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Saw palmetto


What is it?

Saw palmetto is a plant. Its ripe fruit is used to make medicine.

Saw palmetto is best known for its use in decreasing symptoms of an enlarged prostate (benign prostatic hypertrophy, BPH). According to many research studies, it is effective for this use.

Saw palmetto is used for treating certain types of prostate infections. It is also sometimes used, in combination with other herbs, to treat prostate cancer.

Some people use saw palmetto for colds and coughs, sore throat, asthma, chronic bronchitis, chronic pelvic pain syndrome, and migraine headache. It is also used to increase urine flow (as a diuretic), to promote relaxation (as a sedative), and to enhance sexual drive (as an aphrodisiac).

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for SAW PALMETTO are as follows:

Possibly ineffective for...

  • Enlarged prostate (benign prostatic hyperplasia; BPH). There is conflicting and contradictory research about the benefits of saw palmetto for prostate symptoms. Some research has shown that saw palmetto might modestly improve symptoms such as going to the bathroom at night in some men. But higher quality and more reliable research seems to indicate that saw palmetto has little or no benefit for reducing these symptoms. Any benefit is modest at best.

Insufficient evidence to rate effectiveness for...

  • Treating prostate infections and chronic pelvic pain syndrome. Saw palmetto doesn’t seem to help prostate infections or chronic pelvic pain syndrome.
  • Prostate cancer. Research studies to date have found that taking saw palmetto doesn’t seem to prevent prostate cancer.
  • Baldness. Some men report that using saw palmetto with beta-sitosterol makes them grow more and better hair.
  • Colds and coughs.
  • Sore throat.
  • Asthma.
  • Chronic bronchitis.
  • Migraine headache.
  • Increasing breast size.
  • Reducing bleeding after prostate surgery.
  • Other conditions.
More evidence is needed to rate the effectiveness of saw palmetto for these uses.

How does it work?

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Saw palmetto doesn’t shrink the overall size of the prostate, but it seems to shrink the inner lining that puts pressure on the tubes that carry urine.

Are there safety concerns?

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Saw palmetto is LIKELY SAFE for most people. Side effects are usually mild. Some people have reported dizziness, headache, nausea, vomiting, constipation, and diarrhea. Some people have reported that saw palmetto causes impotence. But these side effects do not seem to occur any more often with saw palmetto than with a sugar pill.

There is some concern that saw palmetto might cause liver or pancreas problems in some people. There have been two reports of liver damage and one report of pancreas damage in people who took saw palmetto. But there is not enough information to know if saw palmetto was the actual cause of these side effects.

Special precautions & warnings:

Pregnancy and breast-feeding: Saw palmetto is LIKELY UNSAFE when used during pregnancy or breast-feeding. It acts like a hormone, and this could be dangerous to the pregnancy. Don’t use during pregnancy or breast-feeding.

Surgery: Saw palmetto might slow blood clotting. There is some concern that it might cause extra bleeding during and after surgery. Stop using saw palmetto at least 2 weeks before a scheduled surgery.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Birth control pills (Contraceptive drugs)
Some birth control pills contain estrogen. Saw palmetto might decrease the effects of estrogen in the body. Taking saw palmetto along with birth control pills might decrease the effectiveness of birth control pills. If you take birth control pills along with saw palmetto, use an additional form of birth control such as a condom.

Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.

Estrogens
Saw palmetto seems to decrease estrogen levels in the body. Taking saw palmetto along with estrogen pills might decrease the effectiveness of estrogen pills.

Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Saw palmetto might slow blood clotting. Taking saw palmetto along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

Are there interactions with herbs and supplements?

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Herbs and supplements that might slow blood clotting
Using saw palmetto with other herbs that can slow blood clotting might increase the risk of bleeding in some people. These other herbs include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, red clover, turmeric, vitamin E, willow, and others.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For benign prostatic hyperplasia (BPH): 160 mg twice daily or 320 mg once daily.
  • For the treatment of bald spots: 200 mg twice daily combined with beta-sitosterol 50 mg twice daily.

Other names

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American Dwarf Palm Tree, Baies du Chou Palmiste, Baies du Palmier Scie, Cabbage Palm, Chou Palmiste, Ju-Zhong, Palma Enana Americana, Palmier de Floride, Palmier Nain, Palmier Nain Américain, Palmier Scie, Sabal, Sabal Fructus, Sabal serrulata, Saw Palmetto Berry, Serenoa repens, Serenoa serrulata.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Saw palmetto page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/971.html.

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  79. Neff, K. D., Sandoval, H. P., Fernandez de Castro, L. E., Nowacki, A. S., Vroman, D. T., and Solomon, K. D. Factors associated with intraoperative floppy iris syndrome. Ophthalmology 2009;116:658-663. View abstract.
  80. Cai, T., Mazzoli, S., Bechi, A., Addonisio, P., Mondaini, N., Pagliai, R. C., and Bartoletti, R. Serenoa repens associated with Urtica dioica (ProstaMEV) and curcumin and quercitin (FlogMEV) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomised study. Int.J Antimicrob.Agents 2009;33:549-553. View abstract.
  81. Carballido, J., Ruiz-Cerda, J. L., Unda, M., Baena, V., Campoy, P., Manasanch, J., and Slof, J. [Economic evaluation of medical treatment of benign prostatic hyperplasia (BPH) in the specialised care setting in Spain. Application to the cost-effectiveness of two drugs frequently used in its treatment]. Actas Urol.Esp. 2008;32:916-925. View abstract.
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