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Herb library · Herb · Serenoa repens

Saw Palmetto

A small palm whose berries are sold mostly for urinary symptoms of an enlarged prostate. Many studies, including two NIH-funded trials, lead NCCIH to conclude it is probably not helpful for that purpose.

Traditional use

A small palm native to the West Indies and the southeast coast of North America. Native Americans used the fruit as food and medicine. It became a 19th-century remedy for coughs and for prostate complaints. Today it is sold for urinary symptoms of benign prostatic hyperplasia (BPH), male pattern baldness, and chronic prostatitis.

What studies show

  • Established· shows no benefit

    Enlarged prostate (BPH): a 2023 review of 27 studies found saw palmetto alone gives little or no benefit for urinary symptoms. Two NIH-funded trials, one at up to three times the usual dose, found no improvement, and hexane-extracted products did no better. NCCIH concludes it is probably not helpful.

  • Limited

    Chronic prostatitis and pelvic pain: a 2022 review of five studies found no significant benefit.

  • Insufficient

    Male pattern hair loss: a few small studies, by mouth or on the scalp; too limited for conclusions.

Be careful of

Cautions

  • NoteWell tolerated and used safely in studies for up to 3 years. Side effects are mild and infrequent: digestive symptoms, dizziness, headache.
  • NoteIt does not appear to affect PSA (prostate-specific antigen) test readings, even at higher-than-usual amounts.
  • ConditionLiverTox lists saw palmetto as a possible, rare cause of liver injury; its role in the reported cases is uncertain.
  • PregnancySaw palmetto may be unsafe in pregnancy or while breastfeeding.
  • Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines, are pregnant or breastfeeding, or are giving it to a child.

From the old books

What herbals and dispensaries of the past printed. History, in their words.

“The fruit, though sweet and edible, is not regarded as particularly palatable. It is the medicinal part. Animals show a partiality for it, and are said to become fat and sleek when feeding upon the berries.”
Harvey Wickes Felter and John Uri Lloyd, King's American Dispensatory (1905), vol. 2, p. 1751. See the page of King's American Dispensatory, vol. 2, p. 1751 (opens in a new tab) · Read the full passage from King's American Dispensatory, vol. 2, p. 1751
“At any rate, it has been lauded as the "old man's friend," giving relief from the many annoyances commonly attributed to enlarged prostate.”
Harvey Wickes Felter and John Uri Lloyd, King's American Dispensatory (1905), vol. 2, p. 1751. See the page of King's American Dispensatory, vol. 2, p. 1751 (opens in a new tab) · Read the full passage from King's American Dispensatory, vol. 2, p. 1751

Sources

  1. Saw Palmetto: Usefulness and Safety (opens in a new tab) · NCCIH · read September 25, 2026
  2. Saw Palmetto (LiverTox) (opens in a new tab) · NIH · read September 25, 2026

Reviewed September 25, 2026.