Ashwagandha

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Specifically for Anxiety

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Why it works for Anxiety:

Ashwagandha is an adaptogenic herb whose bioactive compounds (mainly withanolides) appear to modulate the stress response (HPA axis), lower cortisol, and influence neurotransmitter systems (GABAergic and others). These combined effects are the biologic basis for reduced perceived stress and anxiety in clinical studies.

Key points and evidence:

HPA-axis / cortisol lowering. Multiple clinical trials and meta-analyses report that ashwagandha reduces serum cortisol and perceived stress — consistent with an effect on the hypothalamic–pituitary–adrenal (HPA) axis. Cambridge University Press & Assessment
Neurotransmitter modulation. Preclinical and mechanistic reviews show withanolides interact with neurotransmitter systems (including pathways linked to GABA and serotonin) and have neuroprotective/anti-inflammatory effects that plausibly reduce anxiety. Frontiers
Adaptogen concept. Ashwagandha is classed as an adaptogen — a compound thought to improve resilience to stress — and many human trials report improvements in stress/anxiety endpoints consistent with that. ScienceDirect

How to use for Anxiety:

Typical dosages used in clinical studies

Common extract doses: 250–600 mg/day of standardized root extract (often given as 300 mg twice daily or 600 mg once daily) was frequently used in RCTs for stress/anxiety. Some trials used 120 mg/day of specific proprietary extracts. Whole-root powder studies used much higher gram amounts (eg. several grams/day). Office of Dietary Supplements
Study durations: Most trials run from 4 to 12 weeks (some extend to 8–12+ weeks) — many report measurable reductions in stress/anxiety within weeks but most clinical trials assess outcomes at 6–12 weeks. Office of Dietary Supplements
Common standardized extracts: Trials use named extracts such as KSM-66, Sensoril, Shoden or other full-spectrum root extracts — these differ in concentration and recommended dose, so follow the manufacturer’s guidance for the specific product or use trial doses as a reference. Office of Dietary Supplements

How to start (practical regimen many clinicians/papers mirror)

Start low and evaluate: for example, 300 mg daily (root extract) for 1 week, then increase to 300 mg twice daily (600 mg/day) if tolerated and if you need a stronger effect. This mirrors many trial regimens. Office of Dietary Supplements
Take with food if you experience GI upset. Many formulations are taken with meals. Office of Dietary Supplements
Trial duration: give it at least 4–8 weeks to judge effect; many trials report clearer effects by 6–8 weeks. Cambridge University Press & Assessment
Monitoring: if you plan to take it long-term (>8–12 weeks), discuss periodic monitoring (including liver function tests) with your clinician, especially if you have liver disease or take other meds. (See warnings below.) NCCIH

Practical note on products:

Use reputable brands that provide standardized extracts, batch testing (heavy metals/microbes), and clear dosing. If a trial used KSM-66 or Sensoril, those product names indicate a specific standardized extract with trial-backed dosing. Office of Dietary Supplements

Scientific Evidence for Anxiety:

Systematic reviews / meta-analyses (best levels of evidence)

BJPsych Open (systematic review & meta-analysis, 2025): looked at randomized trials of ashwagandha for cortisol, stress and anxiety; concluded beneficial effects on stress/anxiety endpoints. Cambridge University Press & Assessment
Recent systematic reviews / meta-analyses (2023–2025) also conclude that evidence overall supports a beneficial effect of ashwagandha on perceived stress/anxiety, while noting heterogeneity in formulations and trial sizes. ScienceDirect

Representative randomized controlled trials

Randomized, double-blind, placebo-controlled trial (Indian J Psychiatry / SAGEPub trial): showed that a high-concentration full-spectrum root extract reduced stress and anxiety and improved general well-being vs placebo. (classic RCT design used in many ashwagandha anxiety trials). SAGE Journals
Recent RCTs (various proprietary extracts): studies of KSM-66, Sensoril, Shoden and other extracts (doses ~120–600 mg/day) reported statistically significant reductions in validated anxiety/stress scales versus placebo in adults reporting stress/anxiety. See trials summarized in NIH/ODS and reviews. Office of Dietary Supplements

Other useful reviews

Comprehensive reviews that summarize clinical and preclinical data, mechanisms, and safety (MDPI, Nutrition & Metabolism, Frontiers) — good for deeper reading on mechanism and trial details. MDPI

Specific Warnings for Anxiety:

Major warnings

Pregnancy / breastfeeding: Avoid. Some sources caution against use during pregnancy (possible uterine activity / risk of miscarriage in animal studies and traditional cautions). Do not take while pregnant or breastfeeding. NCCIH
Autoimmune disease / immunosuppressants: Ashwagandha can stimulate immune activity in some contexts — people with autoimmune disease or on immunosuppressive drugs should avoid or consult a clinician. NCCIH
Thyroid disease / thyroid medications: Ashwagandha can affect thyroid hormone levels (some reports of increased T3/T4) and may interact with thyroid replacement therapy; consult your endocrinologist. NCCIH
Surgery: Stop prior to surgery (may have sedative or other effects that interact with anesthesia). NCCIH

