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Ayurvedic Tradition +1 more

Ashwagandha

Ashwagandha Root; Withania somnifera (L.) Dunal; Asgandh / Asgand (Unani); Winter Cherry; Asvagandha; Ajagandha. Note: "Indian Ginseng" is a 20th-century Western marketing analogy, NOT a traditional Sanskrit name - W. somnifera (Solanaceae) is botanically unrelated to Panax ginseng (Araliaceae) and contains a different bioactive class (withanolides, not ginsenosides).

The dried root of Withania somnifera (L.) Dunal, a small grayish-tomentose subshrub in the Solanaceae. Native range, per Kew Plants of the World Online, spans southern Europe and Macaronesia through North / East / South Africa and the Middle East to South Asia, central China, and Myanmar ("S. Europe to Central China, Africa to Myanmar"). Most cultivation for trade is in Madhya Pradesh and Rajasthan, India; the prized "Nagori" landrace originates near Nagaur (Rajasthan) and Neemuch (Madhya Pradesh). Revered in Ayurveda as a restorative (Rasayana) tonic for depletion.

FamilySolanaceae
Part usedRoot (most clinical evidence; commonly standardized to 1.5–5% withanolides, e.g., KSM-66); root + leaf extracts also used (e.g., Sensoril, Shoden, standardized to withanolide glycosides). Traditional Ayurveda uses primarily the dried root.
OnsetMost clinical-trial benefits appear at 4 to 8 weeks of daily use; subgroup analyses suggest larger effects at 8 weeks or more and doses of 600 mg/day or more. Acute single-dose effects are not well characterised in clinical trials.
Best timeMorning for stress and cortisol balance or Evening for sleep and relaxation.

⚕ Educational content · traditional and historical use · not medical advice

A traditional Ayurvedic Rasayana root; the best-evidenced modern uses are stress reduction and sleep support, with a calming rather than stimulating profile. Carries a documented liver-injury safety signal (see cautions).

StressSleepVitalityRecoveryTradition

Traditional: ashwagandha churna (root powder) with warm milk, ghee, water, or honey; ashwagandharishta (fermented decoction); medicated oils. Modern commercial: standardised root extracts - KSM-66 (Ixoreal Biomed, root-only, >=5% withanolides), Shoden (Arjuna Natural), Sensoril (Natreon, root+leaf, >=10% withanolides). Most modern clinical evidence is on these standardised extracts, NOT on crude churna; doses and effects are not interchangeable.

Capsule, Powder (Churna), Tincture, Tea, Gummy, Ghee (Ashwagandha Ghrita)

With food if stomach-sensitive. Traditionally taken with warm milk or ghee (anupana) per Ayurvedic practice; the lipid vehicle is theorised to support delivery of fat-soluble withanolides, though human pharmacokinetic data specific to milk / ghee co-administration are limited.

Sanskrit asvagandha = asva ("horse") + gandha ("smell") - both for the root's horse-like odour and the belief that the consumer gains a horse's strength. One of the most important Ayurvedic Rasayana (rejuvenative) drugs, also classified as Balya (strength-promoting), Vajikarana (reproductive tonic), and Medharasayana (cognitive tonic); cited in the Charaka and Sushruta Samhitas for karshya (wasting), kshaya (depletion), vatavyadhi, klaibya (impotence), and nidra (sleep - reflected in the epithet somnifera). Used in Unani as "Asgand" and in Siddha. Traditional preparations: ashwagandha churna (root powder, 3 to 6 g with milk, ghee, water, or honey as anupana - the lipid vehicle matches the fat-soluble withanolides), ashwagandharishta (a fermented preparation for insomnia / debility / anxiety), ashwagandha pak, and ashwagandha taila. Major cultivation is in Madhya Pradesh and Rajasthan; the "Nagori" landrace (Nagaur, Rajasthan) is the premium type. IMPORTANT: most modern clinical evidence is on 20th-21st-century STANDARDISED extracts (KSM-66, root-only, >=5% withanolides; Sensoril, root+leaf, >=10%; Shoden) that concentrate withanolides ~10-50x over raw root and are pharmacologically distinct from the classical crude churna - doses and effects are not interchangeable.

Withanolides (withaferin A, withanolide A, withanolide D, withanone)Sitoindosides VII-Xalkaloids (withanine, somniferine, anaferine, anhygrine / cuscohygrine)plus trace minerals (iron is present but NOT at nutritionally meaningful doses - roughly 0.1 to 0.2 mg per 3 to 5 g, well below the 8 to 18 mg RDAthe legacy "iron" framing reflects a classical raktavardhaka concept).

A withanolide-rich root extract. Clinical RCTs consistently show modest reductions in perceived stress, anxiety scores, and morning serum cortisol, consistent with HPA-axis modulation (the best-supported mechanism). Animal and in-vitro data suggest acetylcholinesterase inhibition and neurite-outgrowth effects, but these are NOT confirmed in human pharmacodynamic studies. The herb can also raise circulating T3 / T4 and suppress TSH - this is a SAFETY consideration (the same pharmacology has produced published thyrotoxicosis case reports), NOT a therapeutic mechanism (see Cautions and Contraindications).

