Ashwagandha’s Mystical Roots
Hippocrates first declared his oath of medical practice, to “do no harm”, in Athens two and a half thousand years ago. But as with so many ancient Athenian advancements, their ideas were a “best of” collection and synthesis of ideas originating across the Mediterranean. Mostly east of them. All further back in time.
Ayurvedic medicine in India pre-dates Hippocrates by thousands of years.3 And Ashwagandha was prescribed in Ayurvedic practice long before Athens emerged as a major Mediterranean trade hub.3
In Ayurvedic practices, Ashwagandha was used to aid recovery (“rasayana”, rejuvenation), after some other treatment.3 It survived the transition from an ancient, mysticism-adjacent system to the evidence-based medicine (EBM) system we know and (usually) love today, passing both the test of time and the burden of proof, by redirecting its purpose. Originally a strength-building recovery elixir, now a merely calming one, to help reduce stress and mitigate knock-on effects of the stress hormone, cortisol.
Its ancient “rejuvenation” classification might have been a subjective one. Signs of improved hormonal function have long been interpreted as recovery signals in folk-medicine. Its modern classification, however, is as an adaptogen (promotes homeostasis, balance).19,39 A helpful response to stress-induced chemical imbalances.
Ashwagandha’s Resurrection
The problems people take Ashwagandha for are a reflection of the common challenges of modern life. The demands of hyper-competitive technocratic society are no walk in the park. The pace of social, economic and technological change is trending on an exponential upward arc. And it’s stressing us (TF) out! We’re anxious, can’t sleep, and our stress hormone, cortisol, is through the roof. The results are pandemic levels of weight gain, moodiness, reduced immunity, and brain fog. A downward spiral.
Before the COVID pandemic, most of us hadn’t heard of Ashwagandha. As we sought something to help us cope with pandemic-related anxiety, manufacturers and marketers seized and exploited the opportunity. Now the U.S. market is projected towards $400 million on 11.38% CAGR over the next ten years. The global market is sneaking up on $1.5 billion.7
What is Ashwagandha?
The Withania somnifera aka Ashwagandha plant is an evergreen shrub native to arid regions of India, where 95% of the global supply is farmed and its compound isolates are manufactured for the nutraceutical industry.5,19
The manufacturing process isolates withanolides (C-28 steroidal lactones) and sitoindosides (a sub-class of withanolides with a glucose molecule) from the roots and/or leaves.5,44 Its bioactives are separated and concentrated by solvent extraction systems, using water, ethanol, or hydroethanolic mixtures.5
Withania somnifera aka Ashwagandha plant’s fruit. How cute.
How Ashwagandha Works
Ashwagandha's primary mechanisms: 24, 26, 38, 39
These mechanisms in turn reduce the stress-induced inflammation loop (inflammation increases HPA axis reaction and vice-versa). A downward spiral that Ashwagandha may help reverse.
Ashwagandha’s Benefits
Heightened sense of calm
Decreased subjective anxiety scored by lower cortisol levels.21,24
Sleep quality
Can help people fall asleep faster, wake up less often, and sleep longer.5,12
Cognitive focus
Enhances concentration, multitasking abilities, memory, and general mental clarity.46
Reduced fatigue
People report improved energy levels and reduction in overall fatigue.46
Mood stability
Reported decrease of depression, more managing perception of stressors.21
Endocrine and metabolic regulation
May suppress stress-induced hunger, elevate thyroid hormone levels in those with underactive thyroids, and increase male testosterone levels.30
Athletic Endurance (Before this deep dive, I didn’t know this 😲)
Meta-studies show a significant increase in maximal aerobic capacity by enhanced erythropoiesis and optimized mitochondrial ATP synthesis.23, 47
“Ashwagandha seems to be better at reducing anxiety in people who are chronically stressed and experiencing an anxiety disorder. It seems less effective for standard forms of anxiety that aren't related to stress.”
Ashwagandha’s Risks
Hepatotoxic potential
May cause cholestatic liver injury.1,6 Jaundice, dark urine, and chronic itching. Higher risk with preexisting liver disease.
