Tribulus Terrestris
Tribulus terrestris
A 'test booster' that mostly fails to raise testosterone.
Mixed evidence
⚡Performance
Evidence tier
Mixed
Research weight
Citations
16 verified / 16
Classification
Performance
❝
What the evidence says. Conflicting results across studies; benefit uncertain.
What is Tribulus Terrestris?
Tribulus Terrestris (Tribulus terrestris) is a performance supplement used for raises testosterone. NutriDex grades the human evidence as Mixed. Tribulus is one of the most popular 'testosterone boosters', but the evidence undercuts the marketing. A systematic review of men found low-quality evidence for erectile function and — importantly — most trials showed no rise in testosterone. Some studies in women report modest improvements in sexual function, but with very low certainty. It is widely sold yet poorly supported for its headline claim.
Purported Benefits
✓(Claimed) raises testosterone
✓Possible modest sexual-function effect (esp. women)
Dosing & Compounds
Typical Dose
Commonly 250–750 mg/day standardized extract; benefit for testosterone is unproven.
Active Compounds
Safety & Cautions
Usually well tolerated, but rare, serious liver and kidney injury (including a fatal acute-liver-failure case and reports of nephrotoxicity and rhabdomyolysis) has been attributed to Tribulus itself — not only to adulterated products. A proposed mechanism is steroidal sapogenins forming crystals in bile ducts/renal tubules. Best avoided in pregnancy; OTC product quality and contamination vary. Educational only — always check with your doctor or pharmacist before combining Tribulus Terrestris with any medicine.
Key Studies ★ 16 studies
meta-analysis
ED meta-analysis 2025 (Suharyani)
✓ PubMed
Meta-analysis of 8 randomized trials found Tribulus significantly improved IIEF-5 and IIEF-15 erectile-function scores versus placebo, but produced no significant change in total testosterone.
meta-analysis
Profertility meta-analysis 2023 (Andrologia)
✓ Full text
Meta-analyses pooling human and rodent data reported significant improvements in sperm concentration, motility and viability with Tribulus supplementation regardless of baseline fertility status.
Meta-analysis
Suharyani 2025
✓ Source
Meta-analysis of 8 RCTs found Tribulus improved erectile function (IIEF-5 MD 4.21, p<0.00001; IIEF-15 MD 15.88, p=0.0004) but showed no significant difference in total testosterone levels versus placebo.
Meta-analysis
Ho et al. 2025
✓ PubMed
Meta-analysis of 14 RCTs (1227 men) of herbal supplements for ED; pooled herbal supplements improved erectile function (SMD 1.20) and serum testosterone (SMD 0.54). Benefit was driven by ginseng and saffron, whereas evidence for other single agents was deemed insufficient, underscoring the lack of robust standalone Tribulus efficacy data.
Meta-analysis
Petre et al. 2023
✓ PubMed
Systematic review/meta-analysis of dietary supplements for ED found Panax ginseng, Tribulus terrestris and L-arginine among nutraceuticals able to improve male erectile function; however, 80% of marketed Italian products contained effective ingredients at negligible doses or without evidence, and no supplement qualified as first-line therapy.
systematic review
Sport/health biomarkers systematic review 2022 (IJERPH)
✓ PubMed
Systematic review of 7 studies (165 healthy physically active adult males) found Tribulus supplementation produced significant improvements in lipid profile and moderate beneficial effects on inflammatory and hematological biomarkers with no renal toxicity, but contradictory and uncertain effects on testosterone and performance.
Systematic review
Female Sexual Dysfunction SR 2020
✓ Full text
Systematic review of 5 RCTs (279 participants) assessed Tribulus terrestris for female sexual dysfunction versus inactive/active comparators.
Meta-analysis
Borrelli et al. 2018
✓ PubMed
Systematic review and meta-analysis of 24 RCTs (2080 ED patients) of herbal supplements; the two Tribulus terrestris monopreparation trials (n=202) produced mixed/inconclusive results for erectile function, in contrast to ginseng which significantly improved IIEF-5 (SMD 0.43). Concluded evidence for Tribulus is insufficient to recommend its use.
RCT
CrossFit performance RCT 2021 (Nutrients)
✓ PubMed
Randomized placebo-controlled trial in 30 CrossFit-trained males (770 mg/day for 6 weeks) found no improvement in body composition or overall performance, though the Tribulus group maintained testosterone (-0.2%) versus a 21.9% decline with placebo and showed a modest bench-press gain.
RCT
Diabetic women glucose/lipid RCT (Suppl Care Cancer/J Diabetes)
✓ PubMed
Double-blind RCT in 98 women with type 2 diabetes (1000 mg/day for 3 months) found Tribulus significantly lowered serum glucose, total cholesterol and LDL versus placebo, with no significant change in HDL or triglycerides.
RCT
Rogerson et al. 2007
✓ PubMed
Double-blind RCT in 22 elite male rugby players: 450 mg/day Tribulus terrestris for 5 weeks during resistance training produced no greater gains in strength or fat-free mass than placebo and did not alter the urinary testosterone/epitestosterone ratio, refuting ergogenic and testosterone-boosting claims.
Review
Male ED/testosterone review 2025
✓ Full text
Low-quality evidence for ED; 8 of 10 trials showed no testosterone increase in men.
Review
Female sexual-function review 2020
✓ PubMed
Some improvement in women, but very low certainty of evidence.
Safety / toxicology
Safety
✓ Full text
No serious adverse events reported in trials.
case report
Hepatorenal injury case report 2024 (ACG)
✓ PubMed
A 46-year-old man taking Tribulus daily for 2 months developed severe drug-induced liver injury (peak bilirubin 48 mg/dL) and acute renal failure (creatinine 7.1), recovering after 3 plasmapheresis sessions.
case report
Rhabdomyolysis from statin interaction case report 2024 (Am J Case Rep)
✓ Full text
First documented case of a 71-year-old man on long-term atorvastatin who developed rhabdomyolysis with transaminitis after taking over-the-counter Tribulus, implicating Tribulus as a moderate CYP3A4 inhibitor that raises statin levels.