Ashwagandha is a prime remedy for managing stress and the anxiety that it often generates. It will improve cognitive and mental performance when under pressure. It is particularly helpful where sustained stress leads to fatigue and depleted immune functions. The term ‘adrenal exhaustion’ sums up a situation where turning to ashwagandha is likely to be most helpful.

These properties make ashwagandha useful for chronic insomnia, constant infections and immune weakness, and long-term hot flushes in the menopause, all conditions emerging from a depleted state.

It is most widely used for upset, weak or deficient digestion, particularly in countering nausea and vomiting.

There are likely to be hormonal benefits: as well as to the adrenal cortex, Ashwagandha has long been used for thyroid problems (both hypo and hyper). One of its most persistent reputations now supported by clinical research is in increasing male fertility and there are also some evidence to show it can increase libido in both sexes.

Athletes and body builders may find ashwagandha helpful in their healthy regimes as well.

In Ayurvedic medicine, ashwagandha is known as a ‘rasayana’, meaning a rejuvenative. Rasayanas enhance both the quality and quantity of life, nourish the mind and enhance vigour, making them perfect for weak, debilitated or exhausted conditions. Due to its ability to support the function of both body and mind, ashwagandha is one of Ayurveda’s most prized rejuvenative herbs. Ashwagandha is a modern-day adaptogen, supporting our body’s resistance to physical and emotional stress by strengthening the endocrine and nervous systems. However, this herb is unusual in that it is also a tonic with adaptogenic actions. This means it will strengthen an exhausted or agitated nervous system whilst at the same time calming it.

Ashwagandha’s botanical name, Withania somnifera, gives us further clues as to its properties; ‘somnifera’ is translated as ‘sleep-inducing’, reflecting the relaxing and restful actions that bring us energy through supporting deeper sleep.

Ashwagandha is among the most widespread traditional remedies in the Indian subcontinent and is very widely consumed as a food supplement around the world. In Ayurveda, ashwagandha is described as a medhya rasayan or promoter of learning and memory retrieval. It is given with pungent or heating herbs such as ginger and long pepper to increase its tonic effects. The roots are said to have tonic and anti-inflammatory properties, and to provide support in skin and respiratory conditions, to build strength in sick children and in the elderly and particularly to help sleep.

Ashwagandha is used to promote lactation in Ayurvedic medicine and the traditional medicine of South-East Asia (1). One teaspoon (0.5 g) of ashwagandha powder is recommended twice daily with milk for insufficient lactation in a 1990 WHO manual (2).

• Adaptogenic
• Antioxidant
• Anti-inflammatory
• Aphrodisiac
• Immunomodulant
• Nervine
• Relaxant

Stress response: Ashwagandha is considered a primary herb for supporting ‘generalised adaptation syndrome’ as described by the stress pioneer Hans Selye. It will improve mental capacity and resilience during the stress and help with the recovery phase afterwards.

Muscle tissue: Ashwagandha both reduces inflammation and strengthens muscle tone. It is traditionally applied to muscle weakness, low body weight, emaciation, anaemia, post-convalescent weakness and athletic exertion, and for slow developing children and the elderly. It is used to support smooth muscle organs as well, as a heart tonic, and uterine tonic.

Immunity: Ashwagandha can strengthen a weakened immune system and protect it from becoming depleted from immunosuppressive drugs or lifestyle. It also improves white blood cell counts. Ashwagandha has for long been used for chronic inflammatory and arthritic conditions, and as a support in cancer.

Reproductive: Ashwagandha improves sperm motility, sperm count and poor sexual performance in men. For the female reproductive system, ashwagandha is used in menstrual imbalances caused by a deficient condition with an aggravation of vata and uterine spasms including dysmenorrhoea, amenorrhoea and weakness.

Endocrine: Ashwagandha is used to regulate thyroid activity, helping both hypo- and hyperthyroidism.

