What Is It?
During the past decade, physician, teacher and overall health guru Dr. Deepak Chopra has been instrumental introducing the 5,000 year old Indian holistic medical system known as Ayurveda to the West. Ayurveda promotes significant lifestyle change, including diet, exercise, meditation and bodywork. In addition, a vast number of herbs, many used for millennia, are now being introduced by its practitioners.
The most famous of these herbs is Ashwagandha, a small evergreen shrub, widely cultivated in India and the Middle East for its medicinal properties. An erect, grayish plant with long roots, ashwagandha has small greenish flowers and fruits that turn orange-red when ripe.
In traditional Ayurvedic medicine, ashwagandha has been used as a sedative, a rejuvenating tonic, an anti-inflammatory agent. It’s most compelling modern use is as an “adaptogen.” In fact, Western herbalists refer to Ashwaganda as “Indian ginseng,” because its action for users is to assist the body ‘adapt’ to the negative effects of chronic stress by increasing energy, strength, and stamina.
Adaptogenic plants help maintain a balanced response to any type of stress – physical, chemical, electromagnetic, or emotional. Rather than working to relieve a specific symptom, adaptogens support the ability of a person’s immune, nervous, and hormonal systems to respond to stress in a healthy way. While most of the adaptogenic plants have long histories of traditional use for a wide variety of conditions, contemporary research has identified specific mechanisms of adaptogenic action and how these herbs might be most useful for today’s patient. Other adaptogenic herbs include Chinese and American ginseng, Siberian ginseng (eleuthro), Rhodiola and Holy Basil.
Ashwagandha is commonly used in its powdered form, which is made from the whole plant or from the root alone. Herbalists may recommend using the herb by itself or may combine it with other adaptogenic herbs in a single capsule.
Research on Ashwaganda mainly has been performed in the Indian subcontinent. The herb appears to have several properties with potential clinical use. These include: anti-inflammatory, anti-stress, anti-tumor, antioxidant, and immune enhancement.
The best way to understand Ashwaganda’s effect is to consider the word “enhancement.” While focusing on no single organ system in the body exclusively, Ashwaganda, like ginseng, allows the different systems to function “better.” For example, we already have a functioning immune system within ourselves, but animal studies with ashwaganda show increases in numbers of infection fighting white blood cells. Likewise, we have our own systems to reduce inflammation, buffer stress, relax our minds, and so forth, but with ashwaganda, everything seems to work better.
As recommended by an herbalist or a physician experienced with herbal medicine, ashwagandha may help to:
• Reduce stress and increase endurance. In one of several classic stress test experiments, a group of rats was given a saline solution and then tested for swimming times. A second group, given an ashwagandha solution, was able to swim twice as long. Studies on Army recruits in basic training have shown that adaptogens like ashwagandha prevent stress-induced exhaustion
• Ease arthritis pain. Although the mechanism is not fully understood, ashwagandha has been quite effective in relieving the inflammation associated with arthritis. One clinical trial, again from India, supports this use. Forty-two patients with osteoarthritis were randomly placed in two groups–one receiving ashwagandha, the other a placebo. After three months, pain and disability were markedly reduced in the ashwagandha group.
• Fight depression and mood swings. A small study on patients with affective disorders found that ashwagandha supplementation may help to relieve depression and mood swings. The mechanism is likely to enhance levels of the brain chemical nor-epinephrine. Although no clinical study has been performed comparing ashwagandha to either herbal (St. John’s wort) or prescription anti-depressants, the adaptogenic effect of ashwagandha would suggest real potential use as an antidepressant ‘enhancer.’ However, if you are currently receiving any form of psychotropic medication (anti-depressant, mood stabilizer, etc.) do not discontinue it or replace it with ashwagandha without physician supervision. Clearly, more research is needed in this area.
• Act as an antioxidant. Scientists are now discovering that many conditions can be caused or exacerbated by free-radicals, highly reactive altered oxygen molecules that wreak havoc on virtually all cells of the body. One of the easiest ways to stave off this destruction is to ensure that your diet/supplement program includes adequate supplies of antioxidants which are found primarily in fruit and vegetables. Rat, rabbit, and frog studies have shown ashwagandha is a potent anti-oxidant.
