Ashwagandha – Uses, Side Effects, and More

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Ashwagandha, an evergreen shrub flourishing in the regions of Asia and Africa, is frequently employed to address stress-related concerns. While it is commonly categorized as an “adaptogen,” scientific evidence supporting this classification is limited.

The chemical composition of ashwagandha suggests potential benefits such as brain-calming properties, anti-inflammatory effects, blood pressure reduction, and modulation of the immune system. Rooted in traditional use as an adaptogen, ashwagandha is employed for various stress-related conditions. Adaptogens are believed to fortify the body against both physical and mental stressors. Conditions like insomnia, aging, anxiety, among others, are often associated with ashwagandha use, but it’s important to note that robust scientific evidence supporting most of these applications is lacking. Furthermore, there is no substantiated evidence supporting the use of ashwagandha in the context of COVID-19.

It’s crucial to differentiate ashwagandha from Physalis alkekengi, as both are colloquially referred to as winter cherry. Additionally, caution is advised to avoid confusion with other herbal remedies like American ginseng, Panax ginseng, or eleuthero, which may have distinct properties and applications.

Uses & Effectiveness

Possibly Effective for

Ashwagandha has shown promise in addressing a specific type of enduring anxiety characterized by heightened worry and tension, known as Generalized Anxiety Disorder (GAD). When taken orally, ashwagandha appears to alleviate anxiety symptoms in individuals dealing with persistent anxiety.

In the realm of sleep-related concerns, ashwagandha demonstrates potential benefits. Oral consumption of ashwagandha seems to contribute to overall improvements in sleep and sleep quality for certain individuals grappling with insomnia.

Furthermore, ashwagandha exhibits positive effects in mitigating stress levels for some users. Additionally, there is an indication that it may play a role in curbing stress-related weight gain.

While these aspects showcase the potential of ashwagandha in specific areas, it’s essential to note that there is ongoing interest in exploring its utility for various other purposes. However, the current body of reliable information is insufficient to conclusively determine its effectiveness in these broader applications.

Ashwagandha Side Effects

Oral consumption of ashwagandha is generally considered safe for a duration of up to three months, although the safety profile for long-term use remains uncertain. It’s important to note that elevated doses of ashwagandha may result in adverse effects such as stomach upset, diarrhea, and vomiting. In rare instances, there have been reported cases of liver problems, including severe liver failure, necessitating liver transplantation.

In contrast, when applied topically to the skin, a lotion containing ashwagandha is deemed potentially safe for a period of up to two months. As with any substance, it is advisable to exercise caution and adhere to recommended usage guidelines to minimize potential risks and side effects.

Special Precautions and Warnings

Oral Consumption:

Ashwagandha is deemed potentially safe for oral use within a span of up to three months. However, the long-term safety implications of prolonged use remain unknown. Ingesting large doses of ashwagandha may lead to adverse effects such as stomach upset, diarrhea, and vomiting. In rare instances, severe liver problems, including the potential for liver failure requiring transplantation, have been reported.

Topical Application:

When applied to the skin, a lotion containing ashwagandha is considered possibly safe for a duration of up to two months.

Pregnancy:

During pregnancy, the use of ashwagandha is likely unsafe, as there is evidence suggesting a potential association with miscarriages.

Breastfeeding:

Insufficient reliable information exists to determine the safety of ashwagandha use during breastfeeding. It is advisable to err on the side of caution and abstain from its use.

Autoimmune Diseases:

For individuals with autoimmune diseases such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or similar conditions, caution is advised. Ashwagandha’s potential to stimulate the immune system might exacerbate symptoms, making its use inadvisable.

Surgery:

Due to its potential to slow down the central nervous system, it is recommended to discontinue ashwagandha use at least two weeks before scheduled surgery. Healthcare providers express concerns that the combined effect of anesthesia and other medications during and after surgery could be intensified by ashwagandha.

Thyroid Disorders:

Ashwagandha has the potential to elevate thyroid hormone levels. Therefore, individuals with thyroid conditions or those taking thyroid hormone medications should exercise caution or avoid ashwagandha use altogether.

Moderate Interaction – Exercise Caution with These Combinations:

Medications that decrease the immune system (Immunosuppressants): Ashwagandha has the potential to enhance immune system activity. When paired with medications, especially those prescribed post-transplant that are designed to suppress the immune system, there is a risk of diminishing the effectiveness of the immunosuppressant drugs.

