This page shows what was measured, who it was measured in, and what that does not settle.
What Ashwagandha does in the body
Marketed for stress and sleep; legal status differs between countries
Ashwagandha root contains a family of steroid-like molecules called withanolides. In people under chronic stress, taking a standardised extract lowers the amount of cortisol circulating in the blood and lowers the score people give themselves on stress questionnaires. What nobody has established is which withanolide does it, or where in the stress axis it acts — the effect is measured at the output, not at the mechanism.
What happened in people
Perceived Stress Scale MD -4.72, Hamilton Anxiety Scale MD -2.19 and serum cortisol MD -2.58 against placebo across nine randomised trials in 558 patients
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
No recorded sentence describes the change this makes in a way that stands on its own. The page opens with what it is taken for instead, and the recorded explanation follows below.
Shown as the opening line on this page.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 105 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Stand-in result
A stand-in result is a number measured because the real result takes too long.
A picture of it, and where the picture fails
It is like judging a journey by the speedometer rather than by arriving.
Where that stops being true. Speed does predict arrival. Many stand-in results do not predict the real one.
What people get wrong. A stand-in result is often reported as the result itself.
A surrogate endpoint substituted for a clinical endpoint, valid only where the substitution has been shown to hold.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Receptor
A receptor is a part of a cell that a signal fits into.
A picture of it, and where the picture fails
A receptor is like a lock waiting for one key.
Where that stops being true. A lock either opens or does not. A receptor can be half-triggered, or worn out.
What people get wrong. Fitting a receptor is read as causing a benefit. It causes a step, and nothing more.
A protein that binds a specific ligand and converts that binding into a cellular response.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 14 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Mood
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
…Waiting for a reviewer1 registered symptom measure.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Fertility and sexual health
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Blood sugar
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
△Only a number moved1 registered test measure.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Focus
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
…Waiting for a reviewer1 registered performance measure of this kind.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Mood
hamilton anxiety rating scale total
Fertility and sexual health
female sexual function index
Blood sugar
blood glucose
Focus
cognitive function
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
∅ Nothing in the sources checked
No registered study lists a life outcome for this goal.
… Waiting for a reviewer
1 registered symptom measure.
— Not recorded
Harms were not a registered measure for this goal.
△ Only a number moved
1 registered test measure.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Change in standard stress-assessment scale scores and serum cortisol at day 60
✓ The study showed what it set out to show
Who was studied
Chandrasekhar 2012 (chronic stress, 60 days)
How many people
64
Study design
Randomised, double-blind, placebo-controlled
Compared against
A dummy treatment
Kind of result
A number that stands in for health
What was found
P < 0.0001 for stress scales; P = 0.0006 for serum cortisol
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Single centre, 60 days, and no active comparator. Adverse effects were mild and comparable between arms.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral capsule or tablet of standardised root extract
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
McKeown M. Why did Denmark ban Ashwagandha? McGill University Office for Science and Society, 2 June 2023 (https://www.mcgill.ca/oss/article/critical-thinkin… · a recorded source, not a stored snapshot
Pooled effect on Perceived Stress Scale, Hamilton Anxiety Scale and serum cortisol
✓ The study showed what it set out to show
Who was studied
Arumugam 2024 pooled analysis (nine randomised trials)
How many people
558
Study design
Systematic review and meta-analysis
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
All three pooled estimates significant; confidence intervals wide
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Four of nine included studies reported mild to moderate adverse events. The review noted that long-term safety information remains insufficient.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral capsule or tablet of standardised root extract
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
McKeown M. Why did Denmark ban Ashwagandha? McGill University Office for Science and Society, 2 June 2023 (https://www.mcgill.ca/oss/article/critical-thinkin… · a recorded source, not a stored snapshot
Clinical phenotype of suspected ashwagandha-induced liver injury
✓ The study showed what it set out to show
Who was studied
Björnsson 2020 (hepatotoxicity case series, Iceland and US DILIN)
How many people
5
Study design
Adjudicated case series
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Not applicable — causality assessed by DILIN structured expert opinion rather than by hypothesis test
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Four of five patients were taking additional supplements, and in one case rhodiola was a possible co-causative agent. This limits attribution without weakening the signal.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral capsule or tablet of standardised root extract
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
McKeown M. Why did Denmark ban Ashwagandha? McGill University Office for Science and Society, 2 June 2023 (https://www.mcgill.ca/oss/article/critical-thinkin… · a recorded source, not a stored snapshot
What we know
RNAWiki holds 3 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
■Living longer, or avoiding a major eventEvidence recorded. Death, a heart attack, a stroke, a hospital stay.1 registered measure of this kind. No reviewed result.
