TESTOSTERONE SUPPLEMENTS / ASHWAGANDHA

Ashwagandha

Withania somnifera

Ashwagandha is a plant traditionally used in Ayurvedic medicine to promote a youthful state of physical and mental well-being.


Sourced from India

Non-GMO

Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

Vitals

Some studies have shown that ashwagandha supplementation improves muscle strength, improves semen quality, and raises testosterone levels in men.

Common side effects include sleepiness (approximately 20% of users in one study), loose stools (approximately 20% of users in one study), and gastrointestinal discomfort (approximately 10% of users in one study).

Talk to your doctor about taking ashwagandha if you are already taking anticonvulsants, barbiturates, or benzodiazepines as there may be an interaction.

What is ashwagandha?

Ashwagandha, also known as “Indian ginseng,” “winter cherry,” and “poison gooseberry,” is an herb that is commonly used in Ayurvedic medicine. Ayurvedic medicine, also simply called Ayurveda, is a form of traditional Indian medicine that dates back to approximately 6000 BCE and relies on a natural, holistic approach to healing. In Ayurveda, ashwagandha is used as a Rasayana, a tonic that promotes a youthful state of physical and mental well-being. Ashwagandha is also in the family of herbs known as “adaptogens,” which are believed to help regulate physical, mental, and emotional stresses in the body.

The ashwagandha plant belongs to the Solanaceae, or nightshade, family of flowering plants. This means ashwagandha is related to many shrubs, trees, spices, and weeds as well as familiar foods like bell peppers, eggplants, potatoes, and tomatoes. The root of ashwagandha gives off an odor described as being similar to a horse and it is considered to be an aphrodisiac, narcotic, antimicrobial, and stimulant. The leaves, flowers, and seeds are also thought to have medicinal benefits. Ashwagandha’s suspected active ingredients include its alkaloids, steroidal lactones, saponins, and withanolides.

What are the benefits of ashwagandha?

As a Rasayana and an “adaptogen,” ashwagandha has a number of purported health benefits. Traditionally, it has been used in formulations to treat ailments ranging from anxiety and stress to fatigue, pain, skin problems, diabetes, and rheumatoid arthritis. While numerous studies have looked into the health benefits of ashwagandha, most have been conducted in vitro, on animals, or in small human clinical trials. This means the findings are limited, making it difficult to determine precisely how effective supplementation with ashwagandha can be. Larger studies with greater generalizability are still needed to better understand the exact benefits, side effects, and optimal dosing of ashwagandha.

Studies looking specifically at ashwagandha’s effects on men include the following:

Muscle strength and weight loss: One study compared young male subjects taking 300mg of ashwagandha twice daily to those taking a placebo while undergoing a resistance training program. The participants receiving ashwagandha experienced improved muscle strength, increased muscle size, increased testosterone levels, decreased exercise-induced muscle damage, and decreased body fat percentage (15).

Semen: One study in infertile men found that supplementation with 5g of ashwagandha root powder daily for three months led to improved semen quality, increased antioxidant activity, and elevation of testosterone levels. Treatment also led to pregnancy in the partners of 14% of the study participants (1,10).

Testosterone: One study evaluated the hormonal effects of ashwagandha in older, overweight males. Although no statistically significant difference was seen in terms of fatigue, vigor, or sexual/psychological well-being, after eight weeks, study participants taking ashwagandha extract in an amount equaling 21mg of withanolides daily did have increased levels of DHEA-S (a steroid hormone that helps make testosterone) and testosterone (9).

Studies focusing on the other claims made about ashwagandha include the following:

Cancer: In one study, ashwagandha root extract administered to mice with skin cancer demonstrated potential anticancer activity (11).

Diabetes: In a study on rats with non-insulin dependent diabetes mellitus, ashwagandha improved insulin sensitivity, leading to a normalization of high blood sugar (2).

Energy: In one small study of human patients with breast cancer, ashwagandha root extract given at a dose of 2g every 8 hours throughout chemotherapy led to an improvement in cancer-related fatigue and quality of life (5).

