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Yohimbine Safety – What does the science say?

Yohimbine is an energizing and metabolism-boosting supplement derived from the Yohimbe tree. It increases levels of adrenaline in the body and inhibits an enzyme in cells that normally suppresses fat burning. It is often used as an aphrodisiac because of its effects on vitality. It is also sometimes used as a wakefulness-promoting supplement.[1]

Clinical studies have found that Yohimbine is effective as an aphrodisiac and energizing supplement that is generally well-tolerated. [2] [3] The serving size used in studies is generally around 5 mg, taken once to four times daily. At this amount, the benefits of Yohimbine generally outweigh the mild side effects experienced by some participants.[4]

However, when taken at larger servings, Yohimbine presents a number of concerning side effects. Not only this, but it has been found to interact with numerous medications and to aggravate a number of medical conditions. As a result, it is important that anybody using Yohimbine be aware of the potential adverse effects associated with it.

yohimbine safety and side effects

What are Yohimbine side effects?

When used at the recommended serving size, it is unusual to experience adverse effects. However, some people may experience one or more of the following, even when taken at the recommended serving size. Increasing the serving size increases the chances of experiencing these side effects:

  • yohimbe treeUpset stomach
  • Excitation, tremor
  • Sleep problems
  • Anxiety or agitation
  • High blood pressure
  • Racing heartbeat
  • Dizziness
  • Drooling
  • Sinus pain
  • Irritability
  • Headaches
  • Frequent urination
  • Bloating
  • Rash
  • Nausea, and vomiting.[5]

Using excessively large amounts of Yohimbine (HCL) can put you at risk for more severe side effects such as:

  • Irregular or rapid heartbeat
  • Kidney failure
  • Seizure
  • Difficulty breathing
  • Paralysis
  • Hypertensive crisis
  • Very low blood pressure
  • Heart problems [1]

As with all supplements, there is also a rare chance of experiencing an allergic reaction. According to WebMD, one person reported an allergic reaction involving:

  • Fever
  • Chills
  • Listlessness
  • Itchy, scaly skin
  • Progressive kidney failure
  • Auto-immune effects.

In 2010, a retrospective review examined all cases of serious side effects that were reported to the California Poison Control System (CPCS) between 2000 and 2006. A total of 238 cases were identified. Of these, around half required only medical monitoring. Around 10% of cases required de-contamination therapy with charcoal and benzodiazepines. Less than 4% of cases required antihypertensive medication, and 2% required supportive care in a hospital.[6]

According to this review, the most common side effects reported to the CPCS included:

  • Gastrointestinal distress
  • Increased heart rate
  • Anxiety
  • Hypertension (high blood pressure).

high blood pressure yohimbine

If there are so many side effects, why do people use Yohimbine?

It’s important to remember that many people are able to use Yohimbine without experiencing any negative effects. The most important factor is to not exceed the recommended serving size and to always use the lowest possible serving that allows you to feel the desired effects.

It is also important to consider Yohimbine’s interactions with other substances, which we’ll get to below.

In 2001, researchers published a study on the efficacy and toxicology of Yohimbine. In the article, the researchers reviewed the results of 26 clinical studies on human participants with either normal blood pressure or high blood pressure. Overall, servings ranging from 5 mg – 20 mg tended to have little to no effects on heart rate or blood pressure, with few mild adverse effects being reported, if any at all. In some studies, participants’ blood pressure was increased mildly with no effect on heart rate.[7]

The same review also considered a further 11 studies on male participants. Adverse effects included increased blood pressure, gastrointestinal disturbances, headache, difficulty sleeping, frequent urination, and increased anxiety, in some participants. However, Yohimbine was generally well-tolerated and effective in its measured outcomes. [2]

Overall, the consensus is that Yohimbine, when used at the correct serving size, confers more benefits than side effects. It is good for promoting sexual vitality and wakefulness, and many people around the world are able to use it to their overall benefit. Again, the most important factor determining the risk of negative effects is the serving size. Using the correct serving size reduces the chances of side effects.

yohimbine energizing effects

Quality concerns about Yohimbine safety

There are two complicating factors when reviewing Yohimbine for safety.

liftmode yohimbine supplement facts panelFirst, the quantity of Yohimbine in any given supplement is not always as listed on the supplement facts panel.

