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Your Guide to Ashwagandha: Does Ashwagandha Work?

May 26, 2019

Does Ashwagandha Work?

While there is no conclusive, scientific proof, the fact that it has been used successfully for thousands of years in holistic medicine may be an encouraging factor. Additionally, the number of studies already conducted, as well as the number of new studies either currently in progress or being planned, indicate there may be significant potential with this herb to treat a wide range of health conditions.

How does ashwagandha work, though? While many of its effects are not yet well understood by science, some have been determined. Ashwagandha is what is called an adaptogen, which means that it has demonstrated an ability to help the body withstand the effects of stress.

Merriam-Webster dictionary defines an adaptogen as, “a non-toxic substance and especially a plant extract that is held to increase the body’s ability to resist the damaging effects of stress and promote or restore normal physiological functioning.”

According to Time magazine, “Adaptogens are nontoxic plants that are marketed as helping the body resist stressors of all kinds, whether physical, chemical, or biological. These herbs and roots have been used for centuries in Chinese and Ayurvedic healing traditions, but they’re having a renaissance today. Some, like holy basil, can be eaten as part of a meal, and some are consumed as supplements or brewed into teas.”

Healthline broadens this definition by explaining, “Adaptogens are herbal pharmaceuticals. They work to counteract the effects of stress in the body. Stress causes real physical changes in the body, including harming the neurological, endocrine, and immune systems. Adaptogens have stimulant properties that help counteract those harmful effects.”

We have known about adaptogens for thousands of years, but it was not until WWII that they began to see scientific research. Scientists at the time sought a means to help air force pilots improve their performance and alertness in flight. Russian scientists were the first to publish the results of their findings, citing the effects of Schisandra chinesis, or five-flavor berry.

How Do Adaptogens Work?

When it comes to answering the question of whether ashwagandha works or not, we need to study how adaptogens as a whole affect the human body. While many different herbs fall under the adaptogen heading, they tend to work similarly.

With that being said, each brings its unique blend of benefits to the table, as well. For instance, while ashwagandha may be beneficial for depression, building muscle mass, and even boosting mental cognition, other adaptogenic herbs help improve liver health (Schisandra) or also combat the flu (arctic root).

Adaptogens work to keep our bodies within the central segment of our stress response. When stress affects the human body, it begins to go through three distinct segments or phases. The first is the alarm. The alarm is when your adrenaline kicks in, your heartbeat increases, and your focus sharpens. These results are evolutionary adaptations to help us survive in life and death situations – being stalked by a lion on the savannah, for instance.

After the alarm, comes the resistance phase. In this segment, your body is actively resisting whatever the stressor might be. The resistance delivers increased energy and clearer thinking. However, that eventually wears off and fatigue or exhaustion set in. In this phase, you experience the downsides of the stress response – shaky hands, tremors, reduced energy, and the like.

Adaptogens like ashwagandha keep the body firmly in the middle resistance segment for a more extended period. They extend the amount of time that we can experience improved blood flow and cognition, improved oxygenation in the blood, and other benefits. However, this goes deeper than merely offering a more prolonged boost of energy and clearer thinking.

Adaptogens have shown to have numerous powerful effects on the human body (and on other animals, such as rats and mice in laboratory testing). Some of the advantages conferred by taking an ashwagandha supplement may include:

  • Stimulates the central nervous system
  • Fights fatigue and exhaustion
  • Combats depression, anxiety, and stress
  • Offers neuroprotective properties to support healthy brain function
  • Increases mental work capabilities
  • Increases attention and concentration

However, bear in mind that because ashwagandha is an herb/supplement, it means that the FDA does not monitor it, nor does the US government vouch for benefits of taking this supplement. Also, because there is no FDA oversight of supplement formulation, finding a high-quality product from a reputable manufacturer is essential. Less than reputable companies may include very little ashwagandha in their formulation or even none at all.

What Are the Most Common Ashwagandha Side Effects?

