Saw palmetto
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Prostate Support Complex · 90 capsules
6 reviewsSupports optimal prostate health and may counteract bothersome symptoms of prostate enlargement such as nighttime urination, urinary problems, inco...
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The saw palmetto or saw palmetto fruit, with the botanical name Serenoa repens, is marketed to the general public mainly as a treatment for benign prostatic hyperplasia or BPH. In the USA, this genus is called Serenoa repens. In other parts of the world it is known as Sabal Serrulatum, Sabal Serulata, Sabalis Serulata, Sabalis Serulatae, Serenoa Serrulata, Serenoa Serrulatae and many other synonyms. The saw palmetto, the common name, is also known worldwide as Sabal, Sabal Fructus, Sabal Fruit, Fructus Serenoae, or Saw Palmetto. For the purposes of our website, we use the name saw palmetto and the generic name Serenoa Repens for the sake of simplicity.
The benefits of the saw palmetto can be traced back to the early 18th century, when the Native Americans of the Florida peninsula depended mainly on the properties of this fruit. The fruit was used by Native Americans as a remedy for testicular atrophy, impotence, inflammation of the prostate, lack of sex drive in men and as an all-purpose remedy to stimulate bodily functions. Other historical uses include treatments for female infertility, underdeveloped breasts, excessive milk production, painful menstruation and use as an anti-inflammatory, appetite stimulant and as a tonic and expectorant, particularly for the bronchial tract. It has also been marketed as a sexual enhancer for men and women and referred to as the "sex pill of the nineties".
Mechanisms of action of saw palmetto
- Saw palmetto inhibits the enzyme 5-reductase, which converts testosterone into dihydrotestosterone (DHT) (1).
- Saw palmetto blocks the 1-adrenoceptors (2).
- Saw palmetto reduces the activity of several genes associated with inflammation (3).
- Saw palmetto increases the production of p57 protein, a protein that counteracts tumor formation (4).
- Saw palmetto reduces the production of the p21 protein, which activates tumor growth (5).
Health benefits and possible applications of saw palmetto
Treatment and prevention of benign prostate enlargement
Nowadays, the product is mainly used in the treatment of cases related to BPH (the non-malignant enlargement of the prostate). Various factors play a role in the development of BPH: firstly, functional testicles and a critical amount of androgen are a prerequisite for the development of BHP. Secondly, a change in prostatic androgen metabolism causes the accumulation of dihydrotestosterone (DHT), and thirdly, an increase in the ratio of plasma estrogens to androgens. Recent clinical research appears to show that saw palmetto extract has a positive effect on BHP.
Its mechanisms of action in the treatment of BHP are reported to prevent the conversion of testosterone to DHT, the substance believed to be the cause of prostate enlargement. In addition, saw palmetto extract inhibits the binding of DHT to receptors and thus prevents its action. It has also been shown to have an inhibitory effect on both androgen and oestrogen nuclear receptors. This is achieved without affecting the amount of testosterone, follicle stimulating hormones or luteinizing hormones. Most importantly, saw palmetto has no effect on PSA levels, so that PSA tests for the detection of cancer cells are not distorted.
Summary: Scientific research shows that saw palmetto may help prevent benign growth of the prostate.
Saw palmetto could prevent hair loss
Hair loss is a common condition that can be caused by a number of factors including genetic predisposition, certain diseases, hormonal changes and the use of certain medications such as stimulants and blood thinners. Saw palmetto is often used to balance hormone levels and combat hair loss (6). According to a study review, saw palmetto may help inhibit the activity of the 5-alpha reductase enzyme - an enzyme that converts testosterone into a hormone called dihydrotestosterone (DHT), which is associated with hair loss.
This could also prevent hair loss by reducing DHT uptake in the hair follicles, as it reduces the ability of DHT to bind to certain hormone receptors (7). In one study, saw palmetto was shown to be effective in improving hair growth in 60% of male subjects between the ages of 23 and 64 who suffered from androgen-induced hair loss (8). Another study conducted on 62 adults showed that applying saw palmetto directly to the scalp over a 3-month period increased hair density by 35% (7).
Summary: Saw palmetto may prevent hair loss and increase hair density by reducing levels of a specific enzyme associated with hair loss.
