Last Updated on July 17, 2023 by Robert Price

66%. That’s the percentage of men who start losing hair by the age of 35.

Per the American Hair Loss Association, a shocking 1 in 4 guys begin the balding process before their 21st birthday. They recommend finasteride unequivocally, stating that it’s the best first line of attack against hair loss.

Yet here you are, researching saw palmetto.

So it’s probably safe to say you don’t want to take finasteride if you can help it.

The side effects, while rare, are beyond unappealing.

And if you’re like me, you hate the idea of blocking a hormone over the course of years or decades in order to save your hair.

Is saw palmetto a viable, natural alternative to finasteride?

Sorry. I wouldn’t go that far.

But based on my many hours of researching the studies and evidence, I can tell you that I think it may help slow down the hair loss process to a degree. I’ll explain why shortly.

In this post, I’ll objectively review the four Saw palmetto studies for you in plain English. I’ll also cover the potential side effects and dosage recommendations. Should you decide it’s a treatment you want to try, I’ll review a few of the top-rated products for your consideration.

My aim to provide you with everything you need to know about saw palmetto, in an unbiased manner, so you can decide for yourself whether or not it’s worth a try. Let’s start with basics.

Saw Palmetto for Hair Loss – Introduction

What Is Saw Palmetto?

Saw Palmetto comes from Serenoa repens, a 7-10 foot plant that is prevalent in the Southeastern United States.

How it Works for Hair Loss

Saw Palmetto can lower your DHT levels; DHT is the hormone that effectively causes pattern hair loss in men and women.  Saw palmetto is believed to help slow hair loss and promote hair health from within.

Other Uses

Saw palmetto has also reportedly been used to treat bladder infections, prostate issues, and low libido.

Who It’s For

Both men and women can benefit from saw palmetto. However it’s not recommend for women who are pregnant or nursing. I’ll review the contraindications shortly.

4 Saw Palmetto Studies – Reviewed in Plain English

Saw palmetto hasn’t been researched extensively. But a number of studies, along with significant anecdotal evidence, seem to suggest that it can slow the progression of pattern hair loss to some degree. Moreover, it has been studied — and that alone sets it apart from the majority of natural hair loss remedies. Below is a synopsis of the pertinent trials for you to review or skim — all outlined in plain English. Links to the studies are numbered. Here goes:

1. Journal of Alternative and Complementary Medicine Study

This 2002 study was conducted on 10 male patients, all of whom had mild to moderate pattern hair loss. The study was double-blind and placebo-controlled.  60% of the treated patients showed positive results, and saw an improvement in their symptoms (1).

2. Turkish Journal of Dermatology Study

25 men with androgenic alopecia — male pattern baldness — were evaluated in this 2014 study. They were treated with a hair lotion containing saw palmetto and a 10% trichogen veg complex.  It was conducted over 4 months. At the end of the study, the total hair count among the patients increased by 11.9%.

Additionally, upon evaluating vertex photographs, improvements were noted in 48% of patients. Researchers concluded that the topical saw palmetto and TVC lotion was efficient and safe for the treatment of male pattern baldness (2).

3. Saw Palmetto vs. Finasteride Study

This 40-participant study compared a Saw Palmetto blend with finasteride, AKA Propecia. Researchers evaluated the effect each treatment had on prostatic tissue androgen levels. Patients took the special Saw Palmetto blend three times per day. It contained the following:

• Saw palmetto, 106 mg
• Stinging nettle root extract, 80 mg
• Pumpkin seed extract, 160 mg
• Lemon flavinoid extract, 33 mg
• Vitamin A, 90 mg

They found that the saw palmetto blend reduced DHT levels by 32%. Comparatively, the finsasteride group saw an 80% reduction in their DHT levels (3). So, saw palmetto won’t lower your DHT levels as much as finasteride will, but it may help reduce it and slow down your hair loss.

