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Tribulus Terrestris
Saponin-rich herb that consistently improves libido and sexual function, though evidence for testosterone elevation remains weak.
What the evidence says
Tribulus appears to help in 3 of 3 studies with measurable effects — the evidence leans clearly favourable.
Most evidence is from high-quality meta-analyses and randomised trials published 2000–2026 with a typical study size of 60 participants.
Based on 43 studies · 3 meta-analyses · 27 RCTs · 1,292 total participants
Confidence
High confidenceWhat the studies found
By outcome
Meta-analyses and many RCTs consistently support libido and sexual-function benefits in both sexes, but the evidence firmly shows tribulus does not reliably raise testosterone, and many trials are low quality.
21 randomised trials
86% were about Tribulus in an audit of 21 of them
Every randomised or controlled trial of Tribulus indexed in PubMed, not a hand-picked subset. Meta-analyses and systematic reviews are deliberately excluded from this count: most of them cover many compounds at once, so counting them would inflate it.
PubMed · as of Sep 2026
2 trials ongoing or recruiting · 6 completed on ClinicalTrials.gov
Registered trials show research momentum for Tribulus, not proof of effect — a registration is a plan, and posted results are sponsor-reported, not peer-reviewed. They are never counted toward the evidence rating above.
Browse these trials on ClinicalTrials.govClinicalTrials.gov · as of Oct 2026
Tribulus Terrestris is a flowering plant traditionally used in Ayurvedic and Chinese medicine for vitality and libido. Despite marketing claims, research does not support significant testosterone-boosting effects in healthy individuals.
However, it does show consistent benefits for libido, sexual function, and may help with blood pressure and blood sugar. The active compounds include steroidal saponins, primarily protodioscin.
Increases sexual desire
May enhance NO production
May help regulate glucose
How Tribulus works — from molecular targets to health outcomes. Click an edge to see supporting research.This visualization is in beta — pathways are being refined and expanded.
Good evidence for libido; don't expect testosterone changes
May have additive hypotensive effects A grade for this interaction is held for clinical review and has not been validated, so no severity is given. The precaution still applies: ask a pharmacist about the exact supplement and medicine. Do not stop or change prescribed medicines based on this notice.
May enhance blood sugar lowering A grade for this interaction is held for clinical review and has not been validated, so no severity is given. The precaution still applies: ask a pharmacist about the exact supplement and medicine. Do not stop or change prescribed medicines based on this notice.
Tribulus may have diuretic effects that reduce lithium clearance, potentially raising lithium levels toward toxicity — monitor lithium levels if combined.
Tip: Take with food
Tip: Discontinue and seek care for jaundice, dark urine, or right-upper-quadrant pain
Tip: Avoid evening doses
Tribulus has an evidence score of 5.5/10 — moderate evidence based on 43 indexed studies, including 3 meta-analyses. Saponin-rich herb that consistently improves libido and sexual function, though evidence for testosterone elevation remains weak. Representative study: PMID 34638031.
The commonly studied dose of Tribulus is 250-750mg daily (standardized to 45-60% saponins). Individual needs vary — start at the lower end of the range and adjust based on how you respond.
The best time to take Tribulus is with meals. Take it with food. Tribulus terrestris contains steroidal saponins (particularly protodioscin) that are proposed to support LH secretion and testosterone levels.
Tribulus has a safety rating of "moderate". That is a category, not a measure of individual risk, and there are precautions worth knowing. Reported side effects are uncommon and include GI upset, hepatotoxicity (rare case reports), sleep disturbance. Use caution if any of these apply to you: Hormone-sensitive conditions (caution).
Ashwagandha
Likely helpsReduces cortisol and anxiety while improving sleep quality and physical recovery in stressed adults.
Maca
Too few graded studiesAndean root with modest evidence for improving sexual desire — small RCTs are encouraging but reviews still rate the overall evidence as limited.
Tongkat Ali
Too few graded studiesSoutheast Asian herb with moderate RCT evidence for supporting testosterone, reducing stress/cortisol, and improving fatigue and quality of life — strongest in older or hypogonadal men.
Fenugreek
Likely helpsTraditional herb with evidence for supporting testosterone, libido, blood sugar control, and lactation.
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Reviewed by Dr. Baher Al Hakim · Last reviewed May 2026 · evidence from 43 studies · how we score · editorial policy
This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.
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