Helpful Guide to Ashwagandha Use
Americans are consistently looking for ways to lower their stress. They look online for solutions, they might ask their friends and family, or they might just muddle through on their own. What may not cross their minds is asking a health professional if there’s anything they can do. Integrative and functional medicine practitioners would be able to provide some assistance in that area — if only they’d ask, or mention that they’re struggling.
Integrative practitioners often turn patients seeking stress reduction and mitigation to adaptogens, and one of the most popular is an ancient herb from India called ashwagandha. Ashwagandha has been used for centuries to support various aspects of overall health because it has a broad range of benefits and can be applied in many different cases.
While there are still many questions as to how ashwagandha works, how effective it is for supporting specific health issues, and what doses are appropriate for each scenario, preliminary studies have discovered enough to suggest that this herb could be used more often than it currently is, and for a wide variety of conditions. Here’s what we currently know about ashwagandha, how it works, and its possible uses and benefits.
What is Ashwagandha?
Ashwagandha is the common name for Withania somnifera, also commonly known as “Indian Winter cherry” or “Indian Ginseng.” It’s native to India, the Middle East, and parts of Africa and has been used as a tonic for thousands of years. It’s still an important part of traditional Indian medicine, known as .
The word ashwagandha comes from Sanskrit, and means “smell of a horse,” which refers to the scent of the ashwagandha root, but is also a reference to the perceived strength and vitality of those who take it. In modern times, one might choose the colloquial phrase, “healthy as a horse” to make the same point.
Ashwagandha is officially classified as an , which means that it helps the body manage stress. When we feel stress (whether “good” or “bad”), our adrenal glands excrete cortisol to help us manage it. During periods of prolonged stress, our bodies get out of balance because of excess levels of cortisol. Excess cortisol over long periods of time can lead to a multitude of health issues and should not be ignored.
What are Adaptogens?
Adaptogens are herbs that essentially help the body return to a neutral position after times of stress partly by managing and reducing excess cortisol. Dr. Brenda Powell, MD is a Family Medicine physician at the Cleveland Clinic Center for Integrative Medicine. adaptogens are for the adrenal glands what exercise is for muscles: “when we exercise, it’s a stress on our body. But as we continue to train and exercise, our body becomes better at dealing with the stress of it, so we no longer get as tired or as high a heart rate.”
“During times of stress, our bodies activate the adrenal glands via the HPA axis (Hypothalamus-Pituitary-Adrenal) to produce cortisol and the neurotransmitters (epinephrine and norepinephrine),” says Dr. Ivy Branin, ND.
There are many types of adaptogens, such as astragalus, holy basil, maca, rhodiola, schisandra, eleuthero, ginseng and of course ashwagandha. Each type of adaptogen is best suited for its own set of circumstances, but ashwagandha is one of the most widely used because of its gentle action and broad range of benefits.
Ashwagandha Uses and Benefits
Ashwagandha has many uses, and different parts of the plant are used for different purposes. The root of the plant has been used for centuries in association with
- Sleep support
- Neurological and
- Immune support
- Nervous system support
- Increased energy
- Mood and emotional health
- Sexual and reproductive health
- Joint support
- Healthy inflammation
- Digestive concerns
- Skin health
The rest of the plant (leaves, seeds, and fruit) are also used in other ways so nothing goes to waste.
“Ashwagandha’s primary action as an adaptogen is to reduce cortisol in the body, which helps to reduce the negative effects of cortisol such as anxiety, insomnia, insulin resistance, abdominal fat accumulation and high blood pressure,” Branin says. “In my practice, I primarily use it for patients who are over stressed and have difficulty falling and staying asleep. It’s more calming than other adaptogens like ginseng and can also help with focus.”
Provides Calming Effects
One of the resulting effects of lowered (or balanced) cortisol is a greater sense of calm. that those taking ashwagandha felt less anxious or stressed when taking the herb compared to placebo groups. Many people report the calming effect of ashwagandha, and in fact, some believe that this can be obtained in .
“I find in my practice that it helps patients calm the mind particularly when it comes to emotional eating,” says Dr. Sarah Emily Sajdak, DAOM. “Patients taking ashwagandha don’t reach for food as often for comfort and when stress happens, their bodies react less because this herb helps lower cortisol levels which can linger in your system.”
Furthermore, Sajdak says that she’s noted that ashwagandha can help support a healthy weight. “Since ashwagandha lowers blood sugar and cortisol levels, it can help you to not gain weight on your stomach,” she asserts, but she also places the caveat that ashwagandha isn’t a miracle drug. “You still have to eat well and exercise, but if you’re doing everything right already then this herb could really help you bring your health to the next level.” Sajdak says that she finds this is true for both men and women in her practice.
