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Home > Health Library > Saw Palmetto
Saw Palmetto
Overview
Saw palmetto (Serenoa repens/Sabal serrulata) is a palm like plant with berries that were a staple food and medicine for the Native Americans of the southeastern United States. In the early 1900s, men used the berries to treat urinary tract problems, and even to increase sperm production and boost libido. Today, the primary use of saw palmetto is to treat benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate gland. Researchers aren't sure exactly how saw palmetto works, but it contains plant-based chemicals that may be effective for BPH. Researchers think that saw palmetto may affect the level of testosterone in the body, and perhaps reduce the amount of an enzyme that promotes the growth of prostate cells. Saw palmetto is often combined with nettle extract to treat BPH.

What is Saw Palmetto ?
Saw palmetto is a plant. Its ripe fruit is used to make medicine.
Saw palmetto is best known for its use in decreasing symptoms of an enlarged prostate (benign prostatic hypertrophy, BPH). According to many research studies, it is effective for this use.

Saw palmetto is used for treating certain types of prostate infections. It is also sometimes used, in combination with other herbs, to treat prostate cancer.

Some people use saw palmetto for colds and coughs, sore throat, asthma, chronic bronchitis, chronic pelvic pain syndrome, and migraine headache. It is also used to increase urine flow (as a diuretic), to promote relaxation (as a sedative), and to enhance sexual drive (as an aphrodisiac).


Benefits / uses
Benign Prostatic Hyperplasia (BPH)
Several studies suggest that the herb is effective for treating symptoms, including too frequent urination, having trouble starting or maintaining urination, and needing to urinate during the night. The urethra, the tube that empties urine from the body, runs through the prostate gland in men; when the prostate gland is enlarged, men may have trouble urinating.

Some studies show that saw palmetto is as effective in treating symptoms as finasteride (Proscar) without side effects, such as loss of libido. Other studies suggest that saw palmetto may actually shrink the size of the prostate gland.


Other: saw palmetto inhibits the growth of tumor cells, indicating that it may be helpful in the treatment of prostate cancer. Other studies show that saw palmetto improves urinary tract symptoms related to BPH.

Best Form For Human Consumption
Saw palmetto can be purchased as dried berries, powdered capsules, tablets, liquid tinctures, and liposterolic extracts. The product label should indicate that contents are standardized and contain 85 - 95% fatty acids and sterols. Read labels carefully, and buy only from reputable companies.

Doses
arw Liposterolic extract in capsules: One studied dosage for early stages of BPH is 160 mg, twice a day. The supplement should be a fat soluble saw palmetto extract that contains 85 - 95% fatty acids and sterols.
arw Liquid extract: This preparation has not been tested in any studies, so its effectiveness is not known.
arw Tea: Saw palmetto can be taken as a tea, but its active ingredients (fatty acids) are not soluble in water, so tea may not be effective. It has not been tested in any studies. Capsules are recommended instead of tea.
 
Possible Side effects / Precautions / Possible Interactions:
Saw palmetto is LIKELY SAFE for most people. Side effects are usually mild. Some people have reported dizziness, headache, nausea, vomiting, constipation, and diarrhea. Some people have reported that saw palmetto causes impotence. But these side effects do not seem to occur any more often with saw palmetto than with a sugar pill.

Special precautions & warnings:
Pregnancy and breast-feeding: Saw palmetto is LIKELY UNSAFE when used during pregnancy or breast-feeding. It acts like a hormone, and this could be dangerous to the pregnancy. Don’t use during pregnancy or breast-feeding.

Surgery: Saw palmetto might slow blood clotting. There is some concern that it might cause extra bleeding during and after surgery. Stop using saw palmetto at least 2 weeks before a scheduled surgery.

Possible Interactions:
Birth control pills (Contraceptive drugs)
Some birth control pills contain estrogen. Saw palmetto might decrease the effects of estrogen in the body. Taking saw palmetto along with birth control pills might decrease the effectiveness of birth control pills. If you take birth control pills along with saw palmetto, use an additional form of birth control such as a condom.

Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.


Estrogens
Saw palmetto seems to decrease estrogen levels in the body. Taking saw palmetto along with estrogen pills might decrease the effectiveness of estrogen pills. Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.

Medications that slow blood clotting (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.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.


Research studies / References
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Barry MJ, Meleth S, Lee JY, et al. Effect of increasing doses of saw palmetto on lower urinary tract symptoms: a randomized trial. JAMA 2011;306:1344-51.
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Habib FK, Ross M, Ho CK, et al. Serenoa repens (Permixon) inhibits the 5alpha-reductase activity of human prostate cancer cell lines without interfering with PSA expression. Int J Cancer 2005;114:190-4.
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Lopatkin N, Sivkov A, Walther C, et al. Long-term efficacy and safety of a combination of sabal and urtica extract for lower urinary tract symptoms--a placebo-controlled, double-blind, multicenter trial. World J Urol 2005;23:139-46.
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Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med 2008;16:147-54.
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Habib FK, Wyllie MG. Not all brands are created equal: a comparison of selected components of different brands of Serenoa repens extract. Prostate Cancer Prostatic Dis 2004;7:195-200.
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Tacklind J, MacDonald R, Rutks I, Wilt TJ. Serenoa repens for benign prostatic hyperplasia. Cochrane Database Syst Rev 2009;(2):CD001423.
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Tuncel A, Ener K, Han O, et al. Effects of short-term dutasteride and Serenoa repens on perioperative bleeding and microvessel density in patients undergoing transurethral resection of the prostate. Scand J Urol Nephrol 2009;43:377-82.
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Prager N, Bickett K, French N, Marcovici G. 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. J Altern Complement Med 2002;8:143-52.
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Bonnar-Pizzorno RM, Littman AJ, Kestin M, White E. Saw palmetto supplement use and prostate cancer risk. Nutr Cancer 2006;55:21-7.
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Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2.