Saw palmetto
Serenoa repens
also known as Sabal, American dwarf palm
Moderate (contested)
Berries from a small palm native to the southeastern United States, traditionally used by Indigenous peoples and 19th-century American physicians for urinary complaints. Saw palmetto is one of the most-used herbs in the world for an enlarged prostate — though the clinical evidence is genuinely mixed. Some quality studies show benefit, others show no difference from placebo.
- May ease the urinary symptoms of an enlarged prostate (BPH) — frequency, urgency, weak stream, incomplete emptying
- Standardized lipid extracts (the form used in research) appear most effective
- May modestly support hair retention in male-pattern hair loss
- Generally well tolerated, with side effects similar to placebo in most studies
- Approved by Germany's Commission E for BPH
- Best understood as part of a larger plan — diet, exercise, and provider monitoring are still important for prostate health
Active in Fatty acids (lauric, myristic, oleic), Phytosterols (beta-sitosterol).
Clinical evidence for BPH is mixed — some good studies show benefit, others show no difference from placebo. Quality of the extract appears to matter
Skip during pregnancy — affects hormone metabolism
Skip during nursing
Mild blood-thinning effect — caution with blood thinners
Stop two weeks before surgery
Use caution with hormone-sensitive conditions and hormonal medications, including oral contraceptives and finasteride
Cannot replace evaluation for BPH symptoms — these can also be the early signs of more serious conditions
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