create the fluid that carries sperm from the testicles into the urethra, which is expelled with sperm as semen during ejaculation. (4)

What is an Enlarged Prostate Gland?

During the normal aging process in men, the prostate gland can become larger. This noncancerous condition is known as benign prostatic hypertrophy, or BPH, and it affects nearly all men over age 50. (5) Although the prostate gland begins as the size of a walnut, by age 60, the prostate gland may have grown to the size of a lemon, which could strain the urethra, causing unnecessary pressure and problems with urination, such as incontinence (a sudden, intense urge to urinate followed by an involuntary loss of urine). When a prostate gland grows, it squeezes the urethra, and the bladder may not be able to empty completely. Such a urinary blockage may result in urinary tract infections, bladder stones, bladder or kidney damage, or other health issues. (6)

According to WebMD, “Some 8 out of every 10 men eventually develop an enlarged prostate. About 90% of men over the age of 85 will have BPH. About 30% of men will find their symptoms bothersome.” (7)

Below are several common symptoms of BPH. (8)

Symptoms of BPH

  • Frequent or urgent need to urinate
  • Increased frequency of urination at night (nocturia)
  • Difficulty starting urination
  • Weak urine stream or a stream that stops and starts
  • Dribbling at the end of urination
  • Inability to completely empty the bladder
  • Urinary tract infection
  • Inability to urinate
  • Blood in the urine

Depending on the symptoms from an enlarged prostate, treatment may include antibiotics, medications, and/or surgery. Common prescription medications given for this purpose include alpha blockers, which relax certain muscles and open small blood vessels by keeping the hormone norepinephrine (noradrenaline) from tightening the muscles in the walls of small arteries and veins, promoting blood flow, healthy blood pressure, and urine flow. Other medications known as 5-alpha-reductase inhibitors are also recommended to inhibit the enzyme known as 5-alpha-reductase, preventing testosterone from being converted into dihydrotestosterone, or DHT, (a chemical produced when testosterone breaks down in a man’s body that is needed for prostate growth) and thereby supporting urine flow. Saw palmetto is a natural 5-alpha-reductase inhibitor. (9, 10, 11)

Ways to Reduce Symptoms of BPH

  • Urinate when you first get the urge
  • Avoid alcohol and caffeine, before bedtime
  • Spread out fluid intake throughout the day
  • Avoid cold and sinus medications
  • Exercise regularly
  • Do Kegel exercises
  • Try dietary supplements of saw palmetto (12)

Other common prostate gland health issues are prostatitis (inflammation of the prostate, which may be treated with antibiotics) and prostate cancer (the most common form of cancer in men other than skin cancer). According to WebMD, “One in 35 men die from prostate cancer. Surgery, radiation, hormone therapy, and chemotherapy can be used to treat prostate cancer. Some men choose to delay treatment, which is called watchful waiting.” (13)

To check the health of the prostate gland, there are several types of tests that men may try with their physician. The most common prostate health test is a digital rectal examination, which may be helpful in detecting an enlarged prostate, growths from prostate cancer, or tenderness from prostatitis. Another test is the prostate-specific antigen, which looks for high levels a protein created by the prostate, called PSA, possibly indicating an enlarged prostate, or prostate cancer. A third prostate test, the transrectal ultrasound, involves rectal insertion and/or a prostate biopsy that tests for prostate cancer. (14)


How Does Saw Palmetto Support Health?


