Ashwagandha: An Adapotgenic Herb with Many Uses

Ashwagandha, also known by its botanical namewithania somnifera,is a type of medicinal plant. It is classified as an “adaptogen”, or a substance that encourages the body’s physiology to return to a normal state after a stressor has been encountered. Adaptogens help to decrease stress levels through various, non-specific effects within the body. More research is necessary to further understand these mechanisms, but the available evidence regarding ashwagandha’s effectiveness in treating various health conditions is promising. Ashwagandha has been used as medicine in the Ayruvedic tradition for thousands of years. It is an herb with an impressive safety profile and wide variety of uses. Historically, ashwagandha has been used to help mitigate the effects of Type 2 diabetes, stress, anxiety, fatigue and increase physical stamina. 

Withania somniferahas been shown to have hypoglycemic, or blood sugar lowering, effects and improve insulin sensitivity in several small human studies. This research suggests that ashwagandha could be beneficial for individuals with Type 2 diabetes. It is hypothesized that constituents known as withanolides, withaferin A in particular, are responsible for the anti-diabetic effects seen with ashwagandha use. These studies found that patients who were taking high-dose ashwagandha had significantly lower blood sugar levels when compared to placebo and that the effects on blood sugar were dose dependent. Although the results from existing studies are positive, more high quality, human studies are necessary at this time. In addition to its content of withanolides, Ashwagandha’s ability to lower blood sugar levels may be partially due to its effects on the stress hormone cortisol.

Ashwagandha supports the healthy function of the hypothalamic-pituitary-thyroid axis. Elevated levels of cortisol, our main stress hormone, can disrupt this axis and cause thyroid dysfunction and other health conditions including blood sugar dysregulation. Ashwagandha promotes relaxation and a decrease in cortisol levels, thus allowing the thyroid to function optimally. Decreased cortisol levels can also result in improved sleep.

Ashwagandha has long been used in Ayurvedic medicine to help induce sleep. Recent research in mice has shown that triethylene glycol, a constituent found in the leaves of the plant, is responsible for this effect along with decreased serum cortisol levels. Mahesh et al found that triethylene glycol induced sleep in a dose-dependent matter and did not affect the quality of sleep, in contrast to pharmaceutical medications such as benzodiazepines. 

Ashwagandha is most effective at reducing stress and anxiety when used over a period of time. The herb was shown to significantly decrease serum cortisol and improve the results of stress-assessment questionnaires when used for 60 days in a study that evaluated 64 participants experiencing chronic stress. Ashwagandha’s anti-anxiety, or anxiolytic, effects come from its GABA-like activity on the brain. GABA is our chief inhibitory neurotransmitter and is responsible for relaxation. In addition to its anti-anxiety effects ashwagandha may also be useful in strength training regimens.

In a small study of 57 male participants, supplementation with Ashwagandha combined with a resistance training regimen resulted in a significant increase in strength, muscle size, and testosterone levels. Furthermore, participants saw a decrease in body fat percentage and muscle damage post-exercise, as compared to a placebo group. The increased muscle mass associated with ashwagandha use is believed to be due to its ability to increase testosterone and decrease cortisol as excess cortisol can break down muscle and decrease overall muscle mass. 

Withania somnifera may be ingested as a decoction, tea, tincture or in capsule form.It is common to take herbs by capsule or tincture form because they are often more concentrated than a tea or decoction. A tea or decoction can still be effective if brewed for long enough but may need to be drank frequently throughout the day depending on what is being used for and what one is trying to achieve.   

Ashwagandha is usually well-tolerated but side effects are possible, especially with higher doses, including nausea, vomiting or stomach upset. Ashwagandha may interfere with diabetes, thyroid and blood pressure medications and should not be used if you have a history of stomach ulcers. Furthermore, Ashwagandha may not be indicated in auto-immune diseases, such as rheumatoid arthritis, due to its immune-stimulating effects. I recommend speaking with a licensed naturopathic doctor for personalized advice regarding herbal medicine before beginning supplementation.

References:

1. Udayakumar, Rajangam et al. Hypoglycemic and Hypolipidemic Effects ofWithania Somnifera Root Extracts and Leaf Extracts on Alloxan-Induced Diabetic Rats.International Journal of Molecular Sciences.2009. 10(5): 2367-2382.
2. Goerlick, Jonathon et al. Hypoglycemic activity of withanolides and elicitated Withania Somnifera.Phytochemistry.2015. 116: 283-289
3. Sharma, Ashkok Kumar, MD, Basu, Indraneel, MD and Singh, Siddarth, MBBS. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial.The Journal of Complementary and Alternative Medicine. 2018. 24(3): 243-248.
4. Kaushik, Mahesh K et al. Triethylene glycol, an active component of Ashwagandha (Withania Somnifera) leaves, is responsible for sleep induction.PLOS One. 2017. 12(2).
5. Chandrasekhar L, Kapoor J and Anishetty, S. 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. 2012. 34(3): 255-62.
6. Wankhede, Sachin. Examining the effect ofWithania Somnifera supplementation on muscle strength and recovery: a randomized controlled trial.Journal of the International Society of Sports Nutrition. 2015. 12(43).