Saw Palmetto vs Finasteride

If you’re experiencing hair loss, you’ve probably looked into both prescription medications and natural remedies as solutions. These two options usually boil down to Saw Palmetto vs Finasteride. Which is better? That’s a difficult question to answer so let’s look at both of these substances first.

Saw Palmetto

Saw Palmetto extract comes from the berries of the saw palmetto palm plant. Saw palmetto supplements are commonly used to alleviate prostate problems in men, but are also used for several other issues, including hair loss. It is a natural supplement, so it is available over the counter in a number of forms, including oil, capsules, and powder. It works by inhibiting the production of DHT (dihydrotestosterone) in the body. DHT regulates hair growth and excess levels of it may cause hair loss.


Finasteride is the most common prescription medication for male pattern hair loss (androgenetic alopecia). Produced by Merck, it was first approved by the FDA in 1992 for treating prostate issues in men. They later approved it for treating hair loss in 1997 (after many enlarged prostate sufferers realized their hair was growing while on Finasteride). Finasteride is also known as Proscar and Propecia. It requires a prescription, which means a visit to a doctor. It, too, works by inhibiting DHT.

Saw Palmetto vs Finasteride

So, if you’re looking for a solution to hair loss, which is better Saw palmetto or Finasteride? Well, the answer is not a simple one. 

Do you want to try a natural remedy for hair loss? If that’s the case, then saw palmetto is clearly the answer. Finasteride is a drug and in no way falls into the natural category. 

Do you want to avoid potential side effects? Again, saw palmetto is probably the better choice, as it is safer to use than Finasteride.

Perhaps you just want to use whichever is more effective. Is saw palmetto more effective than Finasteride? Probably not. A 2012 study by Rossi, et al. titled: Comparative effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study, divided 100 male patients suffering from androgenetic alopecia into two groups. One group received 320mg of saw palmetto every day for 24 months. The other group received 1mg of Finasteride over the same time span. At the end of the study they found that the only 38% of the saw palmetto patients had an increase in hair growth while 68% of the Finasteride patients experienced hair growth. They also found that Finasteride was more effective on patients with more severe alopecia and that it worked both on the frontal area of the scalp and the vertex, while saw palmetto was predominantly effective only on the vertex.

But, the above study and others have shown that saw palmetto can help with hair loss. It may not be as effective as Finasteride but it is probably safer to use. Which leads us to the subject of possible side effects.

Is saw palmetto safer than finasteride?

Probably. Finasteride is known to have several potential side effects some of which can be persistent even after you quit taking it. The most eye opening issue is what is called Post-Finasteride Syndrome. I won’t get into the details of that here but a meta study done in 2019 concluded that: 

Based on the existing body of evidence in the contemporary clinical literature, the author believes that finasteride and dutasteride induce a constellation of persistent sexual, neurological and physical adverse side effects, in a subset of men. 

They also found: 

…increased depression, anxiety and suicidal ideation in a subset of men treated with these drugs were commonly reported in a number of studies.

To be fair, they found that those severe side effects only manifested in a sub-set of men taking Finasteride. In fact, the study found that only 1.4% of the men in the study suffered from persistent erectile dysfunction (PED). But, “persistent” means that the PED did not go away even after they stopped taking Finasteride. On top of that, it has also been linked to depression and insomnia. Scary stuff.

Saw palmetto has nowhere near those types of side effects. Common side effects that are mentioned while taking saw palmetto are stomach upset and possibly decreased blood clotting. Those taking blood thinners should talk to their doctor before taking saw palmetto.

Is saw palmetto better than finasteride?

Finasteride is more effective than saw palmetto but it’s important to weigh the effectiveness of Finasteride against its potential side effects. If you try Finasteride and suffer side effects, you’ll most likely want to discontinue using it and substitute a more natural ingredient like saw palmetto. The trade off is that saw palmetto is less effective. Some hair loss sufferers even claim that saw palmetto does nothing for them. But, there is quite a lot of anecdotal evidence, and some clinical evidence, that it does have a positive effect for some users. Hair loss has many different root causes, so what works for one person may not work for another.

Can you take saw palmetto and Finasteride together?

Given the potential side effects of Finasteride and the fact that both Finasteride and saw palmetto theoretically work the same way, it’s probably not a good idea to take them together. Definitely seek professional medical advice before going down that path.

Dosage comparison between Finasteride and Saw palmetto

There isn’t any standardized dosage to optimize the benefits of saw palmetto. Most studies used between 100 and 320 mg daily. Finasteride is usually a 1 mg dose. While the dosage for saw palmetto is higher, it is still much cheaper than Finasteride, which may be a benefit for those on a budget.

Here is a breakdown of the pros and cons of saw palmetto and Finasteride:

Saw Palmetto Benefits:

  • Safer
  • Cheaper
  • No prescription required
  • Fewer, less severe side effects
  • Natural
  • Comes in many forms

Saw Palmetto Drawbacks:

  • Less effective
  • May not work at all for some people
  • Inconsistent quality in supplements
  • Not regulated by the FDA

Finasteride Benefits:

  • Effective
  • Consistent quality
  • Lower dosage required
  • Regulated by the FDA

Finasteride Drawbacks:

  • Adverse side effects
  • Expensive
  • Requires prescription
  • Post-Finasteride Syndrome
  • Not a natural substance

In the end you’ll have to weigh the risks and benefits of both saw palmetto and Finasteride. Many choose to try saw palmetto first since it is over the counter, and then, if it is not effective for them, move on to Finasteride. Consult with your doctor whichever path you choose as both substances can have interactions with other drugs and conditions.