Saw palmetto for hair loss

·    Saw palmetto (Serenoa repens or Sabal serrulata) is a dwarf palm plant native to North America. It grows to about two to four feet in height, with fan-shaped leaves and berries. The oil of saw palmetto is medicinally active.

·    Saw palmetto was a popular folk remedy used by Native Americans to treat urinary conditions in men and breast disorders in women.  It primarily grows along the Atlantic coast in Georgia and Florida. The active ingredients are found in the plant's brown-black berries. It contains two types of oils, fatty acids and sterols. It has also been marketed for prostatic (BHP- Benign Hypertrophy of Prostate) and urinary problems besides for the prevention of Hair Loss.

·    Many popular hair loss treatment options today such as Provillus, Procerin, Trochomax Ag and Avacor contain the “active” ingredient saw palmetto.

Mechanism of Action

 Although we still don't know exactly how it works, it's believed that it may block an enzyme (5-alpha-reductase) from allowing the hormone testosterone from being converted to another hormone, dihydrotestosterone. Dihydrotestosterone is considered a key contributing factor to the onset and progression of androgenic alopecia and benign prostatic hyperplasia. There are no well-designed clinical studies showing that saw palmetto can cause hair growth, or stop hair loss or baldness from progressing.

The Dose:

But if there are no current standards on dosages of herbal medications. Clinical studies on Benign Prostrate Hyperplasia (BPH) have used a dosage of 320mg of the berry extract daily (either one 320mg pill or 2 X 160 mg pill).  A daily dosage of 480 mg of saw palmetto berry extract was not found to be any more effective in a six-month study.  If the entire berry was used, up to 1000mg or 2000mg would be required to reach the same goal.

The theory therefore is that if saw palmetto can successfully treat an enlarged prostate similarly to finasteride, it can effectively treat hair loss with a similar dosage.  Many popular “baldness cure” products contain approximately 1500mg of the berry which is equivalent to approximately 240-320mg of the berry extract.  Dosage and how it should be used (orally or topically) therefore is based on conjecture rather that scientific evidence.

  Side effects:   

One false assumption is that “all natural” treatments don’t have potential side effects. 

The most common side effects associated with saw palmetto use are mild digestive distress, including stomach pain, constipation, diarrhea, nausea, vomiting, or bad breath.

There have been rare case reports describing liver inflammation, pancreatitis, jaundice, headache, dizziness, insomnia, depression, breathing difficulties, muscle pain, high blood pressure, chest pain, abnormal heart rhythm, blood clots, and heart disease, but they haven't been clearly caused by saw palmetto.

Some men taking saw palmetto have reported erectile dysfunction, breast tenderness or enlargement, and changes in sexual desire. Although it hasn't been well-demonstrated in humans, saw palmetto may influence levels of sex hormones such as estrogen and testosterone. Until we know more, people with hormone-sensitive conditions, such as breast cancer, should use caution.

At least two case reports have linked saw palmetto with severe bleeding. People with bleeding disorders or who are taking anticoagulant or antiplatelet medications ("blood-thinners") such as warfarin (Coumadin), aspirin, or clopidogrel (Plavix) should avoid taking saw palmetto unless under medical supervision. It should also be avoided at least two weeks before or after surgery.

The safety of saw palmetto for pregnant or nursing women, children, or people with kidney or liver disease hasn't been established.

The most common side effects are gastrointestinal, some of which may be reduced by taking the extract with food. Beta-sitosterol, one chemical present in saw palmetto extract, 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

When using saw palmetto for hair loss one option is using it as an external treatment ( oil extract or ointment) by massaging it into the scalp and hair. This may work because of its  lipophilic nature. This means they are well extracted into the oil base typically used, and are easily absorbed by the skin, therefore providing a more productive treatment.