May Support Sexual Health and Function
Ashwagandha may support healthy sexual function, as it has been shown to support testosterone levels. A pilot study in India looked at ashwagandha use in women to support healthy sexual function, and “may improve sexual function in healthy women.” The study notes the explanation for why ashwagandha was useful may lie in two pathways: (1) ashwagandha’s role in reducing stress, and (2) ashwagandha’s role in supporting testosterone.
A and meta analysis also found that ashwagandha may support fertility through increasing the sperm concentration, semen volume, and sperm motility in oligospermic males. Researchers were careful to note that the possible pool of studies and clinical trials available for their analysis was shallow, and that more research was needed to determine whether or not ashwagandha should be recommended for males struggling with infertility.
May Support Muscle Health
A lesser-known potential benefit to ashwagandha is its role in muscle support. Throughout the course of an , researchers gave 300mg of ashwagandha to a group of men with little experience in strength training or weight lifting at a rate of twice per day (600mg total daily). Half the group was given the herb, while half received a placebo.
Study participants were told to perform two specific weight training exercises (bench press and leg extension). Their performance was measured by the number of repetitions they were able to complete. At the end of the trial period, the group who received ashwagandha were able to perform at a higher level than the control group.
Given that ashwagandha supports testosterone levels, perhaps these findings are unsurprising. However, more research is needed in this area before it can be reliably recommended for this purpose.
Ashwagandha Dosage
Dosage for ashwagandha will vary according to the type of supplement used. Typical dosing of raw, dried herb in capsules is usually 1000-2000 mg a day, and commonly 600 mg per day for extracts of ashwagandha root.
Studies that have looked into ashwagandha use for various purposes found that different doses were applicable in each case. looking into the calming effects of the herb found that 300 mg twice daily (600 mg/day) of high potency ashwagandha extract over the course of 4 to 12 weeks was appropriate and the muscle mass study discussed above used the same dose of 300 mg of ashwagandha root extract twice daily.
Like any other supplement, each individual may react differently to ashwagandha, so it’s always wise to start with a lower dose and increase as tolerated. Currently in the United States, ashwagandha is sold in multiple forms, including powders, capsules, and liquid and it’s best to follow the dosing instructions on the packaging or the advice of a knowledgeable practitioner.
Who Should Not Take Ashwagandha?
While ashwagandha is largely considered very safe, there are certain groups of people to whom it would not be recommended. First and foremost, pregnant women are advised against taking ashwagandha or any other botanicals due to lack of safety studies in this population. Women who are breastfeeding are usually advised to avoid it as well, although some practitioners disagree on this assertion.
Branin brings up two situations in which ashwagandha would be inadvisable. “Adaptogens may decrease blood sugar, so caution should be taken if using diabetic medications and with hypoglycemic patients. It also lowers blood pressure so caution should be taken if on blood pressure medication.”
Recommending Ashwagandha to Patients
Like any other supplement, the recommendations you make as an integrative practitioner will depend on each individual patient’s health history, reasons for taking the supplement, and the desired outcome. The best aspect of ashwagandha is how versatile it can be — how its adaptogenic properties can support so many different aspects of overall health.
“I recommend it very often and typically in combination with other adaptogenic herbs and adrenal supportive nutrients like magnesium, B vitamins and phosphatidylserine,” says Branin. “I often recommend it for menopausal women, as high levels of cortisol with decreased estrogen and progesterone levels can contribute to menopausal weight gain.”
In terms of time of day, Branin has professional opinions about that as well, based on how her patients have responded to the herb, as well as the way it reacts with body chemistry. “Normally I have patients take it at bedtime because it helps with sleep by keeping cortisol levels low.” If cortisol levels are high at bedtime, it is more difficult for people to fall asleep, so ashwagandha can support the body’s natural ability to fall asleep when it gets tired, rather than the brain fighting the need for rest.
While ashwagandha is sometimes marketed as a supplement best suited for women, evidence and observational use in integrative medicine suggest that both men and women can benefit from this ancient herb. “It is more or less equally beneficial in both men and women as it can help manage cortisol levels and improve fertility,” Branin confirms. “For female patients I find it is useful for managing the negative effects of stress and reducing stress’ impact on menstruation and gynecological issues.
The most important factor in determining which ashwagandha supplement to recommend to patients is (of course) quality. At Emerson Ecologics, we’re dedicated to making sure the supplements we carry are held to the highest FDA standards through our Emerson Quality Program (EQP®). You can rest assured that anything you find in our online dispensary has been thoroughly vetted for quality and safety, which will provide you and your patients the peace of mind you deserve.
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