Ashwagandha: What It Is and The Science Behind It's Health Benefits

Ashwagandha: What It Is and The Science Behind It's Health Benefits

You may have heard or read of this Ayurvedic herb before - either online, on the news, or in discussions had by those around you, yet never looked into it much until now. What is this herb that has been touted to have a wide range of health benefits, and which claims have some merit to them? In this article, we’ll cover the health benefits of Ashwagandha in detail, covering the research with the most medical and health that has been done on this adaptogenic herb. But first, a little history as to why this plant has caught the attention of medical and health researchers in the first place.

Historical Origins

Ashwagandha (Withania Somnifera) is a popular herb in both traditional chinese medicine and Ayurveda (traditional Indian medicine) - the latter being where it is most widely used and the most likely to have used it first, as it is more native to regions in India, with ancient historical texts documenting it’s usage predating Chinese ones, and that it was never codified directly into TCM principles (although formal integration into TCM is being worked on in modern times. It is likely that Ayurvedic doctors shared their knowledge with Chinese scholars as time passed, and thus the herb itself began to be grown in the Chinese region as well as medical usage there increased too.[1,2] In these traditional medical practices, the main components of the plant that were used are the root, followed by the fruit, and it had a wider use of applications; from wound care to fertility regulation. Over time though, as medicine advanced, scientists began to look into this herb due to its historical medical usage and anecdotal evidence of helping in some ailments. 

Most Researched Health Benefits

Now onto the harder science: what benefits are the most likely to be true based on current research into Ashwagandha?

The main biologically active components in Ashwagandha that have been identified to have potential benefits are: alkaloids (naturally occurring organic compounds that mostly contain basic nitrogen atoms and which have significant physiological actions on humans), steroidal lactones (carboxylic acids - like amino acids - that are esters and have steroidal effects), and withanolides (steroidal lactones mostly found in the nightshade family, of which Ashwagandha is part of) -  each having different mechanisms of action which affect the body in varying ways. I’ll list out relatively well researched effects which show possible and general health benefits documented with Ashwagandha intake, and any observed mechanisms of action.

Stress, Anxiety, and Depression

Although no single compound has been as of yet identified as the cause of stress and anxiety reduction behind Ashwagandha use, a full-spectrum extract of the root of Withania Somnifera (KSM-66), containing a standardized level of 5% withanolides minimum and insignificant amounts of Withaferin A cytotoxin, has shown in multiple studies to lower negative mood levels pertaining to stress, anxiety, and depression. The first - a randomized double blind, placebo controlled study - consists of a rather small sample size of 61 adults (originally 64, but 3 participants did not follow through) with the following demographics and baseline parameters:

They were split into 2 groups, with one given a placebo and one given 300mg of the KSM-66 extract for 60 days. Before and after, they were given 3 psychometric tests (Perceived Stress Scale or PSS, General Health Questionnaire 28 or GHQ-28, and the Depression Anxiety Stress Scale, or DASS), as well as had their serum cortisol levels measured, since serum cortisol is a frequently used biological marker for stress. The before and after data was then compared to show percent changes in both groups in negative mood reduction or increase. As the following graph shows, there was a significant negative mood reduction in the group taking the Ashwagandha root extract[3]:

Although this shows there is a strong adaptogenic potential in Ashwagandha root lowering stress levels and improving mood, it is a small study. Yet, a systematic review of five human trial results (including the one just used here) show that all five conclude that “W(ithania) S(omnifera) intervention resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales”[4], and a newer 2016 study that looked into the effects of chronic stress reduction and body weight management, found similar results as well[5], reinforcing evidence that there are compounds in Ashwagandha root which lowers stress and aid in improving mood.

Thyroid Affection

There are still few studies on the subject, but it is known that yet unspecified compounds in Ashwagandha root can affect the thyroid. Studies done previously in mice had shown the root having a very notable effect on thyroid stimulation[6], and therefore human trials have since then begun recently. One of the first, a randomized, double-blind, placebo controlled trial done Sudbhawana Hospital, Varanasi, India, was done with 50 subjects (aged 18-50) which had elevated serum thyroid stimulating hormone (TSH) levels, in which 25 received 600mg KSM-66 daily and 25 received a placebo of starch daily (4 participants withdrew consent however - 2 from each group, leaving the total sample size at the end at 46). They had their Serum TSH, serum triiodothyronine (T3), and thyroxine (T4) levels evaluated before starting the trial, at 4 weeks, and at 8 weeks after starting the trial. In all the patients that took the KSM-66 root extract, TSM serum levels had significantly increased and T3 and T4 serum levels had significantly decreased compared to the placebo group - effectively normalizing measure serum thyroid indices during the 8 week trial.[7] Despite the small sample size, this gives strong evidence that Ashwagandha root could potentially have therapeutic effects for thyroid disorders. Yet, until the mechanisms of action are known, and the compounds which affect the thyroid are identified, taking too much Ashwagandha root can cause thyrotoxicosis as well.[8] As the old saying goes, “the dose makes the poison”, and any medicine, adaptogenic or not, can be dangerous in high amounts. Fortunately, it seems it takes a pretty high dose before Ashwagandha root has any severe effects, and low enough doses not causing any noticeable effect on normal, healthy thyroids - of course, that means that due to the known effects Ashwagandha root can have on thyroids, consult your doctor before taking if you are already taking medication for your thyroid.