Most modern clinical evidence is on STANDARDISED root extracts (KSM-66, Shoden, Sensoril), not on traditional crude churna - doses and effects are not interchangeable. A substantial share of positive RCTs are funded by or use product supplied by the extract manufacturers (Ixoreal / Arjuna / Natreon) - a systematic sponsor-bias pattern; interpret efficacy data accordingly. The two independent meta-analyses (Akhgarjand 2022 stress, Cheah 2021 sleep) explicitly flag low certainty and very high heterogeneity (I-squared ~62 to 94 percent). Despite the name "Indian ginseng," ashwagandha is botanically unrelated to Panax ginseng and contains different bioactives (withanolides, not ginsenosides). LiverTox Likelihood B and the EMA HMPC decision NOT to adopt a monograph are meaningful negative regulatory signals. Monitor liver and thyroid status for use beyond ~8 weeks.

⚠ Cautions & Contraindications

Cautions: Common: drowsiness, mild GI upset (nausea, loose stools). HEPATOTOXICITY: documented in a growing case-report literature; LiverTox classifies ashwagandha as Likelihood Score B - a "likely cause of clinically apparent liver injury" (NBK548536, updated Dec 2024). The injury is typically CHOLESTATIC OR MIXED (occasionally hepatocellular at onset), latency 2 to 12 weeks, usually self-limited within 1 to 5 months of stopping; rare fatal acute liver failure and transplant cases have occurred, especially with preexisting liver disease. National authorities have acted: Iceland (MAST 2021 opinion; 2018 product recall), Denmark (2023 ban), France (ANSES 2024 opinion), Netherlands (RIVM 2024); EMA HMPC explicitly DECLINED to adopt a European monograph. THYROID: ashwagandha can raise T3 / T4 and suppress TSH; published case reports document thyrotoxicosis (including a supraventricular-tachycardia presentation) and painless thyroiditis, resolving on cessation. Discontinue and seek medical evaluation for new jaundice, dark urine, abdominal pain, palpitations, unexpected weight loss, or heat intolerance. Additive CNS depression with sedatives / benzodiazepines / opioids / alcohol.

Contraindications: Pregnancy and breastfeeding (traditional Ayurvedic contraindication; WHO, ANSES, MAST, and Denmark DTU recommend avoidance pending human safety data). Active liver disease, cirrhosis, or concurrent hepatotoxic medications (risk of severe or fatal liver injury). Hyperthyroidism, Graves' disease, Hashimoto's thyroiditis, or use of thyroid medication (risk of thyrotoxicosis / painless thyroiditis / additive thyroid-hormone effects). Concurrent sedatives, benzodiazepines, opioids, or alcohol (additive CNS depression). Autoimmune disease with concurrent immunosuppressants (theoretical immunostimulant concern). Pre-surgical - discontinue at least 2 weeks before elective surgery. Hormone-sensitive prostate cancer (precautionary). Known Solanaceae allergy.

  • NIH Office of Dietary Supplements (Ashwagandha Health Professional Fact Sheet, updated May 2025)
  • LiverTox NBK548536 (Likelihood Score B, updated Dec 2024)
  • Memorial Sloan Kettering Cancer Center About Herbs (Ashwagandha, updated April 2024)
  • WHO Monographs on Selected Medicinal Plants, Volume 4 (Radix Withaniae)
  • Royal Botanic Gardens Kew, Plants of the World Online (Withania somnifera (L.) Dunal)
  • Iceland MAST May 2021 Ashwagandha Opinion
  • France ANSES 2024 Avis NUT2021SA0077
  • PubMed: 23439798 (Chandrasekhar 2012 stress RCT); 31517876 (Lopresti 2019 stress RCT); 36017529 (Akhgarjand 2022 anxiety meta-analysis); 34559859 (Cheah 2021 sleep meta-analysis); 33670194 (Bonilla 2021 performance meta-analysis); 24371462 (Ambiye 2013 fertility pilot); 31991029 (Bjornsson 2020 DILIN / Iceland hepatotox case series); 37756041 (Philips 2023 India hepatotox case series); 16355578 (van der Hooft 2005 thyrotoxicosis); 35475098 (Kamal 2022 thyrotoxicosis / SVT); 38559552 (Hayashi 2024 painless thyroiditis); 19633611 (Mirjalili 2009 chemistry / ethnobotany)
  • PubMed Central: PMC6750292
  • PMC8462692
  • PMC8006238
  • PMC11564894
  • PMC3252722

For informational purposes only. This entry does not constitute medical advice. Consult a qualified healthcare provider before starting any supplement, especially if you have existing health conditions, are pregnant or breastfeeding, or take prescription medications.

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