■What a body can do day to dayEvidence recorded. Walking, dressing, breathing, recovering.1 registered measure of this kind.
■Measured performanceEvidence recorded. How much was lifted, how far was run, how fast.1 registered measure of this kind.
■Symptoms and quality of lifeEvidence recorded. Pain, tiredness, mood, sleep, as the person rated it.3 registered measures of this kind.
■A number that stands in for healthEvidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.5 registered measures of this kind.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in C. elegans (roundworm), Drosophila (fruit fly), Mouse. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Ashwagandha
What a person takes: Oral capsule or tablet of standardised root extract.
The measurement behind this step
Sold as a dietary supplement in most jurisdictions with no premarket efficacy review, and prohibited in food supplements in Denmark since April 2023. Commercial extracts differ in solvent, plant part and stated withanolide percentage, and the trial literature is extract-specific rather than ingredient-general.
Getting in
A standardised root extract, not a single molecule
The capsule contains a mixture of dozens of related plant steroids, standardised to a stated percentage of the group as a whole.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Withanolides are C28 steroidal lactones. Commercial extracts state total withanolide percentage rather than individual composition, so two products at the same stated strength can have different withaferin A content and therefore different pharmacology.
Withanolides are absorbed from the gut and processed by the liver, which is also where the documented injury cases occurred.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Withanolides undergo hepatic phase I and phase II metabolism. The published injury phenotype is cholestatic or mixed rather than hepatocellular, with R ratios of 1.4 to 3.3, which points toward interference with bile transport rather than direct hepatocyte necrosis.
Something in the stress axis is dampened, and nobody has established what
The body's stress hormone system runs quieter. The step at which the extract acts has not been pinned down in humans.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Proposed mechanisms include GABA-A receptor modulation, glucocorticoid receptor interaction and direct effects on adrenal steroidogenesis. None has been demonstrated at a human-achievable concentration, and the extract is a mixture, so a single-target account may not be the right shape of explanation.
The measurable consequence is less cortisol in the blood.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The 2024 pooled estimate is a mean difference of -2.58 in serum cortisol against placebo (95% CI -4.99 to -0.16). This is the only objective biochemical endpoint in the meta-analysis, and its confidence interval nearly touches zero.
Self-rated stress and clinician-rated anxiety improve
People report feeling less stressed, and an interviewer-scored anxiety scale agrees.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Perceived Stress Scale MD -4.72 and Hamilton Anxiety Scale MD -2.19 against placebo across nine trials. The Hamilton scale is clinician-rated, which matters: it is harder to move with expectation alone than a self-report questionnaire is.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
hamilton anxiety rating scale total
positive and negative syndrome scale
positive and negative symptom scale
Measured
Things only a test, a scale or a device shows.
c reactive protein
waist circumference
diastolic blood pressure
blood glucose
serum bdnf levels
Meaningful
Things that change how a life goes, not only a number.
progression free survival
cognitive function
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (4)
probing depth
clinical attachment loss
female sexual function index
platelet count
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Adults reporting chronic stress, poor sleep or anxiety, buying it directly. It is also marketed to men for testosterone and to athletes for strength, on a much thinner evidence base than the stress claim.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
Where the result stopped carrying
Denmark could not establish a safe lower intake limit and banned the ingredient in food supplements in 2023
No trial has compared ashwagandha with an approved anxiolytic or antidepressant on a clinician-rated endpoint
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
The product may not be what it says
Contents of a sold product are not always what the label states.
On this record: This is sold as a supplement, so no agency checked what is in a given tub before it was sold.
Other reasons RNAWiki checked and found nothing for (9)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Varies by country
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Oral capsule or tablet of standardised root extract
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
Not usually supervised: sold as a supplement or food ingredient where recorded. That is a legal category, not a safety judgement.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
The identity record classes it as a botanical or organism preparation; no register records an approval.
No source is stored against this line.
What is in the pack
Sold as a dietary supplement in most jurisdictions with no premarket efficacy review, and prohibited in food supplements in Denmark since April 2023. Commercial extracts differ in solvent, plant part and stated withanolide percentage, and the trial literature is extract-specific rather than ingredient-general.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Commonly reported effects are gastrointestinal upset and drowsiness. The documented serious signal is cholestatic or mixed drug-induced liver injury, with jaundice appearing 2 to 12 weeks after starting and pruritus lasting up to 20 weeks; all five published cases resolved without hepatic failure. Withanolides have been reported to affect thyroid and sex hormone measurements. Denmark cited a possible abortifacient effect, which critics note was not supported by clinical evidence.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Oral capsule or tablet of standardised root extract
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
Commercial extracts differ in solvent, plant part and stated withanolide percentage, and the trial literature is extract-specific rather than ingredient-general.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
2200 marketed supplement labels list this ingredient, classed as botanical and botanical with nutrients.
