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Supplement Summary: Ashwagandha


January 5th, 2023


Welcome to this new blog series I’m trying out called “Supplement Summary”. I get questions almost daily about supplements so I thought that I’d create this series to break down the evidence of some supplements. My goal is to provide more concise, evidence-based information about supplements to educate and prevent harm.


My goal is to provide you with more information on what the supplement is, what it’s commonly used for and if you should take it.


Supplements can be a great way to add nutrient density to one’s diet or help with certain physical ailments. Some supplements can be helpful when used properly. Unfortunately, the supplement industry is highly unregulated and too variable between products. In the worst case scenario, taking supplements without proper guidance or information can actually cause harm. Just because a supplement is “natural” and sold over the counter, does not mean that it’s safe.





The first supplement that I will be covering is Ashwagandha.


I first started hearing about adaptogens late in 2020. Since then, I’ve seen adaptogens blowing up in supplement form, coffee alternatives, drinks like tea, sparkling water and powders etc. and I think they’re just getting started.


Background on Adaptogens


An adaptogen is a natural, plant derived compound that offers benefits to humans by “restoring balance”. It is theorized that adaptogens generally work on the adrenal system in the body which is most known for stress response (aka “fight or flight”). Most often, adaptogens are marketed to help with stress, sleep and cognitive function. More on the adrenal glands and system here. Some other claims around adaptogens include: improved immunity, longevity and fertility (most of which have not been proven). In short, the purpose of most adaptogens is to enhance the body’s resilience to stress in some way [1].


What is Ashwagandha?


One of the most popular adaptogens right now is Ashwagandha and for good reason, there have been a number of studies done on this. To start, Ashwagandha is a herbal supplement that is new to the “Western Wellness” world but has long been used in Indian traditional medicine (Ayurveda). The word Ashwagandha is of Sanskrit origin and is directly translated to “horse smell” and is symbolic of the claim that Ashwagandha will provide the strength and virility of a horse [2].


Some of the most popular health claims of Ashwagandha include:

  • Reduced stress and anxiety

  • Improved sleep

  • Increase testosterone levels

  • Improve reproductive health (sperm quality in men)

  • Potential to improve cardiovascular fitness (VO2 max)

  • Blood sugar lowering



It is imperative to note that none of these claims have been proven in the literature. What has been shown, especially in recent years, through systematic reviews and meta-analysis is that Ashwagandha may be effective in helping to control anxiety, fight male infertility, improve the reproductive system function, decreasing cognitive decline and may be a helpful adjunct therapy in diabetes management [3]. There have also been several studies in recent years to demonstrate the safety of Ashwagandha [4,5].


Ashwagandha contains anti-inflammatory and antioxidant properties. It appears to act on the (hypothalamic-pituitary) HP-Axis by way of decreasing cortisol (the hormone released in the stress response). It has also been observed that Ashwagandha may impact neurotransmitters that impact individuals with anxiety disorders and on others such as GABA (a neurotransmitter known for producing a calming effect).


Dosages

The most effective dose of Ashwagandha has been found at 600mg per day broken into two 300mg doses. According to Examine.com, the most common timing of this supplement is with breakfast and in the evening with dinner. So far it is unknown if doses larger than 600mg per day offer large benefits.


It is also currently unknown if long term use of Ashwagandha is beneficial or if it loses its benefits after prolonged uses. The same holds true with cycling on and off the supplement or taking it every other day.


Additional Perspectives


Dr. Andrew Hubberman answered some questions about Ashwagandha on a recent podcast (AMA #3) and he recommends having the two doses of Ashwagandha later in the day (e.g. afternoon and evening) and not before a workout. He explains that Ashwagandha is better to have after a workout and later in the day because the supplement helps to decrease cortisol which is something you want to have happen in the later half of the day. He often explains in his podcasts that cortisol is something we want to have peak early on in the day which helps with sleep later that night. Lastly, Dr. Hubberman suggests cycling off Ashwagandha and does not think that people should take Ashwagandha for a prolonged period of time. Instead, he suggests that “if you know of a stressful period of time coming up, Ashwagandha can be very helpful then”. In his opinion this is because of the supplement’s ability to down-regulate cortisol which is not something that we want to have happen all the time as we need varying levels of cortisol each day.


