Ashwagandha

Effects and Benefits

Core Identification

Common Names:
- Ashwagandha
- Indian ginseng
- Winter cherry
- Withania
- Poison gooseberry
- Asgandh (Hindi)

Latin Name: Withania somnifera

Category: Herb

Uses

Traditional Uses

• General tonic for vitality and longevity - Ayurvedic medicine, 3,000+ years
• Stress and nervous exhaustion - Ayurvedic medicine, ancient origins
• Male reproductive health and fertility - Traditional Indian medicine
• Sleep support and insomnia - Ayurvedic medicine (the species name "somnifera" means "sleep-inducing")
• Supporting recovery from illness - Ayurvedic medicine, used during convalescence
• Memory and cognitive support - Traditional use in elderly care
• Promoting growth in children - Ayurvedic medicine
• Inflammatory conditions (bronchitis, asthma, psoriasis, ulcers) - Ayurvedic medicine
• Wasting in children, senile debility - Ayurvedic medicine
• Leukoderma, lumbago, arthritis, rheumatism - Ayurvedic medicine
• Promoting conception - Ayurvedic medicine
• Nutrient tonic for pregnant women and older adults - Traditional Ayurvedic use (note: modern guidance advises caution in pregnancy)

Modern Uses

• Stress and anxiety reduction | Research quality: Strong
• Key findings: Multiple randomized controlled trials (6+) show significant reductions in perceived stress (44%) and cortisol levels (23-28%) compared to placebo; comparable to some anti-anxiety medications in reducing symptoms. In a 2009 Canadian trial, ashwagandha paired with dietary advice and a multivitamin was found more effective in decreasing anxiety than psychotherapy and placebo.

• Source citations: Chandrasekhar K, et al. Indian Journal of Psychological Medicine, 2012; Lopresti AL, et al. Journal of Clinical Psychiatry, 2019; Chevallier - Encyclopedia of Herbal Medicine

• Cortisol reduction | Research quality: Strong

• Key findings: Consistently shown to lower chronically elevated cortisol levels; 300 mg twice daily reduced serum cortisol by 27.9% over 60 days. A 2012 Indian clinical trial noted those taking ashwagandha had lower stress levels, increased sense of well-being, and lower cortisol and blood pressure levels.

• Source citations: Auddy B, et al. Journal of the American Nutraceutical Association, 2008; Chevallier - Encyclopedia of Herbal Medicine

• Sleep quality improvement | Research quality: Moderate

• Key findings: Improved sleep onset, sleep quality, and sleep efficiency in adults with insomnia; more effective at higher doses (600 mg vs 300 mg). For chronic insomnia, herbalists recommend a daily tonic of ashwagandha with milky oats and tulsi, combined with a separate nighttime formula (passionflower, skullcap, hops).

• Source citations: Langade D, et al. Cureus, 2019; Deshpande A, et al. Sleep Medicine, 2020; Blankespoor - The Healing Garden

• Testosterone and male fertility | Research quality: Moderate

• Key findings: Increased testosterone by 10-22% in stressed men; improved sperm count, motility, and quality in infertile men. Two clinical trials indicate the herb markedly improves semen quality. Studies show ashwagandha "not only reboots enzymatic activity of metabolic pathways and energy metabolism but also invigorates the harmonic balance of seminal plasma metabolites and reproductive hormones in infertile men." Note: One clinical trial found no benefit for erectile dysfunction specifically.

• Source citations: Lopresti AL, et al. American Journal of Men's Health, 2019; Ahmad MK, et al. Fertility and Sterility, 2010; de la Forêt - Alchemy of Herbs; Chevallier - Encyclopedia of Herbal Medicine

• Female sexual function | Research quality: Preliminary

• Key findings: In a pilot study of 50 women, those taking concentrated root extract showed significant improvements in sexual function including lubrication and orgasm after eight weeks compared to placebo.

• Source citations: de la Forêt - Alchemy of Herbs; Dongre S, et al. BioMed Research International, 2015

• Female reproductive health | Research quality: Traditional/Preliminary

• Key findings: Traditional remedy for female infertility and low libido; may help ease menopausal symptoms. Used for dysmenorrhea, irregular and scanty periods, and endometriosis.

• Source citations: Blankespoor - The Healing Garden; McIntyre - The Complete Herbal Tutor

• Athletic performance and strength | Research quality: Moderate

• Key findings: Improved muscle strength, muscle size, and exercise recovery; enhanced cardiorespiratory endurance in athletes. Traditionally used to improve stamina in athletes.

