12 Tongkat Ali Side Effects & Risk Mitigation

Side effects from Tongkat Ali range from mild to severe. Gain more awareness of the side effects and how you can avoid those risks.

Side effects of Tongkat Ali affect less than 1% of Tongkat Ali users around the world. According to public records, there are no severe side effects that lead to hospitalization, or death caused by taking pure 100% Tongkat Ali extract in the last 20 years.

However, users taking Tongkat Ali supplements by Huberman Lab or Nootropics Depot reported irritability, insomnia, nausea, headaches, swollen testes and others; a clear signal of the side effects of Tongkat Ali.

Most of the reported side effects of Tongkat Ali are from users who have bought US-made Tongkat Ali supplements, which may contain adulterants, contaminants, impurities, binder and allergens. Indonesian Tongkat Ali extracts sold in the US add to the rising concerns amongst users who experience constant headaches, nausea and vomitting.

This article shares the common side effects of Tongkat Ali, its severity and their likelihood of occurrence, and ways to mitigate those risks.

SUMMARY

Here is the list of possible side effects that users may experience from Tongkat Ali. The list of Tongkat Ali side effects in the article is categorized based on the likelihood of occurrence and the severity of the side effects.

Tongkat Ali Side Effects

Likelihood of

Occurrence

 

Severity

(Mild, Moderate, Severe)

Loss
of appetite

 

High Unlikely

(Extremely Rare)

 

Mild

Nausea

 

Unlikely

(Frequent)

 

Mild

Heart
Rate & Hypertension

 

Highly Unlikely

(Extremely Rare)

 

Moderate

Restlessness

 

Likely

(Rare)

 

Mild

Insomnia

 

Likely

(Rare)

 

Mild

Anxiety & Panic Attacks

Unlikely

(Rare)

 

Moderate

 

Fatigue
& Weakness

Unlikely

(Rare)

 

Mild

 

Skin Rash

Highly Unlikely

(Extremely Rare)

 

Mild

Diarrhea
/ Abdominal pain

Highly Unlikely

(Extremely Rare)

 

Mild

 

High / low blood sugar

Highly Unlikely

(Extremely Rare)

 

Mild

Liver
& Kidneys

Highly Unlikely

(Extremely rare)

 

Mild

 

Heart Palpitations

Unlikely

(Extremely
rare)

 

Mild

Overview

Tongkat Ali’s side effects range from mild to severe headaches, irritability, insomnia, elevated heart rate, anxiety, and gastrointestinal issues such as nausea and diarrhea that are caused by adulterants, impurities, allergens or preservatives. The addition of excessive maltodextrin in Tongkat Ali extract or capsules may cause side effects such as gastrointestinal symptoms, such as gas and diarrhea, vomiting and others.  Other rare but severe side effects may include changes in blood pressure, changes in blood sugar levels, and liver toxicity.

However, our research from US-based consumer reviews showed that approximately 95% of consumers reported no side effects from taking Tongkat Ali.

If you experience side effects such as headaches, diarrhea, cramps, bloating, or nausea, chances are you may have bought a Tongkat Ali supplement that contains excessive amounts of maltodextrin, which are known to cause side effects including blood sugar spikes.

Despite the use of maltodextrin in Tongkat Ali is regarded as safe by USFDA, many manufacturers have abused the use of maltodextrin as a binder/filler in addition to sourcing low-quality Tongkat Ali extract from Indonesia which contributed to the growing list of side effects of Tongkat Ali.

Topics covered in this article
  • Is Tongkat Ali safe and should I be worried about the side effects of Tongkat Ali?
  • Is Tongkat Ali’s side effects dangerous and detrimental to health?
  • Which side effects of Tongkat Ali that I should be worried about?
  • How could I mitigate the risks of side effects from Tongkat Ali?

Side Effects of Tongkat Ali

1. Loss of appetite

You may eat less after taking Tongkat Ali. The sudden “loss of appetite” can sometimes be misconstrued as a side effect. The explanation behind this is that Tongkat Ali reduces your cortisol (i.e stress hormone), thus preventing emotional eating or overeating habits.

Likelihood: Common

2. Dizziness and nausea

You may experience dizziness and nausea which may be caused by impurities, adulterants and addition of high amount of fillers (eg: maltodextrin) in Tongkat Ali capsules – a filler that is commonly found in lower-quality Tongkat Ali supplements. This side effect usually reduces and goes away after a few days. However, if the symptoms persist, or if you experience an allergic or toxic reaction to Tongkat Ali, please consult your doctor or medical professionals for further advice.

