Ashwagandha benefit, side effects, supplement extract dosage, review and supplement Information
Influence of this herb on brain, thyroid gland and hormone levels, sexuality, relaxation and sleep, how often to use and interactions
May 1 2018 by Ray Sahelian, M.D.

Information, benefit, review
Ashwagandha herb, also known as Indian winter cherry, is a shrub cultivated in India and North America whose roots have been used for thousands of years by Ayurvedic practitioners in many medicinal ways. The root contains flavonoids and many active ingredients of the withanolide class.

Benefits, side effects, uses, which medical conditions does it benefit in men and women?
Several studies over the past few years have looked into whether this herb has anti-inflammatory, anti-tumor, anti-stress, antioxidant, mind-boosting, immune-enhancing, and rejuvenating properties (studies are listed below). Historically ashwagandha root has also been noted to have mild sex-enhancing properties. Many people notice a relaxing effect within hours of taking a 500 mg pill. This article reviews the benefits and side effects.

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Withania somnifera, is an herb that is extensively used in Ayurveda, the traditional health care system in India. This herb is used as a general tonic and "adaptogen," helping the body adapt to stress. In addition, it has been shown to possess antioxidant activity as well as an ability to support a healthy immune system.


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Supplement Facts
Serving Size: 1 Capsule
Servings Per Container: 60 Capsules
  Amount Per Serving % DV
Ashwagandha extract
(Withania somnifera) (roots) (standardized for total alkaloids) (standardized for 2.5% total withanolides)
500 mg
† Daily Value or Recommended Daily Intake not established

Suggested Use, how much to take: As an herbal dietary supplement, take one ashwagandha capsule a few times a week. This herb, in some individuals, may cause drowsiness or sleepiness. Others who are restless or anxious may feel relaxation but no drowsiness. We suggest you avoid a high dose in the evening since sometimes it has a stimulatory effect before leading to sedation. For those who are tense and anxious, and hyper alert, it can be taken during the day, for others, it is best taken in the evening. Most herbs are better absorbed on an empty stomach. There are no dietary restrictions with its use.
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For stress relief consider 5-HTP or the amino acids theanine and tryptophan. Kava can be used occasionally.
For sexual enhancement in a man or woman, Passion Rx with Yohimbe is an excellent choice.
For mental enhancement, try Mind Power Rx formula.

Q. Have there been reviews to see which ashwagandha product is best?
   A. Not that we are aware of. This herb is not expensive and we suspect the vast majority of products on the market to be of good quality. However, different processing procedures and different extraction methods are likely to make the different products produce slightly or moderately different effects in terms of reduction of anxiety or influence on mood and sedation. You may occasionally find a significant difference between products made by different companies depending on the concentration of the different active withanolides and other substances in the herb.

An Ayurvedic doctor told me that you can take ashwagandha herb daily virtually forever with no ill effects. Is this true?
    I prefer taking breaks from the use of herbs, that is just my personal viewpoint since I tend to err on the side of caution.
There can be unexpected bad reactions when certain herbs are used daily for long periods.

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Why buy all the individual herbs and nutrients separately when you can buy this excellent combination?
The herbs and nutrients in this mental enhancement formula include: Ashwagandha root extract, bacopa , Ginkgo biloba, Ginseng, Mucuna pruriens, and Reishi. The nutrients and vitamins include Acetyl l-Carnitine, Carnitine, Carnosine, Choline, Inositol, Trimethylglycine, Tyrosine, and Vinpocetine.

Ashwagandha side effects, safety, risk, danger
Ashwagandha herb does not seem to have any significant side effects but long term studies are not yet available to determine ashwagandha side effects from chronic use. Nevertheless, it is best to take breaks from use. For instance, one can take a week off each month or take it 3 or 4 times a week as opposed to daily. There is one case report from Holland of a person taking high doses for prolonged periods who ended up with excessive thyroid hormone production.