While ashwagandha is generally considered safe, there are some reported side effects that users have experienced. Note that there are no clinical studies on the long-term effects of taking ashwagandha for prolonged periods, and high doses of the herb may cause additional symptoms and side effects, such as vomiting, upset stomach, nausea, and diarrhea.

Blood Pressure – There is a chance that taking ashwagandha may lower blood pressure. In individuals with hypertension, this is beneficial. However, for those who are prone to low blood pressure, this could create a dangerous situation. If you take medication for high or low blood pressure, the herb may interfere with its operation.

Diabetes – Ashwagandha shows excellent promise for lowering blood sugar levels. However, for those taking diabetes medication or those subject to hypoglycemia (low blood sugar), this could create a dangerous situation. Always monitor your blood sugar when taking ashwagandha if you have diabetes, on diabetes medication, or are hypoglycemic.

Gastrointestinal Distress – There is evidence that ashwagandha can cause gastrointestinal distress in people who suffer from stomach ulcers. If you have an ulcer or suspect that you may have an ulcer, do not take this supplement. Work with your doctor to heal the ulcer before taking Ashwagandha. Additionally, some individuals involved in clinical studies have reported experiencing stomach irritation and nausea not related to ulcers.

Central Nervous Systems Impacts – Because ashwagandha affects the central nervous system and may slow it down or speed it up, it is not recommended to take this supplement before any surgical procedure. If you take ashwagandha regularly, speak with your medical provider to determine how long before your surgical procedure to stop taking the supplement.

Auto-Immune Diseases – While there is evidence that suggests ashwagandha might be beneficial for some types of auto-immune diseases, there is also evidence that it might cause the immune system to become more active. In some individuals, this may increase the symptoms or the severity of symptoms caused by the disease.

Skin Health – While ashwagandha might be useful in treating inflammation-related skin conditions, some clinical trial participants have noted that taking the supplement has caused unexpected skin health complications/side effects, such as burning and itching. Some also noticed discolored skin patches.

Heart Health – Some study participants have reported experiencing heart health-related issues, including irregular heartbeat and dizziness. Note that these side effects were not reported in conjunction with ashwagandha alone, but an herb-mineral mixture.

Those Taking Sedatives – Ashwagandha has sedative/tranquilizer properties. It is essential that those taking sedatives understand that this may amplify the effects of their medication. Ideally, you will work with your medical practitioner to determine the right dosage, or whether it is safe to take this supplement in conjunction with your regular medication.

Those Taking Anti-Anxiety Medications – Ashwagandha has classically been taken to help deal with stress and anxiety. However, those taking anti-anxiety medications may find that the supplement amplifies the effects of the medicine. Speak with your healthcare provider before starting to take ashwagandha to determine a safe dosage, or whether you should take ashwagandha with your medication.

Herbal Supplements – While ashwagandha is considered relatively safe for most people to take, it does have some potential to cause problems, particularly for those who take herbal supplements that alter the mood. For instance, those taking St. John’s wort should consult their healthcare provider before combining that supplement with ashwagandha, or consider not taking St. John’s wort with ashwagandha.

Other herbs that may see amplified effects or cause unwanted side effects when combined with ashwagandha include the following:

  • Hops
  • 5-HTP
  • Jamaican dogwood
  • Yerba mate
  • Valerian root
  • Skullcap
  • Calamus
  • California poppy
  • Catnip
  • Kava

Alcohol – Consuming ashwagandha with alcohol, or consuming alcohol after taking ashwagandha is not recommended due to the herb’s soporific effects. Combining the two can lead to drowsiness, and the supplement may amplify the other effects of alcohol, as well.

Pregnancy and Breastfeeding – Do not take ashwagandha if you are pregnant or breastfeeding.

These side effects, while present and reported within clinical trials and studies, remain rare. The herb is rated as being generally safe for most people to consume. However, if you fall into any of the categories above, it may be necessary to speak with your medical provider before adding an ashwagandha supplement to your daily regimen.

Is Ashwagandha Safe for Topical Application?

