Tribulus
Reviews found no clear testosterone rise from tribulus alone. In a 2026 meta-analysis of 8 trials in men with erectile dysfunction, IIEF-5 scores rose 3.23 points more than placebo, though a 2025 review rated the evidence low. Case reports describe kidney and liver injury and a 72-hour priapism needing surgery.
Add to Bio HackChecked 2026-11-09
- Status
- Dietary supplement in the US.
- Also called
- Tribulus terrestris, puncture vine, goathead, caltrop, gokshura, Tribestan, protodioscin, furostanol saponins
- Taken for
- testosterone, libido, erectile function, muscle, strength, athletic performance, male fertility
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help1
Reported risks3
- LimitedCase reports: three men developed serious liver or kidney injury after taking tribulus. Case reports cannot give a rate or prove cause.How often is not known
- LimitedCase reports: one man had a 72-hour erection after a tribulus-based supplement, needing surgery, with impaired sexual function afterward.How often is not known
- LimitedLimited evidence: a review noted one tribulus supplement contaminated with a banned steroid in an anti-doping case. No product-testing study was found.How often is not known
What people take it for, and what was found
Shown to help1
Sperm quality
Shown to improve some sperm measures in infertile men in 6 of 7 studies, though results were not pooled and some studies had no control group.
The numbers and sources
- Effect
- A systematic review found 7 studies of tribulus in men with idiopathic infertility. Six reported improvement in some or all of sperm count, motility and morphology, and one uncontrolled study found no effect [10].
- Population
- Infertile men in clinical trials and quasi-experimental studies [10].
- Sources
- [10]
- Caveats
- The review did not pool results, and some included studies had no control arm [10].
Mixed results1
Erectile function
Mixed results: a meta-analysis found erectile function scores about 3 points higher than placebo in men with erectile dysfunction, while one small trial found no change.
The numbers and sources
- Effect
- A meta-analysis of 8 studies found tribulus raised IIEF-5 by 3.23 points (95% CI 1.89 to 4.58) and IIEF-15 by 14.44 points (95% CI 5.75 to 23.14) more than placebo [6]. A systematic review found improvement in 3 of the 5 studies that measured erectile function, at 400 to 750 mg a day for 1 to 3 months, and rated the evidence low [7]. In 180 men with mild or moderate erectile dysfunction, Tribestan at six 250 mg tablets a day for 12 weeks raised the IIEF score 2.70 points more than placebo (95% CI 1.40 to 4.01), with gains in intercourse satisfaction, orgasmic function, sexual desire and overall satisfaction [8]. In 30 men aged 40 or older, 800 mg a day for 30 days did not change IIEF-5 compared with placebo (p = 0.79) [3].
- Population
- Men with erectile dysfunction in RCTs [6][7]; men aged 18 to 65 in Bulgaria [8]; 30 men in Brazil [3].
- Sources
- [6], [7], [3], [8]
- Caveats
- Single trials disagree [3][8]. Half the studies in the 2025 review had low methodological quality by Jadad score [7]. The larger trial tested a branded extract made by Sopharma AD, and its funding is not stated in the abstract [8]. Doses and durations differed.
Not shown to help2
Testosterone
Not shown to raise testosterone in men when taken alone. Rises appeared only in combined supplements or in a few studies of men with hypogonadism.
The numbers and sources
- Effect
- A systematic review of 11 studies found that testosterone rose in humans only when tribulus was part of a combined supplement, and that trials varied too much to pool [1]. In 21 men aged 20 to 36, 10 or 20 mg/kg a day for 4 weeks did not change testosterone, androstenedione or LH compared with placebo [2]. In 30 men with erectile dysfunction, 800 mg a day for 30 days did not change total testosterone (417 to 409 ng/dL, against 443 to 466 ng/dL with placebo) [3]. A review of 7 studies in physically active men found no clear effect on hormones [4]. In 30 CrossFit-trained men, testosterone fell 21.9% with placebo and was unchanged (-0.2%) with 770 mg a day over 6 weeks [5]. A 2026 meta-analysis of 8 RCTs in men with erectile dysfunction found total testosterone did not differ from placebo [6]. A 2025 systematic review of 10 studies (483 men) found that 8 reported no significant change in androgens. The 2 that found rises, of 60 to 70 ng/dL within groups, were in men with hypogonadism [7].
