Tongkat Ali

    Researchedby:
    Brady Holmer

    Fact-checked

    by:

    Peter Woznik, Nick Milazzo
    Last Updated: April 26, 2023

    Tongkat ali, also known as Eurycoma longifolia, is known for its aphrodisiac and profertility effects. It’s also promoted as a “testosterone booster”, and while some evidence exists for this effect in men with low testosterone and the mechanisms are plausible, the data aren’t convincing.

    What is tongkat ali?

    Tongkat ali (Eurycoma longifolia), also known as longjack or Malaysian ginseng (unrelated to Panax ginseng), is an herb from Southeast Asia. The extract of the roots of the plant has been traditionally used to enhance testosterone levels in men, though it has also been proposed to be able to reduce blood pressure, fever, and fatigue. Unfortunately, there’s scant evidence to support these effects.[1] Furthermore, the internet is full of low-quality information about tongkat ali.[2]

    The main bioactive components in tongkat ali are the quassinoid compounds (eurycomanone and eurycomanol), eurycolactones, canthin-6-one metabolites, eurylene and teurilene (derivatives of squalene), and eurypeptides.

    What are tongkat ali’s main benefits?

    Tongkat ali has mainly been studied for its use as an aphrodisiac. However, the mechanisms by which tongkat ali may enhance aphrodisia are not well understood, and most of the research has been conducted in animals. This effect seems to be based in lore and tradition rather than hard evidence.

    Supplementation may increase total testosterone in healthy and hypogonadal men, improve erectile function and alleviate symptoms of erectile dysfunction, increase fertility, and enhance sexual function and well-being.[3][4][5] One study found evidence of an anxiolytic (anxiety and stress-reducing) effect of tongkat ali.[6] It should be noted that evidence for these outcomes is somewhat limited given the lack of published randomized controlled trials in humans.

    Can tongkat ali improve exercise performance?

    Does tongkat ali increase testosterone levels?

    What are tongkat ali’s main drawbacks?

    There is sparse safety, quality, and toxicity data available for tongkat ali from human studies, along with a lack of standard criteria and regulation for its commercial preparations. Some studies have raised concerns about the possible contamination of herbal preparations of tongkat ali by heavy metals in Malaysia, including levels of lead and mercury above permissible limits.[7][8][9]

    Safety and toxicity studies in rodents have found that the LD50 for tongkat ali (the dose that, when administered all at once, causes death in 50% of test animals) is greater than 3,000 mg/kg for the aqueous extract and between 1,500–2,000 mg/kg for the alcoholic extract.[10] Pathological changes in the liver were observed in rats at a dose of 1,200 mg/kg, corresponding to a 1,200 mg daily dose in humans.[11] However, tongkat ali has been shown to be safe for the liver in humans.[3]

    Studies using a dosage of 200–600 mg/day in humans have noted minor side effects, including gastrointestinal symptoms and itching.[3] Otherwise, adverse effects seem to be rare.[4] Tongkat ali is not recommended for pregnant and lactating women; men with breast or prostate cancer, diabetes, heart disease, kidney disease, liver disease, or sleep apnea; and children, due to a lack of data in these populations.[12][13]

    Tongkat ali may impede the actions of propranolol, a medication used to treat high blood pressure (hypertension), by interfering with its absorption and bioavailability.[14] Anyone using this medication and considering supplementing with tongkat ali should first consult a healthcare professional.

    How does tongkat ali work?

    Tongat ali’s effects on male sexual enhancement are primarily attributed to eurycomanone, which has steroidogenic activity. Eurycomanone has been shown to have anti-estrogenic effects. It inhibits the aromatase enzyme and prevents the conversion of testosterone to estrogen in the Leydig cells of the testes, the primary site of sperm production in men.

    At higher doses, eurycomanone may inhibit phosphodiesterase (PDE) activity, resulting in an accumulation of cyclic AMP, an increase in cholesterol transport, and an increased production of pregnenolone, a precursor for testosterone biosynthesis.[15] Furthermore, activation of the CYP17a enzyme by eurycomanone increased production of testosterone precursors DHEA and androstenedione.[16] Tongkat ali may enhance sperm production by increasing the production of the gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which elevate testosterone and sperm production in the testes, respectively.[17]

    What are other names for Tongkat Ali

    Note that Tongkat Ali is also known as:
    • Eurycoma longifolia
    • Malaysian ginseng
    • Longjack (English)
    • Longjax
    • Bidara laut (Indonesia)
    • Cay Ba Binh (Vietnam)
    • Hau Phat (Vietnam)
    • Bba Binh (Vietnam)
    • Pasak Bumi (Indonesia)
    • Langir Siam (Bahrain)
    • Piak (Thailand)
    • Tung Saw (Thailand)
    • Babi Kurus (Japan)
    • Penawar Pahit (Malayalam)
    • Bedara Mereah (Malayalam)
    • Lempedu Pahit (Malayalam)

    Dosage information

    The standard dosage of tongkat ali for testosterone is 100–600 mg/day. For sexual health and libido, a daily dose of 200–400 mg seems to be effective, which may be divided into 1–2 doses per day, although it’s not known whether one of these dosing regimens is more effective.