There has been little in the way of clinical/scientific research involving the topical application of ashwagandha. Virtually all clinical trials involving humans and animals, and all test-tube tests, have involved oral supplementation. However, ashwagandha has been used topically in Ayurvedic tradition, as well as in other holistic healing modalities.

For instance, the root has historically been ground into a powder and then mixed with oil or a liquid before being applied to skin irritations, lesions, boils, blisters, skin ulcers, and even infections. However, due to the lack of clinical research in this area, it is unclear whether it is safe to apply ashwagandha to the skin in for short or long periods.

Is Ashwagandha Safe to Take?

Yes, ashwagandha is generally considered safe to take for most people. However, there are some exceptions. For instance, pregnant women and breastfeeding mothers should not take ashwagandha under any circumstances due to potentially adverse effects. We will discuss those effects in a separate section. Others who should avoid taking this supplement, or at least consult their physician before taking ashwagandha include:

  • Those with lupus
  • Those with Hashimoto’s thyroiditis
  • Those with type 1 diabetes
  • Those with rheumatoid arthritis
  • Those taking thyroid medications

For those who do not fall into the list above, ashwagandha should be relatively safe to take, but it never hurts to check with your medical practitioner to see what he or she recommends. It is also possible that you might be taking a medication that ashwagandha will create contraindications with, which will be discussed in another section.

You should also only take an ashwagandha supplement for a limited duration. There are no studies on the safety of long-term consumption. Moderation is the key to enjoying the benefits this herb may be able to offer.

What to Know about Ashwagandha and Pregnancy?

Many people wonder if you can take ashwagandha during pregnancy. The answer is a resounding no. This herb, like many natural supplements and medications, should not be taken during pregnancy. It should also be avoided by breastfeeding mothers. However, there is conflicting advice out there.

Some herbalists (not licensed medical professionals), particularly those following Ayurvedic traditions, do recommend taking ashwagandha during pregnancy because it may be able to help alleviate lower back pain, reduce fatigue, and even speed delivery time. Even those herbalists who recommend taking it during pregnancy specify that you should do so only under the guidance of a supervising professional. Most Western medical experts restrict the use of ashwagandha during pregnancy because of some of the potential side effects the herb can cause.

Perhaps the most worrisome side effect for pregnant women is an induced abortion due to the uterine stimulants the herb contains. The same stimulants may cause women further into their pregnancies to give birth prematurely. Both premature births and induced abortions have occurred in animal testing with ashwagandha.

Low doses of the herb will likely cause no issues for you or your baby, but therapeutic doses do have the potential to cause harm. If you are pregnant or plan to become pregnant and still want to include ashwagandha in your daily regimen, consult your doctor before doing so.

Is It Safe to Take Ashwagandha While Breastfeeding?

Few medical studies involving animals or humans have been conducted regarding the safety of taking ashwagandha while breastfeeding. However, most Western physicians recommend avoiding the herb while breastfeeding.

One limited study followed 40 women who suffered from insufficient milk supply at five days after birth who were given a mixture of herbs, including ashwagandha. With the herbs, milk production increased. However, due to the study’s lack of placebo control, randomization, blinding, and instruction for participants, it is considered the low quality and should not be used in determining whether to take ashwagandha while breastfeeding.

The authors of a summary study of ashwagandha’s use during breastfeeding explained, “No data exist on the excretion of any components of Withania [ashwagandha] into breastmilk or on the safety and efficacy of Withania in nursing mothers or infants. In general, Withania is well-tolerated in adults with occasional gastrointestinal upset and allergic skin reactions. It should be used cautiously by patients with diabetes or hypertension. Because there is no published experience with Withania during breastfeeding, it should be avoided, especially while nursing a newborn or preterm infant.”

What Are the Most Notable Ashwagandha Interactions with Other Medications?

While the herb is generally considered safe to take, there are some ashwagandha interactions and contraindications that you should know before adding it to your regimen. With that being said, all ashwagandha interactions are considered either moderate, requiring caution, or minor, requiring watchfulness.

