Medical

For some, this anti-anxiety herb is a godsend. For others, it’s a nightmare. What gives?

In 2020, Savior Minaya noticed a change in his behavior. While he had previously been clinically diagnosed with attention deficit hyperactivity disorder (ADHD) he found himself sometimes pacing around his room and acting more impulsively than before. The behavior worried him, as he sometimes bumped up against feelings of defeat. There were days when he felt like he couldn’t get out of bed.

To alleviate these issues, he decided to make some lifestyle changes. He got sober. He bought a bike to get some exercise. He started prioritizing sleep. And then on Facebook he saw an acquaintance ask about anxiety relief, to which a commenter responded “ashwagandha.”

“I’m usually turned off whenever I see those people suggest anything like that. People usually go off with a whole bunch of myths, nothing ever has a scientific backing,” Minaya told Salon, But then when he went to his girlfriend’s house, he saw she already had it. He decided to try it himself.

“I took maybe like 600 milligrams, and it almost reminded me like if I took a very low dose of Xanax and I was like, wow, this is insane that this even exists.”

“It almost reminded me like if I took a very low dose of Xanax.”

Ashwagandha, one of the common names for Withania somnifera, is an evergreen shrub that is a mainstay of Ayurvedic medicine, in which it is a “revered herb.” Its name comes from the Sanskrit word for “horse smell,” referring to its apparent equine fragrance. Its leaves and roots contain a wealth of different chemicals, some of which act on GABA receptors in the body, the same as benzodiazepine depressants like Xanax (alprazolam.)

The plant is included in the nightshade family, which features a host of toxic and beneficial species, from tomatoes and eggplant to tobacco and belladonna. While ashwagandha has been used in traditional medicine for thousands of years, only recently has it become more popular in the United States, where it is marketed as a so-called “adaptogen” for enhancing one’s life.

On TikTok, #ashwagandha has over 900 million views and many videos visually document peoples’ experiences taking the herb — the good and the bad. Some people claim it helps relieve their stress and anxiety and improves their sleep. Others have reported negative side effects, like experiencing anhedonia, or the inability to feel pleasure.

Many are left wondering if the botanical supplement is safe to take — and does it actually work to relieve stress, anxiety and lack of sleep?

Amala Soumyanath, a professor of neurology at Oregon Health & Science University and Director of BENFRA (Botanical Dietary Supplements Research Center), told Salon ashwagandha is widely researched, at least for being an herb, particularly in preclinical models where testing is done on either animals or cells.

“We’re still trying to get to the bottom of all the potential effects of this herb, but based on existing evidence, it does seem that it affects a number of systems within the body,” Soumyanath said.

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For example, research has shown that ashwagandha has an effect on the hypothalamus pituitary axis, which is responsible for the secretion of cortisol, a hormone released when a person is stressed. In a 60 day, randomized, double-blind and placebo-controlled study, researchers found that people who took ashwagandha scored lower on the Depression, Anxiety and Stress Scale (DASS-21). They also found that peoples’ cortisol levels were lower in the morning compared to people who didn’t take ashwagandha. There’s even evidence that serotonin levels are affected, with some antiinflammatory and antioxidant effects as well.

“There’s a wide variety of effects that have been ascribed to this botanical, and that might sound odd, because when you look at conventional drugs very often you don’t have a long laundry list of activities, you just have a few,” Soumyanath said, adding this isn’t surprising though given botanical extracts usually contain a whole “mishmash of different phytochemicals that are found in the herb.”

“We’re still trying to get to the bottom of all the potential effects of this herb.”

Ashwagandha can be taken in supplement or powder forms. So far, the trials that have been done ruled out placebo effect for sleep and stress, Soumyanath said. That being said, she is also aware of TikTok videos and anecdotes detailing negative ashwagandha experiences.

When he first started taking it, Minaya told Salon he underwent an increase in appetite and increased fatigue. Then, he took a break. When he started taking ashwagandha again, he said he felt emotionally numb and “didn’t care about anything.” Minaya attributes the change in mood to taking too much, but once he lowered his intake, he felt better.

Soumyanath said that the loss of pleasure has been anecdotally documented, but it hasn’t been noted in any clinical or preclinical studies.

“That has not been reported in any of the clinical trials,” Soumyanath said. “I’ve seen some of the TikTok videos and stuff associated with that, and all I can say is that there’s no real evidence or reports of that being found in any of the trials that have been done and reported.”

That being said, Soumyanath said that the ashwagandha being sold on store shelves are “highly variable.” In the United States, the FDA classifies ashwagandha as a “botanical dietary supplement,” which means that the quality and safety of the product isn’t monitored to the same degree as FDA-approved medications and treatments.

“When a study is done, it’s done with a particular product, that is true for that product. But that doesn’t mean that every single other product on the shelf made from that botanical will have the same effect,” Soumyanath said. “That makes the whole picture a little bit more complicated.”

That complication has rolled over to other countries, too. In 2022, the Danish Technical University found in a safety risk assessment that ashwagandha has a potentially harmful effect on thyroid and sex hormones. Some Swedish products with high levels of ashwagandha were banned in Denmark.

The quality and safety of the product isn’t monitored to the same degree as FDA-approved medications and treatments.

Yet there are many people who swear by ashwagandha. Jeff Johnson has been growing ashwagandha in Oregon since 2009. He said he’s seen ashwagandha help people, especially with sleep issues, and that the rise in negative experiences is something “new,” in his opinion.

“It’s really interesting hearing people with negative experiences, because that’s something that we aren’t used to,” Johnson said. “So it was surprising when I stumbled onto Reddit.”

Indeed, in the subreddit r/ashwagandha, some peoples’ experiences are far from great. One person, for example, reported feeling anhedonia even five months after ceasing to take the supplement, while another claimed ashwagandha made them “question reality.”

Overall, Soumyanath said, she believes that ashwagandha is a “really promising botanical.”

“The research done so far really does support that it has very beneficial effects, particularly in areas of stress, insomnia, even anxiety,” Soumyanath said. “But we really need to do more studies in these areas, particularly anxiety and depression. And I think we need to get the word out that any results that are there really relate to the specific product that was tested.”

Soumyanath added there’s still a lot to learn in regards to how it works as well.

“Once we have an understanding of how the herb is working, and what components are providing these different activities, then we can have a better handle on saying, ‘Well if a product is made like this, and it contains these specific components, then we can be sure that it has, an effect on on this particular condition,'” she said. “Unfortunately, we’re not quite there yet.”

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