Ashwagandha, which belongs to the pepper family, is found in India and Africa. The roots of ashwagandha are used medicinally.
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Osteoarthritis (Boswellia, Turmeric)
1,000 mg daily boswellia resin herbal extract or two capsules, three times per day of Aticulin-F (formula containing 100 mg boswellia, 450 mg ashwagandha, 50 mg turmeric, and 50 mg zinc)
A combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness in one study, without the stomach irritation that is a common side effect of NSAIDs.
Boswellia has anti-inflammatory properties that have been compared to those of the NSAIDs used by many for inflammatory conditions.3 Clinical trials have found that boswellia is more effective than a placebo for relieving pain and swelling and preventing loss of function in people with osteoarthritis.4 Boswellia has also been found to be as effective as the anti-inflammatory drug valdecoxib (Bextra). In addition, while the improvements occurred more slowly in the boswellia group than in the valdecoxib group, they persisted for a longer period of time after treatment was discontinued.5 One clinical trial found that a combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness associated with OA but did not improve joint health, according to X-rays of the affected joint.6 Unlike NSAIDs, long-term use of boswellia does not lead to irritation or ulceration of the stomach.
3 to 6 grams daily of the dried root as tea or in a capsule
Ashwagandha stimulates the immune system and is considered a tonic or adaptogen—an herb with multiple actions that counteract the effects of stress and generally promote wellness.
Ashwagandha is considered a general stimulant of the immune system,7 and has been called a tonic or adaptogen8—an herb with multiple, nonspecific actions that counteract the effects of stress and generally promote wellness. More research is needed to better evaluate these claims.
Refer to label instructions
Ashwagandha may be helpful for reducing the effects of stress, including chronic psychological stress.
The herbs discussed here are considered members of a controversial category known as adaptogens, which are thought to increase the body's resistance to stress, and to generally enhance physical and mental functioning.9 , 10 Many animal studies have shown that various herbal adaptogens have protective effects against physically stressful experiences,11 , 12 but whether these findings are relevant to human stress experiences is debatable.
Animal studies have suggested that ashwagandha may be helpful for reducing the effects of stress,13 , 14 , 15 including chronic psychological stress.16 However, no controlled research has been done to explore these effects in humans.
An herbal formula from the Ayurvedic medicine tradition, containing extracts of ashwagandha, asparagus, pueraria, argyreia, dioscorea, mucuna, and piper, has been studied as an aid to coping with the stress of military combat. A double-blind study found that soldiers performed similarly in a set of mental and psychological tests after an eight-day combat mission whether they were given two capsules daily (exact content not revealed) of this formula or a placebo.17 This suggests there was no real benefit of the herbal formula under these conditions.
The health applications for ashwagandha in traditional Indian and Ayurvedic medicine are extensive. Of particular note is its use against tumors, inflammation (including arthritis), and a wide range of infectious diseases.1 The shoots and seeds are also used as food and to thicken milk in India. Traditional uses of ashwagandha among tribal peoples in Africa include fevers and inflammatory conditions.2 Ashwagandha is frequently a constituent of Ayurvedic formulas, including a relatively common one known as shilajit.
The constituents believed to be active in ashwagandha have been extensively studied.18 Compounds known as withanolides are believed to account for the multiple medicinal applications of ashwagandha.19 These molecules are steroidal and bear a resemblance, both in their action and appearance, to the active constituents of Asian ginseng (Panax ginseng) known as ginsenosides. Indeed, ashwagandha has been called “Indian ginseng” by some. Ashwagandha and its withanolides have been extensively researched in a variety of animal studies examining effects on immune function, inflammation, and even cancer. Ashwagandha stimulates the activation of immune system cells, such as lymphocytes.20 It has also been shown to inhibit inflammation21 and improve memory in animal experiments.22 Taken together, these actions may support the traditional reputation of ashwagandha as a tonic or adaptogen23—an herb with multiple, nonspecific actions that counteract the effects of stress and generally promote wellness.
Some experts recommend 3–6 grams of the dried root, taken each day in capsule or tea form.24 To prepare a tea, 3/4–1 1/4 teaspoons (3–6 grams) of ashwagandha root are boiled for 15 minutes and cooled; 3 cups (750 ml) may be drunk daily. Alternatively, tincture 1/2–3/4 teaspoon (2–4 ml) three times per day, is sometimes recommended.
1. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 514–5.
2. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 514–5.
3. Safayhi H, Mack T, Saieraj J, et al. Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther 1992;261:1143–6.
4. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – a randomized double blind placebo controlled trial. Phytomedicine 2003;10:3–7.
5. Sontakke S, Thawani V, Pimpalkhute S, et al. Open, randomized, controlled clinical trial of Boswellia serrata extract as compared to valdecoxib in osteoarthritis of knee. Indian J Pharmacol 2007;39:27–9.
6. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91–5.
7. Wagner H, Nörr H, Winterhoff H. Plant adaptogens. Phytomedicine 1994;1:63–76.
8. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Queensland, Australia: Phytotherapy Press, 1996, 137–41.
9. Brekhman II, Dardymov IV. New substances of plant origin which increase nonspecific resistance. Annu Rev Pharmacol 1969;9:419–30 [review].
10. Panossian A, Wikman G, Wagner H. Plant adaptogens. III. Earlier and more recent aspects and concepts on their mode of action. Phytomedicine 1999;6:287–300 [review].
11. Rege NN, Thatte UM, Dahanukar SA. Adaptogenic properties of six rasayana herbs used in Ayurvedic medicine. Phytother Res 1999;13:275–91 [review].
12. Wagner H, Nrr H, Winterhoff H. Plant adaptogens. Phytomed 1994;1:6376 [review].
13. Bhattacharya S, Goel R, Kaur R, Ghosal S. Anti-stress activity of sitoindosides VII and VIII, new acylsterylglucosides from Withania somnifera. Phytother Res 1987;1:32–39.
14. Grandhi A, Mujumdar AM, Patwardhan B. A comparative pharmacological investigation of Ashwagandha and Ginseng. J Ethnopharmacol 1994;44:131–5.
15. Dhuley JN. Effect of ashwagandha on lipid peroxidation in stress-induced animals. J Ethnopharmacol1998;60:173–8.
16. Bhattacharya SK, Muruganandam AV. Adaptogenic activity of Withania somnifera: an experimental study using a rat model of chronic stress. Pharmacol Biochem Behav 2003;75:547–55.
17. Gopinathan PM, Grover SK, Gupta AK, Srivastava KK. Effects of a composite Indian herbal preparation on combat effectiveness in low-intensity-conflict operations. Mil Med1999;164:814–9.
18. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Queensland, Australia: Phytotherapy Press, 1996, 137–41.
19. Wagner H, Nörr H, Winterhoff H. Plant adaptogens. Phytomed 1994;1:63–76.
20. Wagner H, Nörr H, Winterhoff H. Plant adaptogens. Phytomed 1994;1:63–76.
21. Anabalgan K, Sadique J. Antiinflammatory activity of Withania somnifera. Indian J Exp Biol 1981;19:245–9.
22. Bhattacharya SK, Kumar A, Ghosal S. Effects of glycowithanolides from Withania somnifera on an animal model of Alzheimer’s disease and perturbed central cholinergic markers of cognition in rats. Phytother Res 1995;9:110–3.
23. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Queensland, Australia: Phytotherapy Press, 1996, 137–41.
24. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Queensland, Australia: Phytotherapy Press, 1996, 137–41.
Last Review: 05-01-2013
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