From the Guidelines
Saw palmetto supplements may cause bleeding complications due to their potential effect on hemostasis, although the evidence is conflicting 1. The side effects of Serenoa repens, commonly known as saw palmetto, can vary and may include:
- Gastrointestinal symptoms such as nausea, vomiting, constipation, and diarrhea
- Hormonal effects, including decreased libido or erectile dysfunction, and potential breast tenderness or enlargement in men due to its impact on DHT levels
- Interactions with certain medications, particularly those affecting hormone levels or blood thinners like warfarin Key considerations for saw palmetto use include:
- Discontinuing the supplement 1 to 2 weeks before surgery to minimize the risk of bleeding complications, as recommended by the American Society of Anesthesiology 1
- Avoiding use in people with hormone-sensitive conditions, those scheduled for surgery, pregnant or breastfeeding women, and children
- Monitoring for potential interactions with other medications, especially blood thinners and oral contraceptives It is essential to note that the evidence on saw palmetto's side effects, particularly regarding bleeding complications, is conflicting, and more research is needed to fully understand its effects 1. However, as a precautionary measure, it is recommended to discontinue saw palmetto supplements before surgery and to consult a healthcare provider if any side effects occur.
From the Research
Side Effects of Serenoa Repens (Saw Palmetto)
The side effects of Serenoa repens (saw palmetto) have been studied in various research papers. Some of the reported side effects include:
- Abdominal pain 2
- Diarrhea 2
- Nausea 2, 3
- Fatigue 2
- Headache 2
- Decreased libido 2
- Rhinitis 2
- Acute pancreatitis 3, 4
Serious Adverse Events
Some studies have reported serious adverse events associated with the use of saw palmetto, including:
Drug Interactions
There is limited evidence on drug interactions with saw palmetto. One study found no evidence for drug interactions with saw palmetto 2.
Safety Assessment
A detailed safety assessment of a saw palmetto extract found no significant differences in the risk of suffering at least one serious adverse event or non-serious symptomatic adverse event compared to a placebo 5. Another study found that saw palmetto at 960 mg may be a safe herbal supplement, but its efficacy in managing lower urinary tract symptoms during radiation therapy needs further investigation 6.