Ashvagandha

Withania_somnifera

Botanical name: Withania somnifera, Solanaceae

Other names: Ashgandh (H), Amukkira (T), Winter Cherry (E)

Botany: Aśvagandhā is an erect branching shrub that attains a height between 30-150 cm, covered in a wooly pubescence.  The ovate leaves are up to 10 cm long and 2.5-5 cm wide, margins entire, arranged in an alternate fashion.  The flowers are green or yellow, borne in axillary fascicles, giving rise to red globose fruits when mature.  The roots are fleshy and cylindrical, the epidermis light brown and medulla white.  Aśvagandhā is found throughout the drier parts of India, into West Asia and northern Africa (Kirtikar & Basu 1935, Warrier et al 1995).

Part used: Root.

Dravyaguṇa:
• Rasa: tikta, kaṣāya
• Vipāka: madhura
• Vīrya: uṣṇa, laghu
• Karma: medhya, nidrājanana, stanyajanana, vedanāsthāpana, balya, vajīkaraṇa, rasāyana, vātakaphahara (Dash 1991, Srikanthamurthy 2001, Warrier et al 1996)

Constituents:  Aśvagandhā contains steroidal compounds of great interest to researchers, including ergostane type steroidal lactones, including withanolides A-Y, dehydrowithanolide-R, withasomniferin-A, withasomidienone, withasomniferols A-C, withaferin A, withanone and others.  Other constituents include the phytosterols sitoindosides VII-X and b-sitosterol, as well as alkaloids (e.g. ashwagandhine, cuscohygrine, tropine, pseudotropine, isopelletierine, anaferine), a variety of amino acids including tryptophan, and high amounts of iron (Mills & Bone 2000, Williamson 2003, Yoganarasimhan 2000).

Medical research: 
• In vitro: antifungal (Choudhary et al 1995), antibacterial (Arora et al 2004), anti-angiogenic (Mohan et al 2004), cholinergic (Schliebs et al 1997), GABA-nergic (Mehta et al 1991)
• In vivo: adaptogenic (Bhattacharya and Muruganandam 2003), anti-oxidant (Archana & Namasivayam 1999), anti-inflammatory  (al-Hindawi et al 1992, al-Hindawi 1989), neuroprotective (Parihar & Hemnani 2003), neuroregenerative (Kuboyama et al 2005), immunostimulant (Davis & Kuttan 1999, Dhuley 1998, Ziauddin et al 1996), anti-oxidant (Bhattacharya et al 1997, Dhuley 1998a), hypoglycemic (Hemalatha et al 2004), anti-ischemic (Chaudhary et al 2003), cardioprotective (Gupta et al 2004, Mohanty et al 2004), anti-angiogenic (Mohan et al 2004), chemoprotective (Davis & Kuttan 1998, Diwanay et al 2004, Jena et al 2003; Kuttan 1996), myeloprotective (Davis & Kuttan 1999), radioprotective (Mathur et al 2004), antitumor (Christina et al 2004, Devi 1996, Devi et al 1995, Kaur et al 2004, Leyon and Kuttan 2004, Menon et al. 1997, Sharad et al 1996), antiwithdrawal (Kulkarni & Ninan 1997)
• Human trials: Researchers investigated the impact of Withania somnifera roots on semen profile, oxidative biomarkers, and reproductive hormone levels in 75 normal men and 75 infertile men. Results demonstrated that Withania somnifera inhibits oxidation, improves sperm count and motility, and significantly increases serum testosterone and LH, and reduced the levels of FSH and prolactin (Ahmad et al 2010).  In a randomized controlled trial patients with moderate to severe anxiety received either naturopathic care (NC), consisting of dietary counseling, deep breathing relaxation techniques, a standard multi-vitamin, and Aśvagandhā (300 mg b.i.d. standardized to 1.5% with anolides, prepared from root), or standardized psychotherapy intervention (PT) (n = 40) over a period of 12 weeks.  Results demonstrated that Beck Anxiety Inventory (BAI) scores decreased by 56.5% in the NC group, and 30.5% in the PT group (Cooley et al 2009).  Aśvagandhā demonstrated hypoglycemic and hypolipidemic effects in non-insulin dependent diabetic and hypercholesterolemic patients (Andallu & Radhika 2000); a herbal formulation containing Withania somnifera root, Boswellia serrata stem, Curcuma longa rhizome and zinc (Articulin-F) was found to promote a significant drop in severity of pain and disability in osteoarthritic patients, with minimal side-effects (Kulkarni et al 1991); a proprietary formulation (Immu-25) containing Aśvagandhā was found to promote a significant decrease in viral loads and an increase in CD4+ counts in patients with HIV (Usha et al 2003).

Toxicity: Aśvagandhā appears to be very safe, with an LD50 of a 50% alcohol extract determined to be 1000 mg/kg in rats (Aphale et al 1998, Williamson 2002).

