Tongkat Ali for Seniors: What the Trials in Older Men Show
Informational summary of published trials and the Endocrine Society guideline, not medical advice. If you take prescription medication or have a prostate history, the clinician who knows your chart has the final say.
Quick answer
Tongkat ali is the one “testosterone supplement” with placebo-controlled trials in older men, and what they show is a rise in blood testosterone toward the normal range in men who started low, at 200–400 mg a day of a standardized water extract, over one to three months. The only trial in people aged 57–72 was a 25-person pilot with no placebo group. No trial in older adults measured falls, bone, cognition or the prostate, and none ran past six months. A supplement does not treat a diagnosed deficiency: if a repeated fasting morning test is unequivocally low and you have symptoms, that is hypogonadism, and the decision is a clinical one.
The shelf does not sell the trial. We read 392 tongkat ali labels filed with the NIH: of the 76 sold as tongkat ali with a daily dose, 25% sit inside the 200–400 mg range the trials used, 53.9% direct more than 400 mg, and only 33.8% say what the extract is standardized to. See the census →
Know you want a standardized extract? See the best tongkat ali picks, ranked by disclosed eurycomanone →
On this page
What low testosterone actually is, and when treatment is indicated
Testosterone falls with age. In the Baltimore Longitudinal Study of Aging, which followed 890 healthy men with repeated blood samples, the share with testosterone in the hypogonadal range rose to about 20% of men over 60, 30% over 70 and 50% over 80 (Harman 2001, PMID 11158037). That is the number behind the search query. It is not, by itself, a diagnosis.
The Endocrine Society’s guideline is specific about what a diagnosis needs: symptoms and signs consistent with testosterone deficiency and unequivocally and consistently low serum testosterone, measured as a fasting morning total testosterone, then repeated to confirm, with a free-testosterone measurement added in men near the lower limit. Only then does the guideline recommend testosterone therapy, after a discussion of benefits, risks and monitoring (Bhasin 2018, PMID 29562364). The harmonized lower limit of normal, derived from 9,054 men across four cohorts in the United States and Europe, is 264 ng/dL for healthy non-obese men aged 19–39, with a normal range of 264–916 (Travison 2017, PMID 28324103). The symptoms attached to that number are the ones the supplement adverts borrow: low libido, erectile dysfunction, fatigue, loss of muscle and bone, low mood.
The same guideline lists who should not start testosterone: prostate or breast cancer, a palpable prostate nodule, a PSA above 4 ng/mL without urological evaluation, elevated hematocrit, untreated severe sleep apnea, uncontrolled heart failure, a recent heart attack or stroke, or thrombophilia. Every item is more common at 70 than at 40, and no supplement trial has applied the list.
The honest comparator is testosterone itself. The Testosterone Trials gave 790 men aged 65 and over, with testosterone under 275 ng/dL and symptoms, a year of testosterone gel or placebo, raising levels to the mid-normal range for men aged 19–40. Sexual activity, desire and erectile function improved moderately; vitality did not; walking distance improved only when all three sub-trials were pooled (20.5% of treated men gained at least 50 m against 12.6% on placebo); mood improved slightly; the trial was too small to judge risk (Snyder 2016, PMID 26886521). TRAVERSE later randomized 5,246 men aged 45–80 at high cardiovascular risk with two fasting levels under 300 ng/dL: major cardiac events were no more frequent on testosterone (7.0% against 7.3%), but atrial fibrillation, acute kidney injury and pulmonary embolism were (Lincoff 2023, PMID 37326322). A year of the hormone itself bought a moderate change in sexual function and little else a 70-year-old would feel; a botanical that moves testosterone by less cannot be expected to do more.
What tongkat ali did in trials, and in whom
The human evidence is real, small, and concentrated in exactly the population this page is about. Read it by trial rather than by headline.
