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Ashwagandha supplementation significantly impacts hormone levels, reducing cortisol and increasing serotonin and testosterone in men. Further research is needed due to study heterogeneity.

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Area of Science:

  • Endocrinology
  • Neuroendocrinology
  • Herbal Medicine Research

Background:

  • Hormonal imbalances linked to stress, infertility, and metabolic issues.
  • Ashwagandha (Withania somnifera L.) is an adaptogen with proposed endocrine-modulating effects.

Purpose of the Study:

  • Systematically review randomized controlled trials on oral ashwagandha's effects on adult hormone levels.
  • Evaluate ashwagandha's impact on the hypothalamic-pituitary-adrenal and gonadal axes.

Main Methods:

  • Searched MEDLINE, Embase, ClinicalTrials.gov; registered in PROSPERO.
  • Included 23 randomized, placebo-controlled trials (1706 participants).
  • Performed meta-analyses using random-effects models; assessed bias and heterogeneity.

Main Results:

  • Ashwagandha reduced cortisol (SMD -1.18) and increased serotonin (MD 31.75 ng/ml).
  • Modest increase in T4 (MD 0.61 µg/dL); no effect on TSH or T3.
  • Increased testosterone in men (MD 57.43 ng/dl) but not women; no effect on E2.

Conclusions:

  • Oral ashwagandha supplementation modulates key hormonal pathways, including cortisol and sex hormones.
  • Potential dose-response effects observed based on withanolide content.
  • Further standardized trials are warranted due to heterogeneity and limited data.