Does saw palmetto really work for prostate symptoms?

The evidence is mixed but leans positive. Earlier European studies showed consistent improvements in urinary symptoms, while some larger U.S. trials found more modest results. The key factor appears to be extract quality — the liposterolic extract standardized to fatty acids and sterols (the type NOW uses) has performed better in studies than generic powder or unstandardized extracts. Most men with mild to moderate BPH symptoms report some improvement after 4-8 weeks.

How does saw palmetto compare to prescription prostate medications?

Prescription drugs like finasteride (Proscar) and tamsulosin (Flomax) are generally more effective than saw palmetto for moderate to severe BPH symptoms. However, saw palmetto has significantly fewer side effects — prescription options can cause sexual dysfunction, dizziness, and other issues. For mild symptoms, saw palmetto may provide sufficient relief without the side effect burden. For moderate to severe symptoms, prescription treatment is typically more appropriate.

Can I take saw palmetto if I already take Flomax or finasteride?

You should not combine saw palmetto with prescription prostate medications without your doctor's approval. Saw palmetto works through some of the same mechanisms as these drugs — particularly 5-alpha reductase inhibition — and combining them could amplify effects unpredictably. If you want to try saw palmetto, discuss it with your urologist, who may suggest a supervised transition rather than stacking.

Will saw palmetto affect my hair loss?

Possibly, though evidence is limited. Saw palmetto mildly inhibits 5-alpha reductase, the same enzyme targeted by finasteride (used in hair loss treatment at lower doses). Some small studies suggest saw palmetto may modestly slow hair thinning, but the effect is much weaker than prescription treatments. It should not be considered a reliable hair loss solution.

NOW Saw Palmetto Extract 320mg: Detailed Review for Adults Over 50

Name: NOW Saw Palmetto Extract 320mg
Brand: NOW Foods
Price: 14 USD
Availability: InStock
Rating: 4.3 (1 reviews)

NOW Saw Palmetto Extract 320mg is the straightforward, affordable starting point for men over 50 looking to support prostate and urinary health. It delivers exactly what most clinical research has tested — 320mg of liposterolic saw palmetto extract standardized to 85-95% fatty acids and sterols — in a single daily softgel. No proprietary blends, no filler ingredients, just the most widely studied prostate supplement at the dose that matters.

What Is Saw Palmetto?

Saw palmetto (Serenoa repens) is a small palm tree native to the southeastern United States. The berry extract has been used for prostate health for well over a century and is one of the most popular supplements for urinary symptoms related to benign prostatic hyperplasia (BPH) — the age-related prostate enlargement that affects the majority of men over 50.

The active compounds in saw palmetto are fatty acids and plant sterols found in the berry’s oil. These compounds appear to inhibit 5-alpha reductase — the enzyme that converts testosterone to DHT, a hormone that drives prostate growth — and may also have direct anti-inflammatory effects on prostate tissue.

NOW Foods uses a liposterolic extract, meaning the active fatty acids and sterols have been concentrated and standardized. This is the extract type used in the clinical trials that showed the most positive results. Generic saw palmetto powder, which contains much lower concentrations of these actives, has performed poorly in research by comparison.

What’s Inside

Each softgel provides:

Saw Palmetto Berry Extract (320mg) — liposterolic extract standardized to 85-95% fatty acids and sterols
Softgel capsule — gelatin-based for optimal absorption of the oil-soluble extract
Extra virgin olive oil — used as a carrier for the extract

The formula is simple by design. No added herbs, no vitamins, no proprietary blends. This makes it easy to evaluate whether saw palmetto alone is helping your symptoms, and easy to combine with other specific supplements (like beta-sitosterol or pygeum) if needed.

What the Research Says

Saw palmetto has been studied extensively, with results that are encouraging but not overwhelming.

A 2002 Cochrane review by Wilt et al. analyzed 21 randomized trials involving 3,139 men and concluded that saw palmetto improved urinary symptom scores and peak urinary flow compared to placebo. The effect size was mild to moderate.

However, a large 2006 U.S. trial (STEP study) published in the New England Journal of Medicine found that 160mg of saw palmetto twice daily (320mg total) did not significantly improve symptoms compared to placebo over one year. This study used a different extract formulation than many of the positive European trials, which has led to ongoing debate about whether extract quality is the key variable.

A 2011 follow-up study (CAMUS) tested escalating doses up to 960mg and also found no significant benefit over placebo.

The honest picture: saw palmetto likely provides modest benefit for mild BPH symptoms, but the effect is not dramatic. Extract quality matters — the standardized liposterolic form (like NOW uses) has shown better results than non-standardized preparations. Men with moderate to severe symptoms may need prescription treatment or a more comprehensive formula.

A 2014 study by Novara et al. published in BMC Urology found that a specific liposterolic saw palmetto extract (Permixon) did improve lower urinary tract symptoms in a large Italian registry study, suggesting that high-quality standardized extracts may perform better than generic versions.

Who Is This Best For?

NOW Saw Palmetto Extract is a particularly good fit if you:

Have mild urinary symptoms — increased bathroom frequency, occasional urgency, or slightly reduced flow
Want a simple, single-ingredient approach — one softgel per day, one ingredient, no complexity
Are just starting prostate supplementation — saw palmetto is the logical first option to try before moving to more complex formulas
Prefer to build your own supplement stack — the single ingredient lets you add beta-sitosterol, pygeum, or other compounds individually based on what works
Want an affordable option — at $14 per bottle, it costs less than half of comprehensive prostate formulas

This is not the best choice if you have moderate to severe BPH symptoms (discuss prescription options with your urologist), want the strongest clinical evidence for urinary improvement (beta-sitosterol has more consistent data), or follow a strict vegetarian diet (these softgels contain gelatin).

How to Take It

Take one 320mg softgel daily with a meal containing some fat. The fatty acids in saw palmetto are fat-soluble, so taking it with food improves absorption.

Give it at least 6-8 weeks of consistent daily use before judging results. Some men notice improvements in nighttime bathroom frequency within 4 weeks, but full effects develop over 2-3 months.

Interactions to watch: Saw palmetto may interact with blood thinners (it has mild anticoagulant properties), hormonal medications, and prescription BPH drugs. It may also affect PSA levels — inform your doctor you take it before any prostate screening.

Always consult your doctor before starting saw palmetto, especially if you have a diagnosed prostate condition or take prescription medications for urinary symptoms.

The Bottom Line

NOW Saw Palmetto Extract 320mg is the reliable, no-frills starting point for prostate supplementation. The evidence is mixed but leans positive for men with mild symptoms, particularly when using a high-quality standardized extract like this one. At $14 per bottle, the financial risk is minimal. If it helps your symptoms, you’ve found an affordable long-term solution. If results are insufficient after 2-3 months, you can step up to a comprehensive formula or discuss prescription options with your doctor.