    Tongkat ali is typically administered orally in the form of a standardized water-soluble extract.

    Frequently asked questions

    What is tongkat ali?

    Tongkat ali (Eurycoma longifolia), also known as longjack or Malaysian ginseng (unrelated to Panax ginseng), is an herb from Southeast Asia. The extract of the roots of the plant has been traditionally used to enhance testosterone levels in men, though it has also been proposed to be able to reduce blood pressure, fever, and fatigue. Unfortunately, there’s scant evidence to support these effects.[1] Furthermore, the internet is full of low-quality information about tongkat ali.[2]

    The main bioactive components in tongkat ali are the quassinoid compounds (eurycomanone and eurycomanol), eurycolactones, canthin-6-one metabolites, eurylene and teurilene (derivatives of squalene), and eurypeptides.

    What are tongkat ali’s main benefits?

    Tongkat ali has mainly been studied for its use as an aphrodisiac. However, the mechanisms by which tongkat ali may enhance aphrodisia are not well understood, and most of the research has been conducted in animals. This effect seems to be based in lore and tradition rather than hard evidence.

    Supplementation may increase total testosterone in healthy and hypogonadal men, improve erectile function and alleviate symptoms of erectile dysfunction, increase fertility, and enhance sexual function and well-being.[3][4][5] One study found evidence of an anxiolytic (anxiety and stress-reducing) effect of tongkat ali.[6] It should be noted that evidence for these outcomes is somewhat limited given the lack of published randomized controlled trials in humans.

    Can tongkat ali improve exercise performance?

    There haven’t been many studies investigating the ergogenic effects of tongkat ali. A pilot study (presented as a conference abstract) in men who supplemented with 100 mg of tongkat ali during a 5-week circuit training intervention (60% 1-repetition max for 2 sets of 10 reps, 10 stations total, 1-minute rest intervals) noted that they experienced greater improvements in strength and lean body mass compared to a control group who trained without tongkat ali.[18]

    Five weeks of tongkat ali supplementation (400 mg/day of extract) improved handgrip strength in older men and women between the ages of 57 and 72.[19] However, another study, which combined tongkat ali (200 mg/day) with a resistance training program, found no advantage compared to resistance training alone for muscular strength and power, although peak power output during a cycling test increased only in the combined group.[20] In the same study, tongkat ali supplementation alone did not affect performance outcomes.

    In men with androgen deficiency of aging male (ADAM), 200 mg of tongkat ali with or without concurrent training for 6 months didn’t seem to provide an additional benefit above concurrent training alone for muscle strength, cardiorespiratory fitness, or symptoms of androgen deficiency in men;[21] or erectile function, sexual satisfaction, and testosterone levels.[22]

    Tongkat ali doesn’t seem to improve endurance performance in the heat in recreational runners. Taking 150 mg of Eurycoma daily for 7 days and 1 hour before a time trial had no effect on running economy and performance or body temperature, heart rate, blood glucose, or lipid responses to exercise.[23]

    Does tongkat ali increase testosterone levels?

    One of tongkat ali’s main touted benefits is its ability to increase testosterone levels in men. While the mechanisms in humans are relatively unstudied, there are two primary pathways by which this effect might occur. The first involves the ability of eurycomanone (the main bioactive in tongkat ali) to enhance the production of androgen precursors, including pregnenolone and DHEA. Eurycomanone also inhibits the enzyme aromatase, which converts testosterone into estrogen.[15] It may also increase testosterone by elevating the production of LH.

    Tongkat Ali Mechanisms

    A systematic review and meta-analysis published in 2022 included a total of 9 studies which looked at the effects of tongkat ali supplementation on testosterone compared with placebo. A total of 5 studies with 232 participants were analyzed. A significant increase in testosterone was observed for tongkat ali (with a large effect size) when supplemented at a dose of 100–600 mg for a duration of between 2 weeks and 12 weeks (though one study lasted 6 months). However, significant publication bias was noted, mostly due to participants deviating from their assigned interventions or issues with the randomization process.[3]

    Furthermore, when men were separated into groups with testosterone levels of more than 300 ng/dL and less than 300 ng/dL (hypogonadal men), a significant effect was only observed in the hypogonadal group (average effect of 1.9 versus a nonsignificant effect of 0.8 in the normal testosterone group).

