Saw palmetto

Serenoa repens

Also: Sabal, Serenoa serrulata, American dwarf palm

WarmingMoisteningTonifying

Tones the prostate and bladder and nourishes depleted pelvic tissue.

A low, clumping fan palm of the southeastern coastal plain, with saw-toothed leaf stalks and dark, oily berries that smell strongly of soap and cheese. Saw palmetto tones and nourishes the prostate, bladder, and reproductive tissue, eases urinary urgency, and blocks 5-alpha-reductase, the enzyme that turns testosterone into DHT.

Energetics: Warming, moistening, toning
Taste: Oily, pungent, sweet, soapy
Family: Arecaceae (palm family)
Parts used: Berries

Medicinal uses 3

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Traditional useLab and mechanism studiesClinical studies

Enlarged prostateTLC
Eases the urgency, frequency, night waking, and weak stream of an enlarged prostate by toning the gland and bladder; in Europe a standardized extract is licensed for these symptoms.
Bladder irritationTLC
Strengthens the bladder's emptying and calms urgency, and acts as a mild urinary antiseptic.
Low libidoTLC
Feeds and restores thin, dry, depleted reproductive tissue, a traditional help for flagging desire in any body.

Preparations

Standardized extract capsules, berry tincture and decoction, and a nettle root pairing for the prostate.

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Cautions

Have prostate symptoms checked by a doctor first, to rule out cancer.
Not for children.
Mild stomach upset is the most common side effect; take it with food.
Its effects alongside gender-affirming hormones are unknown and could complicate a course of hormone therapy; talk with your prescriber before combining them.

Medication interactions

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Pregnancy & breastfeeding

PregnancyAvoid

Saw palmetto blocks the enzyme that makes DHT, the same action as finasteride, a drug that can disturb genital development in a male baby. It is avoided throughout pregnancy.

BreastfeedingAvoid

Its anti-androgen action could affect a nursing baby, especially a boy, so it waits until after weaning.

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Folklore

Long before settlers arrived, the Seminole and other nations of the Southeast ate the berries as food and medicine. In 1696 the shipwrecked Quaker merchant Jonathan Dickinson, starving on the Florida coast, wrote that they tasted like rotten cheese steeped in tobacco juice. By the early 1900s Eclectic physicians prescribed it widely, and it had a place in the US Pharmacopeia. Most of the world's supply is still gathered from wild palms in Florida, where black bears fatten on the same berries each fall.

How to grow

A slow, clumping palm for sandy, acid soil in sun or shade, hardy to about 10°F. Once settled it takes drought, salt spray, and fire, resprouting from trunks that creep along or just under the ground. It grows slowly from seed and resents being moved.

In the wild

Pine flatwoods, coastal dunes, and scrub of the southeastern coastal plain, from South Carolina through Florida and west to Louisiana, where it often carpets the ground under pines. Florida now requires a permit to harvest the berries.

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