Tribulus (Tribulus terrestris)

Traditional Indications

Tribulus is an alterative, anthelmintic, aphrodisiac, carminative, demulcent, diuretic,fertility aid, galactagogue and pectoral. Tribulus stimulates blood circulation and it is traditionally indicated to treat impotency in males, nocturnal emissions, gonorrhoea and incontinence of urine. It has also proved effective in treating painful urination, gout and kidney disease. (1)

Tribulus is a well known aphrodisiac and male tonic. In Traditional Chinese Medicine Tribulus is called Bai Ji Li 白蒺藜. Bai Ji Li is warming, pungent, and bitter, and enters the Kidney and Liver channels to calms floating Liver Yang, clear Wind-Heat (particularly from the eyes), moves Liver Qi, and relieve itching (specific for desquamation of palms and soles). Bai Ji Li is a specific if low sperm counts are due to stress (Qi stagnation) and low testosterone levels. Men with low testosterone levels may benefit from the use of Tribulus. (2)

Pharmacognosy

Tribulus terrestris is an herbal nutritional supplement that is promoted to produce large gains in strength and lean muscle mass in 5-28 days .This study found T. terrestris did not alter the urinary T/E ratio and would not place an athlete at risk of testing positive based on the World Anti-Doping Agency's urinary T/E ratio limit of 4:1. (3)

Studies in rats show that it can produce statistically significant increases in levels of testosterone, dihydrotestosterone and dehydroepiandrosterone. (4)

Numerous bioactive phytochemicals, such as saponins and flavonoids, have been isolated and identified from Tribulus terrestris. (5)

A pilot study on the effect of Tribulus terrestris on serum testosterone level and erectile function in aging males with partial androgen deficiency (PADAM) was conducted. Results showed a statistically significant difference in the level of testosterone (total and free) and Index of Erectile Function-5 (IIEF-5). (6)

A prospective, randomised, double-blind, placebo-controlled clinical trial evaluating the efficacy and safety of Tribulus terrestris in male sexual dysfunction found that following the 12-week treatment period, significant improvement in sexual function was observed with TT compared with placebo in men with mild to moderate ED. TT was generally well tolerated for the treatment of ED. (7)

Evidence to date suggests that Tribulus terrestris is ineffective for increasing testosterone levels in humans however the nitric oxide release effect of Tribulus terrestris may offer a plausible explanation for the observed physiological responses to Tribulus terrestris supplementation, independent of the testosterone level. (8)

1. PFAF. Tribulus terrestris. 2019.
2. Lotus S. Bai Ji Li (Caltrop Fruit, Tribulus) 2019.
3. Rogerson S, Riches CJ, Jennings C, Weatherby RP, Meir RA, Marshall-Gradisnik SM. The effect of five weeks of Tribulus terrestris supplementation on muscle strength and body composition during preseason training in elite rugby league players. Journal of strength and conditioning research. 2007;21(2):348-53.
4. Gauthaman K, Ganesan AP. The hormonal effects of Tribulus terrestris and its role in the management of male erectile dysfunction – an evaluation using primates, rabbit and rat. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2008;15(1):44-54.
5. Zhu W, Du Y, Meng H, Dong Y, Li L. A review of traditional pharmacological uses, phytochemistry, and pharmacological activities of Tribulus terrestris. Chemistry Central journal. 2017;11(1):60-.
6. Roaiah MF, El Khayat YI, GamalEl Din SF, Abd El Salam MA. Pilot Study on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Erectile Function in Aging Males With Partial Androgen Deficiency (PADAM). Journal of sex & marital therapy. 2016;42(4):297-301.
7. Kamenov Z, Fileva S, Kalinov K, Jannini EA. Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction—A prospective, randomized, double-blind, placebo-controlled clinical trial. Maturitas. 2017;99:20-6.
8. Qureshi A, Naughton DP, Petroczi A. A Systematic Review on the Herbal Extract Tribulus terrestris and the Roots of its Putative Aphrodisiac and Performance Enhancing Effect. Journal of Dietary Supplements. 2014;11(1):64-79.