Thyroid overdrive
Can excessively stimulate thyroid hormone production, potentially triggering thyrotoxicosis, rapid heart rate, hand tremors, and severe anxiety.17
Autoimmune flares
Its immune-stimulating properties can trigger active flares in patients with lupus or rheumatoid arthritis and counteract critical immunosuppressive medications.40, 49
Uterine stimulation
Strictly contraindicated during pregnancy due to its abortifacient potential, as it can stimulate uterine contractions and induce miscarriage.14
Androgenic upregulation
Elevates free and total testosterone levels, which in turn may increase potential for prostate cancer.30
Sedative and metabolic drug interactions
Can potentiate GABAergic sedatives to cause excessive drowsiness, and interact with blood sugar or blood pressure medications to trigger hypoglycemia or hypotension.12,43
Recommendations
Benefit Type | Daily Dosage |
|---|---|
Stress & Anxiety | 300 to 600 mg standardized root extract |
Sleep Quality | 300 to 600 mg root extract. Or 120 mg of Shoden (proprietary, trademarked) |
Cognitive Focus | 600 to 1,000 mg standardized extract |
Physical Endurance | 300 to 600 mg standardized root extract |
My related protocols, instead of ashwagandha:
Morning calm with caffiene: L-Theanine (200 to 300mg)
Sleep: A chamomile, tryptophan and melatonin formula tablet from Source Naturals, plus a Magnesium Glycinate capsule.
There is no silver bullet, one size fits all supplement stack, routine or protocol. But this has been my routine for many years now, because it works.
Bioavailability
Ashwagandha is best consumed with easily digested fat-rich foods like milk, butter, avocado etc.11 Those with gastrointestinal sensitivities may take ashwagandha after a meal with water, to prevent irritation.
Next week we’ll continue Top Cognitive Enhancements Deep Dive series, with one of my fav Indirect Cognitive Enhancement Supplements, good ol’ Ginseng!
Until then, eat fresh foods and stay active Beautiful Self-aware Brain!
🫶🏽
PS. Was this useful? Interesting? What’s missing? Any corrections?
Let me know in the comments, please.
Footnotes:
1. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020 Apr;40(4):825-829. PMID: 31991029. https://pubmed.ncbi.nlm.nih.gov/31991029/
3. An Overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med. 2011 Jul 3;8(5 Suppl):208–213. PMID: 22754076. https://pmc.ncbi.nlm.nih.gov/articles/PMC3252722/
5. Ashwagandha (Withania somnifera)—Current Research on the Health-Promoting Activities: A Narrative Review. Pharmaceutics. 2023 Mar 24;15(4):1057. PMID: 37111543. https://pmc.ncbi.nlm.nih.gov/articles/PMC10147008/
6. Ashwagandha - LiverTox® - NCBI Bookshelf - NIH. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet] (Bethesda: NIDDK), Last Update: December 3, 2024. PMID: 31643854. https://www.ncbi.nlm.nih.gov/books/NBK548536/
7. Ashwagandha Market Size, Share & Growth Report 2035. SNS Insider Report Scope & Overview (Report Code: SNS/HC/9883), March 25, 2026. PMID: N/A. https://www.snsinsider.com/reports/ashwagandha-market-9883
11. Ashwagandha: Benefits, Forms, Dosing, and Side Effects. Dr Brad Stanfield Articles, Originally Published: Mar. 1, 2024, Last Updated: Jun. 18, 2026. PMID: N/A. https://drstanfield.com/blogs/articles/ashwagandha-benefits-forms-dosing-and-side-effects
12. Ashwagandha: Is it helpful for stress, anxiety, or sleep? Fact Sheet for Health Professionals. National Institutes of Health (NIH) Office of Dietary Supplements (ODS), Updated: May 2, 2025. PMID: N/A. https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/
