Saw palmetto is increasingly appearing on lists of "natural solutions" for hair loss. It is presented as a herbal alternative to finasteride, without the side effects many men fear. But is this perception accurate?
In this blog, we'll take an honest look at what saw palmetto is, what the research says, and for whom it might be worthwhile to try it.
What is saw palmetto?
Saw palmetto (Serenoa repens) is a palm tree that primarily grows in the southern United States. For centuries, the extract from its berries has been used in traditional medicine, particularly for prostate complaints in older men.
The link to hair loss comes from the same mechanism as finasteride: saw palmetto is believed to inhibit the enzyme 5-alpha reductase. This enzyme converts testosterone into DHT, the hormone that gradually damages hair follicles in cases of hereditary hair loss. Less DHT in the scalp theoretically means less hair loss.
What does the research say?
Frankly, the evidence is limited, but it does exist.
A 2012 study, published in the International Journal of Immunopathology and Pharmacology, compared saw palmetto with finasteride in men with androgenetic alopecia. After two years, 68% of the finasteride group showed improvement in hair density. In the saw palmetto group, this was 38%. So saw palmetto also worked, but slightly less effectively.
A smaller 2002 study in the Journal of Alternative and Complementary Medicine showed an improvement in 60% of participants in the saw palmetto group, compared to 11% in the placebo group. This is a significant difference, although the study was small and its design limited.
What you should take from this: saw palmetto is not a fake ingredient. There is a mechanism and there are studies. But the evidence base is nowhere near as strong as it is for finasteride or minoxidil, and the quality of available studies is relatively lower.
How does it compare to finasteride?
Finasteride is clinically proven effective for androgenetic alopecia. Multiple large, well-designed studies show that it lowers DHT levels in the scalp by about 60 to 70%, and that it stops or partially reverses hair loss in the majority of men.
Saw palmetto also appears to inhibit 5-alpha reductase, but less powerfully and less consistently. The DHT reduction is lower and varies greatly between individuals. Those looking for a similar effect to finasteride, but without medication, are likely to be disappointed.
The reason men turn to saw palmetto is understandable. Finasteride has potential side effects, including sexual complaints such as decreased libido or erectile dysfunction. These occur in a minority of users, but the fear of them is real. That makes the search for alternatives logical.
Are there side effects with saw palmetto?
Saw palmetto is generally well tolerated. The most commonly reported side effects are mild stomach upset, especially when taken on an empty stomach.
There are also reports of an effect on libido with long-term use, although this is less documented than with finasteride. Furthermore, you should be careful if you are taking blood thinners, as saw palmetto can affect blood clotting.
The idea that saw palmetto has no side effects at all is therefore too simplistic. It is mild, but not without risk for everyone.
How to use it?
Most studies showing positive results used dosages of 200 to 320 mg of standardized extract per day. When purchasing, ensure the product is standardized for fatty acids and steroids, as the quality of saw palmetto supplements varies widely. A cheap product without standardization will do little to nothing.
A realistic timeframe is at least 3 to 6 months before you can assess whether it's doing anything. Hair growth is slow, and responses to treatments vary greatly from person to person. Anyone who sees no results after six weeks and then stops has never truly given saw palmetto a chance.
For whom is it useful?
Saw palmetto is a serious consideration if you have hereditary hair loss in its early stages and prefer not to use medication. If your hair loss is still mild, you can try saw palmetto as a conservative first step, with a realistic expectation of: possibly stabilization, rarely regrowth.
It is less suitable if you already have visible bald patches and truly want to do something about it. In that case, saw palmetto is likely too weak to turn the tide.
Saw palmetto as a supplement to a hair growth routine is also an option. It works through a different mechanism than serums that directly stimulate the hair follicle, so they are not mutually exclusive.
Combine with a hair serum
Ingredients like Redensyl and Procapil, found in hair growth serums, work by directly stimulating hair follicle stem cells. This means you can easily use saw palmetto and a hair serum together without them affecting each other's efficacy.
If you want to tackle your hair loss but want to avoid medication, a combination of a hair growth serum and a conscious scalp routine is a logical starting point. Check out the Hairborn Growth Serum if you want to know what's in it and how the active ingredients address your hair follicles.
Summary
Saw palmetto is not nonsense, but it's not a miracle cure either. It has some scientific evidence behind it as a mild DHT inhibitor, but its effectiveness is lower and less predictable than finasteride. It is an option for men who consciously choose a conservative approach, with realistic expectations.
Whatever you choose, timing remains important. The earlier you start with hereditary hair loss, the more follicles can still be saved. Waiting until it's really visible makes any treatment harder.