Tongkat Ali Side Effects Australia: Safety Guide 2026

Last updated: November 1, 2026 · Originally published: June 11, 2026 · By Eternal Elixir Editorial

Does tongkat ali cause hair loss? No human trial of tongkat ali that we found has reported hair loss as a side effect. The worry is theoretical: tongkat ali can raise testosterone, and pattern hair loss depends on androgens acting on hair follicles that are genetically prone to it. If baldness runs in your family, that is worth a conversation with your GP before you start.

The other tongkat ali side effects on record are mild. In controlled trials of standardised root extract, the complaints were short bouts of gut upset and some early tiredness, and blood, liver and kidney tests stayed stable over 4 to 12 weeks. The real risks sit elsewhere: poorly made products contaminated with mercury, one reported case of liver injury, and a documented effect on a blood pressure medicine.

This guide goes through each of those with the study behind it. For benefits, dosage and buying advice, see our tongkat ali guide for Australians.

Eternal Elixir makes Tongkat Ali 200:1 Extract 2000mg, and it is our pick for Australians who have checked the safety points below. Each batch is tested by third-party laboratories for contaminants, including heavy metals.

What Are the Side Effects of Tongkat Ali?

Tongkat ali (Eurycoma longifolia) is a shrub from South-East Asia, and supplements use a water extract of its root. People take it mainly for testosterone, energy and stress. A 2022 meta-analysis in Medicina reviewed nine clinical studies, pooled five randomised trials, and found that men taking tongkat ali had significantly higher total testosterone than controls.

That hormonal effect is why people ask about side effects. Across the controlled trials in the next section, the recorded problems were:

• Gut upset. Mild digestive symptoms that lasted three to five days and cleared up on their own.
• Early tiredness. In a four-week trial, two people on tongkat ali and one on placebo felt unusually tired in the first two weeks.
• Nothing measurable in the lab. No sustained changes in blood counts, liver or kidney tests compared with placebo, and no change in blood pressure or pulse.

Two cautions come with that clean record. The trials were small and short, with the longest at 12 weeks. And three of the four tested one branded extract, Physta, with funding from its maker, Biotropics Malaysia. Many products on Australian shelves use different extracts.

Common Tongkat Ali Side Effects and How Often They Happen

Here is what each controlled human trial recorded, with the dose and how long people took it.

The Ismail trial is the most useful for safety because it listed every event. Among the men on tongkat ali, the events included colds, ankle pain and Achilles tendon pain, and the investigators judged every one unlikely to be caused by the extract. The only event rated “probable” was a headache in the placebo group.

What the table does not show matters too. None of these trials listed sleep problems, restlessness or hair loss as a side effect. Reports of those effects do circulate online, but no controlled trial we found has measured them.

If you are comparing brands on extract type and price, our tongkat ali supplement comparison sets them side by side, and our guide to tongkat ali at Chemist Warehouse covers what the pharmacy chains stock.

Add Tongkat Ali 2000mg to cart · $39.99

Does Tongkat Ali Cause Hair Loss?

This is the question most people bring to this page, so here is the evidence in order.

What the trials show. None of the controlled trials in the table reported hair loss. That is reassuring, but it is not proof, because none of them was designed to measure hair and the longest lasted 12 weeks. Pattern hair loss develops over months and years.

Why the worry exists. A review in Endocrine describes pattern hair loss as the result of androgens acting on hair follicles that are genetically susceptible, in the androgen-sensitive areas of the scalp. Testosterone is an androgen, and tongkat ali can raise it. So the chain of reasoning is plausible for people with that genetic tendency.

What has not been measured. We found no tongkat ali trial that measured dihydrotestosterone (DHT). The 12-week Chinnappan trial measured total and free testosterone, SHBG and DHEA, and found no significant change in SHBG. So nobody can say from trial data how much, if at all, tongkat ali shifts DHT.

