Tongkat Ali

What it does

Eurycoma longifolia root extract (usually a standardized hot-water extract) may modestly raise total and free testosterone, possibly by displacing testosterone from sex hormone-binding globulin (SHBG). Effects are most visible in men who start with low testosterone.

What the research says

• May raise total testosterone in men with low baseline levels

  Evidence: moderate. 2022 meta-analysis of 5 RCTs (Leisegang et al.) found a pooled increase, but with high heterogeneity (I2 87%) and a publication-bias signal

• No testosterone change in healthy men with normal levels

  Evidence: moderate. Two 12-week trials (149 men total, 300 mg/day) found no difference versus placebo

• Largest trial: 105 men over 50 with testosterone under 300 ng/dL

  Evidence: moderate. Chinnappan 2021: 200 mg/day of Physta for 12 weeks raised total testosterone from 200.5 to 225.0 ng/dL; placebo declined

• Reduced perceived stress and cortisol in one small trial

  Evidence: emerging. Talbott et al. 2013: 200 mg/day for 4 weeks lowered cortisol and improved mood scores in moderately stressed adults

Positive pooled meta-analysis and one large RCT in hypogonadal men, but the effect is small (roughly +24 ng/dL), heterogeneity is high, and trials in normal-testosterone men were null. Product standardization varies widely.

Is it worth it?

Only plausibly worth trying for low-testosterone men with bloodwork monitoring; evidence gives little reason for healthy men with normal levels to pay for it.