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Ashwagandha is often praised for its health benefits, but it’s important to note that these benefits may not apply to everyone, especially depending on where you live. To better understand this, let’s dive into the human clinical studies and discuss what you can realistically expect from taking ashwagandha.
Clinical benefits
Anxiety and Stress
Ashwagandha is well-known for its ability to help manage anxiety and stress. Many studies suggest that taking 300-600 mg per day can significantly reduce these symptoms. When you combine ashwagandha with dietary counseling and deep breathing exercises, the impact on anxiety can be even more noticeable.
Additionally, when used alongside SSRIs (selective serotonin reuptake inhibitors)—a common medication for anxiety—ashwagandha may further improve anxiety symptoms. Research also indicates that it can lower cortisol levels in stressed individuals, showing that its benefits extend beyond just mental health to include hormonal balance. Interestingly, daily use of ashwagandha may even help prevent stress-related weight gain, as seen in comparison to a placebo.
In fact, the World Federation of Societies of Biological Psychiatry and the Canadian Network for Mood and Anxiety Treatments recommend ashwagandha root extract as a potential therapy for patients with Generalized Anxiety Disorder.
However, not all research is positive. Some studies show little to no effect from ashwagandha. For example, a study involving young adults found that NooGandha, a standardized extract, didn’t significantly improve anxiety, stress, or depression scores compared to a placebo. Another study reported that a standardized ashwagandha extract didn’t reduce perceived stress levels any more than a placebo. Similarly, research involving college students showed no significant improvement in stress levels with ashwagandha compared to a placebo.
So, how should you interpret this mixed data? First, it’s important to note that more studies show benefits than those that don’t, suggesting ashwagandha likely works.
But there’s a catch: most of the studies showing strong benefits were conducted in India or Iran, while many studies with little to no effect took place in other parts of the world, like the United States and Australia. In fact, many U.S.-based studies find that ashwagandha has minimal benefits on stress compared to a placebo.
This suggests that ashwagandha might be more effective in populations from India or Iran than in the U.S. Why this difference exists isn’t clear. It could be that traditional diets in India and Iran enhance ashwagandha’s effects in ways a typical Western diet doesn’t. Or maybe the quality of ashwagandha in India is better than what’s available in the U.S. Genetic differences might also make certain populations more responsive to ashwagandha. Whatever the reason, this is something to consider when discussing how effective ashwagandha really is.
This trend of differing results is common in ashwagandha research. Most of the evidence comes from studies in India and the Middle East, where ashwagandha is traditionally used, while there is much less research from other parts of the world.
Insomnia
If you struggle with insomnia, ashwagandha might offer some relief. A small meta-analysis of insomnia patients suggests that taking ashwagandha extracts daily for 6 to 12 weeks can slightly improve overall sleep quality. It may also enhance sleep and well-being in elderly individuals. However, most of these studies were conducted in India, not North America.
Athletic Performance
Ashwagandha has also been explored for its potential to boost athletic performance. For aerobic exercise, a meta-analysis of small clinical trials indicates that ashwagandha can enhance aerobic capacity in both athletes and non-athletes. When it comes to strength training, another meta-analysis shows that ashwagandha may improve muscle strength, speed, and recovery, regardless of your athletic level.
Psychological Disorders
The research on ashwagandha’s effects on psychological disorders is limited but shows some promise.
For depression, a small clinical study found that taking 500 mg of ashwagandha root extract daily for 90 days reduced the severity of depressive symptoms and increased serotonin levels compared to a placebo.
In the case of bipolar disorder, research suggests that taking 250 to 500 mg of ashwagandha extract can lead to small improvements in certain cognitive measures, though not all, when compared to a placebo.
For obsessive-compulsive disorder (OCD), preliminary research indicates that taking 120 mg of ashwagandha root extract alongside SSRI medication may slightly reduce OCD symptom severity compared to taking SSRIs alone.
Female Health Issues
Ashwagandha has shown potential benefits for certain female health concerns.
For menopausal symptoms, a small clinical study found that women in perimenopause who took 300 mg of ashwagandha root extract twice daily for 8 weeks experienced relief from symptoms like hot flashes.
When it comes to intimacy, another study revealed that ashwagandha helped improve various aspects of intimacy and satisfaction compared to a placebo.
Male Health Issues
Ashwagandha has also been studied for its potential benefits in addressing male health concerns.
For fertility, preliminary studies suggest that taking ashwagandha for about three months can slightly improve sperm count, volume, and motility in men dealing with infertility.
