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Ashwagandha: Exploring the Health Benefits & Side Effects of this Adaptogenic Herb

11 min read

Ashwagandha is a medicinal plant with a long pedigree in Ayurveda, where it’s considered the “King of Herbs.” Many people swear by its ability to reduce stress and anxiety, as well as improve sleep. It’s also been shown to enhance physical performance, combat neurological conditions, and even fight cancer. But does it have any risks? How much should you take, and for how long? And what are the best forms of the herb?

In 1869, a German doctor prescribed the world’s first synthetic pharmaceutical to a patient with sleep problems. Chloral hydrate induced a deep sleep and was easier to administer than morphine. But the drug came with a nasty set of side effects, including a high risk of overdose, rashes, stomach upset, and, eventually, multi-organ failure.

That may seem like a long time ago, but it’s just the blink of an eye in the context of human history. For most of our time on this planet, medicine was made from natural substances, with the vast majority sourced from the plant kingdom. Traditional medicines from around the world have relied on natural herbs for maintaining and restoring health and wellness. And many cultures today still use them instead of or in conjunction with modern pharmaceuticals.

And while long unknown outside their cultures of origin, these healing systems have become increasingly global in scope. The Indian tradition of Ayurveda, for example, is gaining inroads in Western medical practice. And its signature herbs are being studied for their biological properties and risk-benefit profiles compared to prescription drugs.

One such herb, ashwagandha, has become a popular supplement, thanks to a long list of potent health benefits. Ayurvedic practitioners prescribe it to help the body resist stressors of all kinds, and also to fight certain diseases. It has such pride of place in the Ayurvedic tradition that it’s known as the “King of Herbs.”

So what exactly is Ashwagandha? How does it work in the body? What are its purported health benefits? How should it be consumed? And does it have any side effects to consider?

What Is Ashwagandha?

Withania somnifera plant known as Ashwagandha. photography

Ashwagandha is an herb made from the Withania somnifera (meaning “sleep-inducing”) plant, with thousands of years of use in Ayurveda. It’s in the Solanaceae or nightshade family, along with tomatoes, potatoes, and eggplant (and, in the spirit of full disclosure, the extremely toxic belladonna). It’s also known as Indian ginseng or winter cherry (this latter name thanks to the small red fruit that grows on the bush).

The name ashwagandha comes from Sanskrit and can be translated as “the smell of a horse.” Its name refers both to its unique smell and the conviction that consuming it can confer the power of a horse.

The leaves, fruit, and seeds of ashwagandha are all edible and used for medicinal purposes. But it’s the root of the plant that is most prized and frequently used. Ashwagandha contains important plant compounds like alkaloids, phytochemicals, saponins, and antioxidants. These compounds may be primarily responsible for the plant’s health benefits. For instance, ashwagandha can increase concentrations of one of your body’s most powerful antioxidants, glutathione.

Health Benefits of Ashwagandha

Ashwagandha belongs to a category of substances known as adaptogens. These substances, which include members of the plant and fungi kingdoms, are special because they can help your body handle stress more effectively.

Ayurvedic practitioners and a growing body of Western wellness experts and consumers believe ashwagandha can also help improve energy levels, boost concentration, and reduce inflammation. There’s some scientific research backing up these purported benefits as well. And the herb does have thousands of years of Ayurvedic usage to back it up. But more studies are needed to fully understand its effectiveness — especially long-term.

In this article, we’ll focus on the research regarding ashwagandha’s effects on stress, anxiety, and sleep quality; physical performance; neurodegenerative disease; inflammation; and cancer and chemotherapy drugs.

Ashwagandha’s Effect on Stress, Sleep, and Anxiety

Tired hispanic woman at home sitting on a chair in a bright living room with her hand against her head in front of a large window. One worried and anxious young female inside with headache and stress

Several clinical trials from India have found that ashwagandha can be helpful in reducing stress, improving sleep quality and quantity, and lowering anxiety levels.

