- 01Better than other testosterone herbs is a low bar
Most herbs sold as testosterone boosters failed in trials, so tongkat ali stands out. Its own evidence is a handful of small trials, mostly of one branded extract, with total testosterone rising more clearly in men who started low. Free testosterone, the share the body can use, did not beat placebo in the largest trial.
- 02The extract in the trial is not every extract on the shelf
Most positive trials used Physta, a standardized freeze-dried water extract, at 100 to 300 mg a day. A 20:1 extract describes how much root went into it, not what is in it, so milligrams on two labels do not compare directly.
Tongkat ali is the root of Eurycoma longifolia, a Southeast Asian tree, used there as a traditional tonic for energy and male vitality 12. Among herbs sold for testosterone, it has one of the better cases: a 2022 meta-analysis of 5 randomized trials found total testosterone rose, more clearly in men who started low 1, and a 2024 review of 27 so-called testosterone boosters named it as possibly effective, where most failed 2. The trials behind that are small, short, mostly of one branded extract, and in the largest one free testosterone did not beat placebo 3. The label also carries two warnings that matter more than the side effects: hormone-sensitive cancers and antidepressants.
What is tongkat ali?
Tongkat ali is the root of a Southeast Asian tree long used in traditional medicine for low energy, mood and libido 12, and the most studied extract in trials is Physta 35. For the basics, what it is and what it does in your body has its own page. This guide covers what the evidence shows, how much studies use, when and how to take it, side effects, interactions and blood tests.
How it might work on testosterone is not settled. The usual ideas are that it supports the testes' own production or frees more testosterone from its carrier protein, SHBG (sex hormone binding globulin). The trials do not clearly support the SHBG route: in the largest, SHBG did not change 3. That trial also saw DHEA (a hormone made by the adrenal glands that the body can turn into testosterone) rise from week 2 within the treated groups 3.
The LifeFrom capsule is a 20:1 root extract. That ratio means about 20 parts of root went into 1 part of extract. It describes concentration, not standardization to a marker compound, so a 20:1 extract and Physta cannot be compared milligram for milligram.
What tongkat ali is good for: the evidence, graded
Each use carries a grade. Strong means several good randomized trials or a meta-analysis agree. Moderate means several randomized trials, mostly positive but small or short. Limited means few or small trials, or mixed results. Early means lab, animal or one pilot study only. Not supported means good trials found no benefit. Our guide to how to judge a supplement explains why.
| Use | What the research found | Evidence | Source |
|---|---|---|---|
| Total testosterone in men with low levels | Meta-analysis of 5 trials: rise confirmed in the low-testosterone subgroup; review lists it as possibly effective | Moderate | 12 |
| Total testosterone in healthy men | Rise in pooled trials; possibly effective in a 52-study review | Limited | 12 |
| Free testosterone | No difference from placebo in the largest trial | Limited | 3 |
| Ageing male symptoms and fatigue | One 105-man trial: better symptom and fatigue scores over 12 weeks | Limited | 3 |
| Erection and sexual function | 2 trials pooled: no overall difference from placebo; better scores only in men who started with worse function | Limited | 56 |
| Stress hormones and mood | One 4-week trial of 63 adults: lower saliva cortisol, better tension and anger scores; a 24-week trial with multivitamins found no difference from placebo | Limited | 410 |
| Menopause symptoms in women | One trial of a blend with Labisia pumila; tongkat ali alone not yet reported | Early | 1112 |
Does tongkat ali increase testosterone?
Total testosterone is everything in the blood. Free testosterone is the small share not bound to SHBG or albumin, closest to what tissues can use. Most tongkat ali trials report total testosterone, and that is where the signal is.
The 2022 meta-analysis by Leisegang and colleagues reviewed 9 studies and pooled 5 randomized trials. Total testosterone rose with a standardized mean difference of 1.35 (a way of putting trials that used different units on one scale, where 0.8 counts as large), and the rise held in the subgroup of men with low testosterone 1. The authors called it promising, particularly in men with low testosterone, and said more research is needed before clinical use 1. A broad 2024 review of 52 studies of 27 testosterone boosters reached a similar place:
Eurycoma longifolia, a blend of Punica granatum fruit rind and Theobroma cacao seed extracts (Tesnor™) and purified Shilajit extract (PrimaVie™) can be considered possibly effective for men with late-onset hypogonadismMorgado A et al., International Journal of Impotence Research, 2024
The single largest trial shows both the promise and the limits. In 2021, 105 men aged 50 to 70 took 100 mg or 200 mg of Physta, or placebo, for 12 weeks. Total testosterone rose more than with placebo, from week 4 at 200 mg and by week 12 at 100 mg; free testosterone rose within the treated groups but not against placebo, and SHBG did not change 3. Aging Male Symptoms and Fatigue Severity scores improved, and no safety-relevant changes showed up in blood counts, lipids, or liver and kidney tests 3. A 6-month Brazilian trial in 45 men with symptoms of age-related androgen deficiency found the clearest gains when the trial's 200 mg a day was combined with exercise training 7.
