Ashwagandha is an ancient medicinal plant that is becoming increasingly popular for its ability to relieve stress and improve cholesterol levels. But what else does ashwagandha do, and why should you include it in your supplement programme? Here's what the science has to say.
Ashwagandha is a medicinal plant that is getting more and more attention for its ability to reduce stress and anxiety, improve sleep and perhaps even boost athletic performance. But what else does it do, how much should you take and are there any side effects? In this ultimate guide to ashwagandha, you'll learn everything you need to know about this herb and why science says you should include it in your supplement regime.
What is ashwagandha?
Ashwagandha (Withania somnifera), also known as ‘Indian ginseng’ or ‘Indian winter cherry’, is an evergreen shrub native to India and Southeast Asia and is commonly used as a medicinal herb in Ayurvedic medicine. Extracts from the ashwagandha root or leaves (usually in the form of a powder) are used to treat various conditions and can provide numerous health benefits. 
What does ashwagandha do?
Ashwagandha is commonly used to relieve stress, anxiety, depression and insomnia. It can also help lower blood sugar levels, cholesterol levels and inflammation, as well as improve sleep, immunity, athletic performance, memory and brain function in both men and women. Ashwagandha can also help to improve male fertility and alleviate sexual dysfunction in women.
Sources of ashwagandha
The ashwagandha plant is the most natural form of this medicinal plant. In some parts of the world, people eat the shoots, seeds and fruits [20]. The leaves and roots of the plant can also be used to make tea or ground into a powder that can be added to food and drink.
Ashwagandha is also available as a dietary supplement, which usually contains a standardised and more concentrated ashwagandha extract that is around ten times stronger than the whole herb [21]. These supplements are available in different strengths in the form of gummy bears, capsules, powder and liquid.
Benefits of ashwagandha
Science has the following findings on ashwagandha's role in stress reduction, blood sugar control, inflammation and cholesterol levels.
Reduction of stress, anxiety and depression
Studies show that taking ashwagandha can reduce anxiety associated with chronic stress and anxiety disorders and that it is more effective than some medications for social anxiety [1]. In addition, taking ashwagandha may also improve well-being and reduce social dysfunction in anxiety sufferers.
Ashwagandha also appears to significantly reduce symptoms of stress and related disorders - such as fatigue, insomnia and cognitive impairment - and lower blood cortisol levels. Human studies have shown that taking ashwagandha in stressed but otherwise healthy individuals leads to a reduction in cortisol levels of 14.5 to 27.9 %, which is significantly higher than many other supplements [1]. In addition, research suggests that ashwagandha may have some antidepressant effect, although this is less notable than the reduction in anxiety [1].
Improved quality of sleep
Several small studies suggest that ashwagandha may improve sleep, particularly in people suffering from stress-induced insomnia [2].
A systematic review of five randomised controlled trials found a small but significant improvement in overall sleep, with the greatest differences observed in people diagnosed with insomnia and taking ≥600 mg/day for eight or more weeks [2]. In another recent study of 60 people, it was found that those taking 300 mg ashwagandha twice daily for ten weeks had better sleep quality than those taking a placebo [5]. The researchers hypothesise that these effects are due to triethylene glycol (a compound known to promote sleep) and withanolides (substances that appear to improve the body's ability to cope with stress) [3, 4].
Improved blood sugar
Preliminary research suggests that ashwagandha may help lower blood sugar levels in healthy individuals and in people with diabetes.
A systematic review of 24 studies, including five clinical trials in diabetic patients, found that supplementation with ashwagandha significantly lowered blood glucose, HbA1c, insulin, blood lipids and oxidative stress markers without adverse effects [7]. Dosages varied widely in these studies, but as little as 250 to 500 mg/day can significantly improve blood glucose and HbA1c levels.
Despite these positive initial results, further studies are needed to prove the efficacy of ashwagandha in the treatment of diabetes.
Reduced risk of infection and inflammation
Initial research suggests that taking ashwagandha may also have positive effects on the immune system and inflammation. In a preliminary in vivo study, 12ml of ashwagandha root extract per day was found to increase T-cell activation and natural killer cell activity, two important immune cells that help fight infection [8]. In addition, research suggests that taking ashwagandha orally can effectively reduce levels of C-reactive protein (CRP), a protein produced by the liver that rises during inflammation. In one study, taking 250 mg/day resulted in a 36% decrease in CRP compared to a placebo group [9].