Men with late-onset hypogonadism, one month. 76 of 320 men with late-onset hypogonadism took 200 mg a day of a standardized water-soluble extract for one month. Before treatment 35.5% had a normal testosterone level and 10.5% had no complaints on the Aging Males’ Symptoms scale; after it, 90.8% and 71.7% did (Tambi 2012, PMID 21671978). It is the most-quoted tongkat ali result, and the abstract describes no placebo group, so part of that shift is regression toward the mean in men selected for being low.
Men aged 50–70 with testosterone under 300 ng/dL, twelve weeks, placebo-controlled. 105 men were randomized to 100 mg, 200 mg or placebo of a standardized water extract (Physta) daily for 12 weeks. At 200 mg, total testosterone was significantly higher than placebo at weeks 4, 8 and 12; at 100 mg only at week 12. Free testosterone did not differ between groups. Symptom and fatigue scores fell in both extract groups, cortisol fell at 200 mg, handgrip rose within the extract groups, and blood counts, lipids, liver and kidney tests showed nothing clinically relevant (Chinnappan 2021, PMID 34262417). That is the strongest single result in older men.
The seniors trial. The one study that enrolled people by age gave 13 physically active men and 12 physically active women aged 57–72 400 mg of extract daily for 5 weeks. Total and free testosterone and handgrip force rose in both sexes; in the women the free-testosterone rise was attributed to a fall in sex-hormone-binding globulin; hematocrit and red cell count in the men rose slightly. It is titled a pilot study, it had no placebo arm, and 25 people is the whole sample (Henkel 2014, PMID 23754792). Every “tongkat ali for seniors” page rests on it, and it cannot carry more than that.
Men with androgen deficiency of aging, six months. The longest trial randomized 45 men, average age 47, to placebo, extract, exercise, or exercise plus extract (11–12 per arm) at 200 mg a day. Erectile function improved most with exercise plus extract (Leitão 2021, PMID 33541567); knee-extensor peak torque rose 14% with exercise alone and 17% with exercise plus extract, and did not rise in the extract-only arm (Leitão 2021, PMID 33445146). The men were in their forties and the strength came from the training.
Stressed adults, four weeks. In 63 moderately stressed adults, a standardized hot-water extract lowered salivary cortisol 16% and raised salivary testosterone 37% against placebo (Talbott 2013, PMID 23705671); not an older-adult trial.
Pooled. A 2022 systematic review pooled five randomized trials: total testosterone rose with a standardized mean difference of 1.352 (95% CI 0.565–2.138), confirmed in the hypogonadal subgroup, with the authors calling for more research before clinical use (Leisegang 2022, PMID 36013514). An interval that wide is what five small trials in different populations produce.
What it did not do. No trial in older adults measured falls, fractures, bone density, cognition, cardiovascular events, PSA or mortality, and none placebo-controlled ran longer than 12 weeks. The only strength outcome that moved without exercise was a handgrip test in within-group comparisons. Every positive result used a standardized water extract at 100–400 mg; none used raw root powder or a capsule labeled only with a ratio like 200:1.
The doses the trials used
| Trial | Who | Dose & preparation | Duration | Measured | Result |
|---|---|---|---|---|---|
| Tambi 2012 | 76 men with late-onset hypogonadism | 200 mg/day standardized water-soluble extract | 1 month | Serum testosterone, AMS symptom score | Normal testosterone 35.5% → 90.8%; no placebo group described |
| Chinnappan 2021 | 105 men 50–70, testosterone <300 ng/dL | 100 or 200 mg/day Physta vs placebo | 12 weeks | Total & free testosterone, AMS, fatigue, grip, safety labs | Total T up vs placebo at 200 mg from week 4; free T no between-group difference; no safety signal |
| Henkel 2014 | 13 men, 12 women, 57–72, physically active | 400 mg/day extract | 5 weeks | Total & free testosterone, DHEA, cortisol, SHBG, handgrip, blood counts | Testosterone and grip up in both sexes; slight hematocrit rise in men; pilot, no placebo |
| Leitão 2021 | 45 men, mean age 47, with ADAM symptoms | 200 mg/day vs placebo, with or without concurrent training | 6 months | Erectile function, total testosterone, knee peak torque | Best with exercise + extract; strength gains only in the exercise arms |
| Talbott 2013 | 63 moderately stressed adults | Standardized hot-water extract (200 mg/day) vs placebo | 4 weeks | Salivary cortisol and testosterone, mood | Cortisol −16%, testosterone +37% |
200 mg a day is the dose in both hypogonadism trials and the six-month trial, 400 mg is the seniors pilot, and every one used a standardized water extract. Eurycomanone is the marker compound those extracts are standardized to; a label that gives no percentage gives you no way to compare its capsule with the trial’s. The dosage guide covers standardization in detail.