4. Saw Palmetto vs. Finasteride, Second Study

Interesting results here. This study compared finasteride against serenoa repens (saw palmetto) over a two-year period — that’s longer than any of the other studies I reviewed. It involved 100 men with androgenic alopecia, male pattern baldness. 50 were treated with saw palmetto, the other 50 were prescribed finasteride. Here are a few of the key takeaways.

1. “Only” 38% of patients in the saw palmetto group saw an improvement in hair growth. Only was the term the researchers used. But 38% is significant in my view. That means that after 2 years of treatment, if I’m interpreting the data correctly, that 38% of the patients were better off than they were when they started. That’s a positive outcome in my book. It didn’t specify what percentage of the patients were able to stabilize their hair loss with saw palmetto.
2. 68% of the patients treated with finasteride had positive results. So yeah, 68% is much better than 38%. Point, Propecia.
3. Finasteride treated both frontal and vertex balding to varying degrees, whereas Saw palmetto worked primarily on the crown.

You can review the study abstract here.

The Problem with Most Saw Palmetto Studies 

None of these studies were particularly large. Only one of them — a 10-person study — was placebo controlled. Conflicts of interest weren’t noted. Whether or not the patients involved were on other hair loss treatments also wasn’t disclosed, by and large.

Additionally, many of the Saw Palmetto formulas used in the above studies contained a variety of ingredients, some of which have been shown to help combat hair loss to some extent, like Pumpkin Seed Oil. The studies largely found saw palmetto to show promise as a hair growth formula. But did the other ingredients play a role as well? I can’t say for certain one way or the other.

Recommended by Doctors

If you look like Dr. Phil, or are approaching that stage on the Norwood scale, then Saw Palmetto isn’t going to save your hair, sorry. But if you have mild to moderate hair loss, it could be a beneficial treatment.

Saw palmetto is one of the few natural hair loss treatments that hair loss specialists and restoration surgeons recommend to their patients. It’s also extremely popular with naturalists like Dr. Josh Axe.

A 2015 ISHRS — International Society of Hair Restoration Surgeons — survey showed that 8% of the respondents either always or often recommended saw palmetto to their patients. An additional 10.7% of the respondents prescribed saw palmetto “sometimes” in their respective practices (4).

Doctors are often skeptical of supplements. And saw palmetto hasn’t been studied as a long-term hair loss treatment. So, in my view, the fact that 18+% of the ISHRS respondents prescribed saw palmetto always, often, or sometimes to their patients is significant.

6 Saw Palmetto FAQs

1. What are the side effects of Saw Palmetto?

WebMd states that saw palmetto is likely safe for most people, and that its side effects are typically mild. It is not recommended for children, women who are pregnant, or nursing

Some of the side effects they list include dizziness, headache, nausea, vomiting, constipation, and diarrhea (5). Taking the supplement with a meal may ease some of these effects. Some patients have also reported adverse sexual effects while on saw palmetto (but those effects aren’t generally listed on credible sites like WebMd). There’s also a mysterious phenomenon that is sometimes known as “post saw palmetto” syndrome which I’ll discuss shortly.

Saw palmetto may slow blood clotting. Accordingly, if you’re scheduled for a surgery, you should stop taking saw palmetto two weeks prior to the procedure. And of course, you should check with your doctor before beginning a saw palmetto treatment program.

2. Which is better, Saw Palmetto or Propecia?

It appears that Propecia (or generic finasteride) will lower your DHT levels significantly more than Saw Palmetto. So Propecia will likely treat your hair loss more efficiently. People who don’t want to take Propecia — often due to the risk of sexual side effects — frequently look to Saw Palmetto as a natural alternative. It shows significant potential as a relatively effective, natural remedy for hair loss.

3. Should I take a Saw Palmetto lotion or a capsule?

The capsules seem to be more popular than the lotions. They treat hair loss from within. Many people take other topical hair loss remedies like minoxidil in conjunction with saw palmetto. Some lotions containing saw palmetto, such as revinogen, are also generating favorable reviews.

