Ashwagandha is a true healer of a plant and has been used in Ayurveda or traditional Indian medicine for at least 3000 years (Castleman, 2001). In the Charaka Samhita it is recommended as a whole-body tonic, particularly for emancipation, reproductive ability, and longevity. Although, we might find this concept hard to believe from our Western conditioned mindset, I am increasingly coming around to the notion of whole body tonic herbs, not the least from my own experiences with ashwagandha.
In Ayurveda, it is classified as a ‘rasayana’ herb or rejuvenator herb otherwise known as adaptogenic herbs in Western science or Qi tonic in traditional Chinese medicine. While Qi tonics may all be quite different in a way, they have the joint property of activating or stimulating the nervous system while still relaxing. It is thought this is because their modulation of the human stress response system, somehow gently priming it to balance stress hormones such as cortisol, relax, and energise (Reviewed by Panossian, 2017). But don’t worry I believe ashwagandhas medicinal properties extend far beyond one pathway and molecular target and there is now increasing evidence to support its broad medicinal properties in humans. We can see just from these human studies it has likely anti-inflammatory properties (as can help osteoarthritis), anxiolytic properties (helps anxiety), stamina boosting properties (helps fatigue), and modulates hormones of the body (relieves mild thyroid failure).
Anxiety: One study (n = 64, double blind placebo controlled) found that with treatment of 300 mg high-concentration full-spectrum extract of ashwagandha root twice daily reduced stress significantly versus a placebo (Chandrasekhar et al., 2012). Adverse events were mild in nature and similar between both placebo and treatment groups.
Osteoarthritis: One study (n=60, double blind placebo controlled) on patients with osteoarthritis knee pain found that either 250mg or 125mg of ashwagandha per day over 12 weeks found a significant reduction in pain in either group, with the 250mg treatment resulting in a stronger effect and earlier (4 weeks) (Ramakanth et al., 2016).
Mild thyroid failure: One study (n=50, double blind placebo controlled) found patients who took 600mg ashwagandha daily for mild thyroid failure (subclinical hypothyroidism) significantly normalised their thyroid indices (Sharma et al., 2017).
Fatigue: A study (n = 100, open label, placebo controlled) observed significant improvements in fatigue and quality of life in breast cancer patients taking ashwagandha (Biswal et al., 2013). A higher quality study is required.
Why ashwagandha is particularly special among the adaptogens, in my view, is because it is so gentle and relaxing for the whole nervous system. Dosage may be adjusted to the level even in sensitive persons such as myself it actually helps sleep, by calming the nerves, but also provides that gentle calm energy that I think is conductive to the healing process. Whilst is a strong anti-convulsant similar to lyrica, I have found withdrawal from ashwagandha does not cause a withdrawal like lyrica does. I also believe it has been beneficial for my nerve pain and may have a restorative role for (certain kinds of) neuropathic pain in the long term. Ashwagandha is also nicknamed Indian ginseng because its effects are similar to the revered Asian herb, Asian ginseng, as they are so diverse, but I’d chose it over Asian ginseng because I am sensitive to insomnia and ashwagandha is one of the only adaptogens I can safely take.
Energetics: Ashwagandha is warming and slightly dry, although I have not experienced any dryness personally. It is more suited for vata types (cold and dry people), but can be used in others as well. Ashwagandha balances vata and kapha; in excess, and because of its heating, building nature, it can imbalance pitta. Therefore, if you are quite a hot constitution, best not to take too much ashwagandha.
Form: Although I am fan of the traditional tincture approach, in this case I have found the KSM-66 extract useful. The creators have been quite careful to preserve the ratio of the withanolides so they are at the same naturally occurring ratio.
Dose: Between 1-4 300mg KSM-66 capsules may be used per day. For a tincture, a rough dose is 10-30 drops thrice daily.
Contraindications: I wouldn’t use ashwagandha if you have hyperthyroidism as it stimulates the thyroid. It also should be used with caution if combining with sedative medication as may interact unfavourably or enhance effects of these. Ashwgandha like any herb should be treated with respect.
Combines well with: Fresh skullcap and milky oat seed tinctures taken 2-3 times daily (15 drops each roughly) for a worn out depleted nervous system with insomnia, fatigue, and or neuropathic pain. With St. John’s wort for nerve pain.
Biswal, Biswa Mohan, et al. “Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients.” Integrative cancer therapies 12.4 (2013): 312-322.
Castleman, Michael. “The new healing herbs.” Bantam Book, New York (2001): 465-471.
Chandrasekhar, K., Jyoti Kapoor, and Sridhar Anishetty. “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 Journal of Psychological Medicine 34.3 (2012): 255.
Gardner, Tanya, and A. H. P. Level. “The Characteristics, Benefits and Application of Ashwagandha in the West.” Image 2 (2015): 2.
Panossian, Alexander. “Understanding adaptogenic activity: specificity of the pharmacological action of adaptogens and other phytochemicals.” Annals of the New York Academy of Sciences (2017).
Ramakanth, G. S. H., et al. “A randomized, double blind placebo controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint pain.” Journal of Ayurveda and integrative medicine 7.3 (2016): 151-157.
Sharma, Ashok Kumar, Indraneel Basu, and Siddarth Singh. “Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial.” The Journal of Alternative and Complementary Medicine (2017).