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What is Ashwagandha?

Withania somnifera is a plant of the Solanaceae or nightshade family and is commonly known as ashwagandha, Indian ginseng, poison gooseberry, or Indian winter cherry. It is considered an adaptogen, a nontoxic medication that normalizes physiological functions disturbed by chronic stress [R].

Although used as a broad spectrum remedy in India for centuries, ashwagandha has only recently been studied in a laboratory setting [R].

Traditional Medicinal Uses

In Ayurveda, the fresh roots are sometimes boiled in milk prior to drying to leach out undesirable constituents [R].

Milk supplemented with ashwagandha reportedly increases body weight in malnourished children. When given to nursing mothers, ashwagandha is thought to thicken and increase the nutrition of breast milk [R].

Ashwagandha root is used as a nutrient and health restorative agent among postpartum ladies [R].

Ashwagandha Snapshot + Joe’s Experience

Ashwagandha is a very gentle herb, but this also means you likely won’t feel that much with one pill. I personally need to take 4 pills to feel relaxing properties, but then it also makes me nauseous.

Ashwagandha is more suited for Th1 dominant people, so it doesn’t suit me that well.

Overall, I think ashwagandha has more hype than substance and is not one of my favorite supplements. Although ashwagandha increases Th1, it’s more of an immune balancer. Ashwagandha is one of the Th1 boosting supplements that I use that doesn’t cause me any problems [R].

Withanolides are the most active compounds, so try getting those in a high enough percentage (2.5% or more).

PROS

  • It has a wide range of actions and can balance the body in many ways.
  • It stimulates the immune system, while also decreasing inflammation.
  • It’s gentle and can be taken daily. Other herbs have a higher potential for side effects.

CONS

  • You need to take more than one pill if you want to feel the effects.
  • It doesn’t taste good and smells like horses, so pill form can be better.
  • It shouldn’t be taken if pregnant because it may induce abortion.

Health Benefits of Ashwagandha

1) Ashwagandha Combats Anxiety/Stress

Ashwagandha is specifically used as a tonic to calm the nerves [R].

In two DB-RCTs with 116 chronically stressed people, 300 mg/2x a day of ashwagandha improved perceived stress, well-being and happiness, and cortisol levels [R, R].

A DB-RCT with 39 people found that 500-2,250 mg/day of ashwagandha was slightly effective for anxiety. However, both the placebo and treatment groups saw improvements [R].

In several animal studies, ashwagandha was helpful for anxiety, depression, and stress tolerance [R, R, R, R, R, R].

2) Ashwagandha Enhances Brain Function

Ashwagandha belongs to a sub-group of rasayanas, or elixirs, known as medhya rasayanas,  which refers to the mind and mental/intellectual capacity. It is especially useful for children with memory issues and for preventing memory loss in old age [R, R].

In a DB-RCT with 50 people, 600 mg/day ashwagandha root extract improved general and immediate memory in people with mild cognitive impairment [R].

Ashwagandha extract, 500 mg/day, improved auditory-verbal working memory in an RCT of 53 people [R].

This memory-boosting effect may be due to ashwagandha’s relaxing properties, as relaxation also improved long-term visual memory in a clinical trial of 32 people [R].

3) Ashwagandha Improves Male Fertility

In a clinical trial of 150 men, 5 g/day of ashwagandha increased levels of testosterone and luteinizing hormone while reducing FSH and prolactin levels. It also improved sperm count and mobility [R].

In a DB-RCT of 46 men with low sperm count, 675 mg/day ashwagandha restored sperm count and mobility [R].

Treatment with 5 g/day of ashwagandha normalized seminal metabolites levels and semen quality in a trial with 180 men with fertility issues [R].

However, 6 g/day ashwagandha did not improve psychologically-based erectile dysfunction in an RCT with 86 men [R].

Ashwagandha also impaired libido, sexual performance, and vigor, and caused erectile dysfunction in a rat study [R].

4) Ashwagandha May Help Weight Management

Ashwagandha root extract can be used for body weight management in adults. 600 mg/day reduced food cravings, reactive eating, and body weight in a DB-RCT with 52 people [R].

Supplementation of 600 mg/day ashwagandha root during resistance weight training decreased body fat percentage and increased muscle strength in a DB-RCT with 57 people [R].

However, in a study with 18 people, while there was also a trend of decreased body fat percentage with 750-1,250 mg/day of ashwagandha supplementation, it wasn’t statistically significant [R].

5) Ashwagandha Helps Muscle Growth

Ashwagandha supplementation with a resistance training program increased muscle strength, muscle size, and testosterone and had reduced muscle damage and body fat percentage in a DB-RCT with 57 men [R].

