Connect with a U.S. licensed healthcare provider about ED, hair loss, skincare, and more. Start now.

Sep 03, 2021
5 min read

Ashwagandha: what is it, benefits, side effects, and forms

Ashwagandha is a plant that has been used for centuries in Ayurvedic medicine. It’s an adaptogen, meaning it may help your body deal with mental and physical stressors. This plant gets many of its benefits from potent compounds called withanolides. Ashwagandha is known to help with stress, but its potential ability to lower cortisol could benefit other systems in your body, including muscle mass and testosterone. It’s important to buy from a brand you trust to make sure you get a quality product that only uses the plant’s root.

mike bohllinnea zielinski

Reviewed by Mike Bohl, MD, MPH

Written by Linnea Zielinski

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

People are always looking for natural treatments for what ails them. Ashwagandha, a medicinal plant that has been around for centuries, may fit the bill for some. This herb has reportedly wide-reaching health benefits.

But what does the science show? Read on to learn more about ashwagandha, its benefits and side effects, and its different formulations. 

ADVERTISEMENT

Save money on the meds you need most

Switch to Ro Pharmacy to get your prescriptions filled for less.

Learn more

What is ashwagandha?

Ashwagandha or Withania somnifera is an adaptogen, a plant believed to help your body deal with different kinds of stress, both mental and physical. Although the root, leaves, and seeds of this shrub, also called Indian ginseng or winter cherry, has been gaining popularity in the United States for the past few years, ashwagandha has long been an essential herb of Ayurvedic, Indian, and African traditional medicine.

Ashwagandha root is considered a drug of “Rasayana,” a Sanskrit word that translates to “path of essence.” This practice of Ayurvedic medicine focused on the science of lengthening lifespan. But there’s a difference between simply living longer and living well for longer. The potential health benefits of ashwagandha may help with the latter as they’re surprisingly wide-reaching. This supplement may have beneficial effects for systems in your body ranging from testosterone levels in men to cognitive function.

What is ashwagandha used for?

Ashwagandha is best known for its ability to help treat chronic stress and anxiety, but this ayurvedic herb is used for more purposes than that. The way in which ashwagandha extract is believed to help with stress may carry over to other health concerns throughout your body.

Many of the potent effects of this plant are thought to come from compounds called withanolides. The most well-known of these compounds is withaferin A, which sometimes appears on supplement labels. Withanolides are touted for their anxiolytic properties (ability to improve anxiety and chronic stress) (Mandlik Ingawale, 2021). 

But withanolides are not the only vital compounds in this plant. Ashwagandha also has glycowithanolides, which have antioxidant properties, and alkaloids (Mandlik Ingawale, 2021).

Ashwagandha benefits

Studies have shown that ashwagandha may effectively lower cortisol levels. As cortisol is commonly known as the “stress hormone,” it’s easy to see why this supplement is so closely associated with stress management, improved quality of life, and feelings of well-being. But this connection to cortisol means ashwagandha may also affect blood sugar levels, cholesterol levels, and muscle-building potential. Though not all of these potential benefits are connected to cortisol, research suggests that ashwagandha supplementation (Mandlik Ingawale, 2021):

  • May reduce cortisol levels
  • May improve stress and anxiety
  • May boost testosterone levels
  • Shows promise for male fertility
  • May lower blood sugar levels
  • May decrease inflammation
  • May improve sleep quality
  • May increase muscle mass and muscle strength
  • May help lower cholesterol

Ashwagandha forms

Ashwagandha comes in a wide variety of forms, but you’ll quickly notice that some are easier to find than others. You can get ashwagandha supplements as powders, elixirs, pills, and capsules—but the last two are the most common. 

The word ashwagandha is Sanskrit for “smell of the horse,” and references the herb’s ability to increase strength—and its unique smell. So, while you can blend ashwagandha powder into hot beverages or smoothies, you may need to experiment with ingredients to mask the supplement’s unique flavor and smell profile. If you find the smell too strong, capsules and pills are the best alternatives. 

Despite the wide variety of forms of this supplement, the more complicated topic is actually the type of ashwagandha used. Traditional Ayurvedic treatments used the whole, dried root, which was turned into a powder and usually steeped in milk.

However, modern supplements are ashwagandha extracts, which often appear on the label as Withania somnifera extract. These forms start as a powder that is refined in a specific way to retain the compounds believed to drive health benefits. Some extracts are created using water, which is generally preferred, while others use chemicals.

Not all ashwagandha extracts are created equal

Ashwagandha extracts can also be made from the plant’s root, the leaves, or a combination of the two. These supplements aren’t all necessarily equivalent. Studies have shown that the leaves and roots of Withania somnifera have different concentrations of withanolides. The roots are considered the best source of these health-boosting compounds, which is also why most studies on ashwagandha use extracts made from this part of the plant (Kaul, 2016).

