Common Names
- Ashwagandha
- Indian ginseng
- Winter cherry
For Patients & Caregivers
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.
- To treat cancer
Ashwagandha has shown promise in animal and laboratory experiments, but studies in humans are needed to support its use in cancer treatment. - To treat diabetes
Studies in laboratory animals suggest that ashwagandha may improve type 2 diabetes. - To treat epilepsy
There are no data to support this claim. - To reduce fatigue
Ashwagandha has been shown to increase blood cell counts in the lab; however, it is unclear if this will reduce fatigue in humans. - To treat digestive disorders
No scientific evidence supports this use. - To reduce pain
A clinical trial suggests that a standardized water extract of ashwagandha may produce benefit in patients with knee joint pain. Mild side effects like nausea and gastritis were observed in a few patients. - To treat rheumatoid arthritis
A clinical trial showed that a compound of herbs and minerals containing ashwagandha reduced the pain of rheumatoid arthritis. Because the formula contained multiple herbs and minerals, whether ashwagandha played a role in the reduction in pain severity and disability is unclear. - As a sedative
Ashwagandha has been shown to have a tranquilizing effect in animal studies.
Nausea, headache, and stomach irritation that were managed with standard therapies in one study
Case reports
- Overactive thyroid: In a 32-year-old woman following ingestion of ashwagandha capsules for chronic fatigue. Her symptoms resolved after discontinuing ashwagandha.
- Burning, itching, and discoloration of skin/mucous membrane: In a 28-year-old man after taking ashwagandha for decreased libido. His symptoms improved with conventional treatment.
For Healthcare Professionals
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), and topically as an analgesic (3). The active constituents include alkaloids, steroidal lactones, saponins, and withanolides.
In vitro studies suggest that ashwagandha has neuroprotective (26) (37) and 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 an animal model of type 2 diabetes (5). Other studies indicate cytotoxic, chemopreventative, immunomodulating (8), and radiosensitizing effects (1) (9) (10), and enhancement in chromosomal stability (11).
Ashwagandha is rich in iron (2). Small-scale human studies suggest that it may promote growth in children and improve hemoglobin level and red blood cell count, and improve sexual performance in adults (2) and also useful in the treatment of male infertility (27). 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 helpful for anxiety (23), to affect markers of metabolic syndrome in schizophrenia patients receiving antipsychotic therapy, (34) and to improve cognitive function in patients with bipolar disorder (35). In another clinical trial, an herbo-mineral formula containing ashwagandha was shown to benefit osteoarthritis (13). In a double-blind RCT, a standardized aqueous extract of roots and leaves produced dose-dependent analgesic, anti-inflammatory and chondroprotective effects in patients with knee joint pain (41). Preliminary data suggest that ashwagandha may help to improve balance in patients with progressive degenerative cerebral ataxias (24).
Ashwagandha reduced the growth of breast, central nervous system, colon, and lung cancer cells (6) without affecting normal cells (7), but did not show any effectiveness against drug-resistant cancer stem cells (36). The compound Withaferin A enhanced oxaliplatin effects in human pancreatic cancer cells (38). Ashwagandha was also shown to prevent chemotherapy-induced neutropenia in mice (12). In a small study of breast cancer patients, it alleviated chemotherapy-induced fatigue and improved quality of life. Larger trials are needed to confirm these observations (31).
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 anti-arthritic effects. In animal studies, ashwagandha’s anti-inflammatory activity was comparable to hydrocortisone (15). 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). Withanolides in the roots and leaves are considered similar to steroids in their biological activities (41). Triethylene glycol, a compound isolated from the leaves, was identified an active sleep-inducing component in a murine model, and may potentially be used to relieve insomnia (42).
Microarray analysis revealed that ashwagandha represses proinflammatory gene expression, including IL-6, IL-1β, IL-8, Hsp70, and STAT-2, and induces p38/MAPK expression in a prostate cancer cell line (16). 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). Withianone also exerts anticancer activity by binding to the TPX2-Aurora A Complex (29). 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 enhanced the effects of radiation therapy (20) by reducing tumor GSH levels (10). It was also shown to reverse paclitaxel-induced neutropenia in mice (12).
No significant interactions have been reported between ashwagandha and either CYP3A4 or CYP2D6 enzymes in human liver microsomes (40).
Hemolytic anemia and abdominal pain were reported following ingestion of contaminated ashwagandha/mucuna pills (32).
Pregnant women should avoid ashwagandha as it may induce abortion (14).
Case reports
Nausea, headache, and gastritis that in one study were managed with standard therapies (41)
- Thyrotoxicosis: In a 32-year-old woman following ingestion of ashwagandha capsules for chronic fatigue. Her symptoms resolved after discontinuing ashwagandha (25).
- Burning, itching, and discoloration of skin/mucous membrane: In a 28-year-old man after taking ashwagandha for decreased libido. His symptoms abated with conventional treatment (33).
- Triazolam: May potentiate the sedative effects of triazolam (30) .