Research
Tongkat Ali: What the Studies Really Show
Small trials of tongkat ali extract, at 100 to 600 mg a day, found mild testosterone rises, mainly in men whose levels were already low. Healthy men showed no clear change. Product quality varies widely, and long-term safety is not well documented. Vapofil holds 10 mg of extract, a tenth of the lowest trial dose.
Written by the Vapofil editorial teamUpdated · 8 min read
The basics
What is tongkat ali?
Tongkat ali is the root of Eurycoma longifolia, a tree used in traditional medicine in Southeast Asia. In supplements it usually comes as a concentrated root extract.
LiverTox puts the typical traditional dose at 100 to 400 mg a day (LiverTox, Tongkat ali). Most modern trials tested a water extract, weighed as extract, not as raw root (Leisegang 2022, Tongkat ali meta-analysis). That detail matters when you read a label, as the last part of this post shows.
The trials
What did the largest tongkat ali trial find?
The largest trial enrolled 105 men aged 50 to 70 who had low testosterone. They took 100 or 200 mg of extract a day for 12 weeks. Total testosterone rose by about 9% to 12.5%, while the placebo group fell by 3% (LiverTox, Tongkat ali). LiverTox calls these "mild increases."
| Source | Who or what | Dose | What it found |
|---|---|---|---|
| Largest trial (LiverTox) | 105 men, 50 to 70, low testosterone | 100 or 200 mg extract, 12 weeks | Testosterone up about 9% to 12.5%, placebo down 3% |
| 2022 meta-analysis | 5 trials, 232 men | 100 to 600 mg extract, 3 days to 6 months | Significant rise with low levels; not significant in healthy men |
| Product survey | 41 products sold in Malaysia | Not applicable | Only 11 met the recommended eurycomanone level |
| Mercury tests | Two sets of 100 products | Not applicable | 26% and 36% were over the mercury limit |
Pooled data
What does the 2022 tongkat ali meta-analysis add?
A 2022 review pooled 5 randomized trials with 232 men (Leisegang 2022, Tongkat ali meta-analysis). Doses ran from 100 to 600 mg a day, for 3 days up to 6 months. Most trials used one branded water extract.
Overall, total testosterone went up. Split by group, the rise was significant in men with hypogonadism but not in healthy men. The authors also flagged small samples, results that varied a lot and signs of publication bias, which means negative studies may be missing.
The trials measured hormone levels. They were not trials of erections, and they do not show a benefit for men whose levels are normal. Mayo Clinic notes that testosterone falls about 1% a year after 30 or 40, and that treating normal aging is not advisable (Mayo Clinic, Testosterone and aging).
Evidence
How strong is the evidence for tongkat ali?
Higher means more and better research, not a better result.
- 4Guidelines and large trials
- 3Several trials, pooled
- 2Small human trials
- 1Lab and animal studies
- Vapofil itselfNo trials found(NCCIH, Sexual enhancement supplements)
- Horny goat weed (icariin)Mostly lab and animal(MSKCC, Epimedium) (LiverTox, Horny goat weed)
- Tongkat ali, 100-600 mg extractSmall trials, mixed(Leisegang 2022, Tongkat ali meta-analysis) (LiverTox, Tongkat ali)
- Saw palmetto, 320 mgMany trials: little to no benefit(Cochrane review, Saw palmetto)
- PDE5 inhibitors (prescription)Guideline treatment for ED(AUA, ED guideline) (NIDDK, ED treatment)
Higher means more and better research, not a better result: saw palmetto has strong research showing little benefit for urinary symptoms. Vapofil's doses sit well below the studied amounts, and no trial tested the product.
Tongkat ali sits above horny goat weed, which rests mostly on lab and animal work, but below anything a guideline recommends. Small trials with mixed results are a reason for more research, not a reason to expect a result.
Product quality
Are tongkat ali products consistent?
Not very. Of 41 products tested in Malaysia, only 24 contained eurycomanone and only 11 met the recommended level (Leisegang 2022, Tongkat ali meta-analysis). Two mercury studies found a quarter to a third of samples over the legal limit, and passing one batch did not mean the next was safe (Science.gov, Tongkat ali mercury).
Safety
Is tongkat ali safe?
Short-term side effects in studies were uncommon. They included nausea, stomach discomfort, diarrhea, headache and rash (LiverTox, Tongkat ali). The bigger unknown is the long run.
