Is Tongkat Ali Safe? Here is what science says

The concern that arises when consuming Tongkat Ali is its safety and how taking it daily or long term affects our health.  

This is a safety review of Tongkat Ali as a dietary supplement or when taking it as a novel food based on existing toxicology, safety-related research studies and opinion by the European Food and Safety Authority (EFSA).

Overview

Since the first discovery of Tongkat Ali (Eurycoma Longifolia) as a medicinal herb by British William Jack in 1822, there has been 3 reported cases of patients of acute and severe side effects from consuming Tongkat Ali. The latest case was reported in 2024 by a 47-year-old male who was hospitalized due to acute liver injuries after taking Tongkat Ali. Now the odds are relatively low.

Against the backdrop of millions of users who have taken Tongkat Ali in various forms (capsules, extract, raw slices or even drinks) in the last decade and low number of reported cases, this herb is reported to be safe for long term consumption as long as you consume within recommended dosage, typically between 200mg to 400mg daily, but not exceeding 1,000mg per day.

“Although there are no reported death or cases in Malaysia, it does not mean that all Tongkat Ali supplements safe.” Said Dr. Annie from Biotropics Malaysia. 

Currently, only few Tongkat Ali supplements have been thoroughly tested to meet safety standards. Heavy metal tests, microbial and adulterant tests conducted by 3rd party EUROFINS meets the minimum dietary safety standards which reduces the health risks when taking herbal supplements.

As the herbal supplement are not regulated by FDA, users are warned against consuming Tongkat Ali in high doses, or those which are not 3rd party lab-tested by reputable organizations such as EUROFINS as it may contain adulterants, high heavy metal content (eg: mercury, arsenic, lead) and other impurities that may affect your health.

Dr. Annie added “Tongkat Ali supplements using standardized hot water extract are amongst the few types of Tongkat Ali that are has gone comprehensive safety review, assessment and tests in the last decade”.

Standardized hot water Tongkat Ali extract went a thorough safety scrutiny by health authorities in the last decade as opposed to 200:1 extracts and non-standardized ethanol extracts.

The implication of the recent development to the safety aspect of Tongkat Ali are two folds:

  1. Taking Tongkat Ali using standardized hot water extract that meets the Malaysian Tongkat Ali Standards MS2409 may reduce the unwanted side effects and risks of developing liver injuries from impurities or heavy metals.
  2. The switch of consumers behaviour to buying more premium quality extracts to achieve better health gains; higher testosterone increases, more libido improvements and rapid lean muscle development without worrying on the side effects of long term use.

Side Effects & Your Safety

You should consider the severity of the side effects when taking Tongkat Ali as one of your safety measures. 

While some side effects are acute or temporary, negative side effects such as vomiting, consistent headaches, cramps or diarrhea could indicate other serious problems that are caused by toxicity from the impurities.

Here is a list of Tongkat Ali side effects for your reference.

Our findings by the EFSA outlined in this article may be used as a guide to assess and address any safety concerns related to Tongkat Ali consumption as a dietary supplement.

Safety Findings

Firstly, the EFSA Panel concludes that Tongkat Ali was not clastogenic or aneugenic based on in-vitro animal study based on 500mg/kg of bodyweight. However, in another in-vitro animal study, the EFSA researchers observed a potential DNA damage on the stomach tissue of an animal at high dose of 2,000 mg/kg of bodyweight. 

The EFSA safety findings on animal study can be extrapolated to assess the risks to humans when taking Tongkat Ali. 

Based on the EFSA study and adjusting to the Human Equivalent Dose (HED) of 322 mg/kg of human bodyweight, consuming a high dose of 19,354 mg of Tongkat Ali in a single intake may induce potential DNA tissue damage or genotoxic effects on human adult weighing 60kg. 

Tongkat Ali may increase the risk of DNA damage on humans at high dose of 19,354 mg in a single intake.

In conclusion, EFSA’s assessment point to the safety implications of humans consuming Tongkat Ali in high doses, those taking exceeding 2,000 mg/kg animal bodyweight (or 19,354 mg in humans weighing 60 kg) in a single dose may pose higher risks to DNA damage. In reality, the risks are lower if you are taking Tongkat Ali in moderate amount as most recommended daily intake is between 200mg to 400mg.

