Ashwagandha is one of the most well known and universally praised plant medicines 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.
In Ayurveda, it is classified as a rasayana or rejuvenator herb otherwise known as adaptogen 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). These tonics can help reduce fatigue and contribute to overall well being. 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 extract of ashwagandha root twice daily reduced stress significantly versus a placebo (Chandrasekhar et al., 2012). Adverse events were mild and similar to the placebo.
Osteoarthritis: A 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 (Ramakanth et al., 2016).
Mild thyroid failure: Another 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: One study (n = 100, open label, placebo controlled) observed significant improvements in fatigue in breast cancer patients taking ashwagandha (Biswal et al., 2013).
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 it is a fairly strong anti-convulsant and anxiolytic similar to lyrica, I have found withdrawal from ashwagandha does not cause a withdrawal like lyrica does. Quite why we continue to take mainstream anti-anxiety medications on mass, well, I will leave you to figure that out.
Ashwagandha is quite suited to treating vata aggravations (often nervous system imbalances), while having an anti-inflammatory nature suited to treating certain autoimmune conditions. This includes a variety of types of chronic pain conditions especially muscleoskeletal or neurological diseases. Expect to see an increasing level of scientific support for ashwagandha in coming years, but the truth is: ashwagandha is a powerful and gentle healing herb for a range of conditions.
Actions: Rasayana, adaptogen, nervine tonic, nootropic, immune tonic, antirheumatic, aphrodisiac
Specific indications include: Joint or muscle pains and aches, fatigue, red hot inflamed joints or skin, anxiety, cognitive problems, low sex drive
Example diseases: Osteoarthritis, ADD/ADHD, Alzheimer’s, dementia, rheumatoid arthritis, fibromyalgia, stress linked hypertension
Energetics: Ashwagandha is warming and slightly dry. Ashwagandha balances vata and kapha, in excess, because of its heating nature it can imbalance pitta. It is also important to watch out for excess dryness if taking ashwagandha.
Form: I prefer KSM-66 overall. KSM-66 is more energising, the traditional root powder is better for sleep.
Dose: Between 1-4 300mg capsules of KSM66 may be used per day. For a tincture, an approximate dose is 10-60 drops, 2-3 times daily.
Contraindications: It is best to avoid 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. It may cause GI distress on occasion.
Combines well with: Fresh skullcap tincture for a worn out depleted nervous system with insomnia, fatigue, and anxiety. With a fresh St. John’s wort tincture for nerve pain. Alongside gotu kola and calamus root to treat nerve damage. With gotu kola and sarsaparilla for treating inflammatory arthritis.
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).