Unlocking the Potential of the Tongkat Ali (Eurycoma longifolia): A Comprehensive Guide

Tongkat Ali, scientifically known as Eurycoma longifolia, has been studied for its potential effects on immune health, particularly through the Physta® standardized root water extract. The research specifically on Physta® has demonstrated promising results in modulating the immune system in middle-aged individuals.

A randomized, double-blind, placebo-controlled study investigated the effects of Physta® on the immune function of a middle-aged Japanese population over a four-week period[4]. The study involved subjects who had relatively lower scores on the Scoring of Immunological Vigor (SIV) screening, indicating a need for immune support. Participants were administered 200 mg/day of Physta® or a placebo. 

The results showed significant improvements in the SIV and immunological grade in the Physta® group compared to the placebo group. Additionally, the study noted increases in the numbers of total, naïve, and CD4+ T cells in the Physta® group, which are crucial components of the adaptive immune system.

These findings suggest that Physta® can enhance comprehensive immunity by improving the overall immunological vigor and increasing essential immune cells, which play a vital role in defending against infections and maintaining immune health. The study did not report any severe adverse events, indicating that Physta® is a safe option for immune system support in middle-aged adults[4].

In summary, Physta® standardized root water extract of Tongkat Ali appears to be an effective supplement for enhancing immune function in middle-aged individuals, supporting the body’s immune response through the modulation of key immune cells and improving overall immunological assessments.

Clinical References:

[1] Solomon, M C., N. Erasmus, and R. R. Henkel. “In Vivo Effects of Eurycoma Longifolia Jack (Tongkat Ali) Extract on Reproductive Functions in the Rat.” Andrologia, vol. 46, no. 4, May 2014, pp. 339-48. doi:10.1111/and.12082. https://pubmed.ncbi.nlm.nih.gov/23464350/. Accessed 23 Apr. 2024.

[4] George, Annie et al. “Immunomodulation in Middle-Aged Humans Via the Ingestion of Physta® Standardized Root Water Extract of Eurycoma longifolia Jack–A Randomized, Double-Blind, Placebo-Controlled, Parallel Study.” Phytotherapy research : PTR vol. 30,4 (2016): 627-35. doi:10.1002/ptr.5571 https://pubmed.ncbi.nlm.nih.gov/26816234/

Origin of Tongkat Ali

Tongkat Ali, known scientifically as Eurycoma longifolia Jack, is a herbal medicinal plant indigenous to Southeast Asia, derived from the roots of the green shrub tree. This region, renowned for its rich biodiversity and traditional herbal remedies, is where Tongkat Ali has established its roots both literally and culturally.

Geographic and Botanical Profile

Tongkat Ali is typically found in the lush rainforests of Southeast Asia, where it grows as a medium-sized, slender tree. It can reach up to 10 meters in height and is often unbranched, making it a distinctive feature of the natural landscape in countries like Malaysia, Indonesia, and Thailand [4].

Traditional Use and Cultural Significance

For generations, the root of the Tongkat Ali tree has been harnessed as a form of traditional medicine within Southeast Asian communities. Its use is deeply embedded in the cultural practices of the region, where it is revered not only for its medicinal properties but also as a symbol of strength and vitality. The roots are the most valued part of the plant and have been traditionally used in various forms, such as in supplements, as well as additives in food and drinks [4].

Modern Applications and Research

In recent years, scientific interest in Tongkat Ali has surged, with research exploring its potential biological effects. Studies have demonstrated its antimicrobial properties, particularly against oral pathogens such as Candida albicans and Streptococcus mutans, which are common culprits in oral health issues [5][6]. These findings have opened the door to the development of new oral care products that leverage the natural properties of Tongkat Ali extract.

Conclusion

The origin of Tongkat Ali extract is deeply rooted in the traditional medicine of Southeast Asia, where it continues to be a symbol of health and well-being. Modern research has begun to validate its traditional uses, revealing its potential as a natural remedy and as an ingredient in health supplements and oral care products. As interest in natural and holistic health solutions grows, Tongkat Ali extract stands out for its rich heritage and promising health benefits.

Clinical References:

[4] Ramzi, Muhamad Iyad bin, et al. “The Effect of Eurycoma Longifolia Jack (Tongkat Ali) Root Extract on Salivary S. Mutans, Lactobacillus and Candida Albicans Isolated from High-Risk Caries Adult Patients.” Pharmacognosy Journal, 2021. https://www.semanticscholar.org/paper/b6306a05d7dd764aa95d3a68fb966c83a25802ef. Accessed 23 Apr. 2024.

[5] Irani Binti Alloha,Irani Binti Allohaand Nurul ’Ain,L. B. A.and Ghasak Ghazi Faisal,Ghasak Ghazi Faisaland Zurainie Abllah,Zurainie Abllahand Mohd Hafiz Arzmi,Mohd Hafiz Arzmi, 20193500567, India, 11, (6), Bangalore, Pharmacognosy Journal, (1299–1302), Phcog.Net, Effects of Eurycoma longifolia jack (Tongkat Ali) alcoholic root extract against oral pathogens. https://www.cabidigitallibrary.org/doi/full/10.5555/20193500567 Accessed 23 Apr. 2024.

[6] Faisal, Ghasak Ghazi, et al. “Antifungal Effects of Eurycoma Longifolia Jack (Tongkat Ali) Root Extract Against Oral Candida Albicans.” (2018). https://www.semanticscholar.org/paper/86148254dbcdbc51d163743dcab3a5fa32aefe7f. Accessed 23 Apr. 2024.

