Saw palmetto extract

Saw palmetto extract is an extract of the fruit of the saw palmetto. It is marketed as a dietary supplement that may help with benign prostatic hyperplasia, but there is no clinical evidence that it is effective for this purpose.^[1][2][3][4]

Uses and research

Saw palmetto extract is commonly sold as a dietary supplement intended to improve symptoms of benign prostatic hyperplasia (BPH)—also called prostate gland enlargement—which is a common condition among men as they age.^[1][5] An enlarged prostate may cause increased frequency or urgency of urination, difficulty initiating urination, weak urine stream or a stream that stops and starts, dribbling at the end of urination, and inability to completely empty the bladder.^[5]

Saw palmetto extract has been studied in clinical trials as a possible treatment for men with prostate cancer and for men with lower urinary tract symptoms associated with BPH.^[1][3] As of 2023^[update], there is insufficient scientific evidence that saw palmetto extract is effective for treating cancer or BPH and its symptoms.^[2][3] A 2016 review of clinical studies with a standardized extract of saw palmetto (called Permixon) found that the extract was safe and may be effective for relieving BPH-induced urinary symptoms compared with a placebo.^[6] A 2023 review found that saw palmetto extract "provides little to no benefits for men with lower urinary tract symptoms due to benign prostatic enlargement."^[4]

Folk medicine

Saw palmetto was used in folk medicine to treat coughs or other disorders.^[1]

Precautions and contraindications

Children

The use of saw palmetto extract is not recommended in children under 12 years old because it may affect the metabolism of androgen and estrogen hormones.^[7]

Pregnancy and lactation

Saw palmetto extract should not be used during pregnancy because it may affect androgen and estrogen metabolism.^[3][7] As there is no rationale for using saw palmetto during pregnancy, it should be avoided when pregnant or while breastfeeding.^[3]

PSA test interference

Saw palmetto has been shown to reduce the levels of PSA in the blood, a hormone produced by the prostate and used as a marker by healthcare providers to evaluate the presence of prostate cancer. Taking saw palmetto can artificially reduce the levels of PSA, interfering with test results.^[8]

Interactions

Saw palmetto extract has interactions with other medications.^[3] When used in combination with an anticoagulant or anti-platelet drug, saw palmetto extract can increase the risk of bleeding by enhancing the anticoagulation or anti-platelet effects.^[3] Some examples of anticoagulant and anti-platelet drugs include aspirin, clopidogrel, nonsteroidal anti-inflammatory drugs (NSAIDs), and warfarin.^[3]