Safety in older adults, and on medications
The trial safety record is short and clean. Twelve weeks at 200 mg in men aged 50–70 produced no clinically relevant change in blood counts, lipids, or liver and kidney tests (Chinnappan 2021, PMID 34262417). In rats, 13 weeks of powdered root at up to 2 g/kg a day found no adverse effect and no genotoxicity, with an acceptable daily intake calculated at 1.2 g per adult; it also recorded shortened prothrombin and partial thromboplastin times, which the authors classed as pharmacological rather than adverse (Li 2013, PMID 24062779). Twelve weeks is the longest placebo-controlled exposure in older adults, and that is the limit of what “safe” means here.
Blood pressure medication. The one human interaction study is with propranolol. Fourteen healthy young men took a single 80 mg dose with placebo or with 200 mg of a water extract: with the extract, propranolol’s bioavailability fell 29%, its peak concentration fell 42%, and the time to peak was prolonged by about 86%, through reduced absorption rather than faster metabolism. The drug’s measured effect was unchanged in these healthy volunteers, and the authors still advise caution (Salman 2010, PMID 21054461). That is one beta-blocker, one dose, in men in their twenties; nothing equivalent exists for other beta-blockers, ACE inhibitors, angiotensin blockers, calcium-channel blockers or diuretics. In human liver microsomes the root extract weakly inhibited CYP1A2, CYP2A6 and CYP2C19 (Han 2015, PMID 26240600).
Anticoagulants. There is no human study with warfarin, a direct oral anticoagulant or an antiplatelet drug. The only clotting signal is the shortened clotting times in the rat study, and warfarin’s main enzyme, CYP2C9, is not among those the extract inhibited in vitro. “Unknown” is the accurate word, and on a narrow-margin drug it means an INR check or not starting.
Liver. The trials found no liver-enzyme changes. One published case report describes acute liver injury with jaundice in a 47-year-old man shortly after starting tongkat ali, resolving on stopping, with other causes excluded (Kaliounji 2024, PMID 38646387). One case against several hundred trial participants is rare, not a pattern, and a reason to include ALT and AST in routine bloodwork while you take it.
Prostate and blood count. No tongkat ali trial in older men reported PSA, prostate volume or urinary symptoms. The seniors pilot recorded a slight rise in hematocrit and red cell count in the men (Henkel 2014, PMID 23754792), the direction testosterone therapy pushes and the reason the guideline monitors hematocrit. A product meant to raise testosterone deserves the two checks a prescription would get, a PSA and a hematocrit, before and after. A man with prostate cancer, a raised PSA or a history of clots should treat the contraindication list as applying to him.
The documented hazard is contamination. Two surveys of 100 tongkat ali products each, bought in Malaysia, found 36% (Ang 2004, PMID 15162849) and 26% (Ang 2006, PMID 16567029) over the 0.5 ppm mercury limit. They are older surveys of a different market, and they are the only contamination data that exist, which is why a third-party heavy-metal test is the first thing to look for and why the best-overall ranking treats it as a requirement.
Insomnia and restlessness are the complaints users report most; the hub’s side-effects section covers the adverse-event record.