Saw palmetto contains a combination of active ingredients, including fatty acids, plant sterols (known as phytosterols), flavonoids, and other bioactive components, which are all believed to help contribute to its potential beneficial effects on prostate health. In addition, its berrylike fruit contains polysaccharides (sugars), carbohydrates, and lipid components, which may help support the immune system and cell health. (15, 16)

According to research from PennState’s Milton S. Hershey Medical Center, the fatty acids in saw palmetto may inhibit 5-alpha-reductase. (17) According to research from Kansas State University, the phytosterols (beta-sitosterol, campesterol, stigmasterol) in saw palmetto may also inhibit 5-alpha-reductase, which may have an effect on prostate cell changes and BPH symptoms. (18) In addition, the plant sterols in saw palmetto are a group of naturally occurring compounds found in the plant’s cell membranes, which are structurally similar to cholesterol in the human body, so when they are consumed they compete for absorption in the digestive system, blocking actual cholesterol absorption and helping to maintain healthy blood cholesterol levels already in the normal range. (19)

Saw Palmetto May Promote Prostate Gland Function

Due to its nutritional content, saw palmetto is believed to be an anti-androgen, counteracting the effects of the breakdown of testosterone in a man’s body), which is believed to be one of the reason the prostate keeps growing as a man ages. Another theory is that an imbalance of the levels of testosterone and estrogen (typically a female hormone) in men may cause the prostate to grow. (20)

It is also believed that saw palmetto supports prostate gland health specifically by shrinking the inner lining of the prostate, helping reduce pressure on the urethra, the tube in the penis that empties urine from the bladder. (21) In addition, according to the University of Maryland Medical center, saw palmetto also seems to have an anti-inflammatory effect on the prostate. “At least one study has shown even greater anti-inflammatory activity when saw palmetto is combined with lycopene and selenium.” (22)

However, there is an ongoing debate in the medical community over the effectiveness of saw palmetto, especially as an alternative treatment for BPH, since extensive clinical research on its efficacy is lacking. In fact, two clinical trials have found that saw palmetto extract showed no difference in comparison to taking a placebo in regard to the easing the symptoms of BPH. (23)

One study at the Massachusetts General Hospital in Boston involved more than 300 men ages 45 and older who had moderate symptoms suggestive of an enlarged prostate. The men received a daily dose of 320 mg of saw palmetto extract, or a placebo pill. After 24 weeks, that dosage was doubled, and another 24 weeks later, the dosage was tripled. By the end of the study, researchers found no benefit to taking saw palmetto over the placebo. (24)

However, saw palmetto “has been shown to be safe and effective in mild to moderate BPH when compared to finasteride, tamsulosin, and placebo.” (25) For reference, Finasteride (Proscar) is “a drug that prevents the conversion of testosterone to dihydrotestosterone in the body.” (26) Tamsulosin (Flomax) is “an alpha-blocker that relaxes the muscles in the prostate and bladder neck, making it easier to urinate.” (27)

Some clinical studies involving saw palmetto supplementation have resulted in significant improvements in BPH and lower urinary tract symptoms. The variation in results could be explained by different amounts of active components in the saw palmetto supplements. In one study, for example, overweight Korean males with BPH who took a combination treatment of pumpkin seed oil and saw palmetto oil reported positive results, suggesting that pumpkin seed oil and saw palmetto oil are clinically safe and may be effective complementary and alternative medicine for BPH. (28)

Nevertheless, additional research is necessary to determine the true effectiveness of saw palmetto on men’s prostate health.

Additional Potential Health Benefits of Saw Palmetto

In addition to promoting prostate health, natural health practitioners use saw palmetto to support respiratory health, digestion, thyroid gland health, metabolism, appetite, healthy-looking hair, and libido. Low testosterone levels cause low libido in both men and women. Saw palmetto may promote a healthy libido by stopping the breakdown of testosterone and helping to maintain the balance of free testosterone in the body. More testosterone can also mean more hair growth, which is why some people believe saw palmetto is helpful for those affected by thinning hair or hair loss. (29) According to one study, nearly half of the participants who used a topical treatment of saw palmetto showed positive results, increasing their hair count by 11.9 percent after four months of use. (30)

Saw Palmetto for Women

While there is not much scientific research that exists on the use of saw palmetto by women, a few studies in the 1990s indicated that saw palmetto supported healthy-looking hair. However, pregnant women, breastfeeding women, or women taking birth control pills or using the patch should NOT use saw palmetto, because of its potential effect on hormone levels. (31)