Antioxidant properties
Researchers from Banaras Hindu University in Varanasi, India, have discovered that some of its chemicals are powerful antioxidants. They tested these compounds for their effects on rat brain and found an increase in the levels of three natural antioxidants — superoxide dismutase, catalase and glutathione peroxidase. They say, "These findings are consistent with the therapeutic use of ashwagandha as an Ayurvedic rasayana (health promoter). The antioxidant effect of active principles may explain, at least in part, the reported anti-stress, cognition-facilitating, anti-inflammatory and anti-aging effects produced by them in experimental animals, and in clinical situations."

Aphrodisiac properties
Ashwagandha root was used historically as an aphrodisiac and to treat impotence or erectile dysfunction.
It is mentioned in the ancient Kama Sutra as an herb to be used for heightening sexual experience. This herb has the ability to restore sexual health and improve overall vitality while promoting a calm state of mind. Laboratory studies show it can produce nitric oxide which is known to dilate blood vessels. For a potent aphrodisiac formula that enhances libido in a much more reliable way, try Passion Rx with Yohimbe.

Works for sexual health in women
Biomed Res Int. 2015. Efficacy and Safety of Ashwagandha Root Extract in Improving Sexual Function in Women: A Pilot Study. Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties. Ashwagandha is an herb known to improve the body's physical and psychological condition. The purpose of the study was to determine the efficacy and safety of a high-concentration ashwagandha root extract supplementation for improving sexual function in healthy females. 50 study subjects were randomized to either 300 mg herb-treated group or placebo for 8 weeks. Sexual function was assessed using two psychometric scales, the Female Sexual Function Index Questionnaire and the Female Sexual Distress Scale, and by the number of total and successful sexual encounters. Treatment led to significantly higher improvement, relative to placebo, for "arousal" "lubrication" "orgasm" and "satisfaction" and the number of successful sexual encounters. This study demonstrated that oral administration of ashwagandha extract improves sexual function in healthy women.

Testimonial by email
I have just read the side effects from ashwaganda. I have been taken some 8 capcules of KSM 66 for sleep and the side effect was that the sex life started to go completely crazy. I am 67 and single and I am turned on almost the whole time.

Anti-anxiety herb
The roots of ashwagandha are used extensively in Ayurveda, the classical Indian system of medicine. In rodent studies the herb has been shown to reduce anxiety and have a positive effect on mood. Other nutraceuticals used for anxiety relief are 5-HTP, GABA, and theanine.

Do you know whether this herb can act as a stimulant (e.g., in the manner of some forms of ginseng)? I recently tried using ashwagandha to help treat my anxiety and depression, and found that my symptoms may have been exacerbated by its use. I experienced a “wired, edgy” feeling that intensified my feelings of anxiety and depression.
    This could be dose dependent. We have learned that high dosages of ashwagandha can cause a feeling of being restless, but you may try a third or half of a capsule and this way you may notice more of the relaxing effect rather than the stimulation effect. Another option is to use plain herb as opposed to a concentrated extract.

Antibacterial studies
Antibacterial efficacy of Withania somnifera an indigenous medicinal plant against experimental murine salmonellosis.
Phytomedicine. 2005 Mar.
We evaluated the antibacterial activity of ashwagandha root and leaves, against pathogenic bacteria. Both aqueous as well as alcoholic extracts of the plant (root as well as leaves) were found to possess strong antibacterial activity against a range of bacteria including Salmonella typhimurium.

Athletics and exercise performance
Forty elite Indian cyclists were chosen randomly and were equally divided into experimental and placebo groups. The experimental group received 500 mg capsules of aqueous roots of ashwagandha twice daily for eight weeks, whereas the placebo group received starch capsules. There was significant improvement in the experimental group in all parameters, namely, VO(2) max, METS, and time for exhaustion on treadmill in comparison to the placebo group which did not show any change with respect to their baseline parameters. J Ayurveda Integr Med. 2012. Effects of eight-week supplementation of Ashwagandha on cardiorespiratory endurance in elite Indian cyclists. Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India.

Blood sugar
One small study found ashwagandha root was able to reduce blood sugar and cholesterol levels, and had a diuretic effect.

