Abstract Summary
Objective
This study investigates the comparative effectiveness of herbal supplements marketed as testosterone boosters, with the aim of identifying the “most powerful” herb based on human clinical evidence (effect size, study quality, and consistency). Secondary considerations include safety and sustainability.
Context
Interest in testosterone-boosting supplements has grown due to concerns over declining testosterone levels and increased awareness of male health. However, many commercial products are based on traditional use or anecdotal claims rather than robust clinical validation. Only a minority of herbs have been studied in multiple well-designed RCTs, and results often vary by dosage, population, and extract quality. This research seeks to clarify the clinical evidence to guide both consumers and healthcare professionals.
Methods Used
Approach
The study relied on a systematic comparison of peer-reviewed RCTs and meta-analyses examining herbs commonly promoted for testosterone enhancement. Outcomes assessed included serum total testosterone, free testosterone, sex hormone binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Herbs reviewed: tongkat ali, ashwagandha, fenugreek, shilajit, tribulus terrestris, and maca.
Data Collection
Meta-analyses and RCTs for tongkat ali (Eurycoma longifolia).
RCTs/meta-reviews for ashwagandha (Withania somnifera) under stress and training conditions.
Recent RCTs and meta-analyses for fenugreek (Trigonella foenum-graecum).
A randomized, placebo-controlled trial for shilajit.
Systematic reviews for tribulus terrestris.
Researchers’ Summary of Findings
Impact on Health
Tongkat Ali (Eurycoma longifolia): A 2022 meta-analysis of five RCTs (n≈232) found a significant pooled increase in serum testosterone, with the greatest benefits in hypogonadal men (<300 ng/dL). Reported side effects were mild and uncommon.
Ashwagandha (Withania somnifera): RCTs report modest testosterone increases, often linked to reduced cortisol or improved training outcomes. Effects are smaller and more variable than tongkat ali.
Fenugreek (Trigonella foenum-graecum): Mixed evidence. Some RCTs suggest increases, others show no effect, often confounded by use of combined formulations.
Shilajit: A single RCT showed increases in total/free testosterone and DHEA-S, but evidence is limited and concerns remain regarding product purity.
Tribulus terrestris: Systematic reviews find little to no consistent effect on testosterone, despite anecdotal claims for libido enhancement.
Health Implications
Tongkat ali offers the most clinically meaningful testosterone increase, especially in men with low baseline levels.
Effects are modest, not comparable to anabolic steroids. Lifestyle factors such as sleep, exercise, and diet remain essential for testosterone optimization.
Sustainability
Tongkat ali faces sustainability challenges due to wild harvesting pressures; cultivated or sustainably managed sources are preferred.
Ashwagandha is widely cultivated, with organic farming methods supporting environmental sustainability.
DOI
10.3390/medicina58081047