Sedative medications (Benzodiazepines): Ashwagandha may induce drowsiness and slow breathing. Combining ashwagandha with sedative medications, such as benzodiazepines, can intensify these effects, potentially leading to respiratory issues and excessive drowsiness.

Sedative medications (CNS depressants): Similar to the interaction with benzodiazepines, ashwagandha’s sedative properties may interact adversely with other medications classified as CNS depressants. This combination has the potential to cause breathing difficulties and an excess of drowsiness.

Thyroid hormone: Ashwagandha can stimulate the production of thyroid hormones in the body. When used concurrently with thyroid hormone pills, it may lead to an excessive increase in thyroid hormone levels, amplifying both the intended effects and potential side effects of thyroid hormone therapy.

Medications for diabetes (Antidiabetes drugs): Ashwagandha has the capacity to lower blood sugar levels. Combining ashwagandha with antidiabetes medications raises the risk of hypoglycemia (low blood sugar). Close monitoring of blood sugar levels is recommended when these substances are used in tandem.

Medications for high blood pressure (Antihypertensive drugs): Ashwagandha exhibits blood pressure-lowering properties. When taken alongside antihypertensive medications, there is a potential for blood pressure to drop excessively. Close monitoring of blood pressure is advisable to prevent hypotension.

Dosing

Ashwagandha is commonly utilized by adults in daily doses of up to 1000 mg, typically administered over a period of up to 12 weeks. It is crucial to engage in a consultation with a healthcare provider to determine the most appropriate dosage tailored to specific health conditions. Seeking personalized guidance ensures the optimal and safe use of ashwagandha for individual needs.

References

Ahumada F, Aspee F, Wikman G, and et al. Withania somnifera extract. Its effect on arterial blood pressure in anaesthetized dogs. Phytotherapy Research 1991;5:111-114.

Anbalagan K and Sadique J. Withania somnifera (ashwagandha), a rejuvenating herbal drug which controls alpha-2 macroglobulin synthesis during inflammation. Int.J.Crude Drug Res. 1985;23(4):177-183.

Anbalagan, K. and Sadique, J. Influence of an Indian medicine (Ashwagandha) on acute-phase reactants in inflammation. Indian J Exp Biol. 1981;19(3):245-249. View abstract.

Begum, V. H. and Sadique, J. Long term effect of herbal drug Withania somnifera on adjuvant induced arthritis in rats. Indian J Exp Biol. 1988;26(11):877-882. View abstract.

Bhat, J., Damle, A., Vaishnav, P. P., Albers, R., Joshi, M., and Banerjee, G. In vivo enhancement of natural killer cell activity through tea fortified with Ayurvedic herbs. Phytother.Res 2010;24(1):129-135. View abstract.

Bhattacharya, S. K. and Muruganandam, A. V. Adaptogenic activity of Withania somnifera: an experimental study using a rat model of chronic stress. Pharmacol Biochem.Behav 2003;75(3):547-555. View abstract.

Bhattacharya, S. K., Bhattacharya, A., Sairam, K., and Ghosal, S. Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study. Phytomedicine 2000;7(6):463-469. View abstract.

Choudhary, M. I., Nawaz, S. A., ul-Haq, Z., Lodhi, M. A., Ghayur, M. N., Jalil, S., Riaz, N., Yousuf, S., Malik, A., Gilani, A. H., and ur-Rahman, A. Withanolides, a new class of natural cholinesterase inhibitors with calcium antagonistic properties. Biochem.Biophys.Res Commun. 8-19-2005;334(1):276-287. View abstract.

Davis, L. and Kuttan, G. Effect of Withania somnifera on DMBA induced carcinogenesis. J Ethnopharmacol. 2001;75(2-3):165-168. View abstract.

Deocaris, C. C., Widodo, N., Wadhwa, R., and Kaul, S. C. Merger of ayurveda and tissue culture-based functional genomics: inspirations from systems biology. J.Transl.Med. 2008;6:14. View abstract.

Devi, P. U., Sharada, A. C., and Solomon, F. E. Antitumor and radiosensitizing effects of Withania somnifera (Ashwagandha) on a transplantable mouse tumor, Sarcoma-180. Indian J Exp Biol. 1993;31(7):607-611. View abstract.

