Interview with the Experts

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Dr. Ismail Tambi

Dr. Ismail Tambi is a world renowned, highly-published expert in the field of Andrology. For his bio, Click here. Freelance herbal health reporter, May Ling interviewed Dr. Tambi after his lecture at the 2003 SupplySide West Convention in Las Vegas, Nevada.

M: As an MD, how did you become interested in Tongkat Ali?

Dr. T: I came to work with Tongkat Ali in a very round about way. The Forest Research Institute of Malaysia (FRIM) was looking to promote the herbs in the Malaysian Rainforest, and Tongkat Ali is one of the few that can be cultivated in a plantation style. Some of my colleagues had done 15 plus years of research on the herb and its applications. They had isolated a group of compounds that they knew from their testing had specific biological activity. These are the compounds standardized in LJ100^®. As a clinical researcher and Andrologist, they wanted my expertise in accessing the validity of Tongkat Ali as an herb for sexual enhancement in humans.

M: And what did you find?

Dr. T: I found the extract form that was developed by my colleagues to be quite remarkable and published a number of articles and books on the herb.

M: What was so remarkable about this extract?

Dr. T: There's a lot. First of all, it benefits to all four domains of sexual health.

M: Let me stop you there. What does that mean?

Dr. T: Columbia University, it is a well known University here in the United States, developed a survey called the Sexual Health Inventory Survey. It is used by the Clinical Andrologists to assess the benefits of drugs for sexual function. I use it to access the benefit of a drug or, in this case, an herb in the treatment of PADAM (Partial Androgen Deficiency among Men). Basically, PADAM happens as men get older and their body undergoes changes. {Click here for link to Andropause}

M: So this is the same measure used by the drug companies for accessing their drugs?

Dr. T: Yes. It's not the only measure used, but it is a major one.

M: Continue. You were talking about these four domains.

Dr. T: Yes. The four domains are the Physical, Psychological, Vasomoter, and Sexual Domain. The Physical Domain encompasses the health of a patient. If overall health is poor (poor cardio health, lack of fitness, etc), the body will not be able to function sexually. The Vasomoter domain is the actual cycle of stimulation, encompassing the cGMP, Testosterone, PDE-5 cycle. The Sexual domain is the ability of the body to be stimulated. The Psychological domain is a bit broader, encompassing everything from stress to some trauma related issue. I found overall benefit for about 82% of patients. This is a very good result for any drug, let alone an herb. More interestingly, in a few of the domains, the benefit was as high as 91%. I was particularly amazed that all four domains showed improvement. This is not the case with most drugs. For drugs, we primarily see vasomoter benefits. Often you get improvement in the Psychological domain as well. The Psychological benefits primarily come from the act of taking an aphrodisiac, but this may not be the only reason for LJ100^®.

I usually don't see benefits to Physical domain. Generally, the Physical domain is as problem due to drug side-effects. Here, as one would suspect from the traditional use, we do see benefits to overall health.

M: Do we know why LJ100^® is able to affect all four domains?

Dr. T: Because of the research leading to LJ100^®, we do know many of the reasons why. The compounds I mentioned earlier raise testosterone levels, suppress the expression of SHBG (Sex Hormone Binding Globulin), and improve ATP and cGMP production in the body.

Vasomoter is quite obvious. Testosterone is the main hormone necessary to turn on the body's sexual response. The cGMP increase directly affects NO2 synthesis. NO2 increases blood flow and relaxes the smooth muscle tissue in the corpus cavernosa.

In the Sexual Domain, you have an improvement in circulation and the testosterone and cGMP are heightening sensory. I often get feedback from my patients of greater alertness or clear-headed feeling.

Psychologically is a bit less direct. It may be an aphrodisiac effect. Accompanied with benefit in the other three domains, this is powerful and can not be ignored. Indirectly, there may be some ancillary benefit from the increase in testosterone on mood. Or, it could be an psychological improvement coming from the energy benefits of the herb on stress and mental fatigue.

This one is always the toughest to explain. For a person who has had a psychological trauma issue, I would not use LJ100^® as the primarily source of treatment. There may be benefits, but the Psychological domain would need to be addressed by a professional.

The physical domain is to me the most exciting. As men age, they generally have lower testosterone, specifically lower free testosterone, an increased SHBG levels; and as a result a lower metabolism which is either causal or co-causal of lower ATP and cGMP. The original scientists saw the reverse to be the case - an increase in testosterone and a suppression of SHBG - in their early work, but were not sure if it would carry into the human studies. I have found that it very clearly does and this may be causal of a variety of other benefits.

M: When you say other benefits, what do you mean?

Dr. T: I have treated hundreds of patients over the years with LJ100^® both for the clinical trials for the FRIM and for my own clinic. I have found both expected and unexpected benefits. And indeed, many benefits in the herb have nothing to do with sexual health, my area of specialty.

With an increase in Testosterone, cGMP, ATP, and SHBG, we expect an improvement in metabolism, fat free mass (lower fat), muscle build, and energy. However, we also see a stabilization in blood sugar, stabilization of LDL (lower cholesterol), and an increase in Human Growth Hormone (HGH). There are reasons why this would be the case. It may have to do with the fact that the Testosterone, cGMP/ATP, and SHBG have ancillary "causal" effects on other hormones in the body. It may be a direct result of compounds in the herb. Though we know this is a common result of LJ100^® , more work really needs to be done to make sense of it.

We do know that Tongkat Ali is a great anti-histamine. Most of my patients with allergies report a very fast dissipation of symptoms on the first use. I make sure my family travels with LJ100^® in case of allergic reaction.

M: So do you take LJ100^®?

Dr. T: At first I did not. After publishing my first few works on LJ100^® back in '97, I still had not taken the herb. I'm an MD. This is not the way we are taught in school. I had a friend ask me the same question you just did. When I told him I didn't take LJ100^®, he suggested that I could not be a great advocate for this herb, if I did not know its effects personally. I have been taking it ever since.

You know, I am not a young man. I work a lot, and you know I travel so much. LJ100^® is extremely helpful to me.

M: You said you've been treating patients for years with LJ100^® . Are there any side-effects, we should be aware of?

Dr. T: I have found no side effects. I do know it is diuretic and make sure to let my patients know, if they are already taking meds that are diuretic to watch their hydration. However, I have found no problems with those under my care, whether they be on heart medication or mood enhancing drugs.

A lot of people that want help in the area of sexual function, have problems with other areas of health. Many of these symptoms are related or coincidental. Almost all drugs have negative counter-actions in the body. This is why I like this herb, I have found no contra-indications among my patients.

M: Does LJ100^® work for women?

Dr. T: Unfortunately, I have not run tests in this area. I'm a Clinical Andrologist and my clinical work is primarily on Men's health drugs and this project with FRIM. However, from friends and patients at my clinic, I have heard anecdotal evidence to suggest benefits. I would suspect that particularly for women that are older, Perimenopausal & Menopausal, who would naturally have lower progesterone and testosterone levels, LJ100^® should work. These hormones are the primary sex hormones controlling sexual stimulation.

I would say that the four parameters are the same for men and women. Often I find for women, the psychological factor is quite a bit more significant versus men. Stress, work plus family, societal pressure associated with sex, all of these do play a major role for women.

M: Thanks for your time Dr. Tambi. I hope you can come back and visit us in the United States again soon.

Dr. Ismail is not an employee of Herbal Powers. He is a medical consultant for the company, given his past work on LJ100^® and continuing use of the product with his patients. While the content remains the same, this interview has been slightly edited to allow for written format.