How Tribulus Terrestris Benefits were Found?
Among 20 Tribulus genus varieties, Tribulus Terrestris is one of the well established medicinal plants referred by Ayurvedic medicinal system. Different herbal formulations contain this herb as a single ingredient or in combination with other ingredients and also available as a food supplement. India, China, Spain, Mexico, Bulgaria, and the southern USA are subtropical, Mediterranean or desert climatic regions suitable for this annual shrub to grow. Tribulus Terrestris is an indigenous medicinal ingredient of Ayurvedic medicinal system (India), Chinese Traditional medicinal system (China) and south-eastern European traditional medicinal system. “Shen Nong Ben Cao Jing” is the earliest extant Chinese pharmaceutical monograph had mentioned this herb as a top graded medicine. The medicinal uses of Tribulus Terrestris fruits have enlisted in Chinese Pharmacopoeia, which includes kidney tonic, diuretic, expectorant, eyesight improvement, treatment for headache, vertigo, pruritus, and blockage of the mammary duct. In the Ayurvedic medicinal system, Tribulus Terrestris fruit are used to treat infertility, low libido, erectile dysfunction, and impotence. The fruits and roots of this plant have cardiotonic properties. Apart from these, some other countries like Pakistan used Tribulus Terrestris as diuretic and uricosuric properties. Whereas, its demulcent, anti-inflammatory properties, and treatment ability in nephritis condition are used in Sudan. These traditional medicinal applications attract modern researchers to identify the therapeutic benefits of this herb and identification of its phytochemicals reported this herb has potent anti-inflammatory and anti-aging activities. These activities are the underlying cause to exert a wide range of medicinal applications. Over the last several years, Tribulus Terrestris has been certified for its medicinal properties of improving sexual function and cardiac protection along with its antidiabetic, anti-urolithic, antioxidant, anti-inflammatory, and anti-tumor effects. 
What are the Phytochemicals Present in Tribulus Terrestris?
The identified phytochemicals in Tribulus Terrestris include flavonoids, steroidal saponins, glycosides, tannins, phytosterols, terpenoids, amide derivatives, proteins, and amino acids. Flavonoids and steroidal saponins are the two phytochemicals that have potent anti-inflammatory and anti-aging activities and mainly responsible for pharmacological activities. 
What is the Mode of Action of Tribulus Terrestris Health Benefits?
- The urogenital benefits obtain from the Tribulus Terrestris plant has a direct effect on multiple urogenital organs and increases significant endometrial glands releases. It enhances the size and numbers of the follicles in women's genital organs. The significant enhancement of reproductive hormone levels such as FSH and LH and reduction of estradiol promote urogenital organ functioning. The collective weight of ovaries, oviducts and uterus increase with the treatment of Tribulus Terrestris herbal product due to its antioxidant activity. The reduction of estrogen level indicates proper ovulation in females and helps to normalize reproductive functioning in the female. Tribulus Terrestris is also beneficial for male sexual activity as it significantly enhances testosterone and dihydrotestosterone levels due to steroidal glycosides present in it. A bioactive phytochemical protodioscin is present in Tribulus Terrestris plant converts to De-Hydro-Epi-Androsterone and improves sexual desire and also enhances erection.
- The reproductive functioning enhancement ability of Tribulus Terrestris obtain due to the enhancement of estradiol, testosterone, which regulate ovulation, improve libido and reproductive functioning
- Tribulus Terrestris has a diuretic effect due to the presence of a high concentration of potassium salts in it. Animal research confirmed its diuretic effect with a minimum side effect.
- It has a beneficial effect on the cardiovascular system as it promotes nitric oxide release from endothelium and nerve endings and also acts as smooth muscles relaxant. Moreover, it also increases the angiotensin-converting enzyme inhibitory activity. Long term ingestion of Tribulus Terrestris results in herbal products exerts a vasodilatory effect on coronary arteries without any side effects. 
What are the Different Forms of Tribulus Terrestris?
- Terrestris powdered extract dosage form is available and experts recommended 250 mg dose thrice a day for three months to treat erectile dysfunction. 
- Tribulus Terrestris is combined with other herbal ingredients and different dosage forms are available to treat a variety of multivariate disorders. An animal trial reported that the combination of Bombyx mori, Aconitum sinense, Alpinia species, Mentha arvensis, and Sophora flavescens along with Tribulus Terrestris has analgesic and anticholinergic effects. 