Saw palmetto may improve urinary tract function
Urinary tract problems are common in older men and can include symptoms such as incontinence and difficulty urinating. Saw palmetto may reduce urinary tract symptoms associated with benign prostatic hyperplasia - a condition characterized by enlargement of the prostate gland resulting in reduced urine flow. A 12-week study of 92 men showed that taking 2 capsules of Prostataplex - a herbal blend that includes saw palmetto - helped reduce urinary tract symptoms associated with benign prostatic hyperplasia (9).
Another study of 85 men over 45 also found that treatment with 160 mg saw palmetto twice daily reduced lower urinary tract symptoms after 6 months, increased urine flow and improved overall quality of life (10). However, further research is needed to determine whether saw palmetto can improve urinary tract function in the general population, including people without prostate problems.
Summary: Saw palmetto may improve urinary tract function and help relieve urinary tract symptoms associated with benign prostatic hyperplasia.
Saw palmetto may reduce inflammation
Saw palmetto contains the antioxidants epicatechin and methyl gallate - compounds that prevent damage to cells, reduce inflammation and protect against chronic disease (11). Some studies show that saw palmetto has anti-inflammatory properties, which could prove helpful in treating some diseases. For example, one study observed that saw palmetto extract administered to mice with prostate enlargement reduced swelling and several markers of inflammation including interleukin (IL-6) (12). Another study conducted in obese rats with prostate enlargement found that saw palmetto was effective in reducing inflammation and improving antioxidant status (13). However, while these results are promising, further studies are needed to determine how saw palmetto may affect inflammation in humans.
Summary: Saw palmetto is rich in antioxidants and has been shown to reduce inflammation in animal studies.
Saw palmetto may help regulate testosterone levels
Saw palmetto is often used to naturally boost testosterone levels. Regulating testosterone levels can affect several aspects of health including body composition, sex drive, mood and cognition. Testosterone levels decline with age and some research shows that low testosterone levels may contribute to conditions such as heart disease. Saw palmetto works by reducing the activity of the 5-alpha reductase enzyme - an enzyme responsible for converting testosterone to dihydrotestosterone (DHT) - which helps to maintain testosterone levels in the body (14).
A test tube study found that the effect of saw palmetto was comparable to the pharmaceutical 5-alpha reductase inhibitor finasteride when it comes to maintaining testosterone levels (15). Finasteride is used in the medical field to treat hair loss and benign prostate enlargement. Another study involving 40 men found that treatment with saw palmetto reduced DHT levels by 32% after 6 months, suggesting that saw palmetto is effective in maintaining testosterone levels (16).
Summary: Test tube studies have shown that saw palmetto reduces the activity of the enzyme that converts testosterone to DHT, which helps to maintain testosterone levels naturally.
Saw palmetto can improve quality of life
Quality of life is a measure of physical, social and emotional well-being. Supplementation with 320 mg saw palmetto over a period of 8 weeks increased the perceived quality of life score by 42% in a study of 82 men (17).
Saw palmetto is probably ineffective for the following applications
Reducing the risk of prostate cancer
In a cell-based study, a saw palmetto berry extract prevented prostate cancer growth by increasing p53 protein production (18). Another study found that blocking the 5-alpha reductase enzyme with saw palmetto was able to reduce the growth of prostate cancer cells (19). However, a long-term study of over 35,000 men found no link between saw palmetto consumption and the risk of developing prostate cancer (20).
Sexual function
Saw palmetto is traditionally used to treat erectile dysfunction and improve sexual function. A pilot study with 80 men over 30 showed a significant improvement in sexual function. However, it should be noted that this study was funded by the manufacturer of the saw palmetto extract used (Prostasan) (21). Another study of 369 men found no significant difference between saw palmetto and a placebo in the treatment of sexual dysfunction (22).
Need in sport
The substance is of interest to many athletes who use anabolic steroids or prohormones. This often leads to an increase in androgen levels in the body with a resulting increase in DHT levels. Some steroids also act directly on the DHT receptors in the skin and hair follicles and can theoretically be inhibited there by saw palmetto. Even natural athletes could benefit from supplementing with saw palmetto if they want to counteract hereditary hair loss or excessive sebum production in the skin or acne formation.
Saw palmetto also blocks the progesterone receptors (progesterone, like oestrogen, can lead to water retention and gynaecomastia). Saw palmetto is also an effective remedy for these steroid side effects. Many athletes are also convinced that saw palmetto has a positive effect on acne problems and hair loss. Saw palmetto usually has to be taken for 2-3 months before the first positive effects can be seen. Saw palmetto is non-toxic and has no significant side effects, even when taken in higher doses over a longer period of time. The recommended dose is 320mg per day.