• Enhance immune function. In a small rat study, experimental inflammation was reduced by ashwagandha. Researchers also found that the herb increased white blood cell and platelet counts.
• Boost thyroid function. Studies conducted on rats have demonstrated that ashwagandha stimulates thyroid activity. This might be of benefit for people who suffer from underactive thyroid but has not been tested clinically.
• Boost sexual performance. In one study, 101 normal healthy male volunteers aged 50 to 59 took 3 grams of powdered ashwagandha daily for three months. 71% reported improved sexual performance. Although ashwagandha is not considered an aphrodisiac, this rejuvenating effect may be related to the improved endurance shown in animal stress tests.
• Treat dementia and Alzheimer’s Disease. Although these studies have not yet progressed to human trials, researchers are excited about preliminary findings for the treatment of degenerative brain disorders with ashwagandha. Rat studies have shown that ashwagandha may induce neuronal growth, improve memory deficits, and induce brain cells to rebuild lost connections. Other early studies support these conclusions. Some researchers are even postulating that ashwagandha may be useful to help stroke victims who suffer from memory loss and physical disabilities. This research is in its early stages; more studies are needed to determine if ashwagandha can help preserve and restore brain function in humans.
• Loose powder
The root and berry are the principal parts used. The root may be taken as ground powder, in capsule, or boiled in tea. Side effects are best avoided using ashwagandha in capsule form and taking it with food.
When included as part of an herbal blend, ashwagandha’s effects may be diluted or difficult to differentiate from other herbs in the mixture.
• For arthritis: Take 100-200 mg standardized extract or 2 to 4 mL liquid extract twice a day.
• For stress: Take 100-200 mg standardized extract or 2 to 4 mL liquid extract twice a day.
• For antioxidant protection: Take 100-200 mg standardized extract or 2 to 4 mL liquid extract twice a day.
• For immunity: Take 100-200 mg standardized extract or 2 to 4 mL liquid extract twice a day.
• For relaxation: Take 100-200 mg standardized extract or 2 to 4 mL liquid extract twice a day.
• For sexual performance: Take 100-200 mg standardized extract or 2 to 4 mL liquid extract twice a day.
Guidelines for Use
• Take ashwagandha with a meal or a full glass of water.
• Ashwagandha may increase the effect of other herbs or medications. It is important to review with your health-care provider any other herbs or any drugs you are taking before adding ashwagandha.
Possible Side Effects
• Because ashwagandha is an adaptogen, some patients report being excessively energized by it, especially during the first few days of use. Conversely, others have reported mild sedation. This probably reflects ashwagandha’s effect on nor-epinephrine levels in the brain. At any rate, either of these side effects, although uncommon, should be considered during your first few days taking ashwagandha.
• The most common side effect experienced with ashwagandha related to the gastrointestinal system and include mild stomach upset, diarrhea, (when using the liquid form) mouth irritation. These are all best avoided by taking ashwagandha in capsule form with food.
• Since ashwagandha stimulates hormone production in the thyroid gland, inform your doctor that you are taking the supplement when taking thyroid function tests. Supplementation may skew your test results.
• If you are taking other herbs and or supplements with sedative properties, talk to your physician before beginning treatment with ashwagandha. Ashwagandha may intensify the effects of these other remedies.
• Ashwagandha is generally believed to be nontoxic. However, there have been relatively few toxicity studies so this conclusion is based more on observations of herbalists.
• If you currently suffer from a thyroid condition or have a family history of thyroid disease, consult your physician or an endocrinologist before beginning supplementation with ashwagandha. Ashwagandha has been shown to stimulate the thyroid and may lead to excess levels of certain thyroid hormones.
• Do not take ashwagandha if you are pregnant or breast-feeding. Ashwagandha has been shown to cause miscarriage.
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David Edelberg, MD