What is stress?

It is the body's response to dangers or threatening situations that gives us greater awareness of our surroundings, allowing us to act creatively in the face of a threatening situation, such as a car horn, a shout of warning, etc.

The adrenal glands located above the kidneys participate in the defense reaction, secreting cortisol and adrenaline (currently called epinephrine) as a necessary response to a dangerous situation.

What is chronic stress?

When the adrenals secrete cortisol and adrenaline constantly, the result is chronic stress, one of the greatest problems for the population today. Some consequences of chronic stress are low immunity, depression, anxiety, various metabolic disorders, chronic inflammation, sleep disorders, and others. Stress is also related to alterations in the microbiota (dysbiosis), and this negatively affects the axes that relate the state of the microbiota to the brain, skin, respiratory system, immune system, etc.

What is an adaptogen?

In traditional Chinese medicine, the term has been used for thousands of years to define a superior tonic capable of regulating various functions, increasing energy, and promoting general health, without treating specific diseases.

In Russia, in 1947, the pharmacologist Nicolai Lazarev created the term adaptogen to define "pharmacological substances capable of inducing the organism into a state of non-specific increased resistance, counteracting stress, and adapting to exceptional efforts."

In 1968, a student of Lazarev, Israel Brekman, defined three criteria to characterize an adaptogen:

1. Increases the body's resistance against diseases, environmental stressors, of a physical, chemical, or biological nature.
2. Normalizes physiological response regardless of the nature of the pathology.
3. Shows an absence of toxicity and influence on the body's normal functions.

Characteristics of adaptogenic plants.

1. Non-specific response, in a wide range of biochemical actions induced against biological, chemical, or physical stress factors.
2. General non-specific effect.
3. Normalizing action on the equilibrium state of all body systems, increasing the organism's adaptation and resistance capacities against stress.
4. Multiple action that considers various immediate biological mechanisms and effects.

What is Ashwagandha?

Withania somnifera (WS), also known as Ashwagandha, is an evergreen shrub that grows in Asia and Africa. It is used in Ayurvedic medicine and other traditional medicine systems. The plant's active chemical compounds are known as withanolides.

Since Ashwagandha is traditionally used as an adaptogen, it is used for many stress-related conditions.

What is Ashwagandha used for?

Ashwagandha root, also known as Withania somnifera, belladonna, or Indian ginseng, has been used for over 3,000 years to reduce stress, increase energy levels, improve concentration, and preserve mental and physical health. It offers a wide range of benefits.

Benefits of Ashwagandha

The US Natural Medicines Comprehensive Database considers this plant to be possibly effective for:

• A type of persistent anxiety marked by exaggerated worry and tension (generalized anxiety disorder or GAD). Ashwagandha intake appears to improve anxiety in people with persistent anxiety.

• Insomnia. Ashwagandha intake appears to improve sleep patterns and overall sleep quality in certain people.

• Stress. Ashwagandha intake appears to help reduce stress in some people. It could also help reduce stress-related weight gain.

• The same organization considers Ashwagandha possibly safe when used for up to 3 months. This is because long-term safety is unknown.

(Ref: https://medlineplus.gov/spanish/druginfo/natural/953.html)

On the other hand, studies and meta-analyses have confirmed notable adaptogenic, anti-stress, and anxiolytic activity in numerous animal models and in some clinical studies. They point out that Ashwagandha possesses bioactive compounds that exert adaptogenic effects.

Positive activity regarding depression and sleep was also found.

In addition, immunomodulatory, antioxidant, memory-enhancing, anti-Parkinsonian, cleansing, anti-inflammatory, and antitumor properties are described.

Its ability to improve the physical performance of athletes and non-athletes has been proven, with the increase in VO2max being relevant—a marker that expresses the body's ability to transport oxygen to the muscles and control the athlete's stress.

Evidence suggests that Ashwagandha has the capacity to both stimulate a depressed immune system and weaken an overactive immune system, which offers an alternative for treating autoimmune diseases.

Properties of Ashwagandha

• The pharmacological properties of Ashwagandha are attributed to its composition, highlighting withanolides, a group of steroidal lactones.
• Its neuroprotective activity could be due to the presence of constituents such as glycowithanolides, withanolides, and sitoindosides; these act in the inhibition of lipid peroxidation (LPO) and in improving the levels of the enzyme catalase.
• It increases cortical muscarinic acetylcholine, thereby improving cognitive ability. Regarding its influence on the hippocampus, it has been shown to recover cells in this area of the brain in studies with rats.
• Its involvement in the inhibition of inflammatory factors such as TNF-alpha, ROS, NO, and interleukins gives it anti-inflammatory and antioxidant properties.
• The inhibition of pro-inflammatory factors such as TNF-alpha, as well as its involvement in the inhibition of lipopolysaccharide (LPS) and its ability to maintain adequate collagen levels (through inhibition of the enzyme collagenase), mean it is also recommended for treating rheumatoid arthritis.

