C H A P T E R

53Human Performance and Sports Applications ofTongkat Ali (Eurycoma longifolia)
Shawn M. Talbott
GLH Nutrition, LLC, Draper, UT, USA

Eurycoma longifolia is an herbal medicinal plantfound in Southeast Asia (Malaysia, Vietnam, Java,
Sumatra, Thailand). In Malaysia, it is commonly called
tongkat ali and has a range of medicinal properties asa general health tonic, including improvement in physical and mental energy levels and overall quality of life
[1,2]. The roots of tongkat ali, often called “Malaysian
ginseng,” are used as an adaptogen and as a traditional “anti-aging” remedy to help older individuals
adapt to the reduced energy, mood, and libido that
often comes with age [3 7]. In modern dietary supplements, tongkat ali can be found in a variety of products intended to improve libido and energy, restore
hormonal balance (cortisol/testosterone levels), andenhance both sports performance and weight loss.
In both men and women, testosterone levels peak
between 25 and 30 years of age and thereafter drop
approximately 1 2% annually [8,9]. At the age of 60,
testosterone levels are typically only 40 50% of youthful levels and may be lower due to stress and related
lifestyle issues such as diet, exercise, and sleep patterns [10,11]. The benefits of maintaining a youthful
testosterone level are many, including increased muscle mass and reduced body fat, high psychologicalvigor (mental/physical energy), and improved general
well-being [12,13].
Eurycoma contains a group of small peptides
referred to as “eurypeptides” and known to haveeffects in improving energy status and sex drive inrodents [14 16]. The effect of tongkat ali in restoring
normal testosterone levels appears to arise less from
actually “stimulating” testosterone synthesis than fromincreasing the release rate of “free” testosterone fromits binding hormone, sex-hormone-binding globulin(SHBG) [17,18]. In this way, eurycoma may be

Nutrition and Enhanced Sports Performance.
DOI: http://dx.doi.org/10.1016/B978-0-12-396454-0.00053-9

considered not so much a testosterone “booster” (suchas an anabolic steroid), but rather a “maintainer” ofnormal testosterone levels and a “restorer” of normal
testosterone levels (from “low” back “up” to normal
ranges) [19]. This would make eurycoma particularly
beneficial for individuals with subnormal testosterone
levels, including those who are dieting for weight loss,
middle-aged individuals suffering with fatigue or
depression, and intensely training athletes who may be
at risk for overtraining [20,21].

TRADITIONAL USE
Decoctions of tongkat ali roots have been used for
centuries in Malaysia and elsewhere in Southeast Asia
as an aphrodisiac for loss of sexual desire and impotence, as well as to treat a range of ailments including
post-partum depression, malaria, high blood pressure,and fatigue [22].
Tongkat ali has been referred to as Malaysia’s“home-grown Viagra” in respected research journals[4], with the Malaysian government investing considerable effort to license, develop, and sustain research
into the potential health benefits of Eurycoma longifolia
through a variety of governmental organizations,
including the Forest Research Institute of Malaysia(FRIM) [22].

MODERN EXTRACTS
Numerous commercial tongkat ali supplements
claim “extract ratios” from 1:20 to 1:200 without any
information about bioactive constituents, extraction

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53. HUMAN PERFORMANCE AND SPORTS APPLICATIONS OF TONGKAT ALI (EURYCOMA LONGIFOLIA)

methodology (e.g., ethanol versus water), or extract
purity. Alcohol extracts of eurycoma have been studied in mice for antimalarial effects of concentrated eurycomalactone [23], but also exhibit toxic effects at highdoses (LD50 at 2.6 g/kg), which would preclude safe
use in humans as a long-term dietary supplement[24,25]. In contrast, hot-water root extracts standardized
for known bioactive components (1% eurycomanone,
22% protein, 30% polysaccharides, 35% glycosaponin)
have been demonstrated to be extremely safe at highdoses and for long-term consumption [26 28].
Properly standardized hot-water extracts [2,26,29]
have a distinctly bitter taste due to the presence of quassinoids, which are recognized as some of the bitterest
compounds in nature [30,31]. Tongkat ali extracts that do
not taste bitter are either not true Eurycoma longifolia root
(there are many commercial examples of “fake” tongkat
ali extracts) or are subpotent in terms of bioactive constituents, and thus would also be expected to have low efficacy. Because of tongkat ali’s reputation for libido
benefits, there are several examples of dietary supplements labeled as Eurycoma longifolia but containing noneof the actual root, and instead being “spiked” with prescription erectile dysfunction drugs (tadalafil/Cialis,sildenafil/Viagra, vardenafil/Levitra).

