Tongkat Ali

We can tell you what tongkat ali is, what the research found and where it stands under Australian law. We can't tell you it'll work for you, and these questions explain why.

A good fit if

• You want the evidence and the rules laid out before you spend money overseas
• You already take it and want to check whether yours matches what was studied
• You'd rather hear about a gap in the safety data than have it left out

Check with us first if

• You take any prescription medicine. In one study in people, it reduced how well the body absorbed propranolol, a blood pressure medicine.
• You have a hormone-sensitive condition or take hormone therapy. In one trial, oestrogen rose along with testosterone.
• You're combining it with other herbs in a stack, which is where the concern about interactions is greatest.

• Standardised root water extract. Best known for: The well-characterised form, measured for eurycomanone. Absorption: We found no human absorption study. Typical use: 200 mg a day in the human trials. This is the form EFSA assessed and didn't clear. Not allowed in listed medicines here.
• Alcohol or methanol extract. Best known for: A different mix of compounds. Absorption: No human data. Typical use: More acutely toxic than the water extract in mice. No human trials. Not allowed in listed medicines here.
• Raw milled root or decoction. Best known for: The traditional format. Absorption: No human data. Typical use: Traditional use only. A dose of crude root isn't comparable to a dose of extract. Not allowed in listed medicines here.
• Tongkat ali coffee. Best known for: Widely sold in Malaysia. Absorption: No human data. Typical use: Only rat toxicology, with a platelet and kidney signal. Not allowed in listed medicines here.
• Multi-ingredient stacks. Best known for: What most people actually buy. Absorption: Not applicable. Typical use: Results can't be put down to tongkat ali. Not allowed in listed medicines here.

Reference values. There's no Nutrient Reference Value for tongkat ali. It's a plant, not a nutrient, and there's no Australian label dose to quote because no listed medicine can contain it.

Typical supplemental range. The trials in people used 200 mg a day of a water extract for up to six months, and 600 mg a day for two weeks in young men.

Upper level. Not established. Europe's food safety authority (EFSA) assessed 200 mg a day of a standardised water extract as a food supplement and didn't clear it.

Worth knowing. Traditional Chinese sources describe 2 to 10 g a day of raw root boiled in water. That's far more plant material and a different kind of exposure, so it can't be used to justify an extract dose. Products that don't state their eurycomanone content can't be matched to any trial. What you need depends on your age, diet and health, so talk to one of our naturopaths.

Food first, where the diet allows it.

• None: tongkat ali isn't a dietary food. It's only taken as an extract, capsule, powder or infused drink

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• Everyone, because of DNA-damage findings. EFSA found a standardised water extract damaged chromosomes in the lab (clastogenic) and was positive in an animal DNA-damage test, and concluded its safety hasn't been established under any condition of use.
• Liver. One published case report describes jaundice and raised liver enzymes after starting tongkat ali, which improved after stopping.
• Heart rhythm. One published case report describes new atrial flutter in a 71-year-old man four days after starting it.
• If you take any medicine. A crossover study found it cut propranolol's peak level by 42% by reducing absorption. Take care with any medicine taken by mouth.
• Pregnancy and breastfeeding. These groups were excluded from the only formal safety dossier, and there's no data.
• Children and teenagers. There's no data in children; every human trial recruited adults.
• Hormone-sensitive conditions or hormone therapy. In a trial in young men, oestrogen rose alongside testosterone.
• Buying online. In one DNA-testing study only 37% of products were authentic and 27% were adulterated, and a Malaysian survey found several tongkat ali products over the lead limit.