Tribulus, Caltrop, Ci Ji Li 刺蒺藜 Tribulus, Caltrop, Devil’s Thorn Ci Ji Li (TCM) Gokhru, Goksuradi (Ayurveda) Nerunci Mul (Siddha) Hasak (Unani) Gze Ma  གཟེ་མ།  (Tibetan)

Tribulus
Ortus Sanitatis, Meydenbach, 1491

New Kreuterbuch, Matthiolus, 1563

Bulliard, Flora Parisiensis, 1776-1781

Tribulus terrestris plant
(Photo by Bernard DUPONT) (Wikimedia)

Tribulus terrestris seed
(Photo by Roger Culos, edited) (Wikimedia)

Botanical name:

Tribulus terrestris
Local varieties reportedly used include T. lanuginosus, T. subramanyamii, T. alatus

Parts used:

Seed

Temperature & Taste:

Neutral (Warm). Bitter, Pungent
“According to Dioscorides these two kinds of hasak are Cold and Dry but other physicians believe it to be Hot in the beginning of the first degree and Dry in the first degree. The latter description applies well to the hasak found in our country”. (Avicenna)

Classifications:

3I. APHRODISIACS
TCM:
I. Medicines for Internal Wind
N. Tonics

Uses:

1. Benefits Kidney Yang: (Ayurveda, Unani)
-‘stimulates Sexual Desire’. (Avicenna)
-Impotence, Spermatorrhea, Premature Ejaculation (Ayurveda)
-low Libido, poor Sperm Quality or Low Sperm Count; used in various modern formulas as an Aphrodisiac.
-Diabetes (Tibetan Medicine)
-Traditionally said to promote body weight.
–Rasayana in general Debility. (Ayurveda)
-In Tibetan formulas for Kidney weakness, Sexual Debility, Edema, and Osteoporosis, and is regarded as a Brain Tonic.
-“Stimulates Sexual desire” (Avicenna)
=”Long-term use helps muscle growth, brightens the eye and makes the patient happy and vigorous” (Shen Nong Ben Cao)
-“Reinforces the Jing [Essence]”. (Da Ming)
-research has not been able to demonstrate benefit in Erectile Dysfunction when used alone
-it has demonstrated adaptogenic effects
    
2. Clears Heat and Damp, Promotes Urine, Resolves Stones: (Ayurveda, Unani)
-Edema, water retention
-Cystitis, blood in the Urine, Dysuria, burning Urine;
-Bright’s Disease with Edema, Phosphaturia.
-Urinary Calculi; Gout. (Ayurveda)
-recently for Prostatitis and Benign Prostatic Hyperplasia (BPH)
-“dissolves Kidney ana Bladder Stones and, similarly, its extract is useful in Dysuria”. (Avicenna)
-‘swelling of the Testes’ (Ming Yi Bie Lu)

3. Moves the Liver Qi, Resolves Stasis: (Ayurveda, TCM)
-pain and distention of the Liver area, chest or flanks
-Uterine disorders (Ayurveda)
-Polycystic Ovary Syndrome (PCOS)
-‘good for removing blood stasis, dissolving hard mass’ (Shen Nong Ben Cao)
-‘accelerates Delivery and promotes Abortion’ (Da Ming)

4. Calms Internal Wind: (Ayurveda, TCM)
-rising Liver wind with symptoms such as Headache, Dizziness and Hypertension and other similar Wind disorders (TCM)
-Heart disorders coming from Wind such as Palpitations and Angina Pectoris. (Ayurveda)
-also for Asthma in Ayurveda

5. Stops Wind, Relieves Itching: (Ayurveda, TCM)
-various types of skin disease with marked itching
-Dermatitis, Hives, Scabies, Vitiligo etc.
-traditionally used for Leprosy. (TCM)

6. Clears Wind-Heat, Benefits the Eyes:
-various eye conditions with Red, Itchy, Swollen or Painful eyes. (TCM)
 
7. Resists Poison: (Ayurveda, Unani)
-“Commended against Poisons, and restores those who are bitten by Serpents” (Pharmacopoeia Universalis, R. James, M.D., London, 1743);
-“Two dirham (7 gm) of wild hasak is useful in Snake Bite and dose of two dirham (7 gm) with wine is useful in Fatal poisoning”. (Avicenna)
-Used for Scorpion stings in Ayurveda.

