Dear Doctors: I have noticed recent advertisements for ashwagandha, which is supposed to be useful for stress management. I am looking for guidance on this supplement, including whether it works and if there are any side effects. Are there dosage guidelines?
Dear Reader: Ashwagandha is certainly having its moment. It is an evergreen shrub that grows in certain regions of India, Africa and the Middle East, and it has chemical properties that are believed to help manage stress. In recent years, mentions of ashwagandha have exploded on social media. And small wonder. National surveys indicate that half to three-fourths of people living in the United States report suffering from chronic stress and anxiety.
The use of ashwagandha as a nerve tonic springs from Ayurveda, a form of traditional Indian medicine that dates back 3,000 years. Due to the complex chemical properties of its leaves and roots, the herb is considered to be an adaptogen. This term was coined in 1947 by a Russian scientist, who defined it as a natural substance that helps the body manage adverse conditions related to stress.
Ashwagandha is said to relieve anxiety, lower blood pressure, ease fatigue, aid in sleep and bolster immune health. However, at this time, most of the information about the herb's efficacy is anecdotal. A handful of recent studies have shown promising results regarding its potential as a stress reliever, but these have been quite small. Larger, longer and more rigorous studies are needed to draw firm conclusions.
Some people who use ashwagandha report side effects such as stomach upset, loose bowel movements or diarrhea and nausea. For the most part, though, it is considered to be safe for regular use over the course of three months. Information on prolonged use is not available.
Certain groups, including people with thyroid conditions, autoimmune disorders, hormone-sensitive prostate cancers and pregnant women should avoid the herb.
Regarding your question about dosage, it's tricky. Ashwagandha is widely available as capsules, tablets, teas and infusions. These are made from the leaves, the roots or both. However, the shrub is chemically quite complex, and the leaves and roots contain different compounds. Add in the lack of oversight in the nutritional supplement market in the U.S., and it is difficult to know what, exactly, each ashwagandha product contains. As always when using any dietary supplements, talk to your health care provider. If you take medication, ask if adverse interactions are a danger.
As the billion-dollar global anti-stress industry proves, there are no quick fixes. In working with our own patients who suffer from stress and anxiety, we counsel cultivating internal strength and resolve. That means adopting the habits and behaviors we have written about in these columns over the years. That includes regular exercise, good nutrition, adequate sleep, robust social connections and calming practices such as yoga or meditation.
Ashwagandha can certainly have a place in your life. However, it will be most useful as part of a larger program that you sustain from day to day, month to month and year to year.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