Safety

So far and despite wide-spread use, it seems that Ashwagandha is generally regarded as safe [6]. However, most studies indicate the need for research on the safety of long-term use of Ashwagandha.


Potential negative side effects include: gastrointestinal effects (nausea, vomiting, diarrhea) and headache


Ashwagandha is derived from a plant in the nightshade family so if you have severe allergies to other foods in that family such as eggplant, peppers or tomatoes, you may want to steer clear of Ashwagandha.


There have been a few cases in recent years of liver injury to some individuals taking Ashwagandha but it is unknown whether this is due to the Ashwagandha itself or potential contaminants in the supplements taken. This is why it is so important to get a good quality supplement that has been third-party tested.


In terms of pregnancy, ConsumerLab.com advises that those who are pregnant or breastfeeding should avoid taking Ashwagandha. We do not fully know the safety of taking Ashwagandha during pregnancy due to lack of research. My advice is to always take the overly cautious route when it comes to food and supplements in pregnancy, especially because we still don’t have a clear image of the potential benefits. This is a risk outweighing the potential reward situation. If you have more questions about this, please leave me a comment below or fill out the Contact form on my website.


Drug interactions:

As it stands, there appears to be no drug interactions with ashwagandha that are currently known. However, caution is advised with blood pressure lowering medications and immune supportive medications. Be sure to check with your doctor and pharmacist if you are on any prescription drugs prior to adding any new supplements (especially herbal ones)


Bottom Line


If you’re looking for a supplement to help with stress and anxiety, Ashwagandha may be helpful. With supplements such as this, I’d recommend taking it for 1-2 months and if you do not derive any benefits from it, discontinue it. Be sure to talk to your doctor and pharmacist prior to starting this supplement (this is especially imperative if you are on any prescription medications). If you are pregnant or breastfeeding, avoid this supplement altogether.


I hope this article helped you understand Ashwagandha supplements more. If you have questions feel free to leave them in the comments below or shoot me an email!


Until Next time!









*Disclaimer: the views and opinions of this article are based on the best available evidence and my professional opinion as a Registered Dietitian. This article is not meant to act as or substitute for medical or medical nutrition advice. For medical or medical nutrition advice that is designed for your individual needs, please consult your doctor or Registered Dietitian.


References


[1] https://examine.com/supplements/adaptogen/


[2] https://examine.com/supplements/ashwagandha/


[3] Bonilla DA, Moreno Y, Gho C, Petro JL, Odriozola-Martínez A, Kreider RB. Effects of Ashwagandha (Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis. J Funct Morphol Kinesiol. 2021 Feb 11;6(1):20. doi: 10.3390/jfmk6010020. PMID: 33670194; PMCID: PMC8006238.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006238/


[4] Mandlik Ingawale DS, Namdeo AG. Pharmacological evaluation of Ashwagandha highlighting its healthcare claims, safety, and toxicity aspects. J Diet Suppl. 2021;18(2):183-226. doi: 10.1080/19390211.2020.1741484. Epub 2020 Apr 3. PMID: 32242751.

https://pubmed.ncbi.nlm.nih.gov/32242751/


[5] Verma N, Gupta SK, Tiwari S, Mishra AK. Safety of Ashwagandha Root Extract: A Randomized, Placebo-Controlled, study in Healthy Volunteers. Complement Ther Med. 2021 Mar;57:102642. doi: 10.1016/j.ctim.2020.102642. Epub 2020 Dec 15. PMID: 33338583. https://pubmed.ncbi.nlm.nih.gov/33338583/


[6] https://www.consumerlab.com/reviews/ashwagandha-supplements/ashwagandha/?search=Ashwagandha#cautions


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