The Ultimate Guide to Saw Palmetto for Hair Loss
Saw palmetto is (maybe) the world’s most popular hair loss supplement. It comes from the Serenoa repens fruit, and studies show that it can lower levels of DHT – the same hormone implicated in pattern hair loss, and the same hormone that finasteride (Propecia®) reduces to improve hair loss.
This is why so many people refer to saw palmetto as nature’s finasteride…
But is this extract actually effective? Is it safe long-term? Is topical or supplemental saw palmetto better? Is it a substitute for finasteride? Will mega-dosing improve hair regrowth? What are the best extraction methods? And is it worth its costs in hair recovery?
This ultimate guide gives you the answers.
Spoiler alert: saw palmetto isn’t nature’s finasteride… but it’s not completely useless, either. And before you invest $300+ per year in this supplement, you’ll want to uncover how to make the extract as effective as possible.
Saw Palmetto: Highlights
- Effort. Low (requires daily supplementation or application)
- Expectations. Hair loss improvements observed between 6-24 months
- Response rate: 38-60%, depending on dose and delivery (supplement or topical)
- Regrowth rate: 0-10%; potentially higher if used alongside other therapies
- Cost. $30/month
- Problems. Results contingent upon lifelong use; lacking product standardization leads to differences in clinical versus real-world results
Key takeaways
- Saw palmetto may improve hair loss, but the evidence is mixed and generally of low quality. Since there are no best practices for saw palmetto manufacturing or extraction, some brands lower DHT substantially more than others.
- Saw palmetto is not as effective as finasteride – even if you mega-dose it. However, it probably slows down hair loss for most people, and it may improve crown thinning in 38% of men.
- Saw palmetto can enhance the power of other hair loss remedies, and it may be more effective if taken simultaneously as both a supplement and a topical.
- Most studies show that saw palmetto is safe long-term. However, there’s lacking data on women (especially pregnant or breastfeeding mothers).
Saw palmetto: how it became a hair loss supplement
Saw palmetto is a palm plant native to the Southeastern United States. It grows up to 10 feet tall and can live over 700 years.
Thirty years ago, researchers found that saw palmetto reduces the activity of 5-alpha reductase – the enzyme our bodies use to make the hormone dihydrotestosterone (DHT). DHT is a hormone involved in a condition called prostatic hypertrophy (i.e., an enlarged prostate). To oversimplify a complex condition: the more DHT in our prostate, the larger our prostate grows, the more problems we experience with urination.
Encouragingly, early research showed that supplementing with saw palmetto could lower DHT levels enough to reduce prostate size. Resultantly, scientists began to wonder if saw palmetto might also treat other conditions linked to DHT… like pattern hair loss (i.e., androgenic alopecia).
Pattern hair loss & DHT: the evidence
Pattern hair loss is one of the world’s most common hair loss disorders. It’s so common that you often can’t walk a city block without spotting someone with it. In men, it usually starts as hairline recession or a bald spot. In women, it often begins as general thinning throughout the top part of the scalp.
Male pattern hair loss (AGA)
Just like prostatic hypertrophy, studies also show that DHT is causally linked to pattern hair loss (i.e., androgenic alopecia).
- Balding scalps have higher levels of DHT
- Men who can’t produce DHT don’t go bald
- Men with pattern hair loss who get castrated (and see a 95% loss in DHT) will stop balding
Moreover, we know that reducing DHT improves hair loss. For instance, the drug finasteride (Propecia®) reduces DHT levels by 50-70%+. Consequently, it stops hair loss in 80% of men and leads to a 10% increase in hair count over a two-year period.
DHT: the hormone involved in pattern hair loss
If finasteride were the perfect hair loss solution, everyone (including me) would take it. Unfortunately, it’s not. As with most drugs, finasteride can come with side effects.
For instance, finasteride is a synthetic azosteroid. It reduces DHT by competing with (and binding to) a coenzyme that our bodies use to make type II 5-alpha reductase – the enzyme that converts free testosterone into DHT.
This can have unintended consequences. Depending on which study you cite, between 1% and 25% of finasteride users will report issues ranging from brain fog to depression to sexual dysfunction.
This is why so many men feel like finasteride forces them to choose between their hair or their sex life. Which begs the question…
Would a natural DHT reducer, like saw palmetto, help fight hair loss but with fewer side effects?
It’s possible. It all has to do with where (and how) a substance reduces DHT.
DHT is a hormone found nearly everywhere in our bodies: our blood, prostates, scalps, brains, etc. But not all DHT is linked to hair loss. For instance, elevated blood DHT doesn’t cause hair loss. In fact, it’s really just elevated scalp DHT that’s linked to thinning hair.
Long-story short: it’s not in our best interest to reduce DHT everywhere. We don’t want to lower DHT in places where it’s helping to promote health. We only want to lower DHT where it’s producing a negative effect (like our prostates or scalps).
Saw palmetto is a selective DHT reducer. It doesn’t reduce DHT everywhere.
While finasteride lowers DHT almost everywhere, saw palmetto doesn’t.
For instance, saw palmetto doesn’t lower blood DHT, but it does lower prostate DHT. It also lowers DHT wherever it’s applied topically.
And, while we don’t yet have the studies to prove it, clinical trials suggest that saw palmetto also lowers scalp tissue DHT (more on this soon).
The reasons why are a bit complicated and out-of-scope for this article. But the high level overview is that (1) we can reduce DHT in many ways, (2) saw palmetto reduces DHT differently than finasteride, and (3) saw palmetto reduces DHT by…
- Competitively and non-competitively inhibiting type II 5-alpha reductase
- Reducing DHT binding to androgen receptor sites by up to 50%
- Increasing the conversion of DHT to a weaker metabolite called androstanediol
Subsequently, the supplement seems to cause fewer side effects.
In fact, saw palmetto’s overall rate of side effects is just 2%. If side effects do occur, they’re relegated more so to gastrointestinal distress than to sexual dysfunction. And even better, many studies on saw palmetto show no change in libido; some studies show improvement to sexual health (at least for men with enlarged prostates).
Obviously, this tees up saw palmetto to be a potential hair loss miracle…
But is it actually effective?
Maybe, maybe not. The answer really depends on how we use saw palmetto, what we combine it with, and if we have access to saw palmetto made from high-quality harvesting and extraction methods.
Saw palmetto: clinical studies
While saw palmetto is well-studied in the prostate, there are only a handful of studies measuring its effects on androgenic alopecia (pattern hair loss).
We’ll dive into each study and organize them by oral consumption (i.e. a supplement) or topical application (i.e., a lotion). As we’ll soon realize, it’s hard to separate out saw palmetto’s effects from other ingredients. It’s even harder to find a general consensus on whether this extract is actually a viable hair loss remedy.
Oral (supplement)
Saw palmetto + beta-sitosterol and other ingredients
A 2002 study tested 200mg daily of saw palmetto on 10 men with androgenic alopecia. After 5 months, researchers reported that 60% of men experienced some degree of hair regrowth – compared to just 11% in the 9-man control group.
That’s good! And even better: none of the men reported side effects. But there’s a catch (actually, two):
- This study combined saw palmetto with several other ingredients: beta-sitosterol (50mg), lecithin (50 mg), inositol (100 mg), phosphatidyl choline (25 mg), niacin (15 mg), and biotin (100 mg). So, we don’t know how much of the results to attribute to saw palmetto… and how much to attribute to other ingredients.
- This study only included 19 men – 9 of whom took a placebo pill. With just 10 men trying saw palmetto, these results aren’t statistically significant.
The researchers knew this. They even stated that statistical significance was not the goal of the study, and rather, that they just wanted to show that saw palmetto could do something before moving onto larger trials.
Fast-forward another decade: we now have these larger trials. But are they any more impressive?
Saw palmetto versus finasteride
In 2012, researchers published what is (probably) the best study so far on saw palmetto for androgenic alopecia: a comparison of that supplement versus finasteride.
The team randomized 100 men with androgenic alopecia into two groups. They gave one group 320mg of saw palmetto and the other group 1mg of finasteride – every day, for two years.
The results? After 24 months, 68% of finasteride users saw hair regrowth… compared to just 38% of men taking saw palmetto.
Moreover, investigators noted that for saw palmetto, regrowth only occurred in the crown… and that the magnitude of regrowth was less impressive versus finasteride.
