Is Saw Palmetto really safe for your prostate health? This herbal supplement, made from the palmetto berry of the Serenoa repens plant, is often used to manage urinary symptoms and treat benign prostatic hyperplasia (BPH), also known as an enlarged prostate.

It’s a common ingredient in dietary supplements and saw palmetto herbal blends promoted for prostate support, hair loss, and hormone balance. Although natural, saw palmetto can still cause side effects and may interact with certain medications, especially in people with underlying health conditions.

This article explains the safety, benefits, and potential risks of using saw palmetto so you can make an informed decision before adding it to your routine.

Saw Palmetto has gained attention as a natural option for improving prostate health and easing urinary tract symptoms, especially in men with an enlarged prostate. It’s often used in dietary supplements marketed for benign prostatic hyperplasia (BPH), but many people are still unsure how it works or where it comes from.

Saw Palmetto is a type of small palm tree native to the southeastern United States. The active ingredients come from its dark-colored berries, also known as palmetto berries, which are used to make saw palmetto extract. These berries are rich in fatty acids and phytosterols that are believed to support prostate gland function and urinary health.

Many men take palmetto supplements to help manage benign prostatic hyperplasia, also called benign prostate hyperplasia or simply BPH. The herb is found in a variety of herbal supplements, including saw palmetto herbal blends, marketed to support urinary health and reduce symptoms such as frequent or weak urination. It’s also promoted as a natural hair supplement because of its potential to block the hormone linked to hair loss.

Lab studies suggest that saw palmetto may block the enzyme  5-alpha reductase, which helps convert testosterone into dihydrotestosterone (DHT)—a hormone linked to prostate enlargement and hair loss. However, this effect has not been consistently confirmed in human studies. While some research shows potential benefits, more clinical evidence is needed to determine how well this mechanism works. It may help reduce the effects of prostate enlargement and support relief from symptoms like interrupted urination or urgency, though results vary by individual.

Some lab studies suggest that palmetto extracts may affect androgen receptor activity, which refers to how the body’s cells respond to male hormones like testosterone and dihydrotestosterone (DHT). These receptors play a key role in prostate growth and function. By interacting with these receptors, saw palmetto may influence hormone-driven changes in the prostate. 

However, more clinical evidence is needed to confirm this effect in people. While some clinical trials report modest benefits, results are mixed, and further research is needed to fully understand its potential role in easing benign prostatic hyperplasia (BPH) symptoms and reducing prostate cancer risk.

Many people view saw palmetto as a safe, natural option, but like all dietary supplements, it comes with potential side effects and risks. Understanding its safety can help you decide if it’s the right choice for your health.

For most healthy adults, saw palmetto supplements are considered safe when used as directed. They’re widely available in complementary and integrative health products and used globally as part of alternative medicine for prostate health.

Palmetto extract has a long track record in complementary and alternative medicine. In countries like Germany, it is approved for managing benign prostatic hyperplasia (BPH) symptoms under specific regulatory guidelines. The National Institutes of Health notes that Serenoa repens is generally well-tolerated in short-term use, though it’s always best to take it under medical supervision.

Most people tolerate saw palmetto preparation well, but some users may notice mild side effects, especially when starting a new supplement. These effects are usually short-lived and often go away with continued use or after lowering the dose.

Possible side effects may include:

• Mild stomach discomfort or nausea

• Headache or dizziness

• Fatigue or changes in appetite

• Rare cases of digestive upset with palmetto oil-enriched supplements

If any symptoms persist or worsen, it’s a good idea to stop use and speak with your healthcare provider.

While saw palmetto extract is popular for managing benign prostatic hyperplasia (BPH) and urinary symptoms, its long-term safety remains uncertain. Some users may face risks, especially if they are on medications or have hormone-related health conditions. It's important to understand how palmetto supplements may affect your body over time.