Those labels carry all other, nutrient and structure/function claims. A claim of that kind is written by the manufacturer and is not assessed by any regulator, so its presence says nothing about whether it is true.
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
Watching one thing carefully can tell you whether it moved. It cannot tell you what moved it.
This is sold without a prescription, so a person can sensibly watch one thing and see whether it moves.
Pick one goal. One goal only. Two at once cannot be told apart afterwards.
Pick one thing to watch. Registered studies measured things like: c reactive protein; waist circumference; diastolic blood pressure.
Measure before you start. Take the same measurement several times first. One reading is not a starting point.
Know the swing. Write down how much it moves on its own across a normal week.
Change one thing. Change nothing else at the same time, including training and sleep.
Give it the study length. No finished study window is recorded, so no length is suggested here.
Track whether you took it. Missed days are the most common reason a home test shows nothing.
Read the trend. Look at the line across weeks. A single reading tells you almost nothing.
What not to measure
Anything that swings more day to day than the change you are looking for.
A wearable estimate of sleep stages, which is an estimate and not a measurement.
Weight on one morning, which mostly records water.
A feeling you did not write down before starting, such as: hamilton anxiety rating scale total.
When to stop
Stop if something new and unpleasant starts, and ask a pharmacist or doctor.
Stop if you cannot keep everything else steady, because the result will not mean anything.
Stop at the end of the window you set, and read the trend then.
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki does not work out an amount for anyone.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That the stress and cortisol evidence validates the separately marketed testosterone, fertility and strength claims
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That trials on one commercial extract apply to another with a different solvent, plant part or withanolide profile
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That a botanical with a documented hepatotoxicity signal is safe to combine silently with prescription medicine
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
How much did people take in the studies?
The sources RNAWiki checked hold nothing for this field.
Why it matters. A result belongs to an amount. Without the amount the result floats free.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
How fast does the body clear it?
The sources RNAWiki checked hold nothing for this field.
Why it matters. Without this, nothing on this page can say how long anything lasts.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Ashwagandha are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
Nine randomised trials, 558 patients: perceived stress, anxiety and cortisol all fell
In plain words
Pooling the randomised evidence, ashwagandha lowered self-rated stress, a clinician-rated anxiety scale, and the stress hormone in blood.
What was measured
Perceived Stress Scale, Hamilton Anxiety Scale and serum cortisol versus placebo
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
A 2024 systematic review and meta-analysis of nine randomised controlled trials in 558 patients found significant effects on the Perceived Stress Scale (MD -4.72, 95% CI -8.45 to -0.99), the Hamilton Anxiety Scale (MD -2.19, 95% CI -3.83 to -0.55) and serum cortisol (MD -2.58, 95% CI -4.99 to -0.16) against placebo. Four of the included studies reported mild to moderate adverse events. The confidence intervals are wide and the trial base is small, but the direction is consistent across three different kinds of measurement.
Written into the record, not signed off as a reviewed claim
Chandrasekhar 2012: cortisol fell alongside every stress scale in 64 adults
In plain words
The most-cited single trial gave 300 mg of root extract twice daily for 60 days and found lower stress scores and lower cortisol than placebo.
What was measured
Stress-assessment scale scores and serum cortisol at day 60
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Single-centre, prospective, double-blind, randomised, placebo-controlled trial in 64 adults with a history of chronic stress. The treatment arm received 300 mg of a high-concentration full-spectrum root extract twice daily for 60 days. Scores on all stress-assessment scales fell significantly against placebo (P < 0.0001) and serum cortisol fell substantially (P = 0.0006). Adverse effects were mild and comparable between groups. This is a 64-person single-centre trial, which is the honest scale to hold the result at.
Written into the record, not signed off as a reviewed claim
Five published cases of cholestatic liver injury from ashwagandha supplements
In plain words
Five people in Iceland and the United States developed jaundice and severe itching from ashwagandha products, and it took months to resolve.
What was measured
Adjudicated cases of cholestatic or mixed drug-induced liver injury
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Björnsson et al. reported five cases of liver injury attributed to ashwagandha-containing supplements, three collected in Iceland during 2017 to 2018 and two from the US Drug-Induced Liver Injury Network in 2016, with causality assessed by the DILIN structured expert opinion approach. Mean age 43. All developed jaundice after a latency of 2 to 12 weeks. Injury was cholestatic or mixed (R ratios 1.4 to 3.3). Pruritus and hyperbilirubinaemia were prolonged, 5 to 20 weeks. No patient developed hepatic failure and liver tests normalised within one to five months in the four with follow-up. Chemical analysis confirmed ashwagandha in the available supplements and identified no other toxic compound.