Drug interactions

Sedatives / benzodiazepines / alcohol: additive sedative effects are possible — avoid combining without medical advice. NCCIH
Antidiabetic drugs: ashwagandha can lower blood glucose — may potentiate diabetes meds (risk of hypoglycemia). Monitor glucose closely. NCCIH
Antihypertensives: may lower blood pressure — additive effects possible. NCCIH
Thyroid hormone and immunosuppressants / anticonvulsants: potential interactions reported — consult prescriber. NCCIH

Reported serious adverse events (rare but important)

Liver injury (herb-induced liver injury): several case reports and case series describe acute liver injury temporally associated with ashwagandha use, including a few severe cases. These appear rare but have been documented; patients with pre-existing liver disease should be cautious and consider avoiding it. If you develop jaundice, dark urine, severe nausea/vomiting, abdominal pain, or unexplained fatigue, stop supplement and seek medical attention. Cureus

Common minor side effects

GI upset, nausea, drowsiness, headache — generally mild and reported in RCTs. Office of Dietary Supplements

Back to Anxiety

General Information (All Ailments)

Note: You are viewing ailment-specific information above. This section shows the general remedy information for all conditions.

What It Is

Ashwagandha (Withania somnifera) is a medicinal herb traditionally used in Ayurvedic medicine for over 3,000 years. It is sometimes called Indian ginseng or winter cherry, though it’s botanically unrelated to true ginseng. The root and leaf extracts are the primary sources of its active compounds, known as withanolides — natural steroidal lactones thought to be responsible for many of its therapeutic effects.

Ashwagandha is classified as an adaptogen, meaning it helps the body manage stress and maintain physiological balance. It’s available in various forms: powders, capsules, tinctures, teas, and standardized extracts.

How It Works

Ashwagandha’s mechanisms of action are multifaceted and supported by both traditional use and modern research:

Stress Response Modulation

Regulates the hypothalamic-pituitary-adrenal (HPA) axis, which controls the body’s stress response.
Reduces cortisol levels (the main stress hormone), helping mitigate chronic stress, fatigue, and anxiety.

Neuroprotection and Brain Function

Promotes antioxidant activity in the brain, protecting nerve cells from oxidative stress.
May increase levels of acetylcholine and GABA, supporting better focus, memory, and relaxation.

Hormonal and Energy Support

In men, some studies show improved testosterone levels and sperm quality.
Enhances thyroid function in some individuals by stimulating T4 production.
Increases mitochondrial energy production, reducing fatigue and improving endurance.

Anti-inflammatory and Immunomodulatory Effects

Contains withaferin A, which has shown anti-inflammatory effects by inhibiting NF-κB (a key inflammation pathway).
Helps modulate immune activity, potentially balancing overactive or suppressed immune responses.

Why It’s Important

Ashwagandha has gained global attention for its broad spectrum of potential health benefits, including:

Stress and Anxiety Relief: Clinical trials suggest significant reductions in perceived stress and cortisol levels.
Improved Sleep: May promote deeper, more restorative sleep through GABA-mimetic activity.
Cognitive Enhancement: Enhances memory, focus, and information processing speed.
Physical Performance: Boosts muscle strength, VO₂ max, and recovery in athletes.
Hormonal Balance: Supports reproductive and thyroid health in both men and women.
Overall Vitality: Promotes resilience, energy, and mood stability — aligning with its Ayurvedic reputation for rejuvenation (rasayana).

Considerations

While generally well-tolerated, Ashwagandha is not suitable for everyone or in all contexts. Key considerations include:

Dosage

Common clinical dosages range from 300–600 mg/day of standardized extract (with 5% withanolides).
Effects often build over several weeks.

Safety and Side Effects

Mild: Gastrointestinal upset, drowsiness, or headache.
Rare: Allergic reactions or over-stimulation of thyroid hormone.
Avoid very high doses, as these may cause stomach irritation or diarrhea.

Interactions

May potentiate the effects of sedatives, thyroid medications, blood pressure drugs, or immunosuppressants.
Should not be combined with alcohol or other strong adaptogens without guidance.

Who Should Avoid It

Pregnant or breastfeeding women (due to possible uterine stimulation).
Individuals with hyperthyroidism or autoimmune disorders without medical supervision.
Those scheduled for surgery (may interfere with anesthesia or blood pressure).

Quality Matters

Choose extracts standardized to 5% withanolides and tested for contaminants like heavy metals or pesticides.
Reputable brands often use clinically studied extracts such as KSM-66 or Sensoril.

Helps with these conditions

Ashwagandha is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.

Anxiety 0% effective

PTSD 0% effective

Sleep Apnea 0% effective

Alzheimer's 0% effective

Hypothyroidism 0% effective

OCD 0% effective

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Ashwagandha is an adaptogenic herb whose bioactive compounds (mainly withanolides) appear to modulate the stress response (HPA axis), lower cortisol,...

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