The takeaway? That saw palmetto achieves half the response rate of finasteride, and that if regrowth does occur, it’s relegated to the vertex and isn’t as significant versus finasteride.
How come saw palmetto doesn’t lead to the same regrowth as finasteride?
Because saw palmetto doesn’t lower DHT by as much as finasteride. So, as a trade-off to experiencing fewer side effects, we also see less hair regrowth.
Just see this chart comparing saw palmetto, finasteride, and their ability to lower DHT in the blood, prostate, and scalp.
Remember: when it comes to pattern hair loss, scalp DHT is all that matters. Unfortunately, we don’t yet have data on saw palmetto’s ability to reduce scalp DHT.
Yes, prostate DHT levels are a close surrogate (since prostate tissues also rely on the same enzyme for DHT conversion: type II 5 alpha reductase). So technically, we might be able to apply prostate reduction rates to our scalps.
But the bottom line is that saw palmetto just isn’t as powerful as finasteride.
What if we mega-dose on saw palmetto? Will we reduce more DHT and thereby regrow more hair?
Not necessarily. This is because as we ingest more of a medication, we don’t always increase its effects.
Take finasteride as a perfect example. It has a logarithmic response curve. As we increase our dose of finasteride, we quickly plateau to reducing DHT by ~70% regardless of whether we take 1mg or 5mg of the drug.
Does saw palmetto have the same effect? We don’t yet know (there aren’t any studies). However, mega-dosing on saw palmetto probably won’t do much more than regular-dosing. Here’s why.
- Evidence shows that taking two- to three-fold more saw palmetto doesn’t improve enlarged prostate symptoms any more than the recommended dose (320mg).
- Saw palmetto seems to have a high safety profile – even over five years, and even at two- to three-fold larger dosages. Similar to marginal diminishing returns on efficacy, we see little to no increase in side effects as the dose increases.
- There is at least one anecdote of someone mega-dosing saw palmetto after quitting finasteride and reporting zero improvements to their hair.
To me, this suggests saw palmetto’s response curve is logarithmic, that a 320mg dose will likely help as much as a 1000mg dose, and that there’s no use in mega-dosing to try to lower DHT further.
Does this mean saw palmetto is totally useless?
Not at all. It might be helpful if used correctly.
For starters, let’s revisit that study on saw palmetto versus finasteride over a two-year period. According to the investigators, only 38% of saw palmetto users saw improvement. But here’s what gets missed in the abstract…
Of those saw palmetto users, 45/50 men saw a stop in hair loss. In fact, that number was the same in the finasteride group (45/50). In other words, saw palmetto stopped the progression of hair loss in 90% of men. And even better, the saw palmetto group also reported zero side effects.
That’s a huge win for hair loss sufferers. Just think about it: a natural extract that stops hair loss for 90% of people and without side effects. It’s like a hair loss holy grail.
But don’t get too excited. We have to caveat these findings.
Whenever we see favorable results like this, we have to think about clinical versus real-world outcomes. Yes, these findings are exciting. But do 90% of men taking saw palmetto report the same findings in real life? And if not, why not?
The anecdotes might surprise you.
Saw palmetto: clinical trial results = amazing; real-world results = not so impressive
If study results were always consistent with real-life experiences, I would recommend things like pumpkin seed oil and saw palmetto to every hair loss sufferer out there.
Unfortunately, we can’t always assume that clinical results will match real-world experiences. In particular, we should exercise caution on the 2012 saw palmetto study, and for four reasons:
- Despite a sample size of 100 men, there are zero before-after photos. This is unusual, especially as the study used photos to assess subjects’ hair changes.
- Several people have tried reaching out to the authors for follow-up. To my knowledge, none have received a response. This is unusual, as most authors love discussing their research. For reference, I’ve only come across this situation under a few circumstances – all of which involved studies that were flawed or poorly designed.
- I’m aware of at least one clinical trial on supplemental saw palmetto that was never published – probably due to unfavorable results. (Burying unfavorable results is a huge problem in research, but that’s for another post.)
- Anecdotally, a lot of readers here have reported trying saw palmetto without success, and with side effects. As such, a 90% response rate feels completely unrealistic… as does a 0% incidence of sexual side effects or dysfunction.
But again, we can’t dismiss this study’s results entirely. Here’s why.
There’s evidence (here and here) that, in vitro (i.e., in cell cultures), certain saw palmetto extracts reduce DHT levels as well (or better) than finasteride. The different potencies actually depend on saw palmetto’s harvesting techniques and extraction methods.
Think of it this way: finasteride is a tightly regulated drug. It has to be pure; it has to look molecularly identical every time it’s produced. Saw palmetto is a supplement. It isn’t regulated; it comes from different farms; it’s sold in powdered forms and liquid extracts; its varying extraction methods produce varying lipid profiles – each with different properties, different effects.
This is why saw palmetto’s composition and its ability to reduce DHT varies wildly depending on the brand you buy. You can even experience different magnitudes of DHT reduction from the same brand ordered a month apart (i.e., different batch numbers). That’s how inconsistent the product is.
This is the argument that researchers make to explain the mixed results on saw palmetto’s ability to improve benign prostate hyperplasia. Some studies say it helps; others say it doesn’t. But without any standardization, these studies are just apples-to-oranges comparisons.
Extrapolating to every day hair loss sufferers, this is likely why people taking saw palmetto rarely report zero results. They’re likely buying a product is impure, poorly harvested, and/or improperly extracted.
But as a thought exercise, let’s take the positive studies at face-value and assume that saw palmetto can stop hair loss in 90% of men (if we’re getting the good stuff). Does this mean that if we combine saw palmetto with other hair-promoting ingredients, we can move from a “stop” in hair loss to a “reversal” in hair loss – and for the majority of people?
While the evidence is limited, three studies suggest yes. And they’re all on topical saw palmetto.
Topical (lotion)
Saw palmetto improves hair regrowth in a cystine, castor oil, gingko biloba, and azelaic acid topical
This research team added saw palmetto to a topical containing cystine, castor oil, gingko biloba, and azelaic acid. The results after 50 weeks: men and women using the topical with saw palmetto saw twice the hair gains versus the ones without saw palmetto.
In other words, saw palmetto doubled the efficacy of that topical.
Saw palmetto improves hair regrowth in a ginseng, calcium, zinc, niacinamide, glucosamine, and biotin topical
This Turkish team found that over four months, a topical containing saw palmetto and a proprietary blend of ginseng, calcium, zinc, niacinamide, glucosamine and biotin improved hair counts by 11.9% and led to visual hair improvements in 48% of subjects.
Saw palmetto alongside green tea extract, peony root extract, piroctone-olamine, and oligopeptides improves hair loss
This study on 50 men showed that a topical saw palmetto serum / lotion containing the above-mentioned helped regrow hair – with subjects seeing an improvement in hair count at both 12 and 24 weeks.
The bottom-line: topical saw palmetto seems to support (and enhance) hair regrowth alongside other hair-promoting ingredients.
Any other studies on saw palmetto?
Yes, but none that I’m aware of on androgenic alopecia (pattern hair loss).
For example, this 2018 study showed that a supplement containing saw palmetto (and over a dozen other ingredients) increased hair counts by ~10% in six months. But that study was on women with self-perceived hair thinning – not androgenic alopecia.
Given the study’s design, we can’t parcel out if any regrowth was attributable to saw palmetto. Regardless, the results still support the evidence that saw palmetto may enhance the effectiveness of other hair growth-promoting substances.
What about saw palmetto + PRP, microneedling, or massaging?
While the data is limited, anecdotes suggest that saw palmetto may enhance regrowth from wounding-based therapies – like platelet-rich plasma (PRP), microneedling, or massaging.
Our massage study found that taking topicals or supplements alongside massaging didn’t enhance hair regrowth from massaging. At the same time, we didn’t control for people just using saw palmetto (since the sample size was too low).
Having said that, some readers here have reported great results using saw palmetto alongside massaging. For reference, here’s an email I received from just a few weeks ago:
“I am 29, male, and was NW0 until about 22… Then in December last year I suddenly lost an additional cm on each side in the temples, and the hairline moved back a bit (now NW2,5, vertex still unaffected).
In response to the sudden AGA burst, I began massaging and simultaneously started taking saw palmetto, 320g/d, in January… Exactly at the 5-month mark, most of the hair that I had lost since December was back. Of course, I wanted to find out whether this was due to the massages or the [saw palmetto].
