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Herb & Supplement Guide: Saw Palmetto

By Cathy Wong, About.com

Updated: June 15, 2007

About.com Health's Disease and Condition content is reviewed by our Medical Review Board

What is Saw Palmetto?

Alternate names: Sabal, Shrub palmetto, Sabal serrulata, Serenoa repens

Saw palmetto (Serenoa repens or Sabal serrulata) is a dwarf palm plant native to North America. It grows to about two to four feet in height, with fan-shaped leaves and berries. The oil of saw palmetto is medicinally active.

Why Do People Use Saw Palmetto?

Saw palmetto is used primarily as a treatment for benign prostatic hyperplasia (BPH). Symptoms of BPH include frequent urination, difficulty starting urination, dribbling after urination, weak urinary stream, and waking up several times at night to urinate.

Safety

The most common side effects associated with saw palmetto use are mild digestive distress, including stomach pain, constipation, diarrhea, nausea, vomiting, or bad breath.

There have been rare case reports describing liver inflammation, pancreatitis, jaundice, headache, dizziness, insomnia, depression, breathing difficulties, muscle pain, high blood pressure, chest pain, abnormal heart rhythm, blood clots, and heart disease, but they haven't been clearly caused by saw palmetto.

Some men taking saw palmetto have reported erectile dysfunction, breast tenderness or enlargement, and changes in sexual desire. Although it hasn't been well-demonstrated in humans, saw palmetto may influence levels of sex hormones such as estrogen and testosterone. Until we know more, people with hormone-sensitive conditions, such as breast cancer, should use caution.

At least two case reports have linked saw palmetto with severe bleeding. People with bleeding disorders or who are taking anticoagulant or antiplatelet medications ("blood-thinners") such as warfarin (Coumadin), aspirin, or clopidogrel (Plavix) should avoid taking saw palmetto unless under medical supervision. It should also be avoided at least two weeks before or after surgery.

The safety of saw palmetto for pregnant or nursing women, children, or people with kidney or liver disease hasn't been established.

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