Women. In Henkel’s pilot study, both total and free testosterone rose in the 12 women as well as the men, and the rise in free testosterone in women came with a fall in SHBG. If you are a woman with hair thinning, or a hormone condition your doctor is managing, talk to your doctor first. Our guide to tongkat ali for women covers this in more detail.

Who should be careful about hair

• Men with a strong family history of pattern baldness.
• Anyone already taking a prescription hair-loss medicine. Ask your GP before combining them.
• Women with thinning hair or a hormone condition under medical care.

If you notice more hair in the shower after starting tongkat ali, stop taking it and see your GP. Shedding has many common causes, and a GP can check for them. Photos of your hairline taken in the same light every month make any change easier to judge.

Is Tongkat Ali Safe? What the Research Shows

For healthy adults taking a standardised extract for up to 12 weeks, the trial data is reassuring. In the 105-man Chinnappan trial there were no significant and sustained changes against placebo in blood, liver or kidney tests, and blood pressure and pulse held steady. In the Talbott trial, liver enzymes did not change over four weeks. In the Ismail trial, all safety measures were comparable to placebo.

What we still lack is data beyond three months, trials large enough to catch rare reactions, and trials not paid for by the extract’s maker. Three things outside the trials are worth knowing.

Liver safety

In 2024, doctors in New York published the first case report of liver injury linked to tongkat ali. A 47-year-old man developed yellowing of the eyes and skin and raised liver enzymes shortly after starting it, needed a hospital stay, and improved after he stopped. The authors stressed how hard supplement-related liver injury is to diagnose, and urged extra care with people taking several supplements.

One case among many users is rare. It still sets the rule: stop tongkat ali and see a doctor promptly if you notice yellowing of your eyes or skin. If you have a diagnosed liver condition, talk to your doctor before you start.

Contamination and heavy metals

Some of the worst problems with tongkat ali have come from the product rather than the plant. Researchers at Universiti Sains Malaysia tested 100 tongkat ali products sold in Malaysia and found that 36% held mercury above the 0.5 ppm quality limit used for traditional medicines there, with the highest at 5.30 ppm. A second survey of 100 “tongkat ali hitam” products found 26% over the same limit. The authors warned that batch-to-batch variation means a product that passes once cannot be assumed safe.

That is the strongest reason to buy a tested product. Our product page states that every batch of our tongkat ali is tested by third-party laboratories for identity, potency, purity and contaminants, including heavy metals and microbes, and you can ask us for the certificate of analysis for your batch.

Medicine interactions

The one human interaction study we found tested tongkat ali with a common medicine. Fourteen healthy young men took 80mg of propranolol, a beta blocker used for blood pressure, with either a placebo or 200mg of tongkat ali water extract. With tongkat ali, the total amount of propranolol absorbed fell by 29% and the peak level by 42%, and it took longer to reach the blood. The medicine’s effects on the body did not change in these healthy volunteers, but the authors advised caution.

Few other interactions have been studied. If you take any regular prescription medicine, talk to your doctor or pharmacist before you add tongkat ali.

Who Should Avoid Tongkat Ali

Because tongkat ali acts on hormones, some people should skip it or get medical advice first:

• Pregnant or breastfeeding women. No trials exist, so avoid it.
• Anyone under 18. All the trials were in adults.
• People with a hormone-sensitive condition. If you have prostate cancer or any other hormone-sensitive diagnosis, do not take it unless your specialist agrees.
• People on prescription medicines. The propranolol study shows it can change how a medicine is absorbed, so check with your doctor or pharmacist.
• People with a diagnosed liver condition. Given the 2024 case report, ask your doctor first.
• Anyone prone to pattern hair loss or on hair-loss medicine. See the section above.

Some men pair tongkat ali with fadogia agrestis. If that is you, read our fadogia agrestis dosage guide first, and start one herb at a time so any reaction is easy to trace.

How to Minimise Tongkat Ali Side Effects

A few habits cover most of the avoidable risk.

