Yohimbe
OTHER NAME(S): johimbi, Pausinystalia yohimbe, yohimbe, yohimbine
Overview
Yohimbe is a tree called Pausinystalia yohimbe. Dietary supplements that contain yohimbe are made from the bark of the tree. Yohimbe is used for many reasons, but its benefits are not well defined. Common side effects may include anxiety or restlessness, nausea, upset stomach, fast heartbeat, high blood pressure, or sweating. Serious side effects are less common and include seizures and dangerously high blood pressure. Due to the risk of these side effects, some countries have banned the sale of yohimbe products. Before taking yohimbe, make sure to tell your health care provider about any health conditions you have or medicines you are taking.
Uses
What is yohimbe used for?
Yohimbe (Pausinystalia yohimbe) is used for various reasons, but its benefits are not well defined. Some common reasons that people use yohimbe include the following.
- Erectile dysfunction, a condition where you have trouble getting or keeping an erection
- To improve mental and physical performance
- To increase sex drive
- To increase energy levels
Note: The FDA has not reviewed yohimbe for safety and effectiveness. Learn more about dietary supplements here.
How does yohimbe work (mechanism of action)?
Yohimbe is a tree called Pausinystalia yohimbe. Dietary supplements that contain yohimbe are made from the bark of the tree. Yohimbe is sometimes confused with one of the chemicals found in its bark, called yohimbine. Yohimbine is naturally found in yohimbe and some other plants; it can also be made in a lab (synthetic). This chemical may be an ingredient in dietary supplements that do not contain yohimbe bark.
Yohimbe bark contains more than 50 chemicals that may have certain effects on the body. Some of these chemicals, including yohimbine and rauwolscine, are stimulants that can increase mental alertness and energy levels. But the actual amount of each stimulant in yohimbe bark naturally varies. Some products may contain very high amounts of yohimbine and rauwolscine, which can cause serious side effects. Other products may contain low amounts that have no effects in the body. There are also other chemicals in yohimbe that can increase or decrease its effects. As a result, yohimbe products may be unsafe and should not be relied on to improve mental performance or energy levels.
Yohimbe bark is also marketed to help with erectile dysfunction or to increase sex drive. But there is limited research on the use of yohimbe for these reasons. Instead, most studies have looked at pure, synthetic yohimbine. Pure yohimbine may have small benefits for people with erectile dysfunction, but it is unclear whether yohimbe bark has the same effects. The benefits of either yohimbe bark or yohimbine for improving sex drive are not well defined.
Herbal products, such as yohimbe, naturally contain many chemicals, including yohimbine. Some yohimbe bark supplements are made to contain a certain amount of yohimbine. There are also some dietary supplements that contain only yohimbine.
How should I store yohimbe?
You should store yohimbe as directed on the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.
Side Effects
What are the most common side effects of yohimbe?
The most common side effects of yohimbe are listed below. These side effects may vary depending on the dose you are taking or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.
- Anxiety or restlessness
- Fast heartbeat
- High blood pressure (see below)
- Nausea or upset stomach
- Sweating or flushing
There may be other side effects of yohimbe that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of yohimbe?
While less common, the most serious side effects of yohimbe are described below, along with what to do if they happen.
Severe Allergic Reactions. Yohimbe may cause allergic reactions, which can be serious. Stop taking yohimbe and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching or skin rash
- Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
High Blood Pressure (Hypertension). Yohimbe may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while taking yohimbe.
If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but inform your health care provider right away if you have any of the following symptoms of severely high blood pressure.
- Sudden severe headache
- Chest pain
- Dizziness or confusion
- Trouble breathing
- Nausea or vomiting
- Blurry or other changes to vision
- Anxiety
- Buzzing in the ears
- Nosebleed
- Feeling of skipped heartbeats
Seizures. Some people who have taken yohimbe have reported having seizures. There are many different types of seizures, and some of them are not easy to recognize. Stop taking yohimbe and call your health care provider if you have any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Precautions
Who should not use yohimbe?
Allergies to Ingredients. People who are allergic to any of the following should not take yohimbe.
- Johimbe
- Pausinystalia yohimbe
- Rauwolscine
- Yohimbe
- Yohimbine
- Any of the ingredients in the specific product
Your pharmacist can tell you all of the ingredients in the specific yohimbe products they stock.
