Current science tells us that the most effective way to stop the progression of hair loss is to block dihydrotestosterone (DHT). This is because DHT binds to receptors in the hair follicles and causes the process of miniaturization to occur (the shortening of the growth phase of the hair cycle that eventually leads to complete baldness).
There are many different treatments available that attempt to block DHT, some that are effective and some that are not.
The most effective options we currently have are the prescription drugs finasteride and dutasteride (although finasteride can be prescribed for hair loss while dutasteride has to be used off-label). The reason both of these drugs are so effective is because they work in a unique way by blocking 5-alpha reductase (5-AR).
5-AR is an enzyme that is primarily responsible for catalyzing the conversion of testosterone into DHT. Therefore, by blocking 5-AR, finasteride and dutasteride stop that conversion from taking place and subsequently are able to help lower the amount of DHT.
Finasteride is currently the more popular option as it is easier to get your hands on and blocks about 75-80% of DHT, although dutasteride has been shown to block 90+%. Either way both are great options in terms of efficacy, but they both also have a side effect profile that may turn a lot of people off from them. The potential side effects include:
-low sex drive
-inability to keep an erection
Although the side effects are rare, many people turn to natural alternatives in order to avoid them. Though there are many options, saw palmetto has made a name for itself as one of the most effective natural alternatives for blocking DHT, but just how effective is it?
In this article we will be discussing what saw palmetto is, how effective it is at blocking DHT, and looking at the research to determine if you can realistically expect similar results to a prescription DHT blocker or not.
What is saw palmetto?
Saw palmetto (Serenoa repens) is a palm that is native to the southeastern United States, and saw palmetto extract, which is taken from the berry of the plant, is what is used in hair loss supplements.
Though it may have several potential medical applications, saw palmetto is primarily studied as a possible treatment for prostate cancer and benign prostatic hyperplasia (BPH). It is these potential benefits that have led people to believe that it may also benefit people suffering from hair loss, here’s why…
How saw palmetto may affect hair loss
So, you're probably wondering what prostate issues and hair loss have in common.
BPH is just a fancy term for an enlarged prostate. The condition develops because DHT helps contribute to the growth of prostate cells, but if DHT production does not taper off with age it can become problematic and cause, you guessed it, an enlarged prostate.
This caused people to jump to the conclusion that since saw palmetto helps with BPH it must be lowering DHT levels.
Let’s take a look at the research.
Research on saw palmetto for hair loss
In order to sufficiently evaluate the research there are two components that need to be taken into account: research on saw palmetto for prostate issues and research on saw palmetto in regards to DHT.
Saw palmetto and the prostate
Does saw palmetto actually have a proven benefit for prostate cancer and/or BPH?
Although there have been several small studies done that suggested saw palmetto may benefit BPH, there was a 2012 review of 32 randomized control studies that involved 5,666 men which showed that saw palmetto, even at 2-3 times the standard dose, had no effect on prostate size.
There have been several other large studies that also showed that saw palmetto had no significant effect on the prostate.
Therefore, in accordance with what many scientists conclude, the evidence showing that saw palmetto is not effective for prostate issues is much stronger than that which shows it is. This is important because it is the basis for many peoples' arguments that saw palmetto can benefit hair loss.
Saw palmetto and DHT
Just like in regards to prostate issues, the research on saw palmetto for DHT and hair loss is extremely limited, although there are a couple of small studies that have been done.
The first study was conducted on 100 participants and tested saw palmetto against finasteride. As expected, about 70% of the participants in the finasteride group showed improvement, while 38% in the saw palmetto group saw improvement.
Another study was conducted on 34 men and 28 women and showed that saw palmetto produced an average increase of 35% in hair density.
While these studies do show promising results there are a few issues that need to be highlighted.
First, the studies are very small. Larger studies would need to be done to confirm the findings.
Second, they are the only studies of the kind, meaning the research on saw palmetto for hair loss is limited and does not strongly support many of the claims made about it.
Lastly, and most importantly, researchers have not confirmed the mechanism behind which saw palmetto improved hair loss. Though some of the characteristics of saw palmetto led scientists to hypothesize that it affects 5-AR like finasteride, they did not make any conclusions and it has not yet been proven, which means that it is not even confirmed that it has any effect on DHT whatsoever.
It is hard to say why saw palmetto has been deemed an effective DHT blocking alternative to finasteride/dutasteride. Not only is the research extremely limited, but the mechanism behind how saw palmetto showed mild improvement for hair in small studies is not even known.
Also, the claims from which people initially drew conclusions about saw palmetto and hair loss stem from its proposed prostate benefits, which, as we now know, have no merit. It fact it has been shown in large scale studies that saw palmetto has no effect on the prostate whatsoever, which, since the prostate is inherently connected to DHT, may suggest that it doesn’t affect DHT either.
All in all, putting all your eggs in one basket with saw palmetto would be essentially like taking a shot in the dark. It is, at best, an extremely weak version of finasteride with little research backing it. There are better natural alternatives out there, don’t fall for cleverly worded false claims made by marketers that just want you to buy their product.