There is much pre-clinical literature, and some clinical trials, that reinforce the traditional use and benefits of Ashwagandha in anxiety (3, 4, 5) and stress-related symptoms (6). One systematic review of these studies concluded that subject to methodological heterogeneity, ashwagandha interventions resulted in significantly greater score improvements than placebo in outcomes on anxiety or stress scales (7).

In a placebo-controlled studies alongside SSRI antidepressant medication, ashwagandha demonstrated significant additional anxiety reducing effects (8), and reduced symptoms of obsessive-compulsive disorder (9). Anxiety reduction has also been seen in other controlled studies, including in schizophrenic patients (10).

In one randomized, double-blind, placebo-controlled study, ashwagandha supplementation was associated with significant reduction in morning cortisol levels as well as anxiety scales. Subject to further research, these findings suggested that Ashwagandha’s stress-relieving effects may occur via its moderating effect on the hypothalamus-pituitary-adrenal axis (11).

Other controlled clinical trials have demonstrated the benefits of ashwagandha;

• Improving memory and cognitive functioning in adults with mild cognitive impairment (12).
• As an adjuvant in conjunction with anti-TB drugs on symptoms and immunological parameters in patients with pulmonary tuberculosis (13).
• Improving sperm counts, volume and motility in infertile male patients,xiv and at levels comparable to standard treatment pentoxifylline (15).
• Normalising thyroid indices in subclinical hypothyroid patients (16).
• Managing body weight problems in stressed adults (17).
• In two trials demonstrating improved muscle strength and body mass distribution in athletic men (18, 19).

The Sanskrit name for this plant, ‘ashwagandha’, means ‘essence of a horse’, bringing stamina, strength and grace.

Ashwagandha grows in India, the Middle East, and parts of Africa. Predominantly found in dappled shade of woodland edges, on wastelands, grassland and wetlands.

Due to the over exploitation from natural resources for medicinal purposes the plant has been listed in parts of India as endangered hence IUNC has placed it in the ‘red data’ book (22, 23). 

According to the IUCN Red List of Threatened Plants Status, Ashwagandha was last assessed in 2013 in Europe and is currently classed as ‘data deficient’. The IUCN however also states ‘it appears to be very rare and scattered across its distribution, though no specific information on population size or trend is available’. 

It is important to source medicinal plants from a reputable source, particularly where sustainability is concerned, the more popular a medicinal plant becomes the more attention must be paid towards ensuring we are choosing sustainable suppliers – one can find information on the certified producers and registered processors and traders operating in the FairWild trading system. Also find certificate holders in the Union for Ethical BioTrade Programme.

An investigation into the adulteration of Ashwagandha products in the international herbal products industry found that there was a high incidence of adulteration with aerial plant parts in ashwagandha root products. The end product is not necessarily unsafe, however will be less effective for the user (24). Another study identified that powdered preparations of market samples contained plant material that is not related to Ashwagandha, which warrants strict quality control measures and market surveillance (25). 

Herbal Medicines are often extremely safe to take, however it is important to supply herbal medicines from a reputed supplier. Sometimes herbs bought from unreputable sources are contaminated, adulterated or substituted with incorrect plant matter.

Some important markers for quality to look for would be to look for certified organic labelling, ensuring that the correct scientific / botanical name is used and that suppliers states clearly the source of ingredients used in the product. 

A supplier should also be able to tell you where the herbs have come from. There is more space for contamination and adulteration where supply chain is unknown. 

• Plant ashwagandha in a dry and sunny location of your garden.
•  Sandy and well-draining soil in a way that water will drain out quickly, pH level should be around 7.5 – 8, neutral to slightly alkaline (Ashwagandha will not grow successfully in soil that retains moisture and remains waterlogged.

• Plant seeds 2 cm deep and 10 cm apart when the temperature is around 70 F (20 C). 
• Seeds will germinate in two weeks. Water the seedlings well while they are establishing. 
• Thin out the weak plants after a month of growing, leaving the space around 50 – 60 cm between plants.
•  If the soil is poor, add manure to enrich each spring

Winter Tonic Elixir

This is a fun and easy-to-make ‘winter tonic elixir’ with a mix of herbs that raise your energy and warm you to the core.

