Ashwagandha is an evergreen shrub that grows in Asia and Africa and has been used for centuries in traditional medicine. It is often touted for its potential health benefits, particularly in managing stress, anxiety, and insomnia. This article explores the uses, effectiveness, side effects, and precautions associated with ashwagandha, providing a comprehensive overview of this popular herbal remedy.
What is Ashwagandha?
Ashwagandha (Withania somnifera) is a staple in Ayurvedic medicine, a traditional healing system from India that focuses on balancing the body, mind, spirit, and environment through nutrition, exercise, mindfulness practices, and botanicals. The plant is also known as winter cherry or Indian ginseng. Ashwagandha contains chemicals that might help calm the brain, reduce swelling, lower blood pressure, and alter the immune system. Commercially available remedies are typically made from the roots of the ashwagandha plant and are formulated into capsules, gummies, liquid drops, or powders that can be mixed into drinks.
Potential Benefits of Ashwagandha
Thousands of years of Ayurvedic medicine suggest that ashwagandha can help improve both physical and mental health. However, Western medicine requires more rigorous research to confirm these benefits. Studies done on ashwagandha have often been small, with inconsistent dosages and formulations, leading to mixed results. Therefore, drawing definitive conclusions from the available data remains challenging.
Stress Reduction
One of the most well-known benefits of ashwagandha is its ability to reduce stress. Ashwagandha is considered an adaptogen, which are plants that may help reduce the amount of cortisol (stress hormone) released by the body. Less cortisol can lead to reduced mental stress and lessen the physical effects of stress, potentially helping with issues like headaches, high blood pressure, and weight management.
Anxiety Relief
Taking ashwagandha by mouth might reduce anxiety. Specifically, it seems to improve anxiety in people with persistent anxiety, such as those with generalized anxiety disorder (GAD). Some professional organizations, including a task force of the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT), have provisionally recommended ashwagandha as a treatment for GAD.
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Improved Sleep
Ashwagandha may also improve overall sleep and sleep quality in some people. Research shows that certain ashwagandha preparations may be effective for insomnia.
Male Fertility
There is some limited evidence suggesting that taking ashwagandha for 2 to 4 months may increase testosterone levels and sperm quality. A 2017 literature review called the findings "promising" but noted that further studies were needed.
Other Potential Uses
Ashwagandha is promoted for various other health-boosting benefits, although the understanding of its uses is far from definitive. These include:
- Reducing inflammation
- Lowering cancer risk
- Improving memory
- Strengthening immunity
- Slowing aging
- Reducing pain
- Promoting muscle strength and endurance
- Managing blood sugar
- Supporting thyroid function
The National Center for Complementary and Integrative Health (NCCIH) states that there isn't enough evidence to determine if ashwagandha is helpful for any other health conditions aside from its potential benefits for sleep, stress, and male fertility.
Side Effects and Precautions
While ashwagandha is generally considered safe for short-term use, it's essential to be aware of potential side effects and take necessary precautions.
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General Side Effects
When taken by mouth, ashwagandha is possibly safe when used for up to 3 months. The long-term safety of ashwagandha is not known. Large doses of ashwagandha might cause stomach upset, diarrhea, and vomiting. Rarely, liver problems, including severe liver failure and a need for liver transplantation, might occur. When applied to the skin, lotion containing ashwagandha is possibly safe when used for up to 2 months.
Special Precautions and Warnings
- Pregnancy: It is likely unsafe to use ashwagandha when pregnant, as there is some evidence that it might cause miscarriages.
- Breast-feeding: There isn't enough reliable information to know if ashwagandha is safe to use when breast-feeding. It's best to avoid use.
- Auto-immune diseases: Ashwagandha might cause the immune system to become more active, potentially increasing the symptoms of auto-immune diseases such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), and rheumatoid arthritis (RA). If you have one of these conditions, it's best to avoid using ashwagandha.
- Liver disease: Ashwagandha might cause liver damage in some people, although it isn't clear how often this occurs. People with liver disease should avoid taking ashwagandha until more is known.
- Surgery: Ashwagandha may slow down the central nervous system. Healthcare providers worry that anesthesia and other medications during and after surgery might increase this effect. It's recommended to stop taking ashwagandha at least 2 weeks before a scheduled surgery.
- Thyroid disorders: Ashwagandha might increase thyroid hormone levels. It should be used cautiously or avoided if you have a thyroid condition or take thyroid hormone medications.
Interactions
Ashwagandha can interact with certain medications, potentially leading to adverse effects.
- Immunosuppressants: Ashwagandha can increase the activity of the immune system. Taking it along with medications that decrease the activity of the immune system (such as those used after a transplant) might decrease the effects of these medications.
- Sedatives: Ashwagandha might cause sleepiness and slowed breathing. Taking it with sedative medications might cause breathing problems and/or too much sleepiness.
- Thyroid hormones: Ashwagandha might increase how much thyroid hormone the body produces. Taking it with thyroid hormone pills might cause too much thyroid hormone in the body, increasing the effects and side effects of thyroid hormone.
- Diabetes medications: Ashwagandha might lower blood sugar levels. Taking it along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.
- Blood pressure medications: Ashwagandha might lower blood pressure. Taking it along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.
- Hepatotoxic drugs: Ashwagandha might harm the liver. Taking it along with a medication that can harm the liver might increase the risk of liver damage.
Ashwagandha might also change how quickly the liver breaks down some medications, potentially affecting their effects and side effects.
Dosage
Ashwagandha has most often been used by adults in doses up to 1000 mg daily, for up to 12 weeks. It's essential to speak with a healthcare provider to determine the best dose for a specific condition.
Recommendations
If you're considering taking ashwagandha supplements, it's crucial to follow these guidelines:
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- Take a reasonable dosage: Stick to no more than 500 milligrams twice a day, or as recommended by a knowledgeable healthcare professional.
- Opt for tested ashwagandha supplements: Look for supplements that have been independently verified by an outside company, such as ConsumerLab, United States Pharmacopeia (USP), or NSF International.
- Use it for the short term: Ashwagandha is usually well tolerated for about three to six months, but its long-term safety hasn't been well studied.
- Pursue other treatments as well: Ashwagandha should be considered a complementary practice, not as an alternative to tried-and-true treatments and medications.
- Talk with a healthcare provider: Always consult a healthcare provider before taking supplements.
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