After five months of (rather aggressive) massaging, I quit [saw palmetto] and continued the massages to see what would happen. After about a month, it appeared as if the newly-regrown hair went thinner, and another two weeks later (now), it became obvious that I was rapidly losing all that I had gained…”
For this reader, it seems like saw palmetto + massaging worked wonders, but that massaging alone didn’t reap results (at least not within that five-month time window).
Interestingly, that reader’s experience is also supported by data on therapies combining wounding with DHT reducers – like microneedling and finasteride. For non-responders to finasteride, adding in microneedling can kickstart hair regrowth. The inverse might also be true for massaging and saw palmetto… especially since those therapies hit the same targets as microneedling and finasteride.
Saw palmetto: best and worst candidates
While saw palmetto is a natural extract, it’s not right for every hair loss sufferer. If you’re considering using the extract, here are some things worth considering (as always, consult your doctor).
You’re a good candidate for saw palmetto if…
- You have early-to-mid stage androgenic alopecia (pattern hair loss)
- You’re otherwise healthy
- You don’t mind spending an additional $30+ per month on your hair
- You’re also using other hair loss therapies or treatments
You’re a bad candidate for saw palmetto if you have…
- Prostatic cancer
- Pregnancy
- High blood pressure
- Gastrointestinal disorders (i.e., diarrhea or constipation)
- Bleeding disorders (i.e., hemophilia)
- Telogen effluvium (this hair loss disorder is different from androgenic alopecia; saw palmetto doesn’t target its causes)
Saw palmetto may also predispose a few people to easier bruising or bleeding. For this reason, it is should not be used by people taking medications that slow the process of blood clotting. These medications include: aspirin (Tylenol®, naproxen (Naprosyn®, Anaprox®), clopidogrel (Plavix®) and ibuprofen (Motrin®, Advil®).
Using saw palmetto: how to maximize its efficacy
If you’re going to use saw palmetto, follow these steps so that you can maximize your chances for hair regrowth.
#1. Find a reliable brand (good luck)
Harvesting, manufacturing, and extraction practices vary wildly across saw palmetto sellers. Resultantly, most saw palmetto extracts sold on Amazon and big box stores are therapeutically useless.
If you’re going to invest $30+ per month into this product, you’ll need to do the legwork to find a good brand. Unfortunately, this is incredibly difficult to do.
For starters, there are four popular extraction methods for saw palmetto’s fatty acids:
- Ethanolic extraction
- Hexane extraction
- Supercritical CO2 extraction
- Grounded / powdered saw palmetto fruit
Which extraction methods did the saw palmetto-hair loss studies use?
The 2002 study standardized saw palmetto to 85-95% liposterolic content (200mg). Unfortunately, the authors don’t state the extraction method.
The 2012 study used 320mg of dry extract (which implies the powdered variety). Having said that, these authors also don’t state their extraction method.
This is problematic, because while evidence suggests that powdered extract might be helpful for reducing inflammation, this form of saw palmetto is relatively unstudied for its effects on 5-alpha reductase, DHT, and benign prostate hyperplasia.
This leaves us with a question that I (honestly) cannot answer…
Which brand of saw palmetto is best for pattern hair loss?
As an exercise, let’s try to evaluate this from an extraction perspective.
A earlier-cited study found that supercritical CO2 extraction had a superior ability to inhibit 5-alpha reductase (and thereby DHT). Moreover, several studies from 1998-2012 showed that the brand Permixon™ outperformed all other saw palmetto brands in reducing type I and II 5-alpha reductase activity in the prostate.
Permixon™ is made via hexane extraction. And there is that 2012 study showing that a dry saw palmetto fruit extract stopped hair loss in 90% of men. This implies that, at least for hair loss, the most therapeutic saw palmetto extracts will come from…
- Supercritical CO2 extraction
- Hexane extraction
- Powdered fruit
At the same time, that’s not the full story… because there’s also harvesting, manufacturing, and oxidation to worry to about.
Unfortunately, I haven’t yet found a brand that offers enough information for us to make a good purchasing decision. So, we’ll just need to do our best with the information we’ve got.
I’d recommend doing the following:
- Make a list of brands selling saw palmetto
- Call up their customer service
- Ask which extraction methods they’re using
If it’s hexane extraction, supercritical CO2 extraction, or (maybe) powdered /grounded fruit – that’s a good sign. If it’s ethanolic extraction, you may want to hang up the phone.
To help get you started, here’s a table of brands and extraction methods. For reference, brands that sell saw palmetto from the SabalSelect® manufacturer are likely a step in the right direction. But again, extraction is just one factor. You can have the best extraction method, but if you’re extracting sterols from poorly harvested saw palmetto, you’re essentially trying to extract gold from a turd.
So, do your best. It might help to ask others who’ve seen improvements to their hair what brands of saw palmetto they used, for how long, and then look up those manufacturers to see if the anecdotes match the evidence.
Hopefully, a few people will chime in here in the comments.
If you make it past this stage, then you’ll want to ensure you follow our best-practices for both oral and topical use.
#2. If taking orally…
You’ll want to find a brand that sells the right amount of saw palmetto alongside the right ingredients.
- Take 320mg daily. Effective dosages for hair loss range from 200mg – 320mg daily, depending on the extraction method.
- Combine with ingredients to enhance absorption. Specifically beta-sitosterol, lecithin, inositol, phosphatidyl choline, niacin, and biotin.
#3. If taking topically…
You’ll want to find a brand that offers saw palmetto using the right extraction methods, dilution percentages, and includes saw palmetto alongside the right (i.e., synergistic) ingredients.
Unfortunately, in our three topical studies, there’s zero information on saw palmetto extraction methods and dilution percentages. This only leaves us with the ability to shop for saw palmetto topicals with synergistic ingredients.
So, just try to find a topical saw palmetto that includes any (or all) of the following:
- Green tea extract
- Peony root extract
- Piroctone-olamine
- Oligopeptides
- Cystine
- Castor oil
- Gingko biloba
- Azelaic acid
- Ginseng
- Calcium
- Zinc
- Niacinamide
- Glucosamine
- Biotin
In doing so, you’ll likely increase saw palmetto’s bioavailability, effectiveness, and hair growth-promoting properties.
#4. Take supplemental and topical saw palmetto simultaneously
This will likely increase your chances for hair gains, because you’ll be maximizing your chances of reducing type II 5-alpha reductase activity (i.e., DHT) in scalp tissues.
#5. Combine saw palmetto with stimulation-based therapies
While the evidence is limited, studies show that wounding-based therapies + DHT reducers tend to work synergistically. Anecdotes of people using saw palmetto with microneedling, massaging, and/or PRP tend to support this. So, consider adding these therapies into your routine – so long as they’re not time- or cost-prohibitive.
Summary
Saw palmetto is far from a hair loss cure, but it also isn’t completely useless. It’s not as effective as finasteride, but it is safer and seems to produce fewer side effects.
If you do use saw palmetto, don’t expect any miracles. Yes, one study suggests that the supplement can stop hair loss for 90% of men. At the same time, that evidence is preliminary; real-world anecdotes don’t seem to align with those clinical findings.
Having said that, the difference in clinical versus real-world results may just boil down to supplement quality. Most saw palmetto available to consumers isn’t worth buying. You need to make sure you’re getting the right supplement, from the right manufacturer, using the right extraction methods.
If you do use saw palmetto, use it as both a supplement and a topical. Also consider combining it with other hair loss therapies and treatments – preferably previously-studied ingredients (i.e., the ones mentioned earlier in this article). Give yourself at least six months before gauging any changes, and keep in mind that you’ll likely only see a stop in hair loss rather than regrowth.
Questions? Comments? Please reach out in the comments section. I’m happy to help!
Rob English is a researcher, medical editor, and the founder of perfecthairhealth.com. He acts as a peer reviewer for scholarly journals and has published five peer-reviewed papers on androgenic alopecia. He writes regularly about the science behind hair loss (and hair growth). Feel free to browse his long-form articles and publications throughout this site.
Hi there,
I am the guy who wrote the e-mail that Rob quoted, and I would like to add some information that may benefit other readers. This is what I used, which goes back to advice from an experienced pharmacologist:
320 mg, ethanolic extraction (9 – 11 : 1), 96 % (V/V). Powdered stuff, he said, is useless. This is standardised extract, and you can easily get it disguised as prostate medication (at least in Germany) from at least two different brands.
