Materia Medica
Tribulus
Tribulus terrestris
Tribulus is a low, spreading annual herb known for its spiny fruit. In Ayurveda the fruit is gokshura, a urinary and reproductive tonic, and standardised extracts rich in the saponin protodioscin are studied for sexual function in men and women.
What Is Tribulus?
Tribulus is a low, spreading annual herb known for its hard, spiny fruit, which gives it the names puncture vine and goathead 59Reference 59Porter, D. M. Tribulus terrestris Linnaeus — species description, habitat, distribution and weed status — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 12 (Zygophyllaceae). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200012418View study →. In Ayurveda the fruit is gokshura, one of the tradition’s main urinary remedies and a reproductive tonic 55Reference 55Principles and Practice of Phytotherapy.
Tribulus terrestris grows in sandy, dry and disturbed ground across the warmer parts of the world, from the Mediterranean and Africa to Asia and Australia 59,
The plant’s steroidal saponins, chiefly protodioscin, are the marker compounds used to standardise extracts 2Reference 2RCTEvaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction — a prospective, randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study →. Randomised trials have studied standardised extracts for sexual function in men and women, with mostly positive results, while controlled trials have not found a rise in testosterone 1,
How Is Tribulus Used?
- Dried fruit — gokshura in Ayurveda and bai ji li in Chinese medicine, taken as a powder or decoction, usually as part of a formula 55Reference 55Principles and Practice of Phytotherapy.
- Powdered fruit — used in Unani medicine, and the preparation tested in a blood-pressure trial 34,
57Reference 34RCTEfficacy of Khar-i-khasak (Tribulus terrestris) in prehypertension — randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study →Reference 57Indian medicinal plants: An illustrated dictionary . - Standardised extract — made from the aerial parts and standardised to furostanol saponins; the Bulgarian product Tribestan is the best studied 2Reference 2RCTEvaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction — a prospective, randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study →.
- Liquid extract — a 1:2 liquid extract, used in Western herbal practice.
Traditional Uses
Ayurvedic Medicine
The drug is gokshura, the dried fruit, and it is one of Ayurveda’s principal urinary remedies. It is given for urinary-tract infection and inflammation, and for urinary “gravel”, the stone-forming complaints now called nephrolithiasis 55Reference 55Principles and Practice of Phytotherapy.
Gokshura is also prescribed for reproductive disorders and as a restorative tonic 55Reference 55Principles and Practice of Phytotherapy.
It is taken as a decoction or as the powdered fruit, and is more often part of a formula than given alone 55Reference 55Principles and Practice of Phytotherapy.
Unani Medicine
Unani practice uses the same fruit, under the name khar-i-khasak, as a diuretic, a mild laxative and a general tonic 34,
Iraqi Herbal Medicine
Iraqi herbalists, who call the plant al-gutub, have used it alone or with corn silk to help pass urinary stones 21Reference 21AnimalTribulus terrestris — preliminary study of its diuretic and contractile effects in rats — [animal model]View study →.
Traditional Chinese Medicine
Chinese medicine uses the fruit, bai ji li, for chest pain, skin lesions, and swollen or painful eyes 55Reference 55Principles and Practice of Phytotherapy.
Botany
Tribulus is a prostrate annual herb in the caltrop family, Zygophyllaceae 59,
The leaves grow in opposite pairs and are divided into 6–16 small leaflets, each 5–10 mm long 60Reference 60Tribulus terrestris Linnaeus — species description and distribution — floraView study →.
The flowers are yellow and about 1 cm across, on stalks shorter than the leaves 60,
The fruit is hard and woody. It splits into five segments, and each segment carries two spreading spines 3–7 mm long, sometimes with two smaller spines pointing down near its base 59Reference 59Porter, D. M. Tribulus terrestris Linnaeus — species description, habitat, distribution and weed status — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 12 (Zygophyllaceae). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200012418View study →. These burrs spread the plant by sticking to tyres, feet and the coats of livestock 59Reference 59Porter, D. M. Tribulus terrestris Linnaeus — species description, habitat, distribution and weed status — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 12 (Zygophyllaceae). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200012418View study →.
Tribulus terrestris is a highly variable species in the size of its leaves and flowers and in the spines and hairs of its fruit 61Reference 61Tribulus terrestris LinnView study →.