• Source citations: Wankhede S, et al. Journal of the International Society of Sports Nutrition, 2015; Bone - Clinical Guide to Blending Liquid Herbs

• Cognitive function and memory | Research quality: Preliminary to Moderate

• Key findings: Improvements in attention, information processing, and memory; may enhance executive function and reaction time. In one study, 20 men taking extract twice daily showed significant improvements in cognitive ability. Works on acetylcholine receptors, known to be important in memory processing. May help protect against Alzheimer's-like symptoms by reducing the brain's need to break down its own cells for acetylcholine, thereby reducing neurofibrillary tangles.

• Source citations: Choudhary D, et al. Journal of Dietary Supplements, 2017; Simon - The Chopra Center Herbal Handbook; Balch - Prescription for Herbal Healing

• Bipolar disorder support | Research quality: Preliminary

• Key findings: In a double-blind, placebo-controlled trial, ashwagandha improved working memory, reaction time, and social function in people diagnosed with bipolar disorder.

• Source citations: de la Forêt - Alchemy of Herbs; Chengappa KNR, et al. Journal of Clinical Psychiatry, 2013

• ADHD and behavioral problems | Research quality: Traditional/Preliminary

• Key findings: Traditionally used for behavioral problems, poor memory and concentration, and ADHD. Promotes clarity of mind and calmness.

• Source citations: McIntyre - The Complete Herbal Tutor

• Panic attacks and nervous disorders | Research quality: Traditional/Preliminary

• Key findings: Used for stress, anxiety, depression, overwork, panic attacks, nervous exhaustion. Engenders calmness and clarity of mind; useful for drug abuse and addiction recovery.

• Source citations: McIntyre - The Complete Herbal Tutor

• Thyroid function support | Research quality: Preliminary

• Key findings: May increase T3 and T4 thyroid hormones; potential benefit for subclinical hypothyroidism. Popular in formulas for hypothyroid conditions given the relationship between adrenal function and thyroid pathology.

• Source citations: Sharma AK, et al. Journal of Alternative and Complementary Medicine, 2018; Coffman - Herbal Medic

• Blood sugar regulation | Research quality: Preliminary

• Key findings: Evidence of improved insulin sensitivity and reduced fasting blood sugar; hypoglycemic and hypocholesterolemic effects demonstrated. May be useful with insulin resistance and type 2 diabetes.

• Source citations: Andallu B, Radhika B. Indian Journal of Experimental Biology, 2000; de la Forêt - Alchemy of Herbs; Bone - Clinical Guide to Blending Liquid Herbs

• Arthritis and inflammation | Research quality: Preliminary to Moderate

• Key findings: Natural steroidal compounds shown to be more potent than hydrocortisone for controlling inflammation in animal studies; pain relief comparable to aspirin and phenylbutazone without immune-depressing side effects. Used for rheumatic conditions including rheumatoid arthritis.

• Source citations: Balch - Prescription for Herbal Healing; McIntyre - The Complete Herbal Tutor

• Respiratory conditions (asthma, bronchitis) | Research quality: Traditional/Preliminary

• Key findings: Traditional use for inflammatory conditions including asthma and bronchitis. Has bronchodilator and expectorant actions. Relieves allergies including rhinitis.

• Source citations: Bone - Clinical Guide to Blending Liquid Herbs; McIntyre - The Complete Herbal Tutor

• Immune system support | Research quality: Moderate

• Key findings: Shown to increase four different immune system cells, indicating major change in immune cell activation. Capable of protecting immune cell activity when subjected to inhibiting chemicals. Enhances immunity and used for chronic immune deficiency, fibromyalgia, and leucopenia.

• Source citations: de la Forêt - Alchemy of Herbs; Simon - The Chopra Center Herbal Handbook; McIntyre - The Complete Herbal Tutor

• Nerve repair and neurological support | Research quality: Preliminary/Clinical Experience

• Key findings: Used in nerve support and nerve repair formulas, particularly for neuromuscular junction and myelin sheath damage. Effective in nasya formulas for CNS damage with symptoms like "brain fog," chronic fatigue, lack of concentration (as with late-stage Lyme disease or meningitis), trigeminal neuralgia, and migraines.

• Source citations: Coffman - Herbal Medic

• Balance disorders (cerebral ataxias) | Research quality: Preliminary

• Key findings: Patients with balance problems showed improvement with ashwagandha supplementation.

• Source citations: Balch - Prescription for Herbal Healing

• Adjunct therapy during conventional treatment | Research quality: Preliminary to Moderate

• Key findings: May increase blood cell counts during chemotherapy; animal studies suggest it sensitizes certain cells to radiation. Protects bone marrow of animals pretreated with ashwagandha from radiation-induced suppression of white blood cell production. Similar protective effect with cyclophosphamide. May help restore red and white blood cell counts after immunosuppressive treatment. Used by herbalists during and after chemotherapy, radiation, and surgery for immune support and recovery.

