Drug & supplement interaction

Saw Palmetto + Testosterone Undecanoate

Testosterone Undecanoate brand names: Andriol, Aveed, Jatenzo, Kyzatrex.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Saw Palmetto and Testosterone Undecanoate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Saw Palmetto and Testosterone Undecanoate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Testosterone Undecanoate and Saw Palmetto in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Saw Palmetto safety at a glance

Saw Palmetto overall Use caution Generally well tolerated in adults but should be used under guidance, especially for prostate or urinary symptoms.
Pregnancy Likely Unsafe When used orally. Saw palmetto has hormonal activity; avoid using. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. Saw palmetto has hormonal activity; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Pharmacist analysis

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On the whole, saw palmetto has very few reported drug interactions due to its lack of effects on liver metabolizing enzymes (e.g., CYP P450 enzymes).

There have been some reports of minor interactions with anticoagulants, estrogens, and contraceptives due to saw palmetto's purported effects on blood clotting and various hormones in the body. However, these interactions have generally only been seen in lab studies and for most individuals, are not considered clinically significant.

As always, however, be sure to talk to your doctor before starting any new medications or supplements so you can be appropriately monitored.

Comprehensive analysis does not indicate a significant interaction.

Still wondering about combining Testosterone Undecanoate and Saw Palmetto? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Testosterone Undecanoate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Testosterone Undecanoate is filed under 6 classifications — including androgens, thyroid hormone, hepatotoxic drugs. Saw Palmetto has documented interactions with 3 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), contraceptive drugs (moderate) and estrogens (moderate) — and none of Testosterone Undecanoate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Saw Palmetto Does Interact With Other Medications

Saw Palmetto has 174 moderate known drug interactions in our database — Testosterone Undecanoate isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Saw Palmetto

Covers the 2,830 medications we’ve checked against Saw Palmetto. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Saw Palmetto and Testosterone Undecanoate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 8 of them are worth acting on rather than waiting out — marked below.

  • A heart attack / Heart failure / An irregular heartbeat / Chest pain / Raised blood pressure Worth acting on Additional detail

    Saw Palmetto

    “Occasionally, cases of hypertension, postural hypotension, tachycardia, angina pectoris, arrhythmia, extrasystole, angiopathy, myocardial infarction, and congestive heart failure have been reported in patients using saw palmetto orally. One case of severe bradycardia and second degree heart block was reported in a 64 year-old male taking an unknown amount of saw palmetto for a few weeks.”

    Saw Palmetto · Natural Medicines adverse-effect record, reported in angina.

    1 source cited
    1. 96413. Jipescu D, Patel A, Bohra H, Pientka A. Rare case of saw palmetto induced heart block. JACC 2017;69(11) supplement:2310.

    Testosterone Undecanoate

    Listed in the ADVERSE REACTIONS section of the FDA label for Testosterone Undecanoate. Read the label on DailyMed ›

  • Shortness of breath Worth acting on reported in 5.9% of FDA reports for Testosterone Undecanoate Additional detail

    Saw Palmetto

    “Rhinitis is one of the more commonly reported adverse effects of saw palmetto. One patient taking saw palmetto extract 160 mg twice daily reported "breathlessness". Two cases of respiratory depression have been reported in patients using saw palmetto extract (Permixon) 320 mg.”

    Saw Palmetto · Natural Medicines adverse-effect record, reported in depression.

    3 sources cited
    1. 73348. Agbabiaka, T. B., Pittler, M. H., Wider, B., and Ernst, E. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf 2009;32(8):637-647. PubMed
    2. 73388. Braeckman J. The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study. Current Therapeutic Research 1994;55(7):776-785. DOI
    3. 6772. Stepanov VN, Siniakova LA, Sarrazin B, Raynaud JP. Efficacy and tolerability of the lipidosterolic extract of Serenoa repens (Permixon) in benign prostatic hyperplasia: a double-blind comparison of two dosage regimens. Adv Ther 1999;16:231-41.

