Ingredient Spotlight: Ashwagandha (Withania Somnifera)
Ashwagandha is a plant traditionally used in Ayurvedic medicine to promote a youthful state of physical and mental well-being.
Sourced from India
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Multiple studies have shown improvement in stress and anxiety scores after supplementation with ashwagandha.
Some studies have shown that ashwagandha supplementation improves muscle strength, improves semen quality, and raises testosterone levels in men.
Common side effects include sleepiness (approximately 20% of users in one study), loose stools (approximately 20% of users in one study), and gastrointestinal discomfort (approximately 10% of users in one study).
Talk to your healthcare provider if you are concerned about any side effects you experience.
What is ashwagandha?
Ashwagandha, also known as “Indian ginseng,” “winter cherry,” and “poison gooseberry,” is an herb that is commonly used in Ayurvedic medicine. Ayurvedic medicine, also simply called Ayurveda, is a form of traditional Indian medicine that dates back to approximately 6000 BCE and relies on a natural, holistic approach to healing. In Ayurveda, ashwagandha is used as a Rasayana, a tonic that promotes a youthful state of physical and mental well-being. Ashwagandha is also in the family of herbs known as “adaptogens,” which are believed to help regulate physical, mental, and emotional stresses in the body.
The ashwagandha plant belongs to the Solanaceae, or nightshade, family of flowering plants. This means ashwagandha is related to many shrubs, trees, spices, and weeds as well as familiar foods like bell peppers, eggplants, potatoes, and tomatoes. The root of ashwagandha gives off an odor described as being similar to a horse and it is considered to be an aphrodisiac, narcotic, antimicrobial, and stimulant. The leaves, flowers, and seeds are also thought to have medicinal benefits. Ashwagandha’s suspected active ingredients include its alkaloids, steroidal lactones, saponins, and withanolides.
What are the health benefits of ashwagandha?
As a Rasayana and an “adaptogen,” ashwagandha has a number of purported health benefits. Traditionally, it has been used in formulations to treat ailments ranging from anxiety and stress to fatigue, pain, skin problems, diabetes, and rheumatoid arthritis. While numerous studies have looked into the health benefits of ashwagandha, most have been conducted in vitro, on animals, or in small human clinical trials. This means the findings are limited, making it difficult to determine precisely how effective supplementation with ashwagandha can be. Larger studies with greater generalizability are still needed to better understand the exact benefits, side effects, and optimal dosing of ashwagandha.
Studies focusing on claims made about the effects of ashwagandha include the following:
Cognitive function: One study suggested supplementation with ashwagandha could improve cognitive function in those with bipolar disorder (3).
Diabetes: In a study on rats with non-insulin dependent diabetes mellitus, ashwagandha improved insulin sensitivity, leading to a normalization of high blood sugar (2).
Energy: In one small study of human patients with breast cancer, ashwagandha root extract given at a dose of 2 g every eight hours throughout chemotherapy led to an improvement in cancer-related fatigue and quality of life (5).
Immunity: In a study on mice, the stimulatory effect of ashwagandha on the immune system was associated with an increased life span (9).
Pain: Ashwagandha extract was shown to have a pain-relieving effect in those experiencing knee pain (14). Its anti-arthritic and anti-inflammatory effects are thought to be a result of its inhibitory effects on an enzyme involved in inflammation called cyclooxygenase (COX).
Ashwagandha also has the following health benefits, which is why it was chosen to be an ingredient in Hyrbal supplements:
Studies looking specifically at ashwagandha’s effects on mental health include the following:
Anxiety: One study has shown that ashwagandha may be helpful for anxiety. In the study, 75 individuals with moderate to severe anxiety were followed for 12 weeks. Those who received 300 mg twice per day of ashwagandha along with dietary counseling, deep breathing relaxation techniques, and a multivitamin were found to have better improvement in anxiety scores than those who received psychotherapy, deep breathing relaxation techniques, and a placebo (8).
Stress and cortisol levels: One study in individuals with a history of chronic stress found that after 60 days of supplementation with 300 mg twice per day of a high-concentration ashwagandha extract, stress scores were improved and cortisol (commonly considered the “stress hormone”) levels were reduced (6). Another study also found that morning cortisol levels were reduced and that there was an improvement on an anxiety rating scale after 60 days of supplementation with 240 mg per day (11).
