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Puncture vine

Tribulus terrestris

Also calledGokshura / gokhru (Sanskrit / Hindi) · Ji li (Chinese) · Hamabishi (Japanese) · Caltrop, goathead, devil's thorn (English) · Abrojo (Spanish)

In older monographsTribulus lanuginosus L., Fructus Tribuli (drug name)

A sprawling weed with spiny fruits, used in Chinese and Indian medicine and now sold worldwide as a 'testosterone booster' for athletes and for sexual function. Reviews find no reliable rise in testosterone; small, low-quality trials suggest some improvement in erectile function and sexual desire. WHO finds no use supported by clinical data, and case reports link supplements to liver and kidney injury.

What it is used for

Sexual function and libido
Limited
A 2026 meta-analysis of eight trials in men with erectile dysfunction found higher erectile-function scores than placebo (IIEF-5 about 3 points higher) with no change in testosterone; a 2025 systematic review rated the evidence low, with half the studies of low quality. A review of five small trials in women found improved sexual-function scores, with very low certainty. Reviews conclude that marketing claims of raised testosterone are unsubstantiated.^2,3,4,5
Fertility
Limited
A 2019 systematic review of seven small studies in men with unexplained infertility found improved sperm count, motility or morphology in six; most lacked proper controls. WHO describes a small trial with only nine men on placebo.^6,1
Heart
Limited
A 1990 Chinese observational study of 406 patients reported more relief of angina with a tribulus saponin extract than with a control treatment; WHO states that randomised controlled trials are needed before it can be recommended.¹
Kidney stones
Traditional
Traditional use for kidney stones and as a diuretic; supported only by rat studies of urolith formation and urine output.¹
Cough
Traditional
The Chinese Pharmacopoeia, as cited by WHO, lists oral use for cough; no clinical trials.¹
Headache
Traditional
The Chinese Pharmacopoeia, as cited by WHO, lists oral use for headache (and for mastitis); no clinical trials.¹

How it is prepared

decoction

Crushed dried fruit simmered in water.

WHO monograph: 3–6 g powdered fruit a day as a decoction (Ayurvedic Pharmacopoeia of India), or 6–9 g a day in divided doses (Chinese Pharmacopoeia).

Cough · Headache

dry extract / capsule

Standardised fruit extracts in tablets or capsules.

Trials in men reviewed in 2025 used 400–750 mg a day for 1–3 months.

Sexual function and libido

Amounts are as recorded by the named source, not a recommendation.

Safety

Pregnancy: Avoid
Breastfeeding: Avoid
Children: WHO: not recommended under 12 for lack of safety data.

Interactions with medicines

statins and other CYP3A4 substratesModerateA 2024 case report described rhabdomyolysis in a man taking tribulus with long-term atorvastatin; the authors cite research suggesting tribulus moderately inhibits CYP3A4.

Interaction checker →

Do not use if

Hypersensitivity or allergy to the plant

Side effects

Possible phototoxic reactions: WHO advises avoiding strong sun and using high-factor sunscreen
Rare reports of severe liver and kidney injury from supplements

Toxicity

Grazing livestock develop photosensitisation with swelling of the head, fever and jaundice (geeldikkop in South Africa, 'bighead' in Australia and the USA), sometimes fatal, and sheep can develop nervous-system disease after months of grazing. In humans, a 2024 case report describes a 46-year-old man who developed severe jaundice (bilirubin 48 mg/dl) and kidney failure after two months of daily supplements; a liver biopsy showed drug-induced liver injury and he recovered after plasmapheresis.

In the healing traditions

Traditional Chinese Medicine
Ji li (tsi li)
Dried fruit taken in decoction for headache, cough and mastitis.
Pharmacopoeia of the People's Republic of China (2005), as cited by WHO
Ayurveda
Gokshura (goksuraka, trikanta)
The fruit is an official drug of the Ayurvedic Pharmacopoeia of India, taken as a decoction. WHO's list of traditional uses, compiled from Indian and other sources, includes diuretic, kidney-stone, aphrodisiac, galactagogue and tonic use.
Ayurvedic Pharmacopoeia of India, Part I, vol. I (1990), as cited by WHO
Modern pharmacology
Tribulus extract (often standardised to protodioscin)
Sold as a sports and sexual-health supplement on the claim that it raises testosterone; systematic reviews find it does not raise testosterone in men with normal levels.

Active compounds

protodioscin: furostanol steroidal saponin (about 0.25% of the fruit); the usual standardisation marker
terrestrosins, tribulosin and other steroidal saponins: main constituent class of the fruit
harman and norharman: β-carboline alkaloids in trace amounts; implicated in nervous-system disease in grazing sheep
kaempferol, quercetin, rutin: flavonols

History

The five-spined fruit gives the plant its English names caltrop, goathead and puncture vine. It is an official drug in the Chinese, Japanese, Korean and Indian pharmacopoeias, and has more recently become a popular supplement among athletes and bodybuilders on the belief that it raises testosterone, a claim systematic reviews have not borne out.

Sources

Reference, not prescription. Nothing here is medical advice. Herbs can interact with medicines and be dangerous in pregnancy; tell your doctor or pharmacist about anything you take.