Tongkat ali hair loss is an increasingly searched concern as this herbal testosterone-boosting supplement grows in popularity across the UK. Tongkat ali (Eurycoma longifolia), sold here as an unregulated food supplement, is claimed to raise free testosterone and reduce SHBG. Because elevated androgens — particularly dihydrotestosterone (DHT) — are a well-established driver of androgenetic alopecia, questions about whether tongkat ali accelerates hair thinning are biologically reasonable. This article examines the current evidence, identifies who may be at greatest risk, outlines when to seek medical advice, and reviews licensed UK treatment options for hair loss.

Can Tongkat Ali Cause Hair Loss?

Tongkat ali may theoretically raise DHT levels and trigger hair loss in genetically predisposed individuals, but this link has not been confirmed in robust human clinical trials.

Not sure if this is normal? Chat with one of our pharmacists →

Tongkat ali (Eurycoma longifolia), also known as Malaysian ginseng or longjack, is a herbal supplement derived from a South-East Asian shrub. It is widely marketed for its purported ability to boost testosterone levels, enhance libido, and support athletic performance. As its popularity has grown in the UK, questions have arisen about whether it can cause or accelerate hair loss.

In the UK, tongkat ali is sold as a food supplement and is regulated primarily under the Food Standards Agency (FSA) framework, not as a licensed medicine. It has no UK marketing authorisation, no Summary of Product Characteristics (SmPC), and has not been assessed by NICE or the EMA. There is no MHRA safety alert specifically citing alopecia as a confirmed adverse effect of tongkat ali; however, the absence of a formal alert does not exclude the possibility of risk, as spontaneous adverse event reporting for food supplements is incomplete.

The theoretical concern about hair loss is not without biological basis. Small human studies suggest that tongkat ali may modestly increase free testosterone and reduce sex hormone-binding globulin (SHBG), though the evidence remains limited and the magnitude of effect varies between studies and products. If these androgenic effects occur, they could theoretically elevate levels of dihydrotestosterone (DHT) — a potent androgen produced from testosterone via the enzyme 5-alpha reductase — though this has not been directly demonstrated in robust human trials.

DHT is well established as a key driver of androgenetic alopecia (male and female pattern hair loss). In genetically predisposed individuals, elevated DHT binds to androgen receptors in hair follicles, causing progressive miniaturisation and eventual follicle dormancy. Whether tongkat ali meaningfully raises DHT in humans, and whether this translates to clinically significant hair loss, has not been confirmed in clinical studies. The proposed link remains biologically plausible but speculative.

The quality and standardisation of tongkat ali supplements vary considerably between brands and batches. Products sold as food supplements in the UK are not subject to the same pre-market efficacy and safety testing as licensed medicines. Adulteration and heavy metal contamination have been reported in some herbal supplement products. Consumers should purchase only from reputable UK retailers and seek products with independent Certificates of Analysis. Avoid products that make medicinal claims, as these may be unlicensed medicines.

People who are pregnant, breastfeeding, under 18 years of age, or who have hormone-sensitive conditions should avoid androgenic supplements unless specifically advised otherwise by a clinician.

Who May Be at Greater Risk of Hair Loss When Taking It

People with a personal or family history of androgenetic alopecia, women with PCOS or hyperandrogenism, and those combining tongkat ali with other androgenic products are at the greatest theoretical risk.

Not everyone who takes tongkat ali will experience hair loss, and for many users the supplement may have no noticeable effect on hair at all. However, certain individuals may be at greater risk if the supplement does influence androgen levels.

Those most likely to be at increased risk include:

• People with a personal or family history of androgenetic alopecia — if close relatives have experienced significant hair thinning, hair follicles may be more sensitive to DHT fluctuations due to genetic variation in androgen receptor sensitivity.

• Women, particularly those with polycystic ovary syndrome (PCOS) or other signs of hyperandrogenism — women with elevated androgen levels (evidenced by acne, hirsutism, or menstrual irregularity) may be more susceptible to further androgenic stimulation, which could worsen hair thinning.

• People at a stage when androgenetic alopecia is emerging or progressing — any additional androgenic stimulus may accelerate an already active process, regardless of age.

• Individuals taking other supplements or medications that affect hormone levels — combining tongkat ali with other testosterone-boosting products, anabolic steroids, or certain medications may compound androgenic effects.

