Organic Tribulus
Also known as: Caltrop, Puncture vine, Gokhru, Bai ji li, Al-Gutub, Organic Tribulus, Tribulus terrestris
Overview
Tribulus terrestris, commonly known as Caltrop or Puncture vine, is a plant widely used in traditional medicine, primarily as a herbal supplement for enhancing sexual function and reproductive health. It is derived from the fruit, leaves, or roots of the plant and is often marketed for improving libido, erectile function, and, less consistently, increasing testosterone levels. While research into its effects is ongoing, several randomized controlled trials and systematic reviews have been conducted. The evidence quality is generally low to moderate, with some studies highlighting very low certainty due to factors like small sample sizes and heterogeneity. It is typically used for conditions such as erectile dysfunction (ED) and female sexual dysfunction (FSD).
Benefits
Tribulus terrestris has shown moderate evidence for improving sexual function. A 2025 systematic review and meta-analysis of 8 RCTs indicated significant improvements in erectile function scores (IIEF-5 and IIEF-15) in men with ED, with clinically meaningful mean differences compared to baseline and placebo. However, this review found no significant increase in total testosterone levels. For female sexual dysfunction (FSD), a systematic review of 5 RCTs reported increased sexual function scores (FSFI and SQ-F) and serum testosterone in premenopausal women after 1-3 months of supplementation. This evidence, however, was rated as very low certainty due to small sample sizes and study heterogeneity, preventing a meta-analysis. No serious adverse events have been consistently reported in clinical trials, suggesting a favorable short-term safety profile.
How it works
The precise mechanism of action for Tribulus terrestris is not fully understood. It is hypothesized to modulate androgen receptors and enhance nitric oxide synthesis, which could improve blood flow and contribute to better erectile function. The plant contains steroidal saponins, such as protodioscin, which are thought to stimulate endogenous testosterone production. However, clinical evidence for a direct increase in testosterone levels remains inconsistent. Additionally, Tribulus terrestris may inhibit P-glycoprotein (P-gp), a transporter protein, which could potentially influence the metabolism and efficacy of certain drugs.
Side effects
Tribulus terrestris is generally considered safe for short-term use, typically up to 3 months, based on clinical trial data. No common side effects (occurring in >5% of users) have been consistently reported. Uncommon side effects (1-5%) may include mild gastrointestinal discomfort, though this is primarily anecdotal. Rare side effects (<1%) have been noted in isolated case reports, such as mild elevations in liver enzymes and creatinine. It is important to note that no significant difference in adverse events has been observed compared to placebo in randomized controlled trials. Potential drug interactions include an increased risk of thrombosis when combined with clopidogrel, and additive effects with diuretics, antihypertensives, and antidiabetics. Caution is advised for individuals on blood thinners, antihypertensives, or those with pre-existing liver or kidney impairment. Due to limited data, it is not recommended for use during pregnancy or breastfeeding.
Dosage
Effective doses of Tribulus terrestris in clinical trials have ranged from 250 mg to 1500 mg daily. These doses typically refer to extracts standardized for saponin content. Treatment durations in studies commonly span 1 to 3 months. There is no established maximum safe dose, and safety data for doses exceeding these studied ranges are currently lacking. The supplement is usually administered orally, either once or twice daily. While specific timing considerations are not extensively detailed, consistency is often recommended. Bioavailability and absorption factors are not well characterized, making the use of standardized extracts preferable to ensure consistent potency and effects.
FAQs
Does Tribulus terrestris increase testosterone levels?
Evidence from randomized controlled trials is inconsistent; most studies show no significant increase in serum testosterone, despite observed improvements in sexual function.
Is Tribulus terrestris safe for long-term use?
Long-term safety data are currently lacking. Short-term use (up to 3 months) appears safe based on available clinical trial evidence.
How long does it take to see effects from Tribulus terrestris?
Improvements in sexual function have typically been reported after 1 to 3 months of consistent supplementation in clinical studies.
Can Tribulus terrestris replace prescription ED medications?
It is not established as a substitute for approved ED therapies. It may be considered an adjunctive treatment, but consult a healthcare professional.
Are there any risks when taking Tribulus terrestris with other medications?
Yes, caution is advised, especially with blood thinners (e.g., clopidogrel) and antihypertensives, due to potential interactions. Consult your doctor.
Research Sources
- https://www.scielo.br/j/rbgo/a/j9q637hwJbhZDWPb8syg83w/?lang=en – This systematic review investigated the effects of Tribulus terrestris on female sexual dysfunction (FSD). It included 5 RCTs (n=279) and found significant improvements in sexual function scores (FSFI and SQ-F) and serum testosterone in premenopausal women. However, the evidence was rated as very low certainty due to small sample sizes and heterogeneity, precluding a meta-analysis.
- https://pubmed.ncbi.nlm.nih.gov/40360723/ – This systematic review and meta-analysis of 8 RCTs focused on Tribulus terrestris for erectile dysfunction (ED). It concluded that Tribulus terrestris significantly improved erectile function scores (IIEF-5 and IIEF-15) compared to placebo, with clinically meaningful differences. However, no significant increase in total testosterone levels was observed, and no increased adverse events were reported compared to placebo.
- https://www.mskcc.org/cancer-care/integrative-medicine/herbs/tribulus-terrestris – This source provides an overview of Tribulus terrestris, detailing its proposed mechanisms of action, including modulation of androgen receptors and potential P-glycoprotein inhibition. It also outlines potential drug interactions, such as with clopidogrel, diuretics, antihypertensives, and antidiabetics, and highlights contraindications for certain patient groups.
- https://pubmed.ncbi.nlm.nih.gov/40219032/ – This systematic review examined the effects of Tribulus terrestris on erectile dysfunction and testosterone levels. It confirmed improvements in erectile function based on multiple RCTs but noted inconsistent effects on testosterone levels. The review also highlighted the limitation of lacking long-term safety data for the supplement.
