Shilajit is a traditional Ayurvedic supplement increasingly marketed for male sexual health, including erectile dysfunction (ED). Derived from decomposed plant matter in the Himalayas, it contains fulvic acid and minerals. However, shilajit is sold as a food supplement in the UK and is not licensed by the MHRA as a medicine. Whilst some animal studies suggest potential effects on testosterone and blood flow, robust clinical evidence supporting its use for erectile dysfunction remains limited. Men experiencing ED should consult their GP to discuss evidence-based treatments recommended by the NHS and NICE, rather than relying on unproven supplements.

What Is Shilajit and How Does It Work?

Shilajit is a sticky, tar-like substance found primarily in the rocks of the Himalayas, formed over centuries by the gradual decomposition of certain plants. It has been used in traditional Ayurvedic medicine for thousands of years and is rich in fulvic acid, minerals, and various bioactive compounds. Proponents claim it may support energy levels, cognitive function, and male reproductive health, though the quality and composition of shilajit products can vary considerably.

In the UK, shilajit is sold as a food supplement and is not licensed by the MHRA as a medicine. This means it is not subject to the same rigorous testing and quality standards as licensed medicines. The lack of standardisation in shilajit preparations means that the concentration of active ingredients can differ widely between products, making it difficult to draw firm conclusions about efficacy or safety.

In terms of its proposed mechanism of action, shilajit is thought to work through several pathways, though these are based largely on animal and laboratory studies. Fulvic acid, one of its primary active components, may act as an antioxidant, potentially reducing oxidative stress in tissues. Some laboratory studies suggest shilajit might influence testosterone levels and mitochondrial function, which could theoretically support energy metabolism and cellular health. Additionally, certain animal studies have indicated possible effects on nitric oxide pathways, which are crucial for vascular function and blood flow—key factors in achieving and maintaining an erection.

However, it is important to note that the exact mechanisms remain poorly understood in humans, and animal data cannot be directly extrapolated to clinical practice. While traditional use is well-documented, robust clinical evidence supporting its use specifically for erectile dysfunction (ED) is limited.

Clinical Evidence and Research on Shilajit for ED

The clinical evidence supporting shilajit for erectile dysfunction is limited and of variable quality. There are no large, randomised, placebo-controlled trials demonstrating efficacy for ED. A small number of human studies have explored shilajit's effects on male reproductive health, primarily focusing on testosterone levels and sperm parameters rather than erectile function directly. For example, one study published in Andrologia (2016) involving healthy volunteers found that purified shilajit supplementation over 90 days was associated with increased total and free testosterone levels. However, this study did not specifically assess erectile function or include men diagnosed with ED.

Another pilot study examined shilajit's effects on sperm quality in infertile men, reporting improvements in sperm count and motility. While these findings are interesting, there is no established link between shilajit supplementation and improvement in erectile dysfunction in controlled clinical trials.

Animal studies have suggested potential benefits, including improved sexual behaviour and nitric oxide-mediated vasodilation in rodent models. However, animal data cannot be directly extrapolated to humans, and the doses used in such studies often differ significantly from those consumed by people.

Currently, shilajit is not licensed by the MHRA as a medicine and is not recommended by NICE or the NHS for erectile dysfunction. Men experiencing ED should be cautious about relying on supplements with limited clinical validation and are encouraged to discuss evidence-based treatment options with their GP or a specialist. For authoritative guidance on ED assessment and management, see the NICE Clinical Knowledge Summary on Erectile Dysfunction and the NHS website page on erectile dysfunction (impotence).

Safety, Side Effects and Interactions to Consider

While shilajit is generally considered safe when sourced from reputable suppliers, there are important safety considerations to bear in mind. The primary concern is product quality and contamination. Shilajit is a natural substance that can be contaminated with heavy metals (such as lead, mercury, and arsenic), mycotoxins, or other harmful compounds if not properly purified. The MHRA has issued advisories about unlicensed and adulterated sexual enhancement supplements, and shilajit products may carry similar risks if not independently tested. Because shilajit is not regulated as a medicine in the UK, quality control standards can vary widely between manufacturers.

It is essential to purchase shilajit only from reputable UK or EU suppliers that provide certificates of analysis confirming purity and absence of contaminants. Avoid products that make exaggerated health claims or lack transparent sourcing information.

Reported side effects are generally mild and may include:

• Gastrointestinal upset (nausea, diarrhoea, or abdominal discomfort)

• Dizziness or headache

• Allergic reactions in sensitive individuals

• Potential alterations in blood pressure or heart rate

There is limited information on drug interactions, and many claims are theoretical due to the lack of robust clinical data. Shilajit may theoretically interact with medications that affect blood pressure, blood sugar, or hormonal balance. Men taking antihypertensives or medications for diabetes should exercise caution and consult their GP before using shilajit. Additionally, because some studies suggest effects on testosterone, individuals with hormone-sensitive conditions should seek medical advice.