    Testosterone Undecanoate

    Listed in the ADVERSE REACTIONS section of the FDA label for Testosterone Undecanoate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Liver problems Worth acting on Additional detail

    Saw Palmetto

    “A case report describes a patient who developed acute hepatitis and pancreatitis while taking saw palmetto. Symptoms resolved when saw palmetto was discontinued, and reemerged upon re-challenge. Other cases of acute hepatitis and pancreatitis, with elevated alkaline phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and bilirubin have been reported in patients using saw palmetto orally.”

    Saw Palmetto · Natural Medicines adverse-effect record, reported in hepatitis.

    3 sources cited
    1. 14457. Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2. PubMed
    2. 73350. Wargo, K. A., Allman, E., and Ibrahim, F. A possible case of saw palmetto-induced pancreatitis. South.Med.J. 2010;103(7):683-685. PubMed
    3. 73351. Lapi, F., Gallo, E., Giocaliere, E., Vietri, M., Baronti, R., Pieraccini, G., Tafi, A., Menniti-Ippolito, F., Mugelli, A., Firenzuoli, F., and Vannacci, A. Acute liver damage due to Serenoa repens: a case report. Br.J.Clin.Pharmacol. 2010;69(5):558-560.

    Testosterone Undecanoate

    Listed in the ADVERSE REACTIONS section of the FDA label for Testosterone Undecanoate. Read the label on DailyMed ›

  • A higher chance of infection Worth acting on Additional detail

    Saw Palmetto

    “Some clinicians are concerned that saw palmetto might cause erectile dysfunction, ejaculatory disturbance, or altered libido because of its potential effects on 5-alpha-reductase. Some preliminary clinical studies have reported sexual dysfunction, particularly ejaculatory dysfunction, erectile dysfunction, and reduced libido, in patients taking saw palmetto.”

    Saw Palmetto · Natural Medicines adverse-effect record, reported in antidepressant-induced sexual dysfunction.

    5 sources cited
    1. 2732. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998;280:1604-9. PubMed
    2. 6424. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40. DOI
    3. 17306. Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med 2008;16:147-54. PubMed
    4. 107481. Paulis G, Paulis A, Perletti G. Serenoa repens and its effects on male sexual function. A systematic review and meta-analysis of clinical trials. Arch Ital Urol Androl 2021;93(4):475-480. PubMed
    5. 73388. Braeckman J. The extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a multicenter open study. Current Therapeutic Research 1994;55(7):776-785. DOI

    Testosterone Undecanoate

    Listed in the ADVERSE REACTIONS section of the FDA label for Testosterone Undecanoate. Read the label on DailyMed ›

  • A change in sex drive Additional detail

    Saw Palmetto

    “Orally, saw palmetto is well tolerated and adverse effects are mild, infrequent, and reversible.

    Most Common Adverse Effects:

    Orally: Abdominal pain, constipation, decreased libido, diarrhea, dizziness, fatigue, headache, nausea, rhinitis, vomiting.”

    Saw Palmetto · Natural Medicines adverse-effect record, reported in cluster headache.

    Testosterone Undecanoate

    Listed in the ADVERSE REACTIONS section of the FDA label for Testosterone Undecanoate. Read the label on DailyMed ›

  • Acne Additional detail

    Saw Palmetto

    “A case report describes a 61-year-old male who developed a fixed drug eruption with localized blisters and erosions three days after starting oral saw palmetto. The lesions resolved when saw palmetto was stopped, but recurred when it was reintroduced six months later. Topical corticosteroid treatment was necessary and the patient was left with some residual hyperpigmented patches.”

    Saw Palmetto · Natural Medicines adverse-effect record, reported in acne.

    2 sources cited
    1. 104805. Gammoudi R, Ameur K, Ouni B, et al. Fixed drug eruption to Serenoa repens: first case report and consideration of the use of herbal medicine. Dermatol Ther 2020 Aug 29:e14247.
    2. 15550. Prager N, 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

    Testosterone Undecanoate

    Listed in the ADVERSE REACTIONS section of the FDA label for Testosterone Undecanoate. Read the label on DailyMed ›

Showing the 10 most notable of 24 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Saw Palmetto but not commonly for Testosterone Undecanoate: low blood pressure, bloating or gas, bleeding in the gut and severe muscle breakdown.