Also, some comments on the side effects I experienced that may help other readers:
– decrease in beard growth that lasted for a couple of weeks, then subsided
– slight decrease in libido and quality of erections (persistent during use, but completely reversible soon after discontinuation)
-> it may be that if you experience these, you’re a good candidate
I also want to emphasise that for me it worked in the FRONT (cannot comment on vertex efficacy as my vertex is unaffected). Moreover, it only brought back those hairs that I had JUST lost (as I used SP immediately after a major AGA burst); whether it can lead to gains beyond this time frame (say losses that occurred years ago), I cannot say at this point.
As I started SP alongside the massages, the most important question obviously is whether regrowth is attributable to the former or the latter. What I can say is that massaging alone did not help since I lost all my gains when I stopped the SP. What we do not know is whether (a) the massages enhanced the effect of SP or whether SP alone would have been equally effective, and (b) what would happen after 5 months of usage. This is when I discontinued the SP (but kept massaging). It may be that with increased scalp laxity the massages become more effective or it may be that only the SP did any work. I am currently trying to find this out.
Another important issue, which Rob mentioned in his other articles but did not comment on in this one, is whether SP, like FIN, may lead to receptor upregulation. If it does, it may be that if one discontinues the drug, one may even be worse off than if one had never started taking it. From my own experience I cannot answer this question since I restarted SP before the losses would have exceeded the gains – so maybe they would not have.
What’s my best advice? If your AGA is not currently increasing, try ‘massages only’ for 5 months and see if anything happens (that way you avoid any side effects and potentially irreversible receptor upregulation). If the massages are not effective, add SP. If your AGA is progressing, maybe start SP immediately since time is key. Take it for at least 5 months and watch carefully.
I hope other people will find this helpful. We must work on this together!
All best wishes
Wayne
Hi Wayne,
i am from Germany too and im curious which product did you use?
Serenoa or prostagutt uno?
And one more question to you Rob. Somewhere I read that there is an improvement when using ketoconazol + saw palmetto topically than using ket only. Do you have any information about this?
Thanks for this article!
Best regards,
This study cites a textbook, claiming that:
So, that’s probably where you heard the information! This all gives credence to the idea that saw palmetto might work more effectively as an adjunct ingredient to other supplements, shampoos, or topicals.
From a mechanistic perspective, this makes sense. As the article states, multi-therapy approaches to hair loss seem to reap better results than mono-therapy approaches. On that note, saw palmetto + ketoconazole probably reduces inflammation / DHT better than ketoconozale alone.
Best,
Rob
Hi there,
apologies, I did not see your comment. I am using Sabalvit Uno (before that, Serenoa, but it was discontinued). The brand may not be so decisive, however, if the parameters are the same (which I listed above). On the other hand, I have not experimented with other parameters and dosages – it’s just that the first one I tried worked. So there is still the chance that even more effective pills are out there.
One addendum:
I had a relatively bad backlash two moths ago, in which I again lost some (not all) of my gains. This happened WHILE I was on SP. I had at this point in time reduced massage effort a bit (usually 25 min, 1x a day). This may indicate that either the massages are indeed crucial alongside the SP, that SP is not powerful enough over longer periods, or that a third factor is involved. I am doing my best to figure this out and will post when I have any news.
Hope this helps!
All the best
Wayne
Hey there, Wayne, I was wondering if you have a history of baldness in your family. Also, I know this is kind of a personal question, but do you masturbate, and if so, would you mind telling me your frequency? I noticed a stark trend between people who masturbate and receding hairline, especially around the temple. I used to be in the military and abstained for nearly two years, and my hair got REALLY good. I mean really good. I can link pictures if you want. I was discharged last year and started falling back into my old habits as I became a bit depressed and noticed that my hair was really thinning especially around the temples. I’ve been following ROb’s protocol with massaging, but I am skeptical of taking supplements because there is a cost to changing one’s natural hormone cycle, as I should know. My belief is that taking Saw palmetto long term may not be beneficial to young men because DHT is part of an intricate network of hormones that is a self regulating process, and downreulating one thing may lead to other things (namely reduced muscle gains, less height growth, etc.).
I would love if I could have your thoughts on this and, if yo uare interested, we can chat on discord! I have a lot of research that I have been doing on this and just really want to talk to people about health in general. Take care, friend!
Hi Ken,
sorry, I did not notice your reply. Yes, there is a history of baldness in my family, on both sides. Both grandfathers and my father are NW VI. We do have a couple of people with full hair in my family too, but not many and not in a direct line. However, my genes cannot be SO bad because except for the front corners, my hair is very thick and dense. At my current age, my father was already severely balding. So I cannot say whether my findings are applicable to, say, a NW V, but what I can definitely say is that I have AGA – it’s only slowly progressing.
Thanks for your insights on masturbation. This is a very old rumor, even dating back to Aristotle (who believed it to be true). I am not sure. In my own case I could not tell because my frequency did not vary much. If I were you, I would make a list of things that were different in the military in addition to masturbation frequency and try to incorporate them into your current life. It may, for instance, be the case that exercise, food, or sleep pattern had an effect on your hair.
Regarding whether SP is safe to take:
I have these worries too, of course. That goes for any medication one takes. I would not start SP at a very young age, to be on the safe side. On the other hand, SP has additional health benefits, e.g. for the prostate and skin (for assessing the former, I am too young, but I definitely saw a change in the latter ;-)) and it is a relatively mild drug. There are many studies on its side effects that one can find online. The vast majority of them deem it to be harmless.
All the best
Wayne
Wayne,
THANK YOU for commenting! I was hoping you’d see this article before I announce it next week.
On the note of androgen receptor upregulation, I have some VERY good news. This study shows that a blend of saw palmetto (~320mg daily) alongside nettle root, pumpkin seed oil, vitamin A, and a few other ingredients did not change androgen receptor activity in the prostate.
http://www.comilac.com.tr/uploads/pdf/KAYNAK%2037.pdf
At least in my mind, this is a huge win for the supplement as potentially safe long-term. It’s time to update that previous article!
Best,
Rob
Hi Rob,
Do you have another link to the study? Or at least a title? It’s 404’d currently D:
Hi Rob, can there be upregulation of the androgen receptor with daily use of saw palmet shampoo (Hair Restoration Laboratories shampoo)?
Can an 11-year-old girl who falls hair use shampoo? It is safe? Thanks. Please excuse my English. Tingi
Hey Tingi,
At least in prostate tissues, saw palmetto use does not change androgen receptor expression. This is a good thing, as one of the issues with finasteride is that in animal models, finasteride turns on androgen receptors during use which do not turn back off after discontinuance (leading to a DHT “flooding” effect). With saw palmetto, the evidence suggests there’s less of a risk (or no risk) of the same situation occurring if you quit the supplement.
When treating hair loss, we always need to make sure that the causes line up to the treatments. An 11-year old female experiencing hair loss is likely experiencing hair loss that is NOT androgenic (i.e., hormonal) in nature – mainly because she’s too young to see a surge in androgens since she hasn’t yet entered puberty. Rather, she’s likely experiencing telogen effluvium or alopecia areata – two forms of hair loss that are more linked to stress, medication use, an underlying condition, or autoimmunity.
Saw palmetto reduces the androgen DHT, which is causally linked to androgenic alopecia (AGA). But, reducing DHT probably ISN’T the right approach for an 11-year old girl with hair loss – as it’s highly unlikely that she has AGA.
I’d first recommend looking into those other two hair loss conditions. Do her symptoms line up with their causes? If yes, you’ll likely be able to treat her hair loss better.
Best,
Rob
Hi Rob, I’ve been following your blog regularly. I started losing my hair in January of last year, mostly the top and back of my head where men have bald spots. I have almost no hair left, it’s really thinning out, it’s really scary. My GP said it was stress because I had a terrible 2019. My mom was diagnosed with cancer. I told my doctor I don’t see how my hair will grow back because it stresses me to see my hair in the mirror every day.
He sent me to see a dermatologist, I went to see 2. One dermatologist said it was alopecia areata and the other said it was telogen effluvium. They both recommended Rogain but that’s a life sentence. I’m massaging but haven’t seen a difference. Do you recommend palmetto or something else?
