Ashwagandha has been used for over 3,000 years in traditional Ayurvedic medicine, and its popularity continues to soar in modern times. As an evidence-based adaptogen, ashwagandha reduces stress by attenuating the stress hormone cortisol.
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Ashwagandha: An Overview
Also known as Indian ginseng, winter cherry, and Withania somnifera, ashwagandha is a plant belonging to a class called adaptogens, known to help relieve symptoms of stress and anxiety. Ashwagandha has been studied for many purposes. Its physiologic effects are interrelated and tied to its ability to modulate the hypothalamic-pituitary-adrenal (HPA) axis and lower cortisol levels. (29)
Historical and Traditional Use
Ashwagandha has been revered in Ayurveda (India's traditional medicinal system) for over 3,000 years as a Rasayana – a tonic, rejuvenator, and lifespan enhancer. Ancient texts speak to its ability to nourish the body and increase strength, sexual performance, and fertility. (30)
Historically, ashwagandha has been used to treat a wide array of health conditions, including:
- Advanced aging
- Arthritis
- Insomnia
- Constipation
- Diarrhea
- Colic
- Hemorrhoids
- Skin ulcers and infections
- Mood disorders
Active Compounds and Their Actions
Ashwagandha contains over 80 bioactive compounds, including alkaloids, steroidal lactones, saponins, glycosides, and volatile oils. Among these phytochemicals, the medicinal actions of ashwagandha are most attributed to sitoindosides (a steroidal saponin) and withaferin-A (a steroidal lactone). (31, 38)
Collectively, these constituents are responsible for ashwagandha's therapeutic antimicrobial, anti-cancer, immunomodulatory, cardioprotective, antidiabetic, anti-inflammatory, antioxidant, sedative, and adaptogenic actions. (29, 31, 38)
Ashwagandha's Effects on Cortisol Levels
Understanding ashwagandha's mechanisms of actions sheds light on how it influences cortisol levels and its therapeutic potential in managing stress-related conditions.
Understanding Cortisol and Its Impact on Health
Cortisol, known as the "stress hormone," is a steroid hormone produced by the adrenal glands in response to stress. It follows a circadian rhythm, with levels peaking in the morning to help wake us up and gradually declining throughout the day to promote relaxation and sleep at night.
During stressful events, cortisol is released as part of the body's fight-or-flight response, mobilizing energy reserves and suppressing non-essential functions to cope with the stressor. The HPA axis regulates this process.
While cortisol serves a vital role in acute stress management, chronic stress can dysregulate the HPA axis, leading to persistent elevations in cortisol levels. This can have negative consequences for health, including suppressed immune function, metabolic dysfunction, cardiovascular issues, mental health concerns, and digestive problems.
Scientific Evidence
Clinical studies and research provide compelling evidence supporting ashwagandha's efficacy in lowering cortisol levels and mitigating stress-related outcomes.
Ashwagandha exerts its anti-stress effects by modulating the HPA axis. Research indicates that ashwagandha helps regulate the release of adrenocorticotropic hormone (ACTH) from the pituitary gland and cortisol from the adrenal glands, ultimately reducing cortisol levels and promoting a balanced stress response.
A 2023 systematic review of nine studies measuring serum cortisol levels in stressed individuals concluded that using ashwagandha supplements for 30-112 days reduced cortisol secretion by 11-32.63%.
Ashwagandha's withanolides and sitoindosides appear to exert anti-anxiety (anxiolytic) effects by modulating neurotransmitter activity in the brain. Neurotransmitters are chemical messengers that transmit signals between cells in the nervous system. Many neurotransmitters, such as serotonin, gamma-aminobutyric acid (GABA), and norepinephrine, help regulate mood, emotions, and the body's stress response.
Ashwagandha enhances GABAergic neurotransmission, which has calming and anxiety-reducing effects. Additionally, ashwagandha may influence serotonin levels, a neurotransmitter involved in mood regulation, thereby contributing to its anxiolytic properties. (4, 6)
Understanding the Dosage and Duration
The recommended dose for ashwagandha can vary on individual needs, but most research suggests that taking 250-600 mg daily for at least one month is beneficial for treating chronic stress (28).
A 2008 study found that dosing 125 mg of ashwagandha root extract (as Sensoril® standardized extract) daily for eight weeks improved stress and anxiety scores by 62% and reduced serum cortisol by nearly 15%.
Doses as high as 600 mg (as KSM-66® standardized extract) daily for six weeks safely and effectively improve resilience to stress and serum cortisol levels (7).
3 Benefits of Reducing Cortisol With Ashwagandha
Reducing cortisol levels with ashwagandha offers a range of potential benefits for overall health. Clinical studies consistently support positive clinical outcomes linked to the biochemical changes induced by ashwagandha in the body's neuroendocrine response to stress.
1. Improved Stress Response and Mental Well-Being
Surveys indicate that up to 75% of Americans suffer from chronic stress and anxiety, so it's no wonder that the use of ashwagandha has skyrocketed in the last few years (22, 46).