Distribution
Tribulus grows in tropical and subtropical Asia, Africa, southern Europe and northern Australia, and has been introduced to the Americas 61Reference 61Tribulus terrestris LinnView study →. Flora of North America treats it as native to the Mediterranean region and now found throughout the drier temperate parts of the world 59Reference 59Porter, D. M. Tribulus terrestris Linnaeus — species description, habitat, distribution and weed status — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 12 (Zygophyllaceae). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200012418View study →.
It grows in sandy soils, wasteland, cultivated fields, roadsides and other disturbed ground. In China it occurs up to 3,300 m, and in Pakistan up to 3,500 m 60,
In North America it is an introduced weed of farmland, roadsides and railways. Thirteen US states have declared it a noxious weed, and in 1961 California imported two weevils from India to control it 59Reference 59Porter, D. M. Tribulus terrestris Linnaeus — species description, habitat, distribution and weed status — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 12 (Zygophyllaceae). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200012418View study →.
Tribulus is a widespread weed, and harvesting it takes nothing from threatened wild stands. Collection from farmland and roadsides can help keep the burrs out of pasture and paths.
Growing Conditions
Cultivation snapshot for Tribulus
- Grows as a warm-season annual on poor, dry, sandy or gravelly soils; needs full sun and shrugs off drought and heat.
- Prostrate and mat-forming — a single plant can sprawl several feet across, hugging the ground rather than climbing.
- Effectively a weed: it self-seeds aggressively and, once established, is far harder to remove than to grow.
- The spiny five-horned burrs cling to shoes, tyres, fur and clothing and can injure feet and paws, so it is genuinely unwanted in most gardens and pastures.
Grow it yourself
Farm Wiki is our cultivation-focused sister site, also run by Justin Cooke.
Indications
- Erectile dysfunction and low libido in men [standardised extract]
- Low sexual desire in women [extract]
- Male infertility [fruit; Ayurveda] Caution: Most of the small studies in a systematic review reported better sperm counts, motility or shape. One three-month study found no change in sperm or hormones 32,
33 . - Low testosterone [extract] Caution: Controlled trials and systematic reviews have not found a rise in testosterone in men. The small rises reported came from studies in men with low testosterone 1,
35, .37 - Athletic performance [extract] Caution: Trials in resistance-trained men, rugby players and CrossFit athletes found no gain in strength or body composition 38,
39, .40 - Kidney and urinary stones [fruit; Ayurveda, Iraqi herbal medicine]
- Urinary-tract infection and inflammation [fruit; Ayurveda]
- Fluid retention [fruit; Unani]
- High blood pressure [powdered fruit; Unani]
- Type 2 diabetes and high cholesterol [extract]
- Chest pain [fruit; TCM]
- Skin lesions and swollen, painful eyes [fruit; TCM]
Pharmacology & Research
Randomised trials of tribulus have studied four things: sexual function in men, sexual function in women, testosterone, and athletic performance 1,
Standardised extracts improved erectile function in men and sexual function scores in women in several trials 1,
The rest of the research is preclinical, in rodents and cells, and covers the urinary tract, the heart, blood lipids, inflammation and the brain.
Seven human trials are registered as completed, mostly on sexual function and infertility.
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Best-supported: erectile and overall male sexual function on the IIEF across several RCTs and a meta-analysis 1,
2Reference 1Meta-analysisTribulus terrestris for management of patients with erectile dysfunction — a systematic review and meta-analysis of randomized trials — [systematic review and meta-analysis]View study →Reference 2RCTEvaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction — a prospective, randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study → ; female sexual desire and arousal on the FSFI across several RCTs 7,8, .9Reference 7Systematic reviewTribulus terrestris for female sexual dysfunction — a systematic review — [systematic review]View study →Reference 8RCTTribulus terrestris for treatment of sexual dysfunction in women — randomised double-blind placebo-controlled study — [randomised placebo-controlled trial]View study →Reference 9RCTEfficacy of Tribulus terrestris for premenopausal women with hypoactive sexual desire disorder — randomised placebo-controlled trial — [randomised placebo-controlled trial]View study → -
Emerging, worth watching: a glucose- and LDL-lowering signal in one diabetes RCT 22Reference 22RCTEfficacy of hydroalcoholic extract of Tribulus terrestris on serum glucose and lipid profile of women with type 2 diabetes — double-blind randomised placebo-controlled trial — [randomised placebo-controlled trial]View study →, a blood-pressure fall in one prehypertension RCT 34Reference 34RCTEfficacy of Khar-i-khasak (Tribulus terrestris) in prehypertension — randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study →, and consistent anti-ischaemic and anti-atherosclerotic effects in animals 24,
27, .28Reference 24AnimalTribulosin protects rat hearts from ischaemia/reperfusion injury — animal model — [animal model]View study →Reference 27AnimalInfluence of Tribulus terrestris extract on lipid profile and endothelial structure in atherosclerotic rabbits — [animal model]View study →Reference 28In vitroTribulus terrestris extract alleviates atherosclerosis by suppressing TNF-alpha-mediated macrophage inflammation — in vitro and animal model — [animal model]View study → - Mechanistically thin: antioxidant, anti-inflammatory, antiurolithiatic and neuroprotective claims rest on in-vitro and rodent data alone.