Effects for Testosterone Undecanoate come from the ADVERSE REACTIONS section of its FDA label; effects for Saw Palmetto come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 1,859 voluntary FDA FAERS reports for Testosterone Undecanoate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Saw Palmetto in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally. Saw palmetto has hormonal activity; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Saw Palmetto or Testosterone Undecanoate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Saw Palmetto or Testosterone Undecanoate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Testosterone Undecanoate

This page covers Saw Palmetto only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Testosterone Undecanoate page lists 200 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 7 major · 150 moderate · 43 minor.

From our pharmacist’s overview on the Testosterone Undecanoate page

“The supplement list for testosterone undecanoate (Jatenzo, Aveed, Kyzatrex, Andriol) deserves real attention before you combine it with much of anything, and the seven major-rated entries are where I would start. Most of the 200 ingredients on file, 121 of them, can change how the body handles this hormone through the CYP3A4 enzyme; gr…”

Reviewed by 2 · Jul 18, 2026

Open the Testosterone Undecanoate interaction page

One more smart check

Taking Saw Palmetto as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3,466 real supplement products containing Saw Palmetto, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Saw Palmetto. Even though Saw Palmetto itself has no known interaction with Testosterone Undecanoate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Saw Palmetto and Testosterone Undecanoate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Saw Palmetto
Top 10%

#76 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Testosterone Undecanoate
Top half

#920 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Saw Palmetto reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Saw Palmetto and Testosterone Undecanoate records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Saw Palmetto

What is Saw Palmetto?

Saw Palmetto
  • Benign prostatic hyperplasia (BPH) symptoms
  • Urinary problems
  • Hair loss
  • Prostate health
  • Inflammation

Saw palmetto is a plant extract most often used for urinary symptoms linked to an enlarged prostate (BPH). The best research suggests it works no better than a placebo for most men, though it is generally well tolerated. Talk to your doctor or pharmacist before using it, especially for prostate or urinary problems that need proper evaluation.

Serenoa repens · Arecaceae · Fruit (berries) · Capsules, softgels, tablets, liquid extracts, dried berries, tea

An interaction check asks whether these two react with each other — it does not ask whether Saw Palmetto is a good idea for someone in your situation. Here is what our Saw Palmetto record says about it on its own.

Saw Palmetto: dosing

There is no official, agreed-upon dose for saw palmetto. Products vary in strength and how they are prepared, and many are standardized to a certain percentage of fatty acids.The safest approach is to follow the dosing directions on the product label and not exceed them. They can help you decide whether it is appropriate and what dose is reasonable for you.

From our Saw Palmetto monograph — the full record covers uses, side effects and every documented interaction.

Read the full Saw Palmetto monograph & all interactions
Medication

About Testosterone Injection

What Is Testosterone Injection Used For?

Brand names: Andriol, Aveed, Jatenzo, Kyzatrex

Testosterone injection is primarily used in men whose bodies do not produce enough testosterone on their own — a condition called hypogonadism. This includes primary hypogonadism (a problem with the testicles themselves, such as from injury, infection, or surgery) and hypogonadotropic hypogonadism (caused by problems in the brain's hormone signaling from the hypothalamus or pituitary gland). It is also used to stimulate puberty in carefully selected adolescent males with clearly delayed puberty who have not responded to other support.

Testosterone Enanthate Injection is also approved for use in women with advanced, inoperable metastatic breast cancer (specifically skeletal metastases) who are one to five years past menopause, or in premenopausal women with hormone-responsive breast cancer who have had their ovaries removed. This use should be directed by an oncologist. Aveed (testosterone undecanoate) is specifically approved for male hypogonadism only.

See full Testosterone Injection drug information
Keep checking

Other Drugs & Saw Palmetto

Browse every other medication we’ve checked against Saw Palmetto — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
174Moderate
0Minor
2,655No known interaction
Moderate

174 interactions

Showing 60 of 174 moderate interactions — see all 174 on the Saw Palmetto page.

