Ashwagandha — Indian root that puts out stress, or trendy placebo?

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 of the included studies revealed that Ashwagandha supplementation was more efficacious than placebo for improving variables 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 analyzed outcomes, considering 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 derive a more stable estimate of the true underlying effect.

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

Results: Thirteen trials involving 599 participants contributed 79 effect sizes. Samples were mainly young adults or athletes; reported ages included one trial with participants aged 18–40 and one late-adolescent athlete cohort aged 17.4 ± 1.7 years. Trial-level sex composition was four male-only, one female-only, three mixed-sex, and five incompletely reported cohorts. Ashwagandha improved overall exercise performance on average (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), whereas strength effects were positive but uncertain and evidence for power or muscular endurance remained sparse. Dose analyses were hypothesis-generating; 500–600 mg/day was the extract-dose range with the strongest evidence.

Aim of the study: Chronic stress is detrimental to the functioning of the main response system—the hypothalamic-pituitary-adrenal (HPA) axis. The current study aimed to investigate the effectiveness of two plant-based adaptogens, a formula containing Rhodiola, holy basil, and Schisandra chinensis (VL-G-A57) and a full-spectrum ashwagandha (VL-G-E12), on stress and related symptoms in individuals with high stress.

Results: At day 60, both VL-G-A57 and VL-G-E12 significantly reduced Perceived Stress Scale (PSS) scores compared to placebo (p < 0.0001). Sleep quality, as 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 corresponded well with the Restorative Sleep Questionnaire-Weekly (RSQ-W) results in the two IP arms when compared with placebo (p < 0.0001). Additionally, 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) showed significant improvements compared to 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 behavioural 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 (300mg 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 to 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 set analysis was directionally consistent but 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 concentrations remained relatively stable in the ashwagandha group but increased in the placebo group, suggesting attenuation of cortisol reactivity (p = 0.047). However, no statistically significant between-group differences were detected for other secondary and physiological outcomes. An ashwagandha extract (Ashwa.30™) administered at 30 mg daily was associated with reduced self-reported stress in the Full Analysis Set and attenuation of SECPT-related salivary cortisol reactivity.

Aim of the study: Stress and anxiety are prevalent mental health conditions that often coexist with cardiovascular comorbidities, resulting in a complex interplay between psychological and physiological processes, partly mediated through activation of the hypothalamic-pituitary-adrenal (HPA) axis. Ashwagen®, a standardized extract of Withania somnifera (Ashwagandha), has demonstrated adaptogenic and anxiolytic 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 declined 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 adjunctive integrative intervention for stress and anxiety management 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 prevalent in recent years and affects mental and physical health. The study evaluated the effects of ashwagandha on stress, fatigue, and sex hormones in overweight or mildly obese men and women with self-reported stress and fatigue.

Results: Supplementation with ashwagandha was associated with a significant reduction in stress levels based on the Perceived Stress Scale (primary outcome); however, the improvements were not significantly different from those in the placebo group (p = 0.867). Based on the Chalder Fatigue Scale, there was a statistically significant reduction in fatigue symptoms in the ashwagandha group compared to the placebo group (p = 0.016), and participants taking ashwagandha also experienced a significant increase in heart rate variability (p = 0.003). However, there were no significant between-group differences in other self-report outcome measures. In men taking ashwagandha, blood concentrations of free testosterone (p = 0.048) and luteinizing hormone (p = 0.002) increased significantly 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, a statistically significant improvement in VO2 max was observed in the Ashwagandha group compared to the placebo group (P = 0.0074). The subjects in the Ashwagandha group also showed a statistically significant increase at the end of the study compared with baseline (P < 0.0001). TQR scores improved significantly in the Ashwagandha group compared to the placebo group (P < 0.0001). DALDA questionnaire results in the Ashwagandha group were statistically significant (P < 0.0001) compared to the placebo group. RESTQ assessment also showed better outcomes, especially for fatigue recovery (P < 0.0001), lack of energy (P < 0.0001), and fitness analysis (P < 0.0001). The increase in antioxidant levels was significant (P < 0.0001) in the Ashwagandha group.

Aim of the study: Ashwagandha (Withania somnifera) is a well-known adaptogen with established traditional roles in stress modulation 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. Hematological, hepatic, renal, metabolic, and vital sign parameters remained within normal clinical ranges following intake of LDA. LDA supplementation for 8 weeks significantly enhanced cardiorespiratory fitness, delayed fatigue onset, and was safe for use in healthy adults. These findings support its potential as a safe and effective low-dose aid for endurance enhancement and overall exercise performance.

Aim of the study: Objectives: This study investigates the effects of 600 mg/day Ashwagandha root extract on physiological stress biomarkers, perception of recovery, muscle strength, and aerobic capacity in team sports 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 biomarkers, improve perceived recovery, and enhance muscle strength in team sports athletes during pre-season training. The trial is registered on ClinicalTrials.gov with the ID NCT07041853.