Abstract Summary
Objective
To summarize the effects, timeline, and safety profile of ashwagandha (Withania somnifera) supplementation based on clinical evidence.
Context
Ashwagandha, a traditional Ayurvedic adaptogen, has gained popularity in Western wellness culture for stress reduction, sleep support, and hormonal balance, prompting closer examination of what users can realistically expect.
Methods Used
Approach
A review of randomized controlled trials, systematic reviews, and meta-analyses was conducted, focusing on stress, cortisol, sleep, and adverse effect outcomes.
Data Collection
Sources included NIH Office of Dietary Supplements and NCCIH fact sheets, peer-reviewed meta-analyses, and case reports on liver safety, drawn from PubMed and related databases.
Researchers' Summary of Findings
Impact on Health
Clinical trials consistently show that ashwagandha significantly reduces cortisol, perceived stress, and anxiety compared with placebo, with noticeable effects typically emerging within 6 to 8 weeks at daily doses of 300 to 600 mg, and some users reporting mild improvements in sleep or mood as early as two weeks.
Health Implications
Ashwagandha is generally well tolerated for up to three months, with mild gastrointestinal upset and drowsiness being the most common side effects, though rare cases of serious liver injury have been documented, and it should be avoided or used only under medical supervision during pregnancy, breastfeeding, before surgery, or alongside thyroid, diabetes, blood pressure, or sedative medications.
Sustainability
As a drought-tolerant, low-input crop, ashwagandha is considered relatively sustainable to cultivate compared to many other medicinal plants.
DOI
10.1192/bjo.2025.10136