-
The caveat: the sexual-function benefit does not come with a rise in testosterone 1,
35, , and it belongs to standardised, saponin-rich extracts rather than to the herb generally.36Reference 1Meta-analysisTribulus terrestris for management of patients with erectile dysfunction — a systematic review and meta-analysis of randomized trials — [systematic review and meta-analysis]View study →Reference 35Systematic reviewDo ‘testosterone boosters’ really increase serum total testosterone? A systematic review — [systematic review]View study →Reference 36Systematic reviewA systematic review on the herbal extract Tribulus terrestris and its putative aphrodisiac and performance-enhancing effect — [systematic review]View study →
Results depend on the extract. Most trials used extracts standardised to furostanol saponins, and the saponin content and profile of the plant vary with where it grew 2,
1. Erectile & Male Sexual Function
A systematic review and meta-analysis of eight randomised trials found that tribulus outperformed placebo on the International Index of Erectile Function. The difference was about 3.2 points on the IIEF-5 and 14.4 points on the IIEF-15, with no difference in adverse events 1Reference 1Meta-analysisTribulus terrestris for management of patients with erectile dysfunction — a systematic review and meta-analysis of randomized trials — [systematic review and meta-analysis]View study →.
The largest single trial is a phase IV randomised placebo-controlled study of the Bulgarian extract Tribestan in 180 men with mild or moderate erectile dysfunction. After 12 weeks, the IIEF score improved by 2.7 points more than placebo, along with intercourse satisfaction 2Reference 2RCTEvaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction — a prospective, randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study →.
A 30-day trial in 30 men aged 40 and over, at 800 mg a day, found no benefit over placebo and no change in testosterone 3Reference 3RCTTribulus terrestris versus placebo in the treatment of erectile dysfunction — a prospective, randomised, double-blind study — [randomised placebo-controlled trial]View study →. A placebo-controlled study in 70 older men with partial androgen deficiency reported improved erectile function alongside a rise in total testosterone 4Reference 4RCTTribulus terrestris versus placebo in erectile dysfunction and lower urinary tract symptoms in late-onset hypogonadism — [randomised placebo-controlled trial]View study →.
In animals, extracts relax the smooth muscle of the penis and raise intracavernous pressure through nitric-oxide/cGMP signalling linked to protodioscin 5,
Gap: most positive trials are short (4–12 weeks) and several used proprietary standardised extracts. The benefit does not track a measurable rise in testosterone 1Reference 1Meta-analysisTribulus terrestris for management of patients with erectile dysfunction — a systematic review and meta-analysis of randomized trials — [systematic review and meta-analysis]View study →.
2. Female Sexual Dysfunction
A 2020 systematic review of five randomised trials (279 women) found that one to three months of tribulus improved sexual-function scores in both premenopausal and postmenopausal women. Three months of treatment also raised serum testosterone in premenopausal women 7Reference 7Systematic reviewTribulus terrestris for female sexual dysfunction — a systematic review — [systematic review]View study →.
In an Iranian trial in 67 premenopausal women with hypoactive sexual desire disorder, 7.5 mg a day of extract for four weeks improved the total Female Sexual Function Index and its desire, arousal, lubrication, satisfaction and pain domains 8Reference 8RCTTribulus terrestris for treatment of sexual dysfunction in women — randomised double-blind placebo-controlled study — [randomised placebo-controlled trial]View study →. Brazilian trials in premenopausal 9Reference 9RCTEfficacy of Tribulus terrestris for premenopausal women with hypoactive sexual desire disorder — randomised placebo-controlled trial — [randomised placebo-controlled trial]View study →, postmenopausal 10,
Gap: the samples are small, several trials come from a single research group, and the review rated the certainty of the evidence as very low 7Reference 7Systematic reviewTribulus terrestris for female sexual dysfunction — a systematic review — [systematic review]View study →. A clitoral-Doppler study found symptom improvement without any measurable change in clitoral artery blood flow 12Reference 12RCTEffect of Tribulus terrestris on female sexual dysfunction and clitoral vascularisation — randomised study of two dosage regimes — [randomised trial]View study →.
