Tribulus terrestris: Does it Work? (Supplements: Reviewing the Evidence)

They stated that TT extracts increased libido, blood testosterone and spermatogenesis, and improved the male sexual function. To date, there is a lack of reliable data concerning the usefulness and safe usage of TT in sport. However, TT is widely touted among athletes and used by them. Ergogenic anabolic properties are attributed to this plant, since it supposedly elevates the blood testosterone level and stimulates skeletal muscles hypertrophy.

TT was especially promoted in Bulgaria, where it was used from the s as the preparation named Tribestan Bucci, ; Koumanov et al. It was suggested that improvements in physical performance among Bulgarian athletes, especially weightlifters, were achieved due to the use of this product. Indeed, that was a time when Bulgarian weightlifters were the world champions, until more accurate anti-doping controls revealed the use of anabolic-androgenic steroids in these athletes.

Hence, until the absence of steroidal doping will be confirmed by urine analysis, good sport results in weightlifting should be taken with caution. Despite discovered doping cases among Bulgarian weightlifters during the Olympic Games Predergast et al. Because of the disqualification of 11 doping users, the Bulgarian weightlifting team was excluded from the Olympic Games in Beijing Summing up, there is no strong evidence for the contribution of TT to success in weightlifting.

In response to aggressive marketing of nutritional supplements which are to improve health and physical performance, it is worth noting that nutritional supplements which are recommended for competitive athletes to enhance their performance may be contaminated by androgenic-anabolic steroids AAS and so-called pro-hormones that are weak androgens, which are precursors of stronger endogenous androgens such as testosterone and dihydrotestosterone DHT.

Such contamination is not usually described in the list of ingredients; however, on the market there also exist products with a full list of components, including compounds prohibited in sport. Moreover, some researchers undertake studies to examine the biological action of those compositions, i. In the search for appropriate androgens taken by athletes, Brown et al. Assuming that TT would enhance the rate of that conversion, and in consequence increase the effectiveness of relatively small amounts of those pro-hormones, the same authors carried out more comprehensive studies on the biological effect of TT taken concurrently with androstenediol Brown et al.

The mentioned type of experiments indicate that some studies are focused on a search of herbal-androgenic compositions which would have anabolic action despite a relatively small un-detected amount of banned androgens. However, such procedures may suggest that extracts of TT are not as effective as the users, mostly athletes, expect. The same is true regarding other nutritional supplements recommended for athletes. For that reason, it is no wonder that some supplements are contaminated intentionally by banned substances which may enhance athletic performance Aqai et al.

Obviously, the contamination of nutritional supplements may lead to inadvertent doping in competitive sport. One of the most spectacular incidents of non-intentional doping was recorded just prior to the Olympic Games, when the Norwegian weightlifter Stian Grimseth was disqualified for taking nutritional supplements containing ribose, but contaminated by non-listed norandrostenedione, as was described in by the quarterly magazine World Weightlifting.

Since TT is often used by athletes it is worth knowing whether taking TT extract may change the urinary endogenous androgenic profile to give a positive result of an anti-doping test. There are few studies carried out among athletes to elucidate the degree of risk of taking TT. The results showed that taking TT without any contaminations did not cause positive anti-doping tests Saudan et al. Despite this, some scientists state that adequate controls of TT purity are still lacking. Among other aspects, this program aims to allow AIS athletes to focus on the use of supplements and specific sports diet as part of their nutrition plans and to minimize the risk of the supplement use leading to an inadvertent doping offence.

In this program supplements are classified into four groups according to their effectiveness and safety.

Summary of Tribulus terrestris

Compounds from this group should not be used by athletes AIS, These steroids were not listed on the label Geyer et al. Studies on effects of TT on blood androgens and a sexual disposition were conducted mainly among animals, and the results were contradictory. Studies carried out in primates baboons and rhesus monkeys , rabbits and castrated rats showed that acute intravenous treatment with a TT extract 7. Similar results reported by El-Tantawy et al. In contrast to those results, the study carried out by Martino-Andrade et al.

On the other hand, there was evidence that rats concurrently receiving TT and morphine presented significantly lower reduction of blood sex hormones and pituitary gonadotropin luteinizing hormone , in comparison to those exposed only to the narcotic Ghosian Moghaddam et al. A few studies with a TT extract carried out among humans also provided divergent results. Since for the pharmaceutical market, which provides TT extracts, the main targets are athletes and healthy, physically active adults, the whole investigative efforts are aimed at confirming such biomedical properties of TT that are expected by the potential users.

As mentioned, athletes seek performance enhancers, i. Since development of muscle mass and strength depends, in part, on androgenic status, competitive athletes seek substances that are able to increase their endogenous circulating testosterone, while guaranteeing a negative anti-doping test. So far, trustworthy studies on expected TT properties are still insufficient.