We read 392 labels: what the shelf sells versus the studied dose
Original research Every on-market label in the NIH Dietary Supplement Label Database matching eurycoma, tongkat ali or longjack (456 on the market for “eurycoma”, 598 read, 392 with a eurycoma row on the Supplement Facts panel), split into the 80 sold as tongkat ali (76 with a daily dose) and the 312 blends that carry it as one ingredient.
Of the 76 labels sold as tongkat ali with a daily dose, 25% sit inside the 200–400 mg range the trials used, and 53.9% direct more than 400 mg a day. Only 33.8% declare any standardization or extract ratio, and 7.5% declare a ratio of 100:1 or higher, the “200:1” style of claim that describes how much root went in rather than how much eurycomanone came out. Among the 312 blends, 59.3% state a quantity for the eurycoma; the rest bury it in a proprietary blend with no number to compare.
| Item | Value (%) |
|---|---|
| Within 200–400 mg | 25% |
| Above 400 mg | 53.9% |
| Declares standardization | 33.8% |
| Ratio of 100:1 or more | 7.5% |
| Blends quantifying it | 59.3% |
Set that against the table above. Every positive trial in older men used 100–400 mg of a standardized water extract. A 1,000 mg capsule of unstandardized root is not a higher dose of the trial material; it is a different product with the same name, and nothing on its label says whether it carries more eurycomanone than the 200 mg trial capsule or less. The number to look for is a stated eurycomanone percentage, which is the number two-thirds of the shelf leaves off.
Method: 598 labels retrieved from the NIH Dietary Supplement Label Database (DSLD) v9 on 2026-09-16 for the terms eurycoma, tongkat ali and longjack (456 on the market for “eurycoma”); 392 carry a eurycoma row on the Supplement Facts panel; 80 carry the term in the product name and are counted as sold as tongkat ali, 76 of those with a parseable daily quantity; the other 312 are blends. Dose per day is the panel quantity for the labeled serving multiplied by the maximum daily servings the label directs. Studied-range and standardization percentages are stated against the 76 sold-as-tongkat labels with a dose, never against labels read; the blend finding against the 312 blends. Every figure was recomputed in both halves of the corpus, split by DSLD id parity: 5 of 8 findings held within tolerance. The 3 that did not (the median daily dose, the share dosed below 200 mg, and the standalone-versus-blend share of the corpus) did not hold in both halves of the sample and are not published as numbers. The figures are open data (CC BY 4.0). What it cannot tell you: which products sell most, whether a label matches what is in the capsule, the actual eurycomanone content of any product, or anything about products not filed with the NIH.
What a “testosterone booster” blend actually contains
The products the phrase “best testosterone supplements for seniors” returns are rarely tongkat ali alone. A 2019 analysis took the five top-rated, most-reviewed testosterone boosters on Amazon and read them the way a clinician would: 19 unique ingredients; 191 studies on the ten most common, 19% of them in humans; and of 37 human studies, 30% saw testosterone rise and 46% saw no effect. When the customer reviews were filtered for untrustworthy entries, reports of increased libido fell 91%, of improved strength 93%, and of improved erections 60% (Balasubramanian 2019, PMID 30770069). The authors concluded that patients should be cautioned about these products given that approved therapies exist.
Our census puts a number on the same problem from the label side: 312 of the 392 labels carrying eurycoma are blends, and 59.3% of those blends say how much eurycoma is in a serving. A blend that does not quantify its tongkat ali cannot be matched to the 200 mg the trials used. If it also carries zinc, vitamin D or magnesium, each has its own evidence (zinc, vitamin D for seniors, magnesium for seniors), none of it evidence that the blend works. If you want the ingredient with older-men trials, buy it on its own, at the studied dose, from a label that states its standardization.
The product links below go to Amazon and we may earn a commission if you buy. It never changes which product we pick or what we say about it. How we choose.