Effects on Male Fertility

There have been multiple studies done which give some evidence that Ashwagandha root extract (primarily KSM-66) may improve fertility in men by increasing sperm count and motility. A review in the role of withania somnifera shows that multiple studies have observed improvement in fertility in both mice and men, and has a proposed general mechanism of action for how compounds in the root may work in humans:

It’s proposed that the main reason that Ashwagandha can improve fertility is due to a reduction of seminal lipid peroxidation due to specific antioxidants, in combination with GABA-mimetics stimulating a chain response that leads to a slight increase in male testosterone. Ultimately, more research is required to establish what compounds lead to the observed effects to establish an exact mechanism of action, and from there to figure out exactly what dose is needed to best improve fertility in men, as some studies achieved effects with high doses Ashwagandha root which are unsustainable in long term use due to possible negative effects from certain withanolides such as Withaferin-A can have by causing cytotoxic build up.[9] Still, low, inconsistent doses of the root could probably help in maintaining sperm health in men thanks to the seminal antioxidant properties which have been observed.

Anti-inflammatory Effects in Joint Cartilage 

Osteoarthritis is a disease that disproportionately affects women which has mixed results in relation to relief when it comes to current medical treatments in pain management and prevention.[10] Fortunately, recent research has shown the possibility of Ashwagandha possessing analgesic, anti-inflammatory and chondroprotective (protective of chondroblasts, which are progenitor cells that make new cartilage matrix) effects.[11,12] In this case, an aqueous extract high in withanolide glycosides (manufactured by Sensoril) made from both the leaves and root of the plant was used in a randomized, double-blind placebo study. 60 patients were split into three groups and given either 250mg or 125mg of the extract, or a placebo, all given twice daily. Assessment of their condition was done by using a modified Western Ontario and McMaster Universities Arthritis (WOMAC) index , Knee Swelling Index (KSI), and Visual Analogue Scale (VAS) at baseline and at the end of 4, 8, 12 weeks. In all test results, improvement was shown in the two groups which received the extract, with the group that received 250mg showing a statistically significant improvement, as can be seen in the following charts[13]:

Conclusion and Contraindications

There is plenty of evidence that Ashwagandha can bring about a multitude of health benefits due to a plethora of bioactive compounds found in the plant, and it certainly establishes itself as an adaptogen in regards to its ability to regulate stress. However, it is exactly because this plant actually can affect the body that there are a few contraindications to note:

  • As stated previously, consult your doctor before taking Ashwagandha root supplements of any kind if you are already taking a thyroid medication - otherwise it’s like taking two medications for your thyroid at once.
  • Don’t take very high doses of Ashwagandha in any amount and respect its medicinal properties. Just as you wouldn’t take 5 grams of acetaminophen/paracetamol at once, or 4,000mcg of Vitamin A in a day, don’t take more Ashwagandha than would be recommended, either.
  • Talk with your doctor if you are taking immunosuppressants (such as those used after a transplant) as there is evidence that Ashwagandha may strengthen the immune system and cause boosted immune-responses, meaning it can weaken the effect of the immunosuppressant - which is dangerous in the case of organ transplant especially since that increases the likelihood of rejection.
  • Due to Ashwagandha’s potential stress reducing effects, it may interact with sedatives, so keep that in mind if you take sleep aids and mention it to doctors if you will be going into surgery.
  • Likewise, take some minor precautions if using medication that lowers blood pressure, since the stress and anxiety reducing effects mean it can slightly lower blood pressure as well.
  • Do not take if pregnant, or trying to get pregnant - there is evidence that Withaferin A, and other withanolides found in Ashwagandha, can have abortifacient effects and cause miscarriage.

Remember, adaptogens and herbal medicine and supplements can have health benefits on the body, but only when respected and taken as they should be. Even in traditional Ayurvedic medicine, these powerful herbs were given with consideration of the person’s condition. As long as Ashwagandha is taken in low, supplemental doses, it should impart its health benefits to you. As always, take advantage of the benefits nature gives such as those with adaptogens, but do not abuse of it. As long as you respect the herb, it will respect you. Hopefully this article delving into the health benefits of Ashwagandha makes you appreciate the power of nature, and helped you learn how to properly add adaptogens into your life, and how they can help you stay healthy and energized!