Tongkat ali benefits for males: sexual function and energy
Sexual function is the traditional use. In 2012, 109 men aged 30 to 55 took 300 mg of Physta or placebo for 12 weeks; erectile function scores and a physical functioning score improved more than placebo, and libido rose 14% by week 12 5. But when a 2015 meta-analysis pooled the two available trials (139 men), there was no overall difference from placebo on the IIEF-5 erection questionnaire; only men who started with worse scores improved, by about 2 points 6. On energy and wellbeing, a 24-week trial of tongkat ali with multivitamins in 93 moderately stressed adults found no differences from placebo, only improvements within each group 10.
Stress, cortisol and mood
One 4-week trial gave 63 moderately stressed adults (32 men, 31 women) a hot-water root extract or placebo. Saliva cortisol exposure fell 16%, saliva testosterone rose 37%, and tension, anger and confusion scores improved by 11 to 15% 4. It was small, short and measured hormones in saliva, so it counts as an early signal. If stress or sleep is the real issue, ashwagandha has a larger trial base for stress.
Tongkat ali benefits for women
Searches for tongkat ali for women outnumber the trials. Women made up 31 of 63 participants in the stress trial above 4. A 2020 trial in 119 women around menopause tested a product combining tongkat ali with another herb, Labisia pumila, and reported fewer hot flushes, so tongkat ali's own share is unknown 11. A 12-week trial of tongkat ali alone in 150 women around menopause was registered in 2023 12. The label's warning applies to women too: it says not to take tongkat ali with breast cancer or another hormone-sensitive disease, and a past history of one is a question for the oncologist before any testosterone herb.
How much tongkat ali do studies use?
The table lists what studies gave. It is a record of research, not a dose for you.
| Use | Amount studied | Form | Duration | Source |
|---|---|---|---|---|
| Testosterone and symptoms, men 50 to 70 | 100 mg or 200 mg a day | Physta water extract | 12 weeks | 3 |
| Sexual wellbeing, men 30 to 55 | 300 mg a day | Physta water extract | 12 weeks | 5 |
| Testosterone with exercise training | 200 mg a day | Extract | 6 months | 7 |
| Propranolol interaction study | 200 mg once with the drug | Water extract | Single dose | 8 |
Tongkat ali has no official upper limit. Trials of up to 300 mg a day for 12 weeks reported no safety-relevant changes in blood tests 35, but they were small and short. One LifeFrom capsule holds 100 mg of a 20:1 root extract. That matches the lowest amount studied in the largest trial, which raised total testosterone by week 12 3, but that trial used a different, standardized extract, so the comparison is approximate.
When and how to take tongkat ali
How tongkat ali was taken in studies
Trials gave tongkat ali once a day. None tested time of day or cycling on and off, a common practice online with no trial behind it. In the propranolol study, the herb slowed and reduced absorption of the drug when the two were taken together 8; whether spacing them by some hours avoids that has not been tested, so that question belongs with the prescriber.
How long does tongkat ali take to work? In the largest trial, total testosterone separated from placebo from week 4 at 200 mg and by week 12 at 100 mg 3. Sexual wellbeing trials measured at 12 weeks 5, and the stress trial at 4 weeks 4. A before-and-after test should be the same type, fasting, at the same time of morning; our guide to why a trend beats a single reading explains why.
