Ashwagandha, or winter cherry — a natural adaptogen for stress and fatigue?

Aim of the study: Ashwagandha (Withania somnifera) is considered a potent adaptogen and anti-stress agent that could have some potential to improve physical performance.

Results: All Bayesian hierarchical models converged to a target distribution (Ȓ = 1) for both meta-analytic effect size (μ) and between-study standard deviation (τ). The meta-analytic approaches used in the included studies found that Ashwagandha supplementation was more effective than placebo for improving measures related to physical performance in healthy men and women. In fact, the Bayesian models showed that future interventions might be at least somewhat beneficial for the outcomes analyzed, based on the 95% credible intervals for the meta-analytic effect size. Several practical applications and future directions are discussed, although more comparable studies in exercise training and athletic populations are needed to produce a more stable estimate of the true underlying effect.

Aim of the study: Evidence for herbal ergogenic aids remains uncertain, and ashwagandha trials cover a range of different performance areas. This review evaluated oral Withania somnifera supplementation for exercise performance and explored factors related to participants, outcomes, formulations, and supplementation.

Results: Thirteen trials involving 599 participants contributed 79 effect sizes. Participants were mainly young adults or athletes; reported ages included one trial with participants aged 18–40 and one group of late-adolescent athletes aged 17.4 ± 1.7 years. At the trial level, four groups included only men, one only women, three included both sexes, and five did not report this information fully. On average, ashwagandha improved overall exercise performance (Hedges' g = 0.47, 95% CI [0.25, 0.69], p < 0.001; I2 = 60%; 95% prediction interval [-0.40, 1.33]), but the prediction interval crossed zero. Exercise type was the clearest moderator (P_between = 0.006): evidence was most consistent for aerobic endurance (g = 0.54, 95% CI [0.22, 0.85], p = 0.002), while effects on strength were positive but uncertain, and evidence for power or muscular endurance remained limited. Dose analyses were hypothesis-generating; 500–600 mg/day was the extract-dose range best supported by the evidence.

Aim of the study: Chronic stress is harmful to the functioning of the body's main response system—the hypothalamic-pituitary-adrenal (HPA) axis. This study aimed to investigate the effects of two plant-based adaptogens on stress and related symptoms in people experiencing high stress: a formula containing Rhodiola, holy basil, and Schisandra chinensis (VL-G-A57), and a full-spectrum ashwagandha (VL-G-E12).

Results: On day 60, both VL-G-A57 and VL-G-E12 significantly reduced Perceived Stress Scale (PSS) scores compared with placebo (p < 0.0001). Sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), improved significantly in both adaptogen groups (VL-G-A57: p = 0.0008, VL-G-E12: p < 0.0001). This was consistent with the Restorative Sleep Questionnaire-Weekly (RSQ-W) results in both IP groups compared with placebo (p < 0.0001). Mood dysregulation (VL-G-A57: p = 0.0454), anxiety (VL-G-A57: p = 0.0004, VL-G-E12: p = 0.0015), and stress levels (VL-G-A57-VL-G-E12: p < 0.0001) also improved significantly compared with placebo. No differences in mental alertness were observed. The study concluded that both VL-G-A57 and VL-G-E12 were associated with reductions in stress, fatigue, and anxiety, while improving mood and sleep quality.

Aim of the study: Stress and anxiety are interconnected, sharing both behavioral and neural foundations. Ashwagandha (Withania somnifera) helps reduce stress and anxiety.

Results: Between-group comparisons were analyzed using one-way ANOVA with Tukey's post-hoc test, and within-group changes were assessed using paired t-tests. At 8 weeks, all groups showed a significant reduction in serum cortisol and improvements in PSS (P < 0.0001), HAM-A (P = 0.001), and POMS domain scores (tension, depression, and anger, P < 0.0001). In addition, APB showed significant differences compared with ARE and PL for PSS, HAM-A total score, OHQ, and POMS (P < 0.05). The proprietary herbal extract of ashwagandha root (300 mg twice daily) is considered an effective and safe intervention for reducing stress and anxiety.

Aim of the study: Ashwagandha supplementation has been associated with reduced self-reported stress and anxiety, although most trials have used doses of 250–600 mg daily for 6–8 weeks. This study examined the effects of a low-dose ashwagandha extract (Ashwa.30™) on perceived stress, mood, fatigue, and stress reactivity in stressed adults.

