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Tongkat Ali Standardized Extract Improves Testosterone and Stress Hormone Balance and Mood Parameters in Subjects with Moderate Stress

Reviewed: 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(1):28. doi: 10.1186/1550-2783-10-28.

Tongkat ali (Eurycoma longifolia, Simaroubaceae) root water extract is used as an adaptogen for vitality and energy, and for enhancing testosterone. While the precise mechanism of tongkat ali root extract is unknown, it has been suggested that it helps restore normal testosterone levels by increasing the release of free testosterone from its binding hormone, the sex hormone-binding globulin. There are many benefits of tongkat ali that are associated with a more youthful testosterone level,1 including higher physical vigor and strength.2 The objective of this randomized, double-blind, placebo-controlled study was to evaluate the effects of tongkat ali extract on stress hormone (cortisol/testosterone) balance and psychological mood state in moderately stressed subjects.

This study was conducted by SupplementWatch (Draper, UT). Seventy-five subjects in and around Salt Lake City, UT, were recruited and screened for moderate levels of psychological stress using a screening survey. Those who scored six or greater (six-10 indicating moderate stress) on the survey were eligible for enrollment. Sixty-four subjects (32 men and 32 women) were randomly assigned to receive either 200 mg/day tongkat ali (Physta®, Biotropics Malaysia Berhad; Shah Alam, Selangor, Malaysia) or placebo for four weeks. Researchers used the same standardized, patented, hot water-extracted tongkat ali (standardized to 22% eurypeptides) that has been used in previous human tongkat ali supplementation studies. The patent discloses a process wherein tongkat ali roots undergo an aqueous extraction and, when combined with high-performance liquid chromatography (HPLC) and size-exclusion chromatography, yield a bioactive peptide fraction (a 4300 dalton glycopeptide with 36 amino acids) responsible for restorative effects on testosterone levels.

At baseline and post-supplementation, mood states and hormone profiles were analyzed as primary outcome measurements. The researchers did not separate results for males and females but reported only their combined data. Mood state was assessed using the validated Profile of Mood States (POMS) survey. Free cortisol and testosterone levels were assessed in saliva samples collected three times during each collection day (morning, afternoon, and evening) at baseline and after four weeks of supplementation. Secondary measurements included liver enzymes (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), body weight, and body-fat percentage. 63 subjects (32 men and 31 women) completed the study. One woman in the supplement group did not return final samples. Three subjects — two in the tongkat ali group and one in the placebo group — reported feeling unusually fatigued during the first two weeks of the study. No other adverse events or side effects were reported.

There were no significant changes in markers of liver function (AST/ALT), body weight, or body-fat percentage. Mood state surveys showed mixed results, with no effects observed between groups for parameters of depression, vigor, or fatigue. Significant improvements were found in the tongkat ali group compared to placebo for tension (-11%), anger (-12%), and confusion (-15%). A nonsignificant trend (P=0.083) was found for improvement in overall wellbeing in the tongkat ali group (+3% in global mood state). Salivary free cortisol and free testosterone levels were significantly improved by tongkat ali supplementation, with reduced cortisol (-16%), increased testosterone (+37%), and overall improved cortisol/testosterone ratio (-36%) compared to placebo. Error bars are shown in the figures; however, there is no indication of whether or not they signify standard error or standard deviation. They are remarkably stable, however. The authors did not specify the time or day of the female cycle during which samples were taken.

The authors conclude that tongkat ali root extract supplementation can influence anabolic/catabolic stress hormone balance and mood state parameters in subjects with moderate stress levels. They found that 200 mg/day supplementation of patented, standardized, water-extracted tongkat ali improved stress hormone profile by significantly lowering cortisol and increasing testosterone levels. Tongkat ali supplementation also was found to significantly lower certain negative mood state parameters (tension, anger, and confusion). Future trials should have a larger number of cohorts and separate results for males and females.

—Alexis Collins


  1. Keller AC. Tongkat ali aqueous extract shows promise in study for men who are symptomatic of hypogonadism due to low testosterone. HerbClip. November 15, 2011 (No. 071165-436). Austin, TX: American Botanical Council. Review of Standardised water-soluble extract of Eurycoma longifolia, tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? by Tambi MIBM, Imran MK, Henkel RR. Andrologia. 2012;44(Suppl. 1):226-230.
  2. Oliff HS. A Malaysian tongkat ali extract (Physta™) increases quality-of-life benefits in men. HerbClip. January 15, 2013 (No. 121251-464). Austin, TX: American Botanical Council. Review of 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 by Ismail SB, Wan Mohammad WMZ, George A, Nik Hussain NH, Musthapa Kamal ZM, Liske E. Evid Based Complement Alternat Med. 2012;2012:429268. doi: 10.1155/2012/429268.