Pros of Tongkat Ali

Tongkat Ali, scientifically known as Eurycoma longifolia, is a traditional herbal medicine native to Southeast Asia. It is renowned for its potential health benefits, particularly in enhancing vitality and mitigating the effects of ageing.

This section of the supplement guide focuses on the advantages of incorporating Tongkat Ali extract into nutraceutical supplements for natural remedy or prevention strategies.

Enhancing Sexual Health and Treating Hypogonadism

One of the primary benefits of Tongkat Ali extract is its impact on male sexual health. A human study involving patients suffering from late-onset hypogonadism (LOH) demonstrated significant improvements after treatment with Tongkat Ali extract.

The study reported that the extract not only improved symptoms according to the Ageing Males’ Symptoms (AMS) scale but also significantly increased serum testosterone levels. Before treatment, only 35.5% of the patients had normal testosterone levels, which increased to 90.8% post-treatment [8]. This suggests that Tongkat Ali extract can be an effective supplement for enhancing sexual health and managing symptoms associated with testosterone deficiency.

Anticancer Properties

Tongkat Ali has also been studied for its potential anticancer properties. Research involving human lymphocyte cell lines from chronic myelocytic leukaemia (CML) patients showed that Tongkat Ali root extract could inhibit the growth of cancer cells. The study highlighted the extract’s cytotoxic and antiproliferative activities, suggesting a promising role in cancer prevention or adjunct therapy [10].

Safety and Regulatory Approval

Safety is a crucial aspect of any dietary supplement. Tongkat Ali extract has received safety confirmations and health claims approvals from regulatory bodies such as Health Canada, which granted new health claims for a Tongkat Ali product, underscoring its safety and efficacy [9]. This regulatory approval supports the inclusion of Tongkat Ali extract in nutraceutical supplements, providing reassurance to health-conscious consumers about its safety profile.

Conclusion

Tongkat Ali extract offers several health benefits that make it a valuable ingredient in health supplements aimed at prevention strategies. Its ability to enhance sexual health, boost the immune system, and exhibit anticancer properties, combined with its safety profile, makes it an appealing option for individuals seeking natural ways to support their health and well-being.

Clinical References:

[8] Tambi, M. I. B. M., M. K. Imran, and R. R. Henkel. “Standardised Water-Soluble Extract of Eurycoma Longifolia, Tongkat Ali, as Testosterone Booster for Managing Men with Late-Onset Hypogonadism?” Andrologia, vol. 44, Suppl 1, May 2012, pp. 226-230. doi:10.1111/j.1439-0272.2011.01168.x. https://pubmed.ncbi.nlm.nih.gov/21671978/. Accessed 23 Apr. 2024.

[9] Crane, Michael. “LJ 100 Tongkat Ali Extract Granted New Safety Confirmation and Health Canada Claims.” 2016. https://www.semanticscholar.org/paper/b9887b5d11c22e521dbb8dfe8103bb9516f83d09. Accessed 23 Apr. 2024.

[10] Abdulelah, Furqan M., et al. “Ex-Vivo Anticancer Evaluation of Tongkat Ali Roots Extract Against Lymphocyte Cell Line of Human CML Patient.” (2021). https://www.semanticscholar.org/paper/78863cc14ca45f5f65667721f6d7f3b98620fe88. Accessed 23 Apr. 2024.

Cons of Tongkat Ali

Potential Genotoxicity at High Doses

One significant concern regarding the use of Tongkat Ali extract in health supplements is its potential genotoxic effects when consumed at high doses. A study by the European Food Safety Authority (EFSA) on the safety of Eurycoma longifolia (Tongkat Ali) root extract as a novel food highlighted that at the highest dose tested (2,000 mg/kg body weight), the extract induced DNA damage in the stomach and duodenum tissues of tested animals [11]. Although this study was conducted on animals, the findings raise concerns about the potential for DNA damage in humans if high doses are consumed, which is critical information for individuals considering high-dose supplements for long-term use.

Limited Evidence on Safety for Pregnant and Lactating Women

The safety of Tongkat Ali extract has not been extensively studied in pregnant and lactating women. The EFSA report specifically excludes these groups from the target population for the novel food approval, suggesting a lack of data on safety for these vulnerable groups [11]. This exclusion indicates that more research is needed to ensure the safety of Tongkat Ali extract for pregnant and lactating women, making it a potentially risky choice for inclusion in supplements intended for general health and well-being for all adults.

Potential for Drug Interactions

While specific human studies on drug interactions with Tongkat Ali extract are limited, the bioactive compounds present in the extract, such as eurycomanone and various canthin-6-one alkaloids, could potentially interact with other medications [11]. These interactions could alter the effectiveness of other drugs or lead to unexpected side effects, particularly in individuals taking multiple medications for chronic conditions. This potential makes it crucial for individuals to consult healthcare providers before starting any supplement containing Tongkat Ali extract.

Inconsistency in Extract Composition

The composition of Tongkat Ali extract can vary significantly depending on the extraction method and source material, which can affect both efficacy and safety. The EFSA noted that the novel food application for Tongkat Ali extract was for a standardised water extract, but many supplements may use different extraction methods that could alter the concentration of active compounds [11]. This variability can lead to products with inconsistent health effects, which is a significant concern for consumers looking for reliable and safe health supplements.

