What is Ashwagandha?

Stress relief, insomnia treatment, anxiety reduction — you may have heard of the herb ashwagandha and its potential health benefits, but what exactly is it, and what can it do for your body?

Popular in Ayurvedic medicine, a traditional system of medicine from India that provides a holistic approach to health, ashwagandha root is growing in popularity in vitamin aisles.

“Integrative medicine expands our toolbox beyond Western medicine to include evidence-based treatments from Eastern and alternative medicine. Ashwagandha is a well-studied plant that is primarily classified as an adaptogen, a subset of herbs that improve the body’s ability to cope with stress,” says Dr. Zachary Mulvihill, a physician at Integrative Health and Wellbeing at NewYork-Presbyterian, in collaboration with Weill Cornell Medicine. “While ashwagandha can be a potent treatment for many patients, like any herb or supplement, it is most effective when combined with diet and lifestyle changes that are focused on addressing the root cause of your symptoms.”

Dr. Mulvihill shared more with Health Matters on what to know about ashwagandha.

What is ashwagandha?
Dr. Mulvihill: Ashwagandha is a plant native to Asia and Africa. It’s also commonly known as Indian ginseng.

The leaves, berries, and roots have different active ingredients. The root is what is traditionally used for medicine, ground up in a powder that can be consumed.

“Ashwa” comes from the word “horse” in Sanskrit. Some people say the name “ashwagandha” comes from the root’s smelling like a horse, and others say it’s because it gives you the stamina of the animal.

What does ashwagandha do to the body?
We have two nervous systems in our body, and within them there’s the somatic and the autonomic. The somatic nervous system is under our conscious control, allowing us to do things like walk, talk, and write. The autonomic nervous system controls unconscious processes, and has two parts: the sympathetic and the parasympathetic. The sympathetic system is known as the fight-or-flight response, whereas the parasympathetic system helps us to “rest-and-digest.”

Our fight-or-flight response evolved to help us either fight or flee from predators. Nowadays, however, our bodies are responding to sirens in the street, or an email from your boss, as if they were physical threats.

When chronically activated, the sympathetic nervous system triggers the release of stress hormones such as epinephrine (adrenaline) and cortisol. This abnormal release of stress hormones has many negative effects in our body over time, including increased inflammation and disruptions of our digestion and metabolism.

Ashwagandha seems to counteract our sympathetic nervous system and decrease the excessive release of stress hormones, helping our bodies to cope with stress and come back into balance.

Cortisol has a circadian rhythm, tending to go up in the early morning and decrease throughout the day. There’s research that shows that ashwagandha can help reset your circadian rhythm, getting you into a good sleep pattern, and slowly, over the course of weeks to months, rejuvenating your body.

What are the benefits of ashwagandha?
Research supports that ashwagandha can help:

• Improve sleep
• Reduce stress, anxiety, and fatigue
• Enhance cognition and focus

Who should take it?
I usually recommend ashwagandha to patients who are tired and wired. They may be struggling to cope with physical and mental stress, leading to anxiety and poor sleep, which over time can lead to a feeling of burnout and chronic fatigue.

Every person is different, so it’s best to get guidance from a physician or clinician familiar with supplements and herbs.

How much ashwagandha should you take and when?
Supplements are not regulated the same way as medications, so a risk you can encounter is taking something that might be contaminated with different ingredients. I generally advise patients to take herbs that are produced domestically, and that are certified USDA organic. Just like any medication, you want to do your research, talk to your doctor, and see if you are on anything that could potentially interact with it.

The general dosing for ashwagandha is 300 mg, once or twice a day. Don’t go beyond 1,000 mg of an extract without talking to your doctor. You can mix the powder in water, cow milk, or nut milk, or take it in a capsule form. One way I suggest to patients is to mix it into a “golden milk,” which consists of a milk of your choice, turmeric, and spices like cinnamon and ginger.

Generally, ashwagandha is taken before bedtime to help with sleep, but you can take it in the morning if you find it more activating. Some people respond quickly to ashwagandha, while others take more time. Usually, patients notice subtle effects within one month.

Herbs shouldn’t be taken indefinitely. I recommend trying it for a couple of months, then reassessing how you are feeling over time. It’s also about addressing the root cause. Maybe you come in for fatigue and we start ashwagandha, but I’ll also recommend decreasing coffee intake and going to the gym three times a week. If you’re on it for more than three months, ask yourself, why? Did you get the result you were looking for? What’s making you tired or stressed? How’s your diet?

Who should not take it?
People who are pregnant or breastfeeding should avoid ashwagandha, along with people who have autoimmune or thyroid conditions or are on blood pressure medication.

And as with other supplements, people who have cancer should not take herbs or supplements without talking to their doctor, as it could interact with other medicines or treatments.

Are there any side effects of ashwagandha?
Common side effects include nausea or upset stomach.

Ashwagandha can also increase testosterone. Some patients taking large doses of ashwagandha have reported excessive sex drive and feelings of excessive alertness or energy.

If you’re noticing side effects, go down on your dose or consult a healthcare professional.