LABORATORY AND ANIMAL RESEARCH
Bhat and Karim [1] conducted an ethnobotanicaland pharmacological review on tongkat ali, noting thatlaboratory research such as cell assay studies offers
possible mechanistic support for the myriad traditional
uses of tongkat ali, including aphrodisiac [32], antimalarial [33], antimicrobial [34], anticancer [35] and antidiabetic effects [36].
Numerous rodent studies exist demonstrating
reduced anxiety and improved sexual performance following tongkat ali feeding [37 40], with such effects
thought to be due to a restoration of normal testosterone levels. Eurycoma’s anxiolytic effects have been
demonstrated in a variety of behavioral tests, including
elevated plus-maze, open field, and anti-fighting, suggesting an equivalent anti-anxiety effect to diazepam
as a positive control [37].
Animal studies have shown that many of the effectsof the extract are mediated by its glycoprotein components [14]. The mechanism of action of the bioactive
complex polypeptides (“eurypeptides” with 36 aminoacids) has been shown to be activation of the CYP17
enzyme (17 alpha-hydroxylase and 17,20 lyase) toenhance the metabolism of pregnenolone and progesterone to yield more DHEA (dehydroepiandrosterone) andandrostenedione, respectively [29]. This glycoprotein
water-soluble extract of Eurycoma longifolia (tradename:Phystat) has been shown to deliver anti-aging and antistress benefits subsequent to its testosterone-balancing
effects [41,42].

HUMAN-FEEDING TRIALS
Based on a long history of traditional use and confirmation of biological activity via cell culture and animalfeeding studies, several human supplementation studies
have been conducted to evaluate the potential benefits oftongkat ali for sexual function, exercise performance,
weight loss, and vigor (mental/physical energy).
Importantly, all of the human trials have used thesame water-extracted and standardized eurycoma root
(Phystat, Biotropics Malaysia) for which a patent has
been issued jointly to the Government of Malaysia andthe Massachusetts Institute of Technology (UnitedStates Patent #7,132,117) [29]. The patent discloses a
process whereby Eurycoma longifolia roots undergo an
aqueous extraction combined with HPLC and sizeexclusion chromatography to yield a bioactive peptide
fraction (a 4300-dalton glycopeptide with 36 aminoacids) that is responsible for its effects in maintaining
testosterone levels. Phystat is a freeze-dried standardized extract of the root of Eurycoma longifolia whichcontains numerous active compounds including phenolic components, tannins, high molecular weightpolysaccharides, glycoproteins, and mucopolysaccharides. The bioactive fraction of Eurycoma longifolia root
delivers a demonstrated ability to improve testosterone
levels [41], increase muscle size and strength [43,44],
improve overall well-being [45,46], accelerate recovery
from exercise [47], enhance weight loss [48,49], reducestress [50], and reduce symptoms of fatigue [51 53].
In two recent studies of young men undergoing aweight-training regimen [43,44] tongkat ali supplementation (100 mg/day of Phystat) improved lean bodymass, 1 RM strength, and arm circumference to a significantly greater degree compared with a placebo group.
In a recent 12-week trial [46] of Eurycoma longifolia
supplementation (300 mg/day of Phystat in men aged
30 55 years), subjects showed significant improvementcompared with placebo in the Physical Functioning
domain of the SF-36 survey. In addition, sexual libido
was increased by 11% (week 6) and 14% (week 12) andabdominal fat mass was significantly reduced in subjects with BMI . 25 kg/m2.
In men with low testosterone levels (average age 51
years), 1 month of daily supplementation with tongkat
ali extract (Phystat, 200 mg/day) resulted in a significant improvement in serum testosterone levels andquality-of-life parameters [41], suggesting a role for
tongkat ali as an “adaptogen” against aging-related
stress. In another study of healthy adult males

