Tongkat Ali extract side effects, benefits, review, dosage, safety, danger
Research studies and honest review, Malaysia or Indonesia, works in women and men
Influence on testosterone levels, testimonials, best product
November 16 2018 by
Ray Sahelian, M.D., author of Natural Sex Boosters, a review of common and effective aphrodisiac herbs from around the globe

Tongkat ali benefits and side effects, review, for a man and woman
Tongkat Ali is a tree native to the jungles of Malaysia, Thailand, and Indonesia. There is confusion regarding the ideal dosage of this root and its extracts. I have done my best to provide you with reliable and honest information based on the latest scientific evidence of its benefits and my personal experiences as a medical doctor who has had extensive feedback from patients.

   Some people call tongkat ali "Malaysia's herbal Viagra" or even "female Viagra" although its effect on the human body, influence on neurotransmitters and chemicals, and sexual enhancement is very different than the prescription erectile dysfunction medications such as Levita, Cialis, and Viagra.

Tongkat Ali root powder 200 mg, where to buy, high quality and reliable, best tongkat ali product
LJ100 25 mg, a potent extract of the tongkat root
Passion Rx with Tongkat ali powder and extract is perhaps the best option
You have the option to take Tongkat Ali root powder 200 mg, LJ100 Tongkat ali extract at 25 mg, or Passion Rx with Yohimbe which is an effective combination of these two plus a dozen additional aphrodisiac herbal extracts. It is difficult to predict in any one individual which product will work better. The surest way is to try them separately to see which one is most suitable to your own body chemistry. Passion Rx with Yohimbe has a high rate of reorder and is my favorite aphrodisiac formula.

Buy Tongkat ali root powder, LJ100 extract, Passion Rx with Yohimbe natural sex enhancer, Prostate Power Rx, or other aphrodisiac sex herbs such as horny goat weed, mucuna pruriens, tribulus terrestris, maca, catuaba

Suggested Use for benefits, what is a good dose for this herb and how often?
For libido enhancement, take one 25 mg LJ100 capsule or one tongkat ali root powder capsule every day or every other day at least 20 minutes before breakfast. Results begin within a couple of days. The dosage that provides benefits varies among individuals. Women and small individuals, and seniors, require less. Young, large men require a higher dose.

Caution in combining several sex enhancing pills and herbal products
Note: Passion Rx and tongkat ali supplements are best taken on separate days since taking them together may cause excessive stimulation. It is preferable not to take them on days that you take herbs and supplements that have stimulant properties such as ginseng, tyrosine, acetylcarnitine, or SAM-e. I suggest you have at least 2 or 3 days a week when you do not take any herbal aphrodisiacs since daily use can cause insomnia or shallow sleep and cause too much stimulation.

Products sold online. How does one know how reliable they are, which tongkat ali is best?
There are many sexual enhancing products on the market that have tongkat ali in various extract potencies. Before you purchase such a product make sure the company you are buying from is a legitimate and has an actual physical address in the United States.

Q. I have seen a product that has 80 mg of LJ100 which is claimed to be a 100 to 1 tongkat ali extract. Why not take the higher dose of 80 mg instead of 25 mg?
   A. LJ100 80 mg may work quicker but it will cause severe insomnia, increased body temperature and restlessness in most users. We prefer using lower amounts to minimize adverse effects. Another risk to high dose use is rapid heart beat or heart rhythm problems.

Do not trust some of the claims made on certain internet sites, for instance:
Indonesian tongkat ali is superior to Malaysian or vice versa. Lead content is higher in one country than the other.
   I have spoken to various scientists from these regions who claim people making such claims are misleading the public in order to sell their products. I have not seen convincing evidence that lead content is different when the tree grows is one country versus the other. Lead content is checked by manufacturers before releasing the product to the public. The actual active and inactive substances within the root can vary based on elevation, microenvironment, soil content, humidity, rainfall and other factors, not necessarily the country it grows in.

Only the extract works and the plain powder is not effective.
   For centuries, and even today, people in Thailand, Indonesia, and Malaysia have been using the plain tongkat ali root powder as a potent aphrodisiac. The extraction process become available only in modern times. Therefore, if you read anywhere that the root powder does not work, consider the rest of the information on that page unreliable.

Other herbs added to tongkat ali will not help its effectiveness.
   Anyone who makes this claim is not experienced in herbal formulations. An experienced herbalist knows how to combine several herbs for maximal effect. In fact, for millennia Chinese doctors preferred using formulas consisting of several herbs rather than one alone.

An extract of 200 to 1 is more effective than other versions.
   There is no scientifically accepted determination of what a 200 to 1 extract is. Tongkat ali researchers I have spoken to deny such a 200 to 1 extraction process exists.
Scientific standards of how to judge the extraction process of this herb have barely begun. This whole area is like the Wild West where promoters make unsubstantiated claims about the potency of their product.