Even after considering the safety factor of 10, the safety limit of Tongkat Ali extract is reduced to 1,935 mg in a single dose, indicating that it may not be safe if you are consuming more than 1,000mg of Tongkat Ali per day. 

However, the safety review of Tongkat Ali is limited and its effects on DNA stomach tissue damage by the EFSA Panel using genotoxicity assessment was based on one rat. In reality, they found no implications on cell death or duodenal tissues.

The EFSA study on Tongkat Ali found no histological damage in the duodenal tissue in the follow-up experiment, and there were no associated signs of cytotoxicity or cell death in the stomach and duodenal tissues in the main experiment.

Toxicity studies

Acute and Sub-acute toxicity studies on Tongkat Ali have been established as early as 2011, through in-vitro and in-vivo animal study. A study published in the International Journal of Pharmacology found no significant changes in biochemical and haematological parameters while thin blood films were found as “normal”. 

The same study showed no pathological changes in the testes and kidneys. This study shows the EL extract does not cause acute toxicity.

In another 13-week toxicity and genotoxicity study published in the Evidence Based Complementary Medicine Journal showed that Tongkat Ali (Eurycoma Longifolia) at 1,200 mg/kg and 2,000 mg/kg bodyweight produced no adverse effects on the body weight, hematology, serum biochemistry, urinalysis, macropathology, or histopathology. The study further concluded that the acceptable daily intake (ADI) of Tongkat Ali is 1,200 mg per day for adult weighing 60kg.

On this note, health experts are of the opinion that 200mg to 400mg of Tongkat Ali may be an acceptable daily intake which is far below the safety limit of 1,200 mg per day based on existin toxicity studies. However, the safety tolerance of Tongkat Ali extract is dose-dependent and the results of the heavy metal, microbial and purity tests should be taken consideration when establishing the safety limit.

If you are diagnosed with past history of kidney or liver diseases, taking Tongkat Ali may increase the risks of liver injuries. Thus, Tongkat Ali consumption should be limited to less than 200mg daily.

Which type of Tongkat Ali is safe?

Most toxicity and safety studies were conducted on Yelllow Tongkat Ali (Eurycoma Longifolia), indicating that this type of Tongkat Ali is relatively safe when consumed in low dosages. Other sub-species such as Black Tongkat Ali and Red Tongkat Ali are not assessed and the safety limit or acceptable daily intake (ADI) has not been well established. 

Users are encouraged to consume 3rd party lab-tested Tongkat Ali that uses standardized hot water extract, which is known to have higher safety limit of 3,000 mg/kg of bodyweight, which translate to approximately 32,000 mg of Human Equivalent Dose (HED).

Conclusions:

Based on EFSA’s findings, past toxicity studies and reported cases in other literatures, standardized hot water Tongkat Ali extract is relatively safe when consumed as a dietary supplement below 1,935 mg daily, or between 200mg to 400mg daily as long as it is 3rd party lab-tested.

This may not be applicable in the case of non-standardized Tongkat Ali extracts, which warrants further investigations. The safety standards and limits of non-standardized ethanol-based Tongkat Ali extracts have not been established, assessed and documented. Consumers taking Indonesian Tongkat Ali extract may exercise more caution as there is no safety review conducted by reputable panels such as the European Food Safety Authority (EFSA) or independent lab tests by EUROFINS to assess the risks and impact to health, particularly DNA damage, tissue liver damage and long term impact on kidneys.

Author

Naressa Khan contributes regularly on AKARALI. As a researcher and investigative journalist, Naressa is all about creating, deconstructing, and reassembling meaningful content through words and facts. With this approach always in mind, she eagerly explores the nuances in life via the aspects of lifestyle, culture, travel, health, and wellness in Malaysia .

Our articles are third party reviewed by our panel of experts and medical advisors to ensure the facts are accurate and credible. These are validated against multiple source references which include but not limited to research studies, peer-reviewed journals, pre-clinical studies, clinical tests and other credible publications.

Our panel of medical advisors and experts are highly experienced in their individual fields. However, they do not provide any medical advice or recommendations arising from content published in this article.

Disclaimer: 

The content published on this website is for educational purposes and should not be viewed, read, or seen as a prescription or constitute any form of medical advice. We recommend you consult your nearest GP or doctors before consuming Tongkat Ali or any products which contain Tongkat Ali. For further information, kindly refer to our Frequently Asked Questions (FAQ) for more information.

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