Eurycoma longifolia, commonly known locally as Tongkat Ali, is considered the most popular medicinal plant in Malaysia.¹ It is a slow-growing, slender evergreen plant reaching 15 to 18 metres in height, with few upright branches capped by umbrella-like rosette of leaves.^2-4 As it is a protected plant, harvesting is highly restricted.²

In the common name, tongkat translates as cane or staff, and so generally means 'walking stick', due to the long twisted roots.^5,6 The qualifier, ali, may indicate the effectiveness: Ali, the Prophet Muhammad's cousin, carries a connotation of effectiveness and strength. The common name may also suggest its utility: the cane supports failing strength, possibly a reference to supporting erectile strength.⁶

In Malaysia, the consumption of Tongkat Ali is popular, and it is incorporated into food and beverages. It was first added into coffee in the late 1990s and has continued to be a popular drink.^7,8 As of 2005 there were nearly 200 such products available in Malaysia.⁹

Tongkat Ali has documented traditional use in Malaysia, Thailand and Indonesia:^10-19

• particularly as a male aphrodisiac
• a general tonic, including during illness
• to enhance stamina or relieve fatigue after exertion
• for fevers, stomach-ache, respiratory conditions such as sore throat and tonsillitis
• as an anthelmintic
• as an antiaging herb
• topically for wounds and ulcers

Tongkat Ali root contains bitter-tasting quassinoids. Good quality liquid extracts should taste distinctly bitter due to the presence of these constituents.^20,21

The major traditional actions have been highlighted in the results of some clinical studies.

• Pooling of the results of two controlled trials found a significant increase in total testosterone levels in men with hypogonadism after Tongkat Ali supplementation for 3 to 6 months).²²
• Androgen-deficient men treated with Tongkat Ali experienced significant improvement in sexual satisfaction at four months (by 96% from baseline), and orgasmic function at one month (by 63%). Better results were obtained when the herb was combined with exercise.²³
• Treatment with Tongkat Ali for three weeks improved quality of life with regard to physical, sexual and psychological well being, in 30 healthy men aged between 31 and 52 years.²⁴
• A randomised, double-blind trial observed significant reductions in fatigue in men throughout 12 weeks for those taking Tongkat Ali, compared to placebo. One hundred and five men, approximately 57 years old completed the study. A significant increase in muscle strength was also observed.²⁵

Tongkat Ali is a well-known Malaysian herb, with a strong history of traditional use as a male aphrodisiac and general tonic. Clinical trials further highlight its use as part of a naturopathic formulation to support men as they age and for those with reduced libido, sexual dysfunction, low testosterone levels and/or fatigue.

References

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² Bhat R, Karim AA. Tongkat ali (Eurycoma longifolia Jack): a review on its ethnobotany and pharmacological importance. Fitoterapia. 2010 Oct 1;81(7):669-79.

³ Brinckmann J, Brendler T. Tongkat ali: Eurycoma longifolia. HerbalGram. 2019;122:6-16.

⁴ Wizneh FM, Asmawi MZ. Eurycoma longifolia Jack (Simarubaceae); advances in its medicinal potentials. Phcog J. 2014;6(4):1-9.

⁵ Li CH, Liao JW, Liao PL, Huang WK, Tse LS, Lin 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;2013:102987. DOI: 10.1155/2013/102987.

⁶ Roseberg V. Brunei Malay traditional medicine: persistence in the face of western medicine and Islamic orthodoxy. PhD [thesis]. University of Western Australia; 2017.

⁷ Ahmad N, Samiulla DS, Teh BP, Zainol M, Zolkifli NA, Muhammad A, et al. Bioavailability of eurycomanone in its pure form and in a standardised Eurycoma longifolia water extract. Pharmaceutics. 2018 Jul 11;10(3):90. DOI: 10.3390/pharmaceutics10030090.

⁸ Chelliah S, Kwon CK, Annamalah S, Munusamy J. Does marketing mix still relevant? A study on herbal coffee in Malaysia. Int J Manag Innov. 2013;5(1):31-45.

⁹ Cyranoski D. Malaysian researchers bet big on home-grown Viagra. Nat Med. 2005 Sep 1;11(9):912.

¹⁰ Ong HC, Nordiana M. Malay ethno-medico botany in Machang, Kelantan, Malaysia. Fitoterapia. 1999 Oct 1;70(5):502-13.

¹¹ Lin KW. Ethnobotanical study of medicinal plants used by the Jah Hut peoples in Malaysia. Indian J Med Sci. 2005 Apr;59(4):156-61.

¹² de Padua LS, Bunyapraphatsara N, Lemmen RHMJ, editors. Plant resources of south-east asia. No. 12(1), medicinal and poisonous plants 1. Leiden: Backhuys Publishers; 1999.

¹³ Gimlette JD, Burkill IH. The medical book of Malayan medicine. Gard Bull Straits Settlem. 1930;6:323-474.

¹⁴ Silalahi M, Nisyawati. Ethnobotany of pasak bumi (Eurycoma longifolia) on batak ethnic, north sumatera. Pros Sem Nas Masy Biodiv Indon 2015 Jul 4;1(4):743-46.

¹⁵ Silalahi M. Relationships for the utilization of pasak bumi plants (Eurycoma longifolia Jack.) as a

traditional medicine and its bioactivity. EHI 2020;1(2):36-43.

¹⁶ Wardah, Setiawan M. An ethnobotanical study of tongkat ali (Eurycoma longifolia Jack) on Malay ethnic group in Tanjung Balai, Karimun, Riau Islands. J Trop Ethnobiol. 2021 Jun 26;4(1):58-65. no initial on first author on article

¹⁷ Burkill IH, Haniff M. Malay village mediicine. Gard Bull Straits Settlem. 1930;6:167-321.

¹⁸ Farnsworth NR, Bunyapraphatsara N, editors. Thai medicinal plants. Medicinal Plant Information Center: Bangkok; 1992.

¹⁹ Tambi MI. Standardized water soluble extract of Eurycoma longifolia (LJ100) on men’s health. Int J Androl. 2005 Jun 1;28(Suppl 1):27.

²⁰ Rehman SU, Choe K, Yoo HH. Review on a traditional herbal medicine, Eurycoma longifolia Jack (tongkat ali): its traditional uses, chemistry, evidence-based pharmacology and toxicology. Molecules. 2016 Mar 10;21(3):331. DOI: 10.3390/molecules21030331.

²¹ Talbott SM, Talbott JA, George A, Pugh M. Effect of tongkat ali on stress hormones and psychological mood state in moderately stressed subjects. J Int Soc Sports Nutr. 2013 May 26;10(1):28. doi: 10.1186/1550-2783-10-28.

²² Leisegang K, Finelli R, Sikka SC, Panner Selvam MK. Eurycoma longifolia (Jack) improves serum total testosterone in men: a systematic review and meta-analysis of clinical trials. Medicina (Kaunas). 2022 Aug

4;58(8):1047. DOI: 10.3390/medicina58081047.

²³ Leitão AE, Vieira MCS, Pelegrini A, da Silva EL, Guimarães ACA. 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 Mar;145:78-85. DOI: 10.1016/j.maturitas.2020.12.002.

²⁴ Tambi MI, Saad JM. Water-soluble extract of Eurycoma longifolia Jack soluble extract as a potential natural energizer for healthy aging men. First Asian Andrology Forum, Asian Society of Sexology Conference. 2002 Dec; Singapore.

²⁵ Chinnappan SM, George A, Pandey P, Narke G, Choudhary YK. 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 May 19;65:5647. DOI: 10.29219/fnr.v65.5647.