Results: Compared with placebo, ashwagandha intake was associated with greater reductions in self-reported stress in the full analysis set (primary analysis; p = 0.046). The per-protocol analysis showed a similar trend but was not statistically significant. Mean daily stress ratings were also lower in the ashwagandha group (p = 0.043). During the Day 28 SECPT, the ashwagandha group reported lower stress ratings (p = 0.044), and salivary cortisol levels remained relatively stable in the ashwagandha group but rose in the placebo group, suggesting a reduction in cortisol reactivity (p = 0.047). However, no statistically significant differences between groups were found for other secondary and physiological outcomes. Taking 30 mg daily of an ashwagandha extract (Ashwa.30™) was associated with reduced self-reported stress in the Full Analysis Set and reduced SECPT-related salivary cortisol reactivity.

Aim of the study: Stress and anxiety are common mental health conditions that often coexist with cardiovascular conditions, resulting in a complex interaction between psychological and physiological processes, partly mediated by activation of the hypothalamic-pituitary-adrenal (HPA) axis. Ashwagen®, a standardized extract of Withania somnifera (Ashwagandha), has shown adaptogenic and anxiety-reducing properties in preclinical and clinical studies.

Results: HAM-A, GAD-7, and PSS scores decreased by 26.94%, 50.77%, and 30.47%, respectively, in the Ashwagen® group. Cortisol levels fell by 28.99% and triglycerides by 13.00%, with favorable trends in LDL and blood pressure. No serious adverse events were reported. Ashwagen® was found to be a safe and effective complementary intervention for managing stress and anxiety in patients with pre-existing hypertension.

Aim of the study: Stress is a state in which the body's homeostasis is challenged, resulting in a systemic response. It has become more common in recent years and affects mental and physical health. This study evaluated the effects of ashwagandha on stress, fatigue, and sex hormones in overweight or mildly obese men and women who reported stress and fatigue.

Results: Ashwagandha supplementation was associated with a significant reduction in stress levels according to the Perceived Stress Scale (the primary outcome); however, the improvement was not significantly different from that in the placebo group (p = 0.867). According to the Chalder Fatigue Scale, fatigue symptoms decreased significantly more in the ashwagandha group than in the placebo group (p = 0.016), and participants taking ashwagandha also had a significant increase in heart rate variability (p = 0.003). However, there were no significant between-group differences in other self-reported outcomes. Men taking ashwagandha had a significant increase in blood levels of free testosterone (p = 0.048) and luteinizing hormone (p = 0.002) compared with the placebo group.

Aim of the study: This study aimed to evaluate the efficacy and safety of Ashwagandha root extract in enhancing cardiorespiratory endurance in healthy athletic adults.

Results: At the end of the study, the Ashwagandha group showed a statistically significant improvement in VO2 max compared with the placebo group (P = 0.0074). Participants in the Ashwagandha group also showed a statistically significant increase from baseline by the end of the study (P < 0.0001). TQR scores improved significantly in the Ashwagandha group compared with the placebo group (P < 0.0001). DALDA questionnaire results in the Ashwagandha group were statistically significant compared with the placebo group (P < 0.0001). RESTQ assessments also showed better results, especially for fatigue recovery (P < 0.0001), lack of energy (P < 0.0001), and fitness (P < 0.0001). Antioxidant levels increased significantly in the Ashwagandha group (P < 0.0001).

Aim of the study: Ashwagandha (Withania somnifera) is a well-known adaptogen traditionally recognized for its role in stress regulation and improving physical performance. Low-dose Ashwagandha (LDA/Ashwa.30) is a bioactive-optimized root-only extract standardized to withanolides (> 15% w/w) and an ATP-active fraction (> 15% w/w).

Results: LDA was well tolerated, with no treatment-related adverse events. Blood, liver, kidney, metabolic, and vital-sign measures remained within normal clinical ranges after LDA was taken. Eight weeks of LDA supplementation significantly improved cardiorespiratory fitness, delayed the onset of fatigue, and was safe for healthy adults to use. These findings support its potential as a safe and effective low-dose aid for improving endurance and overall exercise performance.

Aim of the study: Objectives: This study investigates the effects of 600 mg/day of Ashwagandha root extract on physiological stress markers, perceived recovery, muscle strength, and aerobic capacity in team-sport athletes during pre-season training, a period associated with elevated cortisol and accumulated training stress.

Results: In males, salivary cortisone increased significantly in PLA (p = 0.022), while Countermovement Jump (CMJ) improved significantly in ASH (p = 0.018). Pull-up performance increased in both PLA (p = 0.004) and ASH (p < 0.0001) in males. Conclusions: Supplementation with 600 mg/day of Ashwagandha root extract for 42 days may stabilize stress markers, improve perceived recovery, and increase muscle strength in team-sport athletes during pre-season training. The trial is registered on ClinicalTrials.gov with the ID NCT07041853.