A 2019 study randomized 60 “stressed adults” into three groups. They received either 250 or 600 mg of ashwagandha per day for 8 weeks, or a placebo. Compared to the control group, those given the herb reported significant reductions in how stressed they felt. And those perceptions were supported by reductions in their serum levels of the stress hormone cortisol. Both ashwagandha groups also showed significant improvement in sleep quality compared to the placebo group. Interestingly, the group receiving 600 mg of ashwagandha per day fared better on all counts than the one receiving 250 mg per day — which, in turn, fared better than the placebo.

A 2022 meta-analysis of 12 studies that included over 1,000 adults found that ashwagandha seems to lower anxiety and stress when compared to a placebo. Taking up to 12,000 mg (4 teaspoons) per day seemed to be the sweet spot to treat anxiety, while a much smaller dose of 300–600 mg per day was found to help with stress.

Ashwagandha and Exercise Performance

Can ashwagandha really give you the “power of a horse?” A 2015 study found that an extract of the root can improve both fitness and quality of life. When 50 healthy athletic adults took ashwagandha, they significantly increased cardiorespiratory endurance, as measured by oxygen consumption levels, compared to those given a placebo. Additionally, quality of life, including physical and psychological health, social relationships, and environmental factors, improved to a greater extent in the ashwagandha group.

A 2021 systematic review and meta-analysis also suggests that the claim may be more than just a metaphor. (I suppose it depends on the horse.) Researchers in 2021 looked at 13 studies on ashwagandha supplementation in healthy individuals. They found that ashwagandha can improve muscle strength and cardiorespiratory fitness in both men and women, while at the same time reducing fatigue. That’s nothing to neigh about!

Ashwagandha and Brain Health

Male Doctor and Patient Examining brain MR

A 2020 literature review found that ashwagandha could help to protect the brain from a number of neurodegenerative conditions, including Alzheimer’s, Huntington’s, and Parkinson’s diseases. The mechanisms at play appear to be the herb’s ability to enhance mitochondrial and endothelial health, and reduce cell death, inflammation, and oxidative damage.

A 2021 study of cultured brain cells (that is, the cells were cultured in test tubes, not that they listened to Beethoven or read Goethe) looked at how an extract from the ashwagandha plant could protect human brain cells from damage caused by a toxin related to Parkinson’s disease. The results showed that this extract increased cell survival, improved antioxidant defenses, and reduced harmful proteins in the cells. This suggests that the ashwagandha extract might be helpful in treating brain diseases like Parkinson’s.

Ashwagandha even appears to help protect us from nasty chemicals like BPA, an endocrine disruptor found in many kinds of plastic. A 2019 animal study (our view on the use of animals in medical research is here) showed that while BPA exposure impaired spatial memory and cognitive function in mice, ashwagandha root extract restored proper functioning. It did so by restoring NMDA receptors in the hippocampus (which are critical for learning and memory), reducing oxidative stress, and enhancing antioxidant levels in the brain.

Ashwagandha and Inflammation

Inflammation is an immune response that can be lifesaving when deployed against an infection or other invasion of foreign matter in the body, but can cause disease when allowed to become chronic. Researchers have identified many compounds in ashwagandha that fight chronic inflammation, with fun names like alkaloids, steroidal lactones, and steroidal saponins. The herb has shown beneficial effects on immunological diseases by modulating inflammatory cytokines and enhancing immune cell functions that reduce inflammation.

A 2023 study investigated the anti-inflammatory properties of ashwagandha in reducing lung inflammation caused by conditions like bronchitis and pneumonia, including in COVID-19 patients. The research showed that ashwagandha extract reduced the levels of inflammatory markers in human lung cells and tissue, as well as in animals. The authors of the paper suggest that ashwagandha could be a potential natural therapy to help combat lung inflammation, offering a safer alternative to corticosteroids in managing conditions like severe cases of COVID-19.