The different options available to the consumer, be careful and don't get fooled
Buy from a company based in the USA. If you purchase from a company based in a foreign country, they could be adding dangerous hormones or pharmaceutical medications to their products. If they are a reliable company doing business in the United States, they should have a physical office in this country.

Tongkat Ali root is sold as a powder in capsules by itself such as the one mentioned above at 200 mg per capsule, which is a good dose. It is also combined with other herbs in libido products. There are also concentrated forms which I will refer to as extracts. One well known and potent tongkat ali extract is LJ100 which is standardized to contain 40% glycosaponins and 22% eurypeptides. You can find tongkat ali promoted as 4:1, 5:1, 10 to 1, 20:1, 50:1, 100:1 and 200:1 extract concentrations. These can be quite misleading since there are no accepted scientific standards of what constitutes a 4:1 versus a 200 to1. In fact, be very skeptical of products that claim to be 20 to 1, 50 to 1, 100 to 1 or 200 to 1. There are no standards that say a 40% glycosaponin content constitutes a particular extract concentration. Any company who claims they are selling a product that is 200 times as potent as the regular powder is misleading you.
   To make things a little more complicated, each raw material supplier and manufacturer has a different way of preparing and extracting the active ingredients, and has a different raw material source. This means that, let's say, a 4:1 extract sold by one company may have a different effect than a 4:1 extract from another company. It is difficult to give a dosage recommendation that would apply to all the products on the market.
   After years of getting feedback from users of sexual enhancing herbs I have created a formula called Passion Rx which works very well as a sex booster in men and women with a low rate of side effects. You have the option of taking tongkat ali powder in capsules by itself, LJ100 by itself, or a libido enhancing formula. I prefer combinations since one can take advantage of different herbs which work in different ways to enhance the overall sexual experience, including sex drive, sensation, stamina, erectile function, orgasms, and lubrication.

Tongkat Ali side effects, caution, safety, toxicity, and adverse events, overdose - increased body temperature, anxiety, restlessness, rapid heart beat, insomnia or sleep problems
I have read articles in health magazines that it has wonderful benefits with absolutely no side effects. This has not been my personal or professional experience. Even though this herbal aphrodisiac is potent and effective, it does have shortcomings. One of the side effects of high dose tongkat ali herb use is insomnia. This can be quite unpleasant leading to tossing and turning all night. Lack of adequate sleep, when repeated over many days, can lower sex drive and cause fatigue, tiredness. So it's better to take smaller amounts over several days than a very high amount in one day.
   I have personally tested various extracts in different doses and realized that it has additional side effects not often mentioned in articles or in research papers. Many of my friends and patients have given me feedback regarding their personal experiences. I am convinced that high doses can cause increased body temperature, which is not a good thing during hot and steamy days without air conditioning, but a good thing if you live in Alaska or enjoy taking a walk outside in cool weather. Some notice having anxiety and being tense. Some people find that when they take a high dose, they become restless and impatient, easily angered, short-tempered and prone to snap at someone. Therefore, you don't want to swallow several capsules of tongkat ali if you expect to be driving in heavy traffic. You may get road rage. Being patient and taking lower doses is the preferred option. There could also be heart related side effects. High doses can increase heart rate which is not acceptable to those who have heart disease.
   I am not sure yet how much it influences blood pressure, whether it has an effect good or bad on the kidneys or liver, but it does increase heart rate. I also do not know for sure whether a person with diabetes can take it safely, I assume they can if used in a low dosage. If you take it before bed it could cause insomnia.

Q. I just ordered this product and I read where you don't recommend sex enhancing formulas for men past 70. I am a very healthy 77 and don't take any meds except eye drops for glaucoma. I walk a lot and am trim so I would guess I can take this low dose. Your description of it sounded interesting. I will take every other day for a couple weeks to see if it increases libido.
   A. Older individuals have heart functions that are weaker than the young and should be careful with the use of such aphrodisiac remedies.

Passion Rx - Medical Doctor Formulated for men and women who wish to improve libido
This natural sexual enhancer provides results that are noticed within two to four days, and improve over several days of use. We have tested various doses and extracts of tongkat ali  from a number of raw material suppliers to determine the ideal dose and combination for optimal libido enhancement with fewest side effects. After years of research, an effective proprietary blend, along with more than a dozen additional herbal extracts, has been created. Passion Rx provides a natural solution for those looking for an alternative to synthetic drugs.

  •      Sexual stamina, sensation, libido
  •      Erectile function, lubrication
  •      Orgasms and climaxes
  •      Mood, motivation, and energy

Some of the potent herbal extracts in this formula include ashwagandha, Catuaba, Herba Cistanches, Horny goat weed, Maca, Muira puama, Passion flower, Tongkat Ali herb and LJ100, Tribulus and yohimbe. I do not suggest taking full capsules of these natural aphrodisiacs together the same day. For instance, when high doses of tongkat ali are taken with other herbs that have stimulating properties, such as ginseng or other adaptogens, there is the potential for restlessness, irritability, rapid heart beat, elevated body temperature, and insomnia.