4. What is the optimal dosage to take? 

320 milligrams is often the recommended starting dosage. Again, you should check with your doctor first. Dr. Andrew Weil, M.D., a prominent physician and naturalist, suggests taking 160 mg, twice daily for hair loss (6), as does Dr. James Duke PhD.

5. Will my sex drive decrease if I take it?

It’s possible but unlikely. Saw palmetto has reportedly been used to treat low libido! It lowers your DHT levels, but DHT alone doesn’t determine how voracious your sex drive is. Hormones are complicated. Aerobic exercise and certain foods can also lower your DHT levels. And neither your diet or your exercise routine is likely to have a tremendous affect on your sex drive.

6. What is post Saw-Palmetto Syndrome? 

This is a controversial subject. Post finasteride syndrome is also a controversial subject, though it does appear that some men have been struck with the devastating affliction marked by long-term sexual dysfunction, among other things. Some speculate and even claim that saw palmetto can have similar consequences. I’ve yet to see any credible, scientific evidence to support these assertions.

And keep in mind that there’s a lot of fear mongering and misinformation being passed around with regard to finasteride. There are legitimate risks with the drug, but people seem almost incapable of discussing the topic rationally. And I’m not some biased shill for the drug companies. I personally wouldn’t use finasteride, at least not without exploring the alternatives first.

Moving back to saw palmetto. It’s a DHT-lowering supplement, not a DHT blocker like finasteride. That’s the big difference. Could saw palmetto really cause the supposed endocrine “crash” that a very small percentage of finasteride users experience? Anything’s possible I suppose. But I’m skeptical, obviously.  I believe the “nocebo” phenomenon is playing a huge role here. Men take finasteride  (or saw palmetto, in some cases) with negative expectations, which are ultimately realized. If you expect to have horrible side effects on any medication or supplement, you likely will.

I debated whether or not this section was worth including. I don’t want to contribute to the hysteria, but you may have heard of the so-called post saw palmetto syndrome, so I figured it was worth discussing. Moving on.

Tips for Using Saw Palmetto Safely

1. Don’t take it if you’re unhealthy – If you’re experiencing any kind of chronic, acute, or lingering medical issue, don’t take Saw Palmetto. At least not without clearing it with your doctor first.
2. Make sure your state of mind is right – People who expect to have side effects have side effects, generally. Go in with an open mind. If you’re experiencing any kind of mental health issue, proceed with extra caution and seek counsel from a professional.
3. Read the back of your bottle and follow the instructions – Obviously. Many skip this step though.
4. Get checked out –  This is really a good idea. Make sure your hormones are functioning normally and at healthy levels. Have your annual physical a little bit early this year. I believe it’s probable that a significant percentage of post-finasteride syndrome sufferers had medical issues they didn’t know about before they started with the drug.

Saw Palmetto Pros

• Affordable – It shouldn’t cost more than a few dollars per month. Very affordable. And hopefully, you’ll get a lot of bang for your buck.
• May Help Slow Your Hair Loss – Real people are seeing tangible results with Saw Palmetto. It’s been studied and some researchers are encouraged by what they’ve seen so far.
• Doctor Approved – This is very significant, by my estimation. The fact that hair loss specialists and hair transplant surgeons recommend saw palmetto to their patients says a lot.
• Natural – No chemicals. Saw Palmetto is definitely NOT brought to you by big pharma.
• Well-Tolerated – It’s generally regarded as a safe and well-tolerated supplement. It’s recommended by both naturalists and physicians.

The Cons

• Not as Effective as Propecia – It won’t lower your DHT levels or slow your hair loss to the extent that Propecia will.
• Probably Won’t Work Alone – You’ll likely want to use Saw Palmetto in combination with other hair loss remedies to maximize your results. More on that shortly.
• Still Unproven to Some Degree – How long will it work? Only time will tell. The long-term effectiveness of Saw Palmetto remains a question.
• May Only Help on the Crown (or Not at all) – The two year study I cited above, comparing Finasteride to Saw Palmetto, noted that finasteride worked on both the crown and frontal hairline, whereas saw palmetto only worked on the crown.

