About Herbs

Bottom Line: Ashwagandha slows down the growth of cancer cells in laboratory tests and enhances radiation therapy in animals. But anticancer effects have not been demonstrated in humans.

Ashwagandha is a popular Ayurvedic herb. Studies show that it has anti-inflammatory effects. Ashwagandha also relaxes the central nervous system in animals. Laboratory studies found that ashwagandha kills some cancer cells and enhances some immune cells possibly by damaging the cancer cells' ability to generate the energy it needs to reproduce. Ashwagandha also reduces the level of an important antioxidant in tumor cells, which may enhance the ability of radiation therapy to kill those cells. However, this herb may induce abortion, so pregnant women should not use it.

Arthritis:
Forty-two volunteers with osteoarthritis participated in a trial of a herbomineral formula containing ashwagandha. Volunteers were randomly assigned to receive either a combination of herbs and minerals or placebo for three months. After a fifteen-day washout period, treatments were reversed. Volunteers in the treatment group reported significant drops in pain severity and disability score with few side effects. Because a combination of herbs was used, the extent to which ashwagandha alone can alleviate pain remains unclear.

You are pregnant. (Ashwagandha may induce abortion.)

You are taking sedatives. (Ashwagandha may increase sedative effects.)

Case Report: Thyrotoxicosis was reported in a 32-year-old woman following ingestion of ashwagandha capsules for chronic fatigue. Her symptoms resolved after discontinuing ashwagandha.

Ashwagandha, Indian ginseng, Winter cherry

A popular Ayurvedic herb, ashwagandha is often used in formulations prescribed for stress, strain, fatigue, pain, skin diseases, diabetes, gastrointestinal disease, rheumatoid arthritis, and epilepsy ⁽¹⁾. It is also used as a general tonic, to increase energy and improve health and longevity ⁽²⁾. Externally, it can be applied as a local analgesic ⁽³⁾. The active constituents are thought to include alkaloids, steroidal lactones, saponins, and withanolides. In vitro studies suggest that ashwagandha has anti-inflammatory properties which may protect against cartilage damage in osteoarthritis ⁽⁴⁾. In addition, improvements in hyperglycemia, hyperinsulinemia, and insulin sensitivity have been detected in animal model of type 2 diabetes ⁽⁵⁾.

Ashwagandha reduced growth of breast, central nervous system, colon, and lung cancer cells ⁽⁶⁾ without inducing cell death in normal cells in vitro ⁽⁷⁾. In addition, animal studies suggest ashwagandha has antitumor, immunomodulatory, antioxidant, and anti-stress properties. Other studies have shown cytotoxic, chemopreventative, immunomodulating ⁽⁸⁾, and radiosensitizing effects ^{(1) (9) (10)} in addition to enhancement in chromosomal stability ⁽¹¹⁾. The herb may also help prevent chemotherapy-induced neutropenia ⁽¹²⁾. However, the effects of ashwagandha in cancer patients have yet to be determined.

Ashwagandha is rich in iron ⁽²⁾; small scale human studies suggest ashwagandha may promote growth in children and improve hemoglobin level, red blood cell count, and sexual performance in adults ⁽²⁾. An herbal tea containing ashwagandha was shown to increase natural killer cell activity in healthy volunteers with recurrent coughs and colds ⁽²²⁾. Data also indicate that ashwagandha may be useful in the treatment of anxiety ⁽²³⁾. In another clinical trial, an herbomineral formula containing ashwagandha was shown to benefit osteoarthritis ⁽¹³⁾. Preliminary data suggest benefits of ashwagandha in improving balance in patients with progressive degenerative cereberral ataxias ⁽²⁴⁾.

Ashwagandha may induce abortion. Pregnant women should avoid this herb ⁽¹⁴⁾.

Cancer treatment

Diabetes

Epilepsy

Fatigue

GI disorders

Health maintenance

Pain

Rheumatoid arthritis

Sedation

Skin infections

Stress

Alkaloids, steroidal lactones, saponins, and withanolides are thought to be the biologically active components of ashwagandha. Studies have pointed to cyclooxygenase (COX) inhibition as the mechanism for the herb's antiarthritic properties. In animal studies, Ashwagandha's anti-inflammatory effects were comparable to hydrocortisone ⁽¹⁵⁾. Microarray analysis revealed that ashwagandha represses proinflammatory gene expression, including IL-6, IL-1â, IL-8, Hsp70, and STAT-2, and induces p38/MAPK expression in a prostate cancer cell line ⁽¹⁶⁾. It exhibits antioxidant effects in the brain and tranquilizing effects on the central nervous system in animals ⁽²⁾ possibly by influencing GABA receptor function ⁽¹⁷⁾. Ashwagandha may inhibit tumor growth ^{(1) (21)}and increases cytotoxic T lymphocyte production ⁽⁸⁾. In vitro studies have shown that root extracts have cytotoxic properties against lung, colon, central nervous system, and breast cancer cell lines ⁽⁶⁾. Withaferin A induces reactive oxygen species (ROS) generation and disruption of mitochondrial function in a human leukemia cell line, thereby inducing apoptosis ⁽¹⁸⁾. In estrogen receptor-positive (ER+) and negative (ER-) breast cancer cells, withaferin A induces apoptosis and decreased tumor size ⁽¹⁹⁾. Apoptosis of cancer cells by withanone is mediated through p53 ⁽⁷⁾. Other studies show ashwagandha's cytotoxicity is related to its structure; it enhances ATPase and inhibits succinate dehydrogenase activities, impairing oxidative phosphorylation. In animal studies, ashwagandha can enhance the effects of radiation therapy ⁽²⁰⁾ by reducing tumor GSH levels ⁽¹⁰⁾. Ashwagandha can reverse paclitaxel-induced neutropenia in mice ⁽¹²⁾. Significant toxicity was observed at high doses in animal studies ⁽²⁰⁾; however, toxicity studies in humans are limited ⁽²⁾.

This herb may induce abortion. Pregnant women should avoid this herb ⁽¹⁴⁾.

Case Report: Thyrotoxicosis was reported in a 32-year-old woman following ingestion of ashwagandha capsules for chronic fatigue. Her symptoms resolved after discontinuing ashwagandha ⁽²⁵⁾.

May potentiate the sedative effect of barbiturates ⁽¹⁴⁾.

Kulkarni RR, Patki PS, Jog VP, Gandage SG, Patwardhan B. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol. 1991;33:91-5.

42 patients with osteoarthritis participated in a study of a herbomineral formula that included ashwagandha. Patients were randomly assigned to receive the herbomineral formula (900 mg ashwagandha three times daily) or placebo for three months. After a month-long washout period, cross-over followed. Following treatment, patients demonstrated statistically significant reductions in severity of pain and disability score. Because of the presence of other substances in the formula, it is unclear to what extent ashwagandha played a role in the treatment results.

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