Withania somnifera (winter cherry) also known as Ashwagandha is a shrub which has a long history in Ayurveda. Ashwagandha means “smell of horse” in Sanskrit. For over 3000 years, this evergreen shrub which grows in India, Nepal, Middle East and parts of Africa has been used as an adaptogens in a traditional medical system. Modern science is now exploring many of its traditional uses, uncovering a wealth of potential health benefits(1).

Active Compounds Of Ashwagandha

  1. Withanolides
  2. Ashwagandhine
  3. Withasomine
  4. Cuscohygrine
  5. Anaferine
  6. Anahygrine

Ashwagandha Scientific Uses Benefits Dosage and Side Effects

Scientific Benefits Of Ashwagandha

  1. Hypothalamic Pituitary Adrenal (HPA) axis modulation:

    HPA is the key stress response system in the body. Ashwagandha’s active compounds like withanolides modulates the HPA axis and helps to decrease stress.

  2. Regulating Cortisol to Decrease Stress:

    Under prolonged stress, the body’s primary stress hormone known as cortisol levels are elevated which can contribute to various health issues like impaired immunity, weight gain and increase risk of heart disease. According to studies, Ashwagandha can reduce levels of cortisol and lead to noticeable decrease in perceived stress. In a double-blind study conducted in 2012 with 64 adults who suffered from chronic stress showed that those taking 300 mg of Ashwagandha root extract twice daily for 60 days experienced a significant reduction in perceived stress scores on the Perceived Stress Scale (PSS) compared to the placebo group(2). 


  3. Alleviating symptoms of anxiety:

    Studies suggest that it can effectively lessen anxiety symptoms, including worry and tension, promoting a sense of peace and well-being. Some studies have even shown comparable effects to certain anti-anxiety medications. In 2019 double-blind placebo controlled trial involving 60 participants with anxiety found that taking 240 mg of Ashwagandha extract daily for 60 days resulted in reduced anxiety scores on the Hamilton Anxiety Rating Scale (HAM-A) compared to placebo(3).

  4. Improved Sleep :

    Some studies indicate that Ashwagandha may contribute to better sleep quality. Triethylene Glycol(TEG), a bioactive compound has been identified as a sleep inducing component.Four hundred participants from five randomized controlled trials were examined. A slight but noteworthy impact on total sleep was shown by Ashwagandha extract (Standardised Mean Difference -0.59; 95% Confidence Interval -0.75 to -0.42; I2 = 62%). In the subgroup of individuals with an insomnia showed that taking 600 mg of Ashwagandha root extract daily for 8 weeks enhanced their sleep quality (based on the Pittsburgh Sleep Quality Index) and time compared to placebo(4).

  5. Increase Memory and Focus :

    Research suggests that Ashwagandha may improve both immediate and general memory as well as enhanced attention and concentration.Taking 600mg of Ashwagandha root extract daily for eight weeks increased both immediate and general memory as measured by Wechsler Memory Scale III subtests, according to a 2020 study conducted in healthy individuals. Also greater improvement (p < .05) from baseline scores were seen on people taking Ashwagandha root extract as against placebo for Computerised Mental Performance Assessment System (COMPASS) items episodic memory, working memory and accuracy of attention(5).

  6. Mood Regulation

    : It is thought that Ashwagandha affects neurotransmitters such as dopamine and serotonin that are essential for mood control. According to some research, Ashwagandha’s anti-inflammatory qualities may assist lower symptoms of depression(6). 

  7. Increased Strength and Muscle Mass:

    Ashwagandha supplementation can lead to significant gains in muscle strength.A 2015 randomised research of young, healthy men revealed that taking 600 mg of Ashwagandha daily for eight weeks together with resistance training resulted in noticeably larger improvements in arm and chest muscle growth and strength than a placebo(7).

  8. Blood Sugar Management:

    Studies suggest that withaferin A compound of  Ashwagandha may help lower blood sugar levels and improve insulin sensitivity, potentially benefiting individuals with diabetes.

A review of 24 studies (including 5 clinical trials in humans with diabetes) (2003) found that Ashwagandha treatment significantly reduced blood sugar, HbA1c, insulin, blood lipids, and oxidative stress markers(8).

  1. Hormonal Balance and Fertility :

    Ashwagandha may improve hormonal balance in women(alleviating menopausal symptoms), improving sexual function. In men, Ashwagandha supplementation can lead to increase in testosterone level, enhanced sperm count and motility.According to a 2013 study that included 75 infertile males, taking 5 grams of Ashwagandha root powder every day for three months increased sperm count by 167%, semen volume by 53%, and sperm motility by 57% over baseline(9). 

  2. Anti-inflammatory and Antioxidant Properties:

    Withaferin A, a bioactive compound of Ashwagandha can help protect the body against cellular damage and chronic diseases as well as viral dissemination(10)

  3. Anticancer :

    Withanolide molecule of Ashwagandha has shown anticancer activity by binding to specific protein complexes in cancer cells. Withaferin A has been shown to trigger apoptosis by generating reactive oxygen species (ROS) and decreasing tumour size(11). However no definitive proven anticancer effect of Ashwagandha in humans based on large-scale, rigorous clinical trials.

