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Saw Palmetto is the sole species currently classified in the genus Serenoa family. It has been known by a number of synonyms, including Sabal serrulatum, under which name it still often appears in alternative medicine. It is a small palm that is endemic to the southeastern United States, most commonly along the Atlantic and Gulf coastal plains, but also as far inland as southern Arkansas.

Saw palmetto is a fan palm with the leaves with a bare petiole terminating in a rounded fan of about 20 leaflets. The petiole is armed with fine, sharp teeth or spines that give the species its common name. The leaves are 1-2 m in length. The leaflets 50-100 cm long. The flowers are yellowish-white, about 5 mm across, produced in dense compound panicles up to 60 cm long. The fruit is a large reddish-black drupe and is an important food source for wildlife.

Saw palmetto blankets forest floor in southern Highlands County, Florida. Native Americans used the fruit for food, but also in the treatment of a variety of urinary and genital problems. The European colonists learned of the use of saw palmetto. It was used as a crude extract for at least 200 years for various conditions including asthenia (weakness), recovery from major illness, and urogenital problems. Eclectic physician H. W. Felter says "Saw palmetto is a nerve sedative, expectorant, and a nutritive tonic, acting kindly upon the digestive tract. Its most direct action appears to be upon the reprodutive organs when undergoing waste of tissue..."

In modern times, much research has been done on extract made from the fruits which are highly enriched with fatty acids and phytosterols. This research has been the subject of a thorough meta-analysis published in the medical journal JAMA and has been shown effective for the treatment of men suffering from enlargement of the prostate.

There are also small, positive clinical trials published on the use of saw palmetto extracts topically and internally for male-pattern baldness. In 2005, a long-term, placebo-controlled trial showed that a combination of saw palmetto fruit and nettle root extracts were effective in treating urinary tract symptoms in older men. However, in February 2006, a large, blinded placebo-controlled study published in the New England Journal of Medicine showed no reduction of symptoms from enlarged prostate by taking saw palmetto, as compared to placebo.

Other research has shown that it works by multiple mechanisms, including inhibiting 5-alpha-reductase, interfering with dihydrotestosterone binding to the androgen receptor, by relaxing smooth muscle tissue similarly to alpha antagonist drugs, and possibly by acting as a phytoestrogen.

Because the fruit is the part used and because a prolific quantity is produced by an adult saw palmetto tree, this herbal medicine is considered ecologically sustainable.

Though in vitro studies suggest saw palmetto has properties that might make it useful against prostate cancer cells or to reduce prostatitis, clinical trials are lacking.

Though men taking saw palmetto may develop mild nausea, reduced libido, or erectile dysfunction, the rate of such problems is clinically and statistically far less common than in men taking drugs to treat BPH symptoms. There are no known drug interactions. Saw Palmetto should generally be avoided in pregnancy and lactation and in small children due to lack of experience and knowledge in these populations and because of the purely theoretical risk of hormonal interference.

While saw palmetto is generally considered safe, one of its primary active ingredients, beta-sitosterol, is chemically similar to cholesterol. High levels of sitosterol concentrations in blood have been correlated with increased severity of heart disease in men who have previously suffered from heart attacks.

Disclaimer - The information presented here should not be interpreted as or substituted for medical advice. Please talk to a qualified professional for more information about saw palmetto.