In another trial of 18 people, ashwagandha increased muscle strength [R].

Ashwagandha increased the body weight and muscle mass of rats [R, R].

6) Ashwagandha Has Anti-Diabetes Effects

Ashwagandha was able to decrease blood sugar levels similarly to diabetes medication in a trial of 12 people [R].

It also reduced blood sugar levels in several animal studies. In some of the studies, HbA1C and insulin levels were improved as well [R, R, R, R].

In other animal studies, ashwagandha also improved complications from diabetes, such as testicular dysfunction and painful nerve dysfunction as well as improving antioxidant status [R, R, R].

Ashwagandha is also protective against pancreatic cell damage in an animal model of type 2 diabetes [R].

7) Ashwagandha Promotes Heart Health

A review paper found that ashwagandha can be beneficial for the heart. It can reduce blood pressure and cholesterol and prevent the hardening of arteries [R].

Ashwagandha reduced systolic blood pressure in two studies with 65 people [R, R].

Taking 1 g/day of ashwagandha improved athletic endurance in an RCT of 40 people [R].

In animal studies, ashwagandha was shown to:

  • Decrease triglyceride levels [R]
  • Protect against oxidative damage during heart attacks [R]
  • Protect against toxicity in the heart from doxorubicin, a chemotherapy treatment [R]
  • Have a protective effect against stroke [R]
  • Have a protective effect in rats given heart attacks [R]

However, there were two cases where ashwagandha caused fast heartbeat in older men [R+].

8) Ashwagandha Fights Infections

Ashwagandha showed activity against most of the bacteria, fungi, and viruses tested [R].

The root extract also increased immune cell activation in a clinical trial with 5 people. A review paper had similar findings [R, R].

Anti-Bacterial

An herbal preparation containing ashwagandha given with pharmaceutical tuberculosis medication decreased coughing, bloody coughing, and fever and improved breathing and body weight in an RCT with 133 people. Another RCT with 99 people found similar results [R, R].

It also had antibacterial effects on these bacteria:

  • Salmonella infection in mice [R]
  • Clavibacter michiganensis in a cell study [R]
  • Methicillin-resistant Staphylococcus aureus (MRSA) in a cell study [R]

Antiviral

In a DB-RCT with 29 people, a herbal remedy containing ashwagandha helped with viral hepatitis recovery [R].

It also had the following antiviral effects:

  • Chikungunya virus in mice [R]
  • Herpes simplex type 1 in a cell study [R]
  • HIV-1 in a cell study [R]
  • Infectious Bursal Disease virus in a cell study [R]

Anti-Fungal

Ashwagandha inhibited fungal growth in a cell study [R]:

  • Aspergillus flavus
  • Fusarium oxysporum
  • Fusarium verticillioides

Anti-Parasitic

Ashwagandha had anti-parasitic effects in animal studies:

  • Leishmaniasis (Leishmania donovani) [R, R, R, R]
  • Malaria (Plasmodium berghei) [R]

9) Ashwagandha Can Help Obsessive-Compulsive Disorder

In a DB-RCT of 30 OCD patients, 120 mg/day of ashwagandha extract taken with the patients’ normal OCD medication was helpful in reducing symptoms [R].

It was also effective in treating OCD in mice [R].

10) Ashwagandha Can Help Attention Deficit-Hyperactivity Disorder

A herbal mix containing ashwagandha, peony, Gotu kola, spirulina, Bacopa monnieri, and lemon balm improved response time consistency and speed, impulsivity, and focus in a DB-RCT of 120 children with ADHD [R].

11) Ashwagandha Can Reduce Schizophrenia Symptoms

In a pilot trial of 11 people, ashwagandha reduced some of the sensory and cognitive issues experienced by schizophrenia patients [R].

However, it did not help with feelings of isolation or depression in a DB-RCT of 25 schizophrenia patients [R].

12) Ashwagandha Reduces Pain

Ashwagandha is an effective pain reliever [R].

10 g of ashwagandha effectively reduced pain and joint tenderness and swelling in a study of 86 people with rheumatoid arthritis [R].

In a DB-RCT of 42 people, a herb mixture containing Ashwagandha, Indian frankincense, turmeric, and zinc reduced osteoarthritis pain [R].

It also relieved pain in a rat study [R].

13) Relieves Menopausal Symptoms

Ashwagandha is effective in the management of menopausal syndrome. It stimulates the hormonal glands and helps regulate the secretion of hormones during menopause [R, R].