Dosage forms and dosage recommendations
Saw palmetto is readily available in supplement form. It is available in the form of capsules, soft gel capsules and tablets and is often combined with other ingredients such as pumpkin seed extract, which help to improve prostate health. Saw palmetto is also available in grated form, in dried form, as a liquid extract or as a tea.
Most scientific studies used saw palmetto in doses of 320 mg per day, with the daily dose often divided into two single doses. Some recommend taking saw palmetto with food, which may help minimize digestive discomfort and prevent unwanted side effects.
Side effects and precautions
A systematic review concluded that saw palmetto rarely caused mild side effects comparable to those of a placebo (23). According to this review, the most commonly observed side effects were as follows:
- Stomach pain
- diarrhea
- nausea
- fatigue
- headaches
- Reduced sex drive
- Inflammation of the nasal mucous membranes
More severe side effects such as death and bleeding have been reported in isolated cases, but their association with saw palmetto is highly questionable. There are also two cases of inflammation of the pancreas in people who had used saw palmetto (24). In 2 patients, saw palmetto caused liver inflammation and acute liver damage (25, 26). Due to the lack of safety data, saw palmetto should not be used by pregnant or breastfeeding women.
Interactions with medications
Medication to reduce blood clotting
One patient experienced significantly increased blood loss and reduced blood clotting after taking saw palmetto during surgery. After discontinuing the supplement, blood clotting returned to normal in this patient (27). For this reason, saw palmetto should not be combined with medications to reduce blood clotting. These medications include, but are not limited to:
- Aspirin
- Warfarin (Coumadin)
- Apixaban (Eliquis)
- Rivaroxaban (Xarelto)
- Clopidogrel (Plavix)
- Ibuprofen and other non-steroidal anti-inflammatory drugs
Contraceptive pill
Saw palmetto can reduce the effectiveness of the contraceptive pill by lowering estrogen levels (28).
5-alpha reductase inhibitors
Because saw palmetto inhibits the conversion of testosterone to DHT, it should not be combined with prescription DHT blockers such as finasteride (Propecia).
Conclusion
Saw palmetto is a species of palm used to produce a supplement with numerous health benefits. Promising research shows that saw palmetto may help increase testosterone levels, improve prostate health, reduce inflammation, prevent hair loss and improve urinary tract function. However, some studies have come to mixed conclusions about the effectiveness of saw palmetto. Further large-scale studies are therefore needed to fully understand the effects of saw palmetto on health.
References
- https://www.ncbi.nlm.nih.gov/pubmed/8610056
- https://www.ncbi.nlm.nih.gov/pubmed/10068345
- https://www.ncbi.nlm.nih.gov/pubmed/23846725
- https://www.ncbi.nlm.nih.gov/pubmed/20428755
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722839/
- https://www.ncbi.nlm.nih.gov/pubmed/28925637
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840915/
- https://www.ncbi.nlm.nih.gov/pubmed/12006122/
- https://www.ncbi.nlm.nih.gov/pubmed/18082217
- https://www.ncbi.nlm.nih.gov/pubmed/11744467
- https://www.ncbi.nlm.nih.gov/pubmed/25230777
- https://www.ncbi.nlm.nih.gov/pubmed/2568315
- https://www.ncbi.nlm.nih.gov/pubmed/26104840
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476047/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847595/
- https://www.ncbi.nlm.nih.gov/pubmed/11337315
- https://www.ncbi.nlm.nih.gov/pubmed/22522969
- https://www.ncbi.nlm.nih.gov/pubmed/19059205
- https://www.ncbi.nlm.nih.gov/pubmed/16093232
- https://www.ncbi.nlm.nih.gov/pubmed/16965237
- https://www.ncbi.nlm.nih.gov/pubmed/22522969
- https://www.ncbi.nlm.nih.gov/pubmed/21954478
- https://www.ncbi.nlm.nih.gov/pubmed/19591529
- https://www.ncbi.nlm.nih.gov/pubmed/20531057
- https://www.ncbi.nlm.nih.gov/pubmed/16800417/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2856058/
- https://www.ncbi.nlm.nih.gov/pubmed/11489067
- https://www.ncbi.nlm.nih.gov/pubmed/18700016