What is Saw Palmetto?
Saw palmetto, also called Serenoa ripens, is a dwarf palm plant with small berries native to North America. Its name is derived from its saw-toothed leaves.
Native Americans are said to have used it as medicine and food for hundreds of years. Since it was first discovered it has been used to treat a variety of conditions including hair loss, bladder infections, prostate cancer, and decreased sexual drive.
Today the extract is a licensed product in many parts of Europe for treating symptoms associated with benign prostate gland enlargement, otherwise referred to as benign prostatic hyperplasia, or BPH. It’s also widely used in other parts of the world and, in the past, was listed in the United States Pharmacopeia and National Formulary.
As far as saw palmetto for hair loss is concerned, it belongs to a class of treatments commonly referred to as ‘natural’ DHT blockers. Studies demonstrating efficacy of saw palmetto for hair loss are, unfortunately, neither as common nor as well accepted as they are for the treatment of benign prostatic hyperplasia.
We’ll be taking a look at orally ingested saw palmetto for hair loss in this article, as opposed to topical application.
How Does Saw Palmetto Work?
We don’t know exactly how saw palmetto works, however most commentators believe it acts in a similar way to finasteride by blocking an enzyme called 5-alpha-reductase. 5-alpha-reductase is required for the conversion of testosterone into dihydrotestosterone, or DHT.
As you will likely know, DHT is often cited as the main culprit in genetic hair loss, or pattern baldness. DHT contributes to both male (and female) pattern baldness by binding to scalp follicle receptors, causing them to shrink … thus choking off new hair growth and causing existing hair to fall out.
Other theories suggest that saw palmetto works instead by reducing the uptake of DHT at the receptor sites.
Whatever the case, there is agreement that the active ingredients in the saw palmetto berry somehow ‘control’ DHT. There is also no doubt that saw palmetto for hair loss is big business.
How Effective Is Saw Palmetto for Hair Loss?
As I mentioned above, there is a reasonable body of evidence which indicates saw palmetto might be effective in treating benign prostate hyperplasia (BPH). Since DHT is implicated in prostate enlargement, there has been an ongoing temptation to conclude that the saw palmetto berry will be equally effective in treating thinning hair.
Indeed, you will often hear proponents of saw palmetto for hair loss comparing its effectiveness to finasteride (sold under the names Proscar for BPH and Propecia for androgenic alopecia). Finasteride is one of only three FDA-approved hair loss treatments.
The problem is that while there’s numerous well-designed clinical trials supporting finasteride’s efficacy, the same cannot be said of saw palmetto. There are literally a handful (one of which can be found here).
In one small study in 2006, 6 out of 10 participants reported cosmetically significant results. As part of the study, men aged between 23 and 64 with mild to moderate cases of androgenetic alopecia were given a saw palmetto oral supplement of 200 mg to take twice daily for several months. Whilst the researcher concluded that the results justified expansion to larger trials I couldn’t find evidence of any.
Certainly, in each of these studies the sample size, duration and other characteristics of the research do not provide a great deal of confidence in the results.
Some will argue that the lack of effective studies is because pharmaceutical companies can’t patent saw palmetto’s use. I’m not convinced. For one, there have been well over a hundred studies conducted on its treatment of BPH. Why not, then, on saw palmetto for hair loss?
The Mayo Clinic rates saw palmetto for hair loss as a ‘C’. This means there is ‘unclear scientific evidence for this use’ and further research is required before it can be prescribed as an effective treatment for androgenetic alopecia.
Assuming there’s a rationale reason for the lack of studies on saw palmetto for hair loss, however, let’s take a look at the anecdotal evidence.
Anyone who has ever worried about losing his hair and has glanced at the web will have heard of saw palmetto for hair loss. Even products using scientifically proven ingredients such as ketoconazole include it in their formulas (for example the shampoo I use from Salonceuticals).
That said, many of those who recommend saw palmetto for hair loss and /or include it in their products, acknowledge that it is likely a mild to moderate DHT blocker. That is, it’s unlikely to be a primary hair loss treatment for most people. It’s often recommended that people suffering from pattern baldness use saw palmetto in conjunction with other botanicals or supplements which stimulate hair growth.
In actual fact, no matter which treatment protocol you decide to use to combat your hair loss, this is actually very sound advice. Treatment protocols that address both hormonal sensitivity (e.g. anti-androgens such as saw palmetto) and stimulate growth (e.g. minoxidil) are likely to be more effective.
How Long Before I See Results using Saw Palmetto?
