Ashwagandha (root extract)
A standardized root extract of Withania somnifera, an Ayurvedic herb studied mainly for stress, anxiety and sleep.
Anxiety Sleep Focus Energy
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Research
REALITY CHECK // Two meta-analyses of RCTs find lower stress and anxiety scores after about 8 weeks in stressed adults, but certainty is low, results vary widely and most trials are small and funded by extract makers.
Levels: how we grade evidence. Grey = evidence of no benefit; amber = evidence it makes this goal worse.
Ratings are self-reported by a self-selected group of users: how it felt, not proof that it works.
>_ Protocol data coming soon: label checker ("Check your bottle"), study snapshot and form comparison for Ashwagandha (root extract).
How it was studied
Summary
Two meta-analyses of RCTs find lower stress and anxiety scores after about 8 weeks in stressed adults, but certainty is low, results vary widely and most trials are small and funded by extract makers. Sleep gains are small, clearer in insomnia. Evidence covers several root extracts, not one brand. Liver injury is rare but documented. Focus data come from one small trial in adults with mild cognitive impairment.
Mechanism
Proposed: withanolides dampen the stress-hormone (HPA) axis; one RCT measured lower serum cortisol. Trials also show rises in thyroid hormones. Exact active compounds and pathways in humans are not established.
Typical studied dose
Trials mostly used 300-600 mg/day of standardized root extract for 8-12 weeks (e.g. 300 mg twice daily; 200 mg twice daily of another root extract). Sleep effects were larger at 600 mg/day or more and 8 weeks or longer. These are study ranges, not a recommended dose for everyone.
Upper limit
No official tolerable upper intake level exists (it is a botanical, not a nutrient). Long-term safety data beyond about 12 weeks are limited. Doses above 600 mg/day of extract have not shown clearer benefit in trials.
Popular stacks with Ashwagandha (root extract)
Not enough stack data yet. A combination with Ashwagandha (root extract) appears here once 5 people rate the same set.
Red flags: interactions and who should avoid it
Interactions
Thyroid medication (levothyroxine): ashwagandha raised T3/T4 and lowered TSH in an RCT, and thyrotoxicosis has been reported, so combined use needs monitoring. Sedatives, sleep aids and psychiatric drugs: possible additive sedation; this is a theoretical concern without trial data. Immunosuppressants: theoretical opposing effect (no human data). Combining several herbal extracts makes it harder to tell which one caused a liver reaction.
Avoid or ask a doctor first if
Pregnancy or breastfeeding (no safety data in humans). Existing liver disease: in an Indian case series of 8 patients, 3 of the 5 with pre-existing liver disease developed acute-on-chronic liver failure and all 3 died. Hyperthyroidism, or thyroid hormone treatment without medical supervision. Autoimmune disease or immunosuppressive therapy (precaution; no human data). Stop and see a doctor if jaundice, itching, dark urine or pale stools appear. Hormone-sensitive conditions (e.g. prostate cancer): one RCT found raised testosterone in men; ask your doctor.
Sources (PubMed)
- Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials.
PMID 36017529 · 2022 · Meta-analysis of RCTs12 RCTs: lower anxiety and stress vs placebo; low certainty, high heterogeneity.
- Effects of Ashwagandha (Withania Somnifera) on stress and anxiety: A systematic review and meta-analysis.
PMID 39348746 · 2024 · Meta-analysis of RCTs9 RCTs: reduced perceived stress, Hamilton anxiety score and cortisol.
- 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.
PMID 23439798 · 2012 · RCT (n=64)300 mg twice daily root extract lowered stress scores and serum cortisol.
- Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis.
PMID 34559859 · 2021 · Meta-analysis of RCTs5 RCTs: small sleep benefit, larger in insomnia, ≥600 mg/day, ≥8 weeks.
- Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions.
PMID 28471731 · 2017 · Pilot RCT (n=50)Memory and attention improved in adults with mild cognitive impairment.
- Exploring the efficacy and safety of a novel standardized ashwagandha root extract (Witholytin®) in adults experiencing high stress and fatigue in a randomized, double-blind, placebo-controlled trial.
PMID 37740662 · 2023 · RCTFatigue fell vs placebo; primary stress outcome no different from placebo.
- Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial.
PMID 28829155 · 2017 · Pilot RCT (n=50)600 mg/day raised T3 and T4 and lowered TSH vs placebo.
- Ashwagandha as a Unique Cause of Thyrotoxicosis Presenting With Supraventricular Tachycardia.
PMID 35475098 · 2022 · Case reportThyrotoxicosis after self-treating hypothyroidism with ashwagandha; resolved on stopping.
- Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network.
PMID 31991029 · 2020 · Case series (n=5)Cholestatic liver injury with jaundice 2-12 weeks after starting; self-limited.
- Ashwagandha-induced liver injury-A case series from India and literature review.
PMID 37756041 · 2023 · Case series (n=8) + reviewPre-existing liver disease: three acute-on-chronic liver failures, all fatal.
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