Symptoms in schizophrenia: Ashwagandha has been shown to improve stress and other symptoms in those with schizophrenia or schizoaffective disorder. In the study, participants were followed for 12 weeks and received a standardized extract of 1,000 mg per day. Results were determined by the change in score on the Positive and Negative Syndrome Scale, which measures symptoms in schizophrenia (7).
Overall review: One review of the literature identified five human studies that had been conducted on ashwagandha and found that all five had improvements in scores on anxiety and stress scales. However, the review warned that there may be bias amongst the studies (13).
Studies looking specifically at ashwagandha’s effects on men include the following:
Muscle strength and weight loss: One study compared young male subjects taking 300 mg twice per day of ashwagandha to those taking a placebo while undergoing a resistance training program. The participants receiving ashwagandha experienced improved muscle strength, increased muscle size, increased testosterone levels, decreased exercise-induced muscle damage, and decreased body fat percentage (16).
Semen: One study in infertile men found that supplementation with 5 g per day of ashwagandha root powder for three months led to improved semen quality, increased antioxidant activity, and elevation of testosterone levels. Treatment also led to pregnancy in the partners of 14% of the study participants (1, 12).
Testosterone: One study evaluated the hormonal effects of ashwagandha in older, overweight males. Although no statistically significant difference was seen in terms of fatigue, vigor, or sexual/psychological well-being, after eight weeks, study participants taking ashwagandha extract in an amount equaling 21 mg per day of withanolides did have increased levels of DHEA-S (a steroid hormone that helps make testosterone) and testosterone (10).
What doses of ashwagandha have been studied?
Nutritional supplements, like ashwagandha, are not reviewed by the FDA for safety and effectiveness. Additionally, since it comes in many forms, information regarding the exact dosing for ashwagandha is limited. Until more research is done, the dosage of ashwagandha can only be estimated based on existing studies and the doses that were tested. Clinical studies have been conducted which evaluate the efficacy of ashwagandha in various forms at doses ranging from 125 mg per day to more than 5 g per day. More specifically:
- 125 mg per day of a root and leaf extract, 240 mg per day of extract, and 300 mg twice per day of extract have been tested for stress (4,6,11).
- 300 mg twice per day of a standardized extract has been tested for anxiety (8) as well as 300 mg twice per day of a root extract for muscle strength (16).
- 600 mg per day of a root and leaf extract has been tested to improve testosterone (10).
- 5 g per day of root powder has been tested to improve semen quality (1,12).
In what forms is ashwagandha available?
Ashwagandha is a plant whose roots, leaves, and berries can be ground and made available as a powder, tea, or essential oil. Some applications, particularly to assist in pain control, involve mashing ashwagandha root with water to turn it into a paste and applying it topically. Formulations of ashwagandha are available over the counter, however, dosage may vary depending on the method of use/ingestion.
How does Hyrbal offer ashwagandha?
Hyrbal offers ashwagandha in the following supplements:
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What are the side effects of taking ashwagandha?
The most common side effects of ashwagandha are drowsiness, fatigue, gastrointestinal discomfort, and loose stools. Rarely reported side effects include elevation of liver enzymes, fever, headache, inflammation of the stomach lining, nausea, skin rash, and swelling. The long-term effects of taking ashwagandha are unknown. Individual case studies have also revealed the following:
- One 28-year-old man developed burning, itching, and discoloration of the skin while taking ashwagandha. Symptoms resolved after one month of treatment with an oral allergy medication and a topical steroid (3).
- One 32-year-old woman developed an overactive thyroid while taking ashwagandha. Symptoms resolved after discontinuing use (3).
- One 39-year-old man developed hemolytic anemia and abdominal pain following the ingestion of pills that were ordered from India and were labeled “ashwagandha/mucuna.” Analysis of the pills revealed 7.3 mg of lead per pill as well as traces of arsenic, chromium, and mercury. Symptoms resolved after treatment for heavy metal poisoning (15).
- Two cases of heart arrhythmia were possibly associated with preparations that included ashwagandha (3).
Does ashwagandha interact with any other drugs?
Ashwagandha has potential sedative effects, which can be dangerous if taken in combination with certain other medications that act on the central nervous system. Prior to beginning ashwagandha, talk to your healthcare provider if you are taking (please note that this list may not be exhaustive and other medications may also interact with ashwagandha):
Ashwagandha may also impact the activity of immunosuppressive medications and thyroid medications, although the effects are not entirely known.
