The name is a mouthful, and the root has a strong earthy smell that hints at where the word comes from: in Sanskrit, ashwagandha is usually linked with the smell of a horse. It has moved from the traditional medicine of India to supplement shelves around the world, and that journey has brought both interest and exaggeration.
A plant with a long history
Ashwagandha (Withania somnifera) is a small shrub that grows in parts of India, Africa and the Middle East. In Ayurveda, the root has long been used as a general tonic. Modern writing often calls it an adaptogen, a term for plants that are said to help the body cope with stress. Bear in mind that adaptogen is a popular label, and it is not a recognised medical category.
What the research says
Scientists have looked at ashwagandha root extracts in a number of human trials, mostly on self-reported stress, anxiety and sleep. A systematic review and meta-analysis published in Phytotherapy Research in 2022 pooled 12 randomised controlled trials with 1,002 participants and found lower anxiety and stress scores with ashwagandha than with placebo. The same authors rated the certainty of that evidence as low, noted very high variation between trials, and called for better studies before any firm claim of clinical benefit. The US National Center for Complementary and Integrative Health reaches a similar position: some preparations may help with insomnia and stress, the evidence on anxiety is unclear, and many studies are small and use different products, so results are hard to compare. Other limits apply:
- Many trials lasted only a few weeks
- Extracts and amounts differed between studies
- Some of the work was supported by extract manufacturers
- NCCIH says long-term safety is not established, and that use may be safe for up to about 3 months
Overall, the evidence is interesting but limited. Ashwagandha should not be seen as a way to manage anxiety or depression. Those conditions deserve care from a qualified professional.
Who should avoid it or ask first
This section matters more than any promise on a label. Talk to your doctor or pharmacist before taking ashwagandha. NCCIH advises against it in pregnancy and breastfeeding, for people with thyroid or autoimmune conditions, for anyone about to have surgery and for people with hormone-sensitive prostate cancer, and notes possible interactions with:
- Sedatives, since ashwagandha itself can cause drowsiness
- Diabetes and blood pressure medicines
- Immunosuppressants, anti-seizure drugs and thyroid hormone medicines
NCCIH also reports that liver injury is rare but has been linked to some ashwagandha supplements. Stop and get medical advice if you notice yellowing of the eyes or skin, dark urine or unusual tiredness. Stomach upset, diarrhoea and drowsiness are the common side effects.
Stress basics come first
Before looking at any herb, check the fundamentals. The World Health Organization suggests keeping a routine, consistent sleep and wake times, regular meals, daily movement such as walking, time with people you trust and less news and social media if they add to your stress. Are you relying on several cups of coffee and strong tea to get through the afternoon? An evening stroll, a regular bedtime and a real conversation with a friend over tea can do more than people tend to expect.
If worry or low mood persists and disrupts your work, family life or sleep, the WHO advises speaking to a trusted health-care provider, since this may signal anxiety or depression that deserves proper care.
Sources
- Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials · Phytotherapy Research
- Ashwagandha: Usefulness and Safety · National Center for Complementary and Integrative Health (NCCIH), NIH
- Stress · World Health Organization
This article is general health information for educational purposes and is not medical advice. It does not promote any product. Talk to your doctor or pharmacist before starting a supplement, especially if you are pregnant, breastfeeding, have a health condition or take medication.