Ashwagandha Scientific Uses Benefits Dosage and Side Effects

Different Forms Available

  1. Capsules and Tablets : They often contain standardized extracts or whole root powder. Standardised extracts ensure a consistent amount of the active compounds, per dose.
  2. Powder : Ashwagandha powder from the dried root leaf can be mixed into water, milk, ghee, honey or smoothies.
  3. Gummies : For people who don’t like swallowing pills or the taste of powder, flavored Ashwagandha gummies are options.
  4. Liquid Extracts : Liquid extracts are active ingredients diluted in a liquid carrier, such as glycerine or alcohol, and may provide more flexible dosing and faster absorption.
  5. Churna : This powdered ancient Ayurvedic formulation is frequently used in conjunction with other herbs to treat particular health issues, like male fertility.
  6. Tea : To make a tea, sliced and dried Ashwagandha root can be added in boiling water.

Dosage and Timing

  • Dosage : Dose as low as 120 mg to as high as several grams per day can be taken. Dosages between 300-600 mg of extract daily, often divided into two doses for at least a month may be beneficial for stress, anxiety and sleep. 
  • Timing : Depending on the preference, it can be taken both in the morning and/or in the evening. However, consistency is the key to get the benefits.

Some side effects to expect 

  1. Stomach upset, Diarrhea, Nausea and Vomiting especially at higher doses.  
  2. Drowsiness and sedation.  
  3. Headache
  4. Liver problems (rare)
  5. Dizziness 

Who Should Not Take Ashwagandha 

  1. Pregnant Women : Some evidence suggests that Ashwagandha may cause miscarriages.  
  2. Breastfeeding women : There is insufficient reliable information about the safety of Ashwagandha during breastfeeding, so it’s best to avoid it.  
  3. Individuals with Autoimmune Diseases : Ashwagandha could worsen symptoms of autoimmune conditions such as Multiple Sclerosis (MS), Lupus (systemic lupus erythematosus, SLE), and Rheumatoid Arthritis (RA).  
  4. People with Thyroid disorders : Ashwagandha may increase thyroid hormone levels so people with hyperthyroidism should take it under caution.
  5. Individuals with liver disease : Due to the potential risk of liver damage, people with pre-existing liver conditions should avoid ashwagandha or use it with extreme caution under medical guidance.

Drug Interactions 

  1. Antidiabetic Drugs : If taken with antidiabetic drugs, it may result in hypoglycemia, or low blood sugar(hypoglycemia).
  2. Antihypertensive Drugs : Combining it with blood pressure-lowering medications could cause blood pressure to drop too low (hypotension).
  3. Sedatives : It may increase sleepiness and drowsiness if taken with sedative drugs..  
  4. Hepatotoxic Drugs : Ashwagandha may raise the risk of liver damage if used with other medications that can damage the liver.
  5. Thyroid Hormone : It might increase thyroid hormone levels, potentially leading to excessive thyroid hormone in the body if taken with thyroid hormone medications. 

Conclusion :

Ashwagandha is a powerful shrub with variety of health benefits in managing stress, anxiety, and sleep, with some evidence suggesting benefits for male fertility.It is generally considered safe for short term use however, there is not enough information to allow conclusions about its long-term safety to be reached.Research is ongoing to fully understand its wide-ranging effects.

References 

1.Tandon N, Yadav SS. Safety and clinical effectiveness of Withania Somnifera (Linn.) Dunal root in human ailments. Journal of ethnopharmacology. 2020 Jun 12;255:112768.

  1. Salve J, Pate S, Debnath K, Langade D, Langade DG. Adaptogenic and anxiolytic effects of ashwagandha root extract in healthy adults: a double-blind, randomized, placebo-controlled clinical study. Cureus. 2019 Dec 25;11(12).
  2. 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 Jul;34(3):255-62.
  3. Cheah KL, Norhayati MN, Yaacob LH, Rahman RA. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PloS one. 2021 Sep 24;16(9):e0257843.
  4. Kale S, Lopresti A, Suri R, Garg N, Langade D. Safety and Efficacy of Ashwagandha Root Extract on Cognition, Energy and Mood Problems in Adults: Prospective, Randomized, Placebo-Controlled Study. Journal of Psychoactive Drugs. 2024 Nov 6:1-3.
  5. Speers AB, Cabey KA, Soumyanath A, Wright KM. Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia. Current neuropharmacology. 2021 Sep 1;19(9):1468-95.
  6. 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 Dec;12:1-1.
  7. Durg S, Bavage S, Shivaram SB. Withania somnifera (Indian ginseng) in diabetes mellitus: a systematic review and meta‐analysis of scientific evidence from experimental research to clinical application. Phytotherapy research. 2020 May;34(5):1041-59.
  8. Durg S, Shivaram SB, Bavage S. Withania somnifera (Indian ginseng) in male infertility: An evidence-based systematic review and meta-analysis. Phytomedicine. 2018 Nov 15;50:247-56.
  9. Devpura G, Tomar BS, Nathiya D, Sharma A, Bhandari D, Haldar S, Balkrishna A, Varshney A. Randomized placebo-controlled pilot clinical trial on the efficacy of ayurvedic treatment regime on COVID-19 positive patients. Phytomedicine. 2021 Feb 4;84:153494.
  10. Wadhwa R, Singh R, Gao R, Shah N, Widodo N, Nakamoto T, Ishida Y, Terao K, Kaul SC. Water extract of Ashwagandha leaves has anticancer activity: identification of an active component and its mechanism of action. Plos one. 2013 Oct 10;8(10):e77189.