Tongkat Ali aphrodisiac study review, clinical studies
Over the past few years, there have been quite a number of studies (particularly in rodents) that have tested it in relation to sexual effects. The results have been quite positive. There is some evidence that the use of this herb, at least in high dosages in rodents, increases levels of testosterone.

In this study we evaluated the influence of Eurycoma longifolia on sexual behavior (including both motivation and copulatory performance) of sexually sluggish and impotent male rats. Treatment with the root powder significantly reduced ejaculation latencies, increasing also the percentage of mounting and ejaculating animals. In impotent rats treatments increased the percentage of mounting and ejaculating rats. Testosterone serum levels were increased in rats treated in comparison with controls. Influence of Eurycoma longifolia on the copulatory activity of sexually sluggish and impotent male rats. J Ethnopharmacol. 2009. Department of Biomedical Sciences, Section of Pharmacology, University of Modena and Reggio Emilia, Modena, Italy.

Randomized Clinical Trial on the Use of PHYSTA Freeze-Dried Water Extract of Eurycoma longifolia for the Improvement of Quality of Life and Sexual Well-Being in Men.
Evidence Based Complement Alternative Med. 2012. School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Kubang Kerian, Malaysia. A randomized, double-blind, placebo controlled, parallel group study was carried out to investigate the clinical evidence of TA in men. The 12-week study in 109 men between 30 and 55 years of age consisted of either treatment of 300 mg of water extract of tongkat ali (Physta) or placebo. Primary endpoints were the Quality of Life questionnaire and Sexual Well-Being investigated by International Index of Erectile Function and Sexual Health Questionnaires ; Seminal Fluid Analysis, fat mass and safety profiles. The TA group showed higher scores in sexual libido and better sperm motility and semen volume. Subjects with BMI ≥ 25 kg/m(2) significantly improved in fat mass loss. All safety parameters were comparable to placebo.

Complement Ther Med. 2015. Efficacy of Tongkat Ali (Eurycoma longifolia) on erectile function improvement: systematic review and meta-analysis of randomized controlled trials. To determine the efficacy of Tongkat Ali herbal extract on erectile function improvement. Comprehensive electronic databases were searched. Randomized controlled trials investigating Tongkat Ali compared to placebo were included regarding improvement of erectile dysfunction. The difference of changes from baseline of the outcome between Tongkat Ali and placebo was pooled. Methodological quality of included studies was assessed using Jadad's quality scale and Cochrane's risk of bias. Of the 342 articles identified, 2 studies involving a total of 139 participants were analyzed. Based on current evidence, the herbal extract of Tongkat Ali may have clinical effect on erectile function. However, more efficacy trials are warranted to further support current evidence.

Chin J Nat Med. 2017. Eurycoma Longifolia as a potential adoptogen of male sexual health: a systematic review on clinical studies. Tongkat ali has been recognized as a booster of male sexual health. Numerous in vivo animal studies and human clinical trials have been conducted across the globe to explore its promising role in managing various male sexual disorders which include erectile dysfunction, male infertility, low libido, and downregulated testosterone levels. This review analyzes and summarizes the literature on human clinical trials which reveal the clinical significance and therapeutic feasibility of EL in improving male sexual health. This systematic review is focused on the following databases: Medline, Wiley Online Library, BioMed Central, Hindawi, Web of Knowledge, PubMed Central and Google Scholar, using search terms such as "Eurycoma longifolia", "Tongkat Ali", "male sexual health", "sexual infertility", "erectile dysfunction", "male libido", and "testosterone levels". Out of 150 articles, 11 met the inclusion criteria. The majority of articles included were randomized placebo-controlled trials, multiple cohort studies, or pilot trials. All these studies demonstrated considerable effects of tongkat ali on male sexual health disorders. There is convincing evidence for the prominence of eurycoma in improving male sexual health.

J Basic Clinical Physiol Pharmacol. 2018. Phenolic-rich extracts of Eurycoma longifolia and Cylicodiscus gabunensis inhibit enzymes responsible for the development of erectile dysfunction and are antioxidants.

The effects of this aphrodisiac herb were studied on libido of male rats after dosing them twice daily for 10 days. Tongkat ali produced a dose-dependent increase in mounting frequency; that is, the number of times the male rats tried to mount the female rats increased as the dose given to the rats increased. In addition, the rats displayed more frequent and vigorous licking and anogenital sniffing towards the receptive females. Furthermore, the rats dosed with the plant extract spent more time grooming their genitals compared to the rats who were not given the plant. Genital grooming may be interpreted as self-pleasuring since the rats were most likely enjoying the sensation of touching themselves. The researchers noticed another interesting finding: while the rats who had not received tongkat ali showed normal behavior within the cage such as exploration and climbing the cage wall, the rats given tongkat ali hung around the females instead of exploring the cage.
   Several studies have tested tongkat ali in rodents and shown this plant to have aphrodisiac properties.

