Ashwagandha

Last Updated: November 2, 2023

Ashwagandha has been called the king of Ayurvedic herbs. It’s best known for reducing stress and anxiety. It may also modestly enhance various aspects of physical performance, increase testosterone levels, and improve reproductive health, but more research is needed to confirm these effects.

Ashwagandha is most often used for

What is ashwagandha?

Ashwagandha (Withania somnifera), also known as Indian ginseng, is an herb used in Ayurveda, the traditional medicine of India. Its root has a horsey smell and is said to confer the strength and virility of a horse. In Sanskrit, ashva means “horse” and gandha means “smell.”[8] Various parts of the plant are used, but the most common supplemental form is an extract of its roots. Its use as part of the Ayurvedic system usually involves more than just the herb alone.

Ashwagandha is classified as an adaptogen, meaning it’s purported to enhance the body’s resilience to stress. Rodent and cell culture studies suggest that ashwagandha may provide a wide range of health benefits,[9][10] but evidence in human studies has thus far varied depending on the health state and population of interest. [11][12][13][14][15][6]

What are ashwagandha’s main benefits?

Ashwagandha is best known for its anxiolytic (anti-anxiety) and stress-relieving effects.[16][17][18][19][20] It also seems to reduce cortisol levels.[8][21][18][19][22][20] In addition, a growing body of evidence supports the efficacy of ashwagandha for improving total sleep time and sleep quality in people with and without insomnia.[5]

Since the stress response has a wide range of effects on the human body, it is possible this action is where ashwagandha’s reputation for being a ‘cure all’ originated. There is increasing support for the use of ashwagandha in the context of health states that are typically affected by a chronic stress response.[23] Ashwagandha research in cardio-respiratory and musculoskeletal performance enhancements has shown promise for both athletes and non-athletes.[24][25][26][27][28][15][6] Similarly, ashwagandha may also improve immune health, women’s health, men’s health, and sexual health. Unfortunately, due to inconsistencies in the research, it has been difficult to form any direct conclusions.[29][4][30][31][32][33][7][34]

What are ashwagandha’s main drawbacks?

Ashwagandha appears to be safe, but more long-term research specifically designed to evaluate its safety is needed. Ashwagandha may cause mild drowsiness and sedation for some people.[35][36][10][37]

Some case reports have suggested adverse effects such as rash or thyroid dysregulation may occur with ashwagandha use, but the same has not yet been observed by safety studies with larger samples.[38][39][35] Several case reports have also raised concerns regarding the rare occurrence of liver toxicity with ashwagandha use, but similarly, toxicity has not been observed in clinical safety trials. In the reports, liver toxicity was usually reported within 2–12 weeks of ashwagandha use, and liver function returned to normal in all but one case following medical support and ashwagandha discontinuation.[40][41][42][43][44][45] An in vitro study suggested that withanone (one type of withanolide in ashwagandha), may have toxic effects in the context of low levels of the cellular antioxidant glutathione (GSH), which is involved in drug detoxification.[46] However, this research is far from conclusive and the mechanisms underlying this possible adverse effect are unclear.

How does ashwagandha work?

Ashwagandha contains numerous bioactive compounds, namely alkaloids, flavonoids, glycosides, steroids, and steroidal lactones.[10] Within the steroidal lactones are withanolides, which are considered to be responsible for most of the plant’s benefits.

A prevailing theory that is proposed to explain ashwagandha’s effects in humans involves the plant’s influence on the hypothalamic-pituitary-adrenal (HPA) axis as evidenced by its ability to affect cortisol levels.[47]

Current evidence on the effects of ashwagandha in humans tends to implicate the HPA axis. A majority of the related studies focus on stress and stress-related conditions, which are frequently tied to cortisol, other neuroendocrine hormones, and neurotransmitters. Much research has been devoted to understanding the ability of ashwagandha to mitigate the effects of both healthy and detrimental stress, which, in turn, could affect other outcomes and or health states. Anxiety, depression, fertility, obesity, sleep, exercise recovery, immune health, and cognition are just a few examples. The HPA stress response may also explain some of the varied results seen in the body of evidence. This variance could be the result of ashwagandha affecting the HPA axis differently in different people. It may also be due to the complex relationship between stress and health conditions. If stress isn’t the precipitating factor for a negative health state, ashwagandha may not be an effective treatment for it either.

The strongest evidence to date suggests ashwagandha has cortisol and corticosteroid lowering effects.[47][8][21][18][20][22][19][48][49][50] In studies where cortisol was lowered, other outcomes, such as anxiety, weight management, fertility, cognition, sleep, and/or quality of life, have also shown some improvement.[22][19][49][21][48][8][18][20]

What are other names for Ashwagandha?
Note that Ashwagandha is also known as:
  • Withania somnifera
  • Indian ginseng
  • Smell of Horse
  • Winter cherry
  • Dunal
  • Solanaceae
Ashwagandha should not be confused with:
  • Withania coagulans (Different Plant)
  • Panax ginseng (different plant)
Dosage information

Studies on ashwagandha have used daily dosages ranging from 120–5,000 mg of a root extract. The most common dosing protocol is 600 mg daily, divided into two doses, with one taken in the morning with breakfast and the other in the evening.

Since withanolides are considered to be the major active component in ashwagandha, some extracts are standardized to contain a certain or minimum amount. Clinical trials have used standardized extracts containing anywhere from 1.5% to 35% withanolides,[1][2][3][4][5][6][7] but many studies do not disclose this information and the optimal amount of withanolides is not yet clear. Note that while studies may use standardized extracts or proprietary formulas, variations in extraction methods, formulation, or composition can affect physiological response.

Evidence suggests that 600 mg daily is superior to lower doses for improving sleep.[5] Similarly, 600–1,000 mg daily may be more beneficial than lower doses for athletes undergoing an intensive exercise regimen.[6] However, more research is needed to confirm whether doses above 600 mg daily yield greater benefits.

It is unknown if ashwagandha loses its potency with daily long-term usage, but due to its possible drug-like effects on neurotransmission, this possibility cannot be ruled out. It’s also unknown if taking breaks from ashwagandha or taking it every other day prolongs its effectiveness.

Examine Database: Ashwagandha