Saw Palmetto
Other Names: Cabbage Palm, Fan Palm, Sabal, Sabal serrulata, Scrub Palm, Serenoa, Serenoa repens
Should I take it?
Saw palmetto grows extensively in warm coastal areas of southeastern North American, parts of Africa, and southern Europe. The saw palmetto is easily recognized by its long, thin "saw tooth-edged" leaves and by its characteristic bushy shape. Its trunks may reach 10 feet or more in length, but they tend to lie along the ground, making the fruits relatively easy to reach, although harvesting them is complicated by the sharp spikes that line saw palmetto leaves. It is an evergreen with silvery or bluish leaves. In the spring and summer, multiple small white flowers bloom on long stalks, which sprout from the top of the trunk. Its large clusters of olive-sized fruits turn dark blue when they are ripe in late summer and autumn.
Although they are said to taste somewhat like soap, saw palmetto fruits frequently are eaten fresh or made into jam. They also provide food sources for birds and animals native to the areas where they grow. For use in medicine, ripe fruits are collected in the autumn, the seeds are removed, and the fruits are dried. Most saw palmetto fruit comes from plants that grow wild, but saw palmetto may also be cultivated on farms or in large greenhouses where cold winters prevent its growing outdoors.
Dosage and Administration
Dried saw palmetto fruits are marketed widely. Saw palmetto is also available commercially as capsules, tablets, and several liquid dosage forms. Oral saw palmetto products should be standardized to contain 80% or more of the active ingredients, which are fatty acids. Standardization by the manufacturer assures the same amount of active ingredient in every batch of the commercial preparation. Standardization of herbal products is not required by the U.S. Food and Drug Administration (FDA), so not every product will contain the same amounts of active ingredients. Recently, an analysis of 14 brands of saw palmetto revealed that many of the products did not contain the amounts of active ingredients that were indicated on the labels.
Regular dosing of saw palmetto may be needed for up to 6 weeks before symptom relief begins. Some study participants did not notice changes until saw palmetto had been used for 6 months or longer. Typical dosing ranges from 320 mg to 1800 mg of a standardized commercial saw palmetto product daily--in one dose, two doses, or three doses. Alternately, 1000 mg to 2000 mg (one gram to 2 grams) of the dried fruits can be eaten each day. A tea can be made by soaking 500 mg to 1000 mg (0.5 gram to one gram) of the dried fruits in about 5 ounces of boiling water for 5 minutes to 10 minutes and then straining out the fruits before drinking the tea. Some individuals consume the softened fruits after using them to make tea. Saw palmetto tea is usually taken three times a day, but since the active ingredients are not water-soluble, the effectiveness of saw palmetto tea is questionable.
Saw palmetto is often combined with other herbal or nutritional supplements, such as nettle root and Pygeum africanum, that may also have anti-BPH effects. The FDA has warned against the use of specific combination products, however, because some of them may contain an ingredient that could affect bleeding. A healthcare professional should be consulted before self-treatment with any product that contains saw palmetto is started.
Summary
The main use of saw palmetto is to treat the urinary symptoms of benign prostatic hyperplasia (BPH). Saw palmetto has not been proven effective in treating prostate cancer, however, and it does not have any effectiveness for urinary infections.
Risks
Saw palmetto contains plant sterols that have hormonal effects, so children, women who are pregnant or breastfeeding, and women who have hormone-dependent breast cancer should avoid using it.
Side Effects
Rare and unsubstantiated cases of non-viral hepatitis and impotence have been reported in men using saw palmetto, but the exact causes of the side effects are not known. In clinical studies, taking saw palmetto has caused occasional constipation, diarrhea, dizziness, headache, nausea, or upset stomach.
Interactions
If it is taken with drugs or other herbals that have antiplatelet or anticoagulant effects, saw palmetto can lengthen bleeding time. Saw palmetto's hormonal effects may interfere with the effectiveness of oral contraceptives and hormone replacement therapy.
Last Revised August 1, 2008
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Should I take it? 