Oh and my gynecologist sent me for tests, I’m in early menopause and have low estrogen. Taking the pill is not an option as there’s breast cancer in the family and I was on the pill for far too long already. Please help! Any advice you can give would be greatly appreciated.
Looking at this NOW brand saw palmetto extract on Amazon, people asked what method they use and the answers that came back said supercritical CO2 extract. It’s 90 capsules at 320mg each for less than $14 (with 80mg pumpkin seed oil) . Might be worth looking into: https://www.amazon.com/gp/product/B0013OXII8/
Thanks Aaron!
Positives: (1) good extraction method, (2) combination with pumpkin seed oil (which may have additional DHT-reducing effects).
Negatives: (1) carageenan as an additive agent. This is usually used as an emulsifier / preservative, but can cause some gastrointestinal distress. (2) Pumpkin seed oil will likely oxidize unless packaged properly and stored at low temperatures. I doubt NOW’s manufacturing practices are sophisticated enough to keep oxygen out of these capsules – or to prevent oxidation in the short-term. But I could be wrong.
Best,
Rob
I started applying a topical (nightly) that contains saw palmetto, ginkgo and some other potential helpful ingredients. I am happy to report after 3-4 months my hairloss stopped. I no longer see hair in the shower like I did before. I am now looking to regrow (if possible) some hair back. Currently I’m a NW2. I recently started supplementing with saw palmetto orally (160mg) along with beta sitosterol (50mg). The next supplement I plan to try is a high quality reshi mushroom fruiting body extract. In a Japanese study Reishi showed a 5α-reductase inhibition percentage near 75%. Any thoughts on Reishi mushroom Rob?
Hey neil,
What ingredients does your topical contain? How does it penetrate the skin?
Thanks
Hey Neil,
Great work! Congrats on your progress so far.
Reishi mushroom extracts do have strong type I and type II 5-alpha reductase inhibiting properties, at least on the prostates of castrated rats:
https://www.ncbi.nlm.nih.gov/pubmed/16029938
As far as how this study translates to human dosing? It’s hard to say. The rats were fed a diet of 0.3% Ganoderma lucidum (reishi mushroom) milled fruiting body daily, along with 1.5mg/kg to 15mg/kg per day of oral Ganoderma lucidum extract.
At the upper end, for someone my body weight (200 lbs), if we assume linear scaling, that equates to…
-8 to 10 calories daily worth of dried Ganoderma lucidum mushrooms in my food
-1.365 grams daily of Ganoderma lucidum extract
If you’re going to supplement, you’ll have to go through the same exercises as we did in the saw palmetto article – i.e., making sure the manufacturer harvests, extracts, and manufacturers the supplement correctly. And for that, I don’t yet have any recommendations!
Best,
Rob
Thanks Rob. This is what NOW says about their manufacturing process, not that it would necessarily affect the pumpkin seed oil oxidization issue:
– GMP Quality Assured: NOW closely adheres to both mandatory U.S. FDA Current Good Manufacturing Practices (CGMP) regulations and voluntary Natural Products Association (NPA) Good Manufacturing Practices (GMP) regulations. Good manufacturing practices ensure compliance with sanitation, processing, documentation, and testing requirements that are designed to promote consistent, highly reproducible product quality and safety.
hello rob
I took saw palmetto for a year and I had my breasts swollen like a woman (gynoplasty) I tried also ginger and it was the same my swollen breasts but I had no result I will say even that my hair was getting refined
Hey Toni,
I’m sorry to hear about that!
It seems like there’s a common trend among readers: the people who report finasteride-like side effects from saw palmetto (gynecomastia, low libido) also tend to report some hair regrowth.
Did the breast enlargement reverse after you quit the supplement?
Best,
Rob
hello rob
after two months of stop saw palm saw my breasts were deflated suddenly I dare not try I report that I have an enlarged prostate but it did not work either.
Which saw palmetto product do you recommend for hair loss? The ones I
Looked at the NOW manufacturer were for prostate. Could you give me the
name of the produce for hair loss. Thank you
Hey Alice,
It’s a great question, and unfortunately, I don’t have any brand recommendations or endorsements. There are likely a lot of brands out there that work, even with varying extraction methods. For reference, while I recommended hexane and supercritical CO2 extraction in the article, a commenter (Wayne) saw results with an ethanol extract from Germany.
Having said that, it’s okay if saw palmetto is branded for the prostate but you’re using it for your hair. What matters is just the quality of the product. Since I haven’t used saw palmetto in years, I’m not the right person to ask for a product recommendation. But the information outlined in the article should get you 99% of the way there. Reading others’ endorsements here is also a step in the right direction.
Best,
Rob
Rob, if one were to take both orally and topically, would you recommend doing 320mg/day in *both* forms, or (if possible) do 160mg/day of each?
Hey John,
I’d recommend something around 0.5% to 2.0% saw palmetto extract as a topical alongside 320mg/day oral. If side effects occur, I’d probably start by halving the oral supplement. If no improvement in side effects, I’d likely just continue the topical.
Best,
Rob
Hi Rob thanks for a great article! What are your thoughts on saw palmetto mixed as part or the super zix topical. (zinc sulphate and b6) cheers Phil
Thanks Phil! You can certainly try the Zix topical. The biggest challenge with the topical formulation seems to be penetration. You might want to consider adding in azelaic acid, propylene glycol, another carrier agent, or adding in microneedling to improve penetration. There’s not yet any evidence on systemic absorption of the topical, but I’m assuming there has to be some. So, monitor your side effects and keep us posted. In any case, adding in saw palmetto will probably help.
Hi Rob . I remember we had a similar article in the Dht blocking series a year ago.
I have been taking saw Palmetto since 2017 , along with pumpkin seed oil pills. I knew that saw Palmetto was never going to be stronger than fin or as dangerous.
I now don’t know if my progress can at all be attributed to sp ,as I was massaging well past the 8 month part. I still take it.
I did not choose any brand at all, just purchased off Amazon whatever had good reviews and price.
So can I be silly and ask the obvious.
I haven’t blocked Dht effectively for the past two years?
My thickness and regrowth has been massage orientated, which sped up Dht metabolism.
I also used topical pumpkin seed oil and rosemary twice weekly.
I’ve now purchased pine pollen, which helped another reader.
I have been taking 500mg saw Palmetto aswell. But that shouldn’t mean anything as this article suggests.
So what is the best natural form of Dht blocking that can be effective enough, and less risky than fin ?
Thanks
Hey Paz,
Thanks for reading. In terms of not effectively blocking DHT for two years – I’m sure you ARE reducing some DHT (likely in your prostate and potentially scalp tissues). But, it might benefit you to experiment with different saw palmetto brands to see if you notice any additional changes to your hair.
In terms of the most effective, natural, and safest way to reduce DHT – this is a great question, and something I’m not yet ready to answer. Even with natural extracts, we can reduce 5-alpha reductase activity far enough to trigger some sexual / feminizing side effects (as demonstrated by some of the commenters here). However, if we take the right approach, we can likely mitigate these side effects while also maximizing our potential for hair recovery.
When I’m ready to share more, I’ll certainly let you know. The biggest challenge with all of this isn’t necessarily identifying natural extracts that reduce 5-AR activity (there are plenty); it’s finding the right ingredient providers, who use the right extraction methods, at prices that are affordable.
Best,
Rob
does anyone have experience with this supplement Powerful Hair Plus? it contains biotin, saw palmetto, and a bunch of other ingredients, and both the reviews and before/after pictures on amazon are very positive.
I use one from prairie Natural called prost force. It has everything mixed in.
Libido spike in the first month then faded.
No other issues.
I also use topical fin with monoxidil in it.
Rob, I really need your help with a couple of questions:
1). Will reducing DHT in the body prevent growth? As an 18 year old male, this is concern that I have. When in comes to hormones circulating through the body , we simply cant discount DHT as an ALL BAD waste product of testosterone. It has been linked to increase the features that we associate with men (facial hair, for example). If such is the case, can altering our natural DHT levels be detrimental? I read in a comment above that gynecomastia was associated with taking finasteride, and I believe this is something that we cannot overlook!