Conclusion

While Tongkat Ali extract is celebrated for its potential health benefits, including boosting male fertility and enhancing physical strength, the concerns regarding its genotoxic potential at high doses, undefined safety in pregnant and lactating women, possible drug interactions, and inconsistency in extract composition make it a complex choice for inclusion in dietary supplements. Consumers should exercise caution and seek medical advice before incorporating such supplements into their health regimen, especially if they are pregnant, nursing, or on other medications.

Clinical References:

[11] EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA), et al. “Safety of Eurycoma Longifolia (Tongkat Ali) Root Extract as a Novel Food Pursuant to Regulation (EU) 2015/2283.” EFSA Journal, vol. 19, no. 12, Dec. 2021, p. e06937. PubMed Central, doi:10.2903/j.efsa.2021.6937. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8693240/. Accessed 23 Apr. 2024.

Recent Development of Tongkat Ali

Overview of Tongkat Ali Extract

Tongkat Ali, scientifically known as Eurycoma longifolia, is a traditional herbal remedy widely used in Southeast Asia. It has gained popularity as a key ingredient in health dietary nutraceutical supplements, particularly for its potential benefits in enhancing male reproductive health, boosting energy levels, and managing symptoms associated with hormonal imbalances.

Efficacy in Male Reproductive Health

Tongkat Ali, scientifically known as Eurycoma longifolia, is a traditional herbal remedy widely used in Southeast Asia. It has gained popularity as a key ingredient in health dietary nutraceutical supplements, particularly for its potential benefits in enhancing male reproductive health, boosting energy levels, and managing symptoms associated with hormonal imbalances.

Potential in Managing Menopausal Symptoms in Women

While less commonly recognized for its effects on women, Tongkat Ali has also been studied for its potential benefits in managing menopausal symptoms. A randomised, double-blinded, placebo-controlled study evaluated the efficacy of the standardised water extract of Tongkat Ali in improving the quality of life of perimenopausal and postmenopausal women. The study found improvements in mood state, quality of life, fatigue, sleep quality, sexual function, and pain scores among participants [12].

Safety Profile

Concerning safety, human studies have generally reported that Tongkat Ali is well-tolerated. The research focusing on its use in both male and female populations has not indicated significant adverse effects, making it a viable option for those considering natural remedies nonpharmaceutical interventions for managing hormonal and reproductive health issues [12][13].

Conclusion

Tongkat Ali extract stands out in the nutraceutical field for its potential benefits in reproductive health and hormonal balance. Its use in supplements could be particularly beneficial for individuals looking to manage symptoms associated with hormonal changes such as LOH and menopause. As with any supplement, it is advisable for users to consult healthcare providers before starting any new regimen, especially those with pre-existing conditions or those taking other medications.

Clinical References:

[12] Muniandy, Subashini, et al. “Protocol: 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, vol. 13, no. 11, 2023, PMC10626840. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626840/. Accessed 23 Apr. 2024.

[13] Tambi, M. I. B. M., M. K. Imran, and R. R. Henkel. “Standardised Water-Soluble Extract of Eurycoma Longifolia, Tongkat Ali, as Testosterone Booster for Managing Men with Late-Onset Hypogonadism?” Andrologia, vol. 44, Suppl 1, May 2012, pp. 226-230. doi:10.1111/j.1439-0272.2011.01168.x. https://pubmed.ncbi.nlm.nih.gov/21671978/. Accessed 23 Apr. 2024.

What Are The Better Dietary Supplement Alternatives to Tongkat Ali in the Market Now?

When considering alternatives to Tongkat Ali (Eurycoma longifolia) for dietary supplementation, it’s important to first identify the specific benefits one is seeking, as Eurycoma longifolia is primarily known for its potential to enhance physical performance, increase muscle mass, and support male sexual health. Given these areas of focus, several dietary supplements present themselves as viable alternatives, each with its own set of benefits and mechanisms of action.

1. Ashwagandha (Withania somnifera):

This adaptogenic herb is renowned for its ability to reduce stress and anxiety, enhance stamina and endurance, and improve overall vitality. It has also been shown to increase testosterone levels and improve fertility in men, making it a comprehensive alternative for those looking to support physical and sexual health.

2. Panax Ginseng:

Another adaptogen, Panax ginseng, offers benefits for energy enhancement, improved cognitive function, and potential improvements in erectile dysfunction. Its role in boosting immune function and combating fatigue makes it a well-rounded supplement for overall wellness.

3. Tribulus Terrestris:

Often used for its libido-enhancing and testosterone-boosting effects, Tribulus Terrestris is a popular alternative for those focusing on sexual health and athletic performance. However, it’s worth noting that scientific evidence supporting its efficacy in increasing testosterone levels is mixed.

4. Maca Root (Lepidium meyenii):

Maca is a Peruvian herb known for its ability to enhance energy, stamina, and mood. It has also been traditionally used to improve sexual desire and function, making it a suitable alternative for those interested in the libido-enhancing aspects of Eurycoma longifolia.

5. Fenugreek (Trigonella foenum-graecum):

This herb has been shown to enhance libido, increase testosterone levels, and improve exercise performance, making it another comprehensive alternative for those seeking the multifaceted benefits of Eurycoma longifolia.

6. D-Aspartic Acid:

An amino acid regulator of testosterone synthesis, D-Aspartic Acid is often used by athletes and bodybuilders to increase muscle mass and strength, as well as to enhance libido and testosterone levels in men.

7. Zinc and Magnesium Supplements (often found in ZMA formulations):

These minerals are crucial for hormone production, including testosterone. They can improve sleep quality, recovery, and overall hormonal balance, offering a foundational approach to the benefits sought from Eurycoma longifolia.