Written into the record, not signed off as a reviewed claim
Denmark banned it in 2023; no other major regulator followed
In plain words
One European country decided the safety data were not good enough to set any safe intake and prohibited ashwagandha in supplements. Everyone else kept selling it.
What was measured
That absence of a ban elsewhere means the safety question was settled, when in most jurisdictions it was never formally asked
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The Technical University of Denmark carried out a risk assessment for the Danish Veterinary and Food Administration in 2020, citing reported effects on thyroid and sex hormones, effects on sperm quality in animal studies, and a possible abortifacient effect. The assessment concluded that no safe lower intake limit could be established, and Denmark prohibited ashwagandha in food supplements in April 2023. The FDA, the EMA and other European regulators have not followed. The critique published in the Ayurvedic literature notes the DTU report was not peer-reviewed and that the abortifacient claim was not supported by clinical evidence. Both the ban and the criticism of it are facts about the same document.
Source
McKeown M. Why did Denmark ban Ashwagandha? McGill Office for Science and Society, 2 June 2023
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
contested
Review state
Written into the record, not signed off as a reviewed claim
The testosterone and strength marketing is not what the stress evidence supports
In plain words
The pooled evidence that survives scrutiny is about stress, anxiety and cortisol. The claims about testosterone and muscle rest on a much smaller and weaker set of trials.
What was measured
That a replicated effect on cortisol and perceived stress validates the separate marketed claims about testosterone, fertility and muscle
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The 2024 meta-analysis pooled nine trials and restricted itself to stress and anxiety outcomes, both subjective and objective. Testosterone, sperm parameters and strength outcomes come from individual small trials that have not been pooled to the same standard, and several were conducted or funded by extract manufacturers. Reading the stress meta-analysis as general validation of the ingredient, and then applying it to a hormonal claim, is the specific inference this page flags.
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What is not here
5 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
How this medicine reached us — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
Nine randomised trials pooling 558 patients show a real reduction in perceived stress, anxiety scores and serum cortisol; five published cases of cholestatic liver injury and a Danish national ban show that "herbal" and "harmless" are not the same word.
Recorded evidence blocks (11)
Q1
What did Ashwagandha's largest trial (120 people) and its longest (4.5 years) measure?
120 people in Ashwagandha's largest registered study, 4.5 years in its longest registered window, measuring Change From Baseline in Digit-Span Score at 8 Weeks. ClinicalTrials.gov · 2026-09-01
8 na, 7 phase2, 3 phase1, 2 phase3, 1 phase4; NCT03437668; 2023-06-12; no ageing endpoint recorded. Last human test completed 2026, NCT07151261.
Interpretation These counts include studies where Ashwagandha was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
na
8
phase2
7
phase1
3
phase3
2
phase4
1
Last recorded human testNCT07151261
2026-05-05
recorded 2026-09-01 · last checked 2026-09-04
Q2
From C. elegans to human: where has Ashwagandha shown lifespan?
"Unable to reach enrollment target due to COVID"; 1 of 18 registered studies
Show the evidence
TrialNCT03437668
terminated; "Unable to reach enrollment target due to COVID"
recorded 2026-09-01 · last checked 2026-09-04
Q4
Could one person measure Ashwagandha's effect on hamilton anxiety rating scale total?
Hamilton anxiety rating scale total: measured in Ashwagandha's trials.
Interpretation hamilton anxiety rating scale total is the recorded endpoint.
Show the evidence
biomarkers
hamilton anxiety rating scale total; 2026-09-01
positive and negative syndrome scale; 2026-09-01
positive and negative symptom scale; 2026-09-01
c reactive protein; 2026-09-01
probing depth; 2026-09-01
clinical attachment loss; 2026-09-01
8 more recorded rows
biomarkers
progression free survival; 2026-09-01
biomarkers
female sexual function index; 2026-09-01
biomarkers
platelet count; 2026-09-01
biomarkers
waist circumference; 2026-09-01
biomarkers
diastolic blood pressure; 2026-09-01
biomarkers
blood glucose; 2026-09-01
biomarkers
serum bdnf levels; 2026-09-01
biomarkers
cognitive function; 2026-09-01
human trials at or under30
3
Not recorded for this substance
a recorded half-life
smallest human trial
19; NCT06900569; NA; the smallest recorded human enrolment at or below 30; the registry states no direction of its result; COMPLETED
Q5
Which of blood glucose, c reactive protein and clinical attachment loss did Ashwagandha's trials measure?
blood glucose, c reactive protein and clinical attachment loss lead 14 outcome terms across Ashwagandha's trials. ClinicalTrials.gov · 2026-09-01
Interpretation c reactive protein, probing depth, clinical attachment loss, progression free survival, female sexual function index and platelet count follow.