Bipolar disorder
J Clin Psychiatry. 2013 Nov. Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder. We assessed the cognitive effects of a standardized extract of the medicinal herb Withania somnifera (WSE) in bipolar disorder. Sixty euthymic subjects with DSM-IV bipolar disorder were enrolled in an 8-week, double-blind, placebo-controlled, randomized study of WSE (500 mg/d) as a procognitive agent added adjunctively to the medications being used as maintenance treatment for bipolar disorder. Although results are preliminary, ashwagandha extract appears to improve auditory-verbal working memory (digit span backward), a measure of reaction time, and a measure of social cognition in bipolar disorder.

Brain health
Ashwagandha is used in India to treat mental deficits in geriatric patients, including amnesia. Researchers from the University of Leipzig in Germany wanted to find out which neurotransmitters were influenced by the herb. After injecting some of the chemicals in ashwagandha into rats, they later examined slices of their brain and found an increase in acetylcholine receptor activity. The researchers say, "The drug-induced increase in acetylcholine receptor capacity might partly explain the cognition-enhancing and memory-improving effects observed in animals and humans."
   A study done in 1991 at the Department of Pharmacology, University of Texas Health Science Center indicated that extracts of ashwagandha had GABA-like activity. This may account for this herb’s anti-anxiety effects.
   A 2002 laboratory study indicates ashwagandha extract stimulates the growth of axons and dendrites. A 2001 study in rodents showed the extract had memory boosting ability. A 2000 study with rodents showed it to have anti-anxiety and anti-depression effects.

J Nat Prod. 2013 Oct. Withaferin A, a steroidal lactone from Withania somnifera, induces mitotic catastrophe and growth arrest in prostate cancer cells.

PLoS One. 2014. Pharmacological levels of Withaferin A (Withania somnifera) trigger clinically relevant anticancer effects specific to triple negative breast cancer cells. Withaferin A (WA) isolated from Withania somnifera (Ashwagandha) has recently become an attractive phytochemical under investigation in various preclinical studies for treatment of different cancer types.

Withaferin A inhibits JAK/STAT3 signaling and induces apoptosis of human renal carcinoma Caki cells. Biochem Biophys Res Commun. 2012.

Withaferin A is a potent inhibitor of angiogenesis (new blood vessel growth). Angiogenesis 2004.

Growth inhibition of human tumor cell lines by withanolides from ashwagandha leaves.
Life Sci. 2003.
The leaves of ashwagandha are used in the treatment of tumors and inflammation in several Asian countries. We have isolated twelve withanolides from the leaves of this species. Compounds were tested for their anti-proliferative activity lung, colon, central nervous system and breast human tumor cell lines. Withaferin A and its derivatives exhibited inhibitory concentrations. Viscosalactone B showed the 50% inhibition. Therefore, incorporation of ashwagandha in the diet may prevent or decrease the growth of tumors in human.

My mother was recently diagnosed with triple negative breast cancer and it was suggested that she supplement with ashwaganda. The thing is that all the dosage recommendations are for dry weight (mg) though the extract is said to be more effective. When taking a liquid extract, how many drops would you suggest per day?
   A. There are a number of different companies that make ashwagandha liquid extract and each one is a different potency. Human studies with this herbal medicine and cancer are not available to know which product or dosage works best.

Diabetes and high blood sugar
Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry root.
Indian J Exp Biol. 2000.
Blood sugar lowering, diuretic and cholesterol lowering effects of roots of ashwagandha were assessed on human subjects. Six mild non insulin dependent subjects and six mild high cholesterol subjects were treated with the powder of roots of ashwagandha for 30 days. Decrease in blood glucose was comparable to that of an oral hypoglycemic drug. Significant increase in urine sodium, urine volume, significant decrease in serum cholesterol, triglycerides, LDL (low density lipoproteins) and VLDL (very low density lipoproteins) cholesterol were observed indicating that this plant is a potential source of hypoglycemic, diuretic and cholesterol lowering agent.

Heart attack
Cardioprotection from ischemia and reperfusion injury by ashwagandha
Mol Cell Biochem. 2004.
Ashwagandha on chronic administration markedly augmented antioxidants (glutathione, glutathione peroxidase, superoxide dismutase, catalase) while Vitamin E did not stimulate the synthesis of endogenous antioxidants compared to sham. Results indicate that it significantly reduced myocardial injury and emphasize its beneficial action as a cardioprotective agent.

