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Saw Palmetto (Serenoa repens): Herbal Remedy for Androgenic Alopecia and Telogen Effluvium Hair Loss

Posted By Lydian Shipp | Sep 12, 2022

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Saw palmetto berries are one of the primary therapeutic parts of the Serenoa repens plant currently used in herbal medicine.

What is saw palmetto?

Saw palmetto is a plant extract that comes from the berries of Serenoa repens, a small palm tree that grows in the Southeastern United States. It may also be referred to as American dwarf palm tree, cabbage palm, Sabal, Serenoa serrulata, or Sabal serrulata. The extract of saw palmetto has unique antiandrogenic properties, and consists of fatty acids, phytosterols, beta-carotene (the precursor of vitamin A), polysaccharides, and vitamin E derivatives. 

Uses of Saw Palmetto

Besides being a treatment for hair loss, saw palmetto also has a variety of other uses. In my experience, to begin to truly understand a plant medicine, you have to at least know how it can be used. Knowing the successful applications of a plant can help you understand which organ systems that plant works with and exactly how it works to heal, which can help you determine if that plant is right for you and your particular situation (or not). This is why I’ve included this short list of both traditional and more modern, scientifically proven uses of saw palmetto below: 

  • Seborrheic dermatitis
  • Facial sebum
  • Prostate cancer
  • Benign prostatic hyperplasia / Prostate gland enlargement (specifically lower urinary tract symptoms associated with this condition; in France and Germany, saw palmetto berries are approved by the governments of these countries for the treatment of benign prostatic hyperplasia)
  • Coughs
  • Migraine headaches
  • Low libido
  • Low sperm production
  • Chronic pelvic pain
  • Stomachache
  • Dysentery
  • Diuretic (encourages urine production)
  • Testicular or ovarian atrophy
  • Interstitial cystitis, chronic cystitis, and subacute cystitis 
  • Catarrh/excess mucus in the genitourinary tract
  • Disorders relating to the sex hormones
  • Male and female hormone imbalance
  • Snake bites (tree bark)
  • Insect bites (tree bark)
  • Skin ulcers (tree bark)
  • Indigestion
  • Respiratory infection
  • Impotence
  • Urinary tract infections or disorders
  • Asthma
  • Bronchitis
  • Sore throat
  • Bladder infections or disorders
  • Polycystic ovarian syndrome (PCOS)
  • Estrogen dominance


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How does saw palmetto work for hair regrowth? 

Saw palmetto works closely with testosterone and related hormones and enzymes. This herb is especially important for men’s hormone health as men age, since it helps maintain testosterone levels naturally and prevents prostate enlargement. When men are younger, there is a balance between testosterone and dihydrotestosterone (DHT), a hormone produced from testosterone that triggers prostate growth and development; the presence of testosterone ensures that the prostate doesn’t enlarge excessively beyond a healthy size, if at all. In older age, however, testosterone production decreases, and conversion of testosterone to DHT increases. This not only lowers overall testosterone in the body but also increases the presence of DHT, which in some cases, can lead to prostate problems. 

Saw palmetto significantly inhibits this conversion process by inhibiting the activity of an enzyme known as 5-alpha reductase, as well as by blocking the body’s uptake of DHT and the ability of DHT to bind with androgen receptors. This makes balance between these two hormones attainable for the body, even as a man gets older. By inhibiting the conversion of testosterone to DHT (and the ability of DHT to bind to androgen receptors), saw palmetto can help restore testosterone levels to a more comfortable, normal level, and decrease DHT levels. 

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Men who suffer from hormone-related or age-related hair loss therefore may specifically benefit from using saw palmetto since this plant can help balance the necessary male hormones. In fact, in traditional medicine, saw palmetto has even been called “Old Man’s Best Friend”, suggesting its particular benefit to older men in need of hormonal support. While saw palmetto can be beneficial to women as well, it is especially useful for men. 

Scientific Studies on Saw Palmetto for Hair Regrowth

Below are summaries of various scientific studies that prove saw palmetto’s benefit as an herbal hair loss treatment: 

  • One study observed a 17% increase in hair count after 10 weeks of topical saw palmetto treatment, and a 27% increase after 50 weeks of treatment in a group of 60 male and female subjects with androgenic alopecia. In a different part of the same study, similar results were obtained in a similar timeframe. The control subjects receiving the placebo lotion experienced less positive results, with only a 6% and 14% increase in hair count in comparison. 


  • Another study on a group of 50 male patients with androgenic alopecia noted a 21.4% increase in hair count after 12 weeks of topical saw palmetto lotion treatment, and a 74.1% increase after 24 weeks. The main side effects of the topical treatment were a mild burning sensation, forehead acne, and an itchy scalp. 


  • In a group of 35 female subjects with telogen effluvium hair loss, oral supplementation with 100mg of saw palmetto over the course of 6 months improved scores on the hair pull test, and patients in the test group reported increased hair volume and overall positive improvements in hair and quality of life. 


Both men and women with hair loss benefitted from oral supplementation with saw palmetto extract and topical application of saw palmetto lotion to the scalp. Very few studies demonstrated results where the saw palmetto test group didn’t show any improvements from treatment in comparison with the test group; the vast majority demonstrated notable improvements in regard to hair growth and quality. 

