Hormone Guide · Spoke 11

Testosterone Boosters: Do Ashwagandha, Tribulus and Co Work?

Boosters sell a simple promise. One powder, one push, more testosterone. This honest evidence check looks at what the controlled trials on ashwagandha, tribulus, maca and co actually show, and where correcting a deficiency ends and hype begins.

Shukri Jarmoukli · Physician, Integrative Medicine · ViveCura Berlin
My starting point

Almost every man who comes to my practice wanting more testosterone already has a booster powder in his cupboard. I understand that. The promises are loud, the images muscular, the price affordable. What I offer is not a new miracle, but an honest look at the data. Some ingredients are better than their reputation, some much worse. And almost always: what can truly help your testosterone is not in the booster, but in your daily life.

Maybe you know the shelf in the drugstore or the ad in your feed. Testo-boost, men's power, natural testosterone complex. The message is always the same. Take this powder, and your body makes more of the hormone that supposedly makes you a man. That sounds tempting, especially when you feel tired, low on drive or simply not quite like you used to.

This article takes the best-known ingredients seriously and examines them soberly. We look at what ashwagandha, tribulus, tongkat ali, maca, fenugreek and shilajit actually do in controlled human studies. We separate correcting a deficiency from booster hype. And at the end we look at the levers that, according to the data, move more than any powder. My goal is not to sell you anything or talk you out of anything. My goal is for you to make an informed decision.

What testosterone boosters are and what they are not

First the terms. A testosterone booster is an over-the-counter dietary supplement, not a medication and not a hormone. It contains no testosterone. The idea behind it is to give the body substances that are meant to prompt it to produce more testosterone itself, or that make existing testosterone more available. This is an important difference from testosterone replacement therapy, which is prescription-only and adds real hormone.

Most products are blended formulas. They combine plant extracts with vitamins and minerals. This is exactly what makes assessment hard, because if ten ingredients are inside, it is barely possible to say which of them does what. One careful analysis once looked at these products systematically.

Study · analysis of 50 booster products

Nine in ten boosters promise a lot, a quarter has data

Product analysis, literature review Chase Clemesha and colleagues evaluated 50 over-the-counter testosterone boosters in 2019 in the World Journal of Men's Health. 90 percent advertised that they raise testosterone, but only about a quarter had any data supporting a rise. About ten percent contained components with hints of a rather lowering effect. On average, more than eight ingredients were inside each product, many with vitamin doses far above the daily requirement. Thirteen products even exceeded the upper safe intake level for zinc, niacin or magnesium.

Clemesha CG, Thaker H, Samplaski MK. World J Mens Health. 2020;38(1):115-122. doi:10.5534/wjmh.190043 · PMID: 31385468

And now you know why the word booster should be treated with caution. It describes a marketing category, not a proven effect. That does not mean no single ingredient can do anything. It means we have to look at each ingredient on its own.

Reframe

A booster sells you the hope that a number rises. But your testosterone is not an isolated number that you pump up from outside. It is your body's answer to sleep, weight, stress and exercise. So the interesting question is not which powder boosts hardest, but what keeps your body from producing enough on its own in the first place.

Ashwagandha: the ingredient with the best data

If one booster ingredient has a serious study base, it is ashwagandha, a medicinal plant from the Ayurvedic tradition. It is described as an adaptogen, that is, a plant meant to help the body cope with stress. Several controlled studies have looked at its effect on testosterone, and the picture is cautiously positive.

Study · resistance-training men

Ashwagandha plus training: a clearer testosterone rise than placebo

RCT, double-blind, n=57 Sachin Wankhede and colleagues studied 57 young men in 2015 in the Journal of the International Society of Sports Nutrition who did eight weeks of strength training. One half took ashwagandha root extract twice daily, the other a placebo. The ashwagandha group showed a markedly stronger rise in strength and muscle mass and also a significantly greater rise in testosterone than the placebo group. This suggests that ashwagandha in combination with training may have a measurable, if moderate, effect.

Wankhede S, Langade D, Joshi K, et al. J Int Soc Sports Nutr. 2015;12:43. doi:10.1186/s12970-015-0104-9 · PMID: 26609282

In older men the picture is more mixed. A crossover study by Adrian Lopresti and colleagues from 2019 in the American Journal of Men's Health gave overweight men between 40 and 70 with mild fatigue ashwagandha or placebo for eight weeks. Testosterone rose about fifteen percent more in the ashwagandha group, as did the hormone DHEA-S. For fatigue, mood and sexual well-being, however, there were no significant differences from placebo (doi:10.1177/1557988319835985, PMID: 30854916).

