# Saw palmetto (Serenoa repens) *Sabal; *Sabal serrulata* of Grieve; *Serenoa repens* (W. Bartram) Small; in pharmacy *Sabalis serrulatae fructus** **Known today as.** *Serenoa repens*, a small palm of the family Arecaceae with a creeping, branching stem six to ten feet long and bright-green, fan-shaped leaves on spiny-edged stalks. King’s Dispensatory finds it plentiful along the Atlantic shores from Florida to South Carolina, where it forms the ‘palmetto scrub’ of the coast. The drug is the fruit, a one-seeded, blackish-brown drupe half an inch to an inch long, sweet and edible but, King’s says, not particularly palatable; a single panicle may yield six to eight pounds of berries, and the fresh berries have a characteristic cheesy odour. Kind: Plant > **Caution.** Men should see a doctor if their complaints worsen or if fever, spasms, blood in the urine, painful urination, or retention of urine occur. A few cases of suspected interaction with warfarin, with raised INR, have been reported. Abdominal pain and headache are common; nausea, raised liver enzymes, rash, and reversible enlargement of the breasts are uncommon. LiverTox finds it implicated in rare cases of clinically apparent liver injury, its specific role uncertain. ## 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. ## 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. ## Pharmacognosy and toxicology - **fatty acids**: free and as esters, in which the fruit is rich - **beta-sitosterol**: chief of the sterols - **flavonoids**: **Mechanism.** Not established in the sources read for this entry. **Standing.** European Union herbal monograph (2015): well-established use of a hexane extract and traditional use of an ethanol extract for benign prostatic enlargement. A Cochrane review (2023) found little to no benefit. ## 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.” ## Sources - Grieve, M. *A Modern Herbal*, “Saw Palmetto.” As published on botanical.com. - Felter, H. W., & Lloyd, J. U. (1898). *King’s American Dispensatory*, vol. 2, “Serenoa.” Internet Archive, kingsamericandis02kinguoft. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Sabalis serrulatae fructus (Saw Palmetto Fruit)*. EMA/HMPC/280079/2013, 24 November 2015. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Sabalis serrulatae fructus*. EMA/HMPC/137250/2013, 24 November 2015. - Franco JV, et al. (2023). Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement. *The Cochrane database of systematic reviews*. PMID 37345871. - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, “SawPalmetto.” National Institute of Diabetes and Digestive and Kidney Diseases, updated 2020. NCBI Bookshelf. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Sabalis serrulatae fructus (Saw Palmetto Fruit)*. EMA/HMPC/280079/2013, 24 November 2015. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Sabalis serrulatae fructus*. EMA/HMPC/137250/2013, 24 November 2015. - Franco JV, et al. (2023). Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement. *The Cochrane database of systematic reviews*. PMID 37345871. - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, “SawPalmetto.” National Institute of Diabetes and Digestive and Kidney Diseases, updated 2020. NCBI Bookshelf. --- *Saw palmetto.* In *Materia Medica*, edited by B. C. P. Statema. Version 1, revised 2026-10-17. The Thinking Press. https://thethinkingpress.org/materia-medica/saw-palmetto Historical description, not medical advice.