Ashwagandha also has the potential to alleviate osteoarthritis. A 2019 study gave the herb to arthritic rats in the hope that it would reduce inflammation and protect cartilage in joints. While the rats with arthritis had higher levels of inflammation and joint damage markers compared to healthy control rats, their levels of inflammation and joint damage markers decreased significantly upon consumption of ashwagandha. The herb seemed to work by increasing the levels of an anti-inflammatory molecule called IL-10 and decreasing the activity of a molecule that promotes inflammation, known as NF-κB. (In case you’re wondering, there’s actually a protein that researchers have named R2D2. And in an affront to Star Wars fans everywhere, it has no especially strong relationship to C-3PO.)

See our comprehensive article on the dangers of chronic inflammation and how to “put out the fire” with food, here.

Ashwagandha and Cancer

The beautiful woman smiles at the camera to take a photo in her home. Productions

Many researchers are optimistic about ashwagandha’s potential to fight cancer. Compounds present in the herb, such as withaferin A and withanone, have been shown to combat the proliferation of several types of cancer cells, including breast cancer, prostate cancer, colorectal cancer, and leukemia. Studies suggest that these compounds may induce cancer cell death, inhibit cancer cell growth, and reduce tumor formation through various mechanisms such as oxidative stress, mitochondrial dysfunction, and modulation of specific signaling pathways involved in cancer progression.

Ashwagandha appears to enhance the effectiveness of at least some forms of chemotherapy for cancer, too. In a 2017 test-tube study, researchers found that pretreating colon cancer cells with ashwagandha root extract increased the potency of the chemotherapy drug cisplatin. It did so by actually increasing oxidative stress, which damaged the mitochondria of the cancerous cells, making them easier to kill with chemo. Remarkably enough, this “priming” effect was not observed in noncancerous cells.

Where to Find Ashwagandha

Ashwagandha is typically sold as a dietary supplement or functional food. You can find it in the form of capsules, gummies, powders, teas, beverages and beverage mixes, and in protein and energy bars.

Many ashwagandha supplements and products are available online or at natural foods stores and traditional grocery stores. It’s mostly available in powdered form, but you can sometimes find the whole root, too.

Another place to look for whole ashwagandha root is your local farmers markets and CSAs. It’s harvested only for a short period of time, in late winter and early spring, so you’ll find it in season only for a few months of the year.

How Much Ashwagandha Should You Take?

Ashwagandha (Withania somnifera) capsules. Concept for a healthy dietary supplementation. Bright stone background. Copy space. Dudzinski

The best way to take ashwagandha is dependent on the dosage and condition you’re addressing. There is no set recommended amount, as it’s not regulated by the FDA.

Typical amounts used for sleep, anxiety, and stress in studies are 500–600 mg. Doses as low as 250 mg, which are commonly found in ashwagandha products intended for general consumers, may also be helpful.

At the upper limits, research shows tolerance up to 1,250 mg/day without an issue. Problems can arise when extracts or tinctures are produced from the root, as they can become quite concentrated (especially when alcohol is the solvent).

Tinctures are prepared in a ratio depending on the strength of the herb, and can dose you with more of the herb than is recommended because the solvent has been removed. Unfortunately, tinctures are not regulated, so it’s difficult to tell how much of the plant is in any particular formulation.

Traditionally, ashwagandha has not been prescribed for long-term consumption. While studies have found that it is likely safe for up to three months of continuous use, we don’t have much research beyond that. We do know that many Ayurvedic and traditional Chinese medicine practitioners recommend taking breaks before the body can develop a tolerance to the herb.

Ashwagandha Side Effects to Consider

Ashwagandha may not be for everyone. Some people may experience short-term side effects, including drowsiness and gastrointestinal effects.

Those who are pregnant are advised against using ashwagandha, as it is possible that it may have abortive properties.

And because it might increase testosterone levels, people with hormone-sensitive prostate cancer may want to avoid it as well. On the other hand, ashwagandha may be helpful for people who need or want to increase their testosterone levels.

Because ashwagandha can impact levels of thyroid hormones, people with existing hyperthyroid disorders may want to avoid it. At the same time, it may also help those with underactive thyroid, although care should be taken to ensure it doesn’t negatively interact with thyroid medications.