Indications: Anorexia, bronchitis, asthma, consumption, leucoderma, edema, asthenia, anemia, exhaustion, aging, insomnia, ADD/ADHD, infertility, impotence, repeated miscarriage, paralysis, memory loss, multiple sclerosis, immune dysfunction, immunodeficiency, cancer, rheumatism, arthritis, lumbago.

Contraindications: Caution should be used with patients on anticonvulsants, barbituates and benzodiazepines due to its GABA-nergic and sedative properties.  Aśvagandhā is traditionally avoided in lymphatic congestion, during colds and flu, or symptoms of āma (Frawley & Lad  1986, 160).

Medicinal uses:  Aśvagandhā is often considered the Indian equivalent to Ginseng (Panax ginseng), but unlike Ginseng, Aśvagandhā has a ‘sedative’ (nidrājanana) rather than stimulant action on the central nervous system, making it a superior medicine for exhaustion with nervous irritability.  Aśvagandhā is a useful nervine, taken before bed to relax and nourish the body in deficiency diseases, but is only seen to be efficacious when taken on a sustained basis – it is not a sufficient sedative to treat acute insomnia.  For poor memory, lack of concentration and in the treatment of ADD/ADHD Aśvagandhā may be used in equal proportions with Brāhmī and Ling zhi (Ganoderma lucidum)Aśvagandhā is widely used in any debility, emaciation or consumptive condition, in both adults and children (Kirtikar & Basu 1935, Nadkarni 1954).  One rejuvenating preparation can be made by mixing Aśvagandhā with 10-15% Pippalī, taken with one half part ghṛta and one part honey on an empty stomach, morning and evening.  As its name ‘smelling like a horse’ suggests, Aśvagandhā is an important vajīkaraṇa dravya, indicating the sexual potency of a stallion, used in the treatment of infertility, impotence and “seminal depletion” (Nadkarni 1954).  When mixed with equal parts Śatāvarī, it is an appropriate treatment for female infertility and frigidity, useful in threatened miscarriage, and is an excellent post-partum restorative.  In the treatment of uterine prolapse a paste prepared from equal parts Aśvagandhā, Vacā, Kuṣṭha, Haridrā, Marica and Nīlotpala is recommended by the Cakradatta to restore uterine tone (Sharma 2002).  In the treatment of infertility in both sexes a simple decoction of Aśvagandhā in milk is indicated, taken with ghṛta as an anupāna (Sharma 2002).  Similarly, a medicated taila called Aśvagandhādi taila is prepared by decocting Aśvagandhā, Śatāvarī, Kuṣṭha, Jaṭāmāṃsī and Bṛhatī in sesame oil, massaged into the breasts and genitalia to make them stronger and larger (Sharma 2002).  Mixed with equal parts Vṛddhadāruka, Aśvagandhā cūrṇa is allowed to sit in a pot with ghṛta for a few days, and is then administered in doses of 12 g taken with milk as a vajīkaraṇa rasāyana (Srikanthamurthy 1984).  In the treatment of consumptive conditions the Cakradatta recommends a decoction of equal parts Aśvagandhā, Guḍūcī, Śatāvarī, Daśamūla, Balā, Vāsaka, Puṣkaramūla root and Ativiṣā, taken in conjunction with a diet of milk and meat broth (Sharma 2002).  A more recently developed formula by the Hospital of Integrated Medicine in Madras is Aśvagandhādi lehya, used in dosages of 6-12 g in milk to strengthen the body, and promote fertility and long life (India 1978).  For poor eyesight Aśvagandhā powder is mixed with equal proportions of Yaṣṭimadhu powder and the fresh juice of Āmalakī (Nadkarni 1954).  Nadkarni mentions that Aśvagandhā is used in the treatment of anti-inflammatory  joint disease (1954), but may facilitate the production of āma (Frawley & Lad  1986), and thus an eliminative regimen is best implemented prior to using this herb.  Likewise, Aśvagandhā is an appropriate remedy in the treatment of asthma and bronchitis (Kirtikar & Basu 1935), but should be used concurrently with dravyāṇi that have a dīpanapācana property to avoid the production of āma.  Warrier et al mention that a paste made of the roots and bruised leaves may be applied to carbuncles, ulcers and painful swellings (1996).  Based on its traditional use and the experimental data Aśvagandhā appears to be an excellent choice to support the health of patients undergoing conventional cancer treatment or are suffering from immunodeficiency, to protect against injury and infection, improve immune status, and enhance recovery.  Combined with Yaṣṭimadhu and used in sufficient doses Aśvagandhā may be used to wean a patient off of corticosteroid therapy, or may be used in place of it.

Dosage:
• Cūrṇa: 3-15 g b.i.d.-t.i.d.
• Kvātha: 1:4, 60-120 mL b.i.d.-t.i.d.
• Tincture: fresh root, 1:2, 95% alcohol; dried root, 1:3; 35% alcohol; 1-15 mL b.i.d.-t.i.d.