3. Antioxidant
In rodent models of heart, kidney and nerve injury, tribulus extracts restore glutathione, SOD and catalase and lower lipid peroxidation 26,
Human data is limited to exercise trials. One randomised trial in CrossFit athletes reported higher total antioxidant status 13Reference 13RCTFernandez-Lazaro D (2022). 6-week supplementation with Tribulus terrestris in trained CrossFit athletes — muscle, inflammation and antioxidant status — randomised controlled trial — [randomised controlled trial]. Int J Environ Res Public Health. https://pubmed.ncbi.nlm.nih.gov/36498228/View study →, and a trial on exercise-induced oxidative stress and muscle soreness found more modest effects 14Reference 14RCTEffect of Tribulus terrestris supplementation on exercise-induced oxidative stress and delayed-onset muscle soreness — randomised controlled trial — [randomised controlled trial]View study →.
Gap: no trial has tested an antioxidant endpoint in a disease population.
4. Anti-Inflammatory
Two amides isolated from the plant, N-trans-p-caffeoyl tyramine and tribulusamide D, each suppress nitric oxide, PGE2, COX-2 and TNF-α/IL-6 in LPS-stimulated macrophages 15,
A whole-extract rat study reported anti-oedema activity comparable to diclofenac at 150–200 mg/kg 17Reference 17AnimalStudy of the anti-inflammatory properties of a thick extract of Tribulus terrestris — rat carrageenan/zymosan model — [animal model]View study →.
Gap: all of it is cell and rodent work, and none of it has been tested clinically.
5. Antiurolithiatic & Diuretic
In vitro, aqueous extract inhibits the nucleation and growth of calcium-oxalate crystals and protects kidney tubular cells from oxalate injury 18Reference 18In vitroDiminution of oxalate-induced renal tubular cell injury and inhibition of calcium oxalate crystallisation in vitro by Tribulus terrestris — [in vitro]View study →. A protein of about 60 kDa has been identified as one active component 20Reference 20In vitroA novel antilithiatic protein from Tribulus terrestris with cytoprotective potency — in vitro — [in vitro]View study →.
In rats with kidney stones, the extract improved kidney function and reduced stone burden 19Reference 19AnimalAntiurolithiatic potential of Tribulus terrestris extract — in vivo efficacy and preclinical safety in Wistar rats — [animal model]View study →. An aqueous extract of the leaves and fruit, at an oral dose of 5 g/kg, produced diuresis in rats slightly greater than furosemide, with more sodium, potassium and chloride in the urine 21Reference 21AnimalTribulus terrestris — preliminary study of its diuretic and contractile effects in rats — [animal model]View study →.
Gap: no human trial has tested tribulus for kidney stones, and the herb itself carries case reports of kidney injury 42,
6. Hypoglycemic
A double-blind randomised trial in 98 women with type 2 diabetes found that 1,000 mg a day of hydroalcoholic extract for three months lowered blood glucose against placebo. It also reduced total and LDL cholesterol, without affecting triglycerides or HDL 22Reference 22RCTEfficacy of hydroalcoholic extract of Tribulus terrestris on serum glucose and lipid profile of women with type 2 diabetes — double-blind randomised placebo-controlled trial — [randomised placebo-controlled trial]View study →. In vitro the plant inhibits α-amylase, α-glucosidase and pancreatic lipase 23Reference 23In vitroInhibitory effects of chickpea and Tribulus terrestris on lipase, alpha-amylase and alpha-glucosidase — in vitro — [in vitro]View study →.
Gap: the clinical evidence is a single trial in women only.
7. Cardioprotective & Hypolipidemic
The spirostanol saponin tribulosin protects rat heart muscle against ischaemia/reperfusion injury through protein kinase C-epsilon 24Reference 24AnimalTribulosin protects rat hearts from ischaemia/reperfusion injury — animal model — [animal model]View study →. Pretreatment with the whole extract protects against ischaemia through a MAPK-mediated anti-apoptotic pathway 25Reference 25AnimalPretreatment with Tribulus terrestris causes anti-ischaemic cardioprotection through a MAPK-mediated anti-apoptotic pathway in rat — [animal model]View study →.