Availability online and in health food stores, where to buy
Tongkat Ali is sold as a powder and in capsules, and it is often combined with other herbs in libido products. There are a number of extracts available in various potencies, and since each raw material supplier and manufacturer has a different way of preparation and extraction of the root material, and since there are no established standards, it is difficult to give dosage recommendations that would be consistently effective. In addition to tongkat ali being available as a raw powder, it is sold as a 4:1, 5:1, 20:1 and a 100:1 concentration although these could be misleading. At the higher concentrations it becomes difficult to dose appropriately since the margin of error in terms of effectiveness versus side effects becomes quite challenging.

Mechanism of action, how it works, effect on testosterone, probably no effect on estrogen
More studies are required to determine the exact mechanisms of action. Recent studies indicate that the root contains several compounds including beta-carboline alkaloids and quassinoid-type glycosides, including eurycomaoside. How these compounds and many others in tongkat ali influence hormonal release or the human sexual response is not clearly understood (at least by me) at this time. I have read promotional material by some vitamin companies and articles in health magazines that tongkat ali enhances testosterone production or release. Apparently some human trials have been conducted in Malaysia that indicate tongkat ali influences testosterone and this herb in has shown to raise testosterone levels in rodent studies. I would not be surprised if compounds within it, such as glycoproteins, do influence blood, testes, or brain levels of testosterone. Does this effect on testosterone continue with prolonged use? I would also not be surprised additional compounds within the plant influence sexuality in ways other than just testosterone or hormone effects. I have not seen any research on how it influences dopamine levels.
   The plant parts have many compounds (such as eurycomaoside, eurycolactone, eurycomalactone, eurycomanone, and pasakbumin-B) among which the alkaloids and quassinoids form a major portion.

Int J Prev Med. 2014. Supplementation of Eurycoma longifolia Jack Extract for 6 Weeks Does Not Affect Urinary Testosterone: Epitestosterone Ratio, Liver and Renal Functions in Male Recreational Athletes.

Andrologia. 2011. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Wellmen Clinic, Damai Service Hospital, Kuala Lumpur, Malaysia;  Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kbg Kerian, Kelantan, Malaysia. Considering that human studies are not available, 76 of 320 patients suffering from late-onset hypogonadism (LOH) were given 200 mg of a standardised water-soluble extract of Tongkat ali for one month. The Ageing Males' Symptoms (AMS) according to the standardised rating scale and the serum testosterone concentration were taken. Results show that treatment of LOH patients with this Tongkat ali extract significantly improved the AMS score as well as the serum testosterone concentration. While before treatment only 10% of the patients did not show any complaint according to the AMS scale and 35% had normal testosterone levels, after the completed treatment 71% and 90% of the patients showed normal values, respectively. Thus, Tongkat ali extract appears to be useful as a supplement in overcoming the symptoms of LOH and for the management of hypogonadism.

J Sex Med. 2012. 13.9-hydroxycanthin-6-one induces penile erection and delays ejaculation. National Research Institute of Chinese Medicine, Taipei, Taiwan. We examined the effect of 9-hydroxycanthin-6-one (9-HC-6-one), a β-carboline alkaloid isolated from E. longifolia, on penile erection and ejaculation, and further elucidated the mechanism of action. Results show 9-HC-6-one might be the active component that contributed to the aphrodisiac effect by antagonizing the smooth muscle tone of corpus cavernosum through interfering with Ca2+ mobilization.

Nat Prod Res. 2013. Plant proteins, minerals and trace elements of Eurycoma longifolia. Metabolites Profiling Laboratory, Institute of Bioproduct Development, Universiti Teknologi Malaysia, UTM Skudai, Johor, Malaysia. A water extraction method has been used to extract plant proteins from the roots of TA harvested from Perak and Pahang, Malaysia. On the basis of the spectroscopic Bradford assay, Tongkat Ali Perak and Pahang contained 0.38 and 0.95 mg mL of crude protein, respectively. Both plant samples showed differences in the mineral and trace element profiles, but the minerals calcium, magnesium and potassium were present in the highest concentration. The highly concerned toxic metals such as arsenic and lead were not detected.

Q. Does it effect the prostate gland? I have BPH prostate gland enlargement.
   A. Thus far I have not seen any human research that it has influence on prostate gland tissue or had any such feedback from users.

Some claim that use of this tree root leads to improved lean muscle mass, skin tone and overall vitality. I am not yet convinced that this occurs. Here are some claims you will see on the internet that have little merit:

Increases your body's ability to burn fat.
Increases your ability to build lean muscle.
Improve cardiac function.
Stimulates of the pituitary gland (My comments: stimulation of the pituitary gland can be beneficial or harmful).

