Eurycoma longifolia

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 1,2-Seco-1-nor-6(5->10)abeo-picrasan-2,5-olide skeleton quassinoids, 1beta,12alpha,15beta-triacetyleurycomanone, 1-hydroxy-9-methoxycanthin-6-one, 3-methylcanthin-5,6-dione, 4,5,7,8,17-penta-hydr-oxy-14,18-dimethyl-6-methyl-ene-3,10-dioxapenta-cyclo-[9.8.0.0.0.0]nona-dec-14-ene-9,16-dione methanol solvate dehydrate, 5,6-dehydroeurycomalactone, 5alpha,14beta,15beta-trihydroxyklaineanone, 5-hydroxymethyl-9-methoxycanthin-6-one, 6alpha-hydroxyeurycomalactone, 6-dehydroxylongilactone, 7alpha-hydroxyeurycomalactone, 9,10-dimethoxycanthin-6-one, 9-hydroxycanthin-6-one, 9-hydroxycanthin-6-one n-oxide, 9-methooxycanthin-6-one, 9-methoxycanthin-6-one, 9-methoxycanthin-6-one n-oxide, 10-hydroxy-9-methoxycanthin-6-one, 10-hydroxycanthin-6-one, 11-dehydroklaineanone, 12-epi-11-dehydroklaineanone, 13-21-dihydroeurycomanone, 13alpha,21-dihydroeurycomanone, 13alpha(21)-epoxyeurycomanone, 13beta,18-dihydroeurycomanol, 13beta,21-dihydroxyeurycomanol, 13-beta-21-dihydroxyeurycomanone, 14,15beta-dihydroxyklaineanone, 14-deacetyleurylene, 15beta-acetyl-14-hydroxyklaineanone, 23,24,25-trihydroxytirucall-7-en-3,6-dione, aervin, Ali’s cane, Ali’s walking stick, amino acids, anthraquinone, anthraquinone glucosides, babi kurus (Javanese), bedara merah (Malay), bedara putih (Malay), beta-7-methoxycarboline-1-propionic acid, beta-carboline alkaloids, beta-carboline-1-propionic acid, bidara laut (Indonesian), biphenylneolignans (2-hydroxy-3,2′,6′-trimethoxy-4′-(2,3-epoxy-1-hydroxypropyl)-5-(3-hydroxy-1-propenyl)-biphenyl and 2-hydroxy-3,2′-dimethoxy-4′-(2,3-epoxy-1-hydroxypropyl)-5-(3-hydroxy-1-propenyl)biphenyl), bitter charm, bitter medicine, C18 quassinoids, C19 skeleton quassinoids, C20-skeleton quassinoids, campesterol, canthin-6-one alkaloids (4,9-dimethoxycanthin-6-one, 5,9-dimethoxycanthin-6-one, 9,10-dimethoxycanthin-6-one, 9-methoxy-3-methylcanthin-5,6-dione, 10-hydroxy-11-methoxycanthin-6-one, and 11-hydroxy-10-methoxycanthin-6-one), cay ba binh (Vietnamese), dihydroniloticin, eurycolactone B, eurycolactone D, eurycolactone E, eurycolactone F, Eurycoma apiculata, Eurycoma harmandiana, Eurycoma longifolia Jack, Eurycoma Madu, eurycomalactone, eurycomalide A, eurycomalide B, eurycomanol, eurycomanol-2-O-beta-D-glucoside, eurycomanone, eurycomaoside, eurylactone A, eurylactone B, Force Pill Tongkat Ali, Great Pill Tongkat Ali Plus, laurycolactone A, laurycolactone B, lempedu pahit (Malay), longilactone, Malaysian ginseng, M-Tongkat Ali, muntah bumi (Malay), n-pentyl beta-carboline-1-propionate, oxasqualenoid, pasakbumin B, pasak bumi (Malay), payong ali (Malay), penawar bias (Malay), penawar pahit (Malay), petala bumi (Malay), plalaipeag, saponins, Simaroubaceae (family), sitosterol, squalene-type triterpenes (eurylene, 14-deacetyl eurylene, and longilene peroxide), stigmasterol, Sukarno Tongkat Ali, Super Pill Tongkat Ali, Super Pill Tongkat Ali Plus, TA-a, TA-b, Tender Pill Tongkat Ali, teurilene, tho nan (Laotian), tirucallane-type triterpenes (niloticin, dihydroniloticin, piscidinol A, bourjotinolone A, 3-episapelin A, melianone, and hispidone), tongka ali tea, tongkat ali, tongkat ali hitam, tongkat baginda.

