During a recent integrative medicine consult, I wrapped up with my usual, “Tell me your questions.”
“Oh,” she said. “Do you think I would benefit from taking ashwagandha?”
We laughed at the fact that ashwagandha is having a moment. Triggered by social media, interest in the botanical has skyrocketed of late. However, this woman did have a high stress burden related to her busy life full of work and family responsibilities. She was constantly feeling behind and exhausted but couldn‘t wind down and go to sleep at bedtime. Maybe she would benefit from this popular botanical.
What is ashwagandha?
Ashwagandha is a small shrub native to India and the Middle East. It has been used traditionally, or historically, for centuries as a health and vitality tonic. In the Ayurvedic philosophy of healing, ashwagandha is commonly incorporated for many reasons, including stress, aging, athletic performance, energy and many others.
For medicinal purposes, the root of the ashwagandha plant is harvested and used. The active components are called withanolides, a naturally occurring chemical with anti-inflammatory properties.
What is ashwagandha good for? What does ashwagandha do?
Since my patient was living with chronic stress, there is evidence to support using ashwagandha. In fact, this is the area in which the plant has been studied the most. In short, ashwagandha has been given to people who report living with chronic stress and has shown improvement in their PSS, or perceived stress score, which is a validated tool that measures the level of stress in the respondent. Studies also show improvement in cortisol levels, a biologic marker of stress burden.
Ashwagandha has not been well studied in depression. It has been studied in anxiety, which is different than stress. A recent study, called a meta-analysis, combined multiple studies looking at ashwagandha for stress and anxiety in over 1,000 people and found benefit in anxiety as well as stress. In those trials, the doses used to treat anxiety were higher than the doses used for stress.
Another potential benefit of ashwagandha is sleep. In people with anxiety, ashwagandha helps improve sleep. So, for this patient who is having trouble quieting her busy brain at bedtime, ashwagandha could be of benefit.
How do you take ashwagandha? How much ashwagandha per day?
Ashwagandha can be taken in a variety of forms. Most clinical trials have used supplements that were concentrated preparations of the root or extracts using the root. The best products are standardized to a specific percentage of withanolides, typically between 0.3% and 1.5%.
Doses up to 1,000 mg per day are believed to be safe for at least three months. Your dose should ideally contain at least 6 mg of withanolides.
Because of its effects on stress and anxiety, ashwagandha is commonly found in combination stress formula supplements. It’s possible that synergy between stress relieving botanicals provides even greater effect, but more research is needed.
Is ashwagandha safe? Does ashwagandha make you sleepy?
Ashwagandha appears to be safe for most people. As with all natural products and botanicals, good manufacturing integrity is important. In some cases, ashwagandha products have been made out of similar but not identical plants.
The most common reported side effects when taking ashwagandha are headache and gastric upset. In addition, supplements can interact with other medications and supplements in harmful ways. Be sure to talk to your health care team before using ashwagandha, especially if you take medications for serious health conditions such as transplant.
Ashwagandha is apparently unsafe in pregnancy. So, if you are pregnant, could be pregnant or might become pregnant, it is best not to use it.
Ashwagandha doesn’t appear to make people sleepy directly. However, if stress and anxiety are interfering with your sleep, it does help with sleep. Still, you should not expect that taking ashwagandha during the day is going to alter your alertness.
In short, many women — including the one I saw in my office — could benefit from incorporating ashwagandha into their health regime.
Relevant reading
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