• Source citations: Simon - The Chopra Center Herbal Handbook; Balch - Prescription for Herbal Healing; de la Forêt - Alchemy of Herbs

• Autoimmune support | Research quality: Preliminary

• Key findings: Immune-balancing qualities may help dampen overactive immune responses in autoimmune conditions and allergies. Used for multiple sclerosis, psoriasis, ankylosing spondylitis, lupus, and rheumatoid arthritis. (Note: Use with caution—see Safety section.)

• Source citations: Blankespoor - The Healing Garden; McIntyre - The Complete Herbal Tutor

• Skin conditions (psoriasis, eczema) | Research quality: Traditional

• Key findings: Used internally and externally for psoriasis and dry, itchy skin conditions including eczema.

• Source citations: McIntyre - The Complete Herbal Tutor; Bone - Clinical Guide to Blending Liquid Herbs

• Pediatric tonic | Research quality: Preliminary

• Key findings: Researched as a tonic suitable for children; increases hemoglobin and serum iron in children. Contains iron which may support growth and hemoglobin levels. Safe for elders and children alike according to traditional use. Use only under healthcare provider guidance.
• Source citations: Chevallier - Encyclopedia of Herbal Medicine; Balch - Prescription for Herbal Healing; Bone - Clinical Guide to Blending Liquid Herbs; Blankespoor - The Healing Garden

Active Compounds

Primary Active Ingredients:
- Withanolides (2-5% in root) - Steroidal lactones including Withaferin A and Withanolide D; primary compounds responsible for anti-stress, anti-inflammatory, and adaptogenic effects. Compounds are similar to the body's own steroid hormones. Note: Leaves actually contain higher withanolide concentrations than roots (Withaferin A in leaves has tremendous antitumor activity), though root extracts remain most common.
- Alkaloids - Including somniferine, anferine, tropine, withanine, and pseudo-withanine; contribute to calming and sedative properties
- Sitoindosides (7 and 8) - Glycowithanolides that support immune function and stress resistance
- Saponins - Support immune modulation
- Iron - Contains iron; may support hemoglobin levels
- Choline, fatty acids, amino acids - Additional nutritive compounds

Mechanism Notes:
- GABA receptor activity - Studies show effects on GABA receptors, the site of action of tranquilizing drugs such as Valium and Ativan, which may explain its calming properties
- Acetylcholine receptor activity - Acts on acetylcholine receptors, known to be important in memory processing, supporting its traditional use for cognitive enhancement

Sources: Simon - The Chopra Center Herbal Handbook; Buhner - Herbal Antibiotics; Chevallier - Encyclopedia of Herbal Medicine

Dosage Information

Standard Dosage:
- Form: Root extract capsule/powder (standardized to withanolides)
- Amount: 300-600 mg per day
- Frequency: Once or twice daily (split doses preferred for steady effects)

Traditional Dosage Forms:
- As powder: 3 to 6 grams per day (or 1 gram per day in warm milk per Ayurvedic tradition)
- As decoction: 20 to 30 grams per day, added to heated milk
- As tincture: 1:4 ratio, 60% alcohol, 2 to 8 mL per day (dry root only; fresh tincture not recommended)

Professional/Practitioner Dosage:
- Liquid Extract (1:2): 5-13 mL per day (35-90 mL per week)
- Source: Bone - Clinical Guide to Blending Liquid Herbs

Alternative Dosage Forms (Easley):
- Standard Decoction: 4-8 ounces 3 times daily (or decoct in coconut milk with vanilla and honey)
- Tincture: Dried root (1:5, 70% alcohol); 1-10 mL (0.2-2 tsp.) 3 times daily
- Capsule: 2-6 capsules (1,000-3,000 mg) 3 times daily

Therapeutic Dosage:
- Form: Standardized root extract (5% or higher withanolides)
- Amount: 600-1,200 mg per day in divided doses
- Purpose: For significant stress, anxiety, sleep issues, or athletic performance
- Duration: Minimum 4-8 weeks for noticeable effects; most studies run 8-12 weeks

Maximum Safe Dosage:
- Daily maximum: Up to 1,200 mg of standardized extract per day (used in clinical studies)
- Warning threshold: Doses above 1,200 mg not well-studied; start low (300 mg) and increase gradually
- Pregnancy note: McIntyre advises avoiding over 3g daily in pregnancy (though most modern sources advise complete avoidance)

