Nutritional Supplement

Saw Palmetto

Also indexed as: Sabal serrulata, Serenoa repens, Serenoa serrulata

Side Effects

No significant side effects have been noted in clinical trials with saw palmetto extracts. However, in rare cases, saw palmetto can cause stomach problems,20 and one individual who was taking saw palmetto developed severe bleeding during surgery.21 According to some clinical trials, saw palmetto extract does not appear to interfere with accurate measuring of prostate-specific antigen (PSA)—a marker for prostate cancer.22 One test tube study found that saw palmetto did not prevent the release of PSA from prostate cells.23 Saw palmetto is most effective in managing symptoms of BPH but has not been shown to aggressively shrink the size of the prostate. BPH can only be diagnosed by a physician (preferably a urologist). Use of saw palmetto extract for BPH should only occur after a thorough workup and diagnosis by a doctor. There are no proven uses of saw palmetto for women.

There is one case report in which the use of saw palmetto was thought to be the cause of pancreatitis in a middle-aged man, although a cause-effect relationship was not conclusively proven.24

References

1. Di Silverio F, Monti S, Sciarra A, et al. Effects of long-term treatment with Serenoa repens (Permixon®) on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia. Prostate 1998;37:77-83.

2. Strauch G, Perles P, Vergult G, et al. Comparison of finasteride (Proscar®) and Serenoa repens (Permixon®) in the inhibition of 5-alpha reductase in healthy male volunteers. Eur Urol 1994;26:247-52.

3. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia. JAMA 1998;280:160-9.

4. Bach D, Ebeling L. Long-term drug treatment of benign prostatic hyperplasia—results of a prospective 3-year multicenter study using Sabal extract IDS 89. Phytomedicine 1996;3:105-11.

5. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40.

6. Metzker H, Kieser M, Hölscher U. Efficacy of a combined Sabal-Urtica preparation in the treatment of benign prostatic hyperplasia (BPH).Urologe [B] 1996;36:292-300.

7. Sökeland J, Albrecht J. A combination of Sabal and Urtica extracts versus finasteride in BPH (stage I and II according to Alken): a comparison of therapeutic efficacy in a one-year double-blind study. Urologe [A] 1997;36:327-33.

8. Schneider HJ, Honold E, Mashur T. Treatment of benign prostatic hyperplasia. Results of a surveillance study in the practices of urological specialists using a combined plant-base preparation. Fortschr Med 1995;113:37-40.

9. Shi R, Xie Q, Gang X, et al. Effect of saw palmetto soft gel capsule on lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized trial in Shanghai, China. J Urol 2008;179:610-5.

10. Koch E, Biber A. Pharmacological effects of sabal and urtica extracts as a basis for a rational medication of benign prostatic hyperplasia. Urologe 1994;334:90-5.

11. Bach D, Ebeling L. Long-term drug treatment of benign prostatic hyperplasia—results of a prospective 3-year multicenter study using Sabal extract IDS 89. Phytomedicine 1996;3:105-11.

12. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40.

13. Braeckman J, Bruhwyler J, Vandekerckhove K, GĂ©czy J. Efficacy and safety of the extract of Serenoa repens in the treatment of benign prostatic hyperplasia: therapeutic equivalence between twice and once daily dosage forms. Phytotherapy Res 1997;11:558-63.

14. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia. A systematic review. JAMA 1998;280:1604-9.

15. Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. N Engl J Med2006;354:557-66.

16. Barry MJ, Meleth S, Lee JY, et al. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA 2011;306:1344-51

17. Felter HW, Lloyd JU. Kings American Dispensatory, Vol II. Portland, OR: Eclectic Medical Publications, 1983, 1751-2.

18. Breu W, Hagenlocher M, Redl K, et al. [Anti-inflammatory activity of sabal fruit extracts prepared with supercritical carbon dioxide. In vitro antagonists of cyclooxygenase and 5-lipoxygenase metabolism]. Arzneimittelforschung 1992;42:547-51 [in German].

19. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publications, 1996, 167-72.

20. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 201.

21. Cheema P, El-Mefty O, Jazieh AR. Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature. J Intern Med 2001;250:167-9.

22. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40.

23. Bayne CW, Donnelly F, Ross M, Habib FK. Serenoa repens (Permixon): a 5alpha-reductase types I and II inhibitor—new evidence in a coculture model of BPH. Prostate 1999;40:232-41.

24. Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.