In rabbits with diet-induced atherosclerosis, the extract lowered cholesterol, LDL and triglycerides and preserved the lining of the arteries 27Reference 27AnimalInfluence of Tribulus terrestris extract on lipid profile and endothelial structure in atherosclerotic rabbits — [animal model]View study →.
A 2025 study attributed the anti-atherosclerotic action to suppression of TNF-α-driven inflammation in macrophages 28Reference 28In vitroTribulus terrestris extract alleviates atherosclerosis by suppressing TNF-alpha-mediated macrophage inflammation — in vitro and animal model — [animal model]View study →.
Gap: all the cardiovascular efficacy data is from animals. The only human lipid result is a secondary outcome of the diabetes trial 22Reference 22RCTEfficacy of hydroalcoholic extract of Tribulus terrestris on serum glucose and lipid profile of women with type 2 diabetes — double-blind randomised placebo-controlled trial — [randomised placebo-controlled trial]View study →.
8. Neuroprotective
Extracts reduced infarct size and inflammation in rats after middle-cerebral-artery occlusion 30Reference 30AnimalSupplementation with Tribulus terrestris extract exhibits protective effects in MCAO rats via modulating inflammation — animal model — [animal model]View study →, and dampened stress-activated kinases 29Reference 29AnimalTribulusterine-containing Tribulus terrestris extract exhibited neuroprotection through attenuating stress kinases in rat — [animal model]View study →. In a rodent Parkinson’s model, the extract acted on acetylcholinesterase, α-synuclein and inflammatory cytokines 31Reference 31AnimalAnti-Parkinson’s activity of Tribulus terrestris via modulation of AChE, alpha-synuclein, TNF-alpha and IL-1beta — animal model — [animal model]View study →.
Gap: the work is confined to rodent models of stroke and neurodegeneration, with no human data.
9. Male Fertility (Sperm Parameters)
A systematic review of seven small studies in men with idiopathic infertility found that tribulus improved some or all sperm parameters, such as count, motility and shape, in six of them 32Reference 32Systematic reviewEffect of Tribulus terrestris on sperm parameters in men with idiopathic infertility — a systematic review — [systematic review]View study →.
The one negative study gave 30 men with unexplained infertility 750 mg a day in three doses for three months. It found no change in testosterone, LH or any semen parameter 33Reference 33RCTProspective analysis of Tribulus terrestris on serum testosterone and semen parameters in males with unexplained infertility — randomised trial — [randomised trial]View study →. It had no control group 32Reference 32Systematic reviewEffect of Tribulus terrestris on sperm parameters in men with idiopathic infertility — a systematic review — [systematic review]View study →.
Gap: the studies are small and differ in extract and duration.
10. Antihypertensive
A randomised, double-blind, placebo-controlled trial at the National Institute of Unani Medicine in Bengaluru gave prehypertensive adults 6 g a day of powdered tribulus fruit, in three doses, for two months. Blood pressure fell by an average of 7.7/5.5 mmHg, against 1.9/0.2 mmHg on placebo 34Reference 34RCTEfficacy of Khar-i-khasak (Tribulus terrestris) in prehypertension — randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study →.
Gap: this is a single small trial of whole dried fruit, with no trial in established hypertension.
11. Testosterone Elevation
Controlled trials and systematic reviews have not found that tribulus raises serum total testosterone in men. A 2024 systematic review of “testosterone boosters” found that most, tribulus among them, did not raise total testosterone against placebo 35Reference 35Systematic reviewDo ‘testosterone boosters’ really increase serum total testosterone? A systematic review — [systematic review]View study →. An earlier review found a rise in humans only when tribulus was one part of a combined supplement 36Reference 36Systematic reviewA systematic review on the herbal extract Tribulus terrestris and its putative aphrodisiac and performance-enhancing effect — [systematic review]View study →.
The 2026 erectile-dysfunction meta-analysis found no difference in testosterone against placebo 1Reference 1Meta-analysisTribulus terrestris for management of patients with erectile dysfunction — a systematic review and meta-analysis of randomized trials — [systematic review and meta-analysis]View study →.