Two people taking the same dose of tongkat ali may have very different outcomes in terms of hair health, owing to individual differences in androgen receptor sensitivity and baseline hormone levels.

Tongkat ali should be avoided without specialist advice in:

• Pregnancy and breastfeeding

• Children and adolescents under 18 years of age

• People with hormone-sensitive conditions, including prostate cancer, breast cancer, or other androgen-sensitive malignancies

• Men with lower urinary tract symptoms or known prostate disease

If you fall into any of the above categories and are considering taking tongkat ali, discuss this with your GP or a pharmacist before starting, particularly if hair retention is a concern. Women with signs of hyperandrogenism and men with symptoms of hypogonadism or prostate disease should seek GP advice before using any androgenic supplement.

What the Current Evidence Says About Safety and Side Effects

Clinical evidence is limited and no studies have investigated hair loss as an outcome; the most clearly documented safety concern is rare herb-induced hepatotoxicity requiring urgent medical attention.

The clinical evidence base for tongkat ali remains limited. Most studies conducted to date have been small in scale, short in duration, or carried out in animal models. A number of human trials have examined its effects on testosterone levels, stress hormones, and physical performance, with some reporting modest increases in free testosterone and reductions in cortisol. A 2013 pilot study published in Evidence-Based Complementary and Alternative Medicine found that a standardised water-soluble extract of tongkat ali increased testosterone levels in a small group of men with late-onset hypogonadism. However, none of these studies have specifically investigated hair loss as an outcome, and the overall evidence base is insufficient to draw firm conclusions about either efficacy or safety.

In terms of general tolerability, short-term use at typical doses appears to be reasonably well tolerated in published studies. Reported side effects in the literature may include:

Experiencing these side effects? Our pharmacists can help you navigate them →

• Insomnia or restlessness, particularly at higher doses

• Increased irritability or agitation

• Gastrointestinal discomfort

Importantly, rare cases of herb-induced liver injury (hepatotoxicity) have been reported in association with Eurycoma longifolia. If you experience jaundice (yellowing of the skin or whites of the eyes), dark urine, pale stools, severe abdominal pain, or persistent itching whilst taking tongkat ali, stop the supplement immediately and seek urgent medical attention.

Concerns also exist about heavy metal contamination and adulteration in some tongkat ali products, particularly those sourced from unregulated suppliers. Purchase supplements only from reputable UK retailers; look for products with independent Certificates of Analysis confirming purity and content. Avoid products making medicinal claims.

Tongkat ali is not recommended during pregnancy or breastfeeding, and is not suitable for children or adolescents.

If you suspect you have experienced an adverse reaction to tongkat ali or any other supplement, you can report this to the MHRA via the Yellow Card scheme (yellowcard.mhra.gov.uk). Reporting helps build the UK's understanding of supplement safety.

In summary, while the theoretical link between tongkat ali and hair loss is biologically plausible given its proposed androgenic mechanism, robust clinical evidence confirming this association is currently lacking. The rare risk of hepatotoxicity is a more clearly documented safety concern. Consumers should approach claims — both for and against — with appropriate caution.

When to Seek Medical Advice About Hair Loss

Consult your GP promptly if you notice increased shedding, patchy loss, or thinning after starting tongkat ali, especially if accompanied by fatigue, weight changes, or skin symptoms suggesting an underlying condition.

Hair loss can have many causes, and it is important not to attribute it automatically to any single supplement without proper evaluation. If you have recently started taking tongkat ali and notice increased hair shedding, thinning at the crown or temples, or a widening parting, it is sensible to consult your GP.

You should seek medical advice promptly if you experience:

• Sudden or patchy hair loss — this may suggest alopecia areata, an autoimmune condition unrelated to androgens, which warrants separate investigation

• Diffuse shedding across the whole scalp — known as telogen effluvium, this can be triggered by hormonal changes, nutritional deficiencies, or physiological stress. Note that telogen effluvium typically begins two to three months after a trigger and may take several months to improve after the cause is addressed

• Hair loss accompanied by other symptoms such as fatigue, weight changes, irregular periods, skin changes, or cold intolerance — these may point to an underlying thyroid disorder, iron deficiency anaemia, or hormonal imbalance

• Rapid or severe hair loss causing significant distress

• Signs that may suggest scarring alopecia — including scalp pain, redness, scaling, or scarring — which requires prompt dermatological assessment

• Hair loss in a child, loss of eyebrows or eyelashes, or hair loss associated with systemic symptoms — these warrant specialist referral

In UK primary care, initial investigations for hair loss commonly include a full blood count (FBC), serum ferritin, and thyroid-stimulating hormone (TSH). Androgen panels (including testosterone and SHBG) are generally reserved for women with clinical features of hyperandrogenism (such as acne, hirsutism, or menstrual irregularity) and for men with symptoms or signs of hypogonadism, rather than being routine for all presentations of hair loss.

