Tribulus terrestris, known colloquially as "puncture vine," has a long history of use in Ayurvedic and traditional Chinese medicine for conditions ranging from sexual dysfunction to edema and cardiovascular diseases. In recent decades, Tribulus Terrestris Extract have grown increasingly popular as performance and vitality enhancers. But what does the science actually say about the potential benefits and safety of tribulus supplements?
Active Compounds
The main active compounds found in tribulus extracts are steroidal saponins, particularly protodioscin and prototribestin. Protodioscin has been reported in quantities around 45-60% in aerial plant parts [1]. Some limited research suggests these compounds may influence hormone levels or impact nitric oxide production [2], which plays various roles in biological functions. However, high-quality evidence and mechanistic understanding are still emerging.
Other compounds identified in tribulus extracts include flavonoids like kaempferol, flavonol glycosides, phytosterols, and lignanamides which may also contribute minor bioactivities [1]. But most efficacy claims focus on the steroidal saponins.
Proposed Mechanisms of Action
Through its protodioscin content, tribulus is often touted as a testosterone booster. However, despite this reputation, there is little evidence that tribulus actually increases testosterone levels consistently in humans [3].
A few theories have been proposed for how tribulus may act instead:
- Increasing luteinizing hormone - This pituitary hormone stimulates natural testosterone production. A small study in primates and some rodent research suggests protodioscin may increase luteinizing hormone levels [4]. But human data is lacking.
- Increasing DHEA precursor hormones - Some research shows tribulus may elevate levels of DHEA precursor steroids. When metabolized, DHEA can convert into testosterone [5]. But this route is likely minor and indirect.
- Increasing nitric oxide - By relaxing smooth muscle tissue, nitric oxide can improve blood flow and circulation, which some speculate may enhance athletic performance, strength, sexual function, and vigor indirectly. A few studies have shown compounds in tribulus, like protodioscin, may increase nitric oxide production by boosting Nitric Oxide Synthase activation [6][7]. But data connecting this effect to meaningful benefits is limited.
So in summary, tribulus likely acts through secondary hormonal pathways and vascular dynamics rather than directly boosting testosterone. But considerable research is still needed to clarify mechanisms.
Potential Benefits and Claims
Some proponents claim tribulus provides benefits like improved athletic performance, sexual function, immune health, heart and circulatory function, reduced blood glucose and cholesterol, decreased inflammation, and more. A few specific claims about tribulus benefits include:
- Building muscle mass and strength due to influences on testosterone
- Enhancing sports performance, endurance and recovery
- Boosting libido and addressing erectile dysfunction
- Supporting reproductive health and fertility
- Promoting prostate health
- Improving cardiovascular circulation
- Reducing inflammation
- Balancing blood sugar
- Protecting the liver and kidneys
While a few lower-quality studies show hints of benefits in some of these areas, high-quality evidence is still very limited. Much more research is needed to substantiate popular marketing claims or traditional medicine uses for tribulus extracts.
1 Muscle Building & Athletic Performance
A few small studies hint that tribulus may enhance athletic performance and strength indirectly by increasing testosterone. However, multiple recent systematic reviews agree that current evidence is preliminary and inconclusive [3][8]. Larger, higher-quality blinded and controlled studies are still needed.
A recent 2021 meta-analysis combining data from 7 studies with 317 participants concluded there is "a potential effect of tribulus terrestris supplementation on improving body composition and muscle strength among healthy subjects undergoing strength training” [9]. However, the review highlighted poor study quality and high risk of bias. It called for longer interventions with larger sample sizes to substantiate claims.
Notably, the purported benefits may also not apply to those with normal hormone levels at baseline. Healthy young men with robust testosterone production are unlikely to experience benefits. But older men or those with existing muscle loss or hormone deficiencies could theoretically derive more benefit. Still, confirmation through rigorous, reproducible research is lacking.
Any athletes considering supplements should consult accredited resources on safety, efficacy legality, and ethics within their sport before using tribulus.
2 Sexual Function
Traditionally, tribulus has been taken to stimulate libido and enhance sexual performance in both men and women. A few studies suggest benefits like improved erections, satisfaction, or desire in those with preexisting dysfunction [10][11]. However, the evidence is still very limited. Most studies are small and lack placebo controls.
Systematic reviews agree larger, more rigorous studies are needed before strong conclusions can be made for sexual enhancement claims, and the existing research may be subject to publication bias [3]. As with athletic uses, benefits may not apply to those without preexisting sexual dysfunction.
In particular, some traditional medicine systems have used tribulus to support female reproductive health and fertility. But modern clinical evidence for such benefits is essentially nonexistent. Anecdotal reports also suggest high doses could unpredictably alter menstrual cycles in some women [12]. So conservative dosing practices would be advisable until more safety data emerges, especially for female hormonal health.
3 Cardiovascular & Immune Health
Some proponents claim tribulus can benefit cardiovascular circulation and immune function. Preliminary cellular and animal research shows isolated compounds like protodioscin may relax blood vessels, act as an antioxidant, or influence certain inflammatory signaling pathways [13][14]. But direct human evidence for cardiovascular or immune benefits is still severely limited.
Safety & Appropriate Use
Small studies generally suggest tribulus is well-tolerated by healthy adults in appropriate therapeutic dosages up to about 1000 mg/day. Reported side effects are mild, like upset stomach. However, most studies last no more than a month or two. Long-term safety remains unclear. And due to insufficient safety data, doses higher than standard therapeutic ranges could pose unpredictable risks.
Those on any medications or with existing health conditions should consult a medical professional before considering tribulus terrestris extracts for hormonal effects due to risk of interactions. Particular caution is warranted for fertility treatments, hormone-sensitive cancers, cardiovascular medications, diabetes drugs, immunosuppressants, sedatives, and mood stabilizers, among others [15]. Pediatric use is also not recommended due to lack of safety data.
For healthy consumers, many authorities recommend periodic cycling rather than continuous dosing. Tribulus supplements likely should not be viewed as everyday vitality products without better long-term safety evidence at higher intakes. Traditional medicinal systems tend to use tribulus temporarily as an adaptogenic herb to restore balance; uninterrupted high doses could have unintended effects on complex hormonal pathways.
Onset & Duration
In the few existing human studies demonstrating quantitative outcomes, apparent benefits from tribulus supplementation have taken around 4-12 weeks to manifest. This slow onset makes effects more difficult to study rigorously compared to faster-acting categories like stimulants or sedatives. If tribulus does gradually enhance testosterone production, nitric oxide availability, or sensitivities to these pathways, such buildups influencing behavior over weeks or months could theoretically explain delayed effects. However, much more controlled replication is needed before making assumptions.
Dosage Considerations
Doses used in most existing tribulus terrestris extract studies range from about 200-1000 mg/day of a 40-60% saponin extract. However, optimal doses have not been well-established. Traditional preparations use doses of 1000-1500mg [1], but modern supplements should likely adhere to lower standardized doses until more safety data emerges, especially for females. Finally, the wide variability of available tribulus products should be considered; saponin content and bioactive profiles can differ drastically between manufacturers [1].
Conclusion
While some traditional medicinal systems and preliminary modern research reports suggest tribulus may offer benefits in select applications, current clinical evidence remains scant. Much more research on safety and efficacy is still needed before informed recommendations can be made. Systematic reviews agree larger, longer, higher-quality placebo-controlled and blinded human studies are necessary to reduce bias and establish true efficacy. Mechanistic confirmation is also largely lacking. As with many herbal supplements, skepticism is warranted alongside open-minded interest. But in coming years, emerging high-quality studies could eventually clarify if tribulus lives up to any of its traditional renown.
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References:
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