Stress is pervasive in our lives, affecting almost everyone to some extent. Stress can be mental or emotional, such as from work, financial and relationship challenges, or physical, such as from illness or excessive exercise. The negative consequences of stress include insomnia, irritability, anxiety and low mood, as well as strain on the adrenals, fatigue and decreased resistance to infection. Ashwagandha is a valuable natural aid to support our minds and bodies during times of stress. In this article we shed light on what ashwagandha is, who might benefit from it and how to take it.

Derived from the Withania somnifera root, the ‘King of Herbs’ has been used for ~4000 years in ayurvedic medicine. Ashwagandha means ‘smell of the horse’ and is said to impart the ‘strength of a stallion’ to its users! It is regarded as an adaptogen, that is, a natural substance that helps the body adapt to stress and maintain homeostatic balance. The simplest supplement form consists of simply the dried, powdered root, but superior extracts are standardised to the percentage of withanolides, the main active substance. During its long historical use, root-only extracts have shown excellent safety and tolerability. 

Stress triggers multiple responses in the body. The amygdala (within the brain) acts as a processing centre for threatening stimuli, activating the hypothalamus, which influences both the hormonal and autonomic nervous systems. During acute stress, the sympathetic ‘fight or flight’ nervous system is turned on and adrenal glands produce adrenaline, leading to rapid pulse and breathing. Noradrenaline is released in the brain, which causes arousal and aggression.

To recover from acute stress, the adrenal glands increase production of cortisol (which also decreases production of thyroid and sex hormones). Prolonged period of stress with raised cortisol can lead to increased appetite and weight gain, osteoporosis, digestive disturbance, hormone imbalance and raised risk of heart disease and diabetes. When the adrenals become exhausted and no longer able to meet the body’s demand for cortisol, so-called ‘adrenal fatigue’ occurs.

In the brain, stress elicits beta brainwaves, and adrenaline and cortisol cause neurons in the brain to become excitable. Brain chemicals (neurotransmitters) are used up more quickly. Low serotonin causes low mood, anxiety, insomnia and irritability, while low dopamine results in lack of motivation and enjoyment, and lethargy.

Brain chemical imbalance produces feelings of anxiety when glutamate, an excitatory neurotransmitter dominates GABA, a calming neurotransmitter which is decreased during stress.

By dampening down the body’s reaction to stressors, ashwagandha decreases the demand placed on the adrenals, reducing excessive amounts of adrenaline and cortisol production. (1-5) This also improves production of thyroid and sex hormones.

In the brain, ashwagandha enhances soothing GABA activity by increasing GABA levels and receptor-binding. Ashwagandha increases levels of serotonin and dopamine and improves serotonin metabolism. (6)

Calming alpha brain waves are promoted and the autonomic nervous system shifts from ‘fight or flight’ sympathetic towards ‘rest and repair’ parasympathetic influence.

Ashwagandha has strong research evidence showing benefit in anxiety, especially when caused by stress. (4) 300 mg KSM-66 Ashwaganda taken twice daily for 8 weeks lowered stress and anxiety by over 60% compared to placebo. Serum cortisol levels also decreased substantially. (1)

In chronically stressed people, ashwagandha may relieve symptoms of depression by ~78% (1) alongside improvements in other symptoms of stress.

Ashwagandha improves sleep by increasing GABA activity. Taking 300mg KSM-66 ashwagandha twice daily for 10 weeks resulted in a significantly shorter time to fall asleep, improved sleep quality and reduced nervousness. (7)

Ashwagandha shows promise in many other emerging areas of research, such as thyroid function (8;9), male infertility (10), cardiorespiratory endurance (11), muscle strength & recovery (12), and memory & cognition. (13)

Due to ashwagandha’s short half-life (in common with many herbs), dividing the daily dose into two rather than taking it all at once, will ensure better all-day levels. Ashwagandha may be both stimulating and relaxing, so depending on individual effects, the second daily dose can be taken either with lunch or dinner. The usual dose is 300mg twice daily. The full benefits of ashwagandha may be felt after 2 weeks to 2 months, and consistent daily intake during this period is recommended.  

Ashwagandha is not advised during pregnancy and breastfeeding, or for children, due to lack of studies in these populations. It can usually be taken with other supplements and medication, but if you are on prescription medication, please check with your GP. 

KSM-66 is the world’s most popular ashwagandha, and also the most researched, with the largest number of published clinical trials. Standardised to 5% withanolides, it is the highest concentration root-only extract, and is very safe compared to leaf products. KSM-66 only manufactures ashwagandha, and is unique in that it oversees the entire production process - from having its own organic-certified farms and manufacturing facilities, to testing and research labs, in India . Each batch is tested for purity and potency. The entire production process is free of synthetic solvents and alcohol. KSM-66 invests significantly into benefit sharing with, and welfare of, its local community. 

L-theanine

An amino acid extract from green tea leaves, L-theanine calms excited brain cells and induces alpha brain waves, which are associated with relaxation and focus. Studies show that L-theanine reduces stress and anxiety in people experiencing stressful situations. (14;15) L-theanine may also increase brain serotonin and dopamine.

