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Effect of Increasing Doses of Saw Palmetto on Lower Urinary Tract Symptoms: A Randomized Trial

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Stats & Storylines: Clemson controls lines of scrimmage, resumes Palmetto Bowl domination

by Ryan Kantor - Contributor - Monday, November 29, 2021, 8:00 AM

After SEC scheduling decisions put a pause on the Palmetto Bowl last season, it returned this week and felt just like old times. Williams-Brice Stadium was loud and raucous at the start, but the Tigers took control early and never relented. They dominated the line of scrimmage on both sides of the ball, allowing them to lean heavily on the running game on offense, while completely taking it away on defense.

Clemson extended its win streak over South Carolina to seven games, tying the longest win-streak in the rivalry (Clemson: 1934-1940). The win pushes the Tigers to 9-3 and a bowl win would continue their decade-long streak of winning 10 games per season.

Clemson Rushing Attack: 43 carries, 265 yards (6.2 YPC), 3 TDs

The Tigers continued the wildly efficient ground assault that gashed Wake Forest a week ago. Will Shipley exploded through holes on his 19 carries for 128 yards and a TD. Kobe Pace ran for 58 yards and a TD on just seven carries. Phil Mafah added 43 yards on 11 carries and gave the Tigers their final TD in the contest. The early season acrimony with Lyn-J Dixon (who announced recently he is transferring to West Virginia) is now a distant memory. Coach CJ Spiller’s running back room is firing on all cylinders.

Clemson’s offense has undergone an unexpected transformation in November. In the first two games of November (at Louisville, vs. UConn), Clemson threw the ball 88 times while only generating 3.3 yards per carry on the ground. In the last two games (vs. Wake Forest, at South Carolina), Clemson passed it just 39 total times and produced a whopping 6.2 yards per carry.

Getting some key players healthy certainly played a role in that. Shipley and Pace were banged up in the game against Louisville and subsequently missed the game against UConn. Right guard Will Putnam was also out for the UConn game. All three were back and appeared at or near 100% against Wake Forest and South Carolina.

It is more than just health though. Mason Trotter seems to have settled in at center. Hunter Rayburn, who played at center earlier in the year, took over for freshman Marcus Tate at left guard during the Wake Forest game and started there against the Gamecocks. He is also playing well and seems much improved from earlier in the season.

Back in fall camp, the coaches’ soundbites about the offensive line gave us all a ton of optimism. It didn’t materialize for most of the season, but it is happening now. All five starting offensive linemen along with the top three running backs are planning to return next season. Clemson may – for the first time in years – be a heavily run-first team in 2022.

Clemson Passing Game: 9/19, 99 yards, 1 INT

Clemson’s dominance on the ground allowed them to hide a struggling passing game. DJ Uiagalelei continues to have accuracy issues. He attacked one-on-one coverage with a deep ball early in the game but threw it on the wrong side of the receiver leading to an interception. He had a few others that weren’t misses but could have been caught if the ball was a bit more on target. The pass catchers were not blameless either. Beaux Collins dropped a pass that would have netted a big gain. Will Shipley dropped a quick pass in the backfield too.

As a result of these struggles and the continued success in the running game, the staff leaned heavily on the latter. Clemson threw the ball just seven times for 34 yards in the second half. With the way the Tigers’ defense was dominating the Gamecocks, they opted for conservative run plays on two different third-and-long situations to avoid turnovers and milk clock. I can’t say I blame them. Dacari Collins was the lone bright spot in the passing game. He had two receptions for 50 yards.

Clemson Defense: 163 passing yards allowed, 43 rushing yards allowed, 1 INT, 1 sack

Despite defensive end Xavier Thomas being out with injury, Clemson’s defense had their way with the Gamecock’s offensive line. Gamecocks running backs had nowhere to run and collected just 38 yards on 17 carries (2.2 YPC). Trailing from early in the game and getting no traction on the ground, South Carolina threw the ball 42 times but connected for just 19 completions and 163 yards – much of which came in garbage time. The Gamecocks started Jason Brown at quarterback but replaced him with Zeb Noland after Brown threw two interceptions.

