Herbal side effects

Pygeum has been well tolerated in most studies, with adverse effects similar to placebo or sugar pill. Some people may experience stomach discomfort, including diarrhea, constipation, stomach pain or nausea. Stomach upset is usually mild and does not typically cause people to stop using pygeum.

Safety of use beyond 12 months has not been reliably studied.

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Few severe side effects of saw palmetto are noted in the published scientific literature.

The most common complaints involve the stomach and intestines, and include stomach pain, nausea, vomiting, bad breath, constipation, or diarrhea. Stomach upset caused by saw palmetto may be reduced by taking it with food. Some reports suggest that there may be less abdominal discomfort with the preparation lipidosterolic extract of Serenoa repens (LSESR). A small number of reports describe ulcers or liver damage and yellowing of the skin (jaundice), but the role of saw palmetto is not clear in these cases. Similarly, reports of headache, dizziness, insomnia, depression, breathing difficulties, muscle pain, high blood pressure, chest pain, abnormal heart rhythm, and heart disease have been reported, but are not clearly caused by saw palmetto. People with health conditions involving the stomach, liver, heart, or lungs should use caution.

At least two case reports describe severe bleeding during saw palmetto use. Caution is advised in people scheduled to undergo some surgeries or dental work, who have bleeding disorders, or who are taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. Several reports describe men with prostate cancer who developed blood clots in the legs and lung while taking saw palmetto. Since cancer may increase the risk of blood clots, it is not clear if saw palmetto was the cause.

In theory, PSA (prostate specific antigen) levels may be artificially lowered by saw palmetto, based on a proposed mechanism of action of saw palmetto (inhibition of 5-α-reductase). Therefore, there may be a delay in diagnosis of prostate cancer, or interference with following PSA levels during treatment or monitoring in men with known prostate cancer.