The short answer
Not known in people. We found no study of gokshura (gokhru) taken with lithium. The concern is theoretical: Memorial Sloan Kettering's herb database says tribulus may add to the effect of diuretics, medicines that make you pass more urine. Lithium toxicity can occur at doses close to the normal treatment level, and losing fluid or salt makes it more likely.
Rare case reports also describe kidney injury after tribulus products, and lithium leaves the body through the kidneys. If you take lithium, tell your prescribing doctor before you start gokshura, and ask whether your lithium level and kidney tests should be checked.
Lithium carbonate is sold in India as Lithosun.
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Possible build-up of lithium[3][4] | Fluid loss from a diuretic effect, or kidney injury, could slow lithium clearance | Lithium level may rise; by how much is not known | Theoretical by mechanism |
| Liver and kidney injury after tribulus, not linked to lithium[1][2] | Not established | Harm to the kidneys, which clear lithium | Case report |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Case report, 2015 Case report
A young, healthy man developed severe jaundice (hyperbilirubinaemia) and then kidney failure after taking tribulus. Memorial Sloan Kettering describes him as a 30-year-old bodybuilder who had taken tablets daily for months. The summary does not say whether he took lithium, and other causes could not be ruled out.[3]
Case report, Iran, 2010 Case report
A 28-year-old man drank tribulus herbal water for two days to prevent kidney stones. He then had seizures, with liver enzymes more than 40 times the upper limit and a raised creatinine, a marker of kidney function. He improved after he stopped. The report is about the herb alone, not an interaction.[3]
What your doctor may watch for
- Lithium blood level, kidney function and salt (electrolyte) levels.[4]
- Signs of too much lithium: a new or worse tremor, vomiting, confusion or unsteadiness.[4]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, gokshura or a tribulus product (name of product, dose) along with lithium. Tribulus may have a diuretic effect, and there are reports of kidney injury. Should my lithium level and kidney function be checked, and when?”
Withheld until review
Questions people ask
Related
Gokshura (gokhru) and blood pressure medicines
Gokshura lowered blood pressure on its own in one trial, so it could add to BP medicines. We found no study of the two taken together.
InteractionNeem and lithium
We found no study of neem with lithium. Lithium's label warns that dehydration raises the risk of toxicity, whatever the cause.
InteractionGokshura (gokhru) and metformin
A tribulus extract lowered blood sugar in one trial, so it could add to metformin. We found no study of the two taken together.
Sources
- Ryan M, Lazar I, Nadasdy GM, Nadasdy T, Satoskar AA. Acute kidney injury and hyperbilirubinemia in a young male after ingestion of Tribulus terrestris. Clin Nephrol. 2015;83(3):177-183. PMID 25295577.
- Talasaz AH, Abbasi MR, Abkhiz S, Dashti-Khavidaki S. Tribulus terrestris-induced severe nephrotoxicity in a young healthy male. Nephrol Dial Transplant. 2010;25(11):3792-3793. PMID 20667992.
- Memorial Sloan Kettering Cancer Center. About Herbs: Tribulus terrestris.
- Lithium carbonate extended-release tablets, US prescribing information (DailyMed). Boxed warning and drug interactions.
Updated 4 November 2026
Taking gokshura with other medicines? A vaidya can check your full list.
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