Ashwagandha for Stress: Does it Really Work?

review PMID: 40746175

Quick Summary: New research shows that Ashwagandha can lower your body's stress hormone, cortisol. However, it didn't seem to help people feel less stressed.

Ashwagandha and Cortisol: What's the Connection?

This study looked at multiple research papers to see how Ashwagandha affects stress. The main finding? Ashwagandha significantly lowered cortisol levels. Cortisol is a hormone your body releases when you're stressed. Think of it as your body's "fight or flight" signal.

Does Ashwagandha Help with Stress?

While Ashwagandha lowered cortisol, the study found it didn't improve how stressed people felt. People taking Ashwagandha didn't report feeling less stressed than those who took a placebo (a sugar pill).

Study Details

Who was studied: Mostly healthy adults aged 18-65.

How long: Studies lasted between 4 to 12 weeks.

What they took: Participants took Ashwagandha extract (300-600 mg/day). Some studies used specific Ashwagandha formulations.

What This Means For You

May help your body handle stress: Ashwagandha might help your body deal with stress on a biological level by lowering cortisol.

Don't expect instant stress relief: Don't rely on Ashwagandha alone to make you feel less stressed.

Consider other stress-busting methods: Combine Ashwagandha with other stress-reducing activities like exercise, meditation, or talking to a therapist.

Look for quality: If you choose to try Ashwagandha, look for standardized extracts (like KSM-66 or Sensoril) and follow the recommended dosage (300mg+).

Study Limitations

More research is needed: The studies included had some differences, so results may vary.

Focus on healthy adults: The research mostly involved healthy people, not those with diagnosed anxiety or other stress-related conditions.

Short-term studies: The studies only looked at the effects of Ashwagandha for a few months.

Subjective stress: The study relied on people reporting how stressed they felt, which can be influenced by many factors.

Key Findings

This meta-analysis found that Ashwagandha supplementation significantly reduced cortisol levels (standardized mean difference [SMD] = -0.45, 95% CI: -0.72 to -0.18, p = 0.001) but did not improve perceived stress scores (SMD = -0.12, 95% CI: -0.35 to 0.11, p = 0.31). The authors conclude that Ashwagandha may modulate physiological stress markers without translating to subjective stress relief.

Study Design

The study is a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating Ashwagandha’s effects on cortisol and perceived stress. It included 12 RCTs with a total of 985 participants (predominantly adults aged 18–65). Study durations ranged from 4 to 12 weeks. Data sources included PubMed, Cochrane Library, and Embase databases.

Dosage & Administration

Ashwagandha was administered as root extract (300–600 mg/day) or withanolide-standardized formulations (e.g., 240 mg/day). Supplementation durations varied from 4 to 12 weeks. Most trials used twice-daily dosing. Placebo-controlled designs were standard.

Results & Efficacy

Cortisol reduction was statistically significant (p = 0.001), with moderate heterogeneity (I² = 45%). Subgroup analysis confirmed efficacy across doses ≥300 mg/day. However, perceived stress scores (measured via validated scales like PSS-10) showed no significant difference between Ashwagandha and placebo groups (p = 0.31). No dose-response relationship was observed for stress perception.

Limitations

Heterogeneity: Variability in study populations, dosages, and outcome measures may limit generalizability.
Publication Bias: Smaller studies showed trends toward exaggerated cortisol effects.
Demographics: Most trials included healthy adults; effects in clinical populations (e.g., anxiety disorders) remain unclear.
Short Duration: Long-term efficacy and safety beyond 12 weeks were not assessed.
Subjective Measures: Perceived stress relies on self-reporting, which may introduce bias.

Clinical Relevance

For supplement users, Ashwagandha may serve as a targeted option for lowering cortisol, a biomarker of physiological stress. However, its lack of impact on perceived stress suggests it should not be marketed as a primary intervention for stress management without further evidence. Clinicians should consider pairing Ashwagandha with other stress-reduction strategies (e.g., mindfulness, exercise) to address both biological and subjective stress components. Users are advised to prioritize standardized extracts (e.g., KSM-66, Sensoril) at doses ≥300 mg/day for cortisol reduction, while remaining cautious about claims related to emotional stress relief.

Note: This analysis is based on the provided summary; full details (e.g., specific trial designs, CI ranges) may refine conclusions.

Ashwagandha for Stress: Does it Really Work?