Potential risks include:

• Rare case reports of liver damage in people taking saw palmetto, though a direct link has not been established

• Potential drug herb interactions, especially with blood-thinning drugs like aspirin or warfarin

• Changes in blood clotting that may increase bleeding risk during surgery

• Preliminary evidence suggests that saw palmetto may affect growth in hormone-sensitive cells, raising concerns for individuals with prostate cancer or other hormone-related conditions

• Risks for individuals with androgen deficiency or those undergoing hormone replacement therapy

More randomized international study data are needed to confirm the long-term effects of saw palmetto and its safety across different populations.

Saw palmetto may not be suitable for everyone, especially individuals with underlying health conditions or those taking certain medications. It’s important to talk with a healthcare provider before adding it to your routine.

People with hormone-sensitive conditions, such as prostate cancer, should avoid using saw palmetto unless specifically advised by a medical professional. The supplement may also interfere with prostate-specific antigen (PSA) levels, potentially affecting the accuracy of prostate cancer screening tests.

Those preparing for surgery or managing benign prostatic hyperplasia (BPH) alongside other medical conditions may also face increased risk of complications. Medical guidance is recommended in these cases.

Saw palmetto can interact with blood-thinning medications and hormone therapies, which may increase the risk of side effects like bleeding or reduced drug effectiveness.

Men taking prescription drugs, especially for urinary symptoms, cardiovascular issues, or hormone-related treatments, should consult their doctor before using saw palmetto supplements. A healthcare provider can help evaluate potential interactions and recommend safer alternatives if needed.

For those concerned about the long-term risks of relying solely on saw palmetto, a more balanced supplement may be worth considering. Alerna Kidney Health’s Prostate Support offers a daily formula designed to support prostate health from multiple angles.

Many prostate formulas focus only on saw palmetto, but that approach may not be enough and may carry risks for some users. Alerna’s Prostate Support combines Saw Palmetto, Nettle Root, and Pumpkin Seed Extract, each selected for its role in promoting prostate comfort, supporting urinary flow, and reducing inflammation.

Unlike single-ingredient products, this formula offers broader support without increasing the risk of hormone imbalance or unwanted side effects. It's crafted to help you maintain your health over time, using a thoughtful blend of complementary herbs.

Click here to learn more about Alerna's Prostate Support Supplements to enhance your prostate health and overall well-being!

Saw palmetto is widely used for managing prostate symptoms, but its long-term effects are still being studied. Some individuals may experience side effects or drug interactions, especially if they take medications that affect hormones, blood clotting, or liver function.

Before relying on saw palmetto alone, talk to your doctor about whether it’s appropriate for you, particularly if you have other health concerns or are using prescription medications.

For those who prefer a broader and potentially safer strategy, multi-ingredient supplements like Alerna’s Prostate Support offer targeted prostate benefits with added support from other herbs. Choosing a well-formulated, balanced supplement can help reduce risk while still supporting long-term urinary and prostate health.

The information provided in this article is for educational and informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider before starting any new dietary supplement, especially if you are pregnant, nursing, have a medical condition, or are taking other medications. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

1. Azzouni, F., Godoy, A., Li, Y., & Mohler, J. (2012). The 5 alpha-reductase isozyme family: a review of basic biology and their role in human diseases. Advances in urology, 2012, 530121. https://doi.org/10.1155/2012/530121

2. Blair H. A. (2022). Hexanic Extract of Serenoa repens (Permixon®): A Review in Symptomatic Benign Prostatic Hyperplasia. Drugs & aging, 39(3), 235–243. https://doi.org/10.1007/s40266-022-00924-3

3. European Medicines Agency. (n.d.). Sabalis serrulatae fructus - herbal medicinal product. Retrieved from https://www.ema.europa.eu/en/medicines/herbal/sabalis-serrulatae-fructus

4. Ng, M., Leslie, S. W., & Baradhi, K. M. (2024). Benign Prostatic Hyperplasia. In StatPearls. StatPearls Publishing.

5. Suzuki, M., Ito, Y., Fujino, T., Abe, M., Umegaki, K., Onoue, S., Noguchi, H., & Yamada, S. (2009). Pharmacological effects of saw palmetto extract in the lower urinary tract. Acta pharmacologica Sinica, 30(3), 227–281. https://doi.org/10.1038/aps.2009.1