8. Promotes Milk:
-insufficient Breast milk due to sluggish Liver Qi

9. Kills Worms:
-It has been used for Worms in Ayurveda.

10. Externally:
-ash of the whole plant is used externally in Rheumatic Arthritis.
-“Used with Honey, it proves useful in Foul Ulcers”. (Avicenna)
-putrid ulcers of the Gums (Avicenna)

Dose:

Decoction: 3–12 grams. Or decoct 3 oz. of the bruised fruit in 1 ½ pints oif water down to 1 pint. Dose: 1–3 fl. oz.
Powder: 2–4 grams (up to 9 grams has been used)

Preparation:

1. The seeds are gently heated in hot sand, then put into a sack and rubbed to remove the sharp spines which are said to be mildly toxic. (Tibetan Medicine)

Corrective:

Almond is considered as a corrective in Unani.

Substitute:

Pedalium murex is used synonymously in Ayurveda, and also goes by the name of Goksura.

Main Combinations:

Urinary:
1. Dysuria, suppressed Urine:
i. Tribulus with Asparagus root
ii. Decoct the fruit and take with Yavakshara (impure Potassium carbonate)
iii. Tribulus with Cubebs, Rhubarb and Saltpeter (as in Goksuradi Churna of Ayurveda)
iv. Shilajit is taken with Decoction of Tribulus and Honey
v. Urinary retention, dysuria, stones, Tribulus with Bdellium, Coriander, Madder (Ayurveda)
vi. Tribulus with Bdellium, Triphala, Long Pepper, Black Pepper, Ginger, Cyperus rotundus (as in Goksuradi Guggulu of Ayurveda). This is also used for Gonorrheal Rheumatism
2. Urinary Tract Infection, Burning Urine:
i. Tribulus, Boerhaavia with Coriander seed, Rose
ii. Tribulus, Hemidesmus, Coriander seed, Sandalwood
iii. Tribulus with Madder, Sandalwood, Coriander seed (Ayurveda)
3. Edema:
i. Tribulus, Ephedra, Coriander seed
ii. Tribulus, Boerhaavia, Coriander seed, Tinospora
iii. from Kidney weakness, Tribulus, Boerhaavia, Shilajit
4. Gravel, Stones:
i. Tribulus with Bergenia ciliata (this is marketed as Cystone)
ii.. burning urine and Stones, Tribulus, Boerhaavia, Madder
iii. Tribulus with Crataeva bark (Varuna), Ginger as a decoction with Honey
iv. Tribulus with Maidenhair, Nettle, Corn Silk, Melon seed (This has been studied)
v. an injection is prepared from Crataeva bark (Varuna) and Tribulus by decocting them, then boiling the concentrated decoction with Sesame oil which is injected in for painful urination and gravel.
5. Diabetes, and to regulate Blood Sugar (especially Phlegm types) Tribulus, Gymnema, Tinospora, Picrorhiza (Ayurveda)
6. Incontinence, Bedwetting, Tribulus with Mullein

