12 Tongkat Ali Side Effects & Risk Mitigation

Less than 1% are experiencing side effects from Tongkat Ali. Gaining more awareness of the side effects is the first step to mitigate 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 these reported side-effects are predominantly from taking Tongkat Ali supplements that are manufactured in the US, which may contain contaminants, impurities and other substances.

This article provides information for first-time users on the potential side effects, their likelihood of occurrence, and ways to mitigate those risks.


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

Likelihood of




(Mild, Moderate, Severe)

of appetite


High Unlikely

(Extremely Rare)









Rate & Hypertension


Highly Unlikely

(Extremely Rare)















Anxiety & Panic Attacks






& Weakness






Skin Rash

Highly Unlikely

(Extremely Rare)



/ Abdominal pain

Highly Unlikely

(Extremely Rare)




High / low blood sugar

Highly Unlikely

(Extremely Rare)



& Kidneys

Highly Unlikely

(Extremely rare)




Heart Palpitations






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

However, it does not mean you should not care about the side effects. Knowing side effects of Tongkat Ali helps to mitigate risks if you are diagnosed with medical conditions, or if you plan to take it long term.

Tongkat Ali side effects range from mild to severe. These side effects include headache, irritability, insomnia, elevated heart rate, anxiety, and gastrointestinal issues such as nausea and diarrhea. Other potential side effects include changes in blood pressure, changes in blood sugar levels, and liver toxicity.

Some of these side effects are extremely rare, whilst some are common amongst those who have an allergy to bioactive compounds such as alkaloids which are present in 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

The dizziness and nausea are rare side-effects for first-time users, or those who have never taken herbal supplements (eg: Panax Ginseng, etc) before. This side-effect usually reduces after a few days. However, if it continues more than few days, then you may 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

You may experience heart pulpatation if you consume high doses of Tongkat Ali (i.e > more than 800mg). Tongkat Ali is known to raise metabolism in your body, and that may cause heart rate to increase.

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. If you are not able to relax, being constantly uneasy, then this may indicate early symptoms of this side effect. The feeling of being jittery or restless are the closest indication that you are having this minor side effect.

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 to those who are intolerant to alkaloids or caffeine / tea.

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

Human and animal studies showed that Tongkat Ali may not affect the liver and kidneys. A randomized clinical study on Tongkat Ali extract based on 400 mg per day does not produce toxic effects on the kidneys and liver.

Meanwhile, 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.

Likelihood: Extremely Rare

14. Heart Palpitations

There have been reports on Reddit that Tongkat Ali produces heart palpitations. This side effect is rare, but if you are a first-time Tongkat Ali user, you may feel that your heart beats faster than usual. This has to do with the blood is being pumped and circulated in your body and usually will 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

Major Causes of Tongkat Ali Side Effects

Here are possible causes of the side effects from Tongkat Ali:

  • Overconsumption or excessive intake at high dosages
  • Adulterants or contaminants in Tongkat Ali
  • High levels of mercury, arsenic or lead in Tongkat Ali
  • Tongkat Ali extract was not clinically tested
  • Tongkat Ali extract was contaminated
  • Allergens
  • Allergic reaction to alkaloids or quassinoids
  • Unknown drug interactions

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

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

Mitigating Side Effects of Tongkat Ali

To 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.


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 likelihood and severity of Tongkat Ali’s side effects largely depend on the dosage and duration of use. You may experience side effects if you are consuming higher dosage than your body can take.

According to a study in Molecules and Healthline, the recommended dosage for Tongkat Ali is between 200 to 400 milligrams per day.

There are no reported Tongkat Ali side effects when taken in a daily dose of 50mg to 200mg.

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.


Users should be aware that not all Tongkat Ali supplements are created equal, and the quality and purity of the supplement may vary depending on the manufacturer. Always use quality Tongkat Ali product that has 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.


Reporting 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.


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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