2). I have been wanting to ask you this question for a REALLY LONG TIME. What is your opinion on masturbation causing hairloss? I actually have a twin brother who has never masturbated, and his hairline at the vertex of the temples is not as badly thinning as mine is. We know FOR A FACT that 1 week after ejaculation, testosterone imroves, transiently, to 300% of its normal value, which must have an indirect effect in DHT production. Do YOU think that ejaculation can cause detrimental effects to hair, and if so, can it be reversed by simply NOT ejaculating, OR would we need some intervention such as Saw Palmetto.
I really want to avoid taking high doses of supplements long term. I’d be okay with taking saw palmetto for four months and then stop it if it would help me keep the hair, but Im not sure that would be the case. I also dont want my subscription to saw palmetto to affect growth, muscle gains, etc.
I really appreciate you taking the time out to read this comment, and would love a response from you at your earliest convenience!
Hi dude,
I was wondering this about masturbation as well. I’m just gonna tell you my experience and opinion about this. I’ve also started balding around 18 and I was fapping a lot at that time (+- twice a day). I came across to reddit forum people saying that nofap improved their hair and also their health in general. So I gave a try (fapping 1x a week) and I have to say especially at the beginning I saw positive changes. I thought my hair looked better and I was balding less and my beard grew more as well. However I have to say I dont think it had some major impact on my overall hair situation. I’m 25 now and since I’ve been 20 I’ve reduced fapping drastically compared to my teen ages. I’ve also tried to have some longer streaks several times (almost one month) but I really don’t think it had some major impact and I’m still losing hair at moderate tempo.
Recently I have done twice blood tests and both times I made sure I fapped 48 hours before the test. I always thought my testosterone is quite low but I was surprised as it was pretty high. First time I had 850 ng/dl and second time I had 1000 ng/dl which is 15% increase. What I think made the difference was the sleep quality because first time I bit tired and didn’t sleep that good. What I want to say that the statment ”We know FOR A FACT that 1 week after ejaculation, testosterone imroves, transiently, to 300% of its normal value” is in my opinion total bullsh*t. Masturbation can influnce T levels but I think those are minor changes. What I think makes more difference is what we eat and the sleep. Lastly, I think if masturbation causes balding it’s not because it’s impact on DHT or T but prolactin or maybe estrogen.
If I should give you advice – try not to fap but if you are doing that only 2-3 a week nofap will not save your hair. If you do it a lot you might see some improvment with nofap.
Dawe – great points, and thanks for sharing your experience! I tend to agree with your take.
Hi Dawe and every one else.
Please use me as an example.
I masterbated twice daily for nearly 10 years and saw no hair loss , even though my genetic predisposition was very high.
However I was slowly receding at temples. However it wasn’t until I reached 28 with a stressful job and lack of sleep. That I started to get over sebum production , itchy scalp and thinning. Along with vertex and temple loss.
I tried nofap going on 14 days ect then relapse. I just don’t believe it contributes to MPB. Hormonal changes maybe , but not enough to impact hair.
Thanks a ton, Rob, I really appreciate your time! SO would you just recommend for young men such as myself to simply stick with massages and good diet? I am a vegetarian but I take a b complex supplement. I try not to fap as much as I can because it really drains me.
Is there any supplement that I can take that *safely* assissts in hair regrowth?
Thanks for the awesome response, man. Here’s my theory, and I HOPE that it is wrong: when someone startes to disrupt the hormone process through fapping, any damages that happen to hair/ buildup of DHT is PERMANENT and thus cannot be improved in a short period of time (<1 year).
I had the same experience as you did: my hair became amazing when I was on nofap. Like seriously good. I was also nail rubbing AND massaging AND oiling, so there are definitely a lot of factors involved.
I really just want to save my temples and hairline, and was wondering what you recommend that I do as an 18 year. Really appreciate your help man!
Hey Ken,
Thanks for your questions. I’ll answer the ones relevant to this article in more detail.
(1) I don’t recommend reducing DHT throughout puberty or early adulthood. The enzyme family 5-alpha reductase and the hormone DHT aren’t just involved in pattern hair loss and benign prostate hyperplasia; they’re also involved in metabolic health, neurological functionality, and several key aspects of male development. There’s also a long-tail to puberty from 18-25 where men are STILL developing. As such, if I were under 25, I wouldn’t try to modulate my DHT levels for the sake of my hair. After all, male DHT levels don’t start to diminish until around 80 years old. This suggests it’s probably a somewhat important hormone – and even throughout adulthood.
(2) This question is off-topic for this article, and I want to keep things about saw palmetto. The short-answer: there’s a discussion going on in the membership community about this, which will give you better answers. My high-level take: if masturbation contributes to hair loss at all, it’s more so through hair shedding and less so through androgenic alopecia.
Best,
Rob
Ken,
I have to absolutely agree with Rob. If NoFap helps with hairloss it’s because it stops hair shedding but not MPB. I have read stories of ton guys on Reddit who claim to stop shedding significantly because of NoFap and I think they’re absolutely legit and I don’t think that they would have any reason to lie. However, most of these guys believe it’s because NoFap decrease DHT – that might be possible but again those are minor changes. If Propecia decreases 60% of DHT and sometimes doesn’t help at all then slight decrease from NoFap shoudn’t have any effect. The reason why NoFap helps is much deeper I think.
Rob u r Awesome!!!
Thanks for reading, Jennifer!
Hi Rob,
I’m doing the messages for a month now and I’m getting a lot of pain in my forearms. I think I get pain from pressing part of the massage . Has anyone else experienced this and how can I alleviate this pain?
Thanks for another good article. I read somewhere that women should take saw palmetto with caution if they suffer from hormonal and hormone sensitive conditions as well as if they’re on birth control. Can you please comment on that?
Hey Anne,
It’s a great question! Saw palmetto is sometimes taken by women suffering from polycystic ovarian syndrome (PCOS).
https://www.ncbi.nlm.nih.gov/pubmed/18203965
PCOS is characterized as insulin resistance + high testosterone, but it morphologically presents as the formation of follicles in the ovaries (i.e., “cysts”).
Interestingly, saw palmetto can help reduce the expression of prolactin receptors in ovarian tissues, and these receptors may play a role in the formation of these follicles:
https://restorativemedicine.org/digest/saw-palmetto-may-reduce-elevated-androgens-and-prolactin-in-women-with-pcos/
There’s also evidence that dietary + lifestyle interventions can help with PCOS, too.
As far as taking saw palmetto while on birth control, this really depends on your type of birth control. If you’re taking oral birth control that acts through synthetic estrogens, then taking saw palmetto might actually decrease its effectiveness (since the supplement can increase estrogen clearance):
https://www.rxlist.com/saw_palmetto/supplements.htm
If you’re considering taking it for hormonal reasons, I’d first check out those links and talk to your doctor before you start experimenting.
Best,
Rob
Hi Rob,
Great article, thank you so much!
I’m a female (Aga for +25 years and approaching menopause) and I have taken Saw Palmetto for about half a year and it did nothing for my hair unfortunately.
I’ve just started oral Finasteride 1.25 mg daily and I was really happy that my doctor prescribed it for me. However, reading the comments someone spoke about “receptor upregulation” with finasteride and saw palmetto.
This literally freaked me out as I might be worse off if I ever stop taking finasteride. Do you know the percentage of people who experience receptor upregulation when they stop taking the drug? Because Are there any studies or reports on women experiencing this as well?
Thank you so much for your reply,
Isa
Rob,
Here is the info on the Reishi mushroom that I ordered. I plan on taking 1-1.5 grams daily in divided doses.
Made from 100% organic reishi mushrooms
Extracted with hot water and alcohol (dual extraction)
Certified Organic ingredients
Gluten-Free, Non-GMO, Vegan
>15% Beta-glucans, >4% Triterpenes, <5% Starch
No added starch, mycelium, or grain of any kind
500mg capsules, 90 capsules, 45 servings
Verified for quality at accredited 3rd party labs
Test,
Here’s the full list of ingredients for the topical:
Safflower Extract, Amla Extract, Eclipta Alba Extract, SynfolexTM, Saw Palmetto Extract, Gotu Kola Extract, Nettle Root Extract, Aloe Vera Juice, Glycerin, Water,Sodium Metabisulfite, Glycine, Larix Europaea Wood Extract, Zinc Chloride, Camellia Sinensis Leaf Extract Chondrus Crispus, Jojoba Oil, Grapeseed Oil, Castor Oil, Magnesium Oil, Cysteine, MSM, Vitamin C, Taurine, Caffeine, Polysorbate 80, Lavender Oil, Honeysuckle Oil, Peppermint Oil, Rose Petal Oil, Potassium Sorbate, Vitamin E.