Likelihood : Rare

3. Increased heart rate and hypertension

Side effects of heart palpitations may occur if you consume high doses of Tongkat Ali (i.e > more than 800mg) or if your Tongkat Ali extract is filled with maltodextrin. Tongkat Ali is known to raise metabolism in your body, and that may cause a moderate to mild increase in heart rate if you are taking it for the first time in high doses.

Consumers with chronic high blood pressure or those with pre-existing heart conditions are advised to consult with their doctors before consuming Tongkat Ali.

Likelihood: Rare

4. Restlessness

Tongkat Ali may cause restlessness if you have mild ADHD or undiagnosed anxiety. This side effect is very uncommon to most people and the feeling of being jittery or restless is the closest indication that you are having this minor side effect. The level of restlessness may vary according to individuals and users are cautioned against taking a high dose of Tongkat Ali (i.e more than 600mg) in the first few weeks.

Likelihood: Common among people who are sensitive to the effect of alkaloids (caffeine), or psychoactive substances.

5. Insomnia

Despite studies showing that Tongkat Ali improves sleep quality, Tongkat Ali may cause mild insomnia for those who are intolerant to alkaloids or caffeine/tea or sensitive to psychoactive substances. Tongkat Ali contains a family of alkaloids that contribute to mental alertness (and mental energy) and this may cause insomnia-like experience to users if taken in high dosages. If you have mild or undiagnosed insomnia, you should avoid taking Tongkat Ali 5 hours before bedtime, and reduce your consumption of coffee or tea when taking Tongkat Ali.

Likelihood: Common among people who are sensitive to the effect of alkaloids (caffeine), or psychoactive substances.

6. Anxiety, panic attacks and depression

Tongkat Ali contains stimulants (alkaloids) that may trigger feelings of anxiety and panic in some users. Whilst Tongkat Ali raises dopamine (happy hormones), it may produce an opposite reaction if you are diagnosed with mental health conditions, or chronic depression or anxiety.

Likelihood: Rare

7. Fatigue and weakness

It is reported that Tongkat Ali that produces more fatigue on those experiencing chronic fatigue syndrome. However, this reported side-effect is extremely rare as multiple clinical studies in the last 20 years showed that Tongkat Ali raises testosterone, energy and stamina.

Likelihood: Extremely Rare

8. Skin Rash

Some people experience skin rashes after using Tongkat Ali although the likelihood is extremely rare. This side effect could be potentially due to allergy and other hormone imbalance. If you develop a rash or other unexplained skin symptoms, discontinue use of Tongkat Ali and speak with your doctor.

Likelihood: Extremely Rare

9. Diarrhea or abdominal pain

Tongkat Ali may cause diarrhea or abdominal pain when consumed in high doses. As reported by EFSA study on animals, high Tongkat Ali doses may lead to localized DNA damage of stomach and duodenum tissue. However, there are no reported adverse side effects from clinical studies showing DNA damage on humans.

Likelihood: Extremely Rare

10. Urinary problems and water retention

In extremely rare occasion, some users may experience urinary problems and/or edema (water retention) after taking Tongkat Ali. This may be due to drug interactions with Tongkat Ali. As a result, some may experience swelling in the hands, feet, and legs.

Likelihood: Extremely Rare

11. High/low blood sugar

As Tongkat Ali lowers your blood sugar levels, it is important to monitor your blood glucose while taking the herb. This is especially important if you have diabetes or prediabetes and are taking medications to control your blood glucose levels. Tongkat Ali should be used cautiously in individuals who may be prone to hypoglycemia or are taking medications that could lower their blood glucose.

Likelihood: Extremely Rare

13. Liver & Kidneys

Present studies from human clinical trials showed taking Tongkat Ali root extract did not affect the liver and kidneys. However, Tongkat Ali containing adulterants, impurities and steroids or taking Tongkat Ali with other herbs may cause acute liver injuries, increasing the risks of jaundice and liver cirrhosis. The risks of Tongkat Ali-induced liver injuries are extremely low. For example, there is a rare case reported in 2024 by a 47-year-old healthy adult who was diagnosed with elevated liver enzymes and jaundice after consuming Tongkat Ali which is not 3rd party lab-tested. Against the backdrop of millions of Tongkat Ali users, the probability of it causing liver or kidney injury is very low.