If tongkat ali is suspected as a contributing factor, stopping the supplement and monitoring for improvement over several months may be recommended as part of the assessment. Do not stop any prescribed medicine without first discussing this with your GP.

Your GP may refer you to a dermatologist if the diagnosis is uncertain, if scarring alopecia is suspected, if hair loss is severe or rapidly progressive, or if initial treatments are ineffective. Always inform your GP and pharmacist about any supplements you are taking, as these are not always considered during routine consultations but can have clinically relevant effects.

Regulated Alternatives and NHS Guidance on Hair Loss Treatments

Licensed UK options for androgenetic alopecia include OTC topical minoxidil for men and women, and prescription-only finasteride 1 mg for adult men, with important MHRA safety warnings regarding finasteride's psychiatric and sexual side effects.

For those experiencing hair loss — whether or not it is related to tongkat ali — there are several evidence-based, regulated treatment options available in the UK. The NHS recognises that hair loss is a common condition affecting both men and women and provides guidance on when treatment may be appropriate.

Licensed options for androgenetic alopecia in the UK include:

• Topical minoxidil (solution or foam) — available over the counter for both men and women. Topical minoxidil prolongs the anagen (growth) phase of the hair cycle and is the most widely used first-line treatment. It does not affect DHT levels but supports follicle activity directly. Common adverse effects include scalp irritation, contact dermatitis, and an initial increase in shedding during the first few weeks of use. Unwanted facial hair growth (hypertrichosis) has been reported. Topical minoxidil should not be used during pregnancy or breastfeeding; refer to the product SmPC for full cautions and dosing guidance.

• Finasteride 1 mg (oral tablet) — a prescription-only medicine licensed for male pattern hair loss in adult men. It works by inhibiting 5-alpha reductase, thereby reducing DHT production. Finasteride is not licensed for use in women of childbearing potential due to the risk of harm to a male foetus; women who are or may become pregnant must not handle crushed or broken tablets. In the UK, finasteride for hair loss is usually prescribed privately rather than on the NHS. Important MHRA safety information: finasteride is associated with sexual dysfunction (including decreased libido, erectile dysfunction, and ejaculatory disorders), which may persist after stopping treatment. Psychiatric adverse effects, including depression and, rarely, suicidal ideation, have also been reported. Patients should be counselled about these risks before starting treatment and provided with the MHRA patient alert card. Stop finasteride and seek medical advice promptly if you experience mood changes, depression, or thoughts of self-harm. Refer to the current SmPC and BNF monograph for full prescribing information.

• Dutasteride — another 5-alpha reductase inhibitor sometimes used for hair loss, but it is not licensed for this indication in the UK. If used, it should be under specialist supervision with full informed consent regarding its off-label status and adverse effect profile.

Non-pharmacological options include wigs, hairpieces, and scalp camouflage products, which the NHS can sometimes provide. Hair transplant surgery is available privately. Referral to a dermatologist may be appropriate when the diagnosis is uncertain or when specialist management is needed.

For general hair health, a balanced diet adequate in iron, zinc, and protein is supportive, though dietary measures alone are unlikely to reverse established androgenetic alopecia.

If you are currently taking tongkat ali and are concerned about hair loss, the most prudent course of action is to discontinue the supplement, allow time to assess whether shedding improves, and consult your GP for a thorough evaluation. Self-treating with unregulated supplements in place of evidence-based care is not recommended, and any significant hair loss should always be investigated to rule out underlying medical causes.

For further information, the NHS Hair Loss page, the British Association of Dermatologists (BAD) patient information resources, and the Primary Care Dermatology Society (PCDS) guidance provide reliable, up-to-date advice.

Frequently Asked Questions