Tonkay Ali, sometimes called Longjack, comes up quite a lot in conversations about supplements. Most commonly in relationship to it’s effect on men’s testosterone levels. What a lot of people don’t discuss however, is one of the main reasons why we don’t score it highly as an ingredient for “testosterone boosting” supplements, and that is the potential Tongkat Ali side effects.
There is also the fact that it’s not the most well studied of herbs for this, and the fact that there are generally better alternatives to Tongkat Ali in most use cases, but that’s another matter.
The most notable issue is that a lot of people look for testosterone boosting herbs to get a little bit of an edge rather than as a treatment for actually low test levels. And Tongkat Ali only seems to work in cases of actual low testosterone, with most other studies showing limited to no difference against a placebo. 
What Is Tongkat Ali?
Tongkat Ali or Eurycoma longifolia, is a flowering plant native to Southeast Asia, particularly Malaysia and Indonesia. It has a long history of use in traditional medicine for its aphrodisiac, energy-boosting, and testosterone-enhancing properties.
The active compounds in Tongkat Ali, such as quassinoids and eurycomanone, which we’ll discuss more later.
Tongkat Ali and Testosterone
As mentioned the primary reason people turn to Tongkat Ali is its potential to increase testosterone levels. Testosterone is a crucial hormone responsible for many aspects of male health, including muscle mass, energy levels, and libido. While research on Tongkat Ali's effects on testosterone is limited, some studies suggest that it may help regulate hormone levels and improve sexual health in men.
The interesting thing is that most studies done on Tongkat Ali, have shown positive resutls, but most of them weren't significant when compared against the placebo contro group.
it's also worth noting that this was more apparent in the groups of men who were not clinically suffering from low testosterone Specifically studies involving individuals with low testosterone levels of (<300 ng/dL) or poor Androgen Deficiency in the Aging Male (ADAM) scores. These groups consistently showed significant improvements in testosterone levels after Tongkat Ali supplementation. Meaning that Tongkat Ali, probably isn't for healthy men looking to boost their gym performance which is a large part of the market for this sort of supplement.
The Importance of Dosage and Quality
When using Tongkat Ali, it's vital to consider the dosage and quality of the supplement. The potency of Tongkat Ali can vary depending on the extraction method and the concentration of active compounds.
Most studies that have shown positive results utilized a commercial water-extracted product called Physta® from Biotropics, with dosages ranging from 100 to 600 mg daily. The duration of supplementation also varied, ranging from a minimum of 3 days to a maximum of 6 months.
It is recommended to choose reputable brands that provide third-party testing to ensure product quality and purity.
Potential Side Effects of Tongkat Ali
While Tongkat Ali offers potential benefits, it's crucial to be aware of the possible side effects. Here are some of the side effects that have been reported:
The Most Common Tongkat Ali Side Effects
Headache and Dizziness - Tongkat Ali, when taken in high doses, may cause headaches and dizziness. This is attributed to its ability to increase blood pressure and heart rate. Which brings us neatly on to our next point. 
Blood Pressure Issues - If you have a history of cardiovascular conditions or are taking medication for high blood pressure, it's essential to consult with your healthcare provider before using Tongkat Ali as it has been shown to both raise and lower blood pressure.
Gastrointestinal Disturbances – This is ultimately the most common issue with taking Tongkat Ali, and whilst it is true for a lot of supplements, it is particularly common with Tongkat Ali, with some research suggesting it’s as high as 15-20%. A lot of individuals may experience gastrointestinal issues such as nausea, vomiting, diarrhea, and abdominal pain when using Tongkat Ali. These side effects are generally mild and resolve on their own.
Restlessness and Insomnia - Tongkat Ali's stimulating properties can sometimes lead to restlessness and insomnia, particularly when taken in the evening. To minimize the risk of sleep disturbances, it is recommended to take Tongkat Ali earlier in the day. However, it should also be noted that seeing as disturbed sleep can lower testosterone, this isn’t really great for a testosterone booster.
Fatigue - While Tongkat Ali is often used to boost energy levels, some individuals may experience fatigue and weakness after taking the supplement. If you are taking medication for chronic fatigue syndrome or any other condition that causes fatigue
Loss of Appetite - Tongkat Ali has the potential to decrease appetite in some individuals. If you are taking medication to manage weight or have a history of eating disorders, it is advisable to consult with your healthcare provider before using Tongkat Ali.
Uncommon Tongkat Ali Side Effects
Anxiety and Mood Changes - In rare cases, Tongkat Ali may cause feelings of anxiety, irritability, and mood swings. This is more common if you have a history of anxiety disorders or are taking medication for mood-related conditions. And also not ideal if you have low mood due to testosterone issues.
Rare Tongkat Ali Side Effects
Memory Problems - While there is limited clinical research to support this claim, some individuals have reported memory problems after using Tongkat Ali. If you experience any cognitive difficulties or changes in memory function, it is important to discontinue use of the supplement and consult with a healthcare professional.
Urinary Problems - Tongkat Ali may cause urinary problems in some individuals. If you experience any changes in urination patterns or other urinary symptoms after taking Tongkat Al
Skin Rash - In rare cases, Tongkat Ali may cause skin rashes or other allergic reactions. If you develop a rash or experience any unexplained skin symptoms after taking Tongkat Ali, it is important to discontinue use and seek medical advice.
Water Retention - Tongkat Ali has a diuretic effect, which means it can increase water excretion from the body. In some cases, this may lead to water retention or edema, causing swelling in the hands, feet, and legs.
Blood Sugar Issues - While Tongkat Ali can lower blood sugar levels, it is also possible for levels to become too low, leading to hypoglycemia. Individuals who are at risk of low blood sugar or are taking medications that may lower blood glucose levels should exercise caution when using Tongkat Ali.
Rare and Severe Tongkat Ali Side Effects
While Tongkat Ali is often used to support healthy testosterone levels, excessive or prolonged use may lead to hormonal imbalances.
As a result this has led to several cases where Tongkat Ali has been suspected of causing:
- Testicular Atrophy
- Reproductive Problems in Men
- Problems With Erections
- Hair Loss
- Liver Toxicity
- Prostate Enlargement
Whilst these seven side effects of Tongkay Ali are very rare, they do of course run contrary to what most of the people taking it are hoping to achieve. And of course are very severe as mentioned.
Allergic Reactions - Although rare, some individuals may experience allergic reactions to Tongkat Ali. Symptoms may include skin rashes, itching, swelling, and difficulty breathing. There have even been some reports of seizures.
Precautions and Considerations
Before incorporating Tongkat Ali into your wellness routine, it's important to consider the following precautions:
Start with Low Dosages - To assess your tolerance and minimize the risk of side effects, it's recommended to start with low dosages of Tongkat Ali. Gradually increase the dosage as needed, under the guidance of a healthcare professional.
Use Reputable Brands - To ensure product quality and safety, choose Tongkat Ali supplements from reputable brands that undergo third-party testing. This helps ensure that you are getting a genuine product without contaminants or adulterants.
Follow Recommended Dosages - Always follow the recommended dosages provided by the manufacturer or as advised by your healthcare professional. Taking excessive amounts of Tongkat Ali can increase the risk of side effects.
Monitor Your Body's Response - Pay attention to how your body responds to Tongkat Ali. If you experience any unusual symptoms or adverse effects, discontinue use and consult with a healthcare professional.
2 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415500/