Regarding intimacy, a small clinical study found that men who took 300 mg of ashwagandha root extract twice daily for 8 weeks reported improvements in various measures of intimacy and satisfaction compared to a placebo.
Hypothyroidism
Ashwagandha has been weakly studied for its potential effects on hypothyroidism. Preliminary research in adults with subclinical hypothyroidism—a condition where hormone levels are slightly low but symptoms are not present—found that taking 300 mg of ashwagandha root extract twice daily for 8 weeks increased T3 and T4 hormone levels compared to a placebo. However, its effects on those with overt hypothyroidism or those taking prescription thyroid hormones remain unknown.
Summary of Benefits
Ashwagandha shows the most promise in managing anxiety, stress, and insomnia, based on clinical research. There’s also evidence suggesting it may help improve athletic performance, ease menopausal symptoms, boost male fertility, and enhance intimacy for both men and women. However, for other conditions that have been studied, the research is too weak to draw solid conclusions. It’s important to note that most of these benefits have been observed in populations from India and the Middle East, not North America.
Safety
When it comes to safety, ashwagandha generally appears to be well-tolerated. Common side effects include drowsiness and headaches, while larger doses might cause gastrointestinal upset. Though rare, there have been reports linking ashwagandha to cases of liver injury.
Another factor to consider is that ashwagandha herbal extracts tend to accumulate higher levels of heavy metals compared to other herbs. Supplements, especially generic or raw forms, might contain high levels of these metals. To minimize this risk, it’s advisable to stick with standardized and purified forms of ashwagandha, especially if you plan on using it long-term. One example is the extract KSM-66, which is standardized to its withanolide content. Other standardized extracts of ashwagandha have also been used in research studies.
Dr. Brian’s Review
Overall, ashwagandha has shown significant benefits in populations from India and the Middle East, which likely explains its popularity as a traditional medicine in those regions. While research on North American populations is limited, the existing evidence is still compelling, especially when it comes to managing anxiety, stress, and insomnia. For example, if you struggle with insomnia due to overthinking at night, ashwagandha might help you fall asleep.
If you’re in North America and considering trying ashwagandha, I suggest using a standardized extract like KSM-66. If it works for you, that’s fantastic. And if it doesn’t, you’ll have a better understanding of why it might not be as effective.
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Citations
Ambiye VR, Langade D, Dongre S, Aptikar P, Kulkarni M, Dongre A. Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study. Evid Based Complement Alternat Med. 2013;2013:571420. doi:10.1155/2013/571420
Ajgaonkar A, Jain M, Debnath K. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus. 2022;14(10):e30787. Published 2022 Oct 28. doi:10.7759/cureus.30787
Akhgarjand C, Asoudeh F, Bagheri A, et al. Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials. Phytother Res. 2022;36(11):4115-4124. doi:10.1002/ptr.7598
Baker C, Kirby JB, O’Connor J, Lindsay KG, Hutchins A, Harris M. The Perceived Impact of Ashwagandha on Stress, Sleep Quality, Energy, and Mental Clarity for College Students: Qualitative Analysis of a Double-Blind Randomized Control Trial. J Med Food. 2022;25(12):1095-1101. doi:10.1089/jmf.2022.0042
Bonilla DA, Moreno Y, Gho C, Petro JL, Odriozola-Martínez A, Kreider RB. Effects of Ashwagandha (Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis. J Funct Morphol Kinesiol. 2021;6(1):20. Published 2021 Feb 11. doi:10.3390/jfmk6010020
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 J Psychol Med. 2012;34(3):255-262. doi:10.4103/0253-7176.106022
Chauhan S, Srivastava MK, Pathak AK. Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: A randomized controlled trial. Health Sci Rep. 2022;5(4):e741. Published 2022 Jul 20. doi:10.1002/hsr2.741
Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLoS One. 2021;16(9):e0257843. Published 2021 Sep 24. doi:10.1371/journal.pone.0257843
Chengappa KN, Bowie CR, Schlicht PJ, Fleet D, Brar JS, Jindal R. Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder. J Clin Psychiatry. 2013;74(11):1076-1083. doi:10.4088/JCP.13m08413
Choudhary D, Bhattacharyya S, Joshi K. Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial. J Evid Based Complementary Altern Med. 2017;22(1):96-106. doi:10.1177/2156587216641830
Cooley K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974. PLoS One. 2009;4(8):e6628. Published 2009 Aug 31. doi:10.1371/journal.pone.0006628
Deshpande A, Irani N, Balkrishnan R, Benny IR. A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults. Sleep Med. 2020;72:28-36. doi:10.1016/j.sleep.2020.03.012
Fuladi S, Emami SA, Mohammadpour AH, Karimani A, Manteghi AA, Sahebkar A. Assessment of the Efficacy of Withania somnifera Root Extract in Patients with Generalized Anxiety Disorder: A Randomized Double-blind Placebo- Controlled Trial. Curr Rev Clin Exp Pharmacol. 2021;16(2):191-196. doi:10.2174/1574884715666200413120413
Gopal S, Ajgaonkar A, Kanchi P, et al. Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study. J Obstet Gynaecol Res. 2021;47(12):4414-4425. doi:10.1111/jog.15030
Gopukumar K, Thanawala S, Somepalli V, Rao TSS, Thamatam VB, Chauhan S. Efficacy and Safety of Ashwagandha Root Extract on Cognitive Functions in Healthy, Stressed Adults: A Randomized, Double-Blind, Placebo-Controlled Study. Evid Based Complement Alternat Med. 2021 Nov 30;2021:8254344. doi: 10.1155/2021/8254344. PMID: 34858513; PMCID: PMC8632422.
