Hey. C’mere. I got this new herb -- it’s that good stuff. All you need to know is it’s legit. Don’t ask questions. Just give me your money.
Buying hair growth solutions online can feel like a bit of a back alley deal. Once you’re hip to the fact that many folks are peddling the hair loss equivalent of snake oil, it’s difficult to believe anything is legitimate. But you’re a discerning man. When presented with facts and evidence, you can make wise decisions. So, what are the facts and evidence surrounding saw palmetto?
We’ll get into those. But first, understand: you will not currently find a product on the market that can unequivocally cure your baldness. It won’t happen because such a product doesn’t exist. However, there are products that may help. Many of these are backed with scientific evidence suggesting their effectiveness. Your job is to decipher which are backed with the most sound evidence and which are actually worth trying.
In the case of saw palmetto, the findings are more promising than among other supplements. Again, it isn’t a cure, but there is evidence that this herb may offer some hair growth benefits.
What you need to know (the TL/DR short version):
- Saw palmetto is an herb that’s no newb to medicinal applications -- Mayans and Native Americans of the Southeastern U.S. are known to have used it.
- There is research suggesting saw palmetto (either in supplement or topical form) may reduce hair loss and even encourage hair growth.
- It’s believed saw palmetto works in much the same way as finasteride, also known as Propecia.
- The evidence surrounding saw palmetto’s effectiveness is not ground-breaking and though some men have experienced positive results, the scientific community remains unconvinced.
- There are few risks associated with saw palmetto and you’ll want to check with your doctor before taking it alongside Propecia (finasteride). More than likely, the worst that will happen is your stomach will hurt, a symptom lessened when it is taken with food.
What is Saw Palmetto?
In its raw form, saw palmetto is a plant native to the Caribbean and currently found in the southeastern United States. It’s been used for centuries by Native Americans as both a source of food and medicine. Before your eyes glaze over at the thought of us recommending you crush it and rub it on your head, sleep with bundles of it under your pillow, or bath in it -- this is not one of those websites and we are not a new age celebrity spouting junk science for profit.
You can find saw palmetto in capsule and oil forms and there are several legitimate studies linking it to potential benefits.
Saw Palmetto, Your Health, and Your Hair
Saw palmetto may be used to treat several health issues including migraines, bronchitis, low sex drive, inflammation, and diabetes, according to the Mayo Clinic. However, the evidence of its effectiveness in all of these symptoms is mixed. Where saw palmetto shines -- or at least where there is a decent amount of scientific evidence of it shining -- is in the treatment of two conditions: enlarged prostate and hair loss.
When you understand how the herb works, it’s easy to see why it may be helpful in these seemingly unrelated symptoms.
It’s believed that saw palmetto blocks the conversion of testosterone into DHT, or dihydrotestosterone. This is important because DHT is the primary androgen, or sex hormone, in both prostate enlargement and androgenic alopecia.
"DHT, a derivative of the male hormone testosterone, is the enemy of hair follicles on your head," according to the American Hair Loss Association. “Simply put...DHT wants those follicles dead.” It essentially works by shrinking hair follicles, choking hair off from its life source.
The effects of saw palmetto are said to resemble the actions and effects of the drug finasteride, also known by its brand name Propecia. Both are believed to inhibit Type 2 5 alpha reductase, an enzyme needed to convert testosterone to DHT. And like saw palmetto, finasteride is primarily used to treat prostate enlargement and hair loss.
There is not a large body of research on saw palmetto and androgenic alopecia. And of the studies that do exist, none are perfect. However, there are three that are frequently cited as possibly demonstrating positive effects on the plant’s extract in the treatment of hair loss.
- A 1999 study published in the Journal of Alternative and Complementary Medicine found saw palmetto capsules, taken over a five-month period, to "improve" participant's hair loss conditions. Unfortunately, the study had several shortcomings: Only 19 men completed the study, with half given the saw palmetto, and the others a placebo. Also, the results were self-reported. In other words, the men were asked to rate the results of the supplement rather than having the results determined by a doctor or scientist. These factors don’t necessarily undermine the findings completely, but they are worth noting.
- In 2012, scientists compared the effects of saw palmetto with the effects of finasteride. Their work was published in the International Journal of Immunopathology and Pharmacology. Though the researchers indicated finasteride is more effective than saw palmetto in increasing hair growth, both had a positive effect. Over a period of two years, 38% of those taking saw palmetto saw increased hair growth, compared with 68% of those using finasteride.
- A study first published in the Australasian Journal of Dermatology in 2015 suggested positive results could also be found with topical products containing saw palmetto. According to the researchers, hair counts increased after 12 and 24 weeks of using the topical product. One major shortcoming with this study: there was no placebo control, so the scientists could not compare their findings with men given no active ingredient.
