Careful, low dose (≈0.2 mg/kg). Products are often mislabeled.
Some benefit, especially in dysfunction of psychological origin.
View the study (meta-analysis) →⏱ 3 min read
Yohimbine is an indole alkaloid extracted from the bark of the African tree Pausinystalia yohimbe, traditionally used as an aphrodisiac and, in regulated pharmaceutical formulations, as a treatment for erectile dysfunction before the appearance of phosphodiesterase-5 inhibitors (sildenafil and similar drugs); its mechanism of action is very specific and well characterized: selective antagonism of presynaptic alpha-2 adrenergic receptors, which increases the release of norepinephrine at sympathetic synapses and modulates lipolysis in hard-to-mobilize subcutaneous adipose tissue.
Unlike most supplements on the market, yohimbine is a drug with a well-defined pharmacological profile and a narrow therapeutic margin that places it in an intermediate category between dietary supplement and medication; its sale is restricted or prohibited in several countries (United Kingdom, Australia, Canada) precisely because of its cardiovascular and neurological effects at high doses, a characteristic that calls for extreme caution given the "natural supplement" image with which it is promoted in many commercial products.
The indication with the best evidence is erectile dysfunction of psychogenic or mild vascular origin: several randomized trials published in the 1980s and 1990s showed significant efficacy of pharmaceutical yohimbine (5.4-10.8 mg three times a day) over placebo, with response rates of 30-40 percent; the magnitude of the effect is notably lower than that of PDE-5 inhibitors (sildenafil, tadalafil), and for that reason yohimbine has moved into the clinical background since their appearance.
In the fitness and body composition setting, yohimbine is used as an aid to mobilize localized subcutaneous fat in areas with a high density of alpha-2 adrenergic receptors (hips, buttocks, and thighs in women; lower abdomen in men); a randomized trial with professional soccer players published in 2006 showed that 10 mg twice a day for 21 days significantly reduced body fat percentage without changes in performance or lean mass, a specific indication with modest clinical support but consistent with the molecular mechanism.
Use for stubborn fat is typically on an empty stomach, before cardiovascular exercise in the postabsorptive state, a strategy that maximizes sympathetic lipolysis (high) and minimizes the opposition of insulin (low when fasting); some athletes use yohimbine specifically in the final phases of competitive cutting, when the last areas of fat are the most resistant to loss.
In neurogenic orthostatic syncope and in autonomic dysfunction with hypotension, doses of 5.4-10.8 mg have shown improvements in blood pressure and symptoms in small studies, a niche clinical indication with some support but rarely used in practice.
The doses studied for erectile dysfunction are 5.4 mg three times a day; for subcutaneous lipolysis, 10-20 mg on an empty stomach before cardio, or 0.2 mg/kg of body weight; commercial products made with yohimbe bark (not purified yohimbine) have variable content and are less pharmacologically predictable than standardized yohimbine HCl.
It is one of the supplements with the most complex safety profile and the most clinically relevant interactions: the most frequent adverse effects are anxiety, tachycardia, high blood pressure, insomnia, sweating, tremor, headache, and, in predisposed people, panic attacks; it is contraindicated in ischemic heart disease, uncontrolled hypertension, arrhythmias, anxiety disorders, bipolar disorder, schizophrenia, significant kidney or liver failure, narrow-angle glaucoma, prostatic hypertrophy, and peptic ulcer; it has serious interactions with MAOIs (absolute contraindication), tricyclic antidepressants, sympathomimetics, nasal decongestants, amphetamines, cocaine, and stimulants in general; it should be completely avoided with high-dose caffeine; it is contraindicated in pregnancy and breastfeeding; it should not be used in people under 18; combining it with stimulants or other adrenergic agents can precipitate severe hypertensive crises.
Information, not medical advice. Scientific evidence reflects the quality of the studies.