No interaction 2,655 drugs checked — show the list
Evidence & sources

Saw Palmetto References

The 22 references that drive our Saw Palmetto monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998;280:1604-9. PubMed
  2. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-40. DOI
  3. Di Silverio F, D'Eramo G, Lubrano C, et al. Evidence that Serenoa repens extract displays an antiestrogenic activity in prostatic tissue of benign prostatic hypertrophy patients. Eur Urol 1992;21:309-14. PubMed
  4. Stepanov VN, Siniakova LA, Sarrazin B, Raynaud JP. Efficacy and tolerability of the lipidosterolic extract of Serenoa repens (Permixon) in benign prostatic hyperplasia: a double-blind comparison of two dosage regimens. Adv Ther 1999;16:231-41.
  5. Cheema P, El-Mefty O, Jazieh AR. Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature. J Intern Med 2001;250:167-9. PubMed
  6. Jibrin I, Erinle A, Saidi A, Aliyu ZY. Saw palmetto-induced pancreatitis. South Med J 2006;99:611-2. PubMed
  7. Prager N, 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
  8. Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract. Complement Ther Med 2008;16:147-54. PubMed
  9. Morgia, G., Mucciardi, G., Gali, A., Madonia, M., Marchese, F., Di, Benedetto A., Romano, G., Bonvissuto, G., Castelli, T., Macchione, L., and Magno, C. Treatment of chronic prostatitis/chronic pelvic pain syndrome category IIIA with Serenoa repens plus
  10. Aliaev, IuG, Vinarov, A. Z., Lokshin, K. L., and Spivak, L. G. [Efficiency and safety of prostamol-Uno in patients with chronic abacterial prostatitis]. Urologiia. 2006;(1):47-50.
  11. Agbabiaka, T. B., Pittler, M. H., Wider, B., and Ernst, E. Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf 2009;32(8):637-647. PubMed
  12. Wargo, K. A., Allman, E., and Ibrahim, F. A possible case of saw palmetto-induced pancreatitis. South.Med.J. 2010;103(7):683-685. PubMed
  13. Lapi, F., Gallo, E., Giocaliere, E., Vietri, M., Baronti, R., Pieraccini, G., Tafi, A., Menniti-Ippolito, F., Mugelli, A., Firenzuoli, F., and Vannacci, A. Acute liver damage due to Serenoa repens: a case report. Br.J.Clin.Pharmacol. 2010;69(5):558-560.
  14. Mantovani, F. Serenoa repens in benign prostatic hypertrophy: analysis of 2 Italian studies. Minerva Urol.Nefrol. 2010;62(4):335-340.
  15. Hanaka, M., Yoshii, C., Yatera, K., Ito, C., Chojin, Y., Nagata, S., Yamasaki, K., Nishida, C., Kawanami, T., Kawanami, Y., Ishimoto, H., and Mukae, H. [A case of rhabdomyolysis caused by saw palmetto of healthy foods]. J.UOEH. 6-1-2012;34(2):193-199. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Saw Palmetto and Testosterone Undecanoate Together: Common Questions

Is it safe to take Saw Palmetto with Testosterone Undecanoate?
We do not list a known interaction between Saw Palmetto and Testosterone Undecanoate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Saw Palmetto and Testosterone Undecanoate have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Saw Palmetto and Testosterone Undecanoate combination checked?
Interactions in our licensed database are recorded against drug classes. Testosterone Undecanoate is filed under 6 classifications, and Saw Palmetto has documented interactions with 3 drug classes — none of Testosterone Undecanoate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Saw Palmetto interact with any other medications?
Yes. Saw Palmetto has 174 documented drug interactions in our database — Testosterone Undecanoate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Testosterone Undecanoate interact with any supplements?
Yes. Testosterone Undecanoate has documented interactions with 200 supplements in our database — Saw Palmetto is not one of them. The Testosterone Undecanoate interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.