Reproductive:
7. Impotence, Aphrodisiac:
i. Tribulus with Sesame seed and Goat Milk and Honey (Ayurveda)
ii. Tribulus with Henbane (Ayurveda)
iii. Tribulus with Cornus Shan Zhu Yu (proven effect, see below)
iv. Tribulus with Mucuna (equal parts), taken with Sugar and warm Milk; this is used as an aphrodisiac (Sushruta)
v. Tribulus with Withania, Asparagus racemosa root, equal parts (Ayurveda)
vi. Tribulus with Withania, Mucuna, Black Sesame seed, Frankincense (Ayurveda)
vii. Tribulus with Ginger, Black Pepper, Long Pepper, Cardamon, Mesua, Indian leaf, Nutmeg, Tabasheer
viii. Chlorophytum with Basil seed, Tribulus, Mucuna
ix. and to increase Virility, Tribulus with Yohimbine, Epimedium Yin Yang Huo, Korean Ginseng and Saw Palmetto
8. Premature Ejaculation, Spermatorrhea:
i. Tribulus, Argyreia root, Leptadenia reticulate, Parmelia perlata
ii. Tribulus with Mucuna, Asparagus racemosa, Sida rhombifolia
iii. Spermatorrhea, Impotence, Tribulus with Sesame, Mucuna, Withania, mixed with Honey and Ghee (Ayurveda)
9. Seminal Debility:
i. Tribulus with Asparagus root
ii. Tribulus with Licorice, Withania, Cuculigo orchioides
iii. Tribulus with Emblic Myrobalan, Tinospora
10. Benign Prostatic Hyperplasia, Prostatitis:
i. Shilajit with Tribulus, Bdellium
ii. Tribulus with Murraya koenigii (proven effect, see below)
11. Female Debility:
i. Tribulus with Dang Gui, Asparagus Shatavari
ii. Tribulus with Curculigo, Mucuna, Tinospora
iii. to increase female strength and beauty, Tribulus with Ginger, Asparagus Shatavari, Pueraria tuberosa, Chlorophytum, Cinnamon, Inula racemosa, Tabasheer, Fenugreek, Licorica, Cyperus rotundus
12. Leukorrhea, Urinary disorders with Weakness Tribulus seed with Chlorophytum, Tragacanth, Quince seed (Ayurveda)
13. Infertility, Female debility, Postpartum to strengthen the Uterus, Tribulus with Asparagus racemosus, Rose, Saffron, Cyperus rotundus (Ayurveda)
14. Infertility:
i. Tribulus, Rose, Withania, Asparagus Shatavari, Mucuna (Ayurveda)
ii. Tribulus, Withania, Mucuna, Argyreia speciosa
15. Polycystic Ovary Syndrome (PCOS):
i. Tribulus, Withania
ii. Tribulus with Cinnamon, Peony Bai Shao, St. John’s wort, Licorice
16. To promote Breast Milk:
i. Tribulus with Fennel seed
ii. Tribulus with Cyperus rotundus
17. Swollen painful Breast abscess, Tribulus with Vaccaria Wang Bu Liu Xing

Other:
18. Skin Itchiness and Inflammation:
i. Tribulus seed with Sesame seed
ii. Tribulus with Cicada slough (TCM)
iii. Tribulus with Neem, Madder, Gotu Kola (Ayurveda)
19. Eczema:
i. Tribulus with Notopterygium Qiang Huo, Astragalus Huang Qi
ii. Tribulus with Neem, Madder, Gotu Kola (Ayurveda)
20. Anxiety and Depression, Tribulus with Emblic Myrobalan and Tinospora Guduchi (proven effect, see below)
21. Nervous disorders, Anxiety:
i. Tribulus with Withania
ii. Tribulus with Centella, Indian Spikenard
22. Parkinsonism, Tribulus with Mucuna

Major Formulas:

Chebula 18 for Urinary Incontinence (Gcin snyi a ru 18) (Tibetan)
Dang Gui Yin Zi
Dhatuvallabha Churna (Ayurveda)
Emblic 6 (Kyu ru duk pa) (Tibetan)
Essence Pills (Bcud len ril bu) (Tibetan)
Lygodium 8 (Gser bye brgyad pa)
Mandala of the Sun (Se bru nye dkyil) (Tibetan)
Musali Churna (Curculigo Powder)
Paraquilegia 6 (Mde’u ‘byin drug pa) (Tibetan)
Pills of Tribulus and Bdellium (Goksuradi Guggulu)
Powder of Tribulus (Goksuradi Churna) (Ayurveda)
Powder for Seminal Debility
Possessor of Ruby Color (Pad rag mdog ldan) (Tibetan)
Tribulus 3 Decoction (Gze ma gsum thang) (Tibetan)
Turmeric Decoction 4 (Yung ba 4) (Tibetan)
Withania 3 Decoction (Ba spru gsum thang)
Women’s Universal Decoction (Mo nad spyi thang) (Tibetan)

Cautions:

1. Not used in Pregnancy
2. Not used in marked Qi and Blood deficiency

Toxicity:

Several cases of Nephrotoxicity have been reported after using large doses or for a prolonged period. Discontinuation of the medicine resulted in improvement.

Main Preparations used:

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‘This plant is the Gokshuri and Ikshu-gandha of Sanskrit writers. The Hindus use the fruit and sometimes the whole plant; they regard it as having cooling, diuretic, tonic and aphrodisiac properties, and use it in gonorrhoea and dysuria; it is one of the ten plants which go to form the Dasamula Kvatha, a compound decoction often mentioned in Sanskrit works. The ten plants are Desinodium gangeticum, Uraria lagopodioides, Solanum jacquini, Solanum Indicum, Tribulus terrestris, Aegle marmelos, Calosathes Indica, Gmelina arborea, Stereospermum suaveolens, and Premna spinosa. The first five of these are called Hrasva pancha inula, or the five minor

plants, and the last five, Vrihat pancha mula, or the five major plants. T. terrestris is the Khasak or Hasak of the Arabs and Persians; it is well described by Ainslie, who says:—”It is a common plant near the Dardanelles, and is called in modern Greek [?]. Dioscorides calls it [?] and Pliny tribulus; they both describe two kinds, ‘terrestris‘ and ‘aquaticus.’ The latter is the Trapa natans, Linn., or Water Chestnut.* In the Pharmacopoeia of India its use as a diuretic in Southern India is noticed.’ (Vegetable Materia Medica of Western India, Dymock, 1885)