Tribulus Terrestris Uses
- Female fertility: Regulation of ovulation and overall reproductive organ functioning improvement by regulating hormonal levels of Tribulus Terrestris uphold female fertility and prevent infertility issues. 
- Treatment of erectile dysfunction: Erectile dysfunction affected males can be benefitted by treating with Tribulus Terrestris herbal remedy, as it enhances testosterone, Dihydrotestosterone and De-Hydro-Epi-Androsterone levels. 
- Enhance libido: Tribulus Terrestris can improve sexual desire and libido in both males and females, as it has a direct effect on urogenital organs and endocrinal system. It enhances erection in males.Tribulus terrestris also enhances the activity of nicotinamide adenine dinucleotide phosphate diaphorase and androgen receptor present in the brain tissue, which is responsible for its aphrodisiac property. 
- Male fertility: Tribulus Terrestris is also beneficial for male fertility not only for the improvement of testosterone levels, and libido; but also promotes spermatogenesis. saponins present in Tribulus Terrestris are effective to enhance luteotropic hormone secretion from the pituitary gland. This underlying mechanisms stimulate testosterone production and also improves sperm production, erectile function, and overall sexual function. Moreover, the Tribulus Terrestris regimen can also improve muscle mass and physical strength. It also maintains the red blood cells count and blood circulation, thus continuous oxygen transportation occurs at every organ. 
- Electrolyte balance: The diuretic property increases urine output and maintains electrolyte balance, which is an essential mechanism to maintain overall vital organs' functionality. 
- Cardio-protective: The angiotensin-converting-enzyme inhibition and vasodilatory effect of Tribulus Terrestris help to prevent hypertension. It also acts as cardiotonic and animal research showed that the treatment of Tribulus Terrestris can increase the rate and amplitude of heart muscle and also reduces the contraction of the heart. All these cardiac effects help to treat the cardiac emergency. 
- Action on Nervous system: The benefits obtain due to the effect of Tribulus Terrestris on nervous provide multiple beneficial effects including pain-relieving effect, controls anxiety and stimulates brain functioning. 
- Anti-arthritic effect: Both flavonoids and steroidal glycoside present in Tribulus Terrestris assist in the anti-arthritic activity. Flavonoids modulate membrane stability and steroidal glycoside inhibits leukocyte migration. Both of these mechanisms are essential for anti-arthritic activity. 
- Muscle spasm: Tribulus Terrestris has both skeletal muscle and smooth muscle relaxant properties, which helps to treat muscle ache and muscular spasm. An animal trial reported the whole plant has an antispasmodic effect. 
- Infection control: Tribulus Terrestris has potent anti-bacterial property against both Gram-positive and Gram-negative bacteria. Aqueous extract of fruits, leaves, and roots of Tribulus Terrestris has both antimicrobial and antifungal effects by disrupting microbial membranes of the infection causing germ. Flavonoids and saponins have the contributory effects on antimicrobial activity of Tribulus Terrestris. 
- Tumor prevention: Tribulus Terrestris has multiple actions against tumor progression, which include suppression of proliferation and induces apoptosis. Researchers considered Tribulus Terrestris has the potential to provide new generation cancer treatment as it acts against UVB-induced carcinogenesis and saponin present in it can control cell death. 
Tribulus Terrestris Side Effects
There is a very limited clinical trial conducted to check the safety of Tribulus Terrestris, therefore detail safety analysis data not available. Some side effects of Tribulus Terrestris include increased heart rate and restlessness. A case study reported a prolonged and painful erection of the penis occurred after consuming this herbal supplement. This type of problem may common who are using this supplement with a higher dosage to improve athletic performance.  Animal research finding reported a higher dose of Tribulus Terrestris can cause cardiac muscle, liver and kidney damage. 
When Should I Avoid Tribulus Terrestris?
Some male patients affected with benign prostatic hypertrophy or prostate cancer experienced increased increase prostate weight after using this herb. Diabetic patients who have taken diabetic medications may experience hypoglycemic condition due to its blood sugar lowering effect. Therefore, this herb may not be useful in combination with other anti-diabetic medications.