Many studies have observed ashwagandha's ability to decrease people's stress and anxiety levels. These improvements are often assessed using standardized psychological measures, such as the Perceived Stress Scale (PSS) and the Hamilton Anxiety Rating Scale (HAM-A). (24, 34)
Clinical trials have also consistently reported improvements in stress-related symptoms, including fatigue, food cravings, and impaired cognitive functioning, in individuals supplementing with ashwagandha.
2. Sleep Quality
Ashwagandha's scientific name is derived from the Latin word "somnifera" (sleep inducer) due to its sedative effects.
In a study conducted at a research center in India, 150 healthy adults aged 18 to 65 with self-reported sleep difficulties were assigned to receive either ashwagandha extract 60 mg (standardized to contain 21 mg of withanolides) or a placebo twice daily for six weeks. The group taking ashwagandha showed better improvement in sleep quality, efficiency, and latency than the placebo group. (15)
3. Metabolism and Strength
During the fight-or-flight response, cortisol mobilizes energy reserves by upregulating gluconeogenesis, the production of glucose from non-carbohydrate sources like amino acids and fats. This catabolic process increases blood sugar levels, providing immediate energy for the body to respond to stressors. However, chronic elevation of cortisol can lead to muscle wasting due to the breakdown of muscle protein to supply amino acids for gluconeogenesis, contributing to insulin resistance and high blood sugar levels.
Clinical findings suggest that ashwagandha can combat the detrimental effects of chronic hypercortisolemia. Clinical studies have found ashwagandha to be helpful in reducing blood sugar levels. One small study found these effects to be comparable to those of antidiabetic medications. Other studies have reported increases in muscle strength in healthy adults taking 500-1,250 mg of ashwagandha daily (35, 37).
Integrating Ashwagandha into Your Wellness Routine
Incorporating ashwagandha into your wellness routine can offer a natural approach to stress management.
Supplementation Guidelines
Experiencing ashwagandha's therapeutic effects relies upon quality supplements and consistency. Ashwagandha can be found in capsule, tablet, powder, tincture, and tea forms.
Not all supplements are created equal. Look for ashwagandha supplements from trusted brands that follow current good manufacturing practices (cGMP) and outsource third-party quality testing to ensure the safety and potency of their products. (9)
For optimal efficacy, ashwagandha extract should be standardized to contain a specific percentage of withanolides. Clinical trials often use a common standardization between 5-10%.
Complementary Lifestyle Practices
While ashwagandha supplementation can provide valuable support for stress management, incorporating complementary lifestyle practices can further enhance and ensure sustained long-term benefits. Consider integrating the following practices into your daily routine:
- Balanced Nutrition: Consume a balanced diet rich in fruits, vegetables, lean proteins, and healthy fats. Limit processed foods, refined sugars, and excessive caffeine/alcohol intake.
- Regular Exercise: Engage in regular physical activity, including aerobic exercises, strength training, yoga, and tai chi. Exercise helps reduce stress, improve mood, and promote longevity.
- Mindfulness Techniques: Setting aside just ten minutes each day for relaxation and self-care activities, including mindfulness meditation, deep breathing, or progressive muscle relaxation, cultivates inner calm and promotes stress resiliency.
Potential Risks and Considerations
While ashwagandha offers numerous health benefits, you should be aware of the potential risks associated with its use before taking it. Understanding these side effects and interactions can help you make informed decisions about incorporating this herb into your wellness routine.
Side Effects and Interactions
Ashwagandha is generally well-tolerated, but some individuals may experience side effects while taking it, especially at higher doses. The most commonly reported side effects associated with its use include:
- Diarrhea
- Nausea
- Vomiting
- Drowsiness
It is also important to note that rare cases of liver injury (hepatotoxicity) have been reported with its use. While there are no reports of liver enzyme elevations or hepatotoxicity in clinical trials, several clinical cases of liver injury have occurred in patients taking commercial products containing ashwagandha. It is unclear if this is related to the ashwagandha or product contamination. (32)
Who Should Avoid Ashwagandha?
While most people can safely take ashwagandha, it is always recommended to consult a doctor before taking it. Certain groups of people may need to avoid ashwagandha due to potential risks:
- Ashwagandha should be avoided during pregnancy and while breastfeeding (2).
- Ashwagandha has potential immune-stimulating effects and may exacerbate preexisting autoimmune diseases.
- Because ashwagandha may increase testosterone levels, it may not be safe for people with hormone-sensitive prostate cancer to take.
- Ashwagandha can augment thyroid function, making it unsafe for patients with hyperthyroidism.
- Ashwagandha might interact with and increase the risk of side effects of some medications, including hypoglycemics, antihypertensives, immunosuppressants, sedatives, and anti-convulsants (2).
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Key Takeaways
- Ashwagandha is a natural adaptogen that helps reduce cortisol levels and enhance stress resilience. Clinical research supports its efficacy in improving stress-related outcomes, such as anxiety, mood, and sleep quality.
- Before starting an ashwagandha supplement, consult a healthcare professional, especially if you have pre-existing health conditions or are taking medications. Personalized advice from healthcare professionals can help ensure safe and appropriate use of ashwagandha as part of your wellness routine.
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