A plausible route of action runs via the stress axis. A further study by Lopresti and colleagues in 2019 in Medicine found that ashwagandha may lower morning cortisol in stressed adults. Testosterone rose in the men over time, but here the difference from placebo was not significant (doi:10.1097/MD.0000000000017186, PMID: 31517876). A study with another extract also found a rise in free testosterone in men, while the stress score did not improve more than under placebo (doi:10.1177/02698811231200023, PMID: 37740662).

On the topic of fertility, a review points to possible effects but urges caution. Sharanbasappa Durg and colleagues summarized the studies on ashwagandha in infertile men in 2018 in Phytomedicine and described improvements in semen parameters and hormone values. But they explicitly stress that the number of good studies is too small to draw solid conclusions (doi:10.1016/j.phymed.2017.11.011, PMID: 30466985). In summary: ashwagandha is the most serious ingredient in the field, with small, plausible effects, but it is no hormone turbo.

Tribulus, tongkat ali, maca and fenugreek in the check

Now to the ingredients that are often named in the same breath but whose data are clearly thinner. Here a close look is especially worthwhile, because it is precisely these plants that are sold with big promises.

Tribulus terrestris is perhaps the best example of the gap between advertising and proof. Despite its reputation as a testosterone plant, no convincing effect is found in humans.

Study · men with erectile dysfunction

Tribulus was no better than placebo on testosterone

RCT, double-blind, n=30 Carlos Santos, Leonardo Reis and colleagues studied 30 men with erectile dysfunction in 2014 in Actas Urológicas Españolas in a double-blind, placebo-controlled trial. Over thirty days one group received tribulus terrestris, the other a placebo. For total testosterone there was no difference between tribulus and placebo. The authors conclude that tribulus, at the dose studied, influenced neither the symptoms of erectile dysfunction nor testosterone more than a dummy preparation.

Santos CA, Reis LO, Destro-Saade R, et al. Actas Urol Esp. 2014;38(4):244-248. doi:10.1016/j.acuro.2013.09.014 · PMID: 24630840

Tongkat ali, botanically Eurycoma longifolia, has a bit more tailwind, but with limits. A study by Alice Leitão and colleagues in 2020 in Maturitas gave men with age-related low testosterone tongkat ali over six months, partly combined with training. Erectile function and testosterone improved, most clearly in the combination of training and plant. But the study had no group taking only the plant without training, so the pure plant effect cannot be cleanly separated (doi:10.1016/j.maturitas.2020.12.002, PMID: 33541567).

Maca, a tuber from the Andes, is often sold as a libido booster. What is interesting is that the studies show hints of better well-being but without a testosterone rise. Tommaso Zenico and colleagues found in 2009 in Andrologia, in 50 men with mild erectile dysfunction, that maca improved subjective well-being and sexual function somewhat more than placebo. An effect on testosterone was not the focus and was not established as a mechanism of action (doi:10.1111/j.1439-0272.2008.00892.x, PMID: 19260845).

Fenugreek shows an inconsistent picture in studies. Sindre Lee-Ødegård and colleagues found in 2024 in PLOS One, in 95 men, a small rise in free testosterone in saliva versus placebo, while the rise in blood versus placebo was not clear-cut (doi:10.1371/journal.pone.0310170, PMID: 39288153). Another fenugreek study in men with benign prostate enlargement found no effect on hormone values (doi:10.1002/ptr.6554, PMID: 31828857).

And shilajit? Here it gets especially thin. In a targeted search of the medical database for shilajit and testosterone in men, practically no controlled clinical studies supporting this claim could be found. As long as that remains the case, the advertised effect is a hypothesis, not proof.

What happens at the cell level: four KPNI lenses on the boosters

In clinical psychoneuroimmunology, KPNI for short, we look not only at whether a value rises, but why. Four lenses help to understand where a booster could act at all and why the effects usually stay small.

Nervous system and stress axis

The most likely real route of action of ashwagandha runs via the stress axis. At the cell level, lowering cortisol may relieve the higher-level control in the brain, which sends the signal for testosterone production to the testes via LH. If chronic stress dampens this control, calming the stress axis could indirectly create some room. This explains why adaptogens are most likely to play a role in stressed men, not as a pure hormone push.

