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Saw Palmetto (Serenoa repens) is a wonderful herb used globally as medicine. Though modern day herbal repertories typically recommend Saw Palmetto primarily for prostate issues, this berry has many, varied applications. It’s a nurturing friend to the genitourinary systems of all genders, as well as the digestive and respiratory systems. 

Botany & Etymology

Saw Palmetto is a perennial, low-growing, many-branched shrub or tree in the Arecaceae, or ‘Palm,’ family.  Its roots and stem systems run horizontally, parallel to the ground, forming rhizomes. Native to the southeastern U.S., Saw Palmetto prefers to grow on dry, well drained soil in humid, subtropical regions. It’s a common understory species in areas like Pine flatlands and high hammocks of the Everglades. 

Saw Palmetto’s leaves are evergreen and fan-shaped with the sharp spines responsible for its common name, ‘Saw Palmetto.’ The flowers are small, white, insect-pollinated blooms that grow on spiked panicles. Its berries are fleshy drupes that ripen to a bluish black when mature, generally in early autumn. The seeds are animal dispersed since Saw Palmetto fruit is a popular food for most wildlife of its region. In most modern herbal medicine practices, we use the berries medicinally, usually dried. (5)

Traditional Use

Seminole Indians and those indigenous to the land currently known as ‘Florida’ used the Saw Palmetto tree for food and medicine. They also made baskets from the woven leaves specifically for medicinal herb harvesting. 

 Saw Palmetto berries were a remedy for urinary, digestive, and respiratory issues, as well as a tonic for increasing lactation during breastfeeding. Externally, the Seminole used the tree’s inner bark as a treatment for topical infections. (1)

Herbal Actions

Saw Palmetto is warming, moistening, and toning energetically. Also, it is a nutritive or anabolic herb. It has a stimulating, strengthening effect on weak or atrophied tissue. (4)

BPH and Urinary Issues

‘Saw Palmetto’ is  best known for its use in the treating benign prostatic hyperplasia (BPH). BPH, or non cancerous prostate gland enlargement, affects the majority of folks with prostates over 50. This enlargement of the prostate and resulting muscle weakness prevents the bladder from fully emptying of urine. Saw Palmetto works against BPH in a few ways. First, by slowing down the production of an enzyme called 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is an androgen that can contribute to enlargement of the prostate. Furthermore, in countless studies, Saw Palmetto has been proven to work at least as well as Finasteride, a pharmaceutical DHT blocker often prescribed for BPH. (3)

Additionally, Saw Palmetto has an anti-inflammatory effect on the prostate and genitourinary system in general. It also increases the powers of contraction of the bladder, toning the tissue for more complete urine evacuation. Saw Palmetto has diuretic and antiseptic properties, making it an effective remedy for urinary tract infections, bladder prolapse, bladder irritation, and interstitial cystitis/cystitis. Since Saw Palmetto is toning, stimulating, and moistening, it moves fluid and stagnation out of the bladder and reproductive organs without being too drying. Also, Saw Palmetto is toning and restorative to the uterus, pelvic floor, and ovaries. (2,4)

Androgen Balancing

As mentioned above, Saw Palmetto can slow down the production of enzyme 5-alpha reductase, and therefore the androgen ‘DHT.’ Saw Palmetto does this by blocking DHT’s receptor sites, reducing the amount of ‘free’ androgen in the body and blood stream. Aside from BPH, elevated levels of DHT often lead to other undesirable effects like androgenic alopecia or ‘male pattern baldness,’ hirsutism in women and folks with estrogen dominant bodies, acne, and symptomatic PCOS in folks with ovaries. In these cases, Saw Palmetto is often a wonderful remedy for mitigating or ceasing these symptoms altogether. (1,4)

Saw Palmetto can also be helpful for those wishing to transition/affirm their true gender. For folks seeking a shift from a testosterone- to an estrogen-dominant body, with typically ‘female’ secondary sex characteristics, Saw Palmetto may help to facilitate. Because Saw Palmetto blocks excess androgens, it can lead to a reduction of facial hair, slight fat redistribution especially around the breasts, and softer, thinner skin especially on the face. It can be a great stand in for or precursor to estrogen-based Hormone Replacement Therapy (HRT). Interestingly, folks who are currently taking testosterone- based HRT may also benefit from Saw Palmetto supplementation to curb side effects like increased acne and androgenic alopecia. (4)

Respiratory and Digestive Issues

Though Saw Palmetto is not a common modern remedy for respiratory and digestive issues, it is effective in cases of irritation, infection, and inflammation in these two systems. This is because Saw Palmetto works on the mucosal membranes of the body to strengthen, restore, and reduce infection and inflammation. Stagnant or boggy issues with weakened tissue or muscles indicate Saw Palmetto. For respiratory issues, Saw Palmetto works as an expectorant, helping to tone lungs and move phlegm out in cases of overproduced mucus, wet coughs, and laryngitis. (2)

As a digestive tonic, Saw Palmetto helps to tone intestinal tissue, aids in assimilation of nutrition, and facilitates the entire digestive process. Historically, Saw Palmetto was used for issues like dysentery and wasting disease. Today, it can be used for complaints like diarrhea, incomplete digestion, and leaky gut syndrome. (2,4)

Contraindications

Saw Palmetto is safe for most individuals. However, please consult a trusted herbalist, physician, or other qualified care provider before sustained use to be sure this herb fits your specific, personal needs. In addition, avoid use during pregnancy or during advanced stages of renal failure or nephritis. 

Methods of Medicinal Use

For prostate and urinary problems, or for use as an androgen regulator, tincture, I recommend taking a capsule from a reputable brand. A dose of 160 mg is ideal, start with 2 per day AM & PM, and increase after 2 weeks up if necessary. For respiratory or digestive issues, a tincture (5-15 drops 2-3x/day) or the powdered berry (1 tsp to 1 cup water) may be more appropriate. 

Sources

  1. American Botanical Council: Expanded Commission E Monographs “Saw Palmetto berry” https://www.herbalgram.org/resources/expanded-commission-e/saw-palmetto-berry/
  2. Bergner, Paul. “Electic Materia Medica: Saw Palmetto.” https://www.botanical-medicine.org/Botanical-Medicine-Speakers/Bergner-Paul
  3. Gordon, Andrea E. M.D., and Shaughnessy, Allen F. Pharm. D. “Saw Palmetto for Prostate Disorders” https://www.aafp.org/afp/2003/0315/p1281.html 
  4. Midura, Ryn and Swift, Katja. Podcast 158: “Saw Palmetto Doesn’t Discriminate on Gender” https://www.aafp.org/afp/2003/0315/p1281.html 
  5. Van Deelen, Timothy R. “Serenoa repens.” U.S. Department of Agriculture, Forest Service, Rocky Mountain Research. https://www.fs.fed.us/database/feis/plants/shrub/serrep/all.html

Micaela Foley

Micaela Foley is a certified herbalist with an educational background in energetic and clinical herbalism, alchemy, & medical astrology. She completed the clinical practitioner course at Blue Otter School of Herbal Medicine in Northern California and the foundational year program at ArborVitae School of Traditional Herbalism in New York City. Her herbal writings can be found through wellness resources like mindbodygreen, Shape magazine, & The Alchemist’s Kitchen, where she previously managed the herbal program. Currently, she lives and farms in Rhode Island. Micaela's herbal practice is committed to social activism, accessibility, & empowerment through education and mutual aid. She is available for private sessions, clinical work, & as a teacher, writer, and consultant.

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