GENERAL REVIEW: –A review of traditional pharmacological uses, phyto-chemistry, and pharmacological activities of Tribulus terrestris. –Steroidal saponins from Tribulus terrestris. EFFECT OF TRADITIONAL PROCESSING: –Comparative Physicochemical Evaluation of Kharekhasak (Tribulus terrestris Linn.) Before and After Mudabbar Process. ANTI-BACTERIAL: –Antibacterial activity of Tribulus terrestris and its synergistic effect with Capsella bursa-pastoris and Glycyrrhiza glabra against oral pathogens: an in-vitro study. –Antibacterial and antifungal activities of different parts of Tribulus terrestris L. growing in Iraq. ANTI-FUNGAL: –Antibacterial and antifungal activities of different parts of Tribulus terrestris L. growing in Iraq. –In vitro and in vivo antifungal activities of the eight steroid saponins from Tribulus terrestris L. with potent activity against fluconazole-resistant fungal pathogens. –Antifungal activities and action mechanisms of compounds from Tribulus terrestris L. ANTI-INFLAMMATORY: –Chromatographic finger print analysis of anti-inflammatory active extract fractions of aerial parts of Tribulus terrestris by HPTLC technique. ANTI-OXIDANT: –Chemical constituents from Tribulus terrestris and screening of their antioxidant activity. ERECTILE DYSFUNCTION: –Tribulus terrestris versus placebo in the treatment of erectile dysfunction and lower urinary tract symptoms in patients with late-onset hypogonadism: A placebo-controlled study. –[Results of a comparative multi-center randomized clinical study of efficacy and safety of EFFEX Tribulus and Tribestan in patients with erectile dysfunction]. –Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis. –Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: Fact or Fiction. –Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study. –Effects and Mechanism of Action of a Tribulus terrestris Extract on Penile Erection. –In vivo and in vitro animal investigation of the effect of a mixture of herbal extracts from Tribulus terrestris and Cornus officinalis on penile erection. –The hormonal effects of Tribulus terrestris and its role in the management of male erectile dysfunction–an evaluation using primates, rabbit and rat. APHRODISIAC: –Evaluation of the aphrodisiac activity of Tribulus terrestris Linn. in sexually sluggish male albino rats. –Ethnopharmacological studies of Tribulus terrestris (Linn). in relation to its aphrodisiac properties. –Sexual effects of puncturevine (Tribulus terrestris) extract (protodioscin): an evaluation using a rat model. –Aphrodisiac properties of Tribulus Terrestris extract (Protodioscin) in normal and castrated rats. INCREASES TESTOSTERONE: –Prospective Analysis on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Semen Parameters in Males with Unexplained Infertility. –Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: Fact or Fiction. –Dietary Adjuncts for Improving Testosterone Levels in Hypogonadal Males. –Pilot Study on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Erectile Function in Aging Males With Partial Androgen Deficiency (PADAM). –Free serum testosterone level in male rats treated with Tribulus alatus extracts ANTI-ANDROGENIC EFFECT: –Anti-Androgenic Activity of Nardostachys jatamansi DC and Tribulus terrestris L. and Their Beneficial Effects on Polycystic Ovary Syndrome-Induced Rat Models. MALE INFERTILITY: –Role of Tribulus terrestris in Male Infertility: Is It Real or Fiction? INCREASES SPERM COUNT AND MOTILITY: –Effect of oral administration of Tribulus terrestris extract on semen quality and body fat index of infertile men. –Prospective Analysis on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Semen Parameters in Males with Unexplained Infertility. –Clinical study of Tribulus terrestris Linn. in Oligozoospermia: A double blind study. TESTICULAR-PROTECTIVE EFFECT: –Assessment of protective and anti-oxidant properties of Tribulus terrestris fruits against testicular toxicity in rats. –Protective effect of an aphrodisiac herb Tribulus terrestris Linn on cadmium-induced testicular damage. BENIGN PROSTATIC HYPERPLASIA: –Comparison of Murraya koenigii- and Tribulus terrestris-based oral formulation versus tamsulosin in the treatment of benign prostatic hyperplasia in men aged 50 years: a double-blind, double-dummy, randomized controlled trial.