In addition, a randomized clinical study on Tongkat Ali root extract based on 400 mg per day did not produce toxic effects on the kidneys and liver.

However, if you have pre-existing medical conditions such as kidney disease, Acute Kidney Injury (AKI) or liver disease, it is recommended to avoid taking Tongkat Ali supplements to avoid any long term side effects on liver and kidneys.

Likelihood: Extremely Rare

14. Heart Palpitations

There have been reports on Reddit that Tongkat Ali produces heart palpitations. Health experts warned that heart palpitations from Tongkat Ali is a side effect that may be caused by adulterants, steroids, magnesium or zinc in excessive quantity.

Although this side effect is rare and never been officially reported to health authorities, the feeling of your heart beating rigorously may to do with the blood being pumped and circulated in your body faster than usual.

It will usually fade away after a few hours. This side effect is often mixed with a feeling of jittery or restlessness, especially if you are taking it for the first time. 

If you are experiencing this side effect, the best way to reduce heart palpitations is to reduce the dosage to a minimum. 

Likelihood: Rare

Should I be worried about the side effects of Tongkat Ali?

Majority of the side effects of Tongkat Ali affects a small number of users who may be diagnosed with underlying medical conditions or those who are sensitive to alkaloids, quassionoids, terpenoids. Generally, most side effects such as feeling jittery, mild nausea, headaches or frequent urination may go away after few days and are non-toxic or harmful to health.

However, if you are buying low quality Tongkat Ali extracts that are filled with impurities, allergens or adulterants (eg: maltodextrin or fillers), you may experience frequent headaches, recurring nausea, frequent diarrhea or occasional vomiting.

If severe side effects occur, please stop taking Tongkat Ali as it may contain impurities or excessive heavy metals due to the extraction technique or poor quality sourcing issues.  

Major Causes of Tongkat Ali Side Effects

Users must take precautions to reduce the risk of side effects when taking Tongkat Ali. There are factors that you can avoid that contribute to the side effects such as: 

  • Overconsumption or excessive intake at high dosages
  • Adulterants such as addition of fillers or maltodextrin to reduce the purity of Tongkat Ali (to save cost)
  • Impurities or contaminants from low-quality extract
  • High levels of mercury, arsenic or lead in Tongkat Ali
  • Tongkat Ali extract was not clinically tested
  • Tongkat Ali plant was contaminated during harvesting
  • Allergens that exist during manufacturing and encapsulation
  • Inherent allergic reaction to alkaloids or quassinoids
  • Unknown drug interactions

Dr. Annie George, a lead scientist with 20 papers published on Tongkat Ali said “Adulterants, contaminants, and impurities are major contributors that cause mild to severe side effects when taking Tongkat Ali”.

Users are cautioned against buying lab-tested Tongkat Ali extracts that are not clinically tested. Clinically tested Tongkat Ali products are considered superior with fewer side effects compared to generic lab-tested Tongkat Ali products due to their purity without being contaminated by allergens or heavy metals.

Find out more about the root cause of these side effects and how you can avoid those risks.

Are the side effects of Tongkat Ali toxic or harmful?

Based on the genotoxicity and toxicology studies on Tongkat Ali based on average consumption of 200mg to 400mg daily showed no negative side effects on liver function, kidneys and may not be toxic to your DNA. It means, Tongkat Ali is relatively safe and non-toxic when consumed in low dosages. In addition, other acute side effects such as headaches or nausea may not be toxic or cause any harm.

Whilst the genotoxicity animal study showed that the recommend human dose (500mg per 60kg of human body weight) may not damage your DNA, taking high dose of Tongkat Ali at 1,940mg per single serving (based on 60kg of human weight) may be toxic. Users are recommended to take Tongkat Ali in low dosage of less than 1,000mg per day to prevent any risks associated with long-term DNA damage. This warrants further research on the long-term safety of Tongkat Ali when taken at high dosages.

Mitigating Side Effects of Tongkat Ali

You may choose to buy hot-water Tongkat Ali extract that adheres to the Tongkat Ali standards, known as the Malaysian Tongkat Ali standards, which is reported to have few side effects based on our customer survey carried out on 1,300 customers.

To further minimize the risk of side effects from Tongkat Ali, it is recommended to consult with a healthcare provider before taking the supplement and to monitor for any adverse reactions if you are already taking Tongkat Ali.