When considering these alternatives, it’s crucial to evaluate the specific health goals, potential interactions with other supplements or medications, and the quality of the supplement brand. Consulting with a healthcare provider is also advisable to ensure the chosen supplement aligns with individual health needs and conditions.

Frequently Asked Questions

What are the health benefits of Tongkat Ali for men?

Tongkat Ali, scientifically known as Eurycoma longifolia, offers several health benefits for men, particularly in the areas of sexual health, energy levels, and overall well-being. Here are the specific benefits based on the user’s interest:

1. Aphrodisiac and Sexual Performance

• Tongkat Ali is widely recognized for its properties as an aphrodisiac.
• Studies have shown that it can enhance sexual desire and performance. For instance, a standardized water-soluble extract of Tongkat Ali significantly improved the symptoms of late-onset hypogonadism (LOH), which includes low libido and sexual dysfunction.
• After treatment, a significant number of patients showed normal sexual function and increased serum testosterone levels[2].
• Additionally, Tongkat Ali has been used traditionally and in various studies to treat erectile dysfunction and enhance sexual health[3][5][13][19].

2. Energy Booster

• Tongkat Ali is also known for its energy-boosting properties. It has been traditionally used to increase physical strength and combat fatigue.
• This is supported by research indicating that Tongkat Ali can improve physical and mental energy levels, making it a useful supplement for managing symptoms related to aging and stress[7][15].
• A study involving physically active seniors found that Tongkat Ali supplementation led to an increase in muscle strength and testosterone levels, which are crucial for energy and vitality[18].

3. Wound Healing

• While the direct effects of Tongkat Ali on wound healing in humans are less documented, its potential is indicated by its general health benefits and the presence of various bioactive compounds.
• These compounds have been shown to have anti-inflammatory and antimicrobial properties, which are beneficial in the healing process[16]. However, more specific studies would be needed to conclusively determine its efficacy in wound healing.

References:

[2] Tambi, M. I. B. M., M. K. Imran, and R. R. Henkel. “Standardised Water-Soluble Extract of Eurycoma Longifolia, Tongkat Ali, as Testosterone Booster for Managing Men with Late-Onset Hypogonadism?” Andrologia, vol. 44, suppl. 1, 2012, pp. 226-230, doi:10.1111/j.1439-0272.2011.01168.x. Accessed 11 Apr. 2024. www.pubmed.ncbi.nlm.nih.gov/21671978/.

[3] Yahya, Muhammad Fuad, et al. “Acclimatization of Eurycoma Longifolia (Tongkat Ali) Plantlets to Ex Vitro Conditions.” Journal of Tropical Resources and Sustainable Science (JTRSS), 2021. Semantic Scholar, www.semanticscholar.org/paper/e91f76ee77dd8639edd67c7cf5981490366cbaa4. Accessed 11 Apr. 2024.

[5] Ali, Tongkat, et al. “Tongkat Ali ? Safe Aphrodisiac for Men ?” Journal of Tropical Resources and Sustainable Science (JTRSS), 2016. Semantic Scholar, www.semanticscholar.org/paper/7debfe56d04105bc4f319c988018fdcc41f0ad93. Accessed 11 Apr. 2024.

[7] Talbott, Shawn M., et al. “Effect of Tongkat Ali on Stress Hormones and Psychological Mood State in Moderately Stressed Subjects.” Journal of the International Society of Sports Nutrition, vol. 10, 2013, Article e28, www.ncbi.nlm.nih.gov/pmc/articles/PMC3669033/. Accessed 11 Apr. 2024.

[13] Rehman, Shaheed Ur, Kevin Choe, and Hye Hyun Yoo. “Review on a Traditional Herbal Medicine, Eurycoma Longifolia Jack (Tongkat Ali): Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology.” Molecules, vol. 21, no. 3, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC6274257/. Accessed 11 Apr. 2024.

[15] Tambi, Mohd Ismail, and Johari M. Saad. “WATER-SOLUBLE EXTRACT OF EURYCOMA LONGIFOLIA JACK AS A POTENTIAL NATURAL ENERGIZER FOR HEALTHY AGING IN MEN.” 2016. Semantic Scholar, www.semanticscholar.org/paper/d2fc02eb7ed97968927f2a3d6cf6bca8d3c058fb. Accessed 11 Apr. 2024.

[16] Yaseen, Maryam Riyadh, et al. “Preparation of Eurycoma Longifolia Jack (E.L) Tongkat Ali (Ta) Root Extract Hydrogel for Wound Application.” Pharmacognosy Journal, 2021. Semantic Scholar, www.semanticscholar.org/paper/a2db4dc0e48551f71fa5228f6770215e1caeca68. Accessed 11 Apr. 2024.

[18] Henkel, Ralf R., et al. “Tongkat Ali as a Potential Herbal Supplement for Physically Active Male and Female Seniors–A Pilot Study.” Phytotherapy Research, vol. 28, no. 4, Apr. 2014, pp. 544-550, doi:10.1002/ptr.5017. Accessed 11 Apr. 2024. www.pubmed.ncbi.nlm.nih.gov/23754792/.

How many men suffer sexual dysfunction in Malaysia in 2024?

The prevalence of erectile dysfunction (ED) among men in Malaysia is 31.6%, as reported in a study analyzing the National Health and Morbidity Survey 2019 data. This study focused on men aged 18 years and above and identified the prevalence of moderate to severe ED, along with its associated factors[1]. This high prevalence indicates that a significant proportion of the male population in Malaysia experiences ED, which is a common form of sexual dysfunction.