Although research has shown promising results in reducing inflammation and improving immune activity, more robust human studies are needed to prove the benefits of ashwagandha.
Lowering cholesterol levels
If you have high cholesterol, taking ashwagandha may help to lower total cholesterol, LDL and triglyceride levels.
In a study of healthy individuals, it was found that higher doses of ashwagandha (starting with 750 mg for ten days, followed by 1000 mg and 1250 mg for ten days each) lowered total cholesterol levels by almost 10% in participants, even those with normal cholesterol levels [10]. In another study, participants with high cholesterol levels who took 250 to 500 mg/day of ashwagandha experienced a slight but scientifically significant reduction in LDL cholesterol levels compared to those who took a placebo [9].
In addition, other studies have shown that triglycerides decreased by 12% in people with metabolic syndrome after taking 1200 mg/day of ashwagandha for 30 days [11]. However, this effect was not observed in people with normal triglycerides.
Ashwagandha may also increase HDL cholesterol (good cholesterol), but further research is needed in this area [1].
Improved athletic performance
New evidence suggests that ashwagandha may prove beneficial for athletic performance, including increasing endurance, speed and strength.
In a study of elite cyclists, 500 mg ashwagandha twice daily was found to significantly increase time to exhaustion in a treadmill test compared to a placebo group [12]. Similar improvements in performance and increases in VO2 max were also found in athletes and untrained individuals [1].
In addition to improving endurance, ashwagandha can also improve sprint and strength training performance. In a study in men, daily intake of 500 mg ashwagandha was found to improve intermittent sprint performance (including power output and sprint speed) in normal, healthy individuals [13]. In addition, another study showed that men who took 600 mg of ashwagandha daily for eight weeks increased their muscle strength by 1.5-1.7 times and their muscle size by 1.6-2.3 times compared to those who took a placebo [14].
Based on current research, doses of 500 to 1,000 mg/day of ashwagandha can lead to modest increases in endurance, sprinting ability and strength in as little as eight weeks. While most studies have focused on men, further research is needed to determine whether taking ashwagandha can improve athletic performance in women.
Improved memory and brain function
Ashwagandha has been shown in many studies to improve numerous aspects of cognitive function, including reaction time, task performance, memory and attention.
In a double-blind, placebo-controlled human study, healthy men who took 500 mg of ashwagandha extract daily reported significant improvements in their reaction time and task performance compared to those who received a placebo [16]. Several studies have also shown that ashwagandha can improve memory and attention in people with anxiety, bipolar disorder and cognitive impairment [1]. However, further research is needed to determine whether ashwagandha can improve memory in healthy individuals.
Benefits of ashwagandha for women
Studies show that ashwagandha has numerous benefits for women, including increased arousal and improved sexual satisfaction [17]. Another small clinical study suggests that taking ashwagandha can relieve mild to moderate symptoms of perimenopause, the time when the body makes the natural transition to menopause [18].
Benefits of ashwagandha for men
Ashwagandha has numerous benefits for men, as scientific evidence suggests that ashwagandha can improve male fertility by naturally increasing testosterone levels and improving sperm quality in infertile men [1]. A randomised study has shown that in patients with low sperm count who took 675 mg/day for 30 days, sperm count improved by 167%, semen volume by 53% and sperm motility by 57% from baseline, while the placebo group experienced minimal improvement [15].
Research in men also shows that ashwagandha can enhance athletic performance in both male athletes and healthy, untrained men [1, 12, 13, 14].
How much ashwagandha should you take?
How much ashwagandha you should take depends on the benefits you want to achieve and how your body metabolises it. There is evidence that 250-600 mg/day may improve sleep quality, while 600-1,000 mg/day may be more beneficial for athletes seeking to enhance performance [1,6].
Typical dosages of ashwagandha root extract range from 250-600 mg/day, with the most common dosage being 600 mg/day, split into two doses for morning and evening [1]. However, one study has found that doses of 750 to 1250 mg/day for 30 days are well tolerated and safe, and although further research is required, it appears to be safe to take up to 1000 mg/day for up to 12 weeks [10,19].
When should ashwagandha be taken?