- Population
- Healthy and athletic men in RCTs [1][4]; young men in Bulgaria [2]; men with erectile dysfunction in Brazil [3]; CrossFit athletes in Spain [5]; men with erectile dysfunction in RCTs [6]; men aged 16 to 70, healthy or with infertility, erectile dysfunction or hypogonadism [7].
- Sources
- [1], [2], [3], [4], [5], [6], [7]
- Caveats
- Small trials of 21 to 30 men. The CrossFit trial was single-blind [5].
Strength and sport performance
Not shown to improve strength, body composition or sport performance in active men. One small trial found a larger bench press gain.
The numbers and sources
- Effect
- In 30 CrossFit-trained men over 6 weeks, body composition and four of five workout tests did not differ from placebo. Bench press rose 19.2% with tribulus against 8.5% with placebo [5]. A systematic review of 7 studies in physically active men found no clear benefit on muscle damage markers or hormones, some lipid improvements and no reported toxicity [4]. A review of athlete use found that tribulus alone did not improve androgen status or physical performance [9].
- Population
- Physically active men [4][5][9].
- Sources
- [4], [5], [9]
- Caveats
- Few and small trials.
Doses studied
A review reported doses of 400 to 750 mg a day for 1 to 3 months in erectile dysfunction studies [7]. Trials used 10 or 20 mg/kg a day for 4 weeks [2], 800 mg a day in two doses for 30 days [3], 770 mg a day for 6 weeks [5], and six 250 mg tablets of Tribestan a day, standardized to at least 112.5 mg of furostanol saponins each, for 12 weeks [8].
Risks
Reported risks3
Kidney and liver injury
Case reports: three men developed serious liver or kidney injury after taking tribulus. Case reports cannot give a rate or prove cause.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- A young man drinking a tribulus water preparation for 2 days to prevent kidney stones developed seizure, very high aminotransferases and raised creatinine, which normalized after stopping [11]. A young healthy man developed severe hyperbilirubinemia followed by acute kidney failure with bile casts in the kidney tubules [12]. A 46-year-old man taking tribulus daily for 2 months had bilirubin peak at 48 mg/dL and creatinine at 7.1, with a liver biopsy consistent with drug-induced injury. He was treated with plasmapheresis and recovered [13].
- Population
- Three case reports [11][12][13].
- Sources
- [11], [12], [13]
- Caveats
- Case reports cannot give a rate or prove cause.
Priapism
Case reports: one man had a 72-hour erection after a tribulus-based supplement, needing surgery, with impaired sexual function afterward.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- A 36-year-old man developed a 72-hour priapism after a tribulus-based herbal supplement. He needed a cavernoglandular shunt, and sexual function afterward was impaired [14].
- Population
- One case report [14].
- Sources
- [14]
- Caveats
- A single case.
Contamination
Limited evidence: a review noted one tribulus supplement contaminated with a banned steroid in an anti-doping case. No product-testing study was found.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- A review of tribulus supplements used by athletes noted one anti-doping incident involving a tribulus supplement contaminated with a banned steroid, and one accidental poisoning of a man [9].
- Population
- Review of published reports [9].
- Sources
- [9]
- Caveats
- No product-testing study of tribulus supplements was located.
Checked, no increase found1
Side effects in trials
Small trials found adverse events about as common as on placebo over 12 weeks or less.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- In the 180-man trial, adverse events did not differ from placebo and no serious events were related to the extract [8]. A review of trials in active men reported no toxicity [4]. In the 8-study meta-analysis, adverse events did not differ from placebo [6].