The study highlights that the problem of ED is mainly linked to age, with the prevalence increasing significantly in older age groups. Specifically, the prevalence of ED increased from 49.7% among men in their 40s to 66.5%, 92.8%, and 93.9% among men in their 50s, 60s, and 70s, respectively[19].

For premature ejaculation (PE), another form of sexual dysfunction, the global Premature Ejaculation Treatment market size is projected to reach USD 5341.1 million by 2028, up from USD 2864 million in 2024, indicating a growing recognition and treatment of the condition[17]. However, specific prevalence rates for PE in Malaysia for the year 2024 are not provided in the available data.

These findings underscore the importance of addressing sexual health issues among the male population in Malaysia, particularly as men age. The high prevalence rates suggest that sexual dysfunction, including ED and potentially PE, is a significant health concern that affects a large number of men in Malaysia.

References:

[1] Rezali, Muhammad Solihin et al. “Prevalence and associated factors of moderate to severe erectile dysfunction among adult men in Malaysia.” Scientific reports vol. 13,1 21483. 6 Dec. 2023, doi:10.1038/s41598-023-48778-y https://pubmed.ncbi.nlm.nih.gov/38057375/

[17] Milestone Achieve Reports. “Premature Ejaculation Treatment Market Size In 2024: Share, Latest Trends & Forecast 2024 To 2031.” LinkedIn, 1 Feb. 2024, www.linkedin.com/pulse/premature-ejaculation-treatment-market-size-9h4vf. Accessed 11 Apr. 2024.

[19] AsnidaNicolosi, RA. “Prevalence of Erectile Dysfunction in Primary Care Setting, Malaysia.” Journal of Men’s Health, vol. 8, suppl. 1, 2011, ScienceDirect, doi:10.1016/S1875-6867(11)60021-3. Accessed 11 Apr. 2024. https://www.sciencedirect.com/science/article/abs/pii/S1875686711600213.

What are the health benefits of Tongkat Ali for women?

Tongkat Ali, scientifically known as Eurycoma longifolia Jack, is a traditional herbal medicine native to Southeast Asia and has been used in various traditional healthcare systems.

For women, the health benefits of Tongkat Ali are primarily associated with its potential effects on well-being, particularly during the menopausal transition, and as an ergogenic supplement for physically active seniors.

1. Menopausal Well-being

• Quality of Life Improvement: A study protocol outlined in a randomized, double-blinded, placebo-controlled trial aims to evaluate the efficacy of a standardized water extract of Tongkat Ali, known as Physta, in improving the quality of life of perimenopausal and postmenopausal women[5].
• Mood, Fatigue, and Sleep: The same study protocol indicates that the outcomes will measure mood state, fatigue, sleep quality, sexual function, and pain score, suggesting that Tongkat Ali may have beneficial effects on these aspects of health for women undergoing menopause[5].

2. Ergogenic Benefits

• Muscle Strength: A pilot study on physically active male and female seniors supplemented with Tongkat Ali extract showed significant increases in muscular force in both men and women, indicating its potential as an ergogenic aid that enhances muscle strength[7].

3. Hormonal Balance

4. General Health Uses

• Traditional Uses: Historically, various parts of the Tongkat Ali plant have been used for different medicinal purposes, such as treating dysentery, high blood pressure, diarrhoea, fever, and as an aphrodisiac, antibiotic, appetite stimulant, and health supplement[10].

Tongkat Ali may offer several health benefits for women, particularly in improving the quality of life during menopause, enhancing muscle strength in physically active seniors, and potentially balancing hormone levels.

However, it is important to note that while these studies suggest potential benefits, more research is needed to fully understand the effects of Tongkat Ali on women’s health, and it should be used under the guidance of a healthcare professional.

**Clinical References**:

[1] Panay, N., & Fenton, A. (2009). The role of testosterone in women. Climacteric, 12(3), 185–187. https://doi.org/10.1080/13697130902973227 

[2] Taylor, Sasha et al. “Endogenous testosterone concentrations and muscle mass, strength and performance in women, a systematic review of observational studies.” Clinical endocrinology vol. 98,4 (2023): 587-602. doi:10.1111/cen.14874 https://pubmed.ncbi.nlm.nih.gov/36585396/ 

[3] Cappola, Anne. “SEX HORMONES ARE ASSOCIATED WITH BONE DENSITY AND PHYSICAL FUNCTION IN WOMEN RECOVERING FROM HIP FRACTURE.” Innovation in Aging vol. 7,Suppl 1 437–438. 21 Dec. 2023, doi:10.1093/geroni/igad104.1442 https://www.ncbi.nlm.nih.gohttps://pubmed.ncbi.nlm.nih.gov/36585396/v/pmc/articles/PMC10737156/ 

[4] van Geel, Tineke A C M et al. “Measures of bioavailable serum testosterone and estradiol and their relationships with muscle mass, muscle strength and bone mineral density in postmenopausal women: a cross-sectional study.” European journal of endocrinology vol. 160,4 (2009): 681-7. doi:10.1530/EJE-08-0702 https://pubmed.ncbi.nlm.nih.gov/19174532/ 

[5] Muniandy, Subashini, et al. “Protocol: 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, vol. 13, no. 11, 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10626840/. Accessed 11 Apr. 2024.

