By Ali Kuoppala | Last reviewed Mon 24 September 2018
Medical Review by Gerardo Sison, PharmD
Cistanche is a parasitic desert plant commonly used in Chinese herbal medicine to support male health.
It’s also one of the herbs I’m most often asked to write about, as there are many claims online of it possibly boosting testosterone and DHT levels naturally, as well as improving circulation by raising nitric oxide (NO) levels.
To what extent is this true and are there any studies backing up the claims? Let’s figure out.
Cistanche, Testosterone, and DHT
The legendary Mongolian warlord, Genghis Khan, has been said to have fathered so many children that a whopping 8% of the men in the World would be his direct line descendants.
One of the claimed reasons for his heightened sexual activity, as well as his desire for war and power, was the fact that Genghis Khan consumed Cistanche on a daily basis.
Although one should always take stories like the one above with a grain of salt, the Traditional Chinese Medicine (TCM) seems to have gone bananas about the desert herb, as most of the formulas aimed for improved men’s health contain large portions of Cistanche.
Sure, there’s plenty of legendary stories behind many herbs, but what do the Western studies say about the effect of Cistanche on testosterone, DHT, and men’s health?
First off, Cistanche has shown fairly strong antioxidant effects1, as well as glutathione replenishing effects2 in an animal model.
Cistanche also improves circulation and improves nitric oxide production3. Possibly the reason why it worked so well for improving erection quality in a randomized, double-blind, placebo-controlled study of Thai males suffering from mild erectile dysfunction4 (ED), and even caused erections in castrated male rats5.
When it comes to hormones, there’s sadly a lot of claims, but not that much science to back all the talks up (for human studies at least). There are however some rodent studies with promising results. One study for example which looked at the effect of Cistanche extract in alleviating testicular damage caused by a chemotherapy drug; hydroxyurea6.
In the study, the researchers saw that the administration of hydroxyurea led to significant damage to testicular Leydig cells and suppression of testosterone levels. When they then gave the rats varying doses of Cistanche extract, their testicular damage was reversed and testosterone levels returned back to normal, and this effect was dose-dependent.
The researchers claim that this is due to Cistanche’s “ectogenic androgen-like effect”. A claim which is supported by the findings of Wang et al7. which showed that the administration of Cistanche extracts to male rodents, led to a significantly larger size of testicles and higher testosterone levels, due to increases in the testicular enzymes (CYP…) necessary for testosterone production.
So does Cistanche really increase testosterone and DHT levels while promoting sexual function?
Apparently yes, but the hard (pun intended) human data on testosterone and DHT is lacking, we only have rodent studies to back the claims for now (although they are pretty impressive so far).
The mechanism of action behind Cistanche seems to be similar to many other adaptogenic herbs; it has a strong antioxidant effect and it stimulates the CYP-enzyme family which results in improved testicular testosterone production (more stimulatory enzymes).
Would we recommend it? At the moment, yes. Cistanche supplements seem promising, and the trials show no toxic effects to liver, kidneys, or testis with the recommended dosages (200-2000mg).
Wang X, Li L, Muhuyati, Wang X, Du N. [Anti-oxidative action of the glycosides of Cistanche in the tissue of mice]. Zhongguo Zhong Yao Za Zhi. 1998;23(9):554-5, inside back cover.
Wong H, Ko K. Herba Cistanches stimulates cellular glutathione redox cycling by reactive oxygen species generated from mitochondrial respiration in H9c2 cardiomyocytes. Pharm Biol. 2013;51(1):64-73.
Seok J, Kim T, Kwon H, et al. Efficacy of Cistanche Tubulosa and Laminaria Japonica Extracts (MK-R7) Supplement in Preventing Patterned Hair Loss and Promoting Scalp Health. Clin Nutr Res. 2015;4(2):124-131.
Punyawudho B, Puttilerpong C, Wirotsaengthong S, Aramwit P. A Randomized, Double-Blind, Placebo-Controlled Crossover Study of Cappra® for the Treatment of Mild or Mild to Moderate Erectile Dysfunction in Thai Male. Afr J Tradit Complement Altern Med. 2012;10(2):310-315.
Gu L, Xiong W, Zhuang Y, Zhang J, Liu X. Effects of Cistanche deserticola extract on penis erectile response in castrated rats. Pak J Pharm Sci. 2016;29(2):557-562.
Gu L, Xiong W, Wang C, Sun H, Li G, Liu X. Cistanche deserticola decoction alleviates the testicular toxicity induced by hydroxyurea in male mice. Asian J Androl. 2013;15(6):838-840.
Wang T, Chen C, Yang M, Deng B, Kirby G, Zhang X. Cistanche tubulosa ethanol extract mediates rat sex hormone levels by induction of testicular steroidgenic enzymes. Pharm Biol. 2016;54(3):481-487.