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Ashwagandha: From Ancient Remedy to Modern Marvel

Updated: 3 days ago

It may be trendy now, but this herb has been used for thousands of years to relieve stress and anxiety and to improve sleep. Here’s what science says about ashwagandha.

Herbal supplements made from either the leaves or roots of ashwagandha plants, as seen above, may be effective for managing stress and anxiety, as well for improving sleep. However, its use is often unregulated.

Ashwagandha is suddenly everywhere. A growing interest in natural healthcare—plus the enthusiastic endorsements of celebrities and influencers—has led to a surge in curiosity about the medicinal plant.

But there’s nothing new about ashwagandha; it’s been used in traditional Indian medicine, or Ayurveda, for thousands of years. Such staying power signals that many people really believe that the herb is good for you, and scientific studies do suggest that ashwagandha offers some benefits for stress, anxiety, sleep, and other aspects of overall health.

“The body of research around botanicals such as ashwagandha is increasing, providing scientific validation for their use,” says Melinda Ring, executive director of the Osher Center for Integrative Health at Northwestern University.

But ashwagandha is no cure-all. Scientists aren’t entirely sure which of the plant’s bioactive components help, or exactly how they work. And supplements like ashwagandha aren’t beneficial for everyone; in Ayurveda, these herbs are prescribed based on an individual’s symptoms, constitution, and medical background, explains Chiti Parikh, co-founder of Integrative Health at New York Presbyterian Hospital - Weill Cornell Medicine. Parikh also cautions that misuse of ashwagandha can produce adverse effects.

What is ashwagandha and how does it work?

Ashwagandha is an evergreen shrub (Withania somnifera) also called Indian ginseng or Indian winter cherry. “Ashwagandha has been used for centuries for various health concerns, Parikh says. “It is often called an adaptogen, meaning it helps the body adapt to stressors and restore balance. Its other benefits are reducing inflammation, increasing energy, alleviating anxiety, and improving sleep.”

It’s believed ashwagandha works by regulating the body's stress response and reducing inflammation via active components that include alkaloids, lactones, and steroidal compounds.

“Different parts of the ashwagandha plant, such as the root, leaves, and berries, may have different concentrations of bioactive compounds,” Parikh explains. Notable among these are withanolides, naturally occurring steroid compounds which have been associated with beneficial antioxidant and anti-inflammatory effects on the body. “Research suggests that standardized extracts containing a high concentration of withanolides are the most effective,” Parikh says.

Ring notes that these bioactive components may impact signaling pathways, the chemical reactions that guide cell function. “However, the precise mechanisms through which ashwagandha exerts its varied effects remain an area of active research,” she says.

What are the benefits of ashwagandha?

Growing scientific research does suggest that, whatever the mechanisms, some people may benefit from consuming the plant product.

A number of small scientific studies suggest that ashwagandha can help relieve stress. A 2021 review compiled the results of seven separate studies involving 491 adults in India. Participants suffering from stress and anxiety took a placebo, or various extracts of ashwagandha root or leaves for six to eight weeks. Participants who took ashwagandha reported significantly reduced levels of stress and anxiety, as did those in several additional studies involving 250 adults in India and the United States.

Ring says these clinical studies “offer promising evidence” of ashwagandha’s ability to reduce anxiety but adds that “it should be approached as part of a comprehensive treatment plan that may include conventional therapies, lifestyle modifications, and other support measures.”

(How magnesium affects your sleep and anxiety.)

The species name somnifera comes from the Latin term for inducing sleep, suggesting the plant has long been esteemed for this property. Sleep studies confirming this effect are also small but promising. In a 2021 review of five separate research studies, all in India, 372 adults took either ashwagandha extract or a placebo. The authors report a “small but significant” impact on improving sleep duration and quality, particularly among those who suffered from insomnia.

Studies conducted in mice suggest that triethylene glycol, a compound that can be isolated from ashwagandha leaves, might somehow promote sleep, perhaps by impacting GABA receptors that trigger a calming effect in the brain by blocking nerve cell activity associated with stress or fear.

“Ashwagandha extract was also found to improve mental alertness on rising, and no serious side effects were reported,” Ring says.

Other studies, past and ongoing, have explored the herb’s possible benefits as an aid for arthritis, sexual health and male infertility, diabetes, and cognition, including attention span and memory. In most cases, more data is needed.

Is ashwagandha safe?

“Using ashwagandha for up to about three months appears to be safe for most people,” says Barbara C. Sorkin, director of the U.S. National Institutes of Health’s Botanical Research Centers Program. “However, ashwagandha might not be safe to use if you are pregnant, breastfeeding, or have prostate cancer. In addition, scientists don’t know whether ashwagandha is safe to use for longer than about three months.”

Generally, side effects tend to be mild and include upset stomach and nausea. “However, in some cases, ashwagandha has been reported to have serious side effects, including liver problems,” Sorkin says. “Ashwagandha might also affect how your thyroid gland works, and it might interact with thyroid hormone medications and other medications.”

In fact, Denmark has banned ashwagandha over the concerns that its use can cause liver problems or cause miscarriages because of its impact on hormone levels.

Furthermore, dietary supplements like ashwagandha aren’t regulated like drugs in the U.S., so it’s difficult to know for certain how much of the plant’s bioactive compounds are actually in a particular supplement—or whether they’re in it at all. Third-party testing platforms, like ConsumerLab, can help consumers identify brands that meet quality standards.

Parikh also advises anyone interested in using ashwagandha to see a doctor first to be sure the herb is the right choice for their own health conditions and medications—and then check in again after using it for a short amount of time.

“As an internal medicine doctor who is also trained in Ayurveda, I use this herb for people dealing with a lot of stress and when inflammation seems to be part of the symptomology,” she says. “Remember, when it comes to ashwagandha more isn't always better.”

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