14. Ashwagandha - Uses, Side Effects, and More. WebMD, Medically Reviewed: Jul 27, 2025. PMID: N/A. https://www.webmd.com/vitamins-supplements/ashwagandha
17. Can Ashwagandha Cause Thyroid Issues? Risks & Benefits. Blue Horizon Blood Tests, June 25, 2026. PMID: N/A. https://bluehorizonbloodtests.co.uk/blogs/thyroid-health/can-ashwagandha-cause-thyroid-issues
19. Critical review of the Withania somnifera (L.) Dunal: ethnobotany, pharmacological efficacy, and commercialization significance in Africa. PMC / Bull Natl Res Cent., 2021;45(1):176. PMID: N/A. https://pmc.ncbi.nlm.nih.gov/articles/PMC8529567/
21. Effects of Ashwagandha (Withania Somnifera) on Stress and Anxiety: A Systematic Review. ResearchGate, 2021. PMID: N/A. https://www.researchgate.net/publication/402114872_Effects_of_Ashwagandha_Withania_Somnifera_on_Stress_and_Anxiety_A_Systematic_Review
23. Effects of Withania somnifera (Ashwagandha) Supplementation on Exercise Performance: A Systematic Review and Three-Level Meta-Analysis. Nutrients, 2026 Jun 12;18(12):1915. PMID: N/A. https://doi.org/10.3390/nu18121915
24. Effects of Withania somnifera on Cortisol Levels in Stressed Human Subjects: A Systematic Review. PMC / Journal of Herbal Medicine, 2021;28:100434. PMID: N/A. https://pmc.ncbi.nlm.nih.gov/articles/PMC8006238/
26. From herbal hope to hormonal havoc: chronic ashwagandha use and HPA axis suppression. PMC / Toxicology and Environmental Health Sciences, 2022;14(2):141–145. PMID: N/A. https://pmc.ncbi.nlm.nih.gov/articles/PMC11113996/
30. Hormonal Modulation with Withania somnifera: Systematic Review and Meta-Analysis of Randomized-controlled Trials. Planta Med, 2026. PMID: N/A. https://doi.org/10.1055/a-2802-8363
38. Pharmacologic overview of Withania somnifera, the Indian Ginseng. PMC / Cell. Mol. Life Sci., 2015 Nov;72(23):4445-4460. PMID: N/A. https://pmc.ncbi.nlm.nih.gov/articles/PMC11113996/
39. Pharmacological Insights Into Ashwagandha (Withania somnifera): A Review of Its Immunomodulatory and Neuroprotective Properties. Cureus, 2025 Aug 12;17(8):e89856. PMID: 40951251. https://pmc.ncbi.nlm.nih.gov/articles/PMC12423730/
40. Why Your Doctor Cautions Against Ashwagandha in Lupus or RA Patients. Ubie Doctor's Note, May 6, 2026. PMID: N/A. https://ubiehealth.com/doctors-note/ashwagandha-autoimmunity-risk-doc-warn-lupus-ra-3751q6
43. Should You Take an Ashwagandha Supplement? Risks and Benefits of Herbal Supplements. Northwestern Medicine HealthBeat, May 2025. PMID: N/A. https://www.nm.org/healthbeat/healthy-tips/should-you-take-an-ashwagandha-supplement
44. Study of Drug Target Identification and Associated Molecular Mechanisms for the Therapeutic Activity and Hair Follicle Induction of Two Ashwagandha Extracts Having Differential Withanolide Constitutions. J Nutr Metab., 2023 Sep 30;2023:9599744. PMID: 37808919. https://pmc.ncbi.nlm.nih.gov/articles/PMC10560109/
46. Systematic Review Findings Indicate that Ashwagandha Improves Physical Performance, Cognitive Health, and Mental Well-being. HerbalGram Issue 777 (American Botanical Council), January 30, 2026. PMID: N/A. https://www.herbalgram.org/resources/herbclip/issues/2026/issue-777/ashwagandha-physical-performance-cognitive-health/
47. The effect of Ashwagandha (Withania somnifera) on sports performance: a systematic review and meta-analysis. Turkish Journal of Sports Medicine, 2025;60(2):64-73. PMID: N/A. https://journalofsportsmedicine.org/full-text/752/eng
49. Why Your Doctor Cautions Against Ashwagandha in Lupus or RA. Ubie Doctor's Note, May 6, 2026. PMID: N/A. https://ubiehealth.com/doctors-note/ashwagandha-autoimmune-flares-lupus-ra-cautionary5751q4