It’s been used as an Ayurvedic treatment for stress and insomnia for generations. But does it actually work?
It’ll come as no surprise to hear that, as a society, we are very stressed out. In fact, the American Psychological Association found that 27% of Americans report that they are too stressed to function.
So, it’s easy to see why any product that is said to help with stress is attractive to potential buyers. While there are claims about many supplements and pills helping you feel a sense of calm, there is one in particular that has been gaining attention online and in the natural health field — ashwagandha.
“[Ashwagandha is] an herb that grows in regions of South and Central Asia, including India, which is where it’s used in Ayurvedic medicine,” said Dr. Susan Blackford, an internal and integrative medicine physician at Duke Integrative Medicine Center in North Carolina.
The Latin name for the shrub is Withania somnifera. In Latin, somnifera means sleep-inducing, Blackford said, which speaks to one of its uses. Ashwagandha claims to assist with issues beyond sleep and stress as well, including anxiety and depression.
So, is it for real? Here’s what experts say:
Some ashwagandha supplements can help with stress and other issues.
“There are many other ways that [people] use it, but I would say in integrative medicine we probably mostly use it for stress,” Blackford said.
This is because ashwagandha is an adaptogen, which means it “enhances the body’s resilience to stress,” she added.
Amala Soumyanath, the director of Oregon Health and Science University’s Botanical Dietary Supplements Research Center, explained that this can refer to multiple types of stress ― psychological stress, physical stress (like from an infection) and more. “These adaptogens [are] supposed to have a very broad range of effects,” Soumyanath noted.
Blackford added that it’s not totally known how ashwagandha impacts stress, but it appears to work with GABA-A and GABA-B receptors, which are “known for producing calming effects” within the body. And a calmer disposition naturally impacts one’s anxiety and sleep, too. So, it’s easy to see how ashwagandha may potentially have an effect on all these issues.
Soumyanath said pre-clinical and clinical studies have looked at ashwagandha as a treatment. A 2019 study of 60 adults found that people who took ashwagandha daily had a reduction in morning cortisol levels, according to Blackford. But it’s worth noting that with only 60 people, this study’s sample size is very small.
“I would say that … there’s some reasonably sound clinical evidence for effects on stress and sleep,” Soumyanath said. “There’s a lot of pre-clinical evidence for its efficacy in anxiety, but maybe less by way of clinical evidence for it.”
In other words, there need to be more studies on ashwagandha’s efficacy in helping manage anxiety before more sound conclusions can be made.
Only specific ashwagandha products have been studied — not everything on the shelf.
There is a big caveat with all of this: While there is some promising evidence of ashwagandha’s effectiveness for certain issues, these studies typically relate to a specific ashwagandha product makeup, Soumyanath said.
This means that not every supplement that contains ashwagandha is created equal. “Because products are variable, we cannot necessarily assume that every product that is on the shelf will have the same effects,” Soumyanath explained.
“If you look on the shelf, you’ll see a whole variety of different ashwagandha products available on sale,” Soumyanath said, noting that these products use different types of extracts, which impacts their efficacy.
“Sometimes it’s just the powdered root, sometimes it’s an extract of the powdered root, sometimes the extract is made with water, sometimes it’s made with an alcohol mixture, sometimes the extract is made from [the] root as well as leaf,” she continued. In other words, there are many formulations, and not all of these extracts have been studied or shown to be effective.
Your first thought might be to find the products that have been studied, but Soumyanath said dietary supplements are not necessarily standardized. The manufacturer can change their manufacturing process at any time, which impacts future batches of the product.
Instead, Soumyanath said, you can compare products that use different formulations, like dried root compared to an extract, and see what works for you. “Generally, products containing extracts are stronger because the extract kind of concentrates down some of the constituents from the botanical,” she said.
Additionally, Blackford said, you can look to consumerlab.com, which compares available products.
“It’s not saying whether or not it’s useful, it’s saying, ‘does it contain what it’s supposed to contain and does it contain any contaminants which you need to be worried about,’” Blackford said. “So it’s sort of like a watchdog group to make sure what you’re taking is safe.”
What exactly makes an effective ashwagandha supplement is still being studied.
Soumyanath said she and other researchers are trying to determine the parameters needed to guarantee that ashwagandha is effective.
“There’s still a lot of research needed trying to link the chemical profile of a botanical of ashwagandha to its biological activity so that better dietary supplements can be designed that contain the right components at the right doses ― but as yet, we don’t have that information,” Soumyanath said.
“I guess the take-home messages within all those caveats of the variability … it’s a very useful botanical and it’s generally being found to be safe, but individual products may or may not deliver” results like stress and anxiety reduction, she said.
Be sure you know about the potential side effects.
When it comes to ashwagandha, there are usually no side effects, Blackford said, and if there are, they tend to be short-term. “It could cause headache, could cause sleepiness … and it could cause stomach upset.”
“There’ve been very rare reports of liver toxicity,” Soumyanath noted.
And while side effects aren’t common, it’s still important to inform your health care provider of any supplements or medicines you’re taking, Soumyanath said.
Ashwagandha also affects other systems; it could also lower your blood pressure, blood sugar and increase hormone levels, Blackford said. “So it probably won’t be dramatic, but if you’re taking medication for blood pressure, blood sugar or thyroid, you just should be aware that you want to be monitoring that.”
Additionally, from a Western medicine standpoint, Blackford said, taking ashwagandha is not recommended during pregnancy or while breastfeeding. “We just don’t have enough data to determine its safety,” she explained.
Soumyanath added that it’s important to follow the recommended dosage — “don’t assume that taking more is always going to be better for you.”
Like any medicine, be responsible when taking ashwagandha. “Don’t assume that natural is safe,” Soumyanath said. Taking too much of the supplement or taking it for a prolonged time can increase your chance of side effects.
Lastly, when it comes to stress relief, Blackford said ashwagandha is not her go-to. “If somebody’s coming to me with stress and anxiety, I’m going to be first of all looking at what factors are contributing to that.”
Think about your stress coping skills, your sleep habits (sleep is big for stress reduction, Blackford added), your exercise patterns (another stress reliever) and your connection to your community.
“[Ashwagandha is] just one tool. I do always get a little concerned when people focus on one thing, whether it’s … one approach, one herb, one medication,” Blackford said. “If we get so focused on one thing, we lose the totality of all the other influencing factors and we’re not going to have a meaningful, long-term change.”
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