- Population
- RCT participants [4][8][6].
- Sources
- [4], [8], [6]
- Caveats
- Trials ran 12 weeks or less.
Claims tested and not found
- That tribulus alone raises testosterone. Testosterone, androstenedione and LH did not differ from placebo in young men [2], and total testosterone did not change in men with erectile dysfunction [3].
- That tribulus improves athletic performance. Body composition and most CrossFit tests did not differ from placebo [5], and reviews found no performance gain from tribulus alone [9].
Sources
- 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. https://doi.org/10.3109/19390211.2014.887602
- Neychev V, Mitev V. The aphrodisiac herb Tribulus terrestris does not influence the androgen production in young men. Journal of Ethnopharmacology. 2005. https://doi.org/10.1016/j.jep.2005.05.017
- Santos C, Reis L, Destro-Saade R, et al. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study. Actas Urológicas Españolas. 2014. https://doi.org/10.1016/j.acuro.2013.09.014
- Fernández-Lázaro D, Fernandez-Lazaro C, Seco-Calvo J, et al. Effects of Tribulus terrestris L. on Sport and Health Biomarkers in Physically Active Adult Males: A Systematic Review. International Journal of Environmental Research and Public Health. 2022. https://doi.org/10.3390/ijerph19159533
- Fernández-Lázaro D, Mielgo-Ayuso J, del Valle Soto M, et al. The Effects of 6 Weeks of Tribulus terrestris L. Supplementation on Body Composition, Hormonal Response, Perceived Exertion, and CrossFit Performance: A Randomized, Single-Blind, Placebo-Controlled Study. Nutrients. 2021. https://doi.org/10.3390/nu13113969
- Suharyani S, Amanda B, Angellee J, et al. Tribulus terrestris for management of patients with erectile dysfunction: a systematic review and meta-analysis of randomized trials. International Journal of Impotence Research. 2026. https://doi.org/10.1038/s41443-025-01086-7
- Vilar Neto JO, de Moraes WMAM, Pinto DV, et al. Effects of Tribulus (Tribulus terrestris L.) Supplementation on Erectile Dysfunction and Testosterone Levels in Men: A Systematic Review of Clinical Trials. Nutrients. 2025. https://doi.org/10.3390/nu17071275
- Kamenov Z, Fileva S, Kalinov K, et al. Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction. A prospective, randomized, double-blind, placebo-controlled clinical trial. Maturitas. 2017. https://doi.org/10.1016/j.maturitas.2017.01.011
- Pokrywka A, Obmiński Z, Malczewska-Lenczowska J, et al. Insights into Supplements with Tribulus Terrestris used by Athletes. Journal of Human Kinetics. 2014. https://doi.org/10.2478/hukin-2014-0037
- Sanagoo S, Sadeghzadeh Oskouei B, Gassab Abdollahi N, et al. Effect of Tribulus terrestris L. on sperm parameters in men with idiopathic infertility: A systematic review. Complementary Therapies in Medicine. 2019. https://doi.org/10.1016/j.ctim.2018.09.015
- Talasaz AH, Abbasi MR, Abkhiz S, et al. Tribulus terrestris-induced severe nephrotoxicity in a young healthy male. Nephrology Dialysis Transplantation. 2010. https://doi.org/10.1093/ndt/gfq457
- Ryan M, Lazar I, Nadasdy GM, et al. Acute kidney injury and hyperbilirubinemia in a young male after ingestion of Tribulus terrestris. Clinical Nephrology. 2015. https://doi.org/10.5414/cn108324
- Mohy-ud-din N, Jonassaint N. Severe Liver and Renal Injury From Tribulus Terrestris. ACG Case Reports Journal. 2024. https://doi.org/10.14309/crj.0000000000001267
- Campanelli M, De Thomasis R, Tenaglia RL. Priapism caused by 'Tribulus terrestris'. International Journal of Impotence Research. 2016. https://doi.org/10.1038/ijir.2015.30