Does Ashwagandha Help with Stress, Anxiety, & Sleep Issues?

Withania somnifera, commonly known as ashwagandha, is an evergreen shrub found in tropical and subtropical regions of Asia, Africa, and Europe. The name "ashwagandha" is derived from the Sanskrit words for horse ("ashwa") and smell ("gandha"), referring to the distinctive aroma of its roots, which is said to resemble that of a wet horse. Often referred to as Indian ginseng or winter cherry, ashwagandha has a long history of use in traditional Ayurvedic and Unani medicine systems in India. It is categorized as an adaptogen, a substance that helps the body resist various stressors—be they biological, physical, or chemical.

The species name "somnifera" translates to "sleep-inducing," highlighting another key benefit attributed to this herb. Ashwagandha is frequently promoted for its potential in reducing stress and anxiety and addressing cognitive disorders.

Ashwagandha is rich in various phytochemicals, including steroidal lactones known as withanolides and alkaloids. While withanolides are believed to contribute significantly to the herb’s effects, emerging evidence from preclinical studies suggests that other non-withanolide components may also play a role.

Efficacy

Stress and Anxiety

Several clinical trials have indicated that ashwagandha extracts might be effective in reducing stress and anxiety. A systematic review analyzed studies involving adults with high stress and anxiety levels or diagnosed anxiety disorders. Participants were randomly assigned to take ashwagandha or a placebo for 6 to 8 weeks. The studies utilized different ashwagandha preparations, including extracts from the root alone, root and leaf, or an unspecified mixture. Dosages ranged from 240 to 1,250 mg/day of extract or up to 12,000 mg/day of whole root granules. Overall, ashwagandha significantly decreased stress and anxiety levels, improved sleep, and reduced serum cortisol, a stress hormone, compared to placebo. Higher doses of 500 to 600 mg/day often showed better results.

Following this review, additional small studies have supported the benefits of ashwagandha on perceived stress. A trial in Florida involved participants who took 225 mg/day or 400 mg/day of a proprietary ashwagandha root and leaf extract or a placebo for 30 days. The results showed improvements in stress, anxiety, depression, and food cravings with both doses of ashwagandha extract compared to placebo. Notably, those on the 225 mg dose had lower saliva cortisol levels than the placebo group.

Another study with healthy individuals aged 20 to 55, who reported stress, involved a sustained-release ashwagandha root extract or placebo over 90 days. Participants on ashwagandha reported better stress levels, sleep quality, psychological well-being, memory, and focus compared to those on placebo, with lower serum cortisol levels noted as well.

A trial at the University of Colorado, Colorado Springs, included students who took an ashwagandha root extract or placebo for 30 days. Participants who took ashwagandha reported enhanced well-being, including increased calmness, better energy levels, mental clarity, and improved sleep quality. Although stress levels were similar across groups, those on ashwagandha described their stress as more manageable compared to the placebo group.

Sleep

While research is somewhat limited, several clinical trials suggest that ashwagandha extracts may aid in improving sleep. For instance, a study involved healthy adults with insomnia and poor sleep quality who took an ashwagandha root and leaf extract or a placebo for 6 weeks. The extract led to more significant improvements in sleep quality, efficiency, total sleep time, and sleep latency compared to placebo. Improvements in quality of life were also reported.

Another trial involved healthy individuals, including those with insomnia, who took ashwagandha root extract or placebo for 8 weeks. Participants with insomnia who took ashwagandha experienced better sleep quality, reduced sleep onset latency, and improved mental alertness upon waking compared to those on placebo. Those without insomnia also reported improved sleep, but without the same extent of benefits in anxiety symptoms or mental alertness.

A systematic review and meta-analysis of studies assessed ashwagandha’s impact on sleep. Participants, either healthy or with insomnia, took ashwagandha or placebo for 6 to 12 weeks. The review found a small but significant effect of ashwagandha on sleep improvement compared to placebo, with more pronounced benefits observed at 600 mg/day and with treatment lasting at least 8 weeks, particularly in individuals with insomnia.

Safety

Ashwagandha has generally been well tolerated in clinical trials lasting up to approximately 3 months. Common side effects include mild stomach upset, loose stools, nausea, and drowsiness. However, there is limited evidence on the safety of long-term ashwagandha use over extended periods.

There have been reports of serious side effects, such as liver dysfunction associated with ashwagandha use. For example, a case involved a young man who experienced liver dysfunction after using ashwagandha with multiple antianxiety medications. Other cases of acute liver injury have been reported in individuals taking ashwagandha supplements. These cases involved daily doses ranging from 450 to 1,350 mg over 1 week to 4 months, with symptoms improving after discontinuation of the supplement and, in some cases, receiving medical treatment. The contents of the supplements were not always verified independently, and some products contained other ingredients.

Research suggests that ashwagandha might affect thyroid function. A study showed small increases in blood thyroxine (T4) levels in men taking ashwagandha extract. Another trial with participants suffering from subclinical hypothyroidism found that ashwagandha decreased serum thyroid-stimulating hormone (TSH) and increased T3 and T4 levels compared to placebo. This indicates potential interactions with thyroid hormone medications. Ashwagandha might also interact with other medications, including those for diabetes, hypertension, immune suppression, and sedatives.

Experts generally advise against using ashwagandha during pregnancy due to potential risks of spontaneous abortion and recommend caution for those breastfeeding. Additionally, ashwagandha may increase testosterone levels, which could be problematic for individuals with hormone-sensitive prostate cancer.

Implications for Use

Various randomized, placebo-controlled clinical trials suggest that ashwagandha may effectively reduce stress and anxiety and improve sleep quality and duration. However, due to the use of different ashwagandha preparations and dosages in these studies, it is challenging to determine specific extracts or recommended amounts. Most studies have been conducted within traditional medical systems, leaving unclear how ashwagandha performs as a dietary supplement.

Ashwagandha seems to be well tolerated for up to 3 months. Nevertheless, the long-term efficacy and safety of using ashwagandha for stress, anxiety, or sleep over extended periods remain uncertain. There are also potential adverse effects, including impacts on the liver and thyroid, and it may not be suitable for those with prostate cancer or those who are pregnant or nursing.

For those looking to incorporate ashwagandha into their routine, consider trying ashwagandha gummies from Reset. These convenient and tasty supplements offer a practical way to benefit from ashwagandha’s potential effects on stress and sleep while supporting overall well-being.