With Thomas out, defensive end KJ Henry started and had one of his better games as a Tiger. He collected the team’s only sack. Henry was a five-star recruit back in 2018, and while he has certainly contributed, he hasn’t lived up to the hype that comes with a five-star rating. He already has a degree in sports communication so he could choose to move on from college and begin a traditional career, but as a redshirt junior, he could also return for another season and likely be a starter. If he can play like this for a whole season, he could become an NFL draft target.

Myles Murphy didn’t collect any sacks but hurried the QB four times. Linebackers Baylon Spector and James Skalski led the team in tackles with six each.

Cornerback Andrew Booth: 2 INT, 1 pass defense, 1 tackle

Andrew Booth is making a case for being one of the best cornerbacks in Clemson history. He had two interceptions in this contest, giving him three on the season and five for his career. In addition to being good in coverage and having good hands, he is an outstanding tackler.

Andrew Booth is projected to go in the first 15 picks of the NFL draft with several mock drafts showing him going at pick No. 11 to the Philadelphia Eagles. He should be one of the first two cornerbacks off the board.

Kicker BT Potter: 3/3 on field goals (29 yards, 47 yards, 49 yards); 3/3 on extra points

BT Potter had another perfect game and is now 16-of-20 on the season with three of his four misses coming in the Florida State game. He is 9-for-11 on field goals of 40 yards or further. With Clemson’s conservative ground and pound offense of the last two weeks, his excellence is all the more critical. He’s truly had a “magical” season:

Around the Country:

It was an exciting Rivalry Week in college football. The biggest story was Michigan’s 42-27 upset of No. 2 Ohio State. Michigan pounded them on the ground for 297 rushing yards. The Wolverines had lost the eight prior meetings and, like the Palmetto Bowl, did not play last season (COVID cancellation on Michigan's part). For Ohio State, it was their second loss of the year, which eliminates them from the Big Ten Championship game and College Football Playoff.

Oklahoma State also snapped their ugly six-game rivalry losing streak by beating the Sooners. If Oklahoma State can beat Baylor in the Big 12 Championship next week, they may be selected for the playoff over Notre Dame, who will be idle next week with no championship game to win as an independent. Many would be pleased to see the committee show that conference championships still have a lot of value.

Auburn forced four overtimes against Alabama, but the Crimson Tide came up with clutch plays down the stretch to steal the victory in Jordan-Hare Stadium. The Crimson Tide are still in the playoff race, but it finally looks like Georgia’s year to knock them out. Florida managed to beat Florida State in a close contest even though they seemed to be plummeting, while Florida State was playing decent football. It will deny Florida State a bowl and the valuable bowl practices that come with it. It is really a wonder that South Carolina beat both Auburn and Florida in recent weeks given how hapless the Gamecocks looked against Clemson.

Wake Forest took care of business against Boston College and clinched the Atlantic division. It was actually a relief for many Clemson fans because North Carolina blew a 9-point lead in the final two minutes against NC State. Had Wake Forest lost, NC State would have won their first-ever Atlantic Division. Now, Wake Forest will play Pittsburgh. Although Pittsburgh was much more impressive in their game against the Tigers than the Demon Deacons, they’re a very pass-oriented team and may not be well-equipped to attack Wake’s weakness in run defense.

For the Tigers, it will be a waiting game to see which bowl selects them. Things could change, but an SEC matchup in the Gator Bowl against Tennessee, Arkansas, or Texas A&M could be on tap.

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Tags: Clemson Football, Will Shipley, Kobe Pace, Phil Mafah, Lyn-J Dixon, Will Putnam, Mason Trotter, Hunter Rayburn, Marcus Tate, DJ Uiagalelei, Beaux Collins, Dacari Collins, Xavier Thomas, KJ Henry, Myles Murphy, Baylon Spector, James Skalski, BT Potter


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What Is Saw Palmetto?

