What is ashwagandha? Doctors debate controversial herbal supplement

Health

By Marc Lallanilla

Social media is swooning over a trendy herbal supplement that’s been around for thousands of years.

Ashwagandha, a shrub that’s native to Asia and Africa, is also known as Indian ginseng, as Withania somnifera to scientists, or as “glizzy pills” to TikTokkers.

A powder made from the ground root of the ashwagandha plant is a staple of Ayurvedic medicine, the traditional Indian health practice.

But new interest in the supplement’s potential benefits has spawned an online craze for ashwagandha.

How much of that is hype, and how much is factual? Doctors are weighing in on the controversial supplement and its potential risks and benefits.

“Ashwagandha has long been used in Ayurvedic medicine to increase energy, improve overall health and reduce inflammation, pain and anxiety,” Dr. Yufang Lin of the Cleveland Clinic’s Center for Integrative Medicine, said in an interview.

Ashwagandha and stress

Lin explained that during periods of stress, levels of the hormone cortisol increase in your body, causing your heart to pump harder and faster. When the stressful event ends, cortisol levels normalize and your heavy breathing and rapid heart rate ease.

“Unfortunately, when a threat is chronic — whether it’s stress from finances or work — the stressful response also becomes chronic,” said Lin.

“Over time, long-term stress can contribute to persistent inflammation and increases the risk for developing chronic conditions like obesity, diabetes, hypertension, heart disease, stroke, cancer, osteoporosis and fibromyalgia.”

The name “Ashwa” comes from the word “horse” in Sanskrit, perhaps because the root smells a little like a horse — though others say the herb gives you the stamina of a horse.

Ashwagandha benefits

“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,” said Dr. Zachary Mulvihill, a physician at Integrative Health and Wellbeing at NewYork-Presbyterian, in collaboration with Weill Cornell Medicine.

“Ashwagandha seems to … decrease the excessive release of stress hormones, helping our bodies to cope with stress and come back into balance,” he said.

“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,” Mulvihill added.

But how does Ashwagandha work?

Dr. Amala Soumyanath, a professor of neurology in the School of Medicine at Oregon Health & Science University, is currently studying ashwagandha and its mechanism of action.

“Laboratory studies show that ashwagandha extracts can act on neurotransmitter pathways including those involving serotonin and gamma-aminobutyric acid (GABA),” she said.

And studies have backed up the herb’s effectiveness: In a 2019 double-blind, placebo-controlled study, the stress-relieving effect of ashwagandha root extract was investigated in stressed healthy adults.

The study showed that cortisol levels were significantly reduced with ashwagandha. Compared to the placebo group, the people receiving ashwagandha also had significant improvement in sleep quality.

Ashwagandha and testosterone

Another study from 2019 found that people who took ashwagandha extract daily for 60 days had significant reductions in anxiety compared with those who received a placebo treatment.

That study also found that the supplement increased testosterone levels in men, a finding that is supported by several smaller studies and a plethora of online chatter from “glizzy pill” users. Some anecdotal evidence suggests the herb might help build muscle mass, making the pills a favorite among bodybuilders.

And while a skeptical 2021 review of studies found there’s not enough evidence to determine an appropriate dosage of ashwagandha for treating stress and anxiety, the study did confirm that there seem to be real benefits to using the herb, and it’s safe for people to take in moderate doses.

Ashwagandha side effects

There are people, however, who should talk to a doctor before using ashwagandha. The herb is not recommended for pregnant women because a safe dose hasn’t been determined yet, and high doses might cause pregnancy loss.

The herb may also be unsafe for people who have hormone-sensitive prostate cancer; are breastfeeding; are taking medications such as benzodiazepines, anticonvulsants, or barbiturates; are about to have surgery; or have an autoimmune, thyroid or liver disorder.

Side effects of ashwagandha can include stomach discomfort, drowsiness, diarrhea and vomiting. Some users report that the herb’s beneficial effects may take several weeks or months to become evident.

“Most people can take this supplement, although it is always best to discuss it with your healthcare provider first,” said Lin, who also notes that no drug or herbal supplement is a cure-all.

“Taking ashwagandha will not make the stress go away, but it may help reduce the symptoms so one feels more at ease,” she added. “But if you take the time to develop coping tools to help manage stress in the future, that will go much further in the long run.”

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