Hormone system and aromatase

Many boosters advertise effects on the enzyme aromatase, which converts testosterone into estrogen. At the cell level this idea is understandable, but in humans the evidence for plant-based aromatase inhibition is weak. More importantly: aromatase sits mainly in belly fat. Anyone who wants to start here often gets further via body fat than via a plant extract whose effect looks bigger in the test tube than in the body.

Metabolism and micronutrients

Minerals like zinc are building blocks in hormone production. At the cell level the body needs them as cofactors. If such a building block is truly missing, refilling it can make sense. But if the stores are full, more of it brings no further push and, at a chronically high dose, can even disrupt, for instance when too much zinc throws the copper balance off. More is not equal to better here.

Immune system and silent inflammation

Silent inflammation from fat tissue can disturb hormone signals at the cell level. Some plant compounds act as antioxidants and could theoretically intervene here. But the step from an antioxidant lab effect to a measurably higher testosterone in everyday life is large and mostly unproven. A lower-inflammation lifestyle through nutrition, sleep and exercise acts at the same point, only broader and more sustainably.

These four lenses explain why the most serious effects are indirect, via stress and correcting a deficiency, and why the direct hormone turbo from a can usually fails to appear. And now you know why a good look at the whole system promises more than the hunt for the strongest ingredient.

Correcting a deficiency or booster hype: the decisive distinction

Here lies the core of the whole topic. There is a big difference between refilling a real shortage and trying to top up at normal values. These two things are deliberately blurred in marketing, because the logic of correcting a deficiency lends booster hype a scientific veneer.

The idea behind correcting a deficiency is simple and correct. If your body lacks a building block it needs for hormone production, then refilling that building block can make sense. This applies, for example, to zinc or vitamin D when a real, measured deficiency exists. But this is exactly where the trap lies. The effect occurs only if a deficiency was truly there. If the stores are full, nothing happens.

Study · men with low testosterone

Vitamin D did not measurably raise testosterone

RCT, double-blind, n=100 Elisabeth Lerchbaum and colleagues studied 100 healthy men with low testosterone and low vitamin D levels in 2018 in the European Journal of Nutrition. Over twelve weeks one half received high-dose vitamin D, the other a placebo. The result was clear: vitamin D had no measurable effect on total testosterone or the other hormone values. This suggests that refilling vitamin D in men without a pronounced deficiency is not a reliable way to raise testosterone.

Lerchbaum E, Trummer C, Theiler-Schwetz V, et al. Eur J Nutr. 2018;58(8):3135-3146. doi:10.1007/s00394-018-1858-z · PMID: 30460609

Booster hype turns this logic into excess. It suggests that more of a substance always means more effect, even when no deficiency exists at all. A second market analysis shows how thin the foundation of these promises often is.

Study · best-selling online boosters

Enthusiastic reviews shrink after filtering

Market analysis, literature review Adithya Balasubramanian and colleagues analyzed the best-selling testosterone boosters of a large online marketplace in 2019 in the Journal of Sexual Medicine. Of the studies on the most common ingredients, only a small part involved humans, and among these no clear proof of effect was found. Striking was the analysis of customer reviews: after filtering out untrustworthy comments, the positive reports of more libido, energy and strength collapsed by up to over ninety percent. This suggests that a large part of the perceived effect comes from marketing, not from the plant.

Balasubramanian A, Thirumavalavan N, Srivatsav A, et al. J Sex Med. 2019;16(2):203-212. doi:10.1016/j.jsxm.2018.12.008 · PMID: 30770069

Common misconception

"If it is in the booster, it surely cannot hurt." That is not quite true. Many boosters are high-dose blended formulas. In one product analysis, several formulas exceeded the upper safe intake level for zinc, niacin or magnesium. Too much zinc over a long time can disturb the copper balance. Over-the-counter does not automatically mean harmless, and with the hormone system more is rarely better.

Three levers that, by the data, move more than a powder

Before you put money into a booster powder, it is worth looking at the basics. They sound unspectacular, but they act exactly on the levers that co-determine testosterone in men. These three levers are a start, not a treatment plan. You find the individual path with medical guidance.

1

Address weight and belly fat

Belly fat converts testosterone into estrogen via the enzyme aromatase and releases inflammatory messengers. A sustained weight loss could therefore noticeably relieve the male hormone system. This is no quick push, but a lever on the whole system. It is not about crash diets, but about a way of eating that keeps blood sugar calm, with enough protein and fiber.

2

Protect your sleep

A large part of testosterone is produced during sleep, especially in the early morning hours. Anyone who chronically sleeps too little or poorly is sawing at one of the foundations of their own hormone production. A fixed rhythm, a dark, cool bedroom and taking snoring and breathing pauses seriously can make a difference. No booster replaces a night slept through.