Safety, side effects, and precautions
Overall, there are few side effects and safety concerns with the use of saw palmetto. In the Journal of Alternative and Complementary study mentioned above, adverse events were reported in 7 of the study’s subjects. These included acne (reported by just one participant) and gastrointestinal symptoms.
The Mayo Clinic reports that some people could be allergic to the plant. They cite a study involving a supplement containing saw palmetto along with seven other herbs, where 3/70 participants reported allergic reactions. However, because there were several other herbs in the supplement, the reactions can’t be definitively connected to saw palmetto.
The most common side effects reported with the supplement are digestive in nature, and include things like constipation and diarrhea, upset stomach, nausea, indigestion, gas, heartburn, and vomiting. These effects may be mitigated by taking saw palmetto with food.
Perhaps the biggest concern with taking saw palmetto, or any 5 alpha reductase inhibitor, is that it may delay the discovery of prostate cancer. Because these products can treat prostate enlargement, a cancerous prostate may go undiagnosed. Regular prostate screenings are important for all men, but especially those who believe they’re at a heightened risk.
Talk to your doctor before taking saw palmetto alongside finasteride. They operate by the same mechanisms and such dual therapy is unlikely to improve results.
As we previously said, there is evidence that saw palmetto may slow hair loss and encourage hair growth. However, the scientific community remains unconvinced. Scientists are a tough crowd, and rightfully so. Hard "proof" is difficult to come by, no matter what health condition and remedy you’re talking about.
Because saw palmetto and finasteride work in the same manner, men interested in reaping these DHA-suppressing benefits should speak with a doctor. FDA approved medications, like finasteride, are developed under tighter controls than supplements, like saw palmetto. Because quality standards are higher, the prescription option stands a chance at being more effective.
The evidence is there: Some men may experience positive results when taking saw palmetto. The risks are low. Now, should you invest your life earnings in a saw palmetto supplement factory? Probably not. But if you decide to opt for a supplement over prescription drug, investing the time and relatively nominal cost in trying saw palmetto personally could pay off.
This article was reviewed by Brendan Levy, MD.
Important Safety information
IMPORTANT SAFETY INFORMATION
Finasteride is for use by MEN ONLY and should NOT be used by women or children.
Read this Patient Information before you start taking Finasteride and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment.
What is Finasteride?
Finasteride is a prescription medicine used for the treatment of male pattern hair loss (androgenetic alopecia).
It is not known if Finasteride works for a receding hairline on either side of and above your forehead (temporal area).
Finasteride is not for use by women and children.
Who should not take Finasteride?
Do not take Finasteride if you:
- are pregnant or may become pregnant. Finasteride may harm your unborn baby.
- Finasteride tablets are coated and will prevent contact with the medicine during handling, as long as the tablets are not broken or crushed. Females who are pregnant or who may become pregnant should not come in contact with broken or crushed Finasteride tablets.
- If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
are allergic to any of the ingredients in Finasteride. See the end of this leaflet for a complete list of ingredients in Finasteride.
What should I tell my healthcare provider before taking Finasteride? Before taking Finasteride, tell your healthcare provider if you:
have any other medical conditions, including problems with your prostate or liver
Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
How should I take Finasteride?
- Take Finasteride exactly as your healthcare provider tells you to take it.
- You may take Finasteride with or without food.
If you forget to take Finasteride, do not take an extra tablet. Just take the next tablet as usual.
Finasteride will not work faster or better if you take it more than once a day.
What are the possible side effects of Finasteride?
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
There may be an increased risk of a more serious form of prostate cancer in men taking finasteride at 5 times the dose of Finasteride.
The most common side effects of Finasteride include:
- decrease in sex drive
- trouble getting or keeping an erection
a decrease in the amount of semen
The following have been reported in general use with Finasteride:
- breast tenderness and enlargement. Tell your healthcare provider about any changes in your breasts such as lumps, pain or nipple discharge.
- decrease in sex drive that continued after stopping the medication;
- allergic reactions including rash, itching, hives and swelling of the lips, tongue, throat, and face;
- problems with ejaculation that continued after stopping medication;
- testicular pain;
- difficulty in achieving an erection that continued after stopping the medication;
- male infertility and/or poor quality of semen.
in rare cases, male breast cancer.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of Finasteride. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA1088.
How should I store Finasteride?
- Store Finasteride at room temperature between 59˚F to 86˚F (15˚C to 30˚C).
Keep Finasteride in a closed container and keep Finasteride tablets dry (protect from moisture).
Keep Finasteride and all medicines out of the reach of children.
General information about the safe and effective use of Finasteride.
Medicines are sometimes prescribed for purposes other than those listed in this Patient Information. Do not use Finasteride for a condition for which it was not prescribed. Do not give Finasteride to other people, even if they have the same symptoms you have. It may harm them.