Dr. Kumar’s Take
This was a single-arm treatment study, not a placebo-controlled trial, so I read it as a signal rather than proof. Men carrying a diagnosis of late-onset hypogonadism took a standardised water-soluble Tongkat Ali extract for a month, and both their symptom scores and their serum testosterone improved. Without a control group I cannot separate the extract from regression to the mean, expectation, or the ordinary variability of testosterone. It is not a substitute for medical therapy in true hypogonadism, and I would want a randomised comparison before treating it as established.
Key Takeaways
✔ Single-arm, uncontrolled study: 76 of 320 men with late-onset hypogonadism took 200 mg of a standardised water-soluble Eurycoma longifolia extract for 1 month.
✔ Ageing Males’ Symptoms (AMS) scores improved significantly (p < 0.0001).
✔ Serum testosterone concentration also improved significantly.
✔ Normal testosterone levels rose from 35.5% of patients before treatment to 90.8% after; complaint-free AMS scores rose from 10.5% to 71.7%.
Actionable Tip
If you are an older man with symptoms of low testosterone, get the diagnosis made properly with symptom assessment and serum testosterone before reaching for a supplement. If you and your clinician want to try a standardised Tongkat Ali extract, use a standardised water-soluble preparation rather than an unstandardised powder, and recheck symptoms and labs rather than relying on how you feel.
Study Summary
This was a single-arm, uncontrolled human treatment study, not a randomised or placebo-controlled trial. From a group of 320 patients with late-onset hypogonadism, 76 were given 200 mg of a standardised water-soluble extract of Eurycoma longifolia (Tongkat Ali) for 1 month. The investigators recorded the Ageing Males’ Symptoms score using the standardised rating scale, along with serum testosterone concentration. Both improved significantly over the month (p < 0.0001). The authors concluded the extract appears useful as a supplement for overcoming the symptoms of late-onset hypogonadism.
Study Design and Methods
- Population: 76 of 320 patients with late-onset hypogonadism.
- Intervention: 200 mg of a standardised water-soluble extract of Eurycoma longifolia (Tongkat Ali).
- Control: None. This was a single-arm study with no placebo group and no randomisation or blinding.
- Duration: 1 month.
- Outcomes: Ageing Males’ Symptoms (AMS) score by the standardised rating scale, and serum testosterone concentration.
Results
- Symptoms: AMS scores improved significantly with treatment (p < 0.0001). Before treatment, 10.5% of patients had no complaint on the AMS scale. After the completed treatment, 71.7% showed normal values.
- Hormones: Serum testosterone concentration improved significantly (p < 0.0001). Before treatment, 35.5% of patients had normal testosterone levels. After treatment, 90.8% did.
- Interpretation: Because every patient received the extract and there was no comparison group, the size of any drug-specific effect cannot be separated from other influences on these measures.
How Tongkat Ali May Raise Testosterone
The authors note that Eurycoma longifolia is used in South-East Asia to combat stress and disease and to improve physical strength, and that compounds from the roots of the plant have been reported to have aphrodisiac and testosterone-enhancing effects in the rat. At the time of this study, human data were not available, which is what prompted this work. The mechanism in humans is not established by this study, which measured only symptoms and serum testosterone.
Practical Considerations
- Who might benefit: Men with a clinical diagnosis of late-onset hypogonadism, which is the only population this study enrolled.
- Dosing: The dose studied was 200 mg of a standardised water-soluble extract, taken for 1 month. Unstandardised herbal powders are not the same product.
- Monitoring: Symptoms and serum testosterone were the measures that moved here, so those are the measures worth tracking with your clinician.
- Limitations to keep in mind: No placebo group, no randomisation, and one month of treatment. Herbal medicines are widely used, which is not the same as being well tested.
Related Studies and Research
Podcast: Testosterone Replacement Therapy Explained: How to think about hormones, goals, and monitoring.
Tongkat Ali Raises Testosterone: Meta-Analysis: Big-picture evidence across multiple clinical trials.
Ashwagandha and Hormones in Aging Men: Crossover trial in older, overweight men.
Ashwagandha Boosts Strength and Recovery: Strength, muscle size, and recovery improvements with training.
Frequently Asked Questions
How fast can I expect changes?
This study measured patients after 1 month of treatment and reported improvement in both symptom scores and serum testosterone at that point. It did not test shorter or longer durations.
Is Tongkat Ali as strong as testosterone therapy?
This study cannot answer that. It compared patients only with their own baseline, not with testosterone therapy or with placebo.
Can I take it with other supplements?
Discuss this with your clinician. This study looked at a single 200 mg standardised extract and did not examine combinations with other supplements or medications.
Conclusion
In men with late-onset hypogonadism, 1 month of a 200 mg standardised water-soluble Tongkat Ali extract was followed by significant improvement in Ageing Males’ Symptoms scores and serum testosterone, with 71.7% and 90.8% of patients respectively reaching normal values. I read that as promising and worth a proper randomised, placebo-controlled test. Until that exists, I would not present this as a proven treatment, and I would not use it in place of a full evaluation for hypogonadism.