Saw palmetto (Serenoa repens or Sabal serrulata) is a plant used in herbal medicine. Often used to fight hair loss, saw palmetto is also commonly used for conditions affecting the prostate.

Saw palmetto supplements typically contain extracts of the fruit of the plant.

What Is Saw Palmetto Used For?

In alternative medicine, saw palmetto is said to aid in the treatment of health problems including asthma, benign prostatic hypertrophy (BPH), chronic pelvic pain syndrome, colds, coughs, migraine, prostate cancer, and sore throat.

Saw palmetto is also thought to increase libido, as well as alleviate stress.

Scientific studies have provided limited support for some of these potential benefits.


One of the most common uses of saw palmetto is the treatment of BPH, a condition marked by enlargement of the prostate. BPH is not considered a serious health issue, but it often causes symptoms such as the increased need to urinate. It also may lead to urinary tract infections and other complications.

Several small studies have shown that saw palmetto may help relieve BPH symptoms. However, a report published in the Cochrane Database of Systematic Reviews in 2012 found that saw palmetto may be ineffective in treating urinary symptoms associated with BPH.

For this report, researchers analyzed 32 previously published clinical trials with a total of 5,666 participants. Their analysis determined that the use of saw palmetto did not improve urinary flow measures or prostate size in men with BPH-related lower urinary tract symptoms.

Hair Loss

Saw palmetto is said to inhibit the activity of 5-alpha-reductase, an enzyme involved in converting testosterone to a hormone called dihydrotestosterone. Dihydrotestosterone appears to play a key role in the development of androgenic alopecia, a condition more commonly known as male-pattern hair loss.

While research on saw palmetto's effects against hair loss is limited, there's some evidence that it may help treat androgenetic alopecia.

In a pilot study published in the Journal of Alternative and Complementary Medicine in 2002, for instance, a group of males with mild to moderate androgenetic alopecia showed a "highly positive response" to treatment with saw palmetto and beta-sitosterol. The study's authors partly attributed this finding to saw palmetto's possibly blocking the activity of 5-alpha reductase.

Other Benefits

Emerging research suggests that saw palmetto shows promise in the treatment of certain other health conditions.

For example, a small study published in the Swiss journal Urologia Internationalis in 2010 found that saw palmetto may be of some benefit to patients with chronic prostatitis/chronic pelvic pain syndrome.

In the study, 102 patients with chronic prostatitis/chronic pelvic pain syndrome were split into two groups: the first group received a combination of saw palmetto, selenium, and lycopene; the second group received saw palmetto alone. After eight weeks of treatment, both groups showed a significant improvement in symptoms. 

There's also some evidence that taking saw palmetto prior to undergoing prostate surgery may reduce the time spent in surgery (as well as blood loss, the development of problems during surgery, and total time spent in the hospital). 

Possible Side Effects

Saw palmetto may cause a number of side effects, including:

• bad breath
• constipation
• diarrhea
• dizziness
• fatigue
• headache
• nausea
• stomach
• vomiting

Additionally, some men taking saw palmetto have reported erectile dysfunction, breast tenderness or enlargement, and changes in sexual desire.

Although it hasn't been well-demonstrated in humans, saw palmetto may influence levels of sex hormones, such as estrogen and testosterone. Therefore, people with hormone-sensitive conditions (including breast cancer and prostate cancer) should consult their healthcare provider prior to using saw palmetto. Children and pregnant women shouldn't take saw palmetto.

There have been rare case reports describing liver inflammation, pancreatitis, jaundice, headache, dizziness, insomnia, depression, breathing difficulties, muscle pain, high blood pressure, chest pain, abnormal heart rhythm, blood clots, and heart disease, but they haven't been clearly caused by saw palmetto.

At least two case reports have linked saw palmetto with severe bleeding. People with bleeding disorders or who are taking anticoagulant or antiplatelet medications such as warfarin (Coumadin®), aspirin, or clopidogrel (Plavix®) should avoid taking saw palmetto unless under medical supervision. It should also be avoided at least two weeks before or after surgery.

