Dual impact of Ashwagandha: Significant cortisol reduction but no effects on perceived stress – A systematic review and meta-analysis.

This article systematically reviews and meta-analyzes randomized controlled trials (RCTs) assessing the effects of Ashwagandha (Withania somnifera), a herb used in Ayurvedic medicine, on cortisol levels and perceived stress measured by the Perceived Stress Scale (PSS). The analysis of seven RCTs (n=488), all conducted in India, found that Ashwagandha supplementation significantly reduced cortisol, a biological marker of stress, but showed no statistically significant effect on perceived stress scores. The studies varied in dosage (240–600 mg/day) and duration (14–90 days), with moderate methodological quality and no detected publication bias. The review highlights limitations including short intervention periods, small sample sizes, and lack of population diversity, emphasizing the need for longer, multi-center trials with diverse participants to clarify Ashwagandha’s long-term safety, optimal dosing, and clinical efficacy across different populations.