Nutritional Supplement

Saw Palmetto

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

Parts Used & Where Grown

Saw palmetto (sometimes referred to as sabal in Europe) is a native of the southeast United States. The berries of the plant are used medicinally.

How It Works

The liposterolic (fat-soluble) extract of saw palmetto provides concentrated amounts of free fatty acids and sterols. One study with a saw palmetto extract suggests that it reduces the amount of dihydrotestosterone (DHT) (an active form of testosterone) binding in the part of the prostate surrounding the urethra (the tube carrying urine from the bladder).1 Test tube studies also suggest that saw palmetto weakly inhibits the action of 5-alpha-reductase, the enzyme responsible for converting testosterone to DHT.2 In test tubes, saw palmetto also inhibits the actions of growth factors and inflammatory substances that may contribute to benign prostatic hyperplasia (BPH). Contrary to some opinions, saw palmetto does not have an estrogen-like effect in men’s bodies.

Over the last decade, double-blind clinical trials have proven that 320 mg per day of the liposterolic extract of saw palmetto berries is a safe and effective treatment for the symptoms of BPH. A recent review of studies, published in the Journal of the American Medical Association, concluded that saw palmetto extract was as effective as finasteride (Proscar®) in the treatment of BPH.3 The clinical effectiveness of saw palmetto has been shown in trials lasting six months to three years.

A three-year trial in Germany found that taking 160 mg of saw palmetto extract twice daily reduced nighttime urination in 73% of patients and improved urinary flow rates significantly.4 In a double-blind trial, 160 mg of saw palmetto extract taken twice daily was found to treat BPH as effectively as finasteride (Proscar) without side effects, such as loss of libido.5

Saw palmetto extract has also been combined with a nettle root extract to successfully treat BPH. One trial using a combination of saw palmetto extract (320 mg per day) and nettle root extract (240 mg per day) showed positive actions on symptoms of BPH (e.g. improved urine flow, decreased nighttime urination, etc.) over a one-year treatment period.6 Another study compared the same combination to finasteride for one year with positive results.7

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.