Immunity: In a study on mice, the stimulatory effect of ashwagandha on the immune system was associated with increased life span (8).

Mental health: One study has shown that ashwagandha may be helpful for anxiety (7). Ashwagandha has also been shown to improve stress and symptoms in those with schizophrenia (6) and to improve cognitive function in those with bipolar disorder (3).

Pain: Ashwagandha extract was shown to have a pain-relieving effect in those experiencing knee pain (12). Its anti-arthritic and anti-inflammatory effects are thought to be a result of its inhibitory effects on an enzyme involved in inflammation called cyclooxygenase (COX).

How does Roman offer ashwagandha?

Roman obtains ashwagandha from a non-GMO source in India that grows Withania somnifera. The root extract used by Roman contains 1.5% withanolides.

Ashwagandha is one of five ingredients in Roman’s daily Testosterone Support supplement. The supplement consists of four tablets that should be taken with water. Each individual tablet contains 75mg of ashwagandha root extract, for a total daily dose of 300mg.

Other ingredients in the tablet include cholecalciferol, maca root powder, magnesium citrate, zinc sulfate, microcrystalline cellulose, dicalcium phosphate, stearic acid, croscarmellose sodium, magnesium stearate, silicon dioxide, and pharmaceutical glaze (shellac, Povidone).

How is ashwagandha dosed?

As a supplement, ashwagandha has not been reviewed by the FDA. Additionally, since it comes in many forms, information regarding exact dosing for ashwagandha is limited. Until more research is done, the dosage of ashwagandha can only be estimated based on existing studies and the doses that were tested. Clinical studies have been conducted which evaluate the efficacy of ashwagandha at doses ranging from 125mg per day to more than 5g per day. More specifically:

  • 125mg daily has been tested for stress (4).
  • 300mg twice daily has been tested for anxiety (6) as well as for muscle strength (15).
  • 600mg daily has been tested to improve testosterone (9).
  • 5g daily has been tested to improve semen quality (1, 10).
  • 2g every 8 hours has been tested to reduce cancer-related fatigue (5).

In what forms is ashwagandha available?

Ashwagandha is a plant whose roots, leaves, and berries can be ground and made available as a powder, tea, or an essential oil. Some applications, particularly for pain control, involve mashing ashwagandha root with water to turn it into a paste and applying it topically. Formulations of ashwagandha are available over the counter, however dosage may vary depending on the method of use/ingestion.

What are the side effects of taking ashwagandha?

The most common side effects of ashwagandha are drowsiness, fatigue, gastrointestinal discomfort, and loose stools. Rarely reported side effects include elevation of liver enzymes, fever, headache, inflammation of the stomach lining, nausea, skin rash, and swelling. The long-term effects of taking ashwagandha are unknown. Individual case studies have also revealed the following:

  • One 28-year-old man developed burning, itching, and discoloration of the skin while taking ashwagandha. Symptoms resolved after 1 month of treatment with an oral allergy medication and a topical steroid (3).
  • One 32-year-old woman developed an overactive thyroid while taking ashwagandha. Symptoms resolved after discontinuing use (3).
  • One 39-year-old man developed hemolytic anemia and abdominal pain following ingestion of pills that were ordered from India and were labeled “ashwagandha/mucuna.” Analysis of the pills revealed 7.3mg of lead per pill as well as traces of arsenic, chromium, and mercury. Symptoms resolved after treatment for heavy metal poisoning (14).
  • Two cases of heart arrhythmia were possibly associated with preparations that included ashwagandha (3).

Does ashwagandha interact with any other drugs?

Ashwagandha has potential sedative effects, which can be dangerous if taken in combination with certain other medications that act on the central nervous system. Prior to beginning ashwagandha, talk to your healthcare provider if you are taking:

  • Benzodiazepines
  • Anticonvulsants
  • Barbiturates

Ashwagandha may also impact the activity of immunosuppressive medications and of thyroid medications, although the effects are not entirely known.