Devi, P. U., Sharada, A. C., and Solomon, F. E. In vivo growth inhibitory and radiosensitizing effects of withaferin A on mouse Ehrlich ascites carcinoma. Cancer Lett. 8-16-1995;95(1-2):189-193. View abstract.

Devi, P. U., Sharada, A. C., Solomon, F. E., and Kamath, M. S. In vivo growth inhibitory effect of Withania somnifera (Ashwagandha) on a transplantable mouse tumor, Sarcoma 180. Indian J Exp Biol. 1992;30(3):169-172. View abstract.

Dhuley, J. N. Effect of ashwagandha on lipid peroxidation in stress-induced animals. J Ethnopharmacol. 1998;60(2):173-178. View abstract.

Dhuley, J. N. Therapeutic efficacy of Ashwagandha against experimental aspergillosis in mice. Immunopharmacol.Immunotoxicol. 1998;20(1):191-198. View abstract.

Ghosal S, Lal J, Srivastava R, and et al. Immunomodulatory and CNS effects of sitoindosides 9 and 10, two new glycowithanolides from Withania somnifera. Phytotherapy Research 1989;3(5):201-206.

Gupta, S. K., Dua, A., and Vohra, B. P. Withania somnifera (Ashwagandha) attenuates antioxidant defense in aged spinal cord and inhibits copper induced lipid peroxidation and protein oxidative modifications. Drug Metabol.Drug Interact. 2003;19(3):211-222. View abstract.

Kaur, K., Rani, G., Widodo, N., Nagpal, A., Taira, K., Kaul, S. C., and Wadhwa, R. Evaluation of the anti-proliferative and anti-oxidative activities of leaf extract from in vivo and in vitro raised Ashwagandha. Food Chem.Toxicol. 2004;42(12):2015-2020. View abstract.

Khattak, S., Saeed, Ur Rehman, Shah, H. U., Khan, T., and Ahmad, M. In vitro enzyme inhibition activities of crude ethanolic extracts derived from medicinal plants of Pakistan. Nat.Prod.Res 2005;19(6):567-571. View abstract.

Kulkarni, S. K. and Dhir, A. Withania somnifera: an Indian ginseng. Prog.Neuropsychopharmacol.Biol.Psychiatry 7-1-2008;32(5):1093-1105. View abstract.

Kuppurajan K, Rajagopalan SS, Sitoraman R, and et al. Effect of Ashwagandha (Withania somnifera Dunal) on the process of ageing on human volunteers. Journal of Research in Ayurveda and Siddha 1980;1(2):247-258.

Lu, L., Liu, Y., Zhu, W., Shi, J., Liu, Y., Ling, W., and Kosten, T. R. Traditional medicine in the treatment of drug addiction. Am J Drug Alcohol Abuse 2009;35(1):1-11. View abstract.

Malhotra, C. L., Mehta, V. L., Das, P. K., and Dhalla, N. S. Studies on Withania-ashwagandha, Kaul. V. The effect of total alkaloids (ashwagandholine) on the central nervous system. Indian J Physiol Pharmacol. 1965;9(3):127-136. View abstract.

Malhotra, C. L., Mehta, V. L., Prasad, K., and Das, P. K. Studies on Withania ashwagandha, Kaul. IV. The effect of total alkaloids on the smooth muscles. Indian J Physiol Pharmacol. 1965;9(1):9-15. View abstract.

Malviya, N., Jain, S., Gupta, V. B., and Vyas, S. Recent studies on aphrodisiac herbs for the management of male sexual dysfunction–a review. Acta Pol.Pharm. 2011;68(1):3-8. View abstract.

Mikolai, J., Erlandsen, A., Murison, A., Brown, K. A., Gregory, W. L., Raman-Caplan, P., and Zwickey, H. L. In vivo effects of Ashwagandha (Withania somnifera) extract on the activation of lymphocytes. J.Altern.Complement Med. 2009;15(4):423-430. View abstract.

Praveenkumar, V., Kuttan, R., and Kuttan, G. Chemoprotective action of Rasayanas against cyclosphamide toxicity. Tumori 8-31-1994;80(4):306-308. View abstract.

Sehgal, V. N., Verma, P., and Bhattacharya, S. N. Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. Skinmed. 2012;10(1):48-49. View abstract.