General cautions:

• Avoid use in pregnancy, breastfeeding, and in children under 18 years

• Discuss with your GP if you have significant liver, kidney, cardiovascular, or endocrine disease before using shilajit

• Do not use as a substitute for evidence-based treatments for erectile dysfunction

Patients should contact their GP if they experience:

• Persistent or severe side effects

• Signs of allergic reaction (rash, swelling, difficulty breathing)

• Worsening of existing health conditions

• No improvement in symptoms after several weeks

If you suspect you have experienced a side effect from shilajit, you can report it via the MHRA Yellow Card Scheme at www.mhra.gov.uk/yellowcard or by searching for 'MHRA Yellow Card' in the Google Play or Apple App Store. Reporting suspected side effects helps improve the safety information available on supplements and medicines.

NHS-Recommended Treatments for Erectile Dysfunction

The NHS and NICE recommend evidence-based treatments for erectile dysfunction, which have been rigorously tested in clinical trials. The first-line approach typically involves lifestyle modifications and addressing underlying health conditions. Men are encouraged to:

• Maintain a healthy weight and engage in regular physical activity

• Reduce alcohol consumption and stop smoking

• Manage cardiovascular risk factors such as hypertension, diabetes, and high cholesterol

• Address psychological factors, including stress, anxiety, or relationship issues

Assessment and investigations are important. Your GP will typically perform a cardiovascular risk assessment (for example, using QRISK) and may arrange blood tests, including:

• Morning total testosterone (with repeat testing and measurement of LH, FSH, and prolactin if low or if symptoms of hypogonadism are present)

• HbA1c or fasting glucose (to screen for diabetes)

• Fasting lipid profile

• Renal function and thyroid function as clinically indicated

• Blood pressure measurement

When lifestyle changes alone are insufficient, pharmacological treatments are available. The most commonly prescribed medications are phosphodiesterase type 5 (PDE5) inhibitors, which include:

• Sildenafil (Viagra)

• Tadalafil (Cialis)

• Vardenafil (Levitra)

• Avanafil (Spedra)

These medications work by enhancing the effects of nitric oxide, promoting smooth muscle relaxation and increased blood flow to the penis. Sexual stimulation is required for these medicines to work. They are effective in around two-thirds of men with ED and are generally well-tolerated. Generic sildenafil is usually available on NHS prescription when clinically appropriate; local policies vary for other PDE5 inhibitors. Sildenafil (Viagra Connect) is also available to purchase over the counter from pharmacies for men over 18 after a consultation with a pharmacist.

Important safety information for PDE5 inhibitors:

• Absolute contraindications: Do not use if you are taking nitrates (e.g., glyceryl trinitrate for angina) or riociguat (for pulmonary hypertension), as the combination can cause a dangerous drop in blood pressure.

• Caution required: If you are taking alpha-blockers (e.g., for prostate symptoms or hypertension), discuss timing and dosing with your GP to minimise the risk of low blood pressure.

• Common side effects include headache, flushing, indigestion, nasal congestion, and visual disturbances.

• Seek urgent medical attention if you experience an erection lasting more than 4 hours (priapism), as this is a medical emergency that requires immediate treatment to prevent permanent damage.

For detailed prescribing information, see the MHRA/emc Summaries of Product Characteristics (SmPCs) for sildenafil and tadalafil.

For men who do not respond to oral medications, second-line treatments include:

• Vacuum erection devices

• Intracavernosal injections (e.g., alprostadil)

• Intraurethral therapy

• Penile implants (in selected cases)

Psychological support is also important. NICE recommends considering psychosexual counselling, particularly when psychological factors contribute to ED.

When to seek specialist referral:

• Urgent referral (same day): Priapism lasting more than 4 hours

• Urology or andrology referral: Failure of first- or second-line therapy, penile deformity or Peyronie's disease, complex cases

• Endocrinology referral: Suspected hypogonadism or complex endocrine issues

• Cardiology referral: High cardiovascular risk or unstable cardiovascular disease

Men experiencing erectile dysfunction should consult their GP for a thorough assessment. Early intervention can improve outcomes and address potentially serious underlying conditions such as diabetes or heart disease. Relying solely on unproven supplements may delay access to effective, evidence-based treatments. For further information, see the NICE Clinical Knowledge Summary on Erectile Dysfunction and the NHS website page on erectile dysfunction.

Frequently Asked Questions