The most common side effects of Tribulus terrestris are digestive symptoms such as nausea, vomiting, diarrhea, stomach cramps, heartburn, and irritation of the digestive tract lining[1][6]. Mild, uncommon side effects may also include stomach pain and cramping[6], trouble sleeping, and irregular menstrual cycles[4].
There are case reports of more serious adverse effects in rare situations or with high doses, including liver and kidney damage and, in some instances, sudden kidney failure or acute tubular necrosis[1][2][5]. Severe hyperbilirubinemia (leading to acute renal failure), neurotoxicity, and hypertension have also been associated with excessive consumption[2]. Isolated cases of priapism (prolonged erections) have been reported[2]. In very rare cases, tribulus use has been linked to rhabdomyolysis (severe muscle injury), particularly when combined with medications like statins due to possible drug interactions[5].
Lab studies have linked the herbal supplement to possible problems with fetal development, so its use during pregnancy or breastfeeding is not recommended[3][4][6]. There are also concerns that tribulus could worsen prostate conditions such as benign prostatic hyperplasia (BPH) or prostate cancer because it might increase prostate weight[3][4].
Drug interactions are another risk. Tribulus may interact with blood thinners, diabetes medications, blood pressure medicines, diuretics, and drugs that use the cytochrome P450 3A4 metabolic pathway[1][3][4][5]. People scheduled for surgery should stop tribulus at least two weeks in advance due to its potential effects on blood sugar and blood pressure[3][6].
Reports of more serious or rare side effects include sudden kidney or liver failure, blood clots (especially if taken with antiplatelet drugs like clopidogrel), and severe lung problems if the spine-covered fruit is ingested[1][2][3][5][6].
Short-term use of Tribulus terrestris at recommended oral doses (usually 750–1500 mg daily for up to 8–12 weeks) is generally considered possibly safe for otherwise healthy adults[3][6]. However, the long-term safety profile remains unclear, and the supplement should be used with caution, especially in those with pre-existing medical conditions or who are taking medications.
References
- [1] Is Tribulus Terrestris Good for You and Are There any Side …
- [2] Tribulus terrestris — Memorial Sloan Kettering Cancer Center
- [3] Tribulus: Health Benefits, Side Effects, Uses, Dose & …
- [4] Tribulus Terrestris: Uses and Risks – WebMD
- [5] Rhabdomyolysis Risk: The Dangers of Tribulus terrestris …
- [6] TRIBULUS – Uses, Side Effects, and More – WebMD