Side Effects and Warnings
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
Side Effects and
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
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
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