Thanks mate, whats the name of the product??
Hello Rob,
what is your opinion on Hairmetto?
It seems to be the only product that fits your requirments.
Are you by any chance cooperating?
Regards
Hi Matias,
I’m not cooperating with Hairmetto, nor have I tried their products. To reiterate from my article, I have no brand recommendations.
On that note, I’m beginning to grow frustrated with your latest series of emails / comments. It feels as though your comments consistently insinuate that I have ulterior motives or undisclosed financial relationships that influence the content of my site.
It’s easy to posit inflammatory questions. It’s harder to think critically and rationalize whether what you’re asking makes sense. So, let’s do an exercise on the latter.
Firstly, the costs of an article…
It takes me ~40 hours to research and write an article. I also work with medical professionals to help research and review my articles for scientific accuracy. This costs ~$250.
For the sake of this exercise, let’s falsely assume that I am “cooperating” with Hairmetto to sell their products. One way to do this is through affiliate marketing, where I would place a referral link to the product and then get a percentage of every purchase.
It seems like Hairmetto sells on Amazon for $60. Amazon referral fees are somewhere around 5%. So, that’s $3.00 per sale to whoever clicks on my referral link and buys.
Now, let’s assume that a typical article-to-purchase sales conversion is 1% (which is very high). In other words, for every 100 people reading this article, one person would purchase the product and earn me $3.00 in commission.
So, when would I break even from affiliate sales? It all depends on how much qualified traffic I can send to this article. And to get traffic, I need to rank in Google. So, let’s falsely assume that this article ranks on the first page of Google for a search term like “Saw palmetto for hair loss”.
Now let’s also assume that I value my time at $30 per hour. This article took 40 hours of work to produce. I also hired that medical professional for $250. So that’s $1,200 of my time plus $250 of someone else’s, which is $1,450 total.
I would need to make $1,450 in Hairmetto referrals just to break even.
That’s over 480 referral purchases. According to our conversion rate estimates (1%), that would require 48,000 page visits. The only way I could hit those numbers – within a year – is if this article ranked on the first page of Google.
This article DOESN’T rank on the first page of Google. I’m not even sure it ranks in the top-30 pages. Why? Because I don’t write articles for the sake of ranking on Google. Rather, I write what interests me (and about what is requested by the readers).
Knowing this, it would hypothetically take several years of referral sales before finally breaking even.
And that’s assuming that I actually have a referral link in the article…
But I don’t have an affiliate link to that product (or mention the product anywhere in the article).
This leaves us with one final possibility…
I’m somehow using this article to influence consumer opinion of saw palmetto, indirectly, so that people will eventually do what you did: stumble across the Hairmetto brand and consider buying their product.
In this scenario, I would need to have some sort of ownership in the company for there to be financial gains…
But I don’t own any part of Hairmetto. If I did, I’d need to legally disclose it in this article. So, this possibility is outside of reality.
So, before you insinuate conspiratorial motives, please first consider the reasonability and rationality of your suggestions. While I won’t entertain any more questions like the one you asked above, I will happily answer questions about the science behind saw palmetto – or anything else presented in this article.
Best,
Rob
Hi,
Looking at the products available, I found this one:
https://www.iherb.com/pr/gaia-herbs-saw-palmetto-60-veggie-liquid-phyto-caps/9980
I havent tried it myself, but I have had experience with other Gaia’s liquid capsule supplements before and they were potent and working. I think I will give a try with this one.
some guys in reviews claims that it works for hair loss:
” My hair seems to be growing. I can feel some thickness when I shampoo. I also noticed that my scalp psoriasis subsided from 100% to 10%. My scalp is less itchy, I dunno what’s in this product but it seemed working wonders compared to other saw palmettos I took with terrible side effects.”
” I brought it for my brother, he only takes one at night and it does help to reduce hair loss”
Hi there Rob,
So its not anything to do with saw palmetto per sey, but ive been using Finasteride for 8 months now and i did so for hair loss with the help of a doctor. Ive had maybe a little side effect, perhaps low libido and brain fog although i have other health problems so i t could be that but im coming off Finasteride very soon, its also done nothing for hair.
What im concerned about however is this understanding that Fianateride remodels the prostate and upregulates androgen receptors, i was never told this by my doctor and now im scared that ive caused permanent damage to my body, is there anyway i can test to see if my receptors are permanently upregulated any signs? or if its possible to somehow undo the process? If i had know this i would not have gone through with the medication, i do have a high risk of prostate cancer because of family history and so i thought reducing DHT would only benefit my prostate too but i dont want coming off finasteride to make things worse.
Thank you
Hey Paul,
the best thing is if u want to stop using finasteride is slowly decreasing the dose over a couple of months. As far as i know not everyone reacts with upregulation. But if so in your case, i think it would be possible that it is reversible when coming off slowly. There is no recommendation on how long but i think its better to go as gentle as possible.
Hi everybody,
@Nas regarding forearm pain
I had also issues with my forearms, ellbows as well as even upper arms and hands.
Luckily, I got rid of it by massaging (what an irony haha) with a small blackroll.
Just google “small blackroll”. Try to massage each arm for about 2 min. tackling the stiff spots where you feel any pain by staying at each spot for about 10 s. You can do it every day or a few days a week. You will see it gets a lot better.
All the best,
Gernot
Thanks for sharing this, Gernot!
Topical Saw Palmetto (high concentrate alcohol extract) slowed if not paused my hair loss for approx 2 yrs. Zero regrowth. When I quit, hair loss advanced rapidly. It is now held stable with Rob’s regime, awaiting regrowth. I would not go back to Saw Palmetto as I do not feel it is useful for regrowth, and as I found the alcohol extracts are terrible for their impact on hair quality (dry looking, brittle hair), SP in oil form seems to be elusive.
Hi Rob,
I read the article and decided to give it a try immediately, so I started taking high quality saw palmetto supercritical extract. When can I possibly expect the effect of stopping hairloss? Thank you for your answer Rob!
Hey John,
Thanks for reaching out. It all depends on the individual, but most clinical studies point to 3-6 months to notice a slowing/stopping of AGA. I’d err on the side of caution and give any intervention (saw palmetto or otherwise) at least 8-12 months to see a discernible effect. Please keep us posted with your progress!
Best,
Rob
Hey Rob,
Following up, it’s been almost 10 months on Saw Palmetto Supercitical CO2 extract, 360g a day. I didn’t notice big improvements overall, I still had some hair shed, but nothing critical. So ~3 months ago I decided to try cheaper brand serenoa repens (fruit) pills 900mg. Well, I’ve been shedding hair like crazy since then and the scalp became very itchy and I see that I have more hair growing on my chest, maybe indicating that overall DHT level went up. Now I went back to the Supercritical CO2, hopefully, I will stop my crazy shedding
Hey John,
Thanks for sharing your experience here, and I’m sorry to hear about your shed. I feel like your switch back to the original, supercritical CO2-extracted brand is a good move. It’s possible that the cheaper brand either didn’t meet its labeling requirements, or that its formulation was far worse than the one you’d originally used. In any case, please keep me posted on your progress.
Have you had DHT levels since trying saw palmetto?
Best,
Rob
Hi Rob,
Do you suggest taking 160mg pill twice a day or two 160mg pills at once?
Hey John,
Spreading out the dosages isn’t studied to my knowledge. However, it likely won’t have much of an impact if you decide to split 320mg into two 160mg dosages per day, or take it all at once. The more important part is finding a brand that gets everything else right in terms of harvesting and manufacturing practices.
Best,
Rob
Hi Rob,
Excellent article and excellent research overall !!!
I am immensely grateful to you …..if there was a Nobel Prize for hair loss I am convinced you would win it three years in a row.
Regarding Saw Palmetto more particularly, have you ever seen/found any evidence that SP oils are more powerful / bio-available than their extract form ?
The Study here contains very interesting charts suggesting that palmetto Oil at 40 mg has +- the same DHT inhibitory effect of 1 mg Finasteride “in vitro” .
https://www.researchgate.net/publication/318354495_Efficacy_of_a_Nutritional_Supplement_Standardized_in_Fatty_Acids_and_Phytosterols_on_Hair_Loss_and_Hair_Health_in_both_Women_and_Men
Furthermore before/after pictures of “in vivo” do not look too bad.