How to Use Saw Palmetto for Hair Regrowth

Saw palmetto is available both for internal as well as external use. Internal supplements are available in capsule form, dried berry form (“loose leaf”), tablets, liquid tinctures, and extracts. External lootions, shampoos, or hair treatments may also be available (keep in mind that many of these are likely to contain other undesirable ingredients, though, so obtaining a saw palmetto tincture or dried saw palmetto berries and then making your own, natural, topical treatment using this and other treatments discussed on this site will likely be preferable). 

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Saw palmetto should be used for at least 8 weeks, if not longer than this (many studies on saw palmetto for hair growth last up to 3 months). The plant may take this long to truly start having a noticeable effect in hair regrowth. 

Follow the dosing guidelines and suggestions below to decide on a saw palmetto protocol that works for you: 

  • Capsulized liposterolic extract consisting of 85-95% fatty acids and sterols - Take internally at a dose of 160mg, twice per day (liquid extracts meeting this description should be taken at an equivalent dose). 
  • Liquid 1:1 extract - Take 1-2ml, twice to three times daily
  • Liquid 1:2 extract - Take 2-4ml, twice daily
  • Dry, normalized 4:1 extract consisting of 25% fatty acids - Take 400mg, twice daily
  • Saw palmetto powder - Take one-third to two-thirds of a gram of powder up to three times per day


Choose only one method of taking saw palmetto at a time to avoid taking too much. If you wish to try using a topical application, ONLY use the topical application. Later, if you want to switch to an oral supplement, stop applying saw palmetto topically and only take the oral supplement. 

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Interestingly, saw palmetto has been shown to be even more effective when taken in combination with selenium supplementation and lycopene (a plant compound related to beta-carotene). Therefore, patients who are using saw palmetto to regrow hair may benefit from taking these supplements at the same time. Selenium may be taken at a dose of 200mcg per day, and lycopene can be taken in doses of 15-45mg per day. 

Contraindications and Side Effects of Saw Palmetto

Saw palmetto has very few side effects and, when used in mature adults, it poses very little risk to health when taken at the appropriate dose (doses of up to 320mg daily have been noted as safe and to produce limited, minor side effects). The most common side effects that have been observed are gastrointestinal in nature, though dizziness has also been reported. 

Some of the individuals who should not use saw palmetto include: 

  • Children under age 12 (this herb has effects on hormones and therefore may negatively affect younger children)
  • Pregnant women (saw palmetto may negatively affect fetal genital development)
  • Breastfeeding women (research is limited, and saw palmetto can pass into breast milk; since the herb should not be taken by children, this may be problematic)
  • People going into surgery, as saw palmetto can increase bleeding risk
  • Individuals taking one of the following medications (this herbal extract can interfere with these medications in various ways, so they should not be combined):
    • Birth control
    • Hormone replacement therapy
    • Anticoagulants and antiplatelet drugs 
    • Finasterida (Proscar)
    • Antiandrogenic drugs
  • People with pancreatitis or with a history of pancreatic health issues
  • People with liver disease
  • Patients with a blood clotting or bleeding disorder 


Saw palmetto use may interfere with iron absorption. Menstruating women in particular should be aware of this since they have higher iron needs than their older female and male counterparts. Taking an iron supplement (in combination with vitamin C to increase iron absorption) is advisable while using saw palmetto to ensure an iron deficiency doesn’t develop. If you suspect that your hair loss may be related to an iron deficiency, start with iron supplements to replenish your iron stores before beginning to use saw palmetto. 

Additional Cures for Hair Loss: The AlivenHealthy Living Database

The AlivenHealthy Living Database of Alternative Medicines and our Living Database of Essential Oils is now available by subscription. Currently our database of alternative medicines with links to scientific research along with our database of essential oil treatments for diseases are available by subscription. Our databases are "alive" and "living" because we add to them daily with new links to scientifically proven cures for diseases, treatments for serious injuries, disorders, mental health problems, and even natural alternatives in terms of insect repellants and sunscreens (for example). It has become more and more difficult to find this information through a search engine so we decided to make these databases available to the public so they can find the documented cures for diseases that we've been studying for years. Also, consider downloading our package that includes The Psoriasis Cure and The Gallbladder as a book bundle to begin working with the core issues underlying hair loss.

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Resources:


Wikipedia (2022). Saw palmetto extract. Retrieved September 12, 2022 from: https://en.wikipedia.org/wiki/Saw_palmetto_extract


Evron, Evyatar, et. al. (2020). Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia. Retrieved September 12, 2022 from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706486/


Mount Sinai (2022). Saw palmetto. Retrieved September 12, 2022 from: https://www.mountsinai.org/health-library/herb/saw-palmetto


NCCIH (2020). Saw Palmetto. Retrieved September 12, 2022 from: https://www.nccih.nih.gov/health/saw-palmetto


American Botanical Council (2022). Saw Palmetto berry. Retrieved September 12, 2022 from: https://www.herbalgram.org/resources/expanded-commission-e/saw-palmetto-berry/


Indigo Herbs (n.d). Saw Palmetto Benefits. Retrieved September 12, 2022 from: https://www.indigo-herbs.co.uk/natural-health-guide/benefits/saw-palmetto


Association for Women’s Medicine (2015). Saw palmetto. Retrieved September 12, 2022 from: https://www.afwomensmed.com/health-library/hw-view.php?DOCHWID=d04415a1


Brighten, Jolene (2022). 10 Best Supplements for PCOS. Retrieved September 12, 2022 from: https://drbrighten.com/supplements-for-pcos/

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