The Hair Loss Community’s Take on Saw Palmetto

The opinion on Saw Palmetto on the hair loss forums, is, from what I’ve gathered, generally negative. Granted, I have not read every thread on the subject!

But, on the threads I’ve read, most users reported little to no regrowth. Some disagree, and the supplement certainly has its advocates as well.

Top Saw Palmetto Supplements

First, a disclaimer: the supplement industry is notoriously unregulated. The quality, consistency, and effectiveness of saw palmetto supplements will vary, widely. So I’d suggest sticking with known and trusted brands. The 160 mg variety of saw palmetto doesn’t seem to be offered by many of the most reputable brands in the industry. But I found a few formulas, made by top brands, that seem to have favorable ratings. They include:

1. Source Naturals Saw Palmetto Extract – Source Naturals is a well-regarded supplement brand that’s been around since the 80s. Their 160 mg saw palmetto supplement looks to be a fairly new offering, but they have a solid reputation, and I’d personally feel comfortable buying this one.
2. Now Foods Saw Palmetto Extract – Now Foods has been a prominent supplement manufacturer since 1968. This product has solid reviews and looks like a good option.
3. Revivogen Scalp Therapy – Formulated by board-certified dermatologist Alex Khadavi, this topical hair regrowth system contains Saw Palmetto Extract, azaelic acid, B vitamins, and a variety of other natural ingredients that can thicken hair. It’s one of the more popular, natural products on the market. Reviews are mixed, but that’s common with most hair loss treatments. I’ve seen quite a few doctors recommend this formula on sites like RealSelf.com.

Supplementary Treatments

Saw palmetto alone is unlikely to stop pattern hair loss. But it can be used with a variety of other treatments to maximize regrowth. Again, you should discuss your plans with your doctor before starting a hair loss treatment program.

Ideally, you should fight hair loss both internally and externally. So if you take saw palmetto orally, then at the very least, you should consider also using a topical hair loss product such as minoxidil.  Doing so could supercharge your regrowth! The saw palmetto would likely lower your DHT levels and combat your hair loss at the source, while the minoxidil would help reinvigorate your thinning hair follicles. Rosemary oil is a natural alternative of sorts to minoxidil.

Laser therapy is another hair loss treatment option worth considering.

Some people go overboard with the supplements! That said, patients have reported favorable results using additional supplements with saw palmetto, like pumpkin seed oil and grape seed oil. A recent study confirmed that pumpkin seed oil shows significant promise as a hair loss remedy; it appears to work similarly to saw palmetto and may have less side effects.

Omega 3’s are also important for your hair health. Fish like salmon and mackerel are great sources of Omega 3 fatty acids, as are nuts and avocados. If you’re not getting enough omega 3’s, you could consider a fish oil supplement. Improving your diet may also help slow down the progression of your hair loss to some extent.

Saw Palmetto for Hair Loss – Closing Thoughts

Saw palmetto appears to be, at the very least, one of the most effective, natural alternatives to Propecia at this time. Even doctors and hair restoration surgeons recommend it to their patients. That says a lot! Saw palmetto by itself won’t stop or reverse your hair loss completely, but it could certainly be a beneficial addition to your treatment program.

It could also do nothing at all to stop your hair loss. The more aggressive your hair loss is, the less likely Saw Palmetto is to work, in my opinion.

But, it’s worth your consideration, at the very least. This concludes my Saw Palmetto review. Please feel free to ask a question, or to share your Saw Palmetto experience in the comment section.

Robert Price

Robert Price is a writer, consumer advocate, and hair loss researcher with thousands of hours of experience in the field. His goal is to keep you out of the hair loss rabbit hole, underworld, or whatever you want to call it. He founded Hair Loss Daily, the unbiased hair loss blog, in 2016. You can learn more about Robert in the my story section of this website.