This leads to a unique problem in this part of the supplement industry: Ashwagandha leaves are cheaper to produce since using the root requires digging up most of the plant. A study looking at over 100 ashwagandha supplements found that only about 77% were pure ashwagandha. Almost one quarter of the supplements tested had other plants mixed into the product (Amritha, 2020). 

This underscores the importance of buying from a brand you can trust to ensure you’re getting a reliable product. Supplements are a class of products only loosely regulated by the U.S. Food and Drug Administration (FDA). Ashwagandha in any form—including ashwagandha root extract—is considered a supplement. 

Ashwagandha dosage

There is no set dosage for ashwagandha—your dose will likely vary depending on the condition you are trying to address. Research across different health concerns has used doses of ashwagandha extract ranging from 125 mg to 5 g (Mahdi, 2009). Most studies divided the ashwagandha dose 2–4 times a day instead of taking it all at once. Currently, there is no specific recommended dose for ashwagandha root extract (Pérez-Gómez, 2020; Raut, 2012; Mandlik Ingawale, 2021). 

Potential side effects of ashwagandha

Most clinical trials on the effects of this adaptogenic herb show a low incidence of side effects, but they can occur. When they happen, the side effects of ashwagandha tend to be mild. Many ashwagandha studies show it is well-tolerated. Small clinical trials demonstrated rare adverse effects from ashwagandha, including nasal congestion (rhinitis), cough and cold, drowsiness, constipation, changes in appetite, and increased libido (Chandrasekhar, 2012; Raut, 2012). 

Safety concerns with ashwagandha

Although everyone should get medical advice from their healthcare provider before starting a new supplement regimen, there are certain people for whom this is even more important, such as those with specific medical conditions, including (MedlinePlus, 2020):

  • Diabetes
  • High blood pressure
  • Thyroid disease
  • Autoimmune diseases, like Hashimoto’s thyroiditis, rheumatoid arthritis, or lupus

If you are pregnant or trying to conceive, you should avoid ashwagandha as it might cause miscarriages (MedlinePlus, 2020).

It’s also part of the Solanaceae or nightshade family, so those following a diet that eliminates this group of plants (including eggplant, tomatoes, and peppers) should avoid taking ashwagandha.

When to talk to your healthcare provider

As we’ve discussed, ashwagandha is not for everyone. Before starting ashwagandha, or any other supplement, talk to your healthcare professional about your medical history and any medicines you are taking to avoid side effects or safety issues. If you experience side effects while taking ashwagandha, check in with your provider and stop taking the supplement if your symptoms worsen.

References

  1. Amritha, N., Bhooma, V., & Parani, M. (2020). Authentication of the market samples of Ashwagandha by DNA barcoding reveals that powders are significantly more adulterated than roots. Journal of Ethnopharmacology, 256, 112725. doi: 10.1016/j.jep.2020.112725. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32126246/
  2. 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 from https://pubmed.ncbi.nlm.nih.gov/23439798/
  3. Kaul, S. C., Ishida, Y., Tamura, K., Wada, T., Iitsuka, T., Garg, S., et al. (2016). Novel methods to generate active ingredients-enriched ashwagandha leaves and extracts. PloS One, 11(12). doi: 10.1371/journal.pone.0166945. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147857/
  4. Mahdi, A. A., Shukla, K. K., Ahmad, M. K., Rajender, S., Shankhwar, S. N., Singh, V., & et al. (2009). Withania somnifera improves semen quality in stress-related male fertility. Evidence-Based Complementary and Alternative Medicine: eCAM, 2011, 576962. Advance online publication. doi: 10.1093/ecam/nep138. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19789214/
  5. Mandlik Ingawale, D. S., & Namdeo, A. G. (2021). Pharmacological evaluation of Ashwagandha highlighting its healthcare claims, safety, and toxicity aspects. Journal of Dietary Supplements, 18(2), 183–226. doi: 10.1080/19390211.2020.1741484. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32242751/
  6. MedLinePlus. (2020, Dec). Ashwagandha. Retrieved Aug 31, 2021 from https://medlineplus.gov/druginfo/natural/953.html
  7. Pérez-Gómez, J., Villafaina, S., Adsuar, J. C., Merellano-Navarro, E., & Collado-Mateo, D. (2020). Effects of Ashwagandha (Withania somnifera) on VO2max: a systematic review and meta-analysis. Nutrients, 12(4), 1119. doi: 10.3390/nu12041119, Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230697/
  8. Raut, A., Rege, N., Shirolkar, S., Pandey, S., Tadvi, F., Solanki, P., et al. (2012). Exploratory study to evaluate tolerability, safety, and activity of Ashwagandha (Withania somnifera) in healthy volunteers. Journal of Ayurveda and Integrative Medicine, 3(3), 111–114. doi: 10.4103/0975-9476.100168. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23125505/