Bioavailability Notes:
- Absorption is generally good - Unlike curcumin, ashwagandha absorbs reasonably well without enhancement
- With food recommended - Taking with a meal (especially containing some fat) improves tolerance and absorption
- Standardized extracts preferred - Look for products standardized to withanolide content (typically 2.5-10%)
- Enhanced forms available: KSM-66® (full-spectrum root extract, 5% withanolides), Sensoril® (leaf and root extract, 10% withanolides - more calming/sedating)
- Traditional absorption enhancement: Combine with pungent herbs like black pepper or trikatu (Ayurvedic blend of black pepper, long pepper, and ginger) to increase absorption

How to Take It

Timing:
- Best time of day: Morning and/or evening depending on goal
- For stress/energy: Morning with breakfast, or split morning and afternoon
- For sleep: Evening, 1-2 hours before bed (traditionally mixed with warm milk, cinnamon, and honey)
- For general adaptogenic support: Split dose morning and evening
- With food or on empty stomach? With food preferred - reduces potential for stomach upset and may improve absorption
- Specific timing notes: Effects build over time; allow 2-4 weeks for initial benefits and 8-12 weeks for full effect. Consistency is more important than perfect timing.

Preparation Tips:
- Ashwagandha has a rather unusual flavor but mixes well with warm, spicy herbs such as ginger and cinnamon
- Try blending with your favorite chai blend
- Can be taken in tincture or capsule form to avoid taste
- Powder mixed with warm milk is the classic Ayurvedic preparation

Sources: Gladstar - Herbs for Stress & Anxiety; de la Forêt - Alchemy of Herbs

Synergies - What It Works Well With

Complementary Supplements:
1. Rhodiola Rosea - Both adaptogens with complementary mechanisms; rhodiola is more stimulating while ashwagandha is calming | Combine for balanced stress support (take rhodiola morning, ashwagandha evening)
2. Magnesium - Both support relaxation and sleep; complementary pathways for calming the nervous system | Combine for enhanced sleep and anxiety support
3. L-Theanine - Both promote calm without sedation; L-theanine enhances alpha brain waves | Combine for focused calm and stress relief
4. Bacopa monnieri - Both support cognitive function through different mechanisms | Combine for memory and brain health (traditional Ayurvedic pairing)
5. Holy Basil (Tulsi) - Fellow adaptogen in Ayurvedic tradition; both reduce cortisol | Combine for comprehensive stress management; traditional pairing for chronic insomnia
6. Milky Oats - Nervous system trophorestorative | Combine with ashwagandha and tulsi as daily tonic for chronic insomnia and nervous exhaustion
7. Black Pepper (Piperine) - May enhance absorption of withanolides | Take together for potentially improved effectiveness
8. Trikatu - Classic Ayurvedic blend (black pepper, long pepper, ginger) | Traditional combination to increase absorption and enhance effects

Avoidance - What NOT to Combine With

Supplement Interactions:
1. Sedating herbs (Valerian, Kava, high-dose Passionflower) - May cause excessive sedation | Severity: Mild to Moderate; use caution and reduce doses if combining
2. Immune-stimulating herbs (Echinacea, Astragalus) - Potential for excessive immune stimulation in those with autoimmune conditions | Use caution if autoimmune disease present

Drug Interactions:
1. Thyroid medications (Levothyroxine, Synthroid) - Ashwagandha may increase thyroid hormone levels | Risk of hyperthyroidism symptoms | Severity: Moderate to Severe - monitor thyroid levels closely
2. Immunosuppressants (Prednisone, Cyclosporine) - Ashwagandha may stimulate immune function | May reduce medication effectiveness | Severity: Moderate
3. Sedatives and Benzodiazepines (Xanax, Valium, Ambien) - Additive sedative effects | Excessive drowsiness or sedation | Severity: Moderate
4. Barbiturates - May potentiate sedative effects | Excessive sedation | Severity: Moderate to Severe
5. Blood sugar medications (Metformin, Insulin) - May lower blood sugar | Risk of hypoglycemia | Severity: Mild to Moderate
6. Blood pressure medications - May lower blood pressure | Risk of hypotension | Severity: Mild to Moderate
7. Seizure disorder medications (anticonvulsants) - Potential interactions | Severity: Moderate - avoid combining

Food Interactions:
- Alcohol - May increase sedative effects; avoid combining, especially at higher ashwagandha doses
- No other significant food interactions known