Long term side effects, toxicity, danger, safety
Since long term human trials have not been published, it would be best to take breaks from use. One option is to take the herbal product every other day or 2 days on, 2 or more days off with a full week off each month. Each person is different and will find their own best schedule.
    It is somewhat difficult to find the right dose and extract of tongkat ali supplement that works without causing insomnia, and that's where an experienced herbalist who has wide knowledge with this plant is crucial in terms of formulating the right product with the right amount and extract potency of tongkat ali.

Molecules. 2016. Review on a Traditional Herbal Medicine, Eurycoma longifolia Jack: Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology. An acute toxicity study has found that the oral Lethal Dose 50 (LD50) of the alcoholic extract of E. longifolia in mice is between 1500-2000 mg/kg, while the oral LD50 of the aqueous extract form is more than 3000 mg/kg. Liver and renal function tests showed no adverse changes at normal daily dose and chronic use of E. longifolia.

Heart problems, heart attacks, hypertension or high blood pressure
Q. I have used tongkat ali in the past and was very happy with the results but I had a heart attack recently caused by blocked arteries, not heart tissue problems. Will the tongkat ali extract cause harm? Does it raise blood pressure? Could it be beneficial or harmful in those with high blood pressure or heart disease? I do not want to cause further injury if there is something I should be aware of.
   A. Tongkat ali can stimulate the heart to beat faster. It is not a safe herb to take in those who have heart problems unless your doctor wants to monitor you on very low doses. Garlic and onions are good aphrodisiacs and they also help improve circulation.

Athletic performance, body building, increase in energy
It is true that tongkat ali increases energy levels, and here again the right dose is crucial since too high a dose will give insomnia, leading to fatigue the next day. However, if you take the right amount which wears off by evening, then you'll be just fine and happy. it is thought that tongkat ali increases energy levels through its actions on ATP. This herb also has an influence on testosterone levels, at least in the short term.

I have read a lot of articles on tongkat and wanted your professional advice. I'm 50 years old and a professional tri-athlete. (swim, bike, run) I was looking into this herb as a supplement for recovery, mental being, and endurance enhancer. Could you please give me a honest opinion about the herb and any positive effects that are proven to help with athletic performance.
   Although this herb increases energy levels, it also increases body temperature which can be counterproductive to performance enhancement particularly if the activity is being done in warm weather. Perhaps this herb could help in situations where the outside temperature is very cold, or swimming in cold waters. However, there is also the risk for increased heart rate from the herb which may not be helpful. Overall, I don't think this herb is helpful for athletes except perhaps in situations where cold tolerance is a benefit. Much depends on the dosage used and this would be learned through trial and error.

Phytother Res. 2014. Tongkat Ali as a potential herbal supplement for physically active male and female seniors--a pilot study. Tongkat Ali (Eurycoma longifolia; TA) is known to increase testosterone levels and alleviate aging males' symptoms. This study aimed at investigating TA as an ergogenic supplement for elderly people. Thirteen physically active male and 12 physically active female seniors (57-72 years) were supplemented with 400-mg TA extract daily for 5 weeks. Standard hematological parameters were taken. In addition, the concentrations of total and free testosterone, dihydroepiandrosterone, cortisol, insulin-like growth factor-1, and sex hormone-binding globulin were analyzed. As additional biochemical parameters, blood urea nitrogen and creatine kinase as parameters of kidney function and muscle damage, respectively, as well as the muscle strength by a simple handgrip test were determined. After treatment, hemoglobin, testosterone, and dihydroepiandrosterone concentrations, and the ratio of total testosterone/cortisol and muscle force remained significantly lower in female seniors than in male seniors. Hematocrit and erythrocyte count in male seniors increased slightly but were significantly higher than in female seniors. Treatment resulted in significant increases in total and free testosterone concentrations and muscular force in men and women. The increase in free testosterone in women is thought to be due to the significant decline in sex hormone-binding globulin concentrations. The study affirms the ergogenic benefit of TA through enhanced muscle strength.

Beta-carboline alkaloids have demonstrated significant cytotoxicity against human lung cancer (A-549) and human breast cancer (MCF-7) cell lines. In plain English, this means that some compounds in tongkat ali can kill cancer cells. The practical significance of this finding in humans is not clear at this time.

Diabetes, high blood sugar
Q. I just wanted some advice if you could on Indonesian Tongkat Ali. Is it just used for sexual performance or does it have other benefits as well. I am 56 single but I found that I have no sexual interest at present not even masturbating. I do have diabetes and I am on Insulin, also I take a antidepressant at night 45mg of Mirtazapine.
   A. It is mostly used to enhance sexual performance and pleasure. Those who are diabetic should have approval by their doctor and perhaps use half a capsule. Mirtazapine belongs to a group of medicines called tetracyclic antidepressants which work in the central nervous system (CNS) to influence brain chemicals. There can be unexpected interactions when this herbal aphrodisiac is combined with prescription antidepressants and hence I do not suggest the combination.