What should I know about yohimbe before using it?
Yohimbe is a dietary supplement. It cannot be marketed to treat or cure a disease.
Read and follow the directions on the specific product you are taking, or take it as recommended by your health care provider.
Keep yohimbe out of the reach of children.
Yohimbe is an herbal product that naturally contains many different chemicals. Some of these chemicals, including yohimbine and rauwolscine, act as stimulants in the body. But the amount of each chemical in a specific yohimbe product can change for many reasons, including the area where the tree was grown, the weather during growth, the time of year when it was harvested, and the way that the bark was processed. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.
Since the amount of each stimulant chemical in yohimbe can vary widely, yohimbe products have the potential to cause serious side effects. As a result, many countries have banned the sale of products that contain yohimbe. Some examples of these countries include the United Kingdom, Netherlands, Canada, and Australia.
In the U.S., yohimbe is found in many dietary supplements that are marketed for sexual or physical performance. These types of products have often been found to contain prescription medicines or harmful chemicals. Some prescription medicines can cause serious side effects and can also interact with other medicines. Use caution when buying a yohimbe product because it may contain harmful ingredients that are not listed on the label. Find a list of potentially harmful products from the FDA here.
The FDA has not tested yohimbe products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.
What should I tell my health care provider before using yohimbe?
Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if yohimbe is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions.Tell your health care provider if you have any of the following.
- Erectile dysfunction
- Heart problems
- High blood pressure
- Kidney or liver problems
- Mental health problems, such as depression, anxiety, or posttraumatic stress disorder (PTSD)
- Prostate problems
- Seizures
Other Medicines and Supplements.Yohimbe may interact with other medicines and supplements. Before taking yohimbe, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how yohimbe could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant.
Breastfeeding. It is not known if yohimbe passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.
Interactions
Does yohimbe interact with foods or drinks?
Yohimbe can have stimulant-like effects. Taking yohimbe with caffeine, which is also a stimulant, may increase the risk of side effects. Caffeine is found in many common foods and drinks, such as coffee, tea, soda, chocolate, and some protein bars.
It is unknown if drinking alcohol will affect yohimbe, but drinking alcohol while taking yohimbe may increase your risk for side effects. It is best to limit the amount of alcohol that you drink.
Does yohimbe interact with medicines (drug interactions)?
Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking yohimbe.
- A medicine for high blood pressure
- A stimulant, such as amphetamine, lisdexamfetamine, or methylphenidate, which is a medicine commonly used to treat attention deficit hyperactivity disorder (ADHD)
- An alpha-blocker, such as alfuzosin, doxazosin, prazosin, or terazosin,which is a medicine that may be used for high blood pressure and/or trouble peeing due to an enlarged prostate
- An opioid, such as fentanyl, methadone, morphine, or oxycodone, which is a medicine used to treat certain types of pain
- Any product that contains caffeine, which is often found in medicines used for reducing water weight (diuretics), staying awake, easing headaches, and relieving hangovers
- A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
The interactions between yohimbe and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with yohimbe is incomplete. Always check with your health care provider before taking yohimbe with any medicines.
Dosing
What should I do if I accidentally use too much yohimbe?
If you or someone else has used too much yohimbe, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
Yohimbe comes in a wide range of doses and may be combined with other ingredients. Read the product label closely and speak to a health care provider about how to take yohimbe safely. Do not take double or extra doses, even if you miss a dose.
References
- Biological Psychiatry: “Yohimbine-induced withdrawal and anxiety symptoms in opioid-dependent patients.”
- EFSA Journal: “Scientific opinion on the evaluation of the safety in use of yohimbe (Pausinystalia yohimbe (K schum) Pierre ex Beille).”
- Gardner, Z; McGuffin, M. Botanical Safety Handbook (Second Edition), American Herbal Products Association, 2013.
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]: “Yohimbine.”
- National Cancer Institute NCI Dictionary of Cancer Terms: “Yohimbe.”
- National Center for Complementary and Integrative Health: “Yohimbe.”
- Operation Supplement Safety: “Yohimbe and yohimbine in dietary supplement products.”
- World Health Organization (WHO): “Hypertension.”