3

Move, especially with resistance

Strength training improves insulin sensitivity, builds muscle and lowers belly fat, that is, exactly the factors linked to testosterone. It is telling that the most positive ashwagandha study ran in training men and that tongkat ali worked mainly in combination with training. Training is the lead actor, the plant at most a supporting role.

And if the symptoms remain despite good basics, a workup belongs to it that looks at the whole picture. Testosterone should be measured in the morning and ideally repeatedly, together with the controlling hormones, blood count, thyroid, iron and blood sugar. This way treatable causes can be found, instead of entrusting symptoms prematurely to a powder. A good workup takes your symptoms seriously.

The core

Boosters sell a shortcut that does not exist in this form

The honest answer is uncomfortable but freeing. No powder can replace what sleep, weight, exercise and stress regulation do for your hormone system. If any ingredient can do something, it is ashwagandha, and even that only to a small degree. Spare yourself the hunt for the strongest booster. Instead, support the whole system, and give your body the chance to find its own rhythm.

Frequently asked questions about testosterone boosters

What are testosterone boosters anyway?

Testosterone boosters are over-the-counter dietary supplements marketed with the message that they raise your own testosterone in a natural way. They are not hormones and contain no testosterone. Instead they usually hold blends of plant extracts such as ashwagandha, tribulus, tongkat ali, maca or fenugreek, plus vitamins and minerals like zinc, vitamin D and B vitamins. An analysis of 50 such products found on average more than eight ingredients per formula. Worth knowing: the word booster is marketing, not proof of effect. Whether a product measurably raises testosterone depends on the single ingredient, and convincing human studies are missing for many advertised components.

Does ashwagandha affect testosterone?

Ashwagandha is the booster ingredient with the best data, even if the effects stay moderate. Several controlled trials suggest that standardized ashwagandha extracts may raise testosterone slightly, often in the range of about ten to fifteen percent versus baseline. A study in resistance-training men found a clearer rise, while other studies in stressed or older men found smaller or not always statistically significant differences from placebo. A plausible route is indirect, via the stress axis, because ashwagandha may lower the stress hormone cortisol. So the picture is cautiously positive, but it is no miracle, and the studies are mostly small.

Does tribulus terrestris do anything for testosterone?

Tribulus terrestris is one of the most heavily advertised but most weakly supported booster ingredients. In controlled studies in men, tribulus showed no convincing effect on testosterone. A double-blind study in men with erectile dysfunction found no difference in total testosterone compared to placebo after the supplement. The often-cited hints of an effect come mostly from animal experiments, which do not transfer reliably to humans. So anyone relying on tribulus as a testosterone push is building on a thin foundation. It is a good example that advertised effect and proven effect can be two different things.

What about tongkat ali, maca and fenugreek?

For these plants the situation is mixed and overall thin. For tongkat ali, also called Eurycoma longifolia, there are single small studies that suggest an improvement in erectile function and a rise in testosterone in combination with training, though without a clean separation of the training effect from the plant. Maca improved subjective well-being and sexual function in small studies, without measurably raising testosterone. Fenugreek showed a small rise in free testosterone in saliva in one study, but the effect in blood remained unclear versus placebo. None of these plants has a robust, repeatedly replicated study base. The effects, where present, are small.

Does shilajit help against low testosterone?

Shilajit is a resin-like material from mountain regions that is marketed as a testosterone booster. The human evidence here is especially thin. In a database search on shilajit and testosterone in men, hardly any controlled clinical studies met the criteria. A few small investigations circulate, but that is not enough for a solid statement. From my perspective the same applies here as for many exotic ingredients: as long as large, well-conducted human studies are missing, the effect stays a hypothesis, not proof. Anyone who tries it should view it soberly as an experiment, not as an established treatment of a deficiency.

What does the analysis of marketed booster products show?

Two analyses of popular products paint a sobering picture. In a study of 50 boosters, 90 percent claimed to raise testosterone, but only about a quarter had any data supporting a rise. About ten percent contained components with hints of a rather lowering effect. Many products also delivered vitamins and minerals far above the daily requirement, some even above the upper safe limit. A second analysis of the best-selling online boosters found that a large share of enthusiastic customer reviews disappeared after filtering out untrustworthy comments. This suggests that the market is driven more by marketing than by evidence.

What is the difference between correcting a deficiency and booster hype?

This is the most important distinction in this topic. Correcting a deficiency means refilling a real, measured shortage of a micronutrient such as zinc or vitamin D. If a deficiency exists, refilling it can make sense, for general health alone. Booster hype, by contrast, promises that a powder pushes testosterone higher even when values are already normal. This is exactly where the evidence is weak. A controlled study showed, for example, that high-dose vitamin D did not measurably raise testosterone in men without a pronounced deficiency. So the honest line is: correct deficiencies, yes. Hope for a booster effect at normal values, rather no.

Can testosterone boosters have side effects?

Yes, they are not automatically harmless. Because many boosters are blended formulas with high doses of vitamins and minerals, an oversupply can occur. In one product analysis, several formulas exceeded the upper tolerable intake level for zinc, niacin or magnesium. Too much zinc over a long time can disturb the copper balance, for example. Plant extracts can also interact with medications, and the quality of over-the-counter products is not always controlled. Dietary supplements are not a free pass. Especially with symptoms or existing conditions, it should be clarified with a doctor beforehand whether and what is sensible.

Do lifestyle measures work better than boosters?

Much suggests that the basics move more than a powder. Sleep, weight, exercise and stress regulation act exactly on the levers that co-determine testosterone in men. A large part of testosterone is produced during sleep, belly fat converts testosterone into estrogen via the enzyme aromatase, and chronic stress may dampen hormone production. Strength training and weight loss improve insulin sensitivity and body composition. These levers are unspectacular, but they act on the whole system, not just on one number. A booster cannot replace these basics. At best it is a small building block, at worst expensive water.

When should I see a doctor about low testosterone instead of reaching for boosters?

If you have persistent symptoms such as marked fatigue, a clear loss of libido, new erectile problems, low mood or an unfulfilled wish to have children, this belongs in a medical assessment before you reach for boosters. Treatable causes can hide behind such symptoms, for instance a thyroid disorder, depression, sleep apnea, iron deficiency or a real hormone deficiency. A booster can neither find nor address these causes, and it can cost valuable time. A good assessment measures testosterone in the morning and repeatedly, together with the controlling hormones, blood count, thyroid and metabolic values. If you have thoughts of no longer wanting to live, please get help immediately.

Connections to other topics

When the value is truly lowUnderstanding testosterone deficiency

The deeper context on when a low value is truly a deficiency, instead of reaching prematurely for a booster.

When stress is the issueCortisol and the HPA axis in burnout

The stress axis is the most likely route of action of adaptogens like ashwagandha and is closely intertwined with testosterone.

When energy is missingIron deficiency and iron infusions

Iron deficiency amplifies many symptoms that look like a pure hormone problem, from exhaustion to reduced stamina.

When the thyroid joins inFunctional hypothyroidism

A borderline thyroid can co-influence drive, mood and energy, which is easily confused with testosterone deficiency.

The other side of hormonesHormonal imbalance in women

How female hormones work as a connected system, with many parallels to the metabolic and stress axis in men.

When the gut is involvedGut reset: holistic gut treatment

The gut co-influences, via the immune system and silent inflammation, how well your hormone balance stays in equilibrium.

SJ
Written by

Shukri Jarmoukli

Physician, Integrative Medicine, Clinical Psychoneuroimmunology · ViveCura Berlin, Skalitzer Straße 137 · Focus: male hormones as a connected system. On the topic of testosterone boosters, I see it as my task to separate marketing from evidence honestly. Instead of fueling hope for a powder, I look at the data on the individual ingredients and at the basics that truly support the male hormone system. This article draws on the controlled studies on ashwagandha (Wankhede 2015, Journal of the International Society of Sports Nutrition; Lopresti 2019, American Journal of Men's Health), on tribulus (Santos and Reis 2014, Actas Urológicas Españolas), on tongkat ali (Leitão 2020, Maturitas), on maca (Zenico 2009, Andrologia), and on the market analyses of over-the-counter boosters (Clemesha 2019, World Journal of Men's Health; Balasubramanian 2019, Journal of Sexual Medicine). My aim is a men's consultation that takes the whole system seriously, not just one number and not one advertising promise.

Sources and further reading

  1. Clemesha CG, Thaker H, Samplaski MK. 'Testosterone Boosting' Supplements Composition and Claims Are not Supported by the Academic Literature. World J Mens Health. 2020;38(1):115-122. doi:10.5534/wjmh.190043 · PMID: 31385468 [Review]
  2. Balasubramanian A, Thirumavalavan N, Srivatsav A, et al. Testosterone Imposters: An Analysis of Popular Online Testosterone Boosting Supplements. J Sex Med. 2019;16(2):203-212. doi:10.1016/j.jsxm.2018.12.008 · PMID: 30770069 [Review]
  3. Wankhede S, Langade D, Joshi K, et al. Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. J Int Soc Sports Nutr. 2015;12:43. doi:10.1186/s12970-015-0104-9 · PMID: 26609282 [RCT]
  4. Lopresti AL, Drummond PD, Smith SJ. A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males. Am J Mens Health. 2019;13(2):1557988319835985. doi:10.1177/1557988319835985 · PMID: 30854916 [RCT]
  5. Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. doi:10.1097/MD.0000000000017186 · PMID: 31517876 [RCT]
  6. Smith SJ, Lopresti AL, Fairchild TJ. Exploring the efficacy and safety of a novel standardized ashwagandha root extract in adults experiencing high stress and fatigue: a randomized, double-blind, placebo-controlled trial. J Psychopharmacol. 2023;37(11):1091-1104. doi:10.1177/02698811231200023 · PMID: 37740662 [RCT]
  7. Durg S, Shivaram SB, Bavage S. Withania somnifera (Indian ginseng) in male infertility: An evidence-based systematic review and meta-analysis. Phytomedicine. 2018;50:247-256. doi:10.1016/j.phymed.2017.11.011 · PMID: 30466985 [Meta-analysis]
  8. Santos CA, Reis LO, Destro-Saade R, et al. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study. Actas Urol Esp. 2014;38(4):244-248. doi:10.1016/j.acuro.2013.09.014 · PMID: 24630840 [RCT]
  9. Leitão AE, Vieira MCS, Pelegrini A, et al. A 6-month, double-blind, placebo-controlled, randomized trial to evaluate the effect of Eurycoma longifolia (Tongkat Ali) and concurrent training on erectile function and testosterone levels in androgen deficiency of aging males (ADAM). Maturitas. 2021;145:78-85. doi:10.1016/j.maturitas.2020.12.002 · PMID: 33541567 [RCT]
  10. Zenico T, Cicero AFG, Valmorri L, et al. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial. Andrologia. 2009;41(2):95-99. doi:10.1111/j.1439-0272.2008.00892.x · PMID: 19260845 [RCT]
  11. Lee-Ødegård S, Gundersen TE, Drevon CA. Effect of a plant extract of fenugreek (Trigonella foenum-graecum) on testosterone in blood plasma and saliva in a double blind randomized controlled intervention study. PLoS One. 2024;19(9):e0310170. doi:10.1371/journal.pone.0310170 · PMID: 39288153 [RCT]
  12. Rao A, Grant R. The effect of Trigonella foenum-graecum extract on prostate-specific antigen, and prostate function in otherwise healthy men with benign prostate hyperplasia. Phytother Res. 2019;34(3):634-639. doi:10.1002/ptr.6554 · PMID: 31828857 [RCT]
  13. Lerchbaum E, Trummer C, Theiler-Schwetz V, et al. Effects of vitamin D supplementation on androgens in men with low testosterone levels: a randomized controlled trial. Eur J Nutr. 2018;58(8):3135-3146. doi:10.1007/s00394-018-1858-z · PMID: 30460609 [RCT]
Note on the evidence: This article combines controlled studies with areas where the research is still thin. Relatively solidly established is that most over-the-counter boosters cannot support their promises with human studies (Clemesha 2019, Balasubramanian 2019) and that vitamin D did not measurably raise testosterone in men without a pronounced deficiency (Lerchbaum 2018). For ashwagandha there are several small controlled studies with moderate, not always consistent effects (Wankhede 2015, Lopresti 2019, Smith 2023, Durg 2018). For tribulus no convincing effect was found (Santos and Reis 2014). For tongkat ali, maca and fenugreek the effects are small and the study base limited (Leitão 2020, Zenico 2009, Lee-Ødegård 2024, Rao 2019). For shilajit, solid controlled human studies on testosterone are largely missing. This text serves information and does not replace a medical examination, diagnosis or treatment. Dietary supplements are not a substitute for a medical assessment. With persistent, new or unusual symptoms, with new erectile problems, with an unfulfilled wish to have children or with breast tissue enlargement, a medical assessment should take place. With low moods that do not pass, or with thoughts of no longer wanting to live, please get medical or psychotherapeutic help immediately (in Germany the Telefonseelsorge is free at 0800 111 0 111 or 0800 111 0 222).

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