Van Eeenoo et al. Likewise, other studies conducted among athletes did not confirm the beneficial effect of supplementation of TT on physical performance. Resistance-trained men who received a daily dose of TT amounting to 3. In contrast to these data, there are two studies confirming beneficial effects after treatment with pharmaceutical products containing TT and other components. The other placebo-controlled double-blind experiment conducted among older men with formerly impaired erectile function and lowered blood total 8. It should be stressed, however, that in both experiments, there was no certainty which component s of those products caused the biological advantages, and whether TT contributed to those effects.

Studies on TT toxicity have been conducted only among animals. The only case of acute poisoning by TT was reported in a young man, who consumed during two days a high dose of TT to prevent kidney stone formation. He was hospitalized, and after 7 days biochemical symptoms of hepatitis and kidney necrosis were decreased Talazas et al.

As was shown, potential benefits and risks for human health as a result of supplementation of TT still remain unclear. Effects of the use of nutritional supplements in sports are widely studied. The results of numerous investigations referring to the biological action, duration of supplementation and recommended doses are currently published in the scientific literature Czeczelewski et al. Yet, knowledge of the physiological action of exotic herbs among sport physicians seems to be inadequate in the light of the large number of easily available over-the-counter new herbal products accompanied by a limited number of clinical trials and up-to-date information.

For that reason, there are concerns that some herbs do not work or, what is worse, may cause unpredicted adverse effects as an alone product, or disadvantageous herb-drug interactions Canter and Ernst, ; Izzo, This refers especially to TT extracts containing biologically active chemical compounds such as alkaloids and glycosides. Considering a relatively low number of conducted studies on the influence of TT on athletes, especially with regard to the effect on performance and androgenic status, one should stress the lack of evidence to show an enhancing effect of the use of TT on expected biomedical properties in humans.

Contradictory results of aforementioned studies suggest that marketing opinions about TT as a testosterone enhancer are unsubstantiated. Therefore, there are athletes who use it in order to improve their performance. It is caused by intensive advertising encouraging TT usage, which may only result in a temporary placebo effect. For that reason, further clinical trials should be carried out in the future. National Center for Biotechnology Information , U. Journal List J Hum Kinet v.

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Insights into Supplements with Tribulus Terrestris used by Athletes

Abstract Herbal and nutritional supplements are more and more popular in the western population. Sports, dietary supplements, doping, placebo, testosterone, herbal supplements. Introduction Nowadays, modern pharmacology is based mostly on synthetic chemical compounds. Aim of the review Taking into consideration an increasing interest in the extract of TT as a supplement improving human vitality, the purpose of this review was to present current knowledge of the effects of the use of TT on androgenic status and physical performance in healthy, physically active men, with special focus on the benefits and risks for human health.

Use of TT in sport. A risk of doping First scientific reports about beneficial effects resulting from the use of TT were provided by researchers of the Bulgarian Pharmaceutical Group. Does TT really work in humans? Side effects Studies on TT toxicity have been conducted only among animals. Herbs and nutritional supplements in sports in the future Effects of the use of nutritional supplements in sports are widely studied. Conclusions and recommendations Considering a relatively low number of conducted studies on the influence of TT on athletes, especially with regard to the effect on performance and androgenic status, one should stress the lack of evidence to show an enhancing effect of the use of TT on expected biomedical properties in humans.

The effect of Tribulus terrestris on body composition and exercise performance in resistance-trained males. High-throughput bioaffinity mass spectrometry for screening and identification of designer anabolic steroids in dietary supplements. Effect of Tribulus terrestris L. Experimental Tribulus terrestris poisoning in sheep: In humans with hypertension, tribulus terrestris given at 2g of the whole fruit extract of a water extract thereof over four weeks noted significant reductions in systolic blood pressure As the reduction in blood pressure was associated with an increase in urinary output, it is though that the observed benefits were secondary to the kidneys.

Tribulus pterocarpus phenolics have been noted to inhibit platelet aggregation induced by thrombin in a concentration dependent manner between 0. A reduction in total cholesterol has been noted with tribulus terrestris fruits or a water extract thereof at 3g daily over four weeks, which reached 9. In humans supplementing tribulus terrestris , resistance trained males using supplementation at 3. When looking at interventions, currently those that show an increase in circulating testosterone including a non-human primate injection of isolated protodioscin 7.

It should be noted that based on body surface area conversions [64] an oral dose of mg Tribulus equates to Some human studies have shown increased testosterone associated with Tribulus supplementation, however they are confounded with coingestion of other nutrients [65] [66] [67] and one which used 6g of the root extract of tribulus terrestris by itself for 60 days in infertile men noted a trend to increase testosterone failed to be statistically significant reaching A case study of tribulus terrestris overconsumption 2L of a tribulus water product for the treatment of kidney stones has resulted in nephrotoxicity which was treated in a clinical setting.