Sharada, A. C., Solomon, F. E., Devi, P. U., Udupa, N., and Srinivasan, K. K. Antitumor and radiosensitizing effects of withaferin A on mouse Ehrlich ascites carcinoma in vivo. Acta Oncol. 1996;35(1):95-100. View abstract.

Singh, R. H., Narsimhamurthy, K., and Singh, G. Neuronutrient impact of Ayurvedic Rasayana therapy in brain aging. Biogerontology. 2008;9(6):369-374. View abstract.

Tohda, C. [Overcoming several neurodegenerative diseases by traditional medicines: the development of therapeutic medicines and unraveling pathophysiological mechanisms]. Yakugaku Zasshi 2008;128(8):1159-1167. View abstract.

Upadhaya L and et al. Role of an indigenous drug Geriforte on blood levels of biogenic amines and its significance in the treatment of anxiety neurosis. Acta Nerv Super 1990;32(1):1-5.

Vaishnavi, K., Saxena, N., Shah, N., Singh, R., Manjunath, K., Uthayakumar, M., Kanaujia, S. P., Kaul, S. C., Sekar, K., and Wadhwa, R. Differential activities of the two closely related withanolides, Withaferin A and Withanone: bioinformatics and experimental evidences. PLoS.One. 2012;7(9):e44419. View abstract.

Ven Murthy, M. R., Ranjekar, P. K., Ramassamy, C., and Deshpande, M. Scientific basis for the use of Indian ayurvedic medicinal plants in the treatment of neurodegenerative disorders: ashwagandha. Cent.Nerv.Syst.Agents Med.Chem. 9-1-2010;10(3):238-246. View abstract.

Venkataraghavan S, Seshadri C, Sundaresan TP, and et al. The comparative effect of milk fortified with Aswagandha, Aswagandha and Punarnava in children – a double-blind study. J Res Ayur Sid 1980;1:370-385.

Agarwal R, Diwanay S, Patki P, Patwardhan B. Studies on immunomodulatory activity of Withania somnifera (Ashwagandha) extracts in experimental immune inflammation. J Ethnopharmacol 1999;67:27-35. View abstract.

Agnihotri AP, Sontakke SD, Thawani VR, Saoji A, Goswami VS. Effects of Withania somnifera in patients of schizophrenia: a randomized, double blind, placebo controlled pilot trial study. Indian J Pharmacol. 2013;45(4):417-8. View abstract.

Ahmad MK, Mahdi AA, Shukla KK, et al. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertil Steril 2010;94:989-96. View abstract.

Ahumada F, Aspee F, Wikman G, Hancke J. Withania somnifera exract. Its effects on arterial blood pressure in anaesthetized dogs. Phytother Res 1991;5:111-14.

Ajgaonkar A, Jain M, Debnath K. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus 2022;14(10):e30787. View abstract.

Akhgarjand C, Asoudeh F, Bagheri A, et al. Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2022. View abstract.

Ambiye VR, Langade D, Dongre S, Aptikar P, Kulkarni M, Dongre A. Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study. Evid Based Complement Alternat Med. 2013;2013:571420. View abstract.

Andallu B, Radhika B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol 2000;38:607-9. View abstract.

Archana R, Namasivayam A. Antistressor effect of Withania somnifera. J Ethnopharmacol 1999;64:91-3. View abstract.

Baker C, Kirby JB, O’Connor J, Lindsay KG, Hutchins A, Harris M. The perceived impact of ashwagandha on stress, sleep quality, energy, and mental clarity for college students: qualitative analysis of a double-blind randomized control trial. J Med Food 2022. View abstract.

Bhattacharya SK, Satyan KS, Ghosal S. Antioxidant activity of glycowithanolides from Withania somnifera. Indian J Exp Biol 1997;35:236-9. View abstract.

Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integr Cancer Ther. 2013;12(4):312-22. View abstract.

Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829. View abstract.

Bonilla DA, Moreno Y, Gho C, Petro JL, Odriozola-Martínez A, Kreider RB. Effects of ashwagandha (Withania somnifera) on physical performance: systematic review and Bayesian meta-analysis. J Funct Morphol Kinesiol. 2021 Feb 11;6(1):20. doi: 10.3390/jfmk6010020. View abstract.

Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255-62. View abstract.