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SUMMARY(average age 25 years), 100 mg/day of tongkat ali
extract (Phystat) added to an intensive strengthtraining program (every other day for 8 weeks)
resulted in significant improvements in fat-free mass,
fat mass, maximal strength (1 RM) and arm circumference compared with a placebo group [43]. These
results indicate that tongkat ali extract can enhancemuscle mass and strength gains, while accelerating fat
loss, in healthy exercisers, and thus may be considereda natural ergogenic aid for athletes and dieters alike.
In a recent study from our group (submitted), we
supplemented 63 subjects (32 Men and 31 women) daily
with tongkat ali root extract (Physta, 200 mg/day) or alook-alike placebo for 4 weeks. Significant (p , 0.05)
mood state improvements were found in the tongkat aligroup for Tension (211%), Anger (212%), andConfusion (215%). Hormone profile (salivary cortisol
and testosterone) was significantly improved by tongkat ali supplementation, with reduced cortisol exposure(216%), increased testosterone status (137%), andoverall improved cortisol:testosterone ratio (236%).
These results indicate that daily supplementation withtongkat ali (Physta) improves stress hormone profileand certain mood state parameters, suggesting an effective natural approach to shielding the body from thedetrimental effects of chronic stress, which may include
the “stress” of intense exercise training.
One study of middle-aged women (aged 45 59
years) found that twice-weekly strength training plus
100 mg/day of Eurycoma longifolia extract for 12 weeks
enhanced fat-free mass to a greater degree than for
women adhering to the same strength-training program
and taking a placebo [44]. Additional studies in dieters[48 50] and athletes [47] have shown 50 100 mg/dayof Tongkat ali extract to help restore normal testosterone levels in supplemented dieters (compared with atypical drop in testosterone among non-supplemented
dieters) and supplemented athletes (compared with atypical drop in non-supplemented athletes). In one trialof endurance cyclists [47], cortisol levels were 32%
lower and testosterone levels were 16% higher in supplemented subjects compared with placebo, indicating
a more favorable biochemical profile for promoting an“anabolic” hormone state.
For a dieter, it would be expected for cortisol to rise
and testosterone to fall following several weeks of dieting [54]. This change in hormone balance (elevated cortisol and suppressed testosterone) is an importantfactor leading to the familiar “plateau” that many dieters hit (when weight loss slows/stops) after 6 8 weeks
on a weight loss regimen. By maintaining normal testosterone levels, a dieter could expect to also maintaintheir muscle mass and metabolic rate (versus a drop in
both, subsequent to lower testosterone levels) and thus
to continue to lose weight without plateauing.

For an athlete, the same rise in cortisol and drop in
testosterone is an early signal of “overtraining”—a
syndrome characterized by reduced performance,increased injury rates, suppressed immune system
activity, increased appetite, moodiness, and weightgain [55]. Maintenance of normal cortisol/testosterone
levels in eurycoma-supplemented subjects may be able
to prevent or reduce some of these overtraining
symptoms as well as help the athlete to recover more
quickly and more completely from daily training
bouts.

SAFETY
Oral toxicity studies (Wistar rats) have determined
the LD50 of Phystat as 2000 mg/kg body weight(acute) and the NOAEL (no observed adverse effectlevel) as greater than 1000 mg/kg body weight (28-day
sub-acute feeding), resulting in a classification as
Category 5 (extremely safe) according to the United
Nations Globally Harmonized System of Classificationand Labeling of Chemicals (GHS).
In addition to the very high safety profile demonstrated in the rodent toxicity studies, there are noreported adverse side effects in human studies of tongkat ali supplementation. For example, one 2-month
human supplementation trial [27] of 20 healthy males(age range 38 58), found high doses of Eurycoma longifolia extract (600 mg/day) to have no influence on blood
profiles (hemoglobin, RBC, WBC, etc.) or any deleterious effects on measures of liver or renal function. In ourown recent supplementation trial (200 mg/day for
4 weeks), there were no changes in measures of liver
enzymes (ALT/AST). Typical dosage recommendations, based on traditional use and on the available scientific evidence in humans, including dieters andathletes, call for 50 200 mg/day of a water-extracted
tongkat ali root standardized to 22% eurypeptides.

SUMMARY
A wide range of investigations, from laboratory
research, to animal feeding studies, to human supplementation trials, have confirmed the health benefits
and traditional use of tongkat ali root extract.
Laboratory evidence shows that eurycoma peptides
stimulate release of free testosterone from its binding
proteins and improve overall hormone profiles. Morethan a dozen rodent-feeding studies have demonstrated improved sex drive, balanced hormonal profiles, and enhanced physical function. Humansupplementation trials show a clear indication of
reduced fatigue, heightened energy and mood, and

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53. HUMAN PERFORMANCE AND SPORTS APPLICATIONS OF TONGKAT ALI (EURYCOMA LONGIFOLIA)

greater sense of well-being in subjects consuming tongkat ali root extracts. It is important to note that the
majority of these studies, and all of the human supplementation trials, have been conducted on specific hotwater-extracts of Eurycoma longifolia (which is the
traditional Malaysian preparation) produced using apatented extraction process to isolate and concentrate
the bioactive compounds (Phystat). Some of the tongkat
ali extracts currently on the US market are alcoholextracts, which provide a substantially different chemical
profile, and may not be as effective or as safe as the more
extensively studied hot-water-extracts.
In conclusion, tongkat ali, used for centuries in
traditional medicine systems of Southeast Asia fortreating lethargy, low libido, depression, and fatigue,
appears to have significant potential for restoring
hormone balance (cortisol/testosterone) and overall
well-being in humans exposed to various modern
stressors, including aging, dieting, and exercise stress.

Disclosure
The author (S. Talbott) has served as principal
investigator on several studies of tongkat ali, includinga recent study of Physta, a brand of tongkat ali extractthat was funded by the manufacturer, Biotropics
Malaysia. Dr. Talbott has no direct financial relationship with Biotropics or with Physta.

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