[6] Frazzetta, Gayle. “Effect of Testosterone Pellet Therapy on Bone Mineral Density in Postmenopausal Women.” Journal of Clinical Densitometry (2023): n. Pag. https://www.semanticscholar.org/paper/7affabf8acf299bcf4a6e3ce59ec86812032b176 

[7] Henkel, Ralf R., et al. “Tongkat Ali as a Potential Herbal Supplement for Physically Active Male and Female Seniors–A Pilot Study.” Phytotherapy Research, vol. 28, no. 4, Apr. 2014, pp. 544-550, doi:10.1002/ptr.5017. Accessed 11 Apr. 2024. www.pubmed.ncbi.nlm.nih.gov/23754792/.

[8] Yakabe, Mitsutaka et al. “Serum free testosterone levels are positively correlated with skeletal muscle mass in older women aged over 75 years.” Geriatrics & gerontology international vol. 19,5 (2019): 460-461. doi:10.1111/ggi.13642 https://pubmed.ncbi.nlm.nih.gov/31044500/ 

[9] Yang, JinXiao et al. “Association between Serum Total Testosterone Level and Bone Mineral Density in Middle-Aged Postmenopausal Women.” International journal of endocrinology vol. 2022 4228740. 17 Aug. 2022, doi:10.1155/2022/4228740 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402345/ 

[10] Rehman, Shaheed Ur, Kevin Choe, and Hye Hyun Yoo. “Review on a Traditional Herbal Medicine, Eurycoma Longifolia Jack (Tongkat Ali): Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology.” PubMed Central (PMC), Molecules, vol. 21, no. 3, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC6274257/. Accessed 11 Apr. 2024.

[11] Woods, Nancy Fugate et al. “Depressed mood during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study.” Menopause (New York, N.Y.) vol. 15,2 (2008): 223-232. doi:10.1097/gme.0b013e3181450fc2 https://pubmed.ncbi.nlm.nih.gov/18176355/ 

[12] Das, Darvin V et al. “Sex Hormone Levels – Estradiol, Testosterone, and Sex Hormone Binding Globulin as a Risk Marker for Atherosclerotic Coronary Artery Disease in Post-menopausal Women.” Indian journal of endocrinology and metabolism vol. 23,1 (2019): 60-66. doi:10.4103/ijem.IJEM_505_18 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446685/ 

[14] Woods, Nancy Fugate et al. “Sexual desire during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study.” Journal of women’s health (2002) vol. 19,2 (2010): 209-18. doi:10.1089/jwh.2009.1388 https://pubmed.ncbi.nlm.nih.gov/20109116/ 

[15] Watts, Eleanor L et al. “Prospective analyses of testosterone and sex hormone-binding globulin with the risk of 19 types of cancer in men and postmenopausal women in UK Biobank.” International journal of cancer vol. 149,3 (2021): 573-584. doi:10.1002/ijc.33555 https://pubmed.ncbi.nlm.nih.gov/33720423/ 

[16] Arthur, Rhonda S et al. “The association of prediagnostic circulating levels of cardiometabolic markers, testosterone and sex hormone-binding globulin with risk of breast cancer among normal weight postmenopausal women in the UK Biobank.” International journal of cancer vol. 149,1 (2021): 42-57. doi:10.1002/ijc.33508 https://pubmed.ncbi.nlm.nih.gov/33567105/

Is it safe to take Tongkat Ali everyday?

• A study evaluating the acute and subchronic toxicity of Tongkat Ali’s powdered root found no adverse effects attributable to the test compound with respect to body weight, haematology, serum biochemistry, urinalysis, macropathology, or histopathology.
• The treatment even showed beneficial pharmacological effects on health, such as reduced prothrombin time and improvements in various blood parameters, especially in males. The acceptable daily intake (ADI) was calculated to be up to 1.2 g/adult/day (max dose for powdered root)[2].
• However, there are some concerns regarding the long-term use of Tongkat Ali. A study on the long-term use of Tongkat Ali on the liver in rats showed mild to moderate degrees of hemorrhage, hepatocytes degeneration, and severe fatty changes in liver tissue of the test groups compared to control[5][7]. This indicates that long-term daily consumption of Tongkat Ali extract in large quantities may have side effects on the liver.
• The systematic review of Tongkat Ali highlighted that the herb supports overall health and improves vigour in both males and females when taken on a daily basis.It was reported that patients who have taken the nutraceutical reported an immunological age four years younger than others taking a placebo, with improvements seen in hormonal balance, strength, quality-of-life, and sexual health[6]. This suggests a positive impact on health with daily consumption.
• Another study assessing the effect of long-term use of Tongkat Ali extract on the pancreas in rats found no signs of adverse effects on pancreatic tissues, suggesting that the daily consumption of Tongkat Ali extract has no side effect on pancreatic tissue when taken in small quantities for a long duration[8].
• In conclusion, Tongkat Ali can be considered safe for daily consumption within the recommended dosage limits, with potential health benefits. However, caution should be exercised regarding long-term use in large quantities due to potential liver toxicity. It is always advisable to consult with a healthcare provider before starting any new supplement regimen, especially for individuals with pre-existing health conditions or those taking other medications.

References:

[2] Li, Ching-Hao, et al. “Evaluation of Acute 13-Week Subchronic Toxicity and Genotoxicity of the Powdered Root of Tongkat Ali (Eurycoma Longifolia Jack).” Evidence-Based Complementary and Alternative Medicine, vol. 2013, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3767077/. Accessed 11 Apr. 2024.

