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The US Food and Drug Administration confirmed that oral administration of bitter orange extracts is safe , and its derivatives have gained popularity as dietary supplements over the last few years [200,204]. Adverse effects are mild and transient; psychiatric and neurological effects are reported in Table 1. Comparison with Other Enhancement Products Also known as longjack, tongkat ali has been shown to increase testosterone levels and decrease various markers of stress at doses ranging from 200mg to 400mg.37 38 It also appears to have a positive influence on erectile performance.39 "If your body has low testosterone levels, then you may not feel like having sex at all. This could lead to erectile dysfunction." For example, if one ingredient can boost testosterone production and another can reduce its attachment to sex hormone binding globulin (SHBG), they would work together to elevate T levels and keep them high. 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