It’s rare, but there have been a few reported cases of liver injury through ashwagandha supplementation.

Ashwagandha also may interact with certain medications, including thyroid hormone medications, antidiabetes medications (including the popular semaglutide drugs now being prescribed for weight loss, such as Ozempic and Wegovy; since the herb may increase hypoglycemia), antihypertensives, immunosuppressants, and sedatives. If you’re taking any of these, you may want to consult with your health care professional before starting to take ashwagandha.

Ashwagandha Recipes

From creamy moon tonics to naturally sweet and energizing bites, you can easily incorporate ashwagandha into tasty recipes with a few additional plant-based ingredients and a bit of kitchen creativity. No matter if you have a taste for sweet or savory, our ashwagandha recipes offer a simple method to incorporate more adaptogens into your meals, enriching your diet with their balancing benefits.

1. Ashwagandha Moon Tonic

Ashwagandha Moon Tonic

Unwind with our calming tonic, thoughtfully blended with soothing and warming spices along with the stress-reducing power of ashwagandha. Ashwagandha, a prized adaptogen in Ayurvedic tradition, stands out for its ability to diminish stress and foster a sense of balance in the body’s stress response. This tonic also features supportive and balancing spices like cinnamon, turmeric, nutmeg, and cardamom, which show promise in their ability to calm nerves, although more research is needed. Each sip of our Ashwagandha Moon Tonic delivers not only comfort but also a wealth of antioxidant and anti-inflammatory properties that are ideal for your overall health.

2. Spiced Apple Carrot Ginger Adaptogen Soup

Spiced Apple Carrot Ginger Adaptogen Soup is extremely delicious and healing on its own, but when you add immune-supportive ashwagandha to it, the level of anti-inflammatory and immune support exponentially increases. Made with sweet apples, carrots, ginger, onion, celery, mustard seed, and turmeric, this soup is perfect whenever you need a soothing, comforting, and inflammation-busting meal!

3. Chai Spiced (No Cook) Ashwagandha Bites

Homemade energy balls with dried apricots, raisins, dates, prunes, walnuts, almonds and coconut. Healthy sweet food. Energy balls in a plate on a white background. Bagrova

Chai Spiced Ashwagandha Bites blend the cozy, sweet, and mildly spicy notes of chai with the energizing benefits of oats, creating the perfect filling snack. Ashwagandha, celebrated for its ability to boost muscle strength and improve cardiorespiratory stamina, also plays a key role in reducing tiredness. Make these bites a treat for post-exercise recovery or a fantastic pick-me-up any time of day.

Give Ashwagandha a Try

Ashwagandha has a long history as a key part of Ayurvedic and traditional Chinese medicine. And it’s now emerging as a popular herb in the modern wellness landscape — for good reason. Its adaptogenic properties offer a natural way to help the body manage stress and improve overall well-being. From enhancing mental clarity and physical performance to its potential to combat inflammation and support neurodegenerative health, ashwagandha’s array of health benefits is as diverse as it is impressive.

Available in various forms like capsules, powders, teas, and functional foods, ashwagandha can easily be integrated into daily routines. However, the lack of FDA regulation, potential side effects, and interactions with medications highlight the importance of informed and cautious use. It may be advisable to consult with a health care professional before taking it, especially if you have any of the potentially impacted health conditions or are taking any of the potentially impacted medications.

Editor’s Note: If you’re looking to incorporate ashwagandha into your daily routine, we like this product from Physician’s Choice. They use organic KSM-66 ashwagandha root extract, which is the most researched ashwagandha, with 22 double-blind clinical studies showing its effectiveness in supporting relaxation and athletic performance as well as reducing stress. And they combine it with black pepper to help with optimal absorption. You can find out more and get it on Amazon, here.

Tell us in the comments:

  • Have you tried ashwagandha?
  • What did you take it for, and what was your experience?
  • Do you have experience with other adaptogens?

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