    Due to the variety of dosages used, it might be useful to look at the results of individual studies:

    • 200 mg/day for 6 months increased total testosterone from 278 to 400 ng/dL.
    • 100 mg/day for 12 weeks increased total testosterone from 187 to 203 ng/dL.
    • 200 mg/day for 12 weeks (same study as above) increased total testosterone from 200 to 225 ng/dL.
    • 600 mg/day for 2 weeks increased total testosterone from 871 to 969 ng/dL.
    • Studies using 600 mg/day for 2 weeks, 200 mg/day for 6 months, 600 mg/day for 8 weeks, and 300 mg/day for 12 weeks noted no difference between tongkat ali and placebo.

    Overall, it seems that tongkat ali is just increasing testosterone levels in men with low testosterone, while it doesn’t seem to benefit men with normal or higher testosterone levels as often.

    It should also be noted that a majority of studies related to the effect of tongkat ali on testosterone were funded by Biotropics Malaysia Berhad, a pharmaceutical company who makes and sells Physta, the tongkat ali supplement used as the intervention, and several of the study investigators are also employees of the company.

    What are tongkat ali’s main drawbacks?

    There is sparse safety, quality, and toxicity data available for tongkat ali from human studies, along with a lack of standard criteria and regulation for its commercial preparations. Some studies have raised concerns about the possible contamination of herbal preparations of tongkat ali by heavy metals in Malaysia, including levels of lead and mercury above permissible limits.[7][8][9]

    Safety and toxicity studies in rodents have found that the LD50 for tongkat ali (the dose that, when administered all at once, causes death in 50% of test animals) is greater than 3,000 mg/kg for the aqueous extract and between 1,500–2,000 mg/kg for the alcoholic extract.[10] Pathological changes in the liver were observed in rats at a dose of 1,200 mg/kg, corresponding to a 1,200 mg daily dose in humans.[11] However, tongkat ali has been shown to be safe for the liver in humans.[3]

    Studies using a dosage of 200–600 mg/day in humans have noted minor side effects, including gastrointestinal symptoms and itching.[3] Otherwise, adverse effects seem to be rare.[4] Tongkat ali is not recommended for pregnant and lactating women; men with breast or prostate cancer, diabetes, heart disease, kidney disease, liver disease, or sleep apnea; and children, due to a lack of data in these populations.[12][13]

    Tongkat ali may impede the actions of propranolol, a medication used to treat high blood pressure (hypertension), by interfering with its absorption and bioavailability.[14] Anyone using this medication and considering supplementing with tongkat ali should first consult a healthcare professional.

    How does tongkat ali work?

    Tongat ali’s effects on male sexual enhancement are primarily attributed to eurycomanone, which has steroidogenic activity. Eurycomanone has been shown to have anti-estrogenic effects. It inhibits the aromatase enzyme and prevents the conversion of testosterone to estrogen in the Leydig cells of the testes, the primary site of sperm production in men.

    At higher doses, eurycomanone may inhibit phosphodiesterase (PDE) activity, resulting in an accumulation of cyclic AMP, an increase in cholesterol transport, and an increased production of pregnenolone, a precursor for testosterone biosynthesis.[15] Furthermore, activation of the CYP17a enzyme by eurycomanone increased production of testosterone precursors DHEA and androstenedione.[16] Tongkat ali may enhance sperm production by increasing the production of the gonadotropins luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which elevate testosterone and sperm production in the testes, respectively.[17]