  • Combination products: Etana (Panax quinquefolius, Eurycoma longifolia, Epimedium grandiflorum, Centella asiatica, and flower pollen extracts).

Background

  • Eurycoma longifolia is a tall, slender, shrubby tree that grows in sandy soil in Southeast Asian countries such as Malaysia, Indonesia, Thailand, and Myanmar (Burma). In Malaysia, it is planted for its medicinal value. Eurycoma longifolia is traditionally known as “tongkat ali.”

  • Eurycoma longifolia is traditionally used in Malaysia to improve sex drive and to cure sexual dysfunction, as well as for its fever-reducing, blood sugar-lowering, antimalarial, and antibiotic properties. Although tongkat ali is mostly used in males, it is thought to be as effective in females. It is believed that Eurycoma longifolia stimulates testosterone levels, resulting in increased sexual desire and ability, as well as increased athletic ability and muscle strength. However, few studies are available investigating the effect of this herb in humans.

  • Further research is needed before conclusions can be made on the effectiveness of tongkat ali for any condition.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Athletic endurance

Preliminary evidence did not find a strong effect of Eurycoma longifolia on athletic endurance in humans. Further research is needed.

Enhanced muscle mass / strength

Some studies found that Eurycoma longifolia increases muscle mass in people taking part in a strength program. Higher testosterone levels may be responsible for these effects. Further human research is required.

Male fertility

Eurycoma longifolia increases sexual desire and testosterone levels. Further research is required before conclusions can be drawn.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Adaptogen (regulates metabolism), aging, antibacterial, anxiety, aphrodisiac (improves sex drive), appetite stimulant, cancer, constipation, diabetes, exercise recovery, fever, increased energy, increased strength, insecticide, leukemia, malaria, osteoporosis, sexual dysfunction, stress, syphilis (sexually transmitted disease).

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • To improve endurance, two 75-milligram capsules of Eurycoma longifolia have been taken by mouth daily for seven days, one hour before exercise.

  • To enhance muscle mass, 100 milligrams of a Eurycoma longifolia extract has been taken by mouth daily for five weeks with an exercise training program. A dose of 300 milligrams of premium Eurycoma longifolia or 900 milligrams of lower-quality material has been taken by mouth daily for an unknown length of time. Eurycoma
    longifolia has been taken by mouth with hormonal therapy in a five-days-on/two-days-off schedule for up to eight weeks, followed by a two-week break. Doses of 400-800 milligrams of Eurycoma longifolia have been taken by mouth less than one hour before working out, for an unknown length of time.

  • To improve male fertility, two 100-milligram capsules of a Eurycoma longifolia extract (U.S. Patent: US7,132,117B2 from Phytes Bioteks, Biotropics Malaysia, Berhad, Malaysia) has been taken by mouth twice daily after eating for up to nine months.

Children (under 18 years old)

  • There is no proven safe or effective dose for Eurycoma longifolia in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid if allergic or sensitive to Eurycoma longifolia, its parts, or members of the Simaroubaceae family.

Side Effects and Warnings

  • Eurycoma longifolia is considered safe when used at commonly suggested levels. There is little information available on side effects.

  • Avoid if allergic or sensitive to Eurycoma longifolia, its parts, or members of the Simaroubaceae family.

  • Eurycoma longifolia may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

  • Eurycoma longifolia may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.

  • Eurycoma longifolia may interfere with the way the body processes certain drugs using the liver’s cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Use cautiously in people who have weakened immune systems.

  • Use cautiously in people taking propranolol.

  • Avoid in men who have breast cancer or prostate cancer, as well as people who have diabetes, heart disease, kidney disease, liver disease, or sleep apnea.

  • Avoid in children and in pregnant or breastfeeding women, due to a lack of safety data.