A 2025 review of ten studies found that eight reported no change in androgens. The two that found a rise were in men with hypogonadism, and the increase was 60–70 ng/dL 37Reference 37Systematic reviewEffects of Tribulus terrestris supplementation on erectile dysfunction and testosterone levels in men — a systematic review — [systematic review]View study →. A pilot study of urinary steroid profiles in 15 recreational athletes found no significant change during supplementation 41Reference 41Impact of Tribulus terrestris supplementation on urinary steroid profiles — a short-term pilot study — [pilot study]View study →.
Some trials in women did report modest rises in free testosterone 7,
Gap: in men with normal testosterone, the controlled evidence is consistently null.
12. Ergogenic / Athletic Performance
Controlled trials do not show a performance effect. Tribulus produced no gain in strength or body composition in resistance-trained men 38Reference 38RCTThe effects of Tribulus terrestris on body composition and exercise performance in resistance-trained males — randomised controlled trial — [randomised controlled trial]View study →, no change in strength or the urinary testosterone/epitestosterone ratio in elite rugby league players 39Reference 39RCTThe effect of five weeks of Tribulus terrestris on muscle strength and body composition in elite rugby league players — randomised controlled trial — [randomised controlled trial]View study →, and no benefit in CrossFit athletes 40Reference 40RCTThe effects of 6 weeks of Tribulus terrestris on body composition, hormonal response and performance in CrossFit athletes — randomised controlled trial — [randomised controlled trial]View study →. A review of sport and health biomarkers found improvement only in the lipid profile 49Reference 49Systematic reviewEffects of Tribulus terrestris on sport and health biomarkers in physically active adult males — a systematic review — [systematic review]View study →.
Gap: a signal for reduced muscle-damage markers exists, but it does not translate into performance 13Reference 13RCTFernandez-Lazaro D (2022). 6-week supplementation with Tribulus terrestris in trained CrossFit athletes — muscle, inflammation and antioxidant status — randomised controlled trial — [randomised controlled trial]. Int J Environ Res Public Health. https://pubmed.ncbi.nlm.nih.gov/36498228/View study →.
Mechanisms
Tribulus’s steroidal saponins, chiefly protodioscin, have been studied for their ability to release nitric oxide and relax the smooth muscle of the penis and blood vessels 5,
Minor amides have been studied for anti-inflammatory activity, and the saponin fraction for calcium-oxalate crystal inhibition and digestive-enzyme inhibition.
| Mechanism | Drives | Key compounds |
|---|---|---|
| NO/cGMP-mediated cavernosal & vascular smooth-muscle relaxation | erectile function | protodioscin |
| Steroidal-saponin effects on sexual behaviour, independent of serum testosterone | male & female sexual function | protodioscin, furostanol glycosides |
| Radical scavenging; ↑ SOD/catalase/glutathione, ↓ lipid peroxidation | antioxidantorgan protection | steroidal saponins, flavonoids |
| NF-κB ↓, COX-2 ↓, TNF-α/IL-6 ↓ | anti-inflammatoryanti-atherosclerotic | tribulusamide D, N-trans-p-caffeoyl tyramine |
| PKC-epsilon activation; MAPK-mediated anti-apoptosis | cardioprotection (ischaemia/reperfusion) | tribulosin |
| Calcium-oxalate anti-crystallisation; renal-cell cytoprotection | antiurolithiatic | saponin fraction, antilithiatic protein |
| α-amylase / α-glucosidase / lipase inhibition | hypoglycemichypolipidemic | saponin fraction |
Clinical Trials
Several registered trials remain unpublished or of uncertain status.
| Completed | Planned | Terminated | Preclinical |
|---|---|---|---|
| 7 | 1 | 1(withdrawn) | ~100+ |
Last checked: July 2026.
Phytochemistry
Tribulus is characterised by steroidal saponins, mostly furostanol glycosides. Protodioscin is the marker compound used to standardise extracts. Each Tribestan tablet contains 250 mg of extract standardised to at least 112.5 mg of furostanol saponins 2Reference 2RCTEvaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction — a prospective, randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study →.
Related saponins include the furostanols prototribestin and protogracillin, the spirostanols tribulosin, dioscin and terrestrosin D, and the sulfated spirostanol tribestin 50,
The saponin profile depends on where the plant grew. Samples from Bulgaria, Greece, Serbia, Macedonia, Turkey, Georgia and Iran shared one chemical profile, with protodioscin and prototribestin as the main saponins. Samples from Vietnam and India lacked prototribestin and tribestin and were high in tribulosin 58Reference 58Distribution of steroidal saponins in Tribulus terrestris from different geographical regionsView study →.