Longevity, lifespan increase, anti-aging?
One small study in a worm shows some potential.
Ann Neurosci. 2013 Jan. Withania somnifera root extract extends lifespan of Caenorhabditis elegans.

Anticarcinogenic activity of Withania somnifera against Dalton's Ascitic Lymphoma.
J Ethnopharmacol. 2004.
The effect of ethanolic extract of ashwagandha root against Dalton's Ascitic Lymphoma has been evaluated in Swiss albino mice. A significant increase in the life span and a decrease in the cancer cell number and tumor weight were noted in the tumor-induced mice after treatment. These observations are suggestive of the protective effect of ashwagandha extract in Dalton's Ascitic Lymphoma.

Muscle strength and recovery
J Int Soc Sports Nutr. 2015. Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. Subjects in the treatment group consumed 300 mg of ashwagandha root extract twice daily, while the control group consumed starch placebos. Ashwagandha supplementation is associated with significant increases in muscle mass and strength and suggests that supplementation may be useful in conjunction with a resistance training program.

Nerve cell growth
Axon- or dendrite-predominant outgrowth induced by constituents from ashwagandha.
Neuroreport. 2002.

Nitric oxide production
Induction of nitric oxide synthase expression by ashwagandha in macrophages.
Life Sci. 2003.
Ashwagandha may induce the synthesis of inducible nitric oxide synthase expression likely by acting at transcriptional level. The increased nitric oxide production by macrophages could account, at least in part, for its immune stimulating properties.

OCD, obsessive compulsive disorder
Extracts of ashwagnadha root given to mice were comparable in efficacy to standard fluoxetine medication treatment. Influence of Withania somnifera on obsessive compulsive disorder in mice. Asian Pac J Trop Med. 2012.

Sleep, insomnia
Q. I wanted to know was whether taking 3000 mg of ashwagandha at night to sleep was too high a dose.
   A. I think it is too high. You many wish to try lower amounts and also try several hours before bed because sometimes ashwagandha can cause alertness initially followed hours later buy sedation. Different brands could also have slightly different effects.

Effect on thyroid gland
My name is Rudger Hogeveen, from Netherlands. am a medical student in Holland. Recently I read an article in a Dutch medical journal regarding ashwagandha and thyroid gland. In this journal was a case report about an patient who had thyrotoxicosis after chronic ashwagandha supplement use.
Ned Tijdschr Geneeskd. 2005: Thyrotoxicosis following the use of ashwagandha.
A 32-year-old healthy woman developed thyrotoxicosis while taking capsules that contained ashwagandha herbal extract for symptoms of chronic fatigue. She was not taking any other remedies or medications. During the first few weeks, she took the capsules only occasionally without any symptoms, but after increasing the dose, she experienced clinical symptoms indicative of excess thyroid hormone. This was confirmed by laboratory assessment. The symptoms resolved spontaneously after discontinuation of the ashwagandha capsules and laboratory values normalised. Data from animal studies, however, have suggested that ashwagandha can increase serum concentrations of thyroid hormones. This case study suggests that excess thyroid hormone effects is a potentially serious side effect of ashwagandha. Note: Rudger Hogeveen approved his name being mentioned.

Q. I have been suffering from a thyroid condition for several years and am taking Synthroid with some benefi. An herbal specialist who recommended ashwahgandha. I did feel significantly better on this supplement, my hair loss stopped, my libido returned, etc, however, I am experiencing some problems with symptoms of increased thyroid production. Because I am finally feeling better/normal for the first time in years, I would like to find a way to perhaps taper my Synthroid and stay on the ashwagandha (since it may enhance thyroid hormone production). my current endocrinologist knows nothing about herb / Ayurvedic medicine.
   A. The influence of ashwagandha on thyroid function is still being evaluated and there is very little research on the topic, including what the appropriate dosage would be for the long term and how such supplements interact wist Synthroid or other thyroid medications.