Finally, checking reviews on popular ecom sites, oil based products seem to have quite high relative ratings.
Have you ever explored the difference oil vs extract ? Are they the same for you ?
Your thoughts are gratefully appreciated ….
All the best for this year !
GABE
I do not personally consider finasteride a viable solution for me due to the risks and potential of persistent/permanent side effects.
Is there any information/rational suggesting this isn’t a concern with saw palmetto?
I have used saw palmetto in the past (ca. 2-3 months) and discontinuned fearing that the product was not pure, ironically because I did receive side effects associated with use of finasteride–breast tenderness, some transient testicle ache, transient mood changes (not applicable to saw palmetto), and some libido/sexual changes (this seemed to pass after a week or two). Placebo cannot be ruled out.
Hi Rob,
Thanks for writing such a great article. Learned a lot from it. My question is, in my Country (Ireland) I can only find the Saw Palmetto Capsules 450mg. https://www.hollandandbarrett.com/shop/product/holland-barrett-saw-palmetto-capsules-450mg-60018932?skuid=018932
I noticed that the daily dose you recommend is between 200-320mg. Can I eat this 450mg one on a daily basis?
Many thanks in advance and looking forward to your reply.
Hi Rob, I’ve been following your blog regularly. I started losing my hair in January of last year, mostly the top and back of my head where men have bald spots. It’s really thinning out, it’s really scary. My GP said it was stress because I had a terrible 2019. My mom was diagnosed with cancer. I told my doctor I don’t see how my hair will grow back because it stresses me to see my hair in the mirror every day.
He sent me to see a dermatologist, I went to see 2. One dermatologist said it was alopecia areata and the other said it was telogen effluvium. They both recommended Rogain but that’s a life sentence. I’m massaging but haven’t seen a difference. Do you recommend palmetto or something else?
Oh and my gynecologist sent me for tests, I’m in early menopause and have low estrogen. Taking the pill is not an option as there’s breast cancer in the family and I was on the pill for far too long already.
Please help! Any advice you can give would be greatly appreciated.
Hey Chantal,
Thanks for reaching out, and for explaining your situation.
Saw palmetto targets to reduce DHT levels, and thereby improve outcomes for pattern hair loss. Since your dermatologists believe you have alopecia areata and telogen effluvium, then unfortunately, saw palmetto won’t be of much help – it won’t target the right mechanisms to act as a therapeutic agent for these types of hair loss disorders. This is because alopecia areata is an autoimmune condition linked to stress + gut biome changes, and telogen effluvium is a shedding disorder associated with stress, chronic conditions, and (sometimes) hormonal shifts linked to menopause… though the latter is generally attributed more so to female pattern hair loss.
If you have high serum androgen levels, then DHT reducers might help. And there are certainly things you can try to improve estrogen levels (and estrogen metabolism) during this period of your life: dietary/lifestyle adjustments, exercise, etc. The good news is that alopecia areata and telogen effluvium can often be reversed if the root causes are tackled. But it can take quite some time to identify + resolve those for each individual. I’m happy to talk more about your situation in a Skype call, but wanted to give you some directional insights regardless.
Best,
Rob
Hi Rob,
I’m interested to know your thoughts on this paper: https://academic.oup.com/endo/article/145/7/3205/2499883
“Saw Palmetto Extract Suppresses Insulin-Like Growth Factor-I Signaling and Induces Stress-Activated Protein Kinase/c-Jun N-Terminal Kinase Phosphorylation in Human Prostate Epithelial Cells”
So the paper says that saw palmetto suppresses IGF-1 signalling. I just read your article on IGF being necessary for removing inflammation; does this imply that saw palmetto would not combine well with mechanical stimulation methods (massaging, needling) which induce inflammation in the scalp? Because the saw palmetto would prevent it from becoming not inflamed.
Last bump on this. I’d really like to hear your thoughts on this if you can, Rob! Thanks!
So you mean to say massaging doesn’t help without suppliments. But in the video you said you stopped using suppliments and tried natural way. Which one I should believe here.
Hi Rob,
My case is totally different. I don’t know what is the exact reason also. My hair fall started temple areas around 2011. I stayed in multiple places don’t know water change could impact. It gradually decreased density. Now it’s almost 1/10. It’s not always noticible. For 4 months it’s regular 4 months couldn’t notice any hair fall. I recently took prp + finasteride treatment like 1 year back. I couldn’t see any improvement. It made my condition worse. Recent days I noticed both body hair and scalp hair both became so thin and body hair stick to soap that’s how I noticed body hair also becoming thin. But scalp hair thinning is easily noticible. Please provide some solution.
Hay Rob. Sorry for my language (I normaly speak Dutch). I’ve read a lot of your articles, but I can’t figure it out very well. As an alternative to Finasteride I now use minoxidil (daily) and as DHT inhibitors I take concentrated tomato, saw palmetto pills and pumpkinseedoil pills. Wouldn’t that bring any improvement to my DHT? Enough to have a stop of hairloss? For a moment I can no longer see the trees through the forest. Kind regard
Hey Koen,
Thanks for your patience with my reply. Firstly, I wanted to confirm your name change to Koen G. This occurred within minutes of your second comment submission. So, while I’m just getting back to your original questions now, please know your name has remained changed for a while.
In regard to botanical DHT reducers – lycopene (from tomatoes), saw palmetto, and pumpkin seed oil all hair some degree of effect on DHT levels, though these are generally much milder than any effects from finasteride and dutasteride. There was a study showing that over a two-year period, 90% of men taking saw palmetto orally were able to maintain their hair density. At the same time, most people agree that saw palmetto alone generally isn’t enough to see major hair count increases – and that for many individuals, its use in the real-world doesn’t live up to the results seen in the few clinical studies we do have on the extract.
I’d be happy to talk more in a consultation inside our membership community. There are plenty of options out there – especially for those who are more interested in an all-natural approach. Regardless, I wanted to provide you with some direction.
Best,
Rob
dear Rob, can you please change my name in Koen G please
Rob, thanks for all of this good information. I want to share my positive experience with saw palmetto extract made by Horbaach (2 oz, bought from Amazon). I have been applying it topically for about two months with some other things (see below). I experienced increased shedding within the first 3 weeks. By week 6 I started to see new hairs at my left temple and in the center above my forehead, and just this past week I noticed new hairs on my right temple. The new growth is almost entirely at the edge of my hairline so far. My two temples have not been receding in the same way – the right side has greater hair density but thinner hairs; left side has fewer hairs but they are thicker and darker. The new hairs that came in have matched this pattern – thicker, dark hairs on the left and tiny vellus hairs on the right. Horbaach’s website doesn’t say how they extract their saw palmetto – I think I will give them a call and ask. Will report back.
Granted, I can’t say for sure that this is due to the saw palmetto because I’m using it as part of an essential oil blend. However, the pattern of shedding + new growth seems consistent with SP to me. (My full topical formula is pumpkin seed oil, saw palmetto, green tea extract, bhringraj, lavender oil, rosemary oil, peppermint oil, cedarwood oil, and thyme oil. About 10% essential oils, 90% carrier – reduced from 20/80 a couple weeks ago.)
I’m surprised you didn’t mention the potential sexual side effects of saw palmetto. There are anecdotal reports floating around of men getting similar side effects to propecia (sexual dysfunction, breast growth, etc.). There are a couple such comments on this page in fact. Seems like it’s pretty rare but still, a good reason to be cautious and perhaps try just topical before taking SP orally.
Hello Rob and all the people here who suffers from hairloss for whatever reason. First of all congratulations for your topic. I want an opinion if possible for doctor’s best saw palmetto 320 mg. This is something that i started today and i will see how it will goes as i am a person witch start to seeing receding hairline almost 1 year now. And i am a little bit scary as my both grandfather’s had bald head. What do you think for this supplement? It look to have pretty clean ingredients. Sorry for my English if something is difficult to understand!
sir your explanation are toooo long and techy, as a layman i get headache understanding the underlying fact that you want to explain. So please answer my two basic queries…
1… does increase in blood circulation in scalp increase hair growth ?
2… does scalp massage increase hair growth ?
if you give me genuine answers at the earliest i will apply these on myself and if i get positive result i will appreciate your good advice lifelong