Australian plants contained the β-carboline alkaloids harman and norharman, at 44 mg/kg of dry matter 48Reference 48Locomotor effects in sheep of alkaloids identified in Australian Tribulus terrestris — animal — [animal]View study →. Perlolyrin has also been reported 56Reference 56Phytochemical and antimicrobial evaluation of Tribulus terrestris L. growing in Nigeria.
Saponin levels also vary with plant part and growth stage, so results for one extract should be read separately from results for another 58Reference 58Distribution of steroidal saponins in Tribulus terrestris from different geographical regionsView study →.
Constituent Summary
The main constituents of the fruit and aerial parts.
Terpenoid1 compound1 with data
Saponin5 compounds5 with data
Sterol1 compound1 with data
Flavonoid3 compounds3 with data
Lignanamide1 compound1 with data
Phenylpropanoid1 compound1 with data
Alkaloid1 compound1 with data
Dosage
Trials almost always used a standardised extract dosed to a set furostanol-saponin content, most often the Bulgarian product Tribestan, so trial doses do not map onto whole-herb or tincture amounts.
| Indication | Preparation | Dose | Est. dried-herb equivalent | Source |
|---|---|---|---|---|
| Erectile dysfunction | Standardized extract (Tribestan, 35–45:1, std. to furostanol saponins) | 3 × 2 × 250 mg tablets/day (1500 mg extract/day) × 12 wk | ~50–65 g/day raw herb at 35–45:1 (assumes extract ratio as labeled) | 2Reference 2RCTEvaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction — a prospective, randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study → |
| Erectile dysfunction | Dried extract capsules | 800 mg/day × 30 days | order-of-magnitude only; no marker % given | 3Reference 3RCTTribulus terrestris versus placebo in the treatment of erectile dysfunction — a prospective, randomised, double-blind study — [randomised placebo-controlled trial]View study → |
| ED + LUTS (late-onset hypogonadism) | Extract, three times daily | three times daily × 3 months | — (dose and marker % not stated in the abstract) | 4Reference 4RCTTribulus terrestris versus placebo in erectile dysfunction and lower urinary tract symptoms in late-onset hypogonadism — [randomised placebo-controlled trial]View study → |
| Female HSDD (premenopausal) | Standardized extract | 7.5 mg/day (high-potency std. extract) × 4 wk | not convertible (proprietary high-potency) | 8Reference 8RCTTribulus terrestris for treatment of sexual dysfunction in women — randomised double-blind placebo-controlled study — [randomised placebo-controlled trial]View study → |
| Female sexual dysfunction (postmenopausal) | Extract | 750 mg/day × 120 days | — | 10Reference 10RCTEfficacy of Tribulus terrestris for hypoactive sexual desire disorder in postmenopausal women — randomised placebo-controlled trial — [randomised placebo-controlled trial]View study → |
| Type 2 diabetes (women) | Hydroalcoholic extract | 1000 mg/day × 3 months | ~tens of g raw herb (assumes ~10:1 hydroalcoholic extract) | 22Reference 22RCTEfficacy of hydroalcoholic extract of Tribulus terrestris on serum glucose and lipid profile of women with type 2 diabetes — double-blind randomised placebo-controlled trial — [randomised placebo-controlled trial]View study → |
| Prehypertension | Powdered dried fruit | 6 g/day (3 divided doses) × 2 months | ~6 g/day (whole dried fruit, direct) | 34Reference 34RCTEfficacy of Khar-i-khasak (Tribulus terrestris) in prehypertension — randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study → |
| Athletic (resistance training) | Extract | 3.21 mg/kg/day × 8 wk | — | 38Reference 38RCTThe effects of Tribulus terrestris on body composition and exercise performance in resistance-trained males — randomised controlled trial — [randomised controlled trial]View study → |
The dried-herb equivalent is a rough estimate on the stated assumption, not a fixed conversion factor. The ~7.5 mg high-potency extract 8Reference 8RCTTribulus terrestris for treatment of sexual dysfunction in women — randomised double-blind placebo-controlled study — [randomised placebo-controlled trial]View study → and the multi-gram whole-fruit dose 34Reference 34RCTEfficacy of Khar-i-khasak (Tribulus terrestris) in prehypertension — randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study → are not interchangeable.