[5] Alfaqeh, Hamoud Hussein Mohammed. “Effect of Long-Term Use of Eurycoma Longifolia Jack on Histopathological Changes in the Liver in Rats.” International Medical Journal Malaysia, vol. 13, 2014, pp. 29-33. Semantic Scholar, www.semanticscholar.org/paper/fd2c7bbbabdd5be41034f4af70fced6011043065. Accessed 11 Apr. 2024.

[6] Koprowski, Eugene J. “Systematic Review of Eurycoma Longifolia Reports Herb Improves Health, Vigor for Male and Female Subjects.” 2017. Semantic Scholar, www.semanticscholar.org/paper/1616b5b817ebee482209927c045f8d8777f1db52. Accessed 11 Apr. 2024.

[7] Alfaqeh, Hamoud Hussein Mohammed. “Long-Term Consumption Effect of Eurycoma Longifolia Jack on Histopathological Changes in the Vital Organs in Rats.” 2014. Semantic Scholar, www.semanticscholar.org/paper/3c16a8d9eb4f5f12231440514fff0378c8799491. Accessed 11 Apr. 2024.

[8] Alfaqeh, Hamoud Hussein Mohammed, and Qamar Uddin Ahmed. “EFFECT OF LONG-TERM USE OF EURYCOMA LONGIFOLIA JACK ON THE PANCREAS IN RATS: HISTOLOGICAL ASSESSMENT.” 2013. Semantic Scholar, www.semanticscholar.org/paper/8c3efc069c77015b62367dc4043b00aa2f5ed2e8. Accessed 11 Apr. 2024.

What are the potential side effects of taking Tongkat Ali?

The potential side effects of taking Tongkat Ali are primarily related to its impact on liver health, as indicated by some studies. While many studies highlight the health benefits of Tongkat Ali, including its effects on enhancing male reproductive functions and general vitality, there are concerns regarding its long-term use, especially in large quantities.

• Liver Health Concerns: One study specifically pointed out that long-term use of Tongkat Ali could lead to mild to moderate degrees of hemorrhage, hepatocytes degeneration, and severe fatty changes in liver tissue[5][7]. This suggests that while Tongkat Ali may have various health benefits, its prolonged consumption at high doses might pose risks to liver health.
• General Side Effects: Although not directly mentioned in the provided studies, common side effects associated with herbal supplements like Tongkat Ali can include insomnia, anxiety, and restlessness. These effects are typically linked to the herb’s capacity to increase testosterone levels and overall energy.

It’s important for individuals considering Tongkat Ali for daily use to consult healthcare providers, particularly due to the potential for liver-related side effects and to ensure safe dosage and duration of use.

References:

[5] Vejayan, Jaya, et al. “Aphrodisiac Potential of Polyalthia Bullata (Tongkat Ali) in Fowl.” Asian Pacific Journal of Reproduction, vol. 10, 2021, pp. 75-81. Semantic Scholar, www.semanticscholar.org/paper/3512c0a899e41bd39b97d3ecd07b4b60d4c91d3e. Accessed 11 Apr. 2024.

[7] Mohamad, Mashani Mohamad, et al. “Exploring the Aphrodisiac Potential of Tongkat Ali Hitam (Polyalthia Bullata) In Male Sprague-Dawley Rats.” 2017. Semantic Scholar, www.semanticscholar.org/paper/60fde3c10b6ef5d51acb287d3ed18c864ecb538c. Accessed 11 Apr. 2024.

What is the recommended dosage of Tongkat Ali?

The recommended dosage of Tongkat Ali root extract, as proposed by the applicant for its use as a novel food supplement, is up to 200 mg/day for the adult population, excluding pregnant and lactating women[1].

Reference:

[1] “Safety of Eurycoma Longifolia (Tongkat Ali) Root Extract as a Novel Food Pursuant to Regulation (EU) 2015/2283.” EFSA Journal, vol. 19, no. 12, 2021, Article e06937, www.ncbi.nlm.nih.gov/pmc/articles/PMC8693240/. Accessed 11 Apr. 2024.

Are there any drug interactions with Tongkat Ali?

• While there are no specific clinical studies directly detailing the interactions between Tongkat Ali and other drugs, the general pharmacological properties of Tongkat Ali and its bioactive compounds suggest the possibility of interactions. Tongkat Ali contains various classes of bioactive compounds such as quassinoids, alkaloids, and steroids, which could potentially interact with other medications[6].
• For instance, the molecular docking studies of a quassinoid from Tongkat Ali with P-glycoprotein (P-gp) suggest that compounds in Tongkat Ali can interact with drug transporters like P-gp, which are known to play a significant role in drug-drug interactions by affecting the absorption, distribution, and elimination of many drugs[1].
• P-gp overexpression is often linked to multidrug resistance in human cancers, indicating that compounds in Tongkat Ali could potentially affect the efficacy of chemotherapeutic drugs by modulating P-gp activity.
• Furthermore, the general principle that patients with complex conditions such as cardiovascular diseases or those in critical care, like neonates in NICUs, are at higher risk for potential drug-drug interactions (DDIs) due to multiple drug regimens[2][3], suggests that adding a complex herbal supplement like Tongkat Ali, with its multiple bioactive compounds, could increase the risk of DDIs.
• The pharmacological activity of Tongkat Ali’s compounds, especially in affecting drug transporters and enzymes involved in drug metabolism, underscores the need for caution and further research into its interactions with other medications.