Jahanbakhsh SP, Manteghi AA, Emami SA, et al. Evaluation of the efficacy of Withania somnifera (Ashwagandha) root extract in patients with obsessive-compulsive disorder: A randomized double-blind placebo-controlled trial. Complement Ther Med. 2016;27:25-29. doi:10.1016/j.ctim.2016.03.018
Kelgane SB, Salve J, Sampara P, Debnath K. Efficacy and Tolerability of Ashwagandha Root Extract in the Elderly for Improvement of General Well-being and Sleep: A Prospective, Randomized, Double-blind, Placebo-controlled Study. Cureus. 2020;12(2):e7083. Published 2020 Feb 23. doi:10.7759/cureus.7083
Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus. 2019;11(9):e5797. Published 2019 Sep 28. doi:10.7759/cureus.5797
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Ashwagandha. [Updated 2019 May 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548536/
Maharia RS, Dutta RK, Acharya R, Reddy AV. Heavy metal bioaccumulation in selected medicinal plants collected from Khetri copper mines and comparison with those collected from fertile soil in Haridwar, India. J Environ Sci Health B. 2010;45(2):174-181. doi:10.1080/03601230903472249
Majeed M, Nagabhushanam K, Murali A, Vishwanathan DT, Mamidala RV, Mundkur L. A Standardized Withania somnifera (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomized, Placebo-Controlled Study. J Integr Complement Med. 2024;30(5):459-468. doi:10.1089/jicm.2023.0279
O’Connor J, Lindsay K, Baker C, Kirby J, Hutchins A, Harris M. The Impact of Ashwagandha on Stress, Sleep Quality, and Food Cravings in College Students: Quantitative Analysis of a Double-Blind Randomized Control Trial [published correction appears in J Med Food. 2023 Apr;26(4):275. doi: 10.1089/jmf.2022.0040.correx]. J Med Food. 2022;25(12):1086-1094. doi:10.1089/jmf.2022.0040
Pérez-Gómez J, Villafaina S, Adsuar JC, Merellano-Navarro E, Collado-Mateo D. Effects of Ashwagandha (Withania somnifera) on VO2max: A Systematic Review and Meta-Analysis. Nutrients. 2020;12(4):1119. Published 2020 Apr 17. doi:10.3390/nu12041119
Remenapp A, Coyle K, Orange T, Lynch T, Hooper D, Hooper S, Conway K, Hausenblas HA. Efficacy of Withania somnifera supplementation on adult’s cognition and mood. J Ayurveda Integr Med. 2022 Apr-Jun;13(2):100510. doi: 10.1016/j.jaim.2021.08.003. Epub 2021 Nov 25. PMID: 34838432; PMCID: PMC8728079.
Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022;23(6):424-455. doi:10.1080/15622975.2021.2013041
Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med. 2018;24(3):243-248. doi:10.1089/acm.2017.0183
Smith SJ, Lopresti AL, Fairchild TJ. Exploring the efficacy and safety of a novel standardized ashwagandha (Withania somnifera) root extract (Witholytin®) in adults experiencing high stress and fatigue in a randomized, double-blind, placebo-controlled trial. J Psychopharmacol. 2023;37(11):1091-1104. doi:10.1177/02698811231200023
Attributions
Dried graded roots of Withania somnifera By Piyush Kothari – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=114405644
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