Tribulus is a traditional Chinese medicinal herb that has gained attention lately for its uses in enhancing sexual and athletic performance and treating painful urination and as a general tonic (Anand et ah, 1994).

The main active components in tribulus appear to be steroidal saponins and protodioscin. Tribulus has been proven to improve sexual desire and erectile function by converting protodioscin to DHEA. Both phyto-chernicals have been shown in preclinical tests to stimulate sexual desire and function .

Few well-designed studies have been conducted on Tribulus terrestris for its primary indications of sexual performance and athletic performance. Of the few human clinical studies involving treatment with only tribulus, the results were favorable. A few other studies exist in the areas of sexual performance and athletic performance, but they used tribulus in a mixture with other supplements, and it is not known how much the tribulus contributed to the clinical results. Of note, a heart drug made from Tribulus terrestris saponins is being recommended for clinical therapy and prevention of atherosclerosis in Russia (Kern ertelidze et al., 1982). Overall, even though tribulus is one of the most popular ingredients in supplements for bodybuilding, clinical support to back up its claims is still lacking.

Sexual Performance
Nikolova and Stanislavov (2000) performed a clinical study involving 51 patients using an extract of Tribulus terrestris (Tribestan) and found statistically significant improvement in parameters to measure infertility.

The use of tribulus treatment over 3 months produced reductions in the leukocyte count and the locally secreted immunoglobulins, elevation of tt-amylase levels, and normalization of seminal parameters. The authors noted that the treatment with Tribulns terrestris extract had a side benefit of improving overall male health, indicated by decreased cholesterol and triglyceride levels and elevated levels of lipoproteins by the end of the study.

Stanislavov and Nikolova (2000) reported thai in 15% of the infertile couples in Russia, 9% of males and 15% of women showed signs of infertility that might have been the result of imrnunological health. In a study of a cohort of this group, Tribulus terrestris extract (Tribestan) was chosen because of the presence of furostanol compounds in the plant and the absence of reported toxicity in humans. As a result of treatment, conception was reportedly good in these couples, especially when the males had high liters of sperm antibodies. The authors noted that due to the good results, they recommended treatment in similar cases in practice.

In a double-blind study with Tribulus terrestris, 45 men with fertility problems {moderate idiopathic oligozoosperms) were given a dry-powder extract or a placebo. After 3 months of treatment, 7 of the 36 men treated successfully conceived with their wives. In the treatment groups, significant increases in normal acrosome morphology and aero-some reaction test were found.

Athletic Performance
Ten highly trained cyclists were given a supplement of Tribulus terrestris and ipriflavone or a placebo for 38 days. Cyclists in the active group improved hormonal markers of overtraining and performance during the period of intense training and competition (McGregor et al., 2000). Street et al. (2000) gave capsules containing 250 mg of Tribulus terrestris, 100 mg of 7-ispropoxyisofavone, 100 mg ofAvena saliva, and 50 mg of saw palmetto to two bodybuilders to determine the effect of the supplement on plasma testosterone and luteinizing hormone. As part of the normal weight-lifting regime, the supplements were administered for 2 weeks, 8 capsules 2 times daily. The luteinizing hormone and plasma

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Testosterone tevels were found not to change within the period of supplementation, nor were biochemical measures of liver function changed.

Hor a standardized extract (60% saponins), the dosage is 100-500 mg 3 times daily; an unspecified preparation of tribulus was used in a couple of clinical studies at the dosage of 750-1,350 mg/day along with other supplements (Brown et al., 2000, 2001a, 2001b, 2001 c).

The only reported side effect of tribulus is frequent urination, and because of its diuretic properties, tribulus is not recommended in cases of dehydration (Singh and Sisodia, 1971). There are no known drug interactions with tribulus.

Possible association with hepatotoxicity, photosensitization, and a disease called geeldikkop have been made with the ingestion of large amounts of tribulus by sheep but have never been confirmed (Bourke, 1984; Clastonbury, 1984).

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