Saw Palmetto Facts: Overview, Health Benefits, Potential Side Effects, and Contraindications

Saw palmetto (commonly known as Serenoa repens, American dwarf palm tree, cabbage palm), is a shrub-like type of palm. It is found in the subtropical southeastern part of the United States, more abundantly along the south Atlantic and Gulf coastal plains and sandhills. It is also seen in Cuba, Florida, Georgia, and the Bahamas.

Saw Palmetto

Saw Palmetto. Image Courtesy of Ted Bodner

It is known as the fan palm, because of the nature of the arrangement of its leaves which have petioles each containing about 20 leaflets.

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Different forms of saw palmetto preparations include:

  • Dried berries
  • Tablets
  • Liquid extracts
  • Powdered capsules

It is a berry-producing plant. These berries are large reddish-black drupes that serve as an important food source for animals and men. The berries can be eaten wholly or dried and used in making tea. The oily extract of these dried berries is the most frequently sold form of saw palmetto. It contains  75-90% fat based on the extraction methods. Typically it contains more vitamin E and other antioxidants than the raw berry form.

Saw palmetto extracts have been extensively studied as a dietary supplement. So far, it is known to possess nutritional, aphrodisiac, sedative, and antitussive properties.

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Health benefits of Saw Palmetto

In prostate health

The prostate is a small organ in the male reproductive system which sits directly below the bladder and functions in the production of semen.

Prostate problems are common and are associated with older men. This is usually characterized by an inflamed prostate, benign prostatic hyperplasia, and occasionally prostate cancer. Such individuals experience difficulties in voiding urine (which might arise from poor bladder tone or urinary tract obstruction).

Saw palmetto could aid prostate health by preventing conditions like prostate cancer and benign prostatic hyperplasia (BPH) which lead to the enlargement of the prostate gland.

Although BPH is a normal condition of aging, its etiology remains unknown though it can be as a result of hormonal changes in male sex hormone levels. Saw palmetto does not shrink the overall size of the prostate but the inner lining of the organ.

In one test study, it was observed that saw palmetto extracts decreased the growth and blocked the spread of prostate cancer cells by denaturing specific androgen receptors. In another, it was shown that saw palmetto could be used in the management of BPH.

In inflammation

Inflammation refers to the body’s mechanism in fighting against infections, injuries, and toxins, in an attempt to heal itself.

Saw palmetto is known to contain antioxidants. Antioxidants could be natural or man-made substances that prevent or reduce damages to cells caused by free radicals. The body produces these free radicals in response to environmental and other pressures.

Antioxidants could be referred to as “free-radical scavengers”. Some antioxidants contained in saw palmetto are epicatechin and methyl gallate. Saw palmetto extracts decrease inflammation as well as improve the overall antioxidant status.

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In testosterone levels

In an attempt to boost testosterone levels naturally, saw palmetto is often recommended.

Body composition, sexual drive, cognition, and mood can be attributed to testosterone levels in men. Age-related changes tend to decrease testosterone levels in most men. Saw palmetto increases testosterone levels by inhibiting the activity of 5-alpha reductase (5a-R), which is an enzyme responsible for converting testosterone to dihydrotestosterone (DHT).

In preventing hair loss

Androgenetic alopecia refers to hair loss in males. It is often a source of significant discomfort, unease, and even trepidation. Hair loss is attributed to a lot of factors ranging from genetic factors, hormonal changes, medications (stimulants, blood thinners, chemotherapy), as well as certain medical conditions.

Saw palmetto helps in maintaining hormonal balance and fights hair loss. As previously mentioned, saw palmetto blocks the activity of 5-alpha reductase, which is an enzyme that converts testosterone to DHT. A reduction in the uptake of dihydrotestosterone (DHT) by hair follicles could be a way of preventing hair loss as DHT is often the culprit in male pattern alopecia. Saw palmetto is also excellent in increasing hair density.

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Saw Palmetto Side effects, interactions, and controversies

Saw palmetto is well tolerated by many. however, it can be associated with mild effects which include digestive symptoms (like nausea, vomiting, constipation, diarrhea), fatigue, headache, dizziness, sleeping disorders, vertigo, and even bad breath.

In severe cases, liver problems may be seen. Intracranial bleeds, pancreatitis, and even death may result.

It is seen on several occasions to interact with some blood-thinning medications (Anticoagulants/antiplatelet drugs) like

  • Warfarin
  • Heparin
  • Ibuprofen
  • Diclofenac
  • Aspirin
  • Coumadin

This increases bleeding risk by slowing down blood clotting.

Saw palmetto use is highly discouraged in children, pregnant women, or lactating mothers.

Saw palmetto alters hormonal levels, and as such is not recommended for people taking hormonal contraceptives (birth control) or hormone replacement therapy.

Certain studies, including this one, have suggested that saw palmetto doesn’t show improved efficacy over placebos on trials. Further studies are still ongoing to resolve the controversy

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Conclusion

Saw palmetto looks to be a useful tool in the management of conditions related to hormonal dyscrasias. However, certain schools of thought are not so convinced of its efficacy.

References

https://www.nccih.nih.gov/health/saw-palmetto

https://pubmed.ncbi.nlm.nih.gov/11276294/

https://pubmed.ncbi.nlm.nih.gov/16965237/

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