You should not take ashwagandha if you have hormone-sensitive prostate cancer, as ashwagandha may increase testosterone levels. You should also not take ashwagandha if you are pregnant, as higher doses of ashwagandha may be related to increased rates of abortion. Ashwagandha may cause the immune system to be more active, which is important to consider for those with autoimmune diseases such as systemic lupus erythematosus, multiple sclerosis, or rheumatoid arthritis. Ashwagandha may also lower your blood pressure, which is important to keep in mind if you are already on blood pressure-lowering medications.
Taking ashwagandha may affect certain lab test results. Thyroxine levels (which may be tested to evaluate thyroid function) and digoxin levels (which may be tested if you are taking digoxin) can be falsely elevated when checked by your healthcare provider. Make sure your healthcare provider knows you are taking ashwagandha before checking these lab tests.
- Ahmad MK, Mahdi AA, Shukla KK, et al. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertility and Sterility. 2010;94(3):989-996. doi:10.1016/j.fertnstert.2009.04.046.
- Anwer T, Sharma M, Pillai KK, Iqbal M. Effect of Withania somnifera on Insulin Sensitivity in Non-Insulin-Dependent Diabetes Mellitus Rats. Basic & Clinical Pharmacology & Toxicology. 2008;102(6):498-503. doi:10.1111/j.1742-7843.2008.00223.x.
- Ashwagandha. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ashwagandha. Published June 20, 2019. Accessed July 15, 2019.
- Auddy B, Hazra J, Mitra A, Abedon B, Ghosal S. A Standardized Withania Somnifera Extract Significantly Reduces Stress-Related Parameters in Chronically Stressed Humans: A Double-Blind, Randomized, Placebo-Controlled Study. Journal of American Nutraceutical Association. 2008;11(1):50-56.
- Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the Development of Chemotherapy-Induced Fatigue and Quality of Life in Breast Cancer Patients. Integrative Cancer Therapies. 2012;12(4):312-322. doi:10.1177/1534735412464551.
- Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults. Indian Journal of Psychological Medicine. 2012;34(3):255. doi:10.4103/0253-7176.106022.
- Chengappa KNR, Brar JS, Gannon JM, Schlicht PJ. Adjunctive Use of a Standardized Extract of Withania somnifera(Ashwagandha) to Treat Symptom Exacerbation in Schizophrenia. The Journal of Clinical Psychiatry. 2018;79(5). doi:10.4088/jcp.17m11826.
- Cooley K, Szczurko O, Perri D, et al. Naturopathic Care for Anxiety: A Randomized Controlled Trial ISRCTN78958974. PLoS ONE. 2009;4(8). doi:10.1371/journal.pone.0006628.
- Davis L, Kuttan G. Effect of Withania somnifera on CTL activity. J Exp Clin Cancer Res. 2002;21(1):115-118.
- Lopresti AL, Drummond PD, Smith SJ. A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males. American Journal of Mens Health. 2019;13(2):155798831983598. doi:10.1177/1557988319835985.
- Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract. Medicine. 2019;98(37). doi:10.1097/md.0000000000017186.
- Mahdi AA, Shukla KK, Ahmad MK, et al. Withania somnifera Improves Semen Quality in Stress-Related Male Fertility [published online ahead of print, 2009 Sep 29]. Evid Based Complement Alternat Med. 2009;2011:576962. doi:10.1093/ecam/nep138.
- Pratte MA, Nanavati KB, Young V, Morley CP. An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera). The Journal of Alternative and Complementary Medicine. 2014;20(12):901-908. doi:10.1089/acm.2014.0177.
- Ramakanth G, Kumar CU, Kishan P, Usharani P. A randomized, double blind placebo controlled study of efficacy and tolerability of Withania somnifera extracts in knee joint pain. Journal of Ayurveda and Integrative Medicine. 2016;7(3):151-157. doi:10.1016/j.jaim.2016.05.003.
- Toniolo M, Ceschi A, Meli M, Lohri A, Favre G. Haemolytic anaemia and abdominal pain – a cause not to be missed. British Journal of Clinical Pharmacology. 2011;72(1):168-169. doi:10.1111/j.1365-2125.2011.03909.x.
- Wankhede S, Langade D, Joshi K, Sinha SR, Bhattacharyya S. Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. Journal of the International Society of Sports Nutrition. 2015;12(1). doi:10.1186/s12970-015-0104-9.