Saw Palmetto for Prostate Health
The best-designed trials found saw palmetto no better than placebo, even at triple the standard dose.
Overview
Verdict
How It Works
Dosing & Protocol
Typical dose
- Recommended dose
- Not recommended
- Expected timeframe
- n/a
Protocol
- form
- Liposterolic Serenoa repens extract standardised to 85-95% fatty acids and sterols; both major negative trials used well-characterised extracts
- duration
- STEP ran 12 months, CAMUS 18 months
- co factor
- Evidence indicates no benefit. Saw palmetto was among the best-selling supplements for prostate symptoms on the strength of earlier small positive trials, but the two large NIH-funded randomised placebo-controlled trials settled the question: STEP found no improvement over placebo in urinary symptom scores or flow rate at 320 mg/day over a year, and CAMUS found no benefit at 320, 640 or 960 mg/day over 18 months. The 2012 Cochrane review of 32 trials in nearly 6,000 men concluded saw palmetto is no better than placebo for lower urinary tract symptoms.
- titration
- CAMUS specifically tested dose escalation to 960 mg/day and found no benefit at any dose
- starting dose
- Not recommended. The STEP trial used 320 mg/day and CAMUS escalated to 640 and 960 mg/day
Evidence
What the studies say
Effect of Increasing Doses of Saw Palmetto Extract on Lower Urinary Tract Symptoms: A Randomized Trial (CAMUS)
Barry MJ, Meleth S, Lee JY +16 more
Saw palmetto extract escalated up to 320 mg three times daily did not reduce lower urinary tract symptoms more than placebo over 72 weeks.
Saw palmetto for benign prostatic hyperplasia
Bent S, Kane C, Shinohara K +4 more
Saw palmetto 160 mg twice daily produced no improvement in urinary symptom scores, peak flow, prostate size or quality of life versus placebo over one year.
Efficacy and safety of a hexanic extract of Serenoa repens (Permixon) for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: systematic review and meta-analysis
Vela-Navarrete R, Alcaraz A, Rodriguez-Antolin A +14 more
The hexanic Serenoa repens extract reduced nocturia and improved peak urinary flow versus placebo.
Safety
Caveats
May affect PSA interpretation. Popularity substantially outruns the evidence.
Less likely to help if
Medical Disclaimer
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