Tongkat ali side effects
In the published trials, side effects were few. In the 109-man trial, all safety measures were comparable to placebo 5. In the 105-man trial, there were no clinically relevant changes in blood counts, lipids, or liver and kidney tests 3. In the 24-week trial, 7 adverse events were reported on tongkat ali and 6 on placebo 10. These trials ran 12 to 24 weeks in a few hundred people at most, so rare or long-term effects could be missed.
| What trials reported | What needs prompt care |
|---|---|
| Adverse events at about placebo rates 510 | On an antidepressant: confusion, agitation, fever, sweating, muscle twitching or stiffness. Same-day care; the label warns against the combination |
| No meaningful changes in liver or kidney blood tests over 12 weeks 3 | Chest pain, fainting, or a pounding or irregular heartbeat, especially on blood pressure medicine 8 |
| DHEA rose and cortisol changed in one trial 3 | Yellow skin or eyes, dark urine, or pain under the right ribs: stop the supplement and get checked the same day |
Who should avoid tongkat ali or ask first
- Breast cancer, prostate cancer or another hormone-sensitive disease: the label says do not take it. A product sold to raise testosterone does not belong alongside a hormone-driven cancer without the oncologist's say.
- Taking an antidepressant, including MAO inhibitors, tricyclics or fluoxetine: the label says not to combine them unless under close supervision of a health care professional. The published trials do not explain the mechanism behind this warning, so it is a question for the prescriber before any combination.
- Pregnancy and breastfeeding: no human safety data; the label says consult a professional first.
- Trying to conceive, or on testosterone or other hormone therapy: ask first; hormone results can become harder to read.
- Blood pressure medicines, especially propranolol: ask first 8.
- Any medicine or medical condition: the label asks anyone taking medication, with a medical condition or under medical supervision to consult a professional first.
- Children: not studied; the label says keep out of reach of children.
- Tested athletes: check your sport's rules and whether the product is batch-tested.
Tongkat ali interactions
| Medicine | What can happen | Why | What to do |
|---|---|---|---|
| Antidepressants: MAO inhibitors, tricyclics, fluoxetine and others | The label warns against combining them | Not established in published trials | The label says not to combine unless under close supervision; talk to the prescriber first |
| Propranolol and possibly other blood pressure medicines | Less drug reached the blood: 29% lower overall exposure, 42% lower peak, peak reached later 8 | Tongkat ali reduced absorption of the drug in the gut 8 | Talk to the prescriber or pharmacist before combining |
| Testosterone, other hormone therapy, or fertility treatment | Unknown; may change hormone results | Tongkat ali is studied for raising testosterone 1 | Tell the prescriber, especially before hormone blood tests |
| Hormone treatments for breast or prostate cancer | Could work against treatment aims | Label warning on hormone-sensitive disease | The label says not to take it with hormone-sensitive disease; ask the oncologist |
| Any regular medicine | Few combinations studied | Limited interaction research | Ask a pharmacist |
Supplements to pair with tongkat ali or keep apart
No study has set a spacing in hours between tongkat ali and another supplement. Everything in a pouch is taken at once, so the table flags combinations to think about.
| Supplement | Together or apart | Why |
|---|---|---|
| Tribulus, fenugreek | No data on combining | All sold for testosterone; no trial tested a stack, and stacking hides which one changed a result |
| Ashwagandha | No data on combining | Also listed as possibly effective for testosterone in healthy men 2; never tested together |
| Rhodiola, tyrosine | Ask first if you take an antidepressant | Each has its own antidepressant caution; stacking adds to the label's warning |
| Zinc | Can be taken together | No known interaction; low zinc is one testable cause of low testosterone |
| Creatine | Can be taken together | No known interaction; creatine has far stronger evidence if the goal is training |
Blood tests worth knowing about
No blood test measures tongkat ali itself. These are the tests the trials measured, and the ones that come up around hormones. Ask your clinician whether any fit your situation.
| Marker | Why it matters with tongkat ali | When it is usually checked |
|---|---|---|
| Total testosterone | What most trials measured; rose in pooled trials, more in men who started low 13 | Fasting, in the morning, repeated to confirm a low result 9 |
| Free testosterone and SHBG | Neither differed from placebo in the largest trial 3 | When total testosterone is borderline or SHBG may be off 9 |
| LH | Helps a clinician tell testicular from pituitary causes of low testosterone 9 | In a low-testosterone workup |
| Estradiol | Men make estradiol from testosterone, so the two are read together | In some hormone workups |
| Morning cortisol | The stress hormone some trials tracked, in saliva 4 | Only when a clinician suspects an adrenal problem |
| PSA | Relevant because of the label's prostate cancer warning; tell the clinician you take it | When a man and his clinician choose prostate screening or follow-up |
The free testosterone calculator estimates free and bioavailable testosterone from total testosterone and SHBG, and the lean body mass calculator is a better way to track body composition than a hormone number.
