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Saw Palmetto

Other Name(s):

American Dwarf Palm Tree, Baies du Chou Palmiste, Baies du Palmier Scie, Cabbage Palm, Chou Palmiste, Ju-Zhong, Palma Enana Americana, Palmier de Floride, Palmier Nain, Palmier Nain Américain, Palmier Scie, Sabal, Sabal Fructus, Sabal serrulata, Saw Palmetto Berry, Serenoa repens, Serenoa serrulata.

Overview

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).

How does it work?

Saw palmetto doesn't shrink the overall size of the prostate, but it seems to shrink the inner lining that puts pressure on the tubes that carry urine.

Uses & Effectiveness

Possibly Effective for...

  • Prostate surgery (transurethral resection of the prostate; TURP). Research shows that taking 320 mg of saw palmetto daily for 2 months before prostate surgery can reduce the time spent in surgery, blood loss, the development of problems during surgery, and the total time spent in the hospital. However, one small study found that taking 160 mg daily 5 weeks before surgery does not lower the risk of problems during surgery.

Possibly Ineffective for...

  • Enlarged prostate (benign prostatic hyperplasia; BPH). There is conflicting and contradictory research about the benefits of saw palmetto for prostate symptoms. Some research has shown that saw palmetto might modestly improve symptoms such as going to the bathroom at night in some men with BPH. However, higher quality and more reliable research seems to indicate that saw palmetto has little or no benefit for reducing these symptoms. Any benefit is modest at best.

Insufficient Evidence to Rate Effectiveness for...

  • Prostate swelling and chronic pelvic pain syndrome. Some early research found that saw palmetto can improve prostate swelling symptoms. Other early research found that taking saw palmetto, selenium, and lycopene, but not saw palmetto alone, can improve symptoms of prostate swelling and chronic pelvic pain syndrome. Taking certain herbal combinations containing saw palmetto seems to improve the effects of sparfloxacin or prulifloxacin in treating prostate swelling symptoms due to infection. However, saw palmetto doesn't seem to improve prostate swelling symptoms not due to infection.
  • Prostate cancer. Research studies to date have found that taking saw palmetto doesn't seem to prevent prostate cancer.
  • Baldness. Some men report that using saw palmetto with beta-sitosterol makes them grow more and better hair.
  • Bladder control (neurogenic bladder). Early research suggests that taking 90-120 drops of a combination of echinacea and saw palmetto for 77 days improves the amount of urine the bladder can hold and the amount left in the bladder after urination in women with neurogenic bladder.
  • Colds and coughs.
  • Sore throat.
  • Asthma.
  • Chronic bronchitis.
  • Migraine headache.
  • Increasing breast size.
  • Reducing bleeding after prostate surgery.
  • Other conditions.
More evidence is needed to rate the effectiveness of saw palmetto for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

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. However, these side effects do not seem to occur any more often with saw palmetto than with a sugar pill.

There is some concern that saw palmetto might cause liver or pancreas problems in some people. There have been two reports of liver damage and one report of pancreas damage in people who took saw palmetto. However, there is not enough information to know if saw palmetto was the actual cause of these side effects.

Saw palmetto is POSSIBLY SAFE when administered into the rectum appropriately for up to 30 days. However, it is not known if it is safe to use for longer periods of time.

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.

Interactions


Birth control pills (Contraceptive drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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.


EstrogensInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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.

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For benign prostatic hyperplasia (BPH): 160 mg twice daily or 320 mg once daily.
  • For the treatment of bald spots: 200 mg twice daily combined with beta-sitosterol 50 mg twice daily.