Given the view that saw palmetto is a relatively mild anti-androgen it’s not surprising to see many users and commentators recommending prolonged use before visible results are achieved. I’ve read anywhere from between 2 months to 1 year depending on whether prevention of hair loss or regrowth of hair is your goal.
If you use saw palmetto as a complex containing other ‘natural’ DHT blockers or growth stimulants, however, this time could possibly be reduced. Good examples of natural DHT blockers often found with saw palmetto are pygeum africanum, stinging nettle, pumpkin seed and beta sitosterol. For a good round up of natural DHT blockers you can read more here.
Best Suited For
Those suffering from either male or female pattern baldness (androgenetic alopecia).
Saw Palmetto has a special significance for women, for whom finasteride (Propecia) is not prescribed. Propecia can cause birth defects and may impact hormonal balance. In fact, women are advised to not even handle a broken tablet!
Guidelines for Effective Use of Oral Saw Palmetto for Hair Loss
Orally ingested saw palmetto comes in several different forms, including whole dried berries, liquid extracts, tablets and powdered capsules.
In the limited research that’s been conducted on saw palmetto for hair loss in live patients, tablets and capsules are the only forms that have been tested for efficacy. They’re also the easiest to find and can usually be bought from most health stores.
As there is little clinical evidence to support saw palmetto’s effectiveness in treating hair loss, and saw palmetto is not necessarily side-effect free for everyone (see below), I recommend using the guidelines for treating BPH symptoms. In this case a typical dose is 160 mg of saw palmetto extract standardized to 85% to 95% fatty acids and sterols, taken orally twice a day.
That last sentence is important. Different brands contain different amounts of the active ingredients. Make sure the quantity of fatty acids and sterols is standardized to 85% or above.
To avoid nausea I also recommend you take it with food.
It’s worth noting that a recent study in 2013 concluded that it was the liquid form of saw palmetto that had the highest concentrations of both fatty acids and phytosterols. This is in contrast to the studies cited above conducted on balding men which used solid forms.
Cost of Saw Palmetto
Cost is highly dependent on brand and quality. You can buy saw palmetto capsules and tablets from as little as USD $2 per month.
If you’re looking for the high-end of the market, such as Solgar, it can cost up to $17 per month.
Saw Palmetto Side Effects
Like most other herbal supplements, saw palmetto has potential side effects.
It is not recommended for use by children and pregnant or breastfeeding women. It’s also not recommended to take saw palmetto for at least two weeks before a scheduled surgery as it may slow blood clotting.
According to the National Center for Complementary and Integrative Health (a service of the US Department of Health and Human Services): “Saw palmetto is well tolerated by most users. It may cause mild side effects, including digestive symptoms or headache … Saw palmetto has not been shown to interact with medications. Information on the safety of saw palmetto comes primarily from studies in men. Little is known about the safety or side effects of saw palmetto in women or children.”
- Relatively inexpensive, depending on which brand you buy
- It can be used in conjunction with other treatments (with the exceptions noted under references in the side effect section above)
- Provided you take saw palmetto orally (not topical), it’s easy to fit into your existing routine
- Unlike some more powerful anti-androgens, can be used by both men and women
- Likely not a primary hair loss treatment
- Assuming it works for you, you need to keep taking the product for as long as you wish to control your hair loss or regrow hair
My Experience Using Saw Palmetto for Hair Loss
I took saw palmetto capsules and tablets for a significant number of my eight years of hair loss, using the best quality supplements I could find. I took saw palmetto by itself and as a saw palmetto complex which included other natural hair growth and DHT blockers. (I’ll talk about some of these in a future article.)
I’ve said this numerous times in my other articles, but it bears repeating here. My hair loss started at age twenty-eight. I stopped it at age 36. Until that time, although eventually limp and lifeless, I managed to retain enough hair to avoid looking like the quintessential balding man.
Now, at age 45, having found something that worked for me, it would also be very difficult for anyone to know I had lost a lot of hair.
I very much doubt if I could have retained, and now regrown, that much hair if something hadn’t worked along the way. Although I can’t give you proof (as I didn’t isolate this treatment), my strong suspicion is that saw palmetto, and / or other natural DHT blockers, were, at least in part, responsible.
Unfortunately, as with many treatments relating to hair loss, you’ll need to reach your own conclusions. This was mine.
Saw palmetto for hair loss, as a standalone treatment, is likely only mildly effective. That said, you may be able to potentiate results with the addition of other herbs or treatments. I’ll cover that possibility more fully in a future article.
Provided you’re under no illusion that natural equals harmless, and don’t expect rapid results, by all means experiment with saw palmetto as a secondary treatment option. You might be pleasantly surprised.