Chauhan S, Srivastava MK, Pathak AK. Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: a randomized controlled trial. Health Sci Rep 2022;5(4):e741. View abstract.

Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLoS One 2021;16(9):e0257843. View abstract.

Chengappa KN, Bowie CR, Schlicht PJ, Fleet D, Brar JS, Jindal R. Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder. J Clin Psychiatry. 2013;74(11):1076-83. View abstract.

Chitre D, Nadkarni S, Jagtap N, et al. Phase III randomized clinical trial of BV-4051, an Ayurvedic polyherbal formulation in moderate SARS-CoV-2 infections and its impact on inflammatory biomarkers. Phytother Res 2022. View abstract.

Choudhary D, Bhattacharyya S, Joshi K. Body weight management in adults under chronic stress through treatment with ashwagandha root extract: a double-blind, randomized, placebo-controlled trial. J Evid Based Complementary Altern Med. 2017 Jan;22(1):96-106 View abstract.

Cooley K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized controlled trial ISRC TN78958974. PLoS One 2009;4:e6628. View abstract.

Dasgupta A, Peterson A, Wells A, Actor JK. Effect of Indian Ayurvedic medicine Ashwagandha on measurement of serum digoxin and 11 commonly monitored drugs using immunoassays: study of protein binding and interaction with Digibind. Arch Pathol Lab Med 2007;131:1298-303. View abstract.

Dasgupta A, Tso G, Wells A. Effect of Asian ginseng, Siberian ginseng, and Indian ayurvedic medicine Ashwagandha on serum digoxin measurement by Digoxin III, a new digoxin immunoassay. J Clin Lab Anal 2008;22:295-301. View abstract.

Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14. View abstract.

Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17. View abstract.

Deshpande A, Irani N, Balkrishnan R, Benny IR. A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults. Sleep Med. 2020;72:28-36. View abstract.

Dongre S, Langade D, Bhattacharyya S. Efficacy and safety of ashwagandha (withania somnifera) root extract in improving sexual function in women: a pilot study. Biomed Res Int 2015;2015:284154.View abstract.

Durg S, Bavage S, Shivaram SB. Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application. Phytother Res. 2020;34(5):1041-1059. View abstract.

Fuladi S, Emami SA, Mohammadpour AH, Karimani A, Manteghi AA, Sahebkar A. Assessment of Withania somnifera root extract efficacy in patients with generalized anxiety disorder: A randomized double-blind placebo-controlled trial. Curr Clin Pharmacol. 2020. View abstract.

Gopal S, Ajgaonkar A, Kanchi P, et al. Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study. J Obstet Gynaecol Res 2021. View abstract.

Gopukumar K, Thanawala S, Somepalli V, Rao TSS, Thamatam VB, Chauhan S. Efficacy and safety of ashwagandha root extract on cognitive functions in healthy, stressed adults: a randomized, double-blind, placebo-controlled study. Evid Based Complement Alternat Med. 2021 Nov 30;2021:8254344. View abstract.

Ireland PJ, Hardy T, Burt AD, Donnelly MC. Drug-induced hepatocellular injury due to herbal supplement ashwagandha. J R Coll Physicians Edinb. 2021;51(4):363-365. View abstract.

Jahanbakhsh SP, Manteghi AA, Emami SA, Mahyari S, et al. Evaluation of the efficacy of withania somnifera (ashwagandha) root extract in patients with obsessive-compulsive disorder: a randomized double-blind placebo-controlled trial. Complement Ther Med 2016 Aug;27:25-9.View abstract.

Kamal HI, Patel K, Brdak A, Heffernan J, Ahmad N. Ashwagandha as a unique cause of thyrotoxicosis presenting with supraventricular tachycardia. Cureus. 2022 Mar 25;14(3):e23494. View abstract.

Katz M, Levine AA, Kol-Degani H, Kav-Venaki L. A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. J Atten Disord 2010;14:281-91. View abstract.

Kelgane SB, Salve J, Sampara P, Debnath K. Efficacy and tolerability of ashwagandha root extract in the elderly for improvement of general well-being and sleep: A prospective, randomized, double-blind, placebo-controlled study. Cureus. 2020;12(2):e7083. View abstract.

Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5. View abstract.