In 2016, researchers working with Examine.com and the US Food and Drug Administration conducted a study on 49 different brands of dietary supplements listing Yohimbine as an ingredient. They also tested the supplements for Corynanthine and Rauwolscine – two derivatives of Yohimbine that sometimes occur alongside the compound, especially in natural extracts.

The results were concerning. They found that the actual amount of Yohimbine in the supplements varied dramatically. Furthermore, 78% of the brands did not list the amount of Yohimbine in their supplement blend. Those that were labelled often showed inaccurate amounts (actual content ranged from 23% to 147% of the labelled content).[8]

Second, supplement brands often sell Yohimbine as a ‘stack’ – often in combination with other energizing or stimulating supplements. As we discuss below, Yohimbine has numerous interactions with other substances, and ‘stacking’ this supplement can be dangerous to your health if it is not done properly.

As an example, medical professionals from Derby, Connecticut, reported two cases of acute liver toxicity in patients who were using a popular weight-loss supplement stack that contained Yohimbine. The supplement stack contained a number of other energizing substances that can affect liver health. So, it is not possible to say whether these effects were from Yohimbine or any of the other ingredients, or a combination of all of them.[9]

 

Can you overdose on Yohimbine?

Absolutely. Even though Yohimbine is of natural origins and is classified as a dietary supplement, it is nevertheless extremely powerful and needs to be used responsibly.

Two cases of fatal overdose from Yohimbine products were reported in the Journal of Analytical Toxicology, in 2013. According to the article, neurotoxic effects have been reported from as little as 200 mg (the recommended serving size is around 8 – 16 mg).

At 1.8 grams, a person experienced unconsciousness. At servings of 3 and 5 grams, two people experienced seizures and hypertension, with the larger serving inducing unconsciousness. The 5-gram serving previously reported resulted in blood concentrations of 5,240 ng Yohimbine / mL. A 37-year-old man was found dead with similar blood concentrations, indicating that 5 grams Yohimbine (and possibly much less) has the potential to cause a fatal overdose in humans.[10]

 

What are the concerns about Yohimbine interactions?

Yohimbine interacts with many different substances and medications. Of special importance are the following interactions, which may increase the effects of Yohimbine and potentially lower the amount needed to experience negative effects.

Antidepressants: Especially monoamine oxidase inhibitors (MAOIs), which increase the number of catecholamines in the brain. Taking Yohimbine with this type of medication may increase the risk of hypertensive crisis.

Blood pressure medication: Medication like Clonidine is used to lower blood pressure for people with hypertension. Taking Yohimbine may reduce the effectiveness of this medication.

Stimulants (including caffeine): Stimulants increase signalling through the nervous system. These effects make you feel energized and more awake. Yohimbine is a powerful energizing supplement and combining it with these types of substances can over-stimulate the nervous system, leaving you jittery, anxious, and at a greater risk of hypertension.

IMPORTANT: Yohimbine’s interactions are not limited to those discussed above. DO NOT USE YOHIMBINE IF YOU ARE TAKING ANY MEDICATION. [11]

yohimbine safety and interactions

Warning for people with existing medical problems

If you have any existing medical issues, it is very important that you speak to your doctor before using Yohimbine or supplements that contain Yohimbine. Depending on your medical condition, Yohimbine may be dangerous to your health.

Yohimbine may aggravate the following conditions:

  • Bleeding disorders
  • Liver disease
  • Anxiety disorders
  • Schizophrenia
  • Post-traumatic stress disorder (PTSD)
  • Heart disease
  • Depression
  • Diabetes
  • Prostate problems

Pregnant and breastfeeding women: There is not enough data to evaluate the safety of Yohimbine for your unborn child or baby.

Surgery: Yohimbine may affect the way that your blood clots, and may interact with the drugs used to keep you under anaesthetic. Do not use Yohimbine for at least 2 weeks prior to surgery. [5]

Anxiety: People with anxiety are advised to avoid Yohimbine as it may trigger extreme anxiety and panic attacks.[12]

doctor consultation for yohimbine

Overview of Yohimbine Safety – Is Yohimbine safe?