Ashwagandha can be taken at any time of day, with or without food, but it may be useful to split the intake and take it in the morning and evening. In addition, studies have shown that taking ashwagandha before bedtime can improve sleep quality by helping you fall asleep faster and reach the REM sleep stage [5].
How long does it take for ashwagandha to take effect?
The effects of ashwagandha can last anywhere from 2-3 days to several weeks. Current research suggests that it may take ten or more weeks to reach maximum effect in terms of stress and anxiety reduction [5].
How long does ashwagandha stay in your body?
How long ashwagandha remains in the body varies from person to person and depends on factors such as age, weight, dose, metabolism, health status and other medications taken. However, anecdotal evidence suggests that the effects of ashwagandha may last for a few days or up to two weeks after discontinuation of this supplement [1].
What are the side effects of Ashwagandha?
The most common side effects of ashwagandha when taken in large doses include upper and lower digestive disorders such as nausea, bloating, flatulence, diarrhoea and vomiting [19]. Although rare, liver problems are also possible [19].
Who should not take ashwagandha?
Although ashwagandha has many benefits, there are some people for whom it is not suitable. Here's what science has to say about who should not take ashwagandha.
Pregnancy: There is evidence that ashwagandha can cause miscarriages and therefore should not be taken during pregnancy [19].
Breastfeeding: There is currently insufficient research to determine whether ashwagandha is safe to take while breastfeeding.
Thyroid disorders: Ashwagandha may increase levels of thyroid hormones and should be taken with caution or avoided altogether if you have hyperthyroidism or are taking thyroid hormone medication [19]. In addition, people with hyperthyroidism should not take ashwagandha as it can exacerbate hyperthyroidism.
Autoimmune diseases: Ashwagandha can increase immune response, so it is recommended that people with autoimmune diseases (such as multiple sclerosis, lupus, rheumatoid arthritis, type 1 diabetes or other conditions) should not take ashwagandha [19].
Immunosuppressants: As it can increase the activity of the immune system, the simultaneous intake of ashwagandha and immunosuppressants can weaken the effect of the medication.
Sedatives: Ashwagandha can increase drowsiness and slow breathing, so taking ashwagandha at the same time as sedatives (such as benzodiazepines or CNS depressants) can lead to breathing problems and excessive drowsiness [19].
Diabetes medications: Ashwagandha can lower blood sugar levels, so taking ashwagandha and diabetes medications at the same time can lead to a dangerous drop in blood sugar levels.
Antihypertensive drugs: Ashwagandha can also lower blood pressure, so taking ashwagandha and antihypertensive drugs at the same time can lead to low blood pressure.
Before taking an ashwagandha supplement, you should speak to your doctor to make sure it is suitable for you.
Summary
Ashwagandha is an evergreen shrub and a medicinal plant commonly used in Ayurvedic medicine to relieve stress, anxiety, depression and insomnia. There is evidence that it can also help lower blood sugar levels, cholesterol levels and inflammation while improving immunity, athletic performance, male fertility, memory, brain function and more.
Although there are many benefits to including this herb in your supplement programme, it is recommended that people who are pregnant, breastfeeding, suffer from thyroid disorders and/or autoimmune diseases should not take ashwagandha. In addition, people taking certain medications (including immunosuppressants, tranquillisers, thyroid hormones, diabetes medications, antihypertensives) should also avoid ashwagandha or speak to their doctor before starting this supplement.
The most important facts in brief
Ashwagandha is an ancient medicinal plant that may offer numerous health benefits, particularly in relieving stress, anxiety, depression and insomnia.
Current research is also investigating the benefits of ashwagandha for blood sugar, immunity, cholesterol, athletic performance, fertility, memory, brain function and more.
Typical doses of ashwagandha range from 250-600 mg/day. In clinical studies, the most common dose is 300 mg taken twice daily for a period of 8-10 weeks, although it appears safe to consume up to 1,000 mg/day for up to 12 weeks.
You can take ashwagandha on an empty stomach or with food. The most common side effects (associated with high doses) are stomach upset, diarrhoea and vomiting.
Avoid ashwagandha if you are pregnant or breastfeeding, have a thyroid condition or an autoimmune disorder. Ashwagandha may also interact with certain medications, including immunosuppressants, sedatives, thyroid hormones, diabetes medications and antihypertensives. If you are taking any of these medications, talk to your doctor before taking ashwagandha.
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