Kumar G, Srivastava A, Sharma SK, Rao TD, Gupta YK. Efficacy and safety evaluation of ayurvedic treatment (ashwagandha powder and sidh makardhwaj) in rheumatoid arthritis patients: a pilot perspective study. Indian J Med Res 2015 Jan;141(1):100-6. View abstract.

Kumar S, Bouic PJ, Rosenkranz B. Investigation of CYP2B6, 3A4 and ß-esterase interactions of Withania somnifera (L.) dunal in human liver microsomes and HepG2 cells. J Ethnopharmacol. 2021;270:113766. View abstract.

Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. View abstract.

Lubarska M, Halasinski P, Hryhorowicz S, et al. Liver Dangers of Herbal Products: A Case Report of Ashwagandha-Induced Liver Injury. Int J Environ Res Public Health 2023;20(5):3921. View abstract.

Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev 2000;5:334-46. View abstract.

Nagashayana N, Sankarankutty P, Nampoothiri MRV, et al. Association of l-DOPA with recovery following Ayurveda medication in Parkinson’s Disease. J Neurol Sci 2000;176:124-7. View abstract.

Narra K, Naik SK, Ghatge AS. A Study of Efficacy and Safety of Ashwagandha (Withania somnifera) Lotion on Facial Skin in Photoaged Healthy Adults. Cureus 2023;15(3):e36168. View abstract.

O’Connor J, Lindsay K, Baker C, Kirby J, Hutchins A, Harris M. The impact of ashwagandha on stress, sleep quality, and food cravings in college students: quantitative analysis of a double-blind randomized control trial. J Med Food 2022. View abstract.

Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol 1998;50:1065-68. View abstract.

Panda S, Kar A. Withania somnifera and Bauhinia purpurea in the regulation of circulating thyroid hormone concentrations in female mice. J Ethnopharmacol 1999;67:233-39. View abstract.

Pérez-Gómez J, Villafaina S, Adsuar JC, Merellano-Navarro E, Collado-Mateo D. Effects of ashwagandha (Withania somnifera) on VO2max: A systematic review and meta-analysis. Nutrients. 2020;12(4):1119. View abstract.

Pusec CM, Wolsky R, Llerena C, Sura P. A Case of Supplement-Induced Hepatitis. Cureus 2022;14(10):e30433. View abstract.

Remenapp A, Coyle K, Orange T, et al. Efficacy of Withania somnifera supplementation on adult’s cognition and mood. J Ayurveda Integr Med. 2021 Nov 25;13(2):100510. View abstract.

Salve J, Pate S, Debnath K, Langade D. Adaptogenic and anxiolytic effects of ashwagandha root extract in healthy adults: A double-blind, randomized, placebo-controlled clinical study. Cureus. 2019;11(12):e6466. View abstract.

Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022;23(6):424-455. View abstract.

Sharma AK, Basu I, Singh S. Efficacy and safety of Ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial. J Altern Complement Med. 2018 Mar;24(3):243-248. View abstract.

Singh P, Salman KA, Shameem M, Warsi MS. Withania somnifera (L.) Dunal as add-on therapy for COPD patients: a randomized, placebo-controlled, double-blind study. Front Pharmacol 2022;13:901710. View abstract.

Sriranjini SJ, Pal PK, Devidas KV, Ganpathy S. Improvement of balance in progressive degenerative cerebellar ataxias after Ayurvedic therapy: a preliminary report. Neurol India 2009;57:166-71. View abstract.

Sud Khyati S, Thaker B. A randomized double blind placebo controlled study of ashwagandha on generalized anxiety disorder. Int Ayurvedic Med J 2013;1(5):1-7.

Suryawanshi G, Abdallah M, Thomson M, Desai N, Chauhan A, Lim N. Ashwagandha-Associated Acute Liver Failure Requiring Liver Transplantation. Am J Ther 2023;30(1):e80-e83. View abstract.

Tharakan A, Shukla H, Benny IR, Tharakan M, George L, Koshy S. Immunomodulatory Effect of Withania somnifera (Ashwagandha) Extract-A Randomized, Double-Blind, Placebo Controlled Trial with an Open Label Extension on Healthy Participants. J Clin Med 2021;10(16):3644. View abstract.

Tóth M, Benedek AE, Longerich T, Seitz HK. Ashwagandha-induced acute liver injury: A case report. Clin Case Rep 2023;11(3):e7078. View abstract.

Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.