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Can ashwagandha soothe stress?
Roger Selvage 1023

Can ashwagandha soothe stress?

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On The Shelf

Mickie Cathers

Photo of ashwagandha plant.

As health concerns over anxiety and stress levels have grown in recent years, sales of ashwagandha have also soared as demand spiked for supplements addressing mood and stress. Sold as a mood enhancer, relaxant, and stress reliever, this supplement has consumer reviewers saying they “can’t live without it.”

Background

Ashwagandha’s Latin name, Withania somnifera, means “sleep-inducing” and highlights the plant’s reputation of having calming effects. Ashwagandha is a small perennial shrub with yellow flowers and is a member of the nightshade family related to potatoes and tomatoes. The plant is native to southern Asia and northern Africa and has been used for thousands of years in ayurvedic medicine to improve fatigue, mood, sleep, and libido.

Ashwagandha root extract has been shown to have gamma-aminobutyric acid–mimetic activity and its bioactive compounds include amino acids, alkaloids (withanine, withasomnin), lactones (withanolides), and glycosides (sitoindosides). Antiangiogenic properties that inhibit inflammation and tumor growth are derived from high concentrations of withanolides found in ashwagandha root extract.

Is there a benefit?

Ashwagandha has recently been promoted for its positive impact on serotonin receptors, thereby helping to suppress stress-induced increases of dopamine receptors in the brain and decreasing cortisol levels. Ashwagandha has been recognized as an adaptogen and, although their effectiveness is controversial, adaptogens’ stress-protective activity has been linked with the hypothalamic-pituitary-adrenal axis and the regulation of key mediators of stress response.

Recent studies have shown similar, if slightly mixed, results. Smith and colleagues explored the efficacy and safety of ashwagandha root extract on stress, fatigue, and sex hormones in overweight or mildly obese patients with self-reported stress and fatigue.

Published online September 23, 2023, in the Journal of Psychopharmacology, this randomized, double-blind, placebo-controlled trial ran for 12 weeks. Patients aged 40 years to 75 years supplemented with 200 mg of ashwagandha root extract or placebo twice daily. Results showed that ashwagandha was associated with a significant reduction in stress levels; however, the improvements were not significantly different compared with the placebo group.

Two 2022 double-blind, randomized, placebo-controlled trials published in the December issue of the Journal of Medicinal Food studied ashwagandha’s effects in the same population of 60 college students who were 18 years to 50 years old. Baker and colleagues evaluated the outcomes of 4 weeks of ashwagandha supplementation on stress, anxiety, depression, and a feeling of overwhelm and exhaustion, randomized to either the intervention (700 mg ashwagandha root extract) or a placebo (glycerol). Findings demonstrated that ashwagandha increased perceived well-being by supporting sustained energy, heightened mental clarity, and enhanced sleep quality.

Meanwhile, O’Connor and colleagues investigated the impact of ashwagandha on stress and sleep quality and found a significant positive impact on reducing stress and improving sleep quality. This study saw more pronounced stress differences at 6 weeks of supplementation, indicating that ashwagandha may require a longer time period of use to show stress-relieving differences.

Availability

Ashwagandha is available as gummies, powders, tablets, liquids, and capsules and is often paired with black pepper to aid absorption and digestion. This supplement can be found on market shelves and online in various dosages ranging from 200 mg to 4,500 mg capsules.

What to tell your patients

Ashwagandha is well-known for its anti-inflammatory activity and may help with fatigue and sleep issues, indirectly affecting stress and anxiety. Inform patients who are interested in taking ashwagandha that this supplement is considered safe for most people with limited reports of adverse effects at dosages of 400 mg to 700 mg tablets per day. Extremely high dosages can cause upset stomach, diarrhea, and vomiting.

Caution pregnant or breastfeeding patients as well as those with lupus, rheumatoid arthritis, T1D, and Hashimoto’s disease to avoid using ashwagandha. Ashwagandha may interact with thyroid, blood sugar, and BP medication. ■

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