Show the evidence
hamilton anxiety rating scale total
1
positive and negative syndrome scale
1
positive and negative symptom scale
1
c reactive protein
1
probing depth
1
clinical attachment loss
1
8 more recorded rows
progression free survival
1
female sexual function index
1
platelet count
1
waist circumference
1
diastolic blood pressure
1
blood glucose
1
serum bdnf levels
1
cognitive function
1
recorded 2026-09-01 · last checked 2026-09-04
Q6
What will the one ongoing trial of Ashwagandha report, and when?
"Combination Therapy for Recurrent Ovarian Cancer"; n 72; "Progression-free survival (PFS)"; 2028-11-30
recorded 2026-09-01 · last checked 2026-09-04
Q7
Which running trial of Ashwagandha could settle lifespan?
NCT05610735 measures Progression-free survival (PFS), reading out 2028-11-30.
1 open trial; n 72; "Combination Therapy for Recurrent Ovarian Cancer"
Show the evidence
TrialNCT05610735
"Combination Therapy for Recurrent Ovarian Cancer"; n 72; "Progression-free survival (PFS)"; 2028-11-30
Q8
Which 5 trials of Ashwagandha posted no result?
Posted no result
5 of 5 completed trials
Registrations
NCT00817752, NCT01311180, NCT03533972, NCT05430685 and NCT06676605
Completion dates
oldest 2008-02; newest 2024-01-30
Show the evidence
Trial
NCT00817752
2008-02
NCT01311180
2012-11
NCT03533972
2018-04-28
NCT05430685
2020-04-10
NCT06676605
2024-01-30
Q9
At the median, Ashwagandha's trials enrolled 57 people — anything larger?
Median enrolment
57
Largest enrolment
120
Registered trials counted
18
Q10
Was Ashwagandha studied with exercise?
exercise is named in Ashwagandha's label sentences: "Eligible randomized controlled trials compared oral ashwagandha with placebo or control conditions and reported objective exercise-performance outcomes." openfda-label+europepmc · 2026-06-12
1 recorded statement; exercise
Show the evidence
exercise
Eligible randomized controlled trials compared oral ashwagandha with placebo or control conditions and reported objective exercise-performance outcomes.
recorded 2026-06-12 · last checked 2026-09-04
Q11
What is recorded about Ashwagandha and AMPK?
"Salidroside has direct MIN6 and isolated-islet evidence supporting AMPK-dependent preservation of β-cell function, whereas ashwagandha is supported mainly by pancreatic findings in diabetic animals and by systemic metabolic or neuroendocrine outcomes." — where Ashwagandha and AMPK appear together. Europe PMC · pathway abstract search · 2026-08-03
AMPK, autophagy; PMID 42546933, 33917328
Show the evidence
AMPKPMID 42546933
"Salidroside has direct MIN6 and isolated-islet evidence supporting AMPK-dependent preservation of β-cell function, whereas ashwagandha is supported mainly by pancreatic findings in diabetic animals and by systemic metabolic or neuroendocrine outcomes."
autophagyPMID 33917328
"While anti-oxidative effects were seen with both agents, Ubisol-Q<sub>10</sub> activated autophagy, whereas ashwagandha showed a better anti-inflammatory response."
recorded 2026-08-03 · last checked 2026-09-04
Where it is registeredIdentifiers, relations and other names
Sold as standardised root extracts including KSM-66 and Sensoril, Adrenal and Dhea, Bestmade Natural Products Bm131, Boostervite, Adrenal and Dhea / Bestmade Natural Products Bm131 / Boostervite
ClinicalTrials.gov — US Government work · Europe PMC — metadata only, under the recorded legal gate · derived from this page's own recorded fields; no external licence · openFDA / DailyMed — US Government work
✗ required summary fields resolved: 4 required field(s) not terminal: Why people use it, Best-supported result, Biggest unanswered question, Human evidence
✓ public claims reviewed: 0 reviewed claim(s); drafts are never rendered
✓ source coverage passed: 6 source rows
✓ no critical contamination: no quarantine open
✓ canonical metadata passed: slug and display name present
✓ no raw internal fields: enforced by the copy-contract test over the rendered page
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