Ashwagandha rx: Take before rounds to decrease stress

It’s time to round, you’re still scribbling your SOAP notes, and you know that you’re about to get pimped on that patient in bed 234A.  Your heart is racing, your anxious foot-tap sets in—you’re totally stressed.  Every single morning. Welcome to the realm of acute-on chronic-stress, effects of which bear no reminding. The good news is that you are not alone in feeling the effects of stress, and that there are healthy ways to protect your body from it. One of these ways is in the form of the herb, Ashwagandha (Withania somnifera), an herb native to India, Pakistan and Sri Lanka.

In India, Ashwagandha has been used medicinally for more than 3000 years. As part of Ayurvedic medicine, the traditional medical system in India, Ashwagandha is used for treating musculoskeletal conditions (e.g., arthritis, rheumatism), and as a tonic to increase energy, improve overall health and longevity, and prevent disease in athletes, the elderly, and during pregnancy. Multiple animal and human studies show that Ashwagandha possesses anti-inflammatory, anti-tumor, anti-stress, antioxidant, immunomodulatory, hematopoietic, and rejuvenating properties (see references, below).

On a personal note, I have found Ashwagandha to work very successfully for my patients; I have patients who see it is a vital source of their daily functioning, need to sleep less while on it, and, in general, feel less like cortisol is fueling their daily routine. In short, they feel less stressed and more energetic. If you are compelled to try Ashwagandha to enhance your own sense of ease, you can find supplements in local natural health food stores or the supplements aisle at Whole Foods; Organic India is a reputable brand. A typical dosing regimen includes:

  • Dried root: 3–6 g/day
  • Root extract standardized to 1.5% with anolides: 300–500 mg/day
  • 1:2 fluid extract: 6–12 ml/day

(Cautionary note: Allergies to any plants in the Solanaceae family (e.g., potato, tomato, eggplant) increase your risk for allergic reactions to Ashwagandha, as it is in the same family. Since Ashwagandha can increase immune system function, anyone on immune-suppressive therapies (e.g., prednisone) should likewise avoid it. And, as you say to all of your patients: talk to a naturopathic doctor or allopathic physician knowledgeable about herbs to assess your need, and prescribe an appropriate regimen.)

In sum, I wish all of you well on your journey to becoming physicians. While positive in many regards, it is also long and stressful. So I hope that, while on the journey, you learn as much about what maintains and promotes your health, as you learn about treating the health of others. This century places many resources at your disposal, such as herbs like Ashwagandha; may you learn about them, and use them, in good health.


About the Author

John Neustadt, ND is a naturopathic physician, Medical Director of Montana Integrative Medicine (MIM) and President of Nutritional Biochemistry, Incorporated (NBI), both located in Bozeman, Mont. Dr. Neustadt has published more than 100 research reviews and four books, edited the textbook Laboratory Evaluations for Integrative and Functional Medicine and was recognized by Elsevier as being a Top Ten Cited Author in 2007 & 2008 for his article, “Mitochondrial Dysfunction and Molecular Pathways of Disease.” For more information, visit or



1.            Monograph. Withania somnifera. Altern Med Rev. Jun 2004;9(2):211-214.

2.            Mishra L-C, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review. Altern Med Rev. 2000;5(4):334-346.

3.            Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. Journal of Ethnopharmacology. 1998;62(3):209-214.

4.            Archana R, Namasivayam A. Antistressor effect of Withania somnifera. Journal of Ethnopharmacology. 1998;64(1):91-93.

5.            Agarwal R, Diwanay S, Patki P, Patwardhan B. Studies on immunomodulatory activity of Withania somnifera (Ashwagandha) extracts in experimental immune inflammation. J Ethnopharmacol. Oct 1999;67(1):27-35.

6.            Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol. Oct 1998;62(3):209-214.

7.            Monograph: Withania somnifera. Altern Med Rev. 2004;9(2):211-214.

8.            Kelly GS. Rhodiola rosea: A possible plant adaptogen. Altern Med Rev. 2001;6(3):293-302.



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