Saw palmetto is a fatty-acid-rich berry extract used for urinary bother from an enlarged prostate and hormone-related hair thinning. Independent placebo comparisons show little or no meaningful urinary change. European literature reports drug-like gains. Safety looks similar to placebo; uncommon events are extra bleeding around surgery or clotting-slowing drugs and rare liver or pancreas reports. Product identity is the hinge. (Full Review)
| Marker | Target | Why |
|---|---|---|
| PSA | Individual trajectory; many functional clinics watch slope, not a single cut-off | Detects a rising cancer-risk signal the extract will not reliably suppress |
| Total testosterone | Often 500–900 ng/dL in functional practice | Checks the claim of “testosterone support” and flags unexpected androgen shifts |
| DHT | No established target; track change from the person’s own baseline | Optional when the goal is follicle-level androgen load |
| ALT | Often <30 U/L in men in functional practice | Screens the rare hepatitis case-report pattern |
| IPSS or AUASI | Sustained drop of 3 or more points | Defines urinary success; no meaningful change by 3 months is a stopping cue |
Cadence: Recheck at 4–8 weeks for tolerability and symptom or shed-count change; about 3 months for the symptom score and photographs; then every 6–12 months with PSA and liver enzymes if use continues