Additional considerations:

You should not take ashwagandha if you have hormone-sensitive prostate cancer, as ashwagandha may increase testosterone levels. You should also not take ashwagandha if you are pregnant, as higher doses of ashwaganda may be related to increased rates of abortion. Ashwagandha may cause the immune system to be more active, which is important to consider for those with autoimmune diseases such as lupus, multiple sclerosis, or rheumatoid arthritis. Ashwagandha may also lower your blood pressure, which is important to keep in mind if you are already on blood pressure-lowering medications.

Taking ashwagandha may affect certain lab test results. Thyroxine levels (which may be tested to evaluate thyroid function) and digoxin levels (which may be tested if you are taking digoxin) can be falsely elevated when checked by your healthcare provider. Make sure your healthcare provider knows you are taking ashwagandha before checking these lab tests.


Sources

1. Ahmad MK, Mahdi AA, Shukla KK, et al. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertility and Sterility. 2010;94(3):989-996.

2. Anwer T, Sharma M, Pillai KK, Iqbal M. Effect of Withania somnifera on Insulin Sensitivity in Non-Insulin-Dependent Diabetes Mellitus Rats. Basic & Clinical Pharmacology & Toxicology. 2008;102(6):498-503. doi:10.1111/j.1742-7843.2008.00223.x.

3. Ashwagandha. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ashwagandha. Published June 20, 2019. Accessed July 15, 2019.

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. Journal of American Nutraceutical Association. 2008;11(1):50-56.

5. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of Withania somnifera (Ashwagandha) on the Development of Chemotherapy-Induced Fatigue and Quality of Life in Breast Cancer Patients. Integrative Cancer Therapies. 2012;12(4):312-322. doi:10.1177/1534735412464551.

6. Chengappa KNR, Brar JS, Gannon JM, Schlicht PJ. Adjunctive Use of a Standardized Extract of Withania somnifera(Ashwagandha) to Treat Symptom Exacerbation in Schizophrenia. The Journal of Clinical Psychiatry. 2018;79(5). doi:10.4088/jcp.17m11826.

7. Cooley K, Szczurko O, Perri D, et al. Naturopathic Care for Anxiety: A Randomized Controlled Trial ISRCTN78958974. PLoS ONE. 2009;4(8). doi:10.1371/journal.pone.0006628.

8. Davis L, Kuttan G. Effect of Withania somnifera on CTL activity. J Exp Clin Cancer Res. 2002;21(1):115-118.

9. Lopresti AL, Drummond PD, Smith SJ. A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males. American Journal of Mens Health. 2019;13(2):155798831983598. doi:10.1177/1557988319835985.

10. Mahdi AA, Shukla KK, Ahmad MK, et al. Withania somnifera Improves Semen Quality in Stress-Related Male Fertility [published online ahead of print, 2009 Sep 29]. Evid Based Complement Alternat Med. 2009;2011:576962. doi:10.1093/ecam/nep138

11. Prakash J, Gupta SK, Dinda AK. Withania somnifera Root Extract Prevents DMBA-Induced Squamous Cell Carcinoma of Skin in Swiss Albino Mice. Nutrition and Cancer. 2002;42(1):91-97. doi:10.1207/s15327914nc421_12.

12.Ramakanth G, Kumar CU, Kishan P, Usharani P. A randomized, double blind placebo controlled study of efficacy and tolerability of Withania somnifera extracts in knee joint pain. Journal of Ayurveda and Integrative Medicine. 2016;7(3):151-157. doi:10.1016/j.jaim.2016.05.003.

13. Singh N, Bhalla M, Jager PD, Gilca M. An Overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda. African Journal of Traditional, Complementary and Alternative Medicines. 2011;8(5S). doi:10.4314/ajtcam.v8i5ss.9.

14. Toniolo M, Ceschi A, Meli M, Lohri A, Favre G. Haemolytic anaemia and abdominal pain – a cause not to be missed. British Journal of Clinical Pharmacology. 2011;72(1):168-169. doi:10.1111/j.1365-2125.2011.03909.x.

15. Wankhede S, Langade D, Joshi K, Sinha SR, Bhattacharyya S. Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. Journal of the International Society of Sports Nutrition. 2015;12(1). doi:10.1186/s12970-015-0104-9.