Magnesium

Magnesium status is inversely associated with stress levels and good quality sleep. Most consuming western-type diets have suboptimal magnesium levels and during stress our needs in-crease as the body excretes more in the urine. Magnesium is an important gatekeeper, preventing excitatory glutamate from getting the upper hand, and for regulating the amount of adrenaline and cortisol produced in response to stress. It enhances brain serotonin activity. (16) Studies conclude that magnesium supplementation has a beneficial effect on anxiety. (17;18)

Zinc

We need adequate zinc for healthy psychological function. Low zinc levels can arise from a vegan or vegetarian diet, poor gut health and certain medication. Zinc enhances the production of calming GABA.

B vitamins

B vitamins play many roles in cognitive function, nerve health and neurotransmitter production. For example, vitamin B6 is a key cofactor for converting excitatory glutamate to calming GABA, and for the production of serotonin and dopamine. Low B vitamin levels are associated with a depressed mood (19), while supplementation has been shown to reduce symptoms of stress. (20)

1. Chandrasekhar K, Kapoor J, Anishetty S. 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 J Psychol Med. 2012; 34(3):255-262. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/

2. Pratte et al., An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera) J Altern Complement Med. 2014 Dec 1; 20(12): 901–908. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270108/

3. Andrade C, Aswath A, Chaturvedi SK, Srinivasa M, Raguram R. A double-blind, placebo-controlled evalua-tion of the anxiolytic efficacy of an ethanolic extract of Withania somnifera. Indian J Psychiatry. 2000;42:295–301. https://pubmed.ncbi.nlm.nih.gov/21407960/

4. Auddy B, Hazra J, Mitra A, Abedon B, Ghosal S. A standardized Withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: A double-blind, randomized, placebo-controlled study. J Am Nutraceutical Assoc. 2008;11:50–6. https://www.liquidwholefood.com/wp-content/uploads/2013/10/LWFwithania_review.pdf

5. Adrian L. Lopresti, Stephen J. Smith, Hakeemudin Malvi, Rahul Kodgule An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled studyMedicine (Baltimore) 2019 Sep; 98(37): e17186. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/

6. Singh N, Bhalla M, de Jager P, Gilca M.An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):208-13. https://pubmed.ncbi.nlm.nih.gov/22754076/

7. Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus. 2019 Sep 28;11(9):e5797. doi: 10.7759/cureus.5797. PMID: 31728244; PMCID: PMC6827862.

8. Gannon, Jessica M et al. Subtle changes in thyroid indices during a placebo-controlled study of an extract of Withania somnifera in persons with bipolar disorder” Journal of Ayurveda and integrative medicine vol. 5,4 (2014):241-5. https://pubmed.ncbi.nlm.nih.gov/25624699/

9. Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid pa-tients: A Double-Blind, Randomised Placebo-Controlled Trial. J Altern Complement Med. 2018 Mar;24(3):243-248. https://pubmed.ncbi.nlm.nih.gov/28829155/

10. Ambiye VR et al. “Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study. Evid Based Complement Altern Med.2013. DOI:10.1155/2013/571420

11. Choudhary D, Shetty A, Langade DG. Efficacy of Ashwagandha (Withania somnifera (L.) Dunal) in improving cardiorespiratory endurance in healthy athletic adults. Ayu. 2015;36:63-8. DOI: 10.4103/0974-8520.169002

12. Wankhede S et al. Examining the effect of Withania somnifera supplementation on muscle strength and re-covery: a randomized controlled trial. JISSN. 2015;12:43. DOI: 10.1186/s12970-015-1014-9.

13. Choudhary D, Bhattacharyya S, Bose S. Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions. J Diet Suppl. 2017; 14(6):599-612

14. Kimura K, Ozeki M, Juneja LR, Ohira H. 2007. l-Theanine reduces psychological and physiological stress responses. Biol Psychol. 74:39–45. https://pubmed.ncbi.nlm.nih.gov/16930802/

15. Hidese S, Ogawa S, Ota M, Ishida I, Yasukawa Z, Ozeki M, Kunugi H Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial. Nutri-ents. 2019 Oct 3;11(10):2362. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836118/

16. Cuciureanu MD, Vink R. Magnesium and stress. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507250/

17. Boyle NB, Lawton CL, Dye L. The effects of magnesium supplementation on subjective anxiety. Magnes Res. 2016 Mar 1;29(3):120-125. https://pubmed.ncbi.nlm.nih.gov/27869100/

18. Boyle NB, Lawton C, Dye L The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients. 2017 Apr 26;9(5):429. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452159/

19. Cornish S, Mehl-Madrona L. The role of vitamins and minerals in psychiatry. Integr Med Insights. 2008;3:33-42. Epub 2008 Sep 24. PMID: 21614157; PMCID: PMC3046018.

20. Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and 'At-Risk' Individuals. Nutrients. 2019 Sep 16;11(9):2232. doi: 10.3390/nu11092232. PMID: 31527485; PMCID: PMC6770181.