Conditions and goals tongkat ali comes up around
Tongkat ali is searched alongside testosterone, libido, energy and the gym. Low testosterone is diagnosed and treated by a clinician, who looks for causes from sleep apnea and weight to pituitary problems 9; tongkat ali is not a treatment for it, and never a swap for prescribed therapy. If high cortisol is the worry, our page on Cushing's syndrome explains how that rare condition is tested. Our hormones hub collects related pages.
Tongkat ali in the LifeFrom pouch
| In the LifeFrom pouch | |
|---|---|
| Product | Tongkat Ali |
| What one serving holds | 1 capsule: Tongkat Ali Extract (Eurycoma longifolia) (Root) 20:1, 100 mg |
| Form | Capsule; vegetarian capsule (hypromellose) |
| How it is packed | One serving in each of your 30 daily pouches, with up to 8 supplements per pouch |
| Price | $6.00 a month, plus the fixed $28.50 a month packing, handling and US delivery line for the whole pouch, not per supplement. Prices as of November 2026; the shop shows the current price |
| Curated packs that include it | None |
One capsule holds 100 mg of a 20:1 root extract, the same milligrams as the lowest amount in the largest trial and below the 200 to 300 mg used in others, though those trials used a different, standardized extract 35. The label says not to take it with breast cancer, prostate cancer or another hormone-sensitive disease, or with antidepressants unless under close supervision. Everything in a pouch is taken at once, so adding tribulus, fenugreek or another testosterone herb means taking them together. See the shop and its packs.
This guide is general education, not medical advice, and it cannot diagnose you. Dietary supplements, tongkat ali included, are not approved by the FDA for safety or effectiveness before they are sold. The clinician who knows your history and medicines is the right person to decide whether tongkat ali makes sense for you. Read our medical disclaimer.
Citations
- Leisegang K, Finelli R, Sikka SC, Panner Selvam MK. Eurycoma longifolia (Jack) improves serum total testosterone in men: a systematic review and meta-analysis of clinical trials. Medicina (Kaunas). 2022;58:1047.
- Morgado A, Tsampoukas G, Sokolakis I, et al. Do testosterone boosters really increase serum total testosterone? A systematic review. Int J Impot Res. 2024;36:348-364.
- Chinnappan SM, George A, Pandey P, Narke G, Choudhary YK. Effect of Eurycoma longifolia standardised aqueous root extract (Physta) on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicentre study. Food Nutr Res. 2021;65.
- Talbott SM, Talbott JA, George A, Pugh M. Effect of tongkat ali on stress hormones and psychological mood state in moderately stressed subjects. J Int Soc Sports Nutr. 2013;10:28.
- Ismail SB, Wan Mohammad WM, George A, et al. 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. Evid Based Complement Alternat Med. 2012;2012:429268.
- Kotirum S, Ismail SB, Chaiyakunapruk N. Efficacy of tongkat ali (Eurycoma longifolia) on erectile function improvement: systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2015;23:693-698.
- Leitão AE, Vieira MCS, Pelegrini A, et al. A 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. Maturitas. 2021;145:78-85.
- Salman SA, Amrah S, Wahab MS, et al. Modification of propranolol's bioavailability by Eurycoma longifolia water-based extract. J Clin Pharm Ther. 2010;35:691-696.
- Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103:1715-1744.
- George A, Udani J, Abidin NZ, Yusof A. Efficacy and safety of Eurycoma longifolia (Physta) water extract plus multivitamins on quality of life, mood and stress: a randomized placebo-controlled and parallel study. Food Nutr Res. 2018;62.
- Chinnappan SM, George A, Evans M, Anthony J. Efficacy of Labisia pumila and Eurycoma longifolia standardised extracts on hot flushes, quality of life, hormone and lipid profile of peri-menopausal and menopausal women: a randomised, placebo-controlled study. Food Nutr Res. 2020;64.
- Muniandy S, Yahya HM, Shahar S, et al. Effects of Eurycoma longifolia Jack standardised water extract (Physta) on well-being of perimenopausal and postmenopausal women: protocol for a randomised, double-blinded, placebo-controlled, parallel group study. BMJ Open. 2023;13:e073323.
Educational context only, not medical advice or a diagnosis. Always discuss your results with a clinician.