The pick that matches the trials: Nootropics Depot Tongkat Ali 2% Eurycomanone (200mg, 120ct) $0.32/day is a 200 mg standardized extract, the dose used in both placebo-controlled trials in older men with low testosterone; it states its eurycomanone content and publishes HPTLC third-party testing, which puts it in the 25% of the shelf inside the studied range and the 33.8% that declares its standardization.
If you are drug-tested or want the seniors pilot’s 400 mg in one serving, Momentous Tongkat Ali (400mg, 30 servings) $0.67/day is Informed Sport certified but states no eurycomanone percentage. Compare every pick in the best tongkat ali guide.
Frequently asked questions
Does tongkat ali work for men over 60?
It raised blood testosterone in the trials that enrolled older men with low levels: 76 men with late-onset hypogonadism at 200 mg/day for one month (Tambi 2012), and 105 men aged 50–70 with testosterone under 300 ng/dL at 200 mg/day for 12 weeks against placebo (Chinnappan 2021). The one trial in people aged 57–72 was a 25-person pilot with no placebo group. No trial in older adults measured falls, fractures, cognition, mortality or prostate outcomes.
How much tongkat ali should a senior take?
The trials used 200–400 mg a day of a standardized water extract, and 200 mg was the dose in both placebo-controlled trials in older men with low testosterone. More was not tested in older adults, so there is no evidence that a 1,000 mg capsule does more than a 200 mg one, yet our census of 76 tongkat ali labels found 53.9% direct more than 400 mg a day. Match the trial dose and buy a product that states its standardization.
How long does tongkat ali take to work in older men?
The 12-week placebo-controlled trial saw a significant difference at week four, and the hypogonadism trial measured at one month. If a fasting morning testosterone test has not moved after eight to twelve weeks at 200 mg of a standardized extract, the trials give no reason to expect it to move later.
What are the side effects of tongkat ali in older adults?
The placebo-controlled trial in men 50–70 reported no clinically relevant changes in blood counts, lipids, liver or kidney tests over 12 weeks. The seniors pilot noted a slight rise in hematocrit in the men, so a blood count is worth having if you take it for months. One case report describes acute liver injury that resolved on stopping. Insomnia and restlessness are the most-reported complaints; take it in the morning. The documented hazard is contamination: in two Malaysian surveys, 36% and 26% of products exceeded the mercury limit, so buy third-party-tested.
Can I take tongkat ali with blood pressure medication?
Ask the prescriber first, and expect them to have no specific data. In the one human interaction study, 200 mg of a water extract cut propranolol's bioavailability 29% and its peak level 42% in 14 healthy young men, through reduced absorption. Nothing equivalent exists for other blood pressure drugs, and there is no human study with warfarin or other anticoagulants. On a narrow-margin drug that is a reason to say no or to monitor, not to guess.
Is tongkat ali a substitute for testosterone replacement therapy?
No. Testosterone therapy replaces the hormone directly and raised levels into the mid-normal range of men aged 19–40 in the Testosterone Trials; tongkat ali nudges the body's own production. If a repeated fasting morning test is unequivocally low and you have symptoms, that is hypogonadism, and the Endocrine Society guideline places the treatment decision with a clinician who also checks the prostate, hematocrit and sleep apnea.
Does tongkat ali do anything for women over 50?
Two trials included women. The seniors pilot gave 12 physically active women aged 57–72 400 mg a day for five weeks; free testosterone and handgrip strength rose, with no placebo group. A 2025 placebo-controlled trial in 138 women aged 40–55 found 100 mg a day of a standardized extract improved a menopausal quality-of-life score over 12 weeks with no change in reproductive hormones. That is the whole evidence base: small, short, and not about testosterone as an outcome.