How to take Ashwagandha?

It is usually indicated in doses of 1,000 mg daily for up to 3 months.

Some publications point to daily doses between 300 and 500 mg.

Contraindications of Ashwagandha according to https://medlineplus.gov/spanish/druginfo/natural/953.html)

• Ashwagandha could increase the amount of thyroid hormone produced by the body, so caution should be exercised if taking medications that have the same function.
• It could reduce blood sugar levels, so this should be taken into account in diabetic people on insulin or taking hypoglycemic agents.
• It could reduce blood pressure. Taking it with other supplements that have the same effect may cause blood pressure to drop too low.
• See the monograph which indicates that these risks may not have been proven in animal studies (https://farmaquimicasur.com/wp-content/uploads/2021/02/Monografico-Ashwagandha.pdf)

References

• Speers AB, Cabey KA, Soumyanath A, Wright KM. Effects of Withania somnifera (Ashwagandha) on Stress and the Stress- Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Curr Neuropharmacol. 2021;19(9):1468-1495. doi: 10.2174/1570159X19666210712151556. PMID: 34254920; PMCID: PMC8762185. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8762185/)

• https://www.phcogrev.com/article/2007/1/1-13?qt-sidebar_tabs=0 -G. Lal Gupta y Rana, AC , Withania somnifera (Ashwagandha): a review , Pharmacognosy Reviews , vol. 1, no. 1, pp. 129-136, 2007.

• Girdhari Lal Gupta , and AC Rana. Withania somnifera (Ashwagandha): a review Pharmacognosy Reviews, 2007, 1, 1, 129-136. Department of Pharmacology, BN College of Pharmacy, Udaipur -313 002 (Rajasthan) India
• https://www.sciencedirect.com/science/article/abs/pii/0378874195013180
• MohammedZiauddinaNeetaPhansalkarbPralhadPatkicShamDiwanaydBhushanPatwardhaneStudies on the immunomodulatory effects of Ashwagandha.  Journal of Ethnopharmacology, Volume 50, Issue 2, February 1996, Pages 69-76 
• Brekhman II. Eleutherococcus [in Russian]. Leningrad, Nauka, 1968:1-168. 
  Brekhman II, Dardymov IV. New substances of plant origin which increase nonspecific resistance. Ann Rev Pharmacol 1968;8:419-30. 
  Panossian A, Wagner H. Stimulating effect of adaptogens: an overview with particular reference to their efficacy following single dose administration. Phytother Res 2005;19:819-38. 
  Panossian A, Wagner H. Adaptogens: a review of their history, biological activity and clinical benefits. HerbalGram 2011 (90):52-63 
• https://www.arkopharma.com/es-ES/news/que-es-una-planta-adaptogena 

• Camelia Akhgarjand, Farzaneh Asoudeh, Amir Bagheri, Zahra Kalantar, Zahra Vahabi, Sakineh Shab-bidar, Hamid Rezvani, Kurosh Djafarian. Does Ashwagandha supplementation have a beneficial effect on anxiety and stress management? A systematic review and meta-analysis of randomized controlled trials. First published: 25 August 2022. https://doi.org/10.1002/ptr.7598 

• Bharti, V. K., Malik, J. K., & Gupta, R. C. (2016). Ashwagandha: multiple health benefits. In Nutraceuticals (pp. 717-733). Academic Press.  

• Chandrasekhar, K., Kapoor, J., & Anishetty, S. (2012). A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian journal of psychological medicine, 34(3), 255-262.  

• Mandlik, D. S., & Namdeo, A. G. (2020). Pharmacological evaluation of Ashwagandha highlighting its healthcare claims, safety, and toxicity aspects. Journal of dietary supplements, 1-44. Udayakumar, R., Kasthurirengan, S., Mariashibu, T. S., Rajesh, M., Anbazhagan, V. R., Kim, S. C., ... & Choi, C. W. (2009). Hypoglycaemic and hypolipidaemic effects of Withania somnifera root and leaf extracts on alloxan-induced diabetic rats. International journal of molecular sciences, 10(5), 2367-2382. 

• https://farmaquimicasur.com/wp-content/uploads/2021/02/Monografico-Ashwagandha.pdf