Ingredients:

• Brandy 700ml/25fl oz
• Amaretto 300ml/10fl oz
• Ginseng root 20g/3/4oz
• Astragalus 10g/1/3oz
• Cinnamon bark 10g (about 2 quills)
• Ashwagandha 5g
• Ginger root powder 5g
• Rosemary 2 sprigs
• Orange peel 5g

This makes 1 litre/35fl oz of tasty tincture.

Method:

• Blend the liquids and soak the herbs in it for 1 month and then strain. Bottle half for you and half for a friend.
• Sip on cold winter nights to raise your spirits and keep you strong.

Joint protector tea

It’s almost an inevitable human condition that we will suffer from some sort of joint pain as we get older. All that wear-and-tear through our life can catch up with us but we have a herbal tea recipe that will help keep the red-hot inflammation of arthritis and gout at bay.

Ingredients:

• Turmeric root powder 3g
• Boswellia resin 2g
• Ginger root powder 2g
• Celery seed 2g
• Ashwagandha root 1g
• Licorice root 1g
• Meadowsweet leaf 1g
• Honey to taste

This will serve 2–3 cups of ache-free tea.

Method:

• Put all of the ingredients (except for the meadowsweet leaf and honey) in a saucepan with 600ml (21fl oz) cold filtered water. Cover with a lid and simmer for 15 minutes.
• Take off the heat and add the meadowsweet leaf.
• Leave to steep for 10 minutes, strain and add some honey to taste.

Aphrodite’s aphrodisiac tea

This tea reaches deep into the reproductive system, nourishing our procreative and sexual energy. Use it when preparing for a family or for nurturing your love life. For men and women, this elixir feeds sex hormone release, improves egg/sperm quality and enhances orgasmic experiences.

Ingredients:

• Shatavari root 4g
• Ashwagandha root 2g
• Licorice root 2g
• Cinnamon bark 2g
• Milk (any type) 250ml/9fl oz
• Damiana leaf 2g
• Cacao powder 1 tsp per cup
• Maca root 1 tsp per cup
• Flower pollen ½ tsp per cup
• Vanilla essence a dash per cup
• Honey (or Amaretto) a drop per cup

Makes 2 cups of the most amorous elixir.

Method:

• Put the shatavari, ashwagandha, licorice and cinnamon in a saucepan with the milk and 250ml/9fl oz cold filtered water.
• Cover, bring to the boil and allow to simmer for 15 minutes. Take off the heat and add the damiana leaf.
• Leave to steep for 10 minutes, then strain.
• To each cup, add the cacao, maca, flower pollen, vanilla essence and honey. Then top with the tea and stir.