Related guides
- Best tongkat ali overall — ranked by disclosed eurycomanone, testing and cost
- Tongkat ali dosage guide — why standardization matters more than milligrams
- Tongkat ali: the evidence — the full trial record, side effects, and why fadogia has no human data
- Natural testosterone stack — tongkat ali, ashwagandha, vitamin D and magnesium at trial doses
- Ashwagandha — the cortisol route, KSM-66 vs Sensoril
- Zinc dosage guide — the mineral in most booster blends
- Vitamin D for seniors
- Creatine for seniors — the supplement with strength trials in older adults
- Magnesium for seniors
Sources
- Harman SM, et al. "Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging." J Clin Endocrinol Metab. 2001. PMID: 11158037
- Bhasin S, et al. "Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline." J Clin Endocrinol Metab. 2018. PMID: 29562364
- Travison TG, et al. "Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe." J Clin Endocrinol Metab. 2017. PMID: 28324103
- Snyder PJ, et al. "Effects of Testosterone Treatment in Older Men." N Engl J Med. 2016. PMID: 26886521
- Lincoff AM, et al. "Cardiovascular Safety of Testosterone-Replacement Therapy." N Engl J Med. 2023. PMID: 37326322
- Tambi MI, Imran MK, Henkel RR. "Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism?" Andrologia. 2012. PMID: 21671978
- Chinnappan SM, et al. "Effect of Eurycoma longifolia standardised aqueous root extract-Physta on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicentre study." Food Nutr Res. 2021. PMID: 34262417
- Henkel RR, et al. "Tongkat Ali as a potential herbal supplement for physically active male and female seniors: a pilot study." Phytother Res. 2014. PMID: 23754792
- Leitão AE, et al. "A 6-month, double-blind, placebo-controlled, randomized trial to evaluate the effect of Eurycoma longifolia (Tongkat Ali) and concurrent training on erectile function and testosterone levels in androgen deficiency of aging males (ADAM)." Maturitas. 2021. PMID: 33541567
- Leitão AE, et al. "Exercise associated or not to the intake of Eurycoma longifolia improves strength and cardiorespiratory fitness in men with androgen deficiency." Complement Ther Clin Pract. 2021. PMID: 33445146
- Talbott SM, et al. "Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects." J Int Soc Sports Nutr. 2013. PMID: 23705671
- Leisegang K, et al. "Eurycoma longifolia (Jack) Improves Serum Total Testosterone in Men: A Systematic Review and Meta-Analysis of Clinical Trials." Medicina (Kaunas). 2022. PMID: 36013514
- Li CH, et al. "Evaluation of Acute 13-Week Subchronic Toxicity and Genotoxicity of the Powdered Root of Tongkat Ali (Eurycoma longifolia Jack)." Evid Based Complement Alternat Med. 2013. PMID: 24062779
- Salman SA, et al. "Modification of propranolol's bioavailability by Eurycoma longifolia water-based extract." J Clin Pharm Ther. 2010. PMID: 21054461
- Han YM, et al. "In Vitro Evaluation of the Effects of Eurycoma longifolia Extract on CYP-Mediated Drug Metabolism." Evid Based Complement Alternat Med. 2015. PMID: 26240600
- Kaliounji A, et al. "A Rare Case of Tongkat Ali-Induced Liver Injury: A Case Report." Cureus. 2024. PMID: 38646387
- Ang HH, et al. "Determination of mercury by cold vapor atomic absorption spectrophotometer in Tongkat Ali preparations obtained in Malaysia." Int J Toxicol. 2004. PMID: 15162849
- Ang HH, Lee KL. "Contamination of mercury in tongkat Ali hitam herbal preparations." Food Chem Toxicol. 2006. PMID: 16567029
- Balasubramanian A, et al. "Testosterone Imposters: An Analysis of Popular Online Testosterone Boosting Supplements." J Sex Med. 2019. PMID: 30770069
- Muniandy S, et al. "Effect of Eurycoma longifolia water extract (Physta) on menopausal quality of life and mood states." World J Clin Cases. 2025. PMID: 41283187
- NIH Office of Dietary Supplements. Dietary Supplement Label Database. dsld.od.nih.gov (tongkat ali labels retrieved 2026-09-16).