Although this article may seem to shed a negative light on Yohimbine’s safety, the general consensus is that the benefits outweigh the potential negative effects, when used correctly. Around the world, many people are able to use this supplement within the correct serving range, to their benefit – see the discussion boards on Reddit.com.[13]

However, Yohimbine is unlike other dietary supplements in terms of how potent it is. This supplement really stresses the need to be responsible and to do some background research prior to using it. Overusing Yohimbine can be seriously harmful to your health and, in extreme cases, may result in loss of consciousness, seizures, and death.

yohimbine_sample-1-gram-liftmodeAlways stick to the recommended serving suggestion, and always use the lowest amount necessary to feel the desired effects. (The recommended serving size is one to two servings of 4 mg, taken once to twice daily). However, many people are able to experience benefits at much lower serving sizes. We recommend starting with 2 mg to assess how your body responds.

While information on Yohimbine’s potential side effects is readily available on the internet, it is possible that many people may not think to go out and research the supplement before using it – which is why we’ve published this article!

If you know anybody who is thinking about taking Yohimbine, please share this article with them! The more people are informed, the less likely it is that they will experience negative effects.

DO NOT USE YOHIMBINE IF YOU ARE TAKING ANY MEDICATION.

DO NOT TAKE YOHIMBINE IF YOU HAVE ANY UNDERLYING MEDICAL CONDITIONS.

yohimbine chemical structure

References:

[1] Patel, K. (2018). Yohimbine. Examine.com [online] Available at https://examine.com/supplements/yohimbine/

[2] Ostojic, S. (2006). Yohimbine: the effects on body composition and exercise performance in soccer players. Res Sports Med, 14(4):289-99.

[3] Ernst, E., Pittler, M.H. (1998). Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. J Urol, 159(2):433-6.

[4] Vogt, H.J., Brandl, P., Kockott, G., Schmitz, J.R., Wiegand, M.H., Schadrack, J., Gierend, M. (1997). Double-blind, placebo-controlled safety and efficacy trial with yohimbine hydrochloride in the treatment of nonorganic erectile dysfunction. Int J Impot Res, 9(3):155-61.

[5] Yohimbe. (2018). WebMD.com [online] Available at:  https://www.webmd.com/vitamins/ai/ingredientmono-759/yohimbe

[6] Kearney, T., Tu, N., Haller, C. (2010). Adverse Drug Events Associated with Yohimbine-Containing Products: A Retrospective Review of the California Poison Control System Reported Cases. Annals of Pharmacotherapy 44(6), 1022–1029.

[7] Tam, S. W., Worcel, M., Wyllie, M. (2001). Yohimbine: a clinical review. Pharmacology & Therapeutics, 91(3), 215–243.

[8] Cohen, P. A., Wang, Y.-H., Maller, G., DeSouza, R., Khan, I. A. (2015). Pharmaceutical quantities of yohimbine found in dietary supplements in the USA. Drug Testing and Analysis, 8(3-4), 357–369.

[9] Dara, L., Hewett, J., Lim, J. K. (2008). Hydroxycut hepatotoxicity: a case series and review of liver toxicity from herbal weight loss supplementsWorld journal of gastroenterology14(45), 6999-7004.

[10] Anderson, C., Anderson, D., Harre, N., & Wade, N. (2013). Case Study: Two Fatal Case Reports of Acute Yohimbine Intoxication. Journal of Analytical Toxicology, 37(8), 611–614.

[11] Horn, J.R., Hansten, P.D. (2012). Yohimbine: Old Drug with New Interactions. Pharmacytimes.com [online] Available at: https://www.pharmacytimes.com/publications/issue/2012/july2012/yohimbine-old-drug-with-new-interactions

[12] Charney, D.S., Heninger, G.R., Breier, A. (1984). Noradrenergic function in panic anxiety. Effects of yohimbine in healthy subjects and patients with agoraphobia and panic disorder. Arch Gen Psychiatry, 41(8):751-63.

[13] Yohimbine - Very underrated nootropic or am I missing something? (2018). Reddit.com [online] Available at: https://www.reddit.com/r/Nootropics/comments/8m1f27/yohimbine_very_underrated_nootropic_or_am_i/