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Benefits of Saw Palmetto

Evidence:Moderate
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This content is for informational purposes only and does not constitute medical advice. Statements about dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary — consult your healthcare provider before starting any supplement. Full disclaimer

Evidence-Based Benefits

  • Prostate symptom relief — a 2012 Cochrane review by Tacklind et al. analyzed 32 RCTs and found saw palmetto provided mild-to-moderate improvement in IPSS (International Prostate Symptom Score) and urinary flow rates in men with BPH
  • DHT reduction — saw palmetto inhibits both type I and type II 5-alpha-reductase isoenzymes, reducing conversion of testosterone to DHT in prostate tissue; this mechanism parallels pharmaceutical 5-alpha-reductase inhibitors like finasteride
  • Anti-inflammatory action — the extract reduces inflammatory markers (COX-2, 5-LOX) in prostate tissue, which may contribute to symptom relief beyond DHT inhibition alone
  • Hair loss support — emerging evidence suggests topical and oral saw palmetto may reduce hair shedding in androgenetic alopecia by lowering scalp DHT, though evidence is less robust than for prostate applications

What the Research Says

Saw palmetto is an herbal supplement commonly studied for its effects on men's health and hair loss. A 2012 Cochrane review by Tacklind et al. analyzed 32 randomized controlled trials involving 5,666 men with benign prostatic hyperplasia (BPH), concluding that Serenoa repens was well-tolerated but only produced mild improvements in urinary symptoms compared to placebo. However, some individual studies reported more significant benefits.

Barry et al. (2011) conducted a large NIH-funded trial (CAMUS study) published in JAMA, which found that saw palmetto at doses up to 960mg did not significantly improve lower urinary tract symptoms (LUTS) compared to placebo. This study was criticized for using an ethanolic extract instead of the standard liposterolic form.

Conversely, Ye et al. (2019) published a meta-analysis in Medicine showing that Permixon, a specific liposterolic saw palmetto extract, significantly improved International Prostate Symptom Score (IPSS) scores and was comparable to tamsulosin for managing symptoms of BPH. The conflicting results likely stem from differences in extract quality, standardization, and study populations.

In terms of safety, Agbabiaka et al. (2009) conducted a systematic review of 40 studies involving 24 manufacturers/distributors and found that Serenoa repens monopreparations are generally well-tolerated, with mild adverse events such as abdominal pain and nausea reported, but no serious drug interactions noted.

Overall, saw palmetto's efficacy and safety profile suggest it may offer mild benefits for urinary symptoms and hair health, but further research is needed to clarify its role in these areas.

Related Conditions

Prostate HealthHair Loss
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References

  1. Meta-analysisTacklind J, Macdonald R, Rutks I, Stanke JU, Wilt TJ (2012). Serenoa repens for benign prostatic hyperplasia. Cochrane Database of Systematic Reviews. DOI PubMed
  2. RCTBarry MJ, Meleth S, Lee JY, et al. (2011). Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA. DOI PubMed
  3. Ernst E (2002). The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava.. Annals of internal medicine. DOI PubMed
  4. Meta-analysisWilt TJ, Ishani A, Stark G, MacDonald R, et al. (1998). Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review.. JAMA. DOI PubMed
  5. ReviewAgbabiaka TB, Pittler MH, Wider B, Ernst E (2009). Serenoa repens (saw palmetto): a systematic review of adverse events.. Drug safety. DOI PubMed
  6. Ulbricht C, Basch E, Bent S, Boon H, et al. (2006). Evidence-based systematic review of saw palmetto by the Natural Standard Research Collaboration.. Journal of the Society for Integrative Oncology. DOI PubMed
  7. Kimura M, Ishii I, Baba A, Takara T (2025). Beneficial effects of saw palmetto (Serenoa repens) fruit extract on the urinary symptoms of healthy Japanese adults with possible lower urinary tract symptoms: A randomized, double-blind, placebo-controlled study.. Nutrition and health. DOI PubMed
Show 3 more references
  1. Zhou L, Zhu W, Chen Y (2025). Effects of dietary supplements on androgenetic alopecia: a systematic review and network meta-analysis.. Frontiers in nutrition. DOI PubMed
  2. Yamada S, Shirai M, Ono K, Kageyama S (2022). Beneficial Effects of Saw Palmetto Fruit Extract on Urinary Symptoms in Japanese Female Subjects by a Multicenter, Randomized, Double-Blind, Placebo-Controlled Study.. Nutrients. DOI PubMed
  3. ReviewEvron E, Juhasz M, Babadjouni A, Mesinkovska NA (2020). Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia.. Skin appendage disorders. DOI PubMed