Diabetes Medications – If you take medication(s) to manage your type 2 diabetes, be aware that ashwagandha can cause unexpected complications by decreasing blood sugar levels. In most cases, you will need to adjust your diabetes medication level. Note that if you have type 1 diabetes, you should not take ashwagandha. Also note that ashwagandha may cause unwanted interactions with all types of diabetes medications, including (but not limited to) the following:

  • Amaryl
  • DiaBeta
  • Micronase
  • PresTab
  • Glynase
  • Insulin
  • Metformin
  • Actos
  • Avandia
  • Diabinese
  • Glucontrol
  • Orinase

High Blood Pressure Medications – In clinical studies, it was found that ashwagandha may help lower blood pressure and combat hypertension. For those taking high blood pressure medications, this can mean a severe drop in pressure that leads to health problems. If you are seeking high blood pressure medications, consult your doctor before taking this supplement. Some of the blood pressure medications that might interact with ashwagandha include:

  • Capoten
  • Vasotec
  • Cozaar
  • Diovan
  • Cardizem
  • Norvasc
  • HydroDIURIL
  • Lasix

Immunosuppressant Medications – Taking an ashwagandha supplement may help with inflammation-related autoimmune conditions. However, the supplement may cause negative interactions with immunosuppressant medications. In most cases, taking ashwagandha in conjunction with immunosuppressant medicines will decrease the effectiveness of the medication. If you take these medications, do not start taking ashwagandha without first discussing it with your medical practitioner. Examples of these medications include (but are not limited to) the following:

  • Imuran
  • Simulect
  • Neoral
  • Sandimmune
  • Zenapax
  • OKT3
  • Orthoclone OKT3
  • CellCept
  • Prograf
  • Rapamune
  • Deltasone
  • Orasone

Sedatives – One of the most common classical uses for ashwagandha was as a sedative. The botanical name of the plant even indicates this. Those taking sedative medications will likely experience negative interactions with this supplement. This includes both benzodiazepines and CNS depressants. In both cases, interactions and side effects include significant drowsiness/sleepiness. Some of the medications that fall into this category include (but are not limited to) the following:

  • Klonopin
  • Valium
  • Ativan
  • Xanax
  • Dalmane
  • Versed
  • Donnatal
  • Ambien

Thyroid Medications – In clinical studies, ashwagandha has been shown to increase the amount of thyroid hormone produced in the body. For those taking thyroid medications, this can cause significant side effects. Speak with your doctor before you begin taking this supplement to determine what dosage amount (if any) is safe for you to intake. Examples of thyroid medications include (but are not limited to) the following:

  • Thyrolar
  • Levothroid
  • Triostat
  • Cytomel
  • Unithroid
  • Synthroid

If you have any questions or concerns about possible interactions with other medications or supplements you are currently taking, the best course of action would be to speak with your physician before adding ashwagandha to your daily regimen.

How Much Ashwagandha Should I Take?

Wondering how much ashwagandha you should take each day? It can be quite confusing, mainly if you read the published scientific studies, as there seems to be very little commonality across the board in terms of dosage size or frequency.

It is essential to understand that, like other herbs, vitamins, and natural supplements, there is a recommended daily allowance set by the FDA or any other government agency. The FDA regulates pharmaceuticals, foods, and is responsible for setting the recommended daily allowance (RDA) of vitamins and nutrients like vitamin C and iron.

Because the FDA does not regulate herbs and supplements, there is no regulated dosage. However, many manufacturers and even holistic health practitioners, have worked together to arrive at what is called “standardized” dosages. With that being said, a lot depends on what benefits you want to see from taking the supplement.

Traditionally, Ayurvedic healers would recommend differing dosage amounts of ashwagandha for each individual being treated based on a wide range of specific factors, including:

  • The patient’s age
  • The patient’s overall health
  • The condition being treated specifically

In classical literature, the average dosage of the herb seems to have been 3,000 mg of ashwagandha containing 5% withanolide concentration twice per day, as mentioned in a clinical study published in the journal BioMed Research International. However, researchers determined that a lower rate of consumption would be more beneficial for most patients. How much should you take? There is no one-size-fits-all dosage, but there are broad-stroke suggestions based on your desired outcome.

