Saw palmetto berry/fruit extract (lipophilic: CO2, hexane or oil; usually standardized to fatty acids/sterols)
Saw palmetto berry/fruit extract (lipophilic: CO2, hexane or oil; usually standardized to fatty acids/sterols) is a unrated form of Saw Palmetto (Serenoa repens), used in 786 on-market products .
Typical standardization: Commonly declared as % free fatty acids/total fatty acids and sterols (raw_form)
Why this tier: The form used in the cited trials (Barry 2011), which found no benefit over placebo at up to 3x the standard dose. Per NCCIH's summary of the 2023 Cochrane review (27 studies), reviewers analyzed hexane-extracted products separately from other products and found no difference in BPH symptoms between them, so no tiering between extract types is supported; brand-to-brand compositional variation is documented but not linked to outcomes.
Source: Barry MJ et al. 2011, JAMA 306(12):1344-1351, PMID 21954478; Franco JV et al. 2023, Cochrane Database Syst Rev 6(6):CD001423, PMID 37345871 (via https://www.nccih.nih.gov/health/saw-palmetto); Habib FK, Wyllie MG 2004, Prostate Cancer Prostatic Dis 7(3):195-200, PMID 15289814