The Effects of Supplementation with Ashwagandha Root Extract on Stress and Anxiety

by | Dec 19, 2023 | 2023, Ashwagandha, Botanicals, Brain Health, Stress

Written by Harold Oster, MD. Supplementation with Ashwagandha root extract is associated with reduced symptoms of stress and anxiety and improvement in some stress hormone levels.

ashwagandha - botanicalsPsychological stress occurs when an individual perceives that environmental or internal demands exceed their ability to adapt1. Repeated stress can lead to anxiety, an emotional state often defined as the anticipation and fear of an uncertain future threat2. Anxiety is associated with physical symptoms, diminished quality of life, and numerous chronic health problems3. Ashwagandha root, a traditional Indian medicine also known as winter cherry, contains withanolides, a group of steroid compounds with numerous biological effects. Ashwagandha extract and withanolides have been reported to improve symptoms of various medical disorders, including anxiety4,5.

Muhammed Majeed et al. evaluated the beneficial effects of Ashwagandha root extract (ARE) on symptoms and quality of life in patients with anxiety and stress. The authors recruited adults between 21 and 54 years old with mild to moderate stress, scoring 15-24 on the Perceived Stress Scale (PSS)6 and mild to moderate anxiety, scoring 10-14 on the Generalized Anxiety Disorder Assessment-7 (GAD-7)7. All participants reported fatigue, insomnia, loss of concentration, and poor appetite, and had no other psychiatric conditions. The participants were randomized to take a capsule containing 500mg of ARE and 5mg of piperine to improve absorption or a placebo once every evening for sixty days. Participants were assessed at the time of screening and on days thirty and sixty by the PSS and GAD-7. At the initiation of intervention and on days thirty and sixty, the participants were evaluated for quality of life with the World Health Organization Quality of Life Brief Version (WHOQOL-BREF)8 and for cognitive functioning with the Cambridge Neuropsychological Test Automated Battery (CANTAB), a web-based tool that assesses various aspects of cognition2. At baseline, day 30, and day 60, biochemical markers for stress and anxiety were measured, including salivary cortisol9 and urinary serotonin10.

The authors noted the following:

  • Based on inclusion criteria, fifty participants completed the study.
  • The intervention and placebo groups did not differ in baseline characteristics.
  • Compared to baseline, at the end of the study, scores on the PSS improved in the Ashwagandha group (20.44 to 11.08) but not in the placebo group.
  • Compared to baseline, at the end of the study, scores on the GAD-7 improved in the Ashwagandha group (13.76 to 9.09) but not in the placebo group.
  • Scores on the PSS in the Ashwagandha group were significantly lower than the placebo group on day 30 and day 60.
  • GAD-7 scores in the Ashwagandha group were significantly lower than the placebo group on day 60.
  • Quality of life scores significantly improved in the Ashwagandha group, while the placebo group did not change.
  • In the CANTAB testing, participants in the Ashwagandha group improved in two parameters of cognitive function compared to the placebo group–latency time to respond to questions and the percentage of correct answers.
  • At the end of the study, salivary cortisol levels decreased in the Ashwagandha group, indicative of improved anxiety. Levels in the placebo group did not change.
  • At the end of the study, urinary serotonin levels increased, indicative of decreased anxiety. Levels in the placebo group did not change.
  • No other biochemical markers indicative of anxiety changed over the course of the study.
  • Mild, transient side effects were seen in eight participants in the study group and four in the placebo group.

Results of the study suggest that supplementation with an extract of Ashwagandha root may improve symptoms, quality of life, and the levels of some stress hormones in adults with anxiety and stress. Limitations of the study include its small size and short duration.

Source: Majeed, Muhammed, Kalyanam Nagabhushanam, and Lakshmi Mundkur. “A standardized Ashwagandha root extract alleviates stress, anxiety, and improves quality of life in healthy adults by modulating stress hormones: Results from a randomized, double-blind, placebo-controlled study.” Medicine 102, no. 41 (2023): e35521.

© 2023 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.

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Posted December 19, 2023.

Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.

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