Reports from user, testimonial
I started taking ashwagandha capsules for the past 2 months. Last year I got my T3, T4, TSH tested and they were all normal. And now when tested again T3, T4, Ft4 are all normal but TSH is abnormal 13.9. I don't have any symptoms of hypothyroidism and still my blood reports TSH have come out positive. When consulted doctors, they asked me to get on medication Thyronorm 50mg for now. I read that ashwagandha can cause hyperthyroidism. My family has no background of any thyroid dysfunction. All of a sudden I have TSH elevated to high level and this is bothering me a lot. Now my doubt is can ashwagandha also cause hypothyroidism.

I have Hashimoto's thyroiditis and when I began the herbal product I was hyperthyroid. After a couple days I felt better, much calmer, more relaxed. I did have to make a slight increase in Methimazole (anti-thyroid medication) to compensate for what I thought was the mild thyrotoxic effects of ashwagandha. After about 6 weeks of continued daily use I could not sleep, and had all of the symptoms of severe hyperthyroidism. I had forgotten about the herb's potential to cause thyrotoxicosis, but "re-discovered" it, and stopped. I had to take very high doses of the Methimazole while experiencing the excess thyroid hormone production. Once I stopped the ashwaganda, my thyroid appeared to normalize to its previous state after about 5 days. Then after another few days, it went very hyper once again. It did finally settle down to the normal range after a couple of weeks as confirmed by blood tests. It is now a couple months later, and I am borderline hyperthyroid. I am just letting you know, so you can warn others about ashwaganda and the danger it can present. I want to also state that your website is very informative and actually was the site that made me recall that ashwaganda can cause thyrotoxicosis. I feel that the information provided is great because it promotes a cautious approach when using supplements, as there have not been adequate studies on them. You are doing a great service for the public.

I find it very interesting and trustworthy to read about various supplements on your site. I have had some mild anxiety and mood disturbances for a while so i decided to try ashwagandha 300 mg of the whole herb, not an extract. I have read that it can interfere with thyroid function. When i have been to the doctor before i asked to have my thyroid checked. I had a normal TSH and a T4 that was in the high normal range. I really want to take this herb. Obviously i am not hyperthyroid since tests are normal and symptoms are non existent. Is it so powerful that 300 mg of the whole herb per day can make the thyroid go hyperthyroid?
   It is unlikely that small amounts of the herb will have a strong influence on thyroid hormone levels, but it is difficult to predict in any one individual what would occur.

Ashwagandha herb grows in India, Pakistan, India Sri Lanka and in parts of Africa. The name is derived from Sanskrit words and means 'horse smell' due to the fact that the plant's root has the odor of a sweaty horse.

Interactions with dietary supplements
Can ashwagandha and St. John's wort be taken together?
    In most cases if the dosages are low, yes. However each person is different and it depends what other medications you may be taking, your overall health, age, and other factors. It is best to learn how each one works for you by itself before combining.

Interactions with medications
Can you please tell me if is compatible with Azilect, Amantadine, Carbidopa, Pramipexole? I have Parkinson's and don't sleep and wanted to try the herb.
   I have not seen any studies with these combinations. As a general rule it is a good idea to begin with a portion of a tablet or capsule when first trying a new supplement while taking medications and to inform one's health care provider.

You dont happen to know if the combination of ashwagandha and low dosage of Amisulpride at 25-50 mg is safe? both medicines increase dopamine levels and i read that benzodiazepines are safe in combination with Amisulpride, so i was thinking if the same is true for ashwagandha.
   I don't know anyone who has used this combination.

Q. I have been impressed with benefits of Ashgawanda, however I'm wondering if I could use a tiny amount io it on my mother who is taking Xarelto and Coreg (Cardevilol).
   A. The interactions between this herb and various medications have not been studied, but generally small amounts should not have major interactions.

Different products on the market
Q. I am from Cupertino and really liked your products and impressed with the detail described on your website. I feel very stressed and exhausted with my work everyday and recently an Ayurvedic physician advised me to use ashwagandha. When I started looking for a good product, I came across an another one called Nutrigold Ashwagandha. How does one know which one of many in stores to take?
   A. Different products on the market will have different potencies and extract composition. Without trial and error, it is not easy to predict which one will work for you best.

Planetary Herbals, Full Spectrum Ashwagandha, 570 mg, 120 Tablets