Supplement evidence

039 / 575Botanical

Ashwagandha

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The short answer

Short-term trials suggest possible improvements in perceived stress or some sleep measures.

Evidence and scope: Emerging evidence
This status does not grade the ingredient for every goal, outcome, or person.
Important limitation: Trials are small and heterogeneous; anti-aging and longevity claims are unsupported.
Before deciding: Avoid in pregnancy; thyroid effects, liver injury, sedation, and drug interactions are concerns.

01 / PRACTICAL GUIDE

Dose, absorption, and combinations

These are indication-specific reference or studied ranges—not a personalized prescription. Start with the objective, then check the form, label, medicines, and health conditions.

Reference range by objective

Stress symptoms300–600 mg/day standardized extract in many short trials

Reference or studied range—not a personalized prescription. The product label or a clinician may specify a different dose.

Dose source ↗

Sleep onsetAbout 300–600 mg/day in selected studies

Reference or studied range—not a personalized prescription. The product label or a clinician may specify a different dose.

Dose source ↗

More is not automatically better. A clinician or product label may specify a different amount.

Absorption / solubilityFormulation-dependent

Not usefully classified as a fat- or water-soluble vitamin; absorption depends on the salt, extract, delivery system, and meal.

How it is commonly taken

Take with food if needed; root-only and root-plus-leaf extracts are not equivalent.

Do not combine casually

Avoid in pregnancy; thyroid, autoimmune, sedative, liver, and immunosuppressant interactions require review.

Dose and use source ↗

Dose and use links lead to primary or official source material. Search links are discovery tools, not proof that every returned paper applies.

02 / EVIDENCE

What the research says

We keep supportive, mixed, negative, safety, and contextual findings together. The headline never replaces the underlying papers.

6research papers in this ledger

16unique primary studies represented

1,187unique participants represented

These are audited counts for this JIVANA collection, not search-result totals. Participants are counted once when multiple papers use the same cohort; review papers are not added again to participant totals.

Open the research timelineResearch timeline

Entries are ordered by publication year. A study period appears only when the source reports it.

2026

Mixed or qualifiedPMID 41767760 · CTRI/2025/01/079238

Efficacy and safety of Ashwagandha root extract in pregnant women

No adverse events were reported and several short-term measures improved, but the trial was small, open-label, second-trimester only, and used per-protocol efficacy analyses. It is insufficient to establish pregnancy safety or justify unsupervised use.

Published: 2026Duration: 12 weeksn=70 participants

Study design and methods

Design: Prospective randomized open-label comparative trial
Population: 70 pregnant women in the second trimester; 63 completed
Intervention: KSM-66 root extract 300 mg twice daily plus standard hematinic care or standard care alone
Outcome: Blood indices, perceived stress, sleep, adverse events, and laboratory safety markers

Funding or conflict note: Ixoreal BioMed supplied the standardized extract; investigators stated that the supplier had no study role and declared no commercial financial conflict.

Open research record ↗

2023

Safety signalPMID 37756041

Ashwagandha-induced liver injury: a case series from India and literature review

Cholestatic hepatitis was common; five patients had chronic liver disease and all three who developed acute-on-chronic liver failure died. The series establishes a serious safety signal but cannot estimate incidence.

Published: 2023n=8 participants

Study design and methods

Design: Multicenter retrospective case series with causality assessment and product analysis
Population: Eight patients with liver injury attributed to single-ingredient ashwagandha products
Intervention: Ashwagandha products used for stress, sleep, or other purposes
Outcome: Liver-injury pattern, chronic liver disease, acute-on-chronic liver failure, and death

Study period: 2019–2022

Open research record ↗

2022

Mixed or qualifiedPMID 36017529

Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress?

Pooled symptoms favored ashwagandha, but heterogeneity was very high and certainty was rated low. The result is promising, not proof that products or doses are interchangeable or that it treats an anxiety disorder.

Published: 2022n=1,002 participants12 primary studies represented

Study design and methods

Design: Systematic review and dose-response meta-analysis of 12 randomized trials
Population: 1,002 adults, generally aged 25–48, across varied stress and anxiety samples
Intervention: Different ashwagandha extracts and doses versus placebo
Outcome: Stress and anxiety symptom scales

Open research record ↗

2021

Mixed or qualifiedPMID 34559859

Effect of Ashwagandha extract on sleep: a systematic review and meta-analysis

Overall sleep improved modestly, with larger effects in insomnia, doses of at least 600 mg/day, and studies lasting at least 8 weeks. Heterogeneity was substantial and serious/long-term safety data were limited.

Published: 2021n=400 participants5 primary studies represented

Study design and methods

Design: Systematic review and meta-analysis of five randomized trials
Population: 400 adults, including healthy people and people with insomnia
Intervention: Ashwagandha extracts versus placebo
Outcome: Sleep quality, sleep quantity, morning alertness, anxiety, and quality of life

Funding or conflict note: This review overlaps the broader stress/anxiety trial base and is excluded from aggregate counts to avoid inflating the evidence total; it was unfunded and authors declared no competing interests.

Open research record ↗

2018

Safety signalPMID 28829155

Efficacy and safety of Ashwagandha root extract in subclinical hypothyroid patients

Thyroid hormone measures shifted toward the reference range in this selected hypothyroid group. Because the herb can alter thyroid markers, the finding is also a safety concern for euthyroid or hyperthyroid people and those using thyroid medicine.

Published: 2018Duration: 8 weeksn=50 participants

Study design and methods

Design: Randomized, double-blind, placebo-controlled pilot trial
Population: 50 adults with subclinical hypothyroidism; 46 completed
Intervention: Ashwagandha root extract 600 mg/day or placebo
Outcome: TSH, T3, and T4 concentrations

Open research record ↗

2015

Supports a specific usePMID 26609282

Examining the effect of Withania somnifera supplementation on muscle strength and recovery

The extract group gained more strength and muscle size during training, but this was a small, short trial in novice young men using one proprietary extract; it does not establish broad athletic-performance benefit.

Published: 2015Duration: 8 weeksn=57 participants

Study design and methods

Design: Randomized, double-blind, placebo-controlled resistance-training trial
Population: 57 young men with little resistance-training experience
Intervention: KSM-66 root extract 300 mg twice daily plus training or placebo plus training
Outcome: Strength, muscle size, recovery, body composition, and testosterone

Funding or conflict note: The proprietary KSM-66 extract was manufactured by Ixoreal BioMed; product specificity limits generalization.

Open research record ↗

Unscreened discovery appendix—not evidence111 candidate publicationsSearch run: Aug 21, 2026

Complete for the displayed PubMed query at the search timestamp—not for all databases or every possible synonym. Candidates can be irrelevant, duplicate the same study, or report negative findings. They are never summed as evidence or participants until screened.

03 / SOURCES

Start with the source material

Official evidence overviewNIH Office of Dietary Supplements Live PubMed discovery searchNational Library of Medicine

The live search is for discovery only. Search-result counts change and are not included in the audited totals above.

Recent PubMed discovery recordsDirect links to the first 12 records returned by the reproducible search. These are discovery candidates—not reviewed summaries or a count of supportive findings.

04 / EXPERT CONTEXT

Expert context—not evidence

Expert positions are dated context—not scientific evidence. They never raise the evidence status or become consensus by repetition.

No direct, source-verified endorsement is currently recorded. Research authorship or discussion alone is not treated as endorsement.