Ashwagandha is effective in reducing symptoms such as hot flashes, mood fluctuations, sleep issues, irritability, and anxiety in a study with 51 women [R].

14) Ashwagandha Can Improve Sexual Function

In a DB-RCT of 50 healthy women, ashwagandha improved sexual function [R].

15) Ashwagandha and Sleep

Some people experienced improved sleep quality following ashwagandha supplementation with 750-1,250 mg/day in a study with 18 people [R].

Ashwagandha was effective in the management of sleep loss and associated oxidative stress in mice [R].

However, in an RCT of 69 people, an herbal preparation containing ashwagandha did not improve sleep [R].

16) Ashwagandha Can Help Gut Issues

In one case, an Ayurvedic medication containing ashwagandha helped treat constipation, stomach pain, and vomiting [R].

Another combination of Ayurvedic herbs containing ashwagandha relieved constipation in a man with a genetic condition [R].

An enema of ashwagandha restored the health of the intestinal lining in rats with inflammatory bowel disease (IBD) [R].

17) Ashwagandha Can Reduce Rheumatoid Arthritis Symptoms

In a study of 86 people, 10 g of ashwagandha relieved symptoms of rheumatoid arthritis [R].

18) Ashwagandha Can Reduce Hair Loss

Ashwagandha was effective in reducing hair loss in a 57-year-old woman with a genetic condition [R].

19) Ashwagandha Can Potentially Boost Longevity

Ashwagandha may potentially boost longevity due to its protective effects on oxidative stress. It increased SOD and decreased MDA levels in a DB-RCT of 30 people [R].

In three studies, it also extended the lifespans of worms (C. elegans) [R, R, R].

Ashwagandha leaf extracts had anti-aging properties on cells [R].

Animal and Cell Studies

The following studies on the health benefits of ashwagandha have only been conducted on animal models or cell lines.

20) Ashwagandha Has Antioxidant Properties

Compounds found in ashwagandha (glycowithanolides) have antioxidant effects [R].

Ashwagandha had the following antioxidant effects:

  • Reduced oxidative damage induced by drugs in rats [R]
  • Had a protective effect against cancer in mice, which may be due to its antioxidant and detoxifying properties [R]
  • Reduced kidney injury due to oxidative stress in rats [R]
  • Increased superoxide dismutase, catalase, and glutathione peroxidase in rats [R].

21) Ashwagandha Has Anti-Inflammatory Properties

Ashwagandha had anti-inflammatory effects in the following studies:

  • Stimulated immune activity and increased natural killer cell activity in mice [R, R]
  • Enhanced the proliferation of lymphocytes, bone marrow cells and thyme cells in mice [R]
  • Increased the expression of Th1 cytokines and stress-induced depleted T-cell population in chronically stressed mice [R, R]
  • Enhanced the activity of macrophages in mice [R]
  • Suppressed myeloid-derived suppressor cells and tumor-associated macrophages in a cell study [R]

22) Ashwagandha May Be Neuroprotective

In animal and cell studies, ashwagandha:

  • Can promote the growth of nerves [R]
  • Had a potential neuroprotective role against stress in rats [R]
  • Could be useful for the treatment of dyskinesia or abnormal movement (rat study) [R]
  • Protected brain cells against a drug that causes amnesia in mice [R]
  • Protected brain cells against toxicity from glutamate in a cell study [R]
  • Stimulated activity in normal and damaged neurons [R]
  • Slows, stops, reverses, or removes neuron atrophy and synaptic loss [R]

Alzheimer’s Disease

Ashwagandha reversed the behavioral deficits and pathology seen in Alzheimer’s disease animal models [R].

It also improved memory loss and boosted neuron regeneration [R].

Ashwagandha was able to reverse cognitive defects in another Alzheimer’s disease model [R].

Parkinson’s Disease

Ashwagandha normalized catecholamines (compounds that include neurotransmitters) and reduced oxidative damage and physiological abnormalities in a Parkinson’s disease model [R].

Ashwagandha improved the behavioral, anatomical and the biochemical deformities in mice with Parkinson’s disease [R].

Huntington’s Disease

Ashwagandha had a protective effect on the behavioral, biochemical, and mitochondrial dysfunction in an animal model of Huntington’s disease [R].

23) Ashwagandha Has Anti-Cancer Effects

Ashwagandha can potentially be a powerful yet relatively safe cancer treatment. It improved fatigue and improved quality of life in cancer patients (clinical trial of 100 cancer patients) [R].

White blood cell count, which is often depleted during chemotherapy, was restored in mice given paclitaxel, a chemotherapy drug [R, R, R].