Recipes from Cleanse, Nurture, Restore by Sebastian Pole

1. Kapoor LD.(1990) CRC Handbook of Ayurvedic Medicinal Plants. Boca Raton, CRC Press, 337-338.
2. World Health Organization (1990) The Use of Traditional Medicine in Primary Health Care: A Manual for Health Workers in South-East Asia, New Delhi, WHO Regional Office for South-East Asia, New Delhi.
3. Cooley K, Szczurko O, Perri D et al (2009) Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974. PLoS One. vol 4, no 8, p 6628.
4. Andrade C, Aswath A, Chaturvedi SK, et al. (2000). A double-blind, placebo-controlled evaluation of the anxiolytic efficacy
5. Chandrasekhar K, Kapoor J, Anishetty S. (2012) 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. vol 34, no 3, pp 255–262.
6. Auddy B, Hazra J, Mitra A, et al. (2008). A standardized Withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study. J Am Nutracetical Association vol 11, pp 50-56
7. Pratte MA, Nanavati KB, Young V, Morley CP (2014). An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). J Altern Complement Med. vol 20, no 12, pp 901- 908.
8. Fuladi S, Emami SA, Mohammadpour AH, et al. (2020) Assessment of Withania somnifera root extract efficacy in patients with generalized anxiety disorder: A randomized double-blind placebo-controlled trial [published online ahead of print, 2020 Apr 13]. Curr Clin Pharmacol.
9. Jahanbakhsh SP, Manteghi AA, Emami SA, et al. (2016) Evaluation of the efficacy of Withania somnifera (Ashwagandha) Med. 27: 25‐29
10. Chengappa KNR, Brar JS, Gannon JM, Schlicht PJ. (2018) Adjunctive Use of a Standardized Extract of Withania Study. J Clin Psychiatry. 79(5): 17m11826
11. Lopresti AL, Smith SJ, Malvi H, Kodgule R. (2019) An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore).
12. Choudhary D, Bhattacharyya S, Bose S. (2017) Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal)Jahanbakhsh SP, Manteghi AA, Emami SA, et al. (2016) Evaluation of the efficacy of Withania somnifera (Ashwagandha) Med. 27: 25‐29.
13. Kumar R, Rai J, Kajal NC, Devi P. (2018) Comparative study of effect of Withania somnifera as an adjuvant to DOTS in patients of newly diagnosed sputum smear positive pulmonary tuberculosis. Indian J Tuberc. 65(3): 246‐251.
14. Gupta A, Mahdi AA, Shukla KK, et al. (2013) Efficacy of Withania somnifera on seminal plasma metabolites of infertile males: a proton NMR study at 800 MHz. J Ethnopharmacol. 149(1): 208‐214.
15. Nasimi Doost Azgomi R, Nazemiyeh H, Sadeghi Bazargani H, et al. (2018) Comparative evaluation of the effects of Withania somnifera with pentoxifylline on the sperm parameters in idiopathic male infertility: A triple-blind randomised clinical trial. Andrologia. 50(7): e13041
16. Sharma AK, Basu I, Singh S. (2018) Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med. 24(3): 243‐248.
17. Choudhary D, Bhattacharyya S, Joshi K. (2017) Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial. J Evid Based Complementary Altern Med. 22(1): 96‐106. 
18. Ziegenfuss TN, Kedia AW, Sandrock JE, et al. (2018) Effects of an Aqueous Extract of Withania somnifera on Strength Training Adaptations and Recovery: The STAR Trial. Nutrients. 10(11): 1807.
19. Wankhede S, Langade D, Joshi K, et al. (2015) Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. J Int Soc Sports Nutr. 12: 43.
20. Patel SB, Rao NJ, Hingorani LL (2016) Safety assessment of Withania somnifera extract standardized for Withaferin A. Acute and sub-acute toxicity study. Journal of Ayurveda and Integrative Medicine, 7, 1, 30-37
21. Pole, S. (2013). Ayurvedic medicine : the principles of traditional practice. London: Singing Dragon.
22. Aslam, S., Raja, N.I., Hussain, M., Iqbal, M., Ejaz, M., Ashfaq, D., Fatima, H., Shah, M.A., Abd-Ur-Rehman and Ehsan, M. (2017). Current Status of Withania somnifera (L.) Dunal: An Endangered Medicinal Plant from Himalaya. American Journal of Plant Sciences, 08(05), pp.1159–1169. doi:10.4236/ajps.2017.85076.
23. Kumari, V. and Mishra, P. (2020). Issue 4 www.jetir.org (ISSN-2349-5162). JETIR2004234 Journal of Emerging Technologies and Innovative Research, [online] 7. Available at: https://www.jetir.org/papers/JETIR2004234.pdf [Accessed 17 Sep. 2022].
24. Vineet, K. S. Et al. 2019. Adulteration of Ashwagandha (Withania somnifera) Roots, and Extracts. https://www.researchgate.net/publication/343862896_Adulteration_of_Ashwagandha_Withania_somnifera_Roots_and_Extracts. Published 2022. Accessed September 17, 2022.
25. Amritha, N., Bhooma, V. and Parani, M. (2020). Authentication of the market samples of Ashwagandha by DNA barcoding reveals that powders are significantly more adulterated than roots. Journal of Ethnopharmacology, [online] 256, p.112725. doi:10.1016/j.jep.2020.112725.