1. Follow the label. Trials used 100mg to 400mg a day of standardised water extracts. Australian labels vary widely, and ours is three capsules, or 2,000mg of a 200:1 extract, a day on an empty stomach. Those are different extracts, so they cannot be compared milligram for milligram. If you would like to start lower, ask your doctor or pharmacist. Our tongkat ali dosage guide goes through the numbers.
2. Watch the first two weeks. The gut symptoms and tiredness in the trials appeared early and passed within days. If your stomach objects, ask a pharmacist before you change how you take it.
3. Take breaks if you plan long-term use. The longest trial ran 12 weeks and no trial has tested years of daily use. Many people take regular breaks for that reason, although no trial has compared cycling with continuous use. The tongkat ali Huberman protocol guide covers the common cycling patterns.
4. Buy a tested product. Mercury contamination is the best-documented hazard with this herb, so choose a brand that tests every batch for heavy metals.
5. Keep notes. Write down when you start, and anything that changes. It makes a GP visit far more useful if something goes wrong.

Our guide to how long tongkat ali takes to work sets out the timelines from the trials.

Eternal Elixir Tongkat Ali: Who It Suits and Who It Doesn’t

Eternal Elixir makes Tongkat Ali 200:1 Extract 2000mg, so read this section as our pick with the working shown. Prices are as of Sep 2026.

• What is in it: 2,000mg of 200:1 tongkat ali extract per three-capsule serve, with rice flour and a cellulose capsule.
• Bottle and cost: 90 capsules, 30 days, $39.99 (regular price $59.99), which works out to $1.33 a day. Three bottles at 15% off cost $101.97, or $1.13 a day, and ship free because the order is over $100.
• Testing: every batch tested by third-party laboratories for identity, potency, purity and contaminants, including heavy metals, with the batch certificate available on request.

Who it suits: adults who want tongkat ali from a local seller that tests each batch for heavy metals, and who have checked the medicine, liver and hair points above.

Who it doesn’t suit: anyone in the “avoid” list above, and anyone who wants the exact branded extract used in most trials. Our label does not state a eurycomanone percentage or name Physta, so if matching the trial extract matters most to you, look for a label that names it.

If you are still choosing between herbs, our comparisons of tongkat ali vs turkesterone and tongkat ali vs shilajit cover the trade-offs, and our roundup of natural testosterone support supplements puts it in wider context.

Tongkat Ali Side Effects: Frequently Asked Questions

Does tongkat ali cause hair loss?

No trial of tongkat ali that we found has reported hair loss, but none was designed to measure it and the longest ran 12 weeks. The concern is theoretical: tongkat ali can raise testosterone, and pattern hair loss depends on androgens acting on genetically prone follicles. If baldness runs in your family or you take a hair-loss medicine, ask your GP first, and stop if you notice extra shedding.

What are the side effects of tongkat ali?

In controlled trials, the recorded side effects were mild gut symptoms lasting a few days and some early tiredness, with no sustained changes in blood, liver or kidney tests. Outside the trials, there is one published case of liver injury and a documented effect on the absorption of propranolol. Contaminated products are the other risk, which is why batch testing for heavy metals matters.

Add Tongkat Ali 2000mg to cart · $39.99

What happens if you take tongkat ali every day?

Daily use is how it was tested. In trials of 4 to 12 weeks, daily standardised extract raised testosterone in several studies and caused few side effects. No trial has tested daily use for years, so many people take breaks, and anyone on regular medication should check with a doctor first.

Can testosterone cause hair loss?

In people who are genetically prone to it, yes. A review in Endocrine describes pattern hair loss as androgens acting on susceptible hair follicles in androgen-sensitive areas of the scalp. Whether the modest rise from tongkat ali is enough to matter has not been studied.

Which supplements cause hair thinning?

