Is tongkat ali still safe? New research

Human whole blood was cultured in medium solution that treated with distilled water, 20% DMSO, extract of EL roots at the concentration of 2.5, 5, 10, 20, 40, 80 µg/mL (extracted with distilled water and ethanol), and nontreated (blank: only culture medium and whole blood)

They made an extract, didn't measure anything about it whatsoever, then added it to red blood cells (at extremely high concentrations), and then want to conclude "yup, EL extract has cytotoxic effects". Ok, so you want to condemn an entire extract for the potential activity of some compounds (of which you don't know the identity or concentration, and didn't even confirm that those compounds are actually from EL, could be residual pesticides or HM in the EL that was used). Alright, lets look at the levels:

vacuum test tubes coated with heparin. Each T-25 flask for each condition comprised 0.5mL of whole blood that was collected in 8 mL RPMI 1640 medium. In treatment groups, the sample was supplemented with 100 mcL of each concentration of EL root extract...

0.5mL of whole blood, diluted into 8mL of buffer, then blasted with 100uL of the extract made above? 0.5mL is 500uL. 100uL is ONE FIFTH (20%!!!) of the blood concentration! Yeah, I would think that if 20% of your blood was suddenly some exogenous mix of compounds, there would be some cellular and genotypic abnormalities. I don't think there's a plant on this entire planet that if you suddenly replaced 20% of your blood with an extract of it, you wouldn't die immediately. That's an insanely high dose.

Also, as noted in that paper, it sounds like the chromosomal aberration test in vitro is a pretty poor way to determine toxicity in vivo, and at common dosages:

Nonetheless, chromosome aberrations could rise from secondary mechanisms involved in cytotoxicity. Therefore, these com-pounds that did not react with DNA were not genetically toxic in vivo, and some positive results in vitro aberration assay did not exhibit cytotoxic in human (Galloway 2000).

Here is Galloway 2000: https://sci-hub.se/10.1002/(SICI)1098-2280(2000)35:3%3C191::AID-EM6%3E3.0.CO;2-4

(These true clastogens are indeed toxic, but it is a delayed toxicity caused by the aberrations they induce.) Those “toxic clastogens” that we have tested are negative in the in vivo assay for chromosome aberrations and have no evidence for genotoxicityinduced tumors in 2-year rodent cancer bioassays. This suggests that the positive in vitro chromosome aberration assays, at high doses with considerable toxicity, and in the absence of other evidence for DNA damage, do not represent a risk of genotoxicity to people.

Known toxic clastogens, things that bind to or break DNA, administered in high doses, do not show up in in vitro chromosomal abberation tests as toxic. It sounds like the meaningfulness of this test is just kinda "meh" overall.

Coming back to the original paper, it is full of speculation and overstatements.

The result from the study in the particle of EL root isolated suggested that several compounds such as eurycomanone, eurycomalactone and alkaloids β-carboline may cause acute cytotoxic, genotoxic and mutation.

Uhh, no... All it showed was that your pesticide containing extracts had some chromosome breaks! You didn't show toxicity (although it was claimed later on). Then this next part is just plain false.

When consumed by pregnant women, substances in EL have direct effects on foetal develop-ment by inducing chromosomal abnormalities due to its cytotoxicity. It is also known as a major cause pregnancy loss in humans with more than 90% of early abortions were contributed by foetal aneuploidy (Low et al. 2013).

Here is Low et al. 2013: https://sci-hub.se/10.1016/j.jep.2012.11.013

It's about rat sperm, not pregnant women!! There is no citation for the 90% of early abortion claim, and certainly not from Low 2013... I'm going to have to guess they just inserted the wrong reference at the end of that sentence. That seems plausible, given the terrible editing of this paper (bad grammar, mistranslations, misspellings, etc).

Currently, prolonged consumption of EL root extract has associated with a range of side effects, including sleep apnea, facial flushing, pressure in the testicles, and hyper-aggressiveness, but there is no scientific evidence to support the mechanism of action.

Ohh really? Citations please!

It should be noted, that we do not recommend to using the EL root extracted with ethanol (pickled in liquor) regarding the safety issue (cytotoxicity). An intake of EL roots powder including capsules, bolus, coffee, and tea (water extraction) is better way to prevent cytotoxic effect in consumers. Most importantly, EL extract should be used at appropriate level and thereby bioactive components can be excreted from the body without being accumulated in a large amount that may induce health problems in long term consumption.

What a useless speculatory bit of drivel... Basically this paper is trash. They're conflating "chromosome breaks" with "toxicity" when Galloway clearly showed in his 2000 paper that these are completely different things and need to be carefully measured as such. They make wild unsubstantiated and non-cited claims, and the sources they do cite do not match up with their conclusions.

Mr. Chaiphech, what you have just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having read it. I award you no points, and may God have mercy on your soul.