  • Eurycoma longifolia may also cause anxiety, restlessness, and sleep problems.

Pregnancy and Breastfeeding

  • Avoid in pregnant or breastfeeding women. There is currently a lack of scientific evidence on the use of Eurycoma longifolia during pregnancy or breastfeeding.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Eurycoma longifolia may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Eurycoma longifolia may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.

  • Eurycoma longifolia may interfere with the way the body processes certain drugs using the liver’s cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Eurycoma longifolia may also interact with agents that affect the immune system, agents that block nerve impulses, agents that block nervous system activity, agents that increase energy, agents that promote fertility, antianxiety agents, antibiotics, anticancer agents, antimalarial agents, antiobesity agents, beta-blockers, heart health agents, heart rate-regulating agents, hormonal agents, osteoporosis agents, and propranolol.

Interactions with Herbs and Dietary Supplements

  • Eurycoma longifolia may interfere with the way the body processes certain herbs or supplements using the liver’s cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the cytochrome P450 system.

  • Eurycoma longifolia may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

  • Eurycoma longifolia may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Eurycoma longifolia may also interact with antibacterials, anticancer herbs and supplements, antimalarials, antiobesity herbs and supplements, herbs and supplements that affect the immune system, herbs and supplements that block nerve impulses, herbs and supplements that increase energy, herbs and supplements that promote fertility, herbs and supplements that promote heart health, herbs and supplements that treat abnormal heartbeat, hormonal herbs and supplements, and osteoporosis herbs and supplements.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Abd Rahman K, Niiyama K, Azizi R, and et al. Species assembly and site preference of tree species in a primary seraya-ridge forest of Peninsular Malaysia. Journal of Tropical Forest Science 2002;14(3):287-303.
  2. Adaikan PG. Phytoandrogen and sexual health. Phytoandrogen & sexual health 2004.
  3. Adimoelja A. Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions. Int J Androl. 2000;23 Suppl 2:82-84. View Abstract
  4. Ang HH. An insight into Malaysian herbal medicines. Trends.Pharmacol.Sci 2004;25(6):297-298. View Abstract
  5. Ang LH, Ho WM, Ang TB, and et al. Establishment of a high value timber production area on tin tailings – Tropical forestry research in the new millennium: meeting demands and challenges. 2001;245-253.
  6. Baharuddin S, Adenan J, and Mashhor M. Some medicinal plants from Sungai Kinchin, Pahang, Malaysia. Malayan Nature Journal 1990;43(4).
  7. Chua GLS, Koh BL, Lau SC, and et al. The nutrient status of the plateau heath forest on Gunung Keriong, Pahang, Peninsular Malaysia. Journal of Tropical Forest Science 1995;8(2):240-246.
  8. Chua LSL, Kamarudin S, Markandan S, et al. A preliminary checklist of vascular plants from the Machinchang Range, Pulau Langkawi, Peninsular Malaysia. Malayan Nature Journal 2005;57(2):155-172.
  9. Chye LHP. Traditional Asian folklore medicines in sexual health. Indian Journal of Urology 2006;22(3):241-245.
  10. Hussein S, Rusli I, and Kiong LPA. A summary of reported chemical constituents and medicinal uses of Eurycoma longifolia. Journal of Tropical Medicinal Plants 2007;8(1):103-110.
  11. Kulip, J. Medicinal plants of Sabah, Malaysia: potential for agroforestry. JIRCAS Working Report 2009;47-48.
  12. Mohd, I. Opportunities on the planting of medicinal and herbal plants in Malaysia. Planter 1998;74(867):339-342.
  13. Mohd NAG, Amran M, and Mohd HT. Sustainable production of medicinal plants through cultivation: the golden hope experience.Towards modernisation of research and technology in herbal industries 2001; Proceedings of the Seminar on Medicinal and Aromatic Plants.
  14. Remli R, Chan SC. Use of complementary medicine amongst diabetic patients in a public primary care clinic in Ipoh. Med J Malaysia. 2003;58(5):688-693. View Abstract
  15. Vittachi N. Flower power. Far Eastern Economic Review 1994;157(18).

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.