A Brief History of Saw Palmetto


Since the 1700s, Native Americans of the southeastern United States have used saw palmetto berries as a staple food and as a medicine for urinary tract support. Practitioners of traditional medicine (also known as indigenous or folk medicine) have also relied on saw palmetto berries to support a healthy libido and prostate function for hundreds of years. Early American settlers used saw palmetto berries to support reproductive health and aid as a sedative. (32)

In the 1800s, John Lloyd, a medical botanist observed that livestock who ate saw palmetto appeared to be healthier and fatter than other animals. In 1879, Dr. J. B. Read, doctor living in Georgia, published a paper on the medicinal uses of saw palmetto in the American Journal of Pharmacy. In the early 1900s, saw palmetto berry tea was used to support enlarged prostate glands and to support urinary tract health. Since the 1960s, saw palmetto clinical studies have been popular in Europe. In fact, a European study showed that half of German urologists preferred saw palmetto over pharmaceuticals for treatment of BPH. (33)

Today, more than 2 million American men still use saw palmetto to support prostate health. (34) The American Dietetic Association reports that saw palmetto is one of the most common supplements among Americans aged 50 to 76. (35) Most commercial saw palmetto is grown and harvested in Florida, where an estimated 1 million acres of wild saw palmetto palms can be found. (36)

How to Buy Saw Palmetto


You should only shop for saw palmetto from reputable sources. Saw palmetto can usually be purchased at health food stores in various forms, including as dietary supplements (powdered capsules, tablets, liquid tinctures, and liposterolic extracts), as whole, ground, or dried berries, or as a tea.

Shop for saw palmetto supplements from for natural products that have been vetted for meeting quality standards and good manufacturing guidelines by our certified nutritionist. Natural Healthy Concepts offers a wide range of saw palmetto supplements in vegetarian capsules, softgels, tablets, multivitamins, tinctures, oral sprays, and creams – oftentimes blended with stinging nettle, Diindolylmethane (DIM), lycopene, pygeum (also known as the African Plum), or other vitamins and minerals, to support optimal male genitourinary health.

For the best possible results, researchers at the National Institute on Aging recommend that people take standardized extracts of saw palmetto containing 85-95% fatty acids and plant sterols. (37) In addition, liquid saw palmetto supplements seem to have the highest bioactive content and may therefore have a better potential effect on overall health. According to researchers, “liquid saw palmetto supplements contain significantly higher (p < 0.05) concentrations of total fatty acids (908.5 mg/g), individual fatty acids, total phytosterols (2.04 mg/g), and individual phytosterols, than other supplement categories,” such as powders, dried berries, or tinctures. (38) Try saw palmetto yourself; it may make a difference to your health!

Dosage Recommendations

Dosages vary depending on the product you are using and the type of saw palmetto used. A typical starting dose is 320 mg per day of a standardized extract of saw palmetto. However, be sure to read the dosage instructions of the product label before use. (39)


Saw palmetto may have an adverse effect on blood-thinning or hormone-related medications and conditions. (40) Pregnant or breastfeeding women should NOT use saw palmetto, because it affects hormone activity in the body. In addition, women taking birth control and anyone taking drugs to reduce or increase hormones should not take saw palmetto. Saw palmetto is also believed to thin the blood and may limit the body’s natural blood clotting ability. Therefore, saw palmetto should not be used with blood pressure medication or with any drugs that may cause an increased risk of bleeding, such as aspirin, Coumadin, Plavix, Motrin and others. Do not take it with any other anti-inflammatory and antibiotic drugs. (41) Possible side effects may include cramps, nausea, diarrhea, or headaches. (42) Do not self-treat for an enlarged prostate or other medical conditions. Instead, consult with your healthcare provider first before trying saw palmetto. (43)