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Ashwagandha root and leaf extract

Also known as: Withania somnifera, Ashwagandha, Indian ginseng, Winter cherry

Overview

Ashwagandha root and leaf extract is derived from the plant *Withania somnifera*, a staple in traditional Ayurvedic medicine. Classified as an adaptogen, it is believed to enhance the body's resilience to physiological and psychological stressors. Extracts are obtained from both the root and leaves of the plant. Ashwagandha is widely used to alleviate stress and anxiety, improve physical performance, and promote better sleep quality. Research on Ashwagandha is relatively robust, featuring numerous randomized controlled trials (RCTs) and systematic reviews/meta-analyses. However, the certainty of evidence is often rated as low to moderate due to study heterogeneity and limitations. It is available in various forms, including capsules, powders, and liquid extracts, with standardized extracts ensuring consistent withanolide content.

Benefits

- **Stress and Anxiety Reduction:** Ashwagandha supplementation has been shown to significantly reduce anxiety and stress levels. A meta-analysis of 12 RCTs found a notable reduction in anxiety (SMD: -1.55) and stress (SMD: -1.75) compared to placebo. The effective dose range for anxiety was up to 12,000 mg/day and for stress between 300-600 mg/day. However, the certainty of evidence was rated low, indicating the need for further high-quality studies. - **Physical Performance:** Supplementation with Ashwagandha, at doses between 120 mg and 1250 mg per day, may improve physical performance metrics such as muscle strength, VO2 max, muscle fatigue, and recovery in healthy adults. A systematic review and Bayesian meta-analysis supports these findings, though detailed effect sizes were not provided. - **Sleep Quality:** Ashwagandha extract significantly improves overall sleep quality compared to placebo (SMD: -0.59). A meta-analysis of five RCTs involving 1,764 participants showed moderate quality evidence supporting this effect. - **Antioxidant Effects:** Supplementation with Ashwagandha root and leaf extract at doses of 500-1000 mg per day over 12 weeks has been reported to increase glutathione levels (31% to 43%), suggesting antioxidant benefits.

How it works

Ashwagandha's adaptogenic effects are primarily attributed to its ability to modulate the hypothalamic-pituitary-adrenal (HPA) axis, leading to reduced cortisol levels and a more balanced stress response. It also exhibits antioxidant properties by boosting endogenous antioxidants like glutathione. The bioactive compounds, particularly withanolides, interact with GABAergic and serotonergic systems, potentially explaining its anxiolytic and sleep-enhancing effects. Absorption and bioavailability can vary depending on the extract formulation, but standardized extracts ensure a consistent concentration of withanolides.

Side effects

Ashwagandha is generally well-tolerated in clinical trials at doses up to 1,000-1,200 mg/day. Common side effects are mild and infrequent, including gastrointestinal discomfort, headache, and drowsiness. No serious adverse events have been consistently reported in RCTs. However, potential drug interactions exist with sedatives, thyroid medications, and immunosuppressants due to its pharmacological effects. Caution is advised in individuals who are pregnant, have autoimmune diseases, or thyroid disorders, and use should be supervised by a healthcare professional. Due to its potential to affect thyroid hormone levels, individuals with thyroid conditions should monitor their thyroid function closely when taking Ashwagandha.

Dosage

The minimum effective dose for stress reduction is approximately 300 mg/day. The optimal dosage range is typically between 300-600 mg/day for stress and anxiety, and up to 1,000-1,200 mg/day for antioxidant and physical performance benefits. Clinical trials have explored doses up to 12,000 mg/day for anxiety in dose-response analyses, but typical supplementation does not exceed 1,200 mg/day. Dividing doses and taking them with meals may improve absorption and reduce gastrointestinal side effects. Standardized extracts with a defined withanolide content are preferred for consistent effects.

FAQs

Is Ashwagandha safe for long-term use?

Clinical trials up to 12 weeks show good safety; longer-term data are limited. Consult with a healthcare provider for extended use.

How soon do benefits appear?

Improvements in stress and anxiety may be observed within weeks; sleep benefits also appear relatively quickly with consistent use.

Can it be taken with other medications?

Consult a healthcare provider, especially if on sedatives, thyroid drugs, or immunosuppressants, due to potential interactions.

Does leaf extract differ from root extract?

Both are used; some studies combine them, but root extract is more commonly studied and may have a more established safety profile.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/36017529/ – This systematic review and dose-response meta-analysis of 12 RCTs (n=1,002) found that Ashwagandha supplementation significantly reduced anxiety and stress levels. The analysis identified a dose-response relationship, but the certainty of evidence was rated low due to high heterogeneity, highlighting the need for further high-quality RCTs to confirm these findings.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8006238/ – This systematic review and Bayesian meta-analysis indicated that Ashwagandha supplementation may improve physical performance metrics such as muscle strength, VO2 max, muscle fatigue, and recovery in healthy adults. While the review suggests potential benefits, detailed effect sizes were not provided, and heterogeneity in study protocols limits the strength of the conclusions.
https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0257843 – This meta-analysis of 5 RCTs involving 1,764 participants showed that Ashwagandha extract significantly improved overall sleep quality compared to placebo. The study provides moderate quality evidence supporting the use of Ashwagandha for improving sleep, but notes moderate heterogeneity across the included studies.
https://onlinelibrary.wiley.com/doi/abs/10.1002/ptr.7598 – This review discusses the clinical use and efficacy of Ashwagandha, highlighting its potential benefits for stress, anxiety, and physical performance. It emphasizes the need for further rigorous trials to confirm these effects and establish optimal dosing strategies.
https://www.nmi.health/ashwagandha-a-review-of-clinical-use-and-efficacy/ – This review summarizes the clinical applications and effectiveness of Ashwagandha, noting its potential in managing stress and enhancing physical capabilities. It underscores the importance of additional comprehensive studies to validate these benefits and determine the most effective usage guidelines.