For Anxiety and Stress

One of the classical uses for ashwagandha was to control anxiety and stress. Today, many people use the supplement for the same reason. Ashwagandha may be able to help reduce levels of the stress hormone cortisol in the body, which may impact everything from stress to anxiety to body fat. In some medical studies, dosages ranging from 125 mg to 5 grams for one to three months were able to help reduce cortisol levels in the bodies of study participants. Participants in other studies were able to reduce their level of perceived anxiety and stress by taking 500 to 600 mg of ashwagandha once per day for up to 12 weeks.

For Blood Sugar Control

While those with type 1 diabetes should not take ashwagandha, those struggling with type 2 diabetes may be able to find help, as may those with hyperglycemia. However, all people with diabetes should discuss taking the supplement with their doctor before beginning a regimen. Individuals seeking to control their blood sugar better may see benefits from ashwagandha’s potential ability to reduce fasting blood sugar levels. In clinical studies, dosages ranged from 250 mg to 3 grams two to three times per day. Patients interested in this benefit are advised to begin with a dose of 250 mg once per day and slowly move up.

For Fertility

Ashwagandha has been used as a fertility aid for thousands of years, and there is scientific evidence that it may be able to improve fertility in both men and women. Several studies have been conducted that found ashwagandha may be able to increase sperm count, sperm motility, and semen volume in men. Most of the studies conducted have focused on using roughly 5 grams of ashwagandha per day for three months. Note that this is a therapeutic dose of 5,000 mg (1 gram equals 1,000 mg).

For Physical Strength and Muscle Mass

Ashwagandha has shown the potential to help increase muscle mass, physical strength, and endurance. This is another of the herb’s traditional uses in Ayurvedic healing. Several clinical studies have been conducted on this subject and found that 500 mg to 1,250 mg per day increased muscle mass, strength, and endurance. Muscle strength increased up to 1.7 times, and muscle size increased up to 2.3 times higher than those participants taking a placebo.

For Whole-Body Inflammation

Ashwagandha has been used for thousands of years to reduce inflammation and to boost the human immune system. Several clinical studies support this use and indicate the ashwagandha may be able to help reduce inflammation within the body while strengthening the immune system and fighting infections. Taking 250 to 500 mg of ashwagandha per day for two months was shown to reduce C-reactive protein levels in the body by 30%, while 12 ml of extract per day might be able to improve immune system function.

For Cognition

Ongoing research shows that regular consumption of ashwagandha may be able to help support brain health and cognition, particularly in the area of boosting memory. In clinical studies, 300 mg to 500 mg once to twice per day showed improvement in patients’ ability to remember information, perform during tasks, focus, and reduce their reaction time. Note that the trials conducted in this area have been limited, and more study is required.

From the information above, you can see that there may be benefits to a wide range of health conditions available by taking a daily ashwagandha supplement. However, remember that only a few medical trials and clinical studies have been conducted and that further research is needed before these claims can be substantiated. Also, remember that none of these health benefits is backed up by the FDA.

Other blogs to read about ashwagandha:

Potential uses and benefits of Ashwagandha [Part 1]: If you don't know about ashwagandha and why it is a superfood, then this blog is a starting point for you. It covers the traditional usage and current usage of ashwagandha in treatments of various ailments. We have also described how ashwagandha might help for good sleep health, treatment of stress and anxiety, depression, and physical health.

Potential uses and benefits of Ashwagandha [Part 2]: This guide covers the benefits of ashwagandha for sexual health, diabetes, inflammation, brain health, cancer treatment, and joint health.

Frequently asked questions about Ashwagandha: An appendix of most commonly asked questions about ashwagandha. It also covers how you should take ashwagandha for better health.





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