Fatigue treatment?
The Dr Oz show was suggesting tongkat ali as a testosterone supplement to assist females with fatigue. Is this product and dosage primarily for men or would it also be safe for females (age 48 perimenopauseal)?
   We don't suggest its use as a treatment for fatigue. Although it can boost energy levels, it can also cause insomnia which can make fatigue worse. We are not sure if Dr. Oz is aware of its effects on sleep.

Use for infertility
This study investigated the effect of treatment with the proprietary standardized, water-soluble extract of the root of the Malaysian plant, Eurycoma longifolia Jack, which is thought to enhance male fertility with regard to higher semen volumes, sperm concentrations, the percentage of normal sperm morphology and sperm motility in male partners of sub-fertile couples with idiopathic infertility. A total of 350 patients were given 200 mg of the extract daily and follow-up semen analyses were performed every 3 months for 9 months. Follow-up semen analyses in these patients showed significant improvement in all semen parameters. The extract significantly improved the sperm quality in these patients, allowing for 11 (14%) spontaneous pregnancies. Eurycoma longifolia Jack in managing idiopathic male infertility. Asian J Andrology. 2010. Bin Mohd Tambi MI. Wellmen Clinic, Damai Service Hospital, Kuala Lumpur, Malaysia. School of Medical Sciences, University Sains Malaysia, Kbg Kerian, Kelantan, Malaysia.

Malaria treatment
Scientists have found that, in addition to its sex-enhancing effects, compounds within tongkat ali have anti-malarial properties. Some of these anti-malaria compounds are known as quassinoids.

Mood and Stress influence
J Int Soc Sports Nutr. 2013. Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects. Previous studies have shown properly-standardized TA to stimulate release of free testosterone, improve sex drive, reduce fatigue, and improve well-being. We assessed stress hormones and mood state in 63 subjects (32 men and 31 women) screened for moderate stress and supplemented with a standardized hot-water extract of TA root  or Placebo for 4 weeks. Significant improvements were found in the TA group for Tension, Anger, and Confusion. Stress hormone profile (salivary cortisol and testosterone) was significantly improved by TA supplementation, with reduced cortisol exposure and increased testosterone status. Results indicate that daily supplementation with tongkat ali root extract improves stress hormone profile and certain mood state parameters, suggesting that this "ancient" remedy may be an effective approach to shielding the body from the detrimental effects of "modern" chronic stress, as well as the stress of dieting, sleep deprivation, and exercise training.
   Comments: My experiences have been different. I often find use of TA leads to increased aggressiveness and restlessness rather than reduction of stress.

Prostate health, BPH, prostate enlargement
We have not seen any studies regarding tongkat ali and prostate gland in humans, so we don't know whether it helps with BPH treatment or induces prostate gland enlargement. We also don't know how it influences prostate cancer, whether it helps prevent it or aggravates it.

Use with other dietary supplements
Fish oils at one to three softgels a day can be taken together. Try to avoid taking it with other potent herbs in their full dosage, especially those that have a stimulating property such as ginseng.

Interactions with medications
J Clin Pharm Ther. 2010. Modification of propranolol's bioavailability by Eurycoma longifolia water-based extract. Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Penang, Malaysia. The bioavailability of propranolol is significantly decreased when consumed together with E. longifolia. The interaction is due to a reduction in absorption, rather than an increase in propranolol's metabolism.

Q. I purchased a 200 mg bottle of Tongkat Ali herb. Does it have any interactions with prescription medications such as Suboxen, Nuvigil, Pristiq and Crestor?
   A. It has not been tested with these medications, so it may be a good idea to begin with a small portion of the contents of the capsule rather than a full one. The capsule can be easily opened by pulling on each side and using a third or half in an ounce or two of water, juice, or tiny amount of liquor or wine.

I am 32 years old and I want to raise my testosterone using tongkat ali. I currently take Naltrexone 50 mg for alcohol overindulgence not everyday but using the Sinclair method which means I only take it on days I drink so a few times a week. My liver is still in excellent shape and I have taken tongkat ali before at 800 mg a day of 200:1 Indonesian extract. I am thinking to try your brand at the recommended dose but I am worried because I read Naltrexone also has an effect on Luteinizing hormone. Is there any possible interactions I should be worried about?
   A. This aphrodisiac herb is potent. I am not aware of research with the combination with Naltrexone, but suggest using very low dosages of tongkat ali and to use it only occasionally.

Ecological concerns
It is commonly known as tongkat ali in Malaysia and Singapore, Tung Saw in Thailand, and Pasak Bumi in Indonesia. Natives consider every part of the tree as medicine. The root has been used as traditional medicine and promoted as a tonic, energy enhancer, and as an aphrodisiac. Tongkat li is harvested in the wild and there is a concern that increasing popularity will deplete the natural preserves. Steps are being taken to cultivate the tree in large plantations. Unlike most trees which have a horizontal root system, the root of a tongkat Ali tree grows as much as one meter straight into the ground. This tough fibrous root penetrates deep into the earth to obtain its nutrients and takes at least five years to mature. Of an older tree (15-20 years), the root itself can grow to a size that is taller than many people. Some people misspell the name of this tree as tonkgat or tonkat ali.

