Saw palmetto

Saw palmetto: what was it used for?

A remedy of the bladder and urethra, and of the prostate. Grieve gives it as diuretic, sedative, and tonic, used for many complaints with chronic catarrh, and records the claim that it could increase “the nutrition of the testicles and mammae in functional atony of these organs”; it probably acted, she thought, by reducing catarrhal irritation and a relaxed condition of the bladder and urethra. LiverTox records that Native Americans used the fruit as food and as a remedy, among other things as a sedative, diuretic, and expectorant and for urinary problems.

Saw palmetto: what does modern science say?

The European Medicines Agency’s herbal committee accepts a hexane soft extract of the fruit on clinical evidence, as ‘well-established use,’ for the symptomatic treatment of benign enlargement of the prostate, and an ethanol soft extract as a traditional herbal medicine, “exclusively based upon long-standing use,” for the lower urinary tract symptoms of the same condition after a doctor has excluded serious conditions (monograph of 2015). Its assessment report finds the fruit rich in fatty acids, free and as esters, with sterols, chiefly beta-sitosterol, and flavonoids. The trials have since turned against it: the Cochrane review of 2023 concluded that saw palmetto alone “provides little to no benefits for men with lower urinary tract symptoms due to benign prostatic enlargement,” on evidence mostly of high or moderate certainty, with more uncertainty about it in combination with other herbs. LiverTox, revised in 2020, likewise notes that short trials suggested benefit, with no effect on prostate size or PSA, while longer studies were less clear.

Saw palmetto: what did the older authorities say?

King’s American Dispensatory (1898)

Parts of the plant served for thatching huts and making mattresses, straw hats, and paper. Animals show a partiality for the fruit “and are said to become fat and sleek when feeding upon the berries.”