Safety Information

Long-Term Use:
- Safety of prolonged use (6+ months): Generally considered safe based on traditional use and studies up to 12 weeks; limited data on very long-term use
- Monitoring recommendations: If taking for thyroid support, monitor thyroid levels every 3-6 months; periodic liver function tests may be prudent at high doses
- Cycle recommendations: Some practitioners recommend cycling (8 weeks on, 2 weeks off) though not strictly necessary; taking breaks may help maintain effectiveness
- Pregnancy and breastfeeding: Contraindicated - may have abortifacient properties; do not use (note: some traditional texts recommend it for pregnant women, and Bone notes "no adverse effects expected," but modern consensus advises avoidance)
- Autoimmune conditions: May stimulate immune system; use caution or avoid in lupus, rheumatoid arthritis, multiple sclerosis, Hashimoto's (unless specifically treating hypothyroid aspect under medical supervision)
- Thyroid disorders: Can increase thyroid hormone levels; those with hyperthyroidism should avoid; those with hypothyroidism should monitor closely
- Surgery: Discontinue 2 weeks before surgery due to potential effects on anesthesia, blood pressure, and blood sugar
- Nightshade sensitivity: Ashwagandha is in the nightshade family (Solanaceae); those with nightshade sensitivities may react (though this affects only a small percentage)
- Upper respiratory infection/congestion: In Ayurvedic theory, ashwagandha should be avoided during active upper respiratory infections or when there is significant mucus congestion
- Ashwagandha berries: Do not consume the berries - they can cause severe gastrointestinal pain; use only root or leaf preparations
- Other sedatives: Do not use with other sedatives without guidance
- Liver safety: Rare cases of liver injury have been reported, though causation is not definitively established; most cases resolved upon discontinuation; avoid if you have liver disease; discontinue if you experience dark urine, yellowing of skin/eyes, or unusual fatigue

Primary Uses At-a-Glance

Primary: Stress and anxiety, cortisol reduction, sleep support, male fertility and testosterone, athletic performance, cognitive function

Secondary: Thyroid support, female reproductive health, arthritis and inflammation, immune support, nerve repair, blood sugar regulation, autoimmune support

Sources

Local Library:
- Bone, Kerry - A Clinical Guide to Blending Liquid Herbs: Actions, professional dosing (liquid extract 1:2), indications list, traditional Ayurvedic uses, pregnancy safety note
- Buhner, Stephen Harrod - Herbal Antibiotics: Plant chemistry details, cultivation requirements, traditional uses, chondroprotective and hematopoietic actions
- Chevallier, Andrew - Encyclopedia of Herbal Medicine: Clinical trial summaries (anxiety, male fertility, chronic stress), key constituents, 2012 Indian trial data
- Coffman, Sam - Herbal Medic: Nerve repair applications, hepatoprotective/cardioprotective actions, neuro support formula, thyroid support notes
- de la Forêt, Rosalee - Alchemy of Herbs: Male and female fertility research, immune system studies, bipolar disorder trial, diabetes applications, dosage forms, trikatu combination
- Gladstar, Rosemary - Herbs for Stress & Anxiety: Nervine classification, preparation tips, indications
- Gladstar, Rosemary - Herbal Recipes for Vibrant Health: Overview, suggested uses, reproductive tonic notes
- McIntyre, Anne - The Complete Herbal Tutor: Comprehensive actions list, external/topical uses, ADHD and behavioral applications, respiratory uses, urinary/menstrual uses
- Simon, David - The Chopra Center Herbal Handbook: GABA and acetylcholine receptor mechanisms, antioxidant activity, immune protection, cognitive studies, Parkinson's context
- Blankespoor, Juliet - The Healing Garden: Insomnia protocol, cultivation notes, female reproductive uses, immune balancing, safety precautions
- Hopman, Ellen Evert - Secret Medicines From Your Garden: Pregnancy contraindication, sedative interaction warning
- Harper-Jones, Miriam - The Holistic Home Apothecary: Stress tonic recipe (powder in warm milk)
- Easley, Thomas - The Modern Herbal Dispensatory: Dosage forms (decoction, tincture, capsule), energetics, warnings

General Knowledge:
- Core Identification, Traditional Uses framework, Active Compounds baseline, Dosage Information ranges, How to Take It guidance, Synergies framework, Avoidances framework, Safety Information baseline
- Cited clinical studies: Chandrasekhar K et al. (2012), Lopresti AL et al. (2019), Auddy B et al. (2008), Langade D et al. (2019), Deshpande A et al. (2020), Wankhede S et al. (2015), Choudhary D et al. (2017), Sharma AK et al. (2018), Ahmad MK et al. (2010), Andallu B & Radhika B (2000), Dongre S et al. (2015), Chengappa KNR et al. (2013)