Review journal article
J Diet Suppl. 2013. An evidence-based systematic review of tongkat ali (Eurycoma longifolia) by the Natural Standard Research Collaboration. An evidence-based systematic review of tongkat ali (Eurycoma longifolia) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

Research studies, does tongkat ali work as an aphrodisiac?
Sexual arousal in sexually sluggish old male rats after oral administration of Eurycoma longifolia.
J Basic Clin Physiol Pharmacol. 2004. Ang HH, Lee K. School of Pharmaceutical Sciences, University Science Malaysia, Minden, Penang, Malaysia. The objective of this study is to evaluate sexual arousal in sexually sluggish old male rats receiving tongkat ali for 10 days. The aphrodisiac effect was monitored by the act of yawning and stretching because yawning, either alone or associated with stretching, is considered an ancestral vestige surviving throughout evolution that promotes sexual arousal. The results showed that tongkat ali increased yawning and stretching in sexually sluggish old male rats. We conclude that the results of this study support the folk use of this plant as an aphrodisiac.

J Basic Clin Physiol Pharmacol. 2003. Eurycoma longifolia enhances sexual motivation in middle-aged male mice. Tongkat Ali  was investigated for sexual motivation activity in adult, middle-aged male mice and in retired breeders. Each mouse received 500 mg/kg of one of 4 fractions of tongkat ali : chloroform, methanol, butanol, and water, whereas the mice in the control and yohimbine groups received 3 ml/kg of normal saline and 30 mg/kg of yohimbine daily respectively for 10 days. Our study showed that this potent herb continues to enhance sexual motivation in adult, middle-aged male mice and in retired breeders.

Phytomedicine. 2003. Effects of Eurycoma longifolia on sexual qualities in middle aged male rats. The effects of tongkat ali were studied on the sexual qualities of middle aged male rats after dosing them with 0.5 g/kg of various fractions of tongkat ali whilst the control group received 3 ml/kg of normal saline daily for 12 weeks. Results showed than tongkat ali enhanced the sexual qualities of the middle aged male rats by decreasing their hesitation time as compared to controls. This study shows that it enhanced the sexual qualities of middle aged male rats, further supporting the folk use of tongkat ali as an aphrodisiac.

J Basic Clin Physiol Pharmacol. 2002. Effect of Eurycoma longifolia Jack on libido in middle-aged male rats. The effect of increasing doses of various fractions of tongkat ali extracts on libido was examined in middle-aged male rats. The results of this study show that tongkat ali extracts can increase libido in middle-aged male rats.

Fundam Clin Pharmacol. 2002. Effect of Eurycoma longifolia Jack on orientation activities in middle-aged male rats. Subjects treated with tongkat ali increased orientation activities towards the receptive females (anogenital sniffing, licking and mounting), increased genital grooming towards themselves and restricted movements to a particular area of the cage but decreased interest in the external environment (climbing, raring, exploration) as compared with the controls during the investigation period.

Testimonials and inquiries
Q. I find tongkat ali works best for me if I take it 2 days on, one or more days off. In fact, sometimes I notice the sexual feelings even on the off days.
   A. Yes, it is one of those sexual enhancing herbs that has a delayed effect.

Q. At first tongkat ali supplement was working great, but now i don't feel it as much. I have been taking it every day for 4 weeks.
   A. There is tolerance that builds up to some herbs, and tongkat ali is one of them. Perhaps it stimulates hormone release which depletes after a while and you may need to take a break from use to replenish the hormones, or maybe there are other factors involved that we don't know about. Nevertheless, it's best to take frequent breaks from use.

Q. I note 2 versions of tongkat Ali -- the 200 mg powder and the LJ 100 extract. How would one decide which formulation to purchase for very low male libido?
   A. We have had positive responses with both, some liking the root powder, others liking the extract.

Q. I purchased tongkat ali 200mg and I was surprised at how strong two capsules were. I have been told that 400 mg of a 50 to 1 extract, 1 dose per day was the correct dose. However, I purchased the product from an Indonesian company Pasam Bumi which sent me 50 to 1 extract 400 mg caps, but the suggested tongkat ali dose on the label was 4 capsules per day. That seems like too high a dose.
   A. Before we formulate a product our research team takes it in varying amounts and concentrations, and we get feedback from many users. Thus we have first hand experience what these products do, as opposed to theoretical dosing. For some people 400 mg tongkat ali root powder may be too high a dosage and they may need only 100 or 200 mg. We have no idea what different companies have or claim to have in their products.

Q. Does tongkat ali cause a woman to have a longer and heavier than usual menstrual flow? I took 400 mg for two weeks, 2 days on and 2 days off, and this is what I experienced.
   A. Although we have not had a previous report of tongkat ali associated with menstrual flow, it is possible since it may influence certain hormone levels or influence the release of certain hormones.