A 60kDa protein found in tribulus terrestris appears to be able to dissolve calcium oxalate kidney stones in vitro with a potency comparable to cystone. In a human study giving 3g of the fruit extract of tribulus terrestris or a water extract thereof, both interventions were effective in increasing urinary output by mL daily when supplemented for a month. Testicular weight may be increased with triblus supplementation without any abnormal changes in histological examination.

In humans with oligozoospermia low sperm count , supplementation of tribulus terrestris at 6g of the root extract daily for two months is able to improve sperm count and motility although the degree of increase was not significantly greater than placebo. Benign Prostatic Hyperplasia BPH is a condition that is not harmful per se but may be indicative of disease pathology leading to more serious diseases such as Prostate Cancer and may be associated with impairment of a male's quality of life or interfering with urinary flow rates.

Tribulus has been investigated for its benefits on BPH, although this study used a combination supplement of Tribulus Terrestris and Murraya koenigii. Another possible confound to the above research is that IPPS symptoms include urinary flow, as Benign Prostatic Hyperplasia may sometimes reduce flow rate. In men with low sperm count, supplementation of 6g tribulus root is associated with a significantly greater improvement in sexual health assessed by survey by In the rabbit corpus cavernosum in vitro , tribulus terrestris fruit extract lyophilized water extract at 0.

Elsewhere, a mixture of tribulus terrestris and cornus officinalis the latter working via nitric oxide metabolism has noted that tribulus alone was more effective than all mixtures of the two herbs and that the mixture was no more proerectile following oral ingestion than tribulus alone. An increase in erectile properties have been noted in rabbits given 2. In persons with low sperm count given 6g of tribulus root daily for two months where almost half of participants reported erectile problems there was significant improvements in the loss of erection 6.

Due to unknown bioavailability, it cannot be estalished what a toxic oral dose would be. One case study noted gynecomastia and reduced testosterone associated with Tribulus terrestris supplementation, amidst other factors. Causation could not be placed on the product. There are well established instances of tribulus terrestris induced neurotoxicity and renal toxicity in ruminant animals known as Geeldikkop and Staggers [94] [95] although this does not appear to extend to humans.

Common misspellings for Tribulus terrestris include territis, terrestis, terestris, tibulus, tribuls. Home Supplements Men's Health Tribulus terrestris Tribulus terrestris Tribulus terrestris is a plant from Ayurveda where the root and fruits are used for male virility and general vitality, respectively. This page is regularly updated, to include the most recently available clinical trial evidence. History Research analysis by Kamal Patel and verified by the Examine.

Last updated on Oct 23, Free 5 day supplement course. Grade Level of Evidence Robust research conducted with repeated double-blind clinical trials Multiple studies where at least two are double-blind and placebo controlled Single double-blind study or multiple cohort studies Uncontrolled or observational studies only. The amount of high quality evidence.

The more evidence, the more we can trust the results. The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.

Tribulus terrestris

Scientific research does not always agree. In otherwise healthy males, testosterone is not influenced with supplementation of tribulus terrestris.

There may be an increase in infertile men, but this is weak. There may be a small effect in postmenopausal women with low libido, however, the difference wasn't statistically significant. A decrease in blood pressure has been noted in hypertensive subjects in one study. Another larger study in normotensive subjects failed to find a significant change.

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More studies in hypertensive subjects are needed before confidence in the effect is warranted. The effect is reliable across all studies so far, however, research is still in its early stage and great confidence in these results would be unwarranted. A decrease in heart rate has been observed in hypertensive persons given tribulus supplementation. Most studies found an improvement in sexual desire in women reporting a general loss of libido.

One study in men found an improvement. The research is still in its early stage and great confidence in these results would be unfounded. Exercise related fatigue and vigor is unaffected by tribulus supplementation in trained men. Insufficient evidence to support a consistent increase of lean mass associated with tribulus relative to placebo during training or in general.

A consistent influence on luteinizing hormone hasn't been detected with supplemental tribulus. No significant alterations in power output associated with tribulus supplementation. Only one uncontrolled trial has found an increase in sperm count with supplementation of 2. One study found an increase but it wasn't significant, and one that used 6g of tribulus root didn't find a significant increase compared with control.

The increase in sperm quality seen with 6g tribulus root has failed to outperform placebo in infertile men. Another uncontrolled study that used 2. A decrease in cholesterol levels has been noted with tribulus supplementation in some studies. However, the largest study found no significant decrease, and none of the studies have made cholesterol their primary endpoint. One uncontrolled study found a notable improvement in seminal motility relative to baseline. One randomized, controlled trial found a modest reduction, accompanied by reduced fasting and postprandial glucose levels.

One study found a significant increase relative to placebo with 2.

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There may be a small improvement in overall sexual function in premenopausal women with libido taking 2. Effects on postmenopausal women are unclear. One study found an increase with 2.