Ashwagandha used with paclitaxel, a chemotherapy medication, can be effective against lung cancer [R, R, R].

Ashwagandha had anti-cancer effects on the following cancers:

  • Brain (in cell studies) [R, R]
  • Breast (in animal and cell studies) [R, R, R]
  • Cervical (in animal and cell studies) [R, R]
  • Colon (in cell studies) [R, R]
  • Kidney (in a cell study) [R]
  • Lung (in animal and cell studies) [R, R]
  • Lymphoma (in an animal study) [R]
  • Ovarian (in an animal study) [R]
  • Pancreatic (in a cell study) [R]
  • Prostate (in animal and cell studies) [R, R]
  • Skin (in animal and cell studies) [R, R, R, R]
  • Stomach (in a cell study) [R]

24) Ashwagandha May Promote Bone Health

In animal studies, ashwagandha:

  • Preserved bone loss by inhibiting resorption and stimulating new bone formation in mice [R]
  • Had a protective effect on arthritis in rats [R]
  • Improved bone calcification in calcium-deficient rats [R]
  • Suppressed gouty arthritis in rats [R]
  • Improved calcium retention and bone calcification in chickens [R]
  • Had beneficial effects on bone calcium and phosphorus content in chickens [R]

In cell studies, ashwagandha stimulated bone formation and had a protective effect in osteoarthritic cartilage [R, R].

25) Ashwagandha Can Protect the Kidneys

In animal studies, ashwagandha had a protective effect in the kidneys against toxicity of:

  • Bromobenzene (a toxic chemical) in rats [R]
  • Carbendazim (antifungal) in rats [R]
  • Gentamicin (antibiotic) in rats [R, R]
  • Lead (heavy metal) in rats [R]
  • Streptozotocin (chemotherapy medication) in rats [R]

It also protected against kidney damage caused by dehydration in rats [R].

26) Ashwagandha Can Protect the Liver

In animal studies, ashwagandha:

  • Increases bile acid content of the liver in rats with high cholesterol [R]
  • Decreased circulating liver enzymes in rats [R]
  • Prevents liver toxicity due to ionizing irradiation in rats [R]
  • Protected the liver against heavy metals in rats [R]

27) Ashwagandha May Help With Respiratory Problems

Carbohydrates extracted from ashwagandha effectively suppressed coughing in guinea pigs [R, R].

It had a protective effect in the lungs against lipopolysaccharides in rats [R].

28) Ashwagandha May Potentially Treat Autoimmune Diseases

Ashwagandha had a preventative effect on a mouse model of systemic lupus erythematosus (SLE) [R].

It also reduced inflammation on a mouse model of lupus, suggesting it can potentially be used as a therapy for autoimmune diseases [R].

29) Ashwagandha May Control Seizures

Although ashwagandha has been traditionally used to control seizures, there are very few studies conducted on humans [R].

Ashwagandha was effective in controlling seizures in several animal studies [R, R, R].

30) Ashwagandha May Reduce Uterine Fibroids

Long-term treatment with Ashwagandha controlled uterine fibroids (non-cancerous growths) [R].

31) Ashwagandha May Help Polycystic Ovary Syndrome (PCOS)

Ashwagandha with Tribulus terrestris was effective in restoring hormone imbalances in a rat model of polycystic ovary syndrome [R].

32) Ashwagandha May Be Used As Anti-Venom

In India, ashwagandha is used to treat snake bites. A compound from ashwagandha was found to inhibit cobra and viper venom [R, R, R].

Ashwagandha in combination with other drugs is often prescribed for scorpion stings as well [R].

33) Ashwagandha May Potentially Reduce Morphine Dependence

Ashwagandha may help reduce dependence on morphine. It reduced withdrawal severity and prevented morphine dependence in rats, which may be due to its effect on opioid receptors [R, R, R].

34) Ashwagandha May Potentially Treat Skin Issues

Traditionally, ashwagandha is used to cure wounds, vitiligo (patches of skin with no color), leprosy, and acne [R, R].

A study on cells determined that ashwagandha may reduce hyperpigmentation (discoloration of the skin) without causing the skin to become too pale/whiten [R].

It also caused skin darkening in lizard cells [R].

35) Ashwagandha and Cataracts

Ashwagandha weakly inhibits an enzyme found in the formation of cataracts due to diabetes in rats [R].

Hormonal Interactions of Ashwagandha

Testosterone

Levels of testosterone were increased in infertile men after treatment with ashwagandha [R].

In one case, a woman had altered hormone levels and excessive facial hair from taking ashwagandha, which resolved after she stopped taking it [R].