I understand there are few human clinical trials using tongkat Ali herb except a few from Malaysia. In theory, could tongkat ali stop the production of important hormones, testosterone, FSH, LH, etc. Have there been any reports of it causing the testicles to shrink, or, could it in theory have that effect?
   The full long term effect of chronic tongkat ali use on hormones is not known, but in my opinion it is a relatively moot point since I do not recommend frequent use of this potent herb. The maximum use, in my opinion, should be no more than 3 times a week, and there should be at least a full week off a month. It is also possible that the hormonal effects are dose dependent, and different people may react differently to tongkat ali and the various extracts that are available.

Q. I have been experimenting using tongkat Ali root powder 200 mg, LJ100 25 mg, and Longjax 20:1 (400 mg). Another web site claims that the root powder is worthless because it would take 50g (50,000 mg!) to equal an effective dose. Therefore the extracts are a better bet, because with two or three pills of the Longjax One approaches at least half this "therapeutic dose". The web site claims it draws this information from direct experience from SE Asia where tongkat ali has a long local history of use in a brewed tea. Apparently the brewed tea starts at around 25-50 grams of root that gets boiled into a bitter tea. So I'm confused. You say that 400 mg of tongkat ali root powder can actually be a very strong and effective dose, yet others question this premise. The fact that you are a doctor leads me to put a lot of faith in your opinion over the others. I have experienced mild improvements with the tongkat Ali products (powder and extract), and am hopeful that it will help ward of andropause and low testosterone. I'm 53 years old, and my wife and I have sex daily - so we are doing OK, but always looking for improvement. I love your website and your work. I hope you don't take this probing question as anything other than someone desperately seeking advice and clarification regarding dosage, but in particular the "value" of root powder vs. extracts of any kind.
   A. I can only speak from my experience with the tongkat ali root powder and feedback from patients and users of this supplement. I can't imagine the health risks of taking 50,000 mg of tongkat ali powder. It could be fatal or at least require several days in intensive care. Even 400 mg is a little bit too much for me. I reduced the tongkat ali powder supplement dosage from 400 mg a capsule to 200 mg per capsule. As with most sexual enhancing supplements, it is preferable to take low dosages and go slow rather than trying to have a quick effect with a high dose. These herbs are potent and should be treated cautiously. I have no intention of discussing or countering every claim that is made on the internet on countless products. People have the right on their own websites to say what they wish. My role is to be honest and accurate writing about my own experiences and knowledge. The final decision as to which web site to rely on for such information rests on the reader and the consumer.

Are there any side effects taking tongkat ali and statin drugs such as Lipitor and Zocor? Is it advisable?
   I have not seen studies that have evaluated the combination of statin medications and this herbal aphrodisiac. The herb itself has a lot of side effects so it needs to be used cautiously. It is a good idea, if combining the herb and the medication, to use very low dosages and to have approval by your doctor.

I recently purchased a bottle of Vitali-T-Aid which has Testofen 600mgs (Fenugreek PE 50% fenuside, Male Wellness Blend 100mg (Saw Palmetto Berry powder, Astragalus Root powder, Phytosterol (40% Beta Sitosterol), Asian Ginseng Root powder, Tribulus Fruit extract, L-Arginine. Can a person take the Tongkat Ali 200mgs and the Vitali-T-Aid together.
   We prefer to alternate them, one day TA and the other day Vitali-T-Aid and to take a day off both every two or three days.

I have been taking between 1500mg to 3000mg per day of tongkat ali for around a week or two now. In the past week I have noticed my testicles have been hurting off and on. I have no signs of infection just testicle pain.

Q. I saw your video on TongKat Ali. I am a healthy 26 year old male that does not suffer from Erectile Dysfunction. My acupuncturist mentioned TongKat Ali and stated that it could have benefits in my athletic training, marked increases in confidence sexual desire and libido. Currently I am prescribed to Adderall IR 20mg for ADD / ADHD and this prescription mutes my sex drive. My main questions are: For a 26-year, having not gone thru Andropause, is taking TongKat Ali recommended? Am I too young to take TongKat Ali? Is it safe to take TongKat Ali in conjunction with my Adderall prescription?
   A. For healthy young people who wish to take this herbal aphrodisiac, occasional use for a few days at a time is fine. It is not safe to take this herbal aphrodisiac and stimulant with prescription stimulants such as
Amphetamine sulfate (Evekeo)
Dextroamphetamine (Adderall and Adderall XR, Dexedrine, ProCentra, Zenzedi)
Dexmethylphenidate (Focalin and Focalin XR)
Lisdexamfetamine (Vyvanse)
Methylphenidate (Concerta, Daytrana, Metadate CD and Metadate ER, Methylin and Methylin ER, Ritalin, Ritalin SR, Ritalin LA, Quillivant XR)