FEMALE HYPOACTIVE SEX DESIRE: –Efficacy of Tribulus Terrestris for the treatment of premenopausal women with hypoactive sexual desire disorder: a randomized double-blinded, placebo-controlled trial. –Efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: a randomized, double-blinded, placebo-controlled trial. –Assessment of the Effects of Tribulus Terrestris on Sexual Function of Menopausal Women. –Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual Dysfunction. –Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo – controlled study. LOWERS BODY FAT INDEX SIGNIFICANTLY: –Effect of oral administration of Tribulus terrestris extract on semen quality and body fat index of infertile men. RENOPROTECTIVE EFFECT: –Proteomic Analysis Reveals the Renoprotective Effect of Tribulus terrestris against Obesity-Related Glomerulopathy in Rats. –Protective effect of hydroalcoholic extract of tribulus terrestris on Cisplatin induced renal tissue damage in male mice. –Protective effects of Tribulus terrestris L extract against acute kidney injury induced by reperfusion injury in rats. –Protective effect of Tribulus terrestris linn on liver and kidney in cadmium intoxicated rats. –Role of Tribulus terrestris (Linn.) (Zygophyllacea) against mercuric chloride induced nephrotoxicity in mice, Mus musculus (Linn.). HEPATOPROTECTIVE EFFECT: –Hepatoprotective activity of Tribulus terrestris extract against acetaminophen-induced toxicity in a freshwater fish (Oreochromis mossambicus). VASODILATOR / ANTI-HYPERTENSIVE: –Antihypertensive and vasodilator effects of methanolic and aqueous extracts of Tribulus terrestris in rats. –Study of antihypertensive mechanism of Tribulus terrestris in 2K1C hypertensive rats: role of tissue ACE activity. VASCULAR PROTECTIVE EFFECT: –Vascular protective effects of aqueous extracts of Tribulus terrestris on hypertensive endothelial injury. ANTI-ATHEROSCLEROTIC: –Cellular and molecular mechanisms in vascular smooth muscle cells by which total saponin extracted from Tribulus terrestris protects against artherosclerosis. ANTI-DEPRESSANT, ANTI-ANXIETY: –Effect of tribulus terrestris saponins on behavior and neuroendocrine in chronic mild stress depression rats. –Evaluation of anti-depressant and anxiolytic activity of Rasayana Ghana Tablet (A compound Ayurvedic formulation) in albino mice. EFFECT ON DERMATITIS: –Effects of the Fruit Extract of Tribulus terrestris on Skin Inflammation in Mice with Oxazolone-Induced Atopic Dermatitis through Regulation of Calcium Channels, Orai-1 and TRPV3, and Mast Cell Activation. DIABETES: –The protective effect of Tribulus terrestris in diabetes. –[Hypoglycemic effect of saponin from Tribulus terrestris]. POLYCYSTIC OVARY SYNDROME (PCOS): –Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial. –Anti-Androgenic Activity of Nardostachys jatamansi DC and Tribulus terrestris L. and Their Beneficial Effects on Polycystic Ovary Syndrome-Induced Rat Models. –Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings. –Alternative treatment of ovarian cysts with Tribulus terrestris extract: a rat model. ANTI-TUMOR: –Antiglycation and antitumoral activity of Tribulus terrestris dry extract. CANCER: BREAST: –[The inhibitory effect of saponins from Tribulus terrestris on Bcap-37 breast cancer cell line in vitro]. KIDNEY: –[Experimental study of saponins from Tribulus terrestris on renal carcinoma cell line]. LIVER: –Aqueous extract of Tribulus terrestris Linn induces cell growth arrest and apoptosis by down-regulating NF-κB signaling in liver cancer cells. –[Investigation on inhibitory and apoptosis-inducing effects of saponins from Tribulus terrestris on hepatoma cell line BEL-7402]. PROSTATE: –Terrestrosin D, a steroidal saponin from Tribulus terrestris L., inhibits growth and angiogenesis of human prostate cancer in vitro and in vivo.