Estrogen

Ashwagandha acts as an anti-estrogen in breast cancer cells, but this may not apply to normal cells [R].

Luteinizing Hormone

Ashwagandha normalized luteinizing hormone in infertile men [R].

Follicle Stimulating Hormone

Levels of follicle stimulating hormone were increased in infertile men when treated with ashwagandha [R].

Thyroid Hormone

In animal studies, ashwagandha:

  • Stimulated an increase of the thyroid hormone, T4, but not T3 in female mice [R]
  • Stimulated an increase in both T4 and T3 in male mice [R]
  • Reversed hypothyroidism from metformin, a diabetes medication, in mice [R]

Ashwagandha Synergies

Ashwagandha had synergistic effects with the following substances:

  • With anti-tuberculosis drugs and other Ayurvedic herbs, treated tuberculosis in a study with 99 people [R]
  • With aloe vera, reduced oxidative damage in the brain in a study with mice [R]
  • With diazepam in protection against social isolation induced behavior in rats [R]
  • With vitamin D in calcium retention and bone calcification in chickens [R]
  • With glucan from maitake mushrooms increased immune health and stress reduction [R]

Mechanism of Action

Cancer:

  • Decreases Nf-kB, suppresses TNF, and increases cell death in cancer cell lines [R]
  • Stimulates the generation of cytotoxic T lymphocytes, to reduce tumor growth [R]
  • Causes selective killing of cancer cells by induction of reactive oxygen species [R]
  • Inhibits cancer gene activation and mitochondrial dysfunction in cells [R]
  • Inhibited activation of STAT3, a transcription factor that causes tumors, in breast cancer cells [R]
  • Targets a protein, Hsp90, in pancreatic cancer cells [R]

Fertility

  • May improve fertility by promoting relaxation and decreasing stress [R]

Other:

  • Has GABA-mimicking properties [R]
  • Promotes sleep via a GABAergic mechanism [R]

Active Chemical Constituents

The biologically active chemical constituents are alkaloids (isopelletierine and anaferine), steroidal lactones (withanolides and withaferins), and saponins (sitoindoside VII and VIII) [R].

Like other plants, ashwagandha also contains terpenoids, flavonoids, tannins, phenols, and resins [R].

Parts Used/Forms of Supplementation

The roots are regarded as a tonic, aphrodisiac, narcotic, diuretic, antiparasitic, astringent, and stimulant [R, R].

The leaves are recommended for fever and painful swelling. The seeds are antiparasitic while the flowers are used as an astringent, diuretic, and aphrodisiac and have purifying/detoxifying effects [R].

The berries and tender leaves are applied externally to tumors, tubercular glands, carbuncles, and ulcers. Other useful parts are the stem, fruit, and bark [R, R].

Ashwagandha is available in many forms, such as powder, capsules, pills, or essential oil. It can also be made into a tea or ointment using honey or ghee.

Dosage

A typical dose of ashwagandha is 3-6 g/day of the dried root and 300-500 mg/day of the extract, with fresh powder having the most benefits [R, R].

Up to 1,250 mg/day was safe in a study with 18 people [R].

Side Effects

Ashwagandha is generally safe when taken in the prescribed dosage range [R, R].

Large doses of ashwagandha can cause abdominal discomfort and diarrhea [R].

Hyperthyroidism is potentially a serious side effect of ashwagandha [R].

Ashwagandha may possibly cause hirsutism (abnormal/excessive facial hair in women) [R].

Don’t Take Ashwagandha If…

Ashwagandha is not recommended during pregnancy since large doses may cause an abortion.

Since ashwagandha acts as a mild depressant, patients should avoid alcohol, sedatives, and other anti-anxiety drugs while taking ashwagandha [R].

Since ashwagandha has the potential to raise thyroid hormone levels, it should not be used by people with hyperthyroidism [R].

Molecular Targets

Anti-Cancer Activity

  • Inhibits proteasome [R]
  • Decreased the expression of anti-apoptotic proteins Bcl-2 and Bcl-XL [R]
  • Inhibits survivin and mortalin [R, R]

Anti-Inflammatory Activity

Neuroprotection Activity

  • Inhibits acetylcholinesterase enzyme [R]
  • Increases stress protein HSP70 [R]

Anti-Stress Activity

  • Induces Nrf2 protein [R]

Immune-Boosting Activity

  • Increased the expression of CD4 on CD3+ T cells [R]
  • Increases expression of IL-2 and IFN-gamma [R]
  • Increases IL-7 [R]

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FDA Compliance

The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. We do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition.

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