Beneficial Role of Ashwagandha Root Extract in Subclinical Hypothyroidism

by | Sep 14, 2020 | 2018, Ashwagandha, Autoimmune Disease, Botanicals, Thyroid

Written by Joyce Smith, BS. Eight weeks of supplementation with ashwagandha root extract significantly improved thyroid hormone levels in participants with subclinical hypothyroidism.

ashwagandha - botanicalsSubclinical hypothyroidism (SCH), often a precursor to hypothyroidism, affects 3-8% of our population (6% – 10% female, 2.4% – 3% males 1,2. Both SCH and hypothyroidism are manifestations of chronic autoimmune disease and may share symptoms of fatigue, depression, weight gain, constipation, and cold sensitivity; however, SCH can be diagnosed by its characteristically normal levels of the T4 and elevated TSH (4.5-10µIU/L) 3. Anti-thyroid antibody clusters, including microsomal anti-thyroperoxidase (TPO) and anti-thyroglobulin may be present in the blood to further help confirm a SCH diagnosis 3,4. SCH may also exacerbate other critical ailments such as dyslipidemia, type 2 diabetes mellitus, aortic calcification, impaired vascular function, atherosclerosis, and myocardial and neuromuscular dysfunction 3. Levothyroxine, an available treatment for SCH, is effective for higher TSH levels 5but remains controversial for TSH levels below 10 mIU/L 6, thus natural alternative therapies such as ashwagandha are urgently needed. Ashwagandha, [Withania somnifera (L.) Dunal], is an adaptogen with anti-inflammatory, antioxidant, anti-anxiety, immunomodulatory, hypotensive, sedative, and hormone balancing properties, that help eliminate toxins, stabilize the physiologic processes, restore homeostasis, and rejuvenate the body 7.

In an 8-week prospective, randomized, double-blind, placebo controlled-clinical pilot study 8 researchers evaluated the efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients. Fifty subjects (18 to 50 years of age) were diagnosed with elevated TSH levels (4.5–10 mIU/L) but with normal T3 and T4 levels. Subjects received either 300 mg capsules of ashwagandha root extract or placebo capsules to be taken twice daily for 8 weeks. Serum TSH, T3, and T4 levels of the subjects were evaluated at baseline and during subsequent visits (fourth and eighth week) to determine ashwagandha’s efficacy.

Serum T3 and T4 levels significantly increased from baseline in the ashwagandha group compared to the placebo group. The ashwagandha group increased their serum T3 by 18.6% (p = 0.0121) at week 4 and 41.5% (p < 0.0001) at week 8 versus a decrease of -15.9% (p = 0.0067) at week 4, with an increase to -0.03% (p = 0.7387) at week 8 in the placebo group. Serum T4 levels in the ashwagandha group also increased significantly from baseline by 9.3% (p = 0.0027) and 19.6% (p < 0.0001) at weeks 4 and 8 respectively, but did not change significantly over time in the placebo group. Between group comparisons for both T3 and T4 were similar at baseline (p = 0.6451), and increased significantly in the ashwagandha group over placebo at weeks 4 and 8. Thyroid-stimulating hormone (TSH) was similar for both groups at baseline p = 0.3067); however, decreased significantly in the ashwagandha group compared to placebo at week 4 (p = 0.0006) and week 8 (p = 0.0002).

These results validate previous studies for ashwagandha’s role in regulating hypothalamic–pituitary–thyroid (HPT) axis, implicating an inverse relationship in the regulation of HPT and hypothalamic–pituitary–adrenal (HPA) axes, where chronic stress activates the HPA axis by increasing cortisol levels, which in turn inhibit the HPT axis and reduces serum T3 and T4 levels 9. In this study, ashwagandha lowered serum cortisol levels by downregulating the HPA axis, which then upregulated the HPT axis to normalize T3 and T4 levels. Studies have shown that other factors such as inflammatory cytokine and dopamine levels also support the upregulation of the HPA axis and downregulation of the HPT axis 10, thus lending credence to the potential thyroid-modulating effect of ashwagandha’s anti-inflammatory and antidopaminergic properties 11. Ashwagandha may have clinical value for bringing thyroid hormone levels within their normal range without the use of Levothyroxine (or by reducing its dose) in patients with SCH.

While this study highlights ashwagandha’s potential role in normalizing thyroid hormone levels in SCT patients, additional studies of larger populations and longer duration are recommended to further clarify the underlying mechanisms.

Source: Sharma, Ashok Kumar, Indraneel Basu, and Siddarth Singh. “Efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients: a double-blind, randomized placebo-controlled trial.” The Journal of Alternative and Complementary Medicine 24, no. 3 (2018): 243-248.

© Mary Ann Liebert, Inc.

Posted September 14, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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