Dosage and Preparation

There is not enough scientific data to provide a recommended dose of saw palmetto. In studies evaluating the effect of saw palmetto on prostate surgery patients, a dose of 320 mg of saw palmetto extract was taken daily for two months before surgery.

The appropriate dose for you may depend on factors including your age, gender, and medical history. Speak to your healthcare provider to get personalized advice.

What to Look For

You can purchase dietary supplements containing saw palmetto in many natural-foods stores, drugstores, and stores specializing in herbal products. Saw palmetto is also widely available for purchase online.

If you choose to buy this or any supplement, the National Institutes of Health (NIH) recommends that you look for a Supplement Facts label on the product that you buy. This label will contain vital information including the amount of active ingredients per serving, and other added ingredients (like fillers, binders, and flavorings).

Lastly, the organization suggests that you look for a product that contains a seal of approval from a third party organization that provides quality testing. These organizations include U.S. Pharmacopeia,, and NSF International. A seal of approval from one of these organizations does not guarantee the product's safety or effectiveness but it does provide assurance that the product was properly manufactured, contains the ingredients listed on the label, and does not contain harmful levels of contaminants.

Frequently Asked Questions

  • Saw palmetto can cause stomach upset, including diarrhea, nausea, vomiting, and constipation. It can also cause bad breath, headache, dizziness, and fatigue. 

    In rare instances, saw palmetto can cause sexual side effects in men, including erectile dysfunction and changes in desire. It may also cause breast tenderness or enlargement in men.

  • Yes. While saw palmetto has traditionally been used to treat benign prostatic hyperplasia (BPH) in men, it is safe for women to take. However, women who are pregnant or breastfeeding should not take saw palmetto. 

  • Possibly. Research suggests saw palmetto may influence male and female sex hormones, including androgen, estrogen, and testosterone. However, it is unclear whether saw palmetto has a measurable effect on hormone levels in humans.

Thanks for your feedback!

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Fagelman E, Lowe FC. Saw Palmetto Berry as a Treatment for BPH. Rev Urol. 2001 Summer;3(3):134-8.

Additional Reading
  • Saw Palmetto. Penn State Hershey. Milton S. Hershey Medical Center. Health Information Library

  • Saw Palmetto. Natural Medicines Database. Professional Monograph.

  • Saw Palmetto. Memorial Sloan Kettering Cancer Center. About Herbs, Botanicals, and Other Products.

  • Agbabiaka TB1, Pittler MH, Wider B, Ernst E. "Serenoa repens (saw palmetto): a systematic review of adverse events." Drug Saf. 2009;32(8):637-47.
  • Gerber GS1. "Saw palmetto for the treatment of men with lower urinary tract symptoms." J Urol. 2000 May;163(5):1408-12.
  • Gordon AE1, Shaughnessy AF. "Saw palmetto for prostate disorders." Am Fam Physician. 2003 Mar 15;67(6):1281-3.
  • Morgia G1, Mucciardi G, Galì A, Madonia M, Marchese F, Di Benedetto A, Romano G, Bonvissuto G, Castelli T, Macchione L, Magno C. "Treatment of chronic prostatitis/chronic pelvic pain syndrome category IIIA with Serenoa repens plus selenium and lycopene (Profluss) versus S. repens alone: an Italian randomized multicenter-controlled study." Urol Int. 2010;84(4):400-6.
  • National Institutes of Health. "Saw palmetto: MedlinePlus Supplements." February 2015.
  • Prager N1, Bickett K, French N, Marcovici G. "A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia." J Altern Complement Med. 2002 Apr;8(2):143-52.
  • Tacklind J1, Macdonald R, Rutks I, Stanke JU, Wilt TJ. "Serenoa repens for benign prostatic hyperplasia." Cochrane Database Syst Rev. 2012 Dec 12;12:CD001423.
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