Saw palmetto (Serenoa repens) is an Arecaceae (palm) family plant whose berries are used widely in herbal medicine.
Saw palmetto is commercially available as dried berries, tincture or standardized capsules of fatty acids and sterols. It is extremely acrid, pungent, and “soapy” so tincture or a decoction of berries is not for the faint of stomach. As tincture, saw palmetto can be taken at a dose of 1-5 ml three times per day. The recommended dose for capsules is 320 mg per day of standardized extract of 85%-95% total fatty acid.
Saw palmetto has been widely studied as a diuretic antiandrogenic and inhibitor of 5-alpha reductase, which converts testosterone to its most potent form, dihydrotestosterone (DHT). As such, saw palmetto has been used by herbalists to address the symptoms of testosterone-mediated conditions, most notably benign prostate hyperplasia (BPH) and androgenic alopecia (sometimes referred to as “male pattern baldness).
In The Modern Herbal Dispensatory by Thomas Easley and Steven Horne, saw palmetto is described not only as a 5-alpha reductase inhibitor and general tonic for urinary problems, but also as a digestive tonic and useful for weight gain in wasting conditions. Saw palmetto has a history of use as an immune tonic as well, specific for a weak, deficient immune system that is subject to frequent infections and irritation of the upper and lower respiratory systems.
I’ve been wondering more and more about saw palmetto for other androgen-mediated conditions. In particular, I wonder about using saw palmetto to address acne vulgaris that is exacerbated by exogenous testosterone use as part of gender-affirming hormone therapy (GAHT). Certainly its use in BPH and androgen-dependent alopecia point to its action as a 5-alpha reductase inhibitor. For that reason, I think saw palmetto could be considered alongside other herbs as part of an internal formula (i.e. tincture or standardized capsule). A 2007 study suggested that saw palmetto fatty acids applied topically to the face in a carrier oil may
also reduce sebum production and thus help reduce acne outbreaks.
Learn more about saw palmetto and other herbs related to GAHT & holistic skin care in my upcoming class: GAHT & Holistic Skin Care on Thursday, May 26th from 5-7 pm CST. Registration is open on my website or by clicking this link.
You can also learn more about exogenous testosterone and acne vulgaris by reading my article in the Journal of the American Herbalist Guild: Volume 19.
For more scientific research about saw palmetto, check out the following publications: