EURYCOMA LONGIFOLIA JACKEURYCOMA LONGIFOLIA JACKTREASURE OF THE RAINFORESTTREASURE OF THE RAINFOREST

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DR. M.I.M TAMBI ,HEAD,SPECIALIST CLINIC ,SPECIALIST REPRODUCTIVE RESEARCH CENTRE ,NATIONAL POPULATION AND FAMILY DEVELOPMENT BOARD,MINISTRY OF WOMEN AND FAMILY DEVELOPMENT.

TONGKAT ALI AND MALE HEALTH

Tall shrub tree of Simaroubacea Tall shrub tree of Simaroubacea familyfamily

Commonly found along the hilly Commonly found along the hilly jungle slopes of Malaysiajungle slopes of Malaysia

Bigger version found in Bigger version found in Himalayas known as Himalayan Himalayas known as Himalayan GinsengGinseng

2 varieties having medicinal 2 varieties having medicinal valuesvalues

E. ApiculataE. Apiculata E.LongifoliaE.Longifolia

EURYCOMALONGIFOLIA

SIMAROUBACEAE

tongkat ali,penawar pahitpasak bumicay ba binhplant that curethousand diseases

Eurycoma LongifoliaEurycoma LongifoliaMedicinal Properties Medicinal Properties

Traditionally used as a multipurpose Traditionally used as a multipurpose health tonic by the Malayshealth tonic by the Malays

Used to treat fever and ‘Deman Kura’Used to treat fever and ‘Deman Kura’ Used to treat ulcer and swellingUsed to treat ulcer and swelling In Indonesia, locally brewed with In Indonesia, locally brewed with

coffee for physical and muscular coffee for physical and muscular reliefrelief

AphrodisiacAphrodisiac AntiviralAntiviral AntimalarialAntimalarial AntipyreticAntipyretic AntihistaminicAntihistaminic AntiulcerAntiulcer cytotoxiccytotoxic

Eurycoma LongifoliaEurycoma LongifoliaMedicinal Properties Medicinal Properties

Antihypertensive Antidysentery Antiaging?

Organic Extract Organic Extract ( ( Most of the work doneMost of the work done))

Mostly Quassinoids ( bitter)Mostly Quassinoids ( bitter)

Eurycomanon, Eurycomanol, Eurycomanon, Eurycomanol, Eurycomalactone, etcEurycomalactone, etc

Generally toxic. Showed biological Generally toxic. Showed biological activity.activity.

Antileukemic, anti tumor, Anti malarial, Antileukemic, anti tumor, Anti malarial, anti inflammation and antiamebicanti inflammation and antiamebic

Most work done by the Japanese and Indonesian gpsMost work done by the Japanese and Indonesian gps

Water soluble ComponentsWater soluble Components

Very little work done- due to Very little work done- due to difficulties of the phenolic cpdsdifficulties of the phenolic cpds

Polimerisation of phenols and tanins.Polimerisation of phenols and tanins. But most of the traditional usage is But most of the traditional usage is

water base.water base. Extract is believed to be biologically Extract is believed to be biologically

active in rendering some of the active in rendering some of the observed health propertiesobserved health properties

Sexual behavior Studies.Sexual behavior Studies.

3 sets of 4 gps of mice consisting of 3 female 3 sets of 4 gps of mice consisting of 3 female and 1 maleand 1 male

Gp 1 treated with salineGp 1 treated with saline Gp 2 female treated with extract, male with Gp 2 female treated with extract, male with

salinesaline Gp 3 both male and female treated with Gp 3 both male and female treated with

extractextract Gp 4 male treated with extract, female with Gp 4 male treated with extract, female with

saline.saline.

Treatment carried out for 7 days and rested for 2 days before Treatment carried out for 7 days and rested for 2 days before matingmating

Mounting and Litter SizeMounting and Litter Size

Group 30 minutes 60minutes litter size male: Group 30 minutes 60minutes litter size male: femalefemale

1 3 2 7 1:11 3 2 7 1:1

2 1 0 4 1:12 1 0 4 1:1

3 3 3 10 3:13 3 3 10 3:1

4 15 10 16 3:14 15 10 16 3:1

J.M. Saad et al 1994J.M. Saad et al 1994

Effects of Effects of E. longifoliaE. longifolia on animal on animal testosteronetestosterone

Animal % increasedAnimal % increased

Mice 479%Mice 479%

Rat 380%Rat 380%

Rabbit 320%Rabbit 320%

*Human testicular homogenate ( *Human testicular homogenate ( in vitroin vitro) 440%) 440%

J.M Saad et al 1995J.M Saad et al 1995

Review of earlier observations.

increase energy production through increase energy production through glycolysis and oxidative glycolysis and oxidative phosphorylationphosphorylation

elevate testosterone levelelevate testosterone level increase sperm quality and quantityincrease sperm quality and quantity increase litter sizeincrease litter size changes in male:female ratio ( 1:1 to changes in male:female ratio ( 1:1 to

3:1)3:1) elevate sperm concentration and elevate sperm concentration and

percentage of motility ratepercentage of motility rate increase percentage of progressive and increase percentage of progressive and

sperm with rapid movementsperm with rapid movement increase VAP,VSL,VCL and ALH valuesincrease VAP,VSL,VCL and ALH values

Pregnenolone metabolite analysisPregnenolone metabolite analysisPregnenolone metabolite analysisPregnenolone metabolite analysis ug steroid/10 mg proteinug steroid/10 mg protein

steroid steroid blank blank control control E.longifolia E.longifolia extractextract

derivatives derivatives 2 2 33 1a1a 2c2c

55-androstenone-androstenone * * * * * * ** ** **

androstenedioneandrostenedione - - -- * * 0.080.08 0.090.09 **

andien andien & an- & an- 4.05 4.05 2.682.68 0.88 0.88 1.421.42 1.541.54 1.791.79

an-an- 22.57 22.57 32.70 32.70 109.99 109.99207.26207.26 90.3890.38 93.8693.86

5-androstediol5-androstediol * * ** * * ** ** **

55-DHT-DHT - - -- * * ** ** **

4-androstenedione4-androstenedione * * ** * * 0.070.07 0.090.09 **

testosteronetestosterone 0.98 0.98 1.681.68 2.43 2.43 2.372.37 2.002.00 2.862.86

55-androstane-diol --androstane-diol - -- * * ** ** **

17-Ohpreg17-Ohpreg 2.43 2.43 5.155.15 1.14 1.14 1.311.31 1.591.59 3.343.34

DHADHA - - -- - - -- -- --

progesteroneprogesterone 3.36 3.36 6.396.39 12.30 12.30 13.2013.20 12.4812.4813.0713.07

17-Ohprog17-Ohprog * * ** * * ** ** * *

Steroid metabolite analysis (in human testes)

Steroid metabolite analysis (in human testes)

ug steroid/ mg protein steroid control pregnenolone E.longifolia derivatives extract

5Androstane-3diol 5.12 1.06 7.89 0.82 5.75 0.32

5-Androstenediol 8.19 0.31 11.39 0.75 7.42 0.19

5-Dihydrotestosterone 21.24 2.13 25.44 2.25 20.53 0.61

16-Dehydropregnenolone 3.72 2.04 3.94 0.91 4.86 0.94

testosterone 2.48 0.96 2.91 0.76 12.91 1.03

17-Hydroxypregnenolone 0.11 0.02 0.76 0.04 0.09 0.00

4-Androstenedione 18.33 4.21 21.58 0.94 24.51 1.83

Some clinical data on humanSome clinical data on human

10 males (>40years) who showed 10 males (>40years) who showed hypogonadism testosterone level less hypogonadism testosterone level less then 11then 11

2x2(450mg) capsules of powdered root 2x2(450mg) capsules of powdered root morning and evening for 1 month.morning and evening for 1 month.

Serum testosterone showed increase inSerum testosterone showed increase in

50% of the consumers.50% of the consumers.

Data from Dr Ismail Data from Dr Ismail

Dosage 2x2(50mg/capsules) morning & evening for 10 days Normal range for athlete 800 = 150ng/dl of bloodVolunteer age pre treatment after treatment

ng/dl blood ng/dl blood 1 26 860 = 30 1,650 = 50 2 28 580 = 30 985 = 35 3 35 875 = 40 1, 576 = 60 4 24 950 = 45 2,210 = 55 5 29 755 = 30 1,345 = 35 6 48 650 = 20 875 = 30 7 52 450 = 25 765 = 35 8 50 585 = 25 875 = 35 9* 42 350 = 30 480 = 35Data – preliminary data - more work to be carried outVolunteer 1-5 active sportmen- data are average of 3 different studies at different time

Saliva testosterone level

Glimpses on Current Human TrialGlimpses on Current Human TrialIn MalaysiaIn Malaysia

TONGKAT TONGKAT ALIALI

OPEN EXPLORATORY OPEN EXPLORATORY HUMAN TRIALHUMAN TRIAL

30 HUMAN 30 HUMAN VOLUNTEERSVOLUNTEERS

AGE RANGES FROM AGE RANGES FROM 31-5231-52

NO SPECIFIC CRITERIANO SPECIFIC CRITERIA 2X50MG WATER-2X50MG WATER-

SOLUBLE EXTRACTSOLUBLE EXTRACT

DAILY FOR THREE DAILY FOR THREE WEEKSWEEKS

UPON REGISTRATIONUPON REGISTRATION

VOLUNTEERS FILLED UP VOLUNTEERS FILLED UP TWO QOL TWO QOL QUESTIONNAIRESQUESTIONNAIRES

SHIQ AND PADAMSHIQ AND PADAM

AND BASELINE AND BASELINE SR.TESTOSTERONE,SR.TESTOSTERONE,

DHEA AND SHBGDHEA AND SHBG THESE WERE THESE WERE

REPEATED ON FIRST REPEATED ON FIRST AND THIRD WEEK AND THIRD WEEK FOLLOWUPSFOLLOWUPS

PERCENTAGE REDUCTION OF PADAM PERCENTAGE REDUCTION OF PADAM SCORE AND COMPONENTSSCORE AND COMPONENTS

Effect on PADAM Score

0

10

20

30

40

50

B C D E F G H I J K L M N O P Q R S T U V W

Individuals

PADA

M S

core

After

Before

TOTAL SCORE REDUCED TOTAL SCORE REDUCED BY 82%BY 82%

PHYSICAL DOMAIN PHYSICAL DOMAIN REDUCED BY 73%REDUCED BY 73%

PSYCHOLOGICAL DOMAIN PSYCHOLOGICAL DOMAIN REDUCED BY 91%REDUCED BY 91%

VASOMOTOR DOMAIN VASOMOTOR DOMAIN REDUCED BY 50%REDUCED BY 50%

SEXUAL DOMAIN REDUCED SEXUAL DOMAIN REDUCED BYBY

91%91%

REDUCTION REDUCTION INDICATES INDICATES IMPROVEMENTIMPROVEMENT

PADAM SCORE

Minimum score/ decreased 82%

Increased score 9%

Same score 9%

SEXUAL HEALTH INVENTORY SCORE SEXUAL HEALTH INVENTORY SCORE (IIEF)(IIEF)

Effect on IIEF

0

10

20

30

40

50

60

A B C D E F G H I J K L M N O P Q R S T U V W

Individuals

IIEF

After

Before

62% INCREASE IN 62% INCREASE IN SCORESCORE

14% HAVING SAME 14% HAVING SAME SCORE AND THE SCORE AND THE REST DECREASED REST DECREASED SCORESCORE

IIEF Score

Maximum score/ increased 62%Decreased score 24%Same score 14%

TOTAL TESTOSTERONETOTAL TESTOSTERONEEffect on Total Testosterone

0

10

20

30

40

50

60

70

80

A B C D E F G H I J K L M N O P Q R S T U V W

Individuals

To

tal

Tes

tost

ero

ne

INDICATES BOTH FREE AND BOUND INDICATES BOTH FREE AND BOUND TESTOSTERONETESTOSTERONE

INCREASE GENERALLY MEANS MORE INCREASE GENERALLY MEANS MORE HORMON FOR THE BODYHORMON FOR THE BODY

HORMON DHEAHORMON DHEA

LEVELS INCREASELEVELS INCREASE

AT ONE WEEKAT ONE WEEK 26%26%

AT THREE WEEKAT THREE WEEK 47%47%

DHEA SHOWED A GRADUAL INCREASE IN THE LEVEL FROM 26% AT FIRST WEEK TO 47% AT THIRD WEEK.DHEA IS AROMATISED TO TESTOSTERONE

RESULT OF SHBG ANALYSISRESULT OF SHBG ANALYSISINCREASEINCREASE

LEVELLEVELDECREASE DECREASE LEVELLEVEL

NO NO CHANGE CHANGE IN LEVELIN LEVEL

AT ONE AT ONE WEEK WEEK INTERVALINTERVAL 52%52% 36%36% 12%12%

AT THREE AT THREE WEEKWEEK

INTERVALINTERVAL 2727 66%66% 7%7%

REDUCTION IN SHBG MEANS MORE FREE TESTOSTERONE FOR UTILISATION OF THE BODY

FREE TESTOSTERONE INDEXFREE TESTOSTERONE INDEX

Effect on FTI (Free Testo Index)

0

50

100

150

200

1 4 5 6 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 25 26 27

Individuals

FTI

INDICATES THE INDICATES THE AMOUNT OF AMOUNT OF TESTOSTERONE TESTOSTERONE FREELY AVAILABLE FREELY AVAILABLE FOR UTILISATION BY FOR UTILISATION BY THE BODYTHE BODY

BY THIRD WEEK BY THIRD WEEK THERE IS INCREASE THERE IS INCREASE AMOUNT OF AMOUNT OF TESTOSTERONE TESTOSTERONE AVAILABLE IN 73% OF AVAILABLE IN 73% OF THE VOLUNTEERS.THE VOLUNTEERS.

CONCLUSIONCONCLUSION

Tongkat Ali has potential value in the Tongkat Ali has potential value in the maintenance of male sexual and maintenance of male sexual and reproductive health besides other reproductive health besides other benefits.benefits.

R&D in this area are currently on going.R&D in this area are currently on going. Presently, Water Extract compound of TA Presently, Water Extract compound of TA

is already available in the market as an is already available in the market as an Health Elixir for men and is already Health Elixir for men and is already going into International Markets. going into International Markets.

THANK YOU