 

References:

1: Charak Samhita 6000BC, author. Charaka translation into English: Translator: Shree Gulabkunverba Ayurvedic Society. Jamnagar, India: 1949

2: Forman, Michael & Kerna, Nicholas. (2018). Merging Ayurvedic Ashwagandha with Traditional Chinese Medicine Part 1. Foundation in Ashwagandha: Physiological Effects, Clinical Efficacy, and Properties. 10.29011/2577-2201/100033. Retrieved 14, December 2019 from https://www.researchgate.net/publication/328769254_Merging_Ayurvedic_Ashwagandha_with_Traditional_Chinese_Medicine_Part_1_Foundation_in_Ashwagandha_Physiological_Effects_Clinical_Efficacy_and_Properties

3: Chandrasekhar, K., Kapoor, J., & Anishetty, S. (2012). A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults. Indian Journal of Psychological Medicine, 34(3), 255. doi: 10.4103/0253-7176.106022 Retrieved 15, December 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/

4: Pratte, M. A., Nanavati, K. B., Young, V., & Morley, C. P. (2014). An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera). The Journal of Alternative and Complementary Medicine, 20(12), 901–908. doi: 10.1089/acm.2014.0177 Retrieved 15, December 2019 from https://www.ncbi.nlm.nih.gov/pubmed/25405876

5: Choudhary, D., Bhattacharyya, S., & Joshi, K. (2016). Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract. Journal of Evidence-Based Complementary & Alternative Medicine, 22(1), 96–106. doi: 10.1177/2156587216641830 Retrieved 15, December 2019 from https://www.ncbi.nlm.nih.gov/pubmed/27055824

6: Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. The Journal of Pharmacy and Pharmacology. 1998 Sep;50(9):1065-1068. DOI: 10.1111/j.2042-7158.1998.tb06923.x.  Retrieved 15, December 2019 from https://europepmc.org/article/med/9811169

7: Sharma, A. K., Basu, I., & Singh, S. (2018). Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. The Journal of Alternative and Complementary Medicine, 24(3), 243–248. doi: 10.1089/acm.2017.0183 Retrieved 15, December 2019 from https://www.ncbi.nlm.nih.gov/pubmed/28829155

8: van der Hooft CS, Hoekstra A, Winter A, de Smet PA, Stricker BH. [Thyrotoxicosis following the use of ashwagandha]. Nederlands Tijdschrift Voor Geneeskunde. 2005 Nov;149(47):2637-2638. Retrieved 15, December 2019 from https://europepmc.org/article/med/16355578

9: Sengupta, P., Agarwal, A., Pogrebetskaya, M., Roychoudhury, S., Durairajanayagam, D., & Henkel, R. (2018). Role of Withania somnifera (Ashwagandha) in the management of male infertility. Reproductive BioMedicine Online, 36(3), 311–326. doi: 10.1016/j.rbmo.2017.11.007 Retrieved 15, December 2019 from https://www.rbmojournal.com/article/S1472-6483(17)30625-9/fulltext#s0025

10: Arthritis-Related Statistics. (2018, July 18). Retrieved December 16, 2019, from https://www.cdc.gov/arthritis/data_statistics/arthritis-related-stats.htm

11: Sumantran, V. N., Kulkarni, A., Boddul, S., Chinchwade, T., Koppikar, S. J., Harsulkar, A., … Wagh, U. V. (2007). Chondroprotective potential of root extracts of Withania somnifera in osteoarthritis. Journal of Biosciences, 32(2), 299–307. doi: 10.1007/s12038-007-0030-3 Retrieved 15, December 2019 from https://www.ncbi.nlm.nih.gov/pubmed/17435322

12: Sumantran, V. N., Chandwaskar, R., Joshi, A. K., Boddul, S., Patwardhan, B., Chopra, A., & Wagh, U. V. (2008). The relationship between chondroprotective and antiinflammatory effects of Withania somnifera root and glucosamine sulphate on human osteoarthritic cartilage in vitro. Phytotherapy Research, 22(10), 1342–1348. doi: 10.1002/ptr.2498 Retrieved 15, December 2019 from https://www.ncbi.nlm.nih.gov/pubmed/18697233

13: Ramakanth, G., Kumar, C. U., Kishan, P., & Usharani, P. (2016). A randomized, double blind placebo controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint pain. Journal of Ayurveda and Integrative Medicine, 7(3), 151–157. doi: 10.1016/j.jaim.2016.05.003 Retrieved 16, December 2019 from https://www.ncbi.nlm.nih.gov/pubmed/27647541




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