    Update History

    Research Breakdown

    References

    1. ^Bhat R, Karim AATongkat Ali (Eurycoma longifolia Jack): a review on its ethnobotany and pharmacological importance.Fitoterapia.(2010-Oct)
    2. ^Wahab MSA, Abd Hamid NN, Yassen AO, Naim MJ, Ahamad J, Zulkifli NW, Ismail FF, Zulkifli MH, Goh KW, Ming LCHow Internet Websites Portray Herbal Vitality Products Containing : An Evaluation of the Quality and Risks of Online Information.Int J Environ Res Public Health.(2022-Sep-20)
    3. ^Leisegang K, Finelli R, Sikka SC, Panner Selvam MK(Jack) Improves Serum Total Testosterone in Men: A Systematic Review and Meta-Analysis of Clinical Trials.Medicina (Kaunas).(2022-Aug-04)
    4. ^Kotirum S, Ismail SB, Chaiyakunapruk NEfficacy of Tongkat Ali (Eurycoma longifolia) on erectile function improvement: systematic review and meta-analysis of randomized controlled trials.Complement Ther Med.(2015-Oct)
    5. ^Thu HE, Mohamed IN, Hussain Z, Jayusman PA, Shuid ANEurycoma Longifolia as a potential adoptogen of male sexual health: a systematic review on clinical studies.Chin J Nat Med.(2017-Jan)
    6. ^Talbott SM, Talbott JA, George A, Pugh MEffect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects.J Int Soc Sports Nutr.(2013-May-26)
    7. ^Ang HH, Lee EL, Cheang HSDetermination of mercury by cold vapor atomic absorption spectrophotometer in Tongkat Ali preparations obtained in Malaysia.Int J Toxicol.(2004)
    8. ^Ang HH, Lee KLContamination of mercury in tongkat Ali hitam herbal preparations.Food Chem Toxicol.(2006-Aug)
    9. ^Ang HH, Lee EL, Matsumoto KAnalysis of lead content in herbal preparations in Malaysia.Hum Exp Toxicol.(2003-Aug)
    10. ^Rehman SU, Choe K, Yoo HHReview on a Traditional Herbal Medicine, Eurycoma longifolia Jack (Tongkat Ali): Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology.Molecules.(2016-Mar-10)
    11. ^Acute and Subacute Toxicity Studies of Eurycoma longifolia in Male Rats
    12. ^, Turck D, Bohn T, Castenmiller J, De Henauw S, Hirsch-Ernst KI, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Cubadda F, Frenzel T, Heinonen M, Maradona MP, Marchelli R, Neuhäeuser-Berthold M, Poulsen M, Schlatter JR, van Loveren H, Matijević L, Knutsen HKSafety of (Tongkat Ali) root extract as a novel food pursuant to Regulation (EU) 2015/2283.EFSA J.(2021-Dec)
    13. ^Ulbricht C, Conquer J, Flanagan K, Isaac R, Rusie E, Windsor RCAn evidence-based systematic review of tongkat ali (Eurycoma longifolia) by the Natural Standard Research Collaboration.J Diet Suppl.(2013-Mar)
    14. ^Salman SA, Amrah S, Wahab MS, Ismail Z, Ismail R, Yuen KH, Gan SHModification of propranolol's bioavailability by Eurycoma longifolia water-based extract.J Clin Pharm Ther.(2010-Dec)
    15. ^Low BS, Choi SB, Abdul Wahab H, Das PK, Chan KLEurycomanone, the major quassinoid in Eurycoma longifolia root extract increases spermatogenesis by inhibiting the activity of phosphodiesterase and aromatase in steroidogenesis.J Ethnopharmacol.(2013-Aug-26)
    16. ^TambiNutrients and botanicals for optimizing men’s health. Examining the evidence for Eurycoma longifolia Jack, the Malaysian Ginseng in men’s healthAsian Journal of Andrology.(2009-01-01)
    17. ^Low BS, Das PK, Chan KLStandardized quassinoid-rich Eurycoma longifolia extract improved spermatogenesis and fertility in male rats via the hypothalamic-pituitary-gonadal axis.J Ethnopharmacol.(2013-Feb-13)
    18. ^MedicineThe Ergogenic Effects of Eurycoma Longifolia Jack: a Pilot Study (Joint Conference of BASEM and BASES)British Journal of Sports Medicine.(2003-10-01)
    19. ^Henkel RR, Wang R, Bassett SH, Chen T, Liu N, Zhu Y, Tambi MITongkat Ali as a potential herbal supplement for physically active male and female seniors--a pilot study.Phytother Res.(2014-Apr)
    20. ^Chen CK, Ooi FK, Abu Kasim NA, Asari MAEffects of Jack Supplementation Combined with Resistance Training on Isokinetic Muscular Strength and Power, Anaerobic Power, and Urinary Testosterone: Epitestosterone Ratio in Young Males.Int J Prev Med.(2019)
    21. ^Alice Erwig Leitão, Melissa de Carvalho Souza Vieira, Diogo Almeida Gomes, Leonessa Boing, Andreia Pelegrini, Edson Luiz, Adriana Coutinho de Azevedo GuimarãesExercise associated or not to the intake of Eurycoma longifolia improves strength and cardiorespiratory fitness in men with androgen deficiencyComplement Ther Clin Pract.(2021 Feb)
    22. ^Alice Erwig Leitão, Melissa Carvalho de Souza Vieira, Andreia Pelegrini, Edson Luiz da Silva, Adriana Coutinho de Azevedo GuimarãesA 6-month, double-blind, placebo-controlled, randomized trial to evaluate the effect of Eurycoma longifolia (Tongkat Ali) and concurrent training on erectile function and testosterone levels in androgen deficiency of aging males (ADAM)Maturitas.(2021 Mar)
    23. ^Effects of Eurycoma longifolia Jack Supplementation on Recreational Athletes’ Endurance Running Capacity and Physiological Responses in the Heat