Traditional Dosage
Traditional systems use the whole dried fruit or a liquid extract.
| System | Preparation | Dose |
|---|---|---|
| Western herbal | Liquid extract 1:2 | 40–100 mL/week |
| Ayurveda (gokshura) | Dried fruit powder / decoction | ~3–6 g/day dried fruit |
| TCM (Bai Ji Li) | Dried fruit, decoction | ~6–9 g/day dried fruit |
Safety & Pregnancy
Tribulus is well tolerated in controlled trials. Rare case reports describe serious liver, kidney and muscle injury from supplements, and one describes a statin interaction.
- Well tolerated in trials. Adverse events were no more common than on placebo across the sexual-function studies 1,
2Reference 1Meta-analysisTribulus terrestris for management of patients with erectile dysfunction — a systematic review and meta-analysis of randomized trials — [systematic review and meta-analysis]View study →Reference 2RCTEvaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction — a prospective, randomised, double-blind, placebo-controlled trial — [randomised placebo-controlled trial]View study → . - Case reports of organ injury. Supplements have been linked to drug-induced liver injury, acute kidney injury and rhabdomyolysis 42,
43, .44Reference 42Case reportSevere liver and renal injury from Tribulus terrestris — case report — [case report]View study →Reference 43Case reportRhabdomyolysis risk — the dangers of Tribulus terrestris, an over-the-counter supplement (with atorvastatin) — case report — [case report]View study →Reference 44Case reportAcute kidney injury and hyperbilirubinaemia in a young male after ingestion of Tribulus terrestris — case report — [case report]View study → - Avoid in pregnancy and breastfeeding. It has not been studied in either.
- Statins. Rhabdomyolysis was reported in a man taking tribulus with atorvastatin 43Reference 43Case reportRhabdomyolysis risk — the dangers of Tribulus terrestris, an over-the-counter supplement (with atorvastatin) — case report — [case report]View study →.
- Liver or kidney disease. Take care, given the case reports, and avoid prolonged high-dose use.
- Product quality. Some performance-marketed products have been found adulterated with anabolic steroids.
Full Safety & Interactions Detail
Trials. Adverse events did not differ from placebo in the meta-analysis of erectile-dysfunction trials or in the largest single trial 1,
Liver and kidney. A 46-year-old man who took tribulus daily for two months developed severe jaundice and kidney dysfunction, with a liver biopsy consistent with drug-induced liver injury 42Reference 42Case reportSevere liver and renal injury from Tribulus terrestris — case report — [case report]View study →. A young man developed severe hyperbilirubinaemia followed by acute kidney failure, with bile casts in the kidney tubules 44Reference 44Case reportAcute kidney injury and hyperbilirubinaemia in a young male after ingestion of Tribulus terrestris — case report — [case report]View study →.
Muscle. A 71-year-old man taking tribulus with atorvastatin developed rhabdomyolysis 43Reference 43Case reportRhabdomyolysis risk — the dangers of Tribulus terrestris, an over-the-counter supplement (with atorvastatin) — case report — [case report]View study →.
Priapism. A 36-year-old man had a priapism lasting 72 hours after taking a tribulus-based supplement 45Reference 45Case reportPriapism caused by Tribulus terrestris — case report — [case report]View study →.
The likely toxin. The spirostanol saponin terrestrosin D caused liver and kidney toxicity in rats at 5–15 mg/kg a day for 28 days, which reversed within 14 days of stopping 46Reference 46In vitroTerrestrosin D, a spirostanol saponin from Tribulus terrestris, with potential hepatorenal toxicity — in vitro and animal model — [animal model]View study →. Whole-extract testing in vitro found no genotoxicity in Comet or Ames assays, and only the methanol extract was cytotoxic 47Reference 47In vitroInvestigation on the toxic potential of Tribulus terrestris in vitro — [in vitro]View study →.
Interactions. The statin case is the only interaction backed by a report 43Reference 43Case reportRhabdomyolysis risk — the dangers of Tribulus terrestris, an over-the-counter supplement (with atorvastatin) — case report — [case report]View study →. Cautions with antihypertensives, antidiabetic drugs, anticoagulants and lithium are theoretical and have not been tested.
Avoid. Tribulus has not been studied in human pregnancy or breastfeeding.
Its steroidal saponins act on the endocrine and reproductive systems in animals, so it is best avoided during pregnancy and while breastfeeding.
Synergy
Tribulus fruit is often combined with ashwagandha in Ayurvedic formulas 55Reference 55Principles and Practice of Phytotherapy.
References
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