LiverTox rates tongkat ali a possible rare cause of liver injury and says its long-term safety has not been well documented. Europe's food safety agency concluded in 2021 that its safety has not been established under any condition of use (LiverTox, Tongkat ali). Ask your doctor first if you have liver disease.
On the Vapofil label
How does the tongkat ali in Vapofil compare with the trials?
Vapofil lists 10 mg of a 100:1 tongkat ali extract per 2-capsule serving. The label adds "equivalent to approximately 1000mg of dry Tongkat Ali powder." That figure is the raw root used to make the extract. The trials also weighed extract, so the fair comparison is 10 mg against 100 to 600 mg.
10 mg of extract
Per day, at two capsules. About 1,000 mg of root went into it.
100 mg of extract
The lower arm of the largest trial, ten times the Vapofil amount (LiverTox, Tongkat ali).
600 mg of extract
The top of the range in the pooled trials, sixty times the Vapofil amount (Leisegang 2022, Tongkat ali meta-analysis).
The eurycomanone content of Vapofil is not published, so it cannot be checked against the survey above. See the Vapofil dose guide for all seven amounts, or the tongkat ali ingredient page for the profile. The sales page makes hormone claims we do not repeat; they are weighed on the sales claims page.
What else helps
What do doctors advise for low testosterone?
The AUA guideline diagnoses low testosterone only with symptoms plus two low early-morning tests, usually under 300 ng/dL. It says every man with a deficiency should be counseled on lifestyle changes (AUA, Testosterone deficiency guideline). Sleep matters too: in a small lab study, a week of 5-hour nights lowered young men's testosterone by 10 to 15 percent (UChicago Medicine, Sleep and testosterone).
If low sex drive or erection problems are what prompted the search, see a doctor. ED can be an early sign of heart disease or diabetes, and our ED guide explains what a doctor checks.
FAQ
Tongkat ali FAQ
Is tongkat ali worth taking if my testosterone is normal?
The evidence says probably not. A 2022 meta-analysis of 5 trials found a significant testosterone rise in men with low levels, but the change in healthy men was not statistically significant. The trials were small, and some negative studies may be unpublished.
How much tongkat ali should I take?
No dose is proven. Trials used 100 to 600 mg of extract a day, most often 100 or 200 mg, and LiverTox lists 100 to 400 mg as the traditional range. Long-term safety is not established, so ask your doctor before taking it.
How long does tongkat ali take to work?
Trials ran from 3 days to 6 months. The largest trial measured a mild testosterone rise after 12 weeks at 100 or 200 mg a day, in men aged 50 to 70 with low levels. No trial shows a quick effect in healthy men.
Can tongkat ali damage your liver?
It is rare, but possible. LiverTox rates tongkat ali a possible rare cause of clinically apparent liver injury, and says long-term safety in humans is not well documented. Anyone with liver disease, or who drinks heavily, should ask a doctor first.
Why do tongkat ali products get tested for eurycomanone?
Eurycomanone is a compound that product testing measures in tongkat ali. In one survey of 41 products sold in Malaysia, only 24 contained it and only 11 met the recommended level. Vapofil does not publish its eurycomanone content.
Is 10 mg of tongkat ali extract enough?
It is a tenth of the lowest dose in the largest trial, which gave 100 or 200 mg of extract a day. That is the amount in a 2-capsule serving of Vapofil. No study has tested 10 mg, so any effect at that dose is unknown.
Who wrote this
Written and reviewed by
Plain-language pages built from the label, the sales page and linked public health sources.
Last updated . Our editorial standards explain how we check reviews. This website is run by Vapofildaily, a U.S. stocking partner for Vapofil, not by the manufacturer or the distributor named on the label. Purchases through our order links earn us a commission.
Keep reading
More about Vapofil
Tongkat ali
10 mg of tongkat ali extract, the 100:1 ratio decoded, the trials and the product quality problems.
Read more
Dose guide
Each Vapofil amount next to the dose used in research, plus what the label's extract ratios do and do not tell you.
Read more
Boron and testosterone
One week, 8 men, 10 mg a day: the boron study behind the testosterone talk, next to the 1 mg in Vapofil.
Read moreU.S. stocking partner for Vapofil
Ready to try Vapofil?
Pick a pack at checkout. 2 capsules a day, 30 days per bottle. Refund window: 60 days; get the terms in writing.
- CartPanda checkout
- 60-day refund window
- Free US shipping on 3 or 6