References:

[1] Sarbini, Sarbini, et al. “Molecular Docking Studies of a Quassinoid and P-Glycoprotein.” 2013 IEEE Symposium on Computers & Informatics (ISCI), 2013, pp. 138-142. Semantic Scholar, www.semanticscholar.org/paper/92abadb34b16d704042e7fe90118f1d9cc9d500b. Accessed 11 Apr. 2024.

[2] Abaeioglu, Nurettin, et al. “Potential Drug-Drug Interactions in Cardiovascular Patients Prescriptions Dispensed in Community Pharmacies in Albyd of Libya.” 2017 IEEE Symposium on Computers & Informatics (ISCI), 2017, pp. 138-142. Semantic Scholar, www.semanticscholar.org/paper/f5f07b4059bd7bed697c885190f8829b45159565. Accessed 11 Apr. 2024.

[3] Rafati, Mohammad Reza, et al. “Drug Interactions in Neonatal Intensive Critical Care Unit in Bu-Ali Sina Teaching Hospital, Sari, Iran.” Journal of Mazandaran University of Medical Sciences, vol. 25, 2016, pp. 305-309. Semantic Scholar, www.semanticscholar.org/paper/765caa7b06659cfc6757d00f935229491ca9903d. Accessed 11 Apr. 2024.

[6] Rehman, Shaheed Ur, Kevin Choe, and Hye Hyun Yoo. “Review on a Traditional Herbal Medicine, Eurycoma Longifolia Jack (Tongkat Ali): Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology.” Molecules, vol. 21, no. 3, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC6274257/. Accessed 11 Apr. 2024.

Does Eurycoma longifolia help to stabilise blood pressure?

Eurycoma longifolia, also known as Tongkat Ali, has been studied for its potential effects on blood pressure, among other health benefits. The results from these studies are mixed:

• One study found that rats with a high-fat diet benefited from treatment with Eurycoma longifolia extract, as there were reduced systolic and diastolic blood pressure significantly[1].
• Another study on rats fed a high-fat diet showed that administration of Eurycoma longifolia led to less increment in body weight, but did not achieve a significant level of change in systolic and diastolic blood pressure[2].
• A review article mentions the traditional use of Eurycoma longifolia‘s root to treat high blood pressure, among other conditions[3].
• A study investigating the blood pressure-lowering properties of Eurycoma longifolia found that a dichloromethane fraction of the root extract caused relaxation of rat aortic rings, suggesting potential antihypertensive effects[4].

While some evidence suggests that Eurycoma longifolia may help stabilize blood pressure, particularly in the context of a high-fat diet in animal models, the results are not conclusive, and more research is needed to determine its effectiveness and safety in humans.

References:

[1] Mokhtar, Rafidah Hanim Binti, et al. “The Effects of Eurycoma Longifolia on Testosterone and Blood Pressure in High-Fat-Fed Animal Model.” Journal of Applied Pharmaceutical Science, vol. 7, 2017, pp. 119-124. Semantic Scholar, www.semanticscholar.org/paper/c1e49064d29a2023e84409cd9de3272890d2d4e6. Accessed 11 Apr. 2024.

[2] Al-Joufi, Fakhria A., et al. “The Effect of Oral Administration of Eurycoma Longifolia Extract on Body Weight and Blood Pressure in Sprague Dawley Rats Fed High-Fat Diet.” 2015. Semantic Scholar, www.semanticscholar.org/paper/b2de323067235ddcea06a795b54b742a5e515e6e. Accessed 11 Apr. 2024.

[3] Rehman, Shaheed Ur, Kevin Choe, and Hye Hyun Yoo. “Review on a Traditional Herbal Medicine, Eurycoma Longifolia Jack (Tongkat Ali): Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology.” Molecules, vol. 21, no. 3, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC6274257/. Accessed 11 Apr. 2024.

[4] Bae Huey Tee, See Ziau Hoe, Swee Hung Cheah, and Sau Kuen Lam. “First Report of Eurycoma Longifolia Jack Root Extract Causing Relaxation of Aortic Rings in Rats.” Biomed Research International, vol. 2016, 2016, Article e1361508, www.ncbi.nlm.nih.gov/pmc/articles/PMC5075299/. Accessed 11 Apr. 2024.

[5] Ong Pui, Wen, et al. “Effects of Short-Term Psyllium Husk and Selected Mixed Herbal Supplementation on Health Indicators in Healthy Male Subjects.” Journal of Applied Pharmaceutical Science, 2022. Semantic Scholar, www.semanticscholar.org/paper/b97682b2ea4e8309d20434f40a9aa06192bde2d7. Accessed 11 Apr. 2024.

[6] Pratomo, Hurip. “Effects of Eurycoma Longifolia Provision on Blood Sugar Level, Cholesterols, and Uric Acid of Etawa Crossbreed Goat.” Journal of Physics: Conference Series, vol. 1025, 2018. Semantic Scholar, www.semanticscholar.org/paper/4b345c0c05af21331a3212d602d6e7fd27ef8939. Accessed 11 Apr. 2024.

[7] Muniandy, Subashini, et al. “Protocol: 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, vol. 13, no. 11, 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10626840/. Accessed 11 Apr. 2024.

[8] Chaiphech, Somkid, et al. “Cytotoxic Evaluation of Eurycoma Longifolia Jack Root Extract on Chromosome Aberrations in Human Lymphocytes In Vitro.” Journal of Tropical Biodiversity and Biotechnology, 2022. Semantic Scholar, www.semanticscholar.org/paper/36d087de7e3a9faf50450f5b2b8dec32e4bddb5e. Accessed 11 Apr. 2024.