Here is what you should do if you suffer any adverse side effects from Tongkat Ali:

  • Stop taking Tongkat Ali completely
  • Lower the doses to 100mg or less
  • Check if you are taking other medications with Tongkat Ali
  • Check if you are taking Tongkat Ali with other supplements.
  • Contact your nearest doctor and explain your symptoms or side effects.

Side Effects Due to Drugs Interaction

There are 26 drug interaction studies on Tongkat Ali. Tongkat Ali may also interact with certain medications, such as blood thinners, hypertension and diabetes medications.

Medicinal drugs such as propranolol may cause side effects when taken with Tongkat Ali.

PROPRANOLOL (INDERAL)

Tongkat Ali interacts with propranolol; medicine to treat heart problems, hypertension, help with anxiety and prevent migraines. It may cause mild side effects or any side-effect symptoms indicated in this article.

A placebo-controlled randomized study published in the Journal of Clinical Pharmacy and Therapeutics found that using propranolol with Tongkat Ali did not affect changes in heart rate or blood pressure.

Propranolol is also known as other names (brands) such as Hemangeol, Inderal, Inderal LA, Inderal XL, InnoPran XL, Propranolol HCl Intensol.

Reference: Salman et.al, Journal of Clinical Pharmacy and Therapeutics (2010)

Source: doi:10.1111/j.1365-2710.2009.01147.x

What should I do?

  1. Please stop taking your existing medications and observe if there are any adverse side effects listed above.
  2. Please consult your physician or healthcare professional before using Tongkat Ali.

Side Effects: Dosage

The side effects of Tongkat Ali may occur such as insomnia if you are taking higher than recommended dosage, more so if the Tongkat Ali extract contains impurities or adulterants such as excessive maltodextrin or synthetic steroids.

According to a study in Molecules and Healthline, the recommended dosage for Tongkat Ali is between 200 to 400 milligrams per day. Although this may not guarantee users from any negative side effects, users are cautioned against consuming Tongkat Ali supplements that are not 3rd party lab-tested or brands that use ethanol extract to reduce the chances of nausea, vomitting or frequent headaches.

Assuming you are taking standardized hot water pure Tongkat Ali extract without mixing it with other medications or herbs, you will be likely to experience zero side effects, even at a higher dose of 400mg daily.

Does Tongkat Ali cause long term side effects?

The long-term side effects of taking Tongkat Ali have not been well established or documented. However, users are warned not to take Tongkat Ali in high doses, or exceed the safety limits of 30,000mg/kg bodyweight to avoid kidney damage or liver damage. The consensus on the safety dosage limit is 1,000mg per day which is relatively safe for long-term use.

Please consult your doctor if you are taking Tongkat Ali long term, or before you consume any Tongkat Ali products or supplements.

Warnings

Users should be aware that not all Tongkat Ali supplements are created equal, and the quality and purity of Tongkat Ali extract are determining factors that contribute to the list of side effects.

To reduce the likelihood of side effects of Tongkat Ali, it is recommended to use quality Tongkat Ali products that have been extensively clinically tested on humans (both men and women) and lab-tested for toxicity. Please consult your physician or healthcare professionals if you are using other medications with Tongkat Ali.

GET THE BEST HELP YOU NEED

Tongkat Ali Side Effects

Ask us if you have any questions, or if you are reporting on adverse side-effects related to Tongkat Ali.



Our experts do not provide any medical advice. Please consult your nearest doctor, physician, or healthcare professional for advice on side effects related to Tongkat Ali consumption, usage and supplementation.

Conclusions

The side effects of Tongkat Ali can range from mild to severe, but in most cases, users will experience mild headaches or nausea that will go away due to the impurities that are widely found in major Tongkat Ali brands sold in the US. This is due to the practice of sourcing low-quality extracts from Indonesia that are filled with impurities and adulterants.

Other severe side effects of Tongkat Ali such as cramping, bloating, vomiting, and diarrhea are rare but may happen if you are taking Tongkat Ali supplements that are filled with excessive amounts of maltodextrin and rice fillers. 

You may experience fewer or virtually no side effects from premium Tongkat Ali extracts that are sourced from pure root extract using hot water technology. Always look out for clinically tested Tongkat Ali supplements to reduce the chances of side effects as they conform to high-quality manufacturing and safety standards. 

Author

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

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.

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