Spotlight on Supplements: Saw Palmetto
Saw palmetto or the American dwarf palm are common names for Serenoa repens, a small palm tree native to the southeastern United States. The first evidence of medicinal uses of saw palmetto berries are traced to the Seminole Tribe of Florida in the early 1700s to treat inflammation. EN takes a closer look at this long-used but still relatively unknown dietary supplement.
Overview: Saw palmetto berries contain more than 100 known compounds including phytoesterols and fatty acids. Extracts are most commonly used in tablets or capsules but can also be found as whole berries, a liquid extract, or as a tea.
Evidence: Saw palmetto is most widely used as a dietary supplement for lower urinary symptoms associated with an enlarged prostate gland or benign prostatic hyperplasia (BPH). Other uses include chronic pelvic pain, migraine, and hair loss. Saw palmetto is thought to be related to relaxation of lower urinary tract smooth muscle, anti-inflammatory effects, and/or alteration of cholesterol metabolism. Though saw palmetto was evaluated in several randomized trials for BPH, its clinical efficacy is not yet clearly demonstrated. A 2012 Cochrane Review concluded that saw palmetto was not better than placebo for many aspects of BPH at standard doses of 320 mg per/day and even up to triple doses. It is not yet considered a replacement for more studied treatments and proper medical consultation.
Safety and Side Effects: Saw palmetto is generally well-tolerated, however, the information on safety is primarily from studies conducted in men. Data is limited on safety and side effects in women and children so it is not recommended for women who are pregnant or breastfeeding. Side effects are often mild and may include digestive symptoms, nausea, dizziness or headache. Saw palmetto also contains tannic acids, which bind to iron and may reduce its usability.
Interactions: Saw palmetto may increase the risk of bleeding or bruising if taken with aspirin or anticoagulants. There is concern it may slow blood clotting and is not recommended prior to surgery. Saw palmetto is also linked to testosterone levels and may decrease estrogen in the body and could interact with oral contraceptives. As with any new diet or supplement regimen, please consult with your physician to discuss if saw palmetto supplementation is appropriate for you.
—Bridget Cassady, PhD, RDN
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