Selenium overdose is a well-documented example. In a 2008 US outbreak traced to a liquid supplement holding 200 times its labelled selenium, 72% of 201 affected people reported hair loss. The lesson carries over to any supplement: label accuracy and batch testing protect you from doses you never meant to take.

Can tongkat ali raise blood pressure or heart rate?

Not in the trial data we found. In the 12-week trial of 105 men, blood pressure and pulse did not change significantly at 100mg or 200mg a day. If you take blood pressure medicine, note that tongkat ali reduced the absorption of propranolol in one study, so talk to your doctor before you start.

Is tongkat ali hard on the liver?

Liver tests stayed stable in the controlled trials. One case of liver injury linked to tongkat ali was published in 2024, and the man improved after stopping. If you have a diagnosed liver condition, talk to your doctor first, and stop and seek care if you notice yellow eyes or skin.

How long do tongkat ali side effects last?

In the trials they were short. Gut symptoms lasted three to five days and cleared without treatment, and the tiredness reported in one trial appeared in the first two weeks. Anything that lasts longer, or any sign of liver trouble, means stopping and seeing a doctor.

Is tongkat ali available in Australia?

Yes. Australian retailers sell it as a supplement, and we ship ours from Sydney. Our roundup of supplements for men over 40 shows where it fits alongside other options, and adaptogens with a different profile are covered in our adaptogen supplement comparison.

The Bottom Line

Tongkat ali has a short, mostly clean safety record in controlled trials: brief gut upsets, some early tiredness and stable lab tests. Hair loss has not been reported, though no trial was built to catch it. The risks worth planning around are contaminated products, the rare liver reaction and interactions with medicines, so buy a batch-tested product and check with your doctor if any of the “avoid” groups apply to you.

More safety guides from our range: shilajit side effects, berberine side effects and hyaluronic acid side effects. For what the research shows on benefits, read tongkat ali benefits, or browse the full range.

Sources

1. 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;65. PubMed 34262417
2. Ismail SB, Wan Mohammad WM, George A, et al. Randomized clinical trial on the use of PHYSTA freeze-dried water extract of Eurycoma longifolia for the improvement of quality of life and sexual well-being in men. Evid Based Complement Alternat Med. 2012;2012:429268. PubMed 23243445
3. 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;10(1):28. PubMed 23705671
4. Henkel RR, Wang R, Bassett SH, et al. Tongkat Ali as a potential herbal supplement for physically active male and female seniors: a pilot study. Phytother Res. 2014;28(4):544-50. PubMed 23754792
5. 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. 2022;58(8):1047. PubMed 36013514
6. Lolli F, Pallotti F, Rossi A, et al. Androgenetic alopecia: a review. Endocrine. 2017;57(1):9-17. PubMed 28349362
7. Kaliounji A, Shadid G, Saba H, Ahlawat S. A rare case of tongkat ali-induced liver injury: a case report. Cureus. 2024;16(3):e56639. PubMed 38646387
8. Ang HH, Lee EL, Cheang HS. Determination of mercury by cold vapor atomic absorption spectrophotometer in Tongkat Ali preparations obtained in Malaysia. Int J Toxicol. 2004;23(1):65-71. PubMed 15162849
9. Ang HH, Lee KL. Contamination of mercury in tongkat Ali hitam herbal preparations. Food Chem Toxicol. 2006;44(8):1245-50. PubMed 16567029
10. Salman SA, Amrah S, Wahab MS, et al. Modification of propranolol’s bioavailability by Eurycoma longifolia water-based extract. J Clin Pharm Ther. 2010;35(6):691-6. PubMed 21054461
11. MacFarquhar JK, Broussard DL, Melstrom P, et al. Acute selenium toxicity associated with a dietary supplement. Arch Intern Med. 2010;170(3):256-61. PubMed 20142570
12. Eternal Elixir, Tongkat Ali 200:1 Extract 2000mg product page (label, directions, testing statement, multi-bottle pricing), read September 2026.