The results of this study into the effects of ashwagandha on fatigue and hormone levels in an overweight male population shows increased testosterone and DHEA-S after eight weeks.
In this article, we summarise the A randomized, double-blind, placebo-controlled, crossover study examining the hormonal and vitality effects of ashwagandha (Withania somnifera) in aging, overweight males (1).
Plant name and species
Ashwagandha (Withania somnifera)
Aim of study
The study aimed to identify the effects of ashwagandha supplementation on energy and androgenic hormones in overweight men with mild-to-moderate self-reported fatigue.
Study method
A randomized, double-blind, placebo-controlled, crossover trial over a 16-week period compared ashwagandha extract to a placebo. Each intervention was taken for eight weeks and there was no washout period between the crossover phases to measure the lasting effect of changes beyond the treatment.
The first eight weeks were called Period 1, and weeks 9 to 16, Period 2.
The following physical and psychological measures were assessed at baseline, Week 4, 8, 12, and 16 after the commencement of the intervention:
- Aging males’ symptoms (AMS) self-report measure of aging and quality of life symptoms (five-point Likert scale)
- Profile of mood states, short form (POMS-SF); Fatigue-inertia and vigor-activity subscale scores, self-reported measures capturing items such as tension, anxiety, fatigue, vigor, activity (five-point Likert scale).
Additional outcome measures included hormone changes, quantified by salivary testosterone, cortisol, DHEA-S, and estradiol through a fasting saliva sample at baseline, week 8 (end of Period 1), and week 16 (end of Period 2).
Herbal preparation
Tablets contained ashwagandha extract (10.5 mg of withanolide glycosides) or a placebo (roasted rice powder) were given, with each tablet weighing 300 mg and appearing identical in appearance, shape, colour and packaging. Two tablets were taken two hours away from food each day (equating to 21 mg withanolide glycosides daily), preferably after dinner. Tablets were counted to determine compliance.
Extracts were produced by Shoden beads; Arjuna Natural Ltd. comprising extract from ashwagandha roots and leaves, standardised to 300 mg, produced to GMP standards.
Sample size
The participants were healthy males aged between 40 and 70 years who reported mild-to-moderate symptoms of fatigue. There were 29 males in the ashwagandha group and 28 in the placebo group. They were non-smokers and not on any medication for the three months leading up to the study. They were selected if they had a body mass index between 25 and 35. There were no differences between the groups for the baseline characteristics including age, weight, and baseline outcome measures. Although 57 participants were enrolled in the study, only 43 (75%) complied consistently with treatment, questionnaire completion and saliva samples as required.
The study was carried out at Murdoch University, Western Australia.
Results of study
Physical and psychological self-reported measures
There were no significant differences between ashwagandha or placebo groups in terms of AMS total score, POMS Fatigue-Inertia subscale score, and POMS Vigor-Activity subscale score at 8 or 16 weeks (Periods 1 and 2).
Both the placebo and ashwagandha groups saw significant improvements in most symptom scores over the first 8-week period for AMS total score, POMS Fatigue-Inertia subscale score and POMS Vigor-Activity scales.
Hormonal changes
For ashwagandha intake, there were significantly higher levels of testosterone and dehydroepiandrosterone-sulphate (DHEA-S) compared to the placebo — elevations of 14.7% (p=0.01) and 18% (p=0.05), respectively. There were no changes in cortisol and estradiol between groups. Further tests suggested that the increases in DHEA-S and testosterone were not sustained at 16 weeks.
Ashwagandha was well tolerated with no significant differences in the adverse events reported between this and the placebo group. Compliance with the study protocol and tablet intake was good, with 86% of participants taking >80% of tablets.
Discussion
An eight-week intake of ashwagandha extract in tablet form increased testosterone and DHEA-S in healthy males with mild to moderate self-reported fatigue and who were overweight. No changes in cortisol or estradiol were reported. There were improvements in self-reported fatigue, vigour, sexual and psychological health measures in both the ashwagandha and placebo groups by the end of the study, but no significant differences between the groups.
There are many studies that report beneficial effects of ashwagandha on alleviating stress and anxiety, and improving energy levels, (as cited in the paper). In one study, ashwagandha (300 mg) given for eight weeks improved perceived stress and wellbeing in stressed adults (2). Here, the ashwagandha contained 5% withanolides. In the present study, the dose was 600 mg per day with a higher percentage of withanolide, so the study protocol seemed to be sufficient to induce similar psychological changes.
It could be that the healthy male participants were not experiencing severe enough symptoms of stress or lack of energy and vitality at the start of the study to observe any meaningful significant changes. The authors suggest that the sample size may also have been under-powered. They also suggest that there was a strong placebo effect with many positive changes seen within the participants in this group over the course of the study.
Ashwagandha did significantly increase testosterone and DHEA-S although the changes were not sustained post-intervention. These hormones are important for men’s quality of life such as mood, musculoskeletal health, energy, libido and insulin resistance (3).
Ashwagandha was well tolerated.
Conclusion
Eight weeks of supplementation with 600 mg (21 mg withanolide glycosides) ashwagandha extract daily significantly increased DHEA-S and testosterone levels in healthy males who were aged between 40 and 70 and experiencing fatigue. Cortisol and estradiol levels were not different between ashwagandha and placebo groups.
Despite the hormonal changes seen, there were no improvements in fatigue, vigor, or sexual or psychological wellbeing from taking ashwagandha compared to the placebo.
Further research is needed to understand the effect that ashwagandha has on increasing levels of androgenic hormones and men’s wellbeing. Investigation into whether the herb’s adaptogenic characteristics are helpful in populations with more severe symptoms relating to stress, fatigue and loss of vitality would also be valuable to elucidate ashwagandha’s therapeutic potential in this context.
References
- Lopresti AL, Drummond PD, Smith SJ. A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males. Am J Mens Health. 2019 Mar-Apr;13(2):1557988319835985. https://doi.org/10.1177/1557988319835985
- Choudhary D, Bhattacharyya S, Joshi K. Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial. J Evid Based Complementary Altern Med. 2017 Jan;22(1):96-106. doi: https://doi.org/10.1177/2156587216641830
- Khera M. Male hormones and men’s quality of life. Curr Opin Urol. 2016 Mar;26(2):152-7. https://doi.org/10.1097/MOU.0000000000000256
