Ashwagandha for Stress: Reading Past the Hype

Walk into a co-op in Portland or a pharmacy aisle in Portsmouth this time of year and you will find ashwagandha staring back at you. It shows up in capsules, gummies, and “stress support” blends, and it gets pushed hardest right when northern New Englanders feel worn down, somewhere in the long stretch of dark afternoons we all know between November and March. The marketing is confident. The research is more careful. Here is the honest version, sorted by what we actually know.

What ashwagandha is, and why it’s everywhere

Ashwagandha (Withania somnifera) is an evergreen shrub that has been used in traditional Ayurvedic medicine for thousands of years. According to the National Center for Complementary and Integrative Health, part of the NIH, its activity is generally credited to a group of plant compounds called withanolides, which have been linked in lab work to anti-inflammatory and antioxidant effects.

That long history plus a tidy “adaptogen” story makes it an easy sell. Living at 44 to 45 degrees north, where winter strips the daylight and the to-do list does not shrink to match, plenty of us are open to anything that promises a calmer nervous system. The shelf appeal is real. Whether the bottle delivers is a separate question.

What the research actually shows on stress and cortisol

The strongest case for ashwagandha sits with cortisol, the hormone your body releases under stress. A 2025 systematic review and meta-analysis in BJPsych Open pooled 15 randomized controlled trials covering 873 adults. At eight weeks, the analysis found that ashwagandha significantly lowered serum cortisol, scores on the Perceived Stress Scale, and scores on a standard anxiety rating scale, all compared with placebo.

An earlier double-blind, placebo-controlled trial points in the same direction. Researchers reported a roughly 23 percent drop in cortisol among people taking a standardized extract, while the placebo group barely moved. On paper, that is a real signal. If you want a deeper look at how the stress hormone behaves over a day and across a year, our piece on the chronic stress cortisol curve walks through what those numbers mean.

The gap between a lab number and how you feel

Now the part the ads skip. Lower cortisol on a blood test is not the same thing as feeling better, and the research is surprisingly blunt about that gap.

In that same 2025 meta-analysis, the effect on quality of life was not statistically significant. Cortisol and stress-scale measures improved, but people’s overall sense of how they were doing did not reliably budge. The 2019 trial showed a similar split: cortisol fell clearly, yet the matching change in how stressed participants actually reported feeling fell short of statistical significance. Federal reviewers describe the human evidence as mixed and limited, noting that some preparations may help with sleep and stress while the effect on anxiety stays unclear, partly because the studies are small and use a grab bag of different ashwagandha products.

The quality problem: what’s really in the bottle

Even if you decide the evidence is good enough to try, there’s a catch you cannot see through the plastic. Two bottles labeled “ashwagandha” may contain wildly different amounts of the active compounds.

Independent testing by ConsumerLab found that 8 of 13 products it analyzed contained just 7.8 to 83 percent of their expected withanolides, with most landing below half. The amount per daily serving ranged from a thin 1.3 mg to 72 mg, and only 5 of the 13 products earned its approval. That is a reminder of something easy to forget at the register. Under the federal supplement law known as DSHEA, the FDA does not review or approve ashwagandha, or any supplement, for safety or effectiveness before it reaches the shelf. What a shopper in Bangor drops in the cart has never been vetted by a regulator the way a prescription drug would be. If label-reading feels like a foreign language, our guide on how to read a supplement label without getting fooled covers the basics.

Safety: liver reports and who should steer clear

This is where the tone needs to get serious. NIH’s LiverTox resource, which tracks medication and supplement liver effects, classifies ashwagandha as a likely cause of clinically apparent liver injury. The pattern usually shows up 2 to 12 weeks after someone starts taking it, often with jaundice and itching, and it is usually mild to moderate and reversible. Rare fatal cases have been reported.

It is uncommon. It is also not just a worry for people who were already sick. A 2023 case series from India documented liver injury in patients taking single-ingredient ashwagandha, and LiverTox notes published cases in otherwise healthy adults as young as their early twenties, with reports spanning the United States, Iceland, Spain, Germany, Poland, and India. Federal guidance adds more guardrails: avoid ashwagandha in pregnancy and while breastfeeding, and know that it may interact with medicines for diabetes, high blood pressure, thyroid conditions, seizures, and sleep, along with immune-suppressing drugs. The available data support short-term use only, up to about three months, with no clear picture on long-term safety.

How to read an ashwagandha label without getting fooled

If you and your healthcare provider decide it’s worth a trial, a few habits separate a product that might do something from a jar of expensive filler.

• Look for root powder or root extract standardized to a stated withanolide percentage, not a vague “proprietary blend.”
• Third-party certification is your only real check on what’s inside. Seals from NSF, USP, or ConsumerLab mean an outside lab confirmed purity and potency.
• Short term, not forever. The safety evidence runs out at roughly three months.
• Tell your provider, especially if you take thyroid, blood pressure, diabetes, seizure, or sedative medications.

None of this makes ashwagandha a scam. It makes it an ordinary supplement: some genuine evidence for lowering a stress hormone, a real gap between that number and daily life, a quality-control problem you have to navigate yourself, and a safety profile that deserves respect. For a Mainer hunting for an edge against the February slump, that’s a more useful starting point than the label promises.

Sources

• National Center for Complementary and Integrative Health (NIH). Ashwagandha: Usefulness and Safety. 2024. https://www.nccih.nih.gov/health/ashwagandha
• BJPsych Open (Cambridge University Press). Effects of Ashwagandha Supplements on Cortisol, Stress, and Anxiety Levels in Adults: A Systematic Review and Meta-Analysis. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12242034/
• Medicine (Baltimore). An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6750292/
• U.S. Food and Drug Administration. Information for Consumers on Using Dietary Supplements. 2024. https://www.fda.gov/food/dietary-supplements/information-consumers-using-dietary-supplements
• NIH / National Library of Medicine. Ashwagandha – LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2024. https://www.ncbi.nlm.nih.gov/books/NBK548536/
• Hepatology Communications. Ashwagandha-induced liver injury – A case series from India and literature review. 2023. https://pubmed.ncbi.nlm.nih.gov/37756041/
• ConsumerLab.com. Little Ashwagandha in Most Ashwagandha Supplements. 2024. https://www.consumerlab.com/news/ashwagandha-supplement-findings-2024/05-23-2024/
• ConsumerLab.com. Ashwagandha Supplements Reviews & Top Picks. 2024. https://